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https://www.readbyqxmd.com/read/29021721/the-effect-of-comorbidities-and-complications-on-the-mortality-of-burned-patients
#1
D Costa Santos, F Barros, N Gomes, T Guedes, M Maia
The World Health Organization has defined 'elderly' as 65 years or older. Age is a known major prognostic factor after burn injury. The objective of this study is to establish whether epidemiologic differences in the elderly contribute to higher mortality compared to younger patients. Patients admitted to the burn unit between 2011 and 2014 (229 patients) were included: 159 were under 65 years old and 70 (30.6%) were 65 or over. The elderly group had a higher mortality rate, 24.6% versus 8.2% (p=0.002). Patients over 65 presented more pre-existing co-morbidities (1...
June 30, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/29016484/a-novel-combination-of-biomarkers-to-herald-the-onset-of-sepsis-prior-to-the-manifestation-of-symptoms
#2
Hallie H Dolin, Thomas J Papadimos, Stanislaw Stepkowski, Xiaohuan Chen, Zhixing K Pan
Sepsis, which kills over 200,000 patients and costs over $20 billion in the U.S. alone, presents a constant but preventable challenge in the healthcare system. Among the more challenging problems that it presents is misdiagnosis due to conflation with other inflammatory processes, as its mechanisms are identical to those of other inflammatory states. Unfortunately, current biomarker tests can only assess the severity and mortality risk of each case, While no single test exists that can predict sepsis prior to the onset of symptoms for the purpose of pre-emptive care and monitoring...
October 6, 2017: Shock
https://www.readbyqxmd.com/read/28993097/prognostic-value-of-early-warning-scores-in-the-emergency-department-ed-and-acute-medical-unit-amu-a-narrative-review
#3
REVIEW
R S Nannan Panday, T C Minderhoud, N Alam, P W B Nanayakkara
BACKGROUND: A wide array of early warning scores (EWS) have been developed and are used in different settings to detect which patients are at risk of deterioration. The aim of this review is to provide an overview of studies conducted on the value of EWS on predicting intensive care (ICU) admission and mortality in the emergency department (ED) and acute medical unit (AMU). METHODS: A literature search was conducted in the bibliographic databases PubMed and EMBASE, from inception to April 2017...
October 6, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28979533/alcoholic-liver-disease-on-the-intensive-care-unit-outcomes-and-prognostication
#4
James I Beck, Anca Staicu, Simon M Everett, Phil Jackson
BACKGROUND: Hospital admissions with decompensated chronic alcoholic liver disease have been increasing, leading to increased pressure on intensive care unit services. We aimed to determine the outcome and prognostic factors for patients with alcoholic liver disease requiring admission to intensive care unit. METHODS: This was a retrospective study over 5 years (January 2006-December 2010) of all intensive care unit admissions with alcoholic liver disease to either of the two Leeds Teaching Hospitals NHS Trust general intensive care units...
February 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28955423/variations-in-injury-characteristics-among-paediatric-patients-following-trauma-a-retrospective-descriptive-analysis-comparing-pre-hospital-and-in-hospital-deaths-at-kamuzu-central-hospital-lilongwe-malawi
#5
Laura Purcell, Charles E Mabedi, Jared Gallaher, Steven Mjuweni, Sean McLean, Bruce Cairns, Anthony Charles
BACKGROUND: Trauma is a major cause of paediatric mortality in sub-Saharan Africa. In absence of pre-hospital care, the injury mechanism and cause of death is difficult to characterise. Injury characteristics of pre-hospital deaths (PHD) versus in-hospital deaths (IHD) were compared. METHODS: Using our trauma surveillance database, a retrospective, descriptive analysis of children (<18 years) presenting to Kamuzu Central Hospital in Lilongwe, Malawi from 2008 to 2013 was performed...
June 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/28900672/extracorporeal-membrane-oxygenation-in-adult-patients-with-acute-fulminant-myocarditis-clinical-outcomes-and-risk-factor-analysis
#6
X Liao, B Li, Z Cheng
BACKGROUND: Our study aimed to summarize the clinical outcomes of extracorporeal membrane oxygenation (ECMO) in adult patients with acute fulminant myocarditis and to investigate the risk factors associated with its application. PATIENTS AND METHODS: We retrospectively examined patients with cardiogenic shock and acute fulminant myocarditis. The following data were collected: patients' preoperative general condition, related clinical factors during ECMO, complications, and outcomes of ECMO...
September 12, 2017: Herz
https://www.readbyqxmd.com/read/28884304/cell-cycle-arrest-biomarkers-in-urine-to-predict-acute-kidney-injury-in-septic-and-non-septic-critically-ill-patients
#7
M Cuartero, J Ballús, J Sabater, X Pérez, N Nin, J Ordonez-Llanos, A J Betbesé
PURPOSE: To analyse the usefulness of the composite index of the tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) as urinary biomarkers for the early prediction of AKI in septic and non-septic patients. METHODS: This is a prospective, observational study including patients admitted to ICU from acute care departments and hospital length of stay <48 h. The main exclusion criteria were pre-existing eGFR <30 mL/min/1...
September 7, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28879784/non-chemotherapy-drug-induced-neutropenia-an-update
#8
Emmanuel Andrès, Rachel Mourot-Cottet
To date, non-chemotherapy drug-induced severe neutropenia (neutrophil count of ≤0.5 x 10(9)/L) also called idiosyncratic drug-induced agranulocytosis is little discussed in the literature. In the present paper, we report and discuss the clinical data and management of this rare disorder. Areas covered: To do this, we carried out a review of the literature using PubMed database of the US National Library of Medicine. We also used data from the American Society of Hematology educational books, textbooks of Hematology and Internal medicine, and information gleaned from international meetings...
November 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28877944/effects-of-external-inspection-on-sepsis-detection-and-treatment-a-study-protocol-for-a-quasiexperimental-study-with-a-stepped-wedge-design
#9
Einar Hovlid, Jan C Frich, Kieran Walshe, Roy M Nilsen, Hans Kristian Flaatten, Geir Sverre Braut, Jon Helgeland, Inger Lise Teig, Stig Harthug
INTRODUCTION: Inspections are widely used in health care as a means to improve the health services delivered to patients. Despite their widespread use, there is little evidence of their effect. The mechanisms for how inspections can promote change are poorly understood. In this study, we use a national inspection campaign of sepsis detection and initial treatment in hospitals as case to: (1) Explore how inspections affect the involved organizations. (2) Evaluate what effect external inspections have on the process of delivering care to patients, measured by change in indicators reflecting how sepsis detection and treatment is carried out...
September 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28869805/pre-operative-trans-catheter-arterial-chemo-embolization-increases-hepatic-artery-thrombosis-after-liver-transplantation-a-retrospective-study
#10
Nicholas Gilbo, Laura Van Praet, Ina Jochmans, Mauricio Sainz-Barriga, Chris Verslype, Geert Maleux, Wim Laleman, Schalk van der Merwe, David Cassiman, Frederik Nevens, Diethard Monbaliu, Jacques Pirenne
Little is known about nonsurgical risk factors for hepatic artery thrombosis (HAT) after liver transplantation (LT). We determined risk factors for HAT occurring within 90 days post-LT and analysed the effect of HAT on graft and patient survival. Donor and recipient demographics, surgery-related data and outcome in transplants complicated by thrombosis (HAT+) and their matched controls (HAT-) were compared. Risk factors were assessed by univariate logistic regression. Median (IQR) is given. A total of 25 HAT occurred among 1035 adult LT (1/1997-12/2014) and 50 controls were manually matched...
September 4, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28851265/post-operative-fever-in-orthopaedic-surgery-how-effective-is-the-fever-workup
#11
Blair Ashley, David A Spiegel, Patrick Cahill, Divya Talwar, Keith D Baldwin
BACKGROUND: Defining the appropriate threshold at which to initiate a fever workup is imperative to promote patient safety, appropriate resource utilization, and antibiotic stewardship. Our group performed a systematic review of the available literature on perioperative fever (POF) workups in orthopaedic patients to evaluate the frequency, timing and utility of blood cultures (BC) and other investigations in the POF workup, to determine the clinical relevance of any infections and to evaluate their cost effectiveness...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28846501/rapid-source-control-laparotomy-is-there-a-mortality-benefit
#12
James Vogler, Laura Bagwell, Leslie Hart, Sharon Holmes, Jason Sciaretta, John Mihran Davis
BACKGROUND: The purpose of this study was to determine the influence rapid source-control laparotomy (RSCL) has on the mortality rate in non-trauma patients with intra-abdominal infection. The hypothesis was that RSCL reduces deaths and hospital lengths of stay (LOS) in patients compared with definitive repair and primary fascial closure (PFC). METHODS: The International Classification of Diseases-10 codes for sepsis, gastric and duodenal ulcer perforation or hemorrhage, incisional or ventral hernia with obstruction, intestinal volvulus, ileus with obstruction, diverticulitis with perforation or abscess, vascular disorder of intestine, non-traumatic intestinal perforation, peritoneal abscess, and unspecified peritonitis were used to query the 2015 National Surgical Quality Improvement Project (NSQIP) database for all patients treated with either RSCL or PFC...
October 2017: Surgical Infections
https://www.readbyqxmd.com/read/28792256/triage-of-septic-patients-using-qsofa-criteria-at-the-samu-regulation-a-retrospective-analysis
#13
R Jouffroy, A Saade, A Carpentier, S Ellouze, P Philippe, R Idialisoa, P Carli, B Vivien
PURPOSE: One of the major prognostic factors in the management of sepsis is the early initiation of appropriate treatment. To serve this purpose, early identification and triage of patients are crucial steps, which are still not optimal. The objective of this study was to determine whether the quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) score is an accurate method for prehospital triaging of septic patients. We evaluated whether the use of qSOFA criteria collected by the Service Mobile d'Urgence et de Réanimation 15 (SAMU 15) regulation call center during prehospital care would facilitate appropriate intensive care unit (ICU) admission of patients with septic syndromes...
August 9, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28753618/clinical-outcomes-and-mortality-before-and-after-implementation-of-a-pediatric-sepsis-protocol-in-a-limited-resource-setting-a-retrospective-cohort-study-in-bangladesh
#14
Teresa Bleakly Kortz, David M Axelrod, Mohammod J Chisti, Saraswati Kache
BACKGROUND: Pediatric sepsis has a high mortality rate in limited resource settings. Sepsis protocols have been shown to be a cost-effective strategy to improve morbidity and mortality in a variety of populations and settings. At Dhaka Hospital in Bangladesh, mortality from pediatric sepsis in high-risk children previously approached 60%, which prompted the implementation of an evidenced-based protocol in 2010. The clinical effectiveness of this protocol had not been measured. We hypothesized that implementation of a pediatric sepsis protocol improved clinical outcomes, including reducing mortality and length of hospital stay...
2017: PloS One
https://www.readbyqxmd.com/read/28713509/mechanical-ventilation-practice-in-egyptian-pediatric-intensive-care-units
#15
Bassant Salah Meligy, Sally Kamal, Seham Awad El Sherbini
INTRODUCTION: Mechanical ventilation is one of the indispensable tools in pediatric intensive care units. Few studies addressed the epidemiology of pediatric patients on mechanical ventilation and the frequently used modes of ventilation. This is the first study to describe the practice of mechanical ventilation (MV) in Egyptian pediatric intensive care units (PICUs). METHODS: This prospective observational study was conducted from January 2014 to December 2014 in two pediatric intensive care units at Cairo University Pediatric Hospital...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28712173/surgical-site-infection-in-orthopaedic-implants-and-its-common-bacteria-with-their-sensitivities-to-antibiotics-in-open-reduction-internal-fixation
#16
Muhammad Qaisar Shah, Muhammad Shoib Zardad, Alamzeb Khan, Sajjad Ahmed, Abdus Saboor Awan, Taj Mohammad
BACKGROUND: Surgical site infection in orthopaedic implants is a major problem, causing long hospital stay, cost to the patient and is a burden on health care facilities. It increases rate of nonunion, osteomyelitis, implant failure, sepsis, multiorgan dysfunction and even death. Surgical site infection is defined as pain, erythema, swelling and discharge from wound site. Surgical site infection in orthopaedic implants is more challenging to the treating orthopaedic surgeon as the causative organism is protected by a biofilm over the implant's surface...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28706103/vitamin-d-levels-in-critically-ill-patients-with-acute-kidney-injury-a-protocol-for-a-prospective-cohort-study-vid-aki
#17
Lynda Katherine Cameron, Katie Lei, Samantha Smith, Nanci Leigh Doyle, James F Doyle, Kate Flynn, Nicola Purchase, John Smith, Kathryn Chan, Farida Kamara, Nardos Ghebremedhin Kidane, Lui G Forni, Dominic Harrington, Geeta Hampson, Marlies Ostermann
INTRODUCTION: Acute kidney injury (AKI) affects more than 50% of critically ill patients. The formation of calcitriol, the active vitamin D metabolite, from the main inactive circulating form, 25-hydroxyvitamin D (25(OH)D), occurs primarily in the proximal renal tubules. This results in a theoretical basis for reduction in levels of calcitriol over the course of an AKI. Vitamin D deficiency is highly prevalent in critically ill adults, and has been associated with increased rates of sepsis, longer hospital stays and increased mortality...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28667715/family-centered-care-to-complement-care-of-sick-newborns-a-randomized-controlled-trial
#18
Ankit Verma, Arti Maria, Ravindra Mohan Pandey, Charoo Hans, Arushi Verma, Fahima Sherwani
OBJECTIVE: To assess the impact of family-centered care in delivery of care to sick newborns, on nosocomial infection rate. DESIGN: Randomized controlled trial. SETTING: Tertiary referral nursery (October 2010 to March 2012). PARTICIPANTS: 295 neonates randomized at the time of hospitalization in neonatal intensive care unit. INTERVENTION: Parent-attendant of intervention group were trained using an indigenously developed and pretested, culturally sensitive, simple audio-video tool that covered domains of personal hygiene, hand washing, danger signs recognition and feeding of sick neonate...
June 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28666578/outpatient-beta-blockers-and-survival-from-sepsis-results-from-a-national-cohort-of-medicare-beneficiaries
#19
Kathleen E Singer, Courtney E Collins, Julie M Flahive, Allison S Wyman, M Didem Ayturk, Heena P Santry
BACKGROUND: Elderly Americans suffer increased mortality from sepsis. Given that beta-blockers have been shown to be cardioprotective in critical care, we investigated outpatient beta-blocker prescriptions and mortality among Medicare beneficiaries admitted for sepsis. METHODS: We queried a 5% random sample of Medicare beneficiaries for patients admitted with sepsis. We used in-hospital and outpatient prescription drug claims to compare in-hospital and 30-day mortality based on pre-admission beta-blocker prescription and class of beta-blocker prescribed using univariate tests of comparison and multivariable logistic regression models and another class of medications for control...
October 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28657382/a-pilot-study-evaluating-the-prescribing-of-ceftriaxone-in-hospitals-in-ghana-findings-and-implications
#20
Daniel Kwame Afriyie, Seth Kwabena Amponsah, Justice Dogbey, Kwabena Agyekum, Samuel Kesse, Ilse Truter, Johanna C Meyer, Brian Godman
BACKGROUND AND OBJECTIVES: Widespread empiric use of antibiotics exists especially in developing countries. This is a concern since inappropriate use of antibiotics, including their extended inappropriate use, will increase resistance rates. Consequently, there is a need to evaluate antibiotic utilisation across healthcare sectors to improve future use. This includes ceftriaxone, widely used among hospitals including those in Ghana. METHODS: A cross-sectional study to evaluate the appropriateness of ceftriaxone prescribing in a leading hospital in Ghana...
October 2017: Hospital Practice (Minneapolis)
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