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pre-hospital sepsis

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https://www.readbyqxmd.com/read/29664874/traumatic-brain-injury-and-infectious-encephalopathy-in-children-from-four-resource-limited-settings-in-africa
#1
Ericka L Fink, Amelie von Saint Andre-von Arnim, Rashmi Kumar, Patrick T Wilson, Tigist Bacha, Abenezer Tirsit Aklilu, Tsegazeab Laeke Teklemariam, Shubhada Hooli, Lisine Tuyisenge, Easmon Otupiri, Anthony Fabio, John Gianakas, Patrick M Kochanek, Derek C Angus, Robert C Tasker
OBJECTIVES: To assess the frequency, interventions, and outcomes of children presenting with traumatic brain injury or infectious encephalopathy in low-resource settings. DESIGN: Prospective study. SETTING: Four hospitals in Sub-Saharan Africa. PATIENTS: Children age 1 day to 17 years old evaluated at the hospital with traumatic brain injury or infectious encephalopathy. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We evaluated the frequency and outcomes of children presenting consecutively over 4 weeks to any hospital department with traumatic brain injury or infectious encephalopathy...
April 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29643892/association-of-in-hospital-outcome-of-acute-kidney-injury-aki-with-etiology-among-newborns-at-a-tertiary-care-unit
#2
Muhammad Asghar Ali, Abdur Rehman, Ejaz Ahmed
Objective: To determine association of in-hospital outcome of AKI with etiology in newborns at a tertiary care hospital. Methods: This descriptive cross-sectional study was conducted at Department of Pediatric Neonatology, The Children's Hospital and Institute of the Child Health, Multan by using non-probability purposive sampling technique from June 2016 to June 2017. A total of 101 newborns diagnosed with acute kidney injury were registered. Etiological factors were assessed and these patients were followed till discharge to monitor in-hospital outcomes...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29616433/mortality-and-detailed-characteristics-of-pre-icu-qsofa-negative-patients-with-suspected-sepsis-an-observational-study
#3
Izumi Nakayama, Junichi Izawa, Hideyuki Mouri, Tetsuhisa Kitamura, Junji Shiotsuka
BACKGROUND: Recent studies have suggested that quick Sequential Organ Failure Assessment (qSOFA) scores have limited utility in early prognostication in high-mortality populations. The purpose of this study was to investigate the association between pre-ICU qSOFA scores and in-hospital mortality among patients admitted to the ICU with suspected sepsis. This study also aimed to describe detailed clinical characteristics of qSOFA-negative (< 2) patients. METHODS: This single center, observational study, conducted in a Japanese tertiary care teaching hospital between May 2012 and June 2016, enrolled all consecutive adult patients admitted to the ICU with suspected sepsis...
April 3, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29605342/safety-and-postoperative-adverse-events-in-management-of-acute-mastoiditis-in-children-30-day-nsqip-outcomes
#4
Matthew G Crowson, Jeffrey Cheng
OBJECTIVE: To examine preoperative risk factors, postoperative 30-day outcomes and adverse events of acute mastoiditis using a national pediatric surgical database. METHODS: We explored our objectives using a cross-sectional analysis of a hospital-based reporting system database. The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) pediatric database was used to identify surgical encounters for the treatment of acute mastoiditis from 2012 to 2015...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29588551/hip-hemi-arthroplasty-vs-total-hip-replacement-for-displaced-intra-capsular-hip-fractures-retrospective-age-and-sex-matched-cohort-study
#5
Daniel Dawson, David Milligan, Fayaz Callachand, Laurence Cusick
Introduction: The Royal Victoria Hospital in Belfast is the largest volume hospital in the UK Hip Fracture Database. Management of displaced intra-capsular hip fractures is evolving in light of NICE2 and BOA guidelines3 , with more patients receiving total hip replacement (THR) over hemi-arthroplasty. With current rationing within the NHS, it is vital that principles of the 'Getting It Right First time' (GIRFT) report4 are implemented and the correct treatment choice made. Our aim was to assess Barthel scores5 , complication rate, blood transfusion rate and post op functional ability in two age and sex matched cohorts to see if our patient selection was appropriate...
January 2018: Ulster Medical Journal
https://www.readbyqxmd.com/read/29579086/tuberculosis-during-pregnancy-in-the-united-states-racial-ethnic-disparities-in-pregnancy-complications-and-in-hospital-death
#6
Erika M Dennis, Yun Hao, Mabella Tamambang, Tasha N Roshan, Knubian J Gatlin, Hanane Bghigh, Oladimeji T Ogunyemi, Fatoumata Diallo, Kiara K Spooner, Jason L Salemi, Omonike A Olaleye, Kashif Z Khan, Muktar H Aliyu, Hamisu M Salihu
BACKGROUND: Despite decades of efforts to eliminate tuberculosis (TB) in the United States (US), TB still contributes to adverse ill health, especially among racial/ethnic minorities. According to the Centers for Disease Control and Prevention, in 2016, about 87% of the TB cases reported in the US were among racial and ethnic minorities. The objective of this study is to explore the risks for pregnancy complications and in-hospital death among mothers diagnosed with TB across racial/ethnic groups in the US...
2018: PloS One
https://www.readbyqxmd.com/read/29557598/community-acquired-methicillin-resistant-staphylococcus-aureus-infections-10-years-experience-in-a-children-s-hospital-in-the-city-of-rosario-argentina
#7
Gabriela Ensinck, Adriana Ernst, Gustavo Lazarte, Antonela Romagnoli, Yanina Sguassero, Nanci Míguez, Santiago López Papucci, Alicia Aletti, Ana Chiossone, Fernanda Pigozzi, Matías Pinotti, Ana Cantador
INTRODUCTION: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are a common reason for consultation in pediatrics. Most of them present as skin and soft tissue infections; however, invasive infections have increased during the last decade. OBJECTIVES: The main objective was to describe the clinical-epidemiological characteristics of CA-MRSA infections. The secondary objective was to compare prevalence, clinical presentation and antibiotic susceptibility with a pre-study period (1/2004-12/2007)...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29552913/clinical-investigation-of-coagulation-markers-for-early-detection-of-sepsis-induced-disseminated-intravascular-coagulation-a-single-center-prospective-observational-study
#8
Takamitsu Masuda, Tomohisa Shoko, Yoshizumi Deguchi
Disseminated intravascular coagulation (DIC) often complicates sepsis, and its early treatment is crucial for improving patient outcomes. Coagulation markers may enable earlier diagnosis of DIC. The purpose of this study was to evaluate whether the risk of DIC onset can be predicted using coagulation markers. Patients who showed symptoms of systemic inflammatory response syndrome ≥2 and the quick Sequential Organ Failure Assessment score ≥2 points were investigated. All blood samples collected from the time of hospital admission to 7 days postadmission were investigated...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29549653/the-h3-haplotype-of-the-epcr-gene-determines-high-sepcr-levels-in-critically-ill-septic-patients
#9
Alice G Vassiliou, Anastasia Kotanidou, Zafeiria Mastora, Carlo Tascini, Gianluigi Cardinali, Stylianos E Orfanos
INTRODUCTION: A soluble (s) form of the endothelial protein C receptor (EPCR) circulates in plasma and inhibits activated protein C (APC) activities. The clinical impact of sEPCR and its involvement in the septic process is under investigation. This study determined the frequencies of EPCR haplotypes H1 and H3 to investigate possible associations with plasma admission levels of sEPCR in an intensive care unit (ICU) cohort of septic patients. METHODS: Three polymorphisms in the EPCR gene were genotyped in 239 Caucasian critically ill patients, and their plasma sEPCR levels were also measured at the time of admission to the ICU...
March 2018: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29544173/early-glycemia-and-mortality-in-critically-ill-septic-patients-interaction-with-insulin-treated-diabetes
#10
Fraser Magee, Michael Bailey, David V Pilcher, Johan Mårtensson, Rinaldo Bellomo
PURPOSE: To investigate the relationship between dysglycemia and hospital mortality in patients with and without a preadmission diagnosis of insulin treated diabetes mellitus (ITDM). MATERIALS AND METHODS: An observational multicentre cohort study using the ANZICS-APD database on adult patients admitted to ICU with sepsis between January 1st 2006 and December 31st 2015. Four domains of dysglycemia were investigated (highest, mean and lowest blood glucose levels and glycemic variability: the absolute difference between the highest and lowest level)...
March 3, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29543684/effect-of-a-sepsis-educational-intervention-on-hospital-stay
#11
Jaime Fernández-Sarmiento, Joseph A Carcillo, Claudia M Salinas, Edgar F Galvis, Paula A López, Andrés Jagua-Gualdrón
OBJECTIVES: To evaluate adherence to the sepsis bundle before and after an educational strategy and its impact on hospital stay. DESIGN: A prospective, analytic, before-and-after study of children with severe sepsis and septic shock who presented to the emergency department. SETTING: Carried out from January to December 2014 in the emergency department of a quaternary care hospital. PATIENTS: Of a total of 19,836 children who presented to the emergency department, 4,383 had an infectious pathology, with 203 of these showing severe sepsis and septic shock (124 pre intervention, and 79 post intervention)...
March 14, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29506150/pharmacokinetics-of-piperacillin-in-critically-ill-patients-with-acute-kidney-injury-receiving-sustained-low-efficiency-diafiltration
#12
Mahipal G Sinnollareddy, Michael S Roberts, Jeffrey Lipman, Sandra L Peake, Jason A Roberts
Background: Piperacillin is a β-lactam penicillin antibiotic commonly used for the empirical therapy of sepsis and other hospital-acquired infections. However, knowledge regarding the effect of sustained low-efficiency diafiltration (SLED-f), a technique increasingly being used in ICUs, on piperacillin pharmacokinetics (PK) and dosing in critically ill patients is lacking. Objectives: To describe the PK of piperacillin during SLED-f and compare the results with those reported for other forms of renal replacement therapies...
March 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29497509/kangaroo-mother-care-for-clinically-unstable-neonates-weighing-%C3%A2-2000-g-is-it-feasible-at-a-hospital-in-uganda
#13
Melissa C Morgan, Harriet Nambuya, Peter Waiswa, Cally Tann, Diana Elbourne, Janet Seeley, Elizabeth Allen, Joy E Lawn
Background: Kangaroo mother care (KMC) for stable neonates ≤2000 g (g) is associated with decreased mortality, sepsis, hypothermia, and length of stay compared to conventional care. The World Health Organization states that KMC "should be initiated… as soon as newborns are clinically stable " [12]. However, the majority of deaths occur in unstable neonates. We aimed to determine the proportion of admitted neonates meeting proposed instability criteria, assess the feasibility of providing KMC to unstable neonates, and evaluate the acceptability of this intervention to parents and providers at Jinja Regional Referral Hospital in Uganda...
June 2018: Journal of Global Health
https://www.readbyqxmd.com/read/29468685/a-rapid-cycle-method-for-local-adaptation-of-an-obstetric-emergencies-training-program
#14
Kiren Ghag, Cathy Winter, Rachna Bahl, Mary Lynch, Nayda Bautista, Rogelio Ilagan, Timothy J Draycott
OBJECTIVE: To describe the adaptation of an obstetric emergencies training program to align with local clinical practice. METHODS: A feasibility study was conducted to investigate the potential implementation of the PRactical Obstetric Multi-Professional Training (PROMPT) program at eight urban tertiary hospitals in the Philippines. Multi-professional teams attended a 2-day course on September 23 and 24, 2015, that comprised a demonstration PROMPT course (day 1) and a Train-the-Trainers session (day 2)...
February 22, 2018: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29468633/prostaglandin-gel-versus-oxytocin-prelabour-rupture-of-membranes-at-term-a-randomised-controlled-trial
#15
Kassam Mahomed, Kellie Wild, Christopher R Weekes
BACKGROUND: Pre-labour rupture of membranes (PROM) at term is a common event with early induction of labour reducing infectious morbidity without increasing the caesarean rate. Syntocinon is commonly used for induction but prostaglandins are also routinely used. Large studies have shown no difference in the maternal and neonatal outcomes with either method. AIM: To assess the safety and efficacy of vaginal prostaglandin (PG) compared to syntocinon for induction of labour in term-PROM...
February 22, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29451643/the-applicability-of-possum-and-p-possum-scores-as-predictors-of-morbidity-and-mortality-in-colorectal-surgery
#16
Maria Emília Carvalho-E-Carvalho, Fábio Lopes DE-Queiroz, Breno Xaia Martins-DA-Costa, Marcelo Giusti Werneck-Côrtes, Vinícius Pires-Rodrigues
OBJECTIVE: to apply the POSSUM and P-POSSUM scores as a tool to predict morbidity and mortality in colorectal surgery. METHODS: we conducted a prospective cohort study of 551 patients submitted to colorectal surgery in a colorectal surgery tertiary referral hospital in Brazil. We grouped patients into pre-established risk categories for comparison between expected and observed morbidity and mortality rates by the POSSUM and P-POSSUM scores. RESULTS: in the POSSUM morbidity analysis, the overall expected morbidity was significantly higher than that observed (39...
2018: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29422154/audit-for-quality-of-care-and-fate-of-maternal-critical-cases-at-women-s-health-hospital
#17
Howieda Fouly, Fayza Ahmed Abdou, Ahmed M Abbas, Ayat Masoud Omar
Maternal deaths remain high, numbers at the facility level are relatively low. AIM: To evaluate effect of management guidelines on occurrence of maternal near miss in Women's Health Hospital. DESIGN: A cross-sectional study. SETTING: ICU of Women's Health Hospital's at Assiut Main University Hospital and Al-fayoum University Hospital. SUBJECTS: Convenient sample of 93 maternal near-miss cases including (Pregnancy or postpartum complications)...
February 2018: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29415741/elucidating-the-impact-of-the-pneumococcal-conjugate-vaccine-programme-on-pneumonia-sepsis-and-otitis-media-hospital-admissions-in-england-using-a-composite-control
#18
Dominic Thorrington, Nick Andrews, Julia Stowe, Elizabeth Miller, Albert Jan van Hoek
BACKGROUND: The seven-valent pneumococcal conjugate vaccine (PCV) was introduced in England in September 2006, changing to the 13-valent vaccine in April 2010. PCV impact on invasive pneumococcal disease (IPD) has been extensively reported, but less described is its impact on the burden of pneumonia, sepsis and otitis media in the hospital. METHODS: Using details on all admissions to hospitals in England, we compared the incidence of pneumococcal-specific and syndromic disease endpoints in a 24-month pre-PCV period beginning April 2004 to the 24-month period ending March 2015 to derive incidence rate ratios (IRRs)...
February 8, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29396511/reducing-antibiotic-utilization-rate-in-preterm-infants-a-quality-improvement-initiative
#19
Ramachandra Bhat, Haidee Custodio, Cathy McCurley, Richard Whitehurst, Rashmi Gulati, Om Prakash Jha, Jayalakshmi Bhat, Benjamin Estrada, Amy Hill, Fabien Eyal, Michael Zayek
BACKGROUND: Judicious use of antibiotic therapy in preterm infants is necessary as prolonged and unwarranted use of antibiotics have been associated with adverse short-term and long-term outcomes. LOCAL PROBLEM: Our baseline data review revealed overuse and unnecessary prolonged antibiotic exposure among preterm infants despite a low suspicion for sepsis. METHODS AND INTERVENTIONS: The baseline overall AUR was calculated retrospectively from our pharmacy database for a period of 4 months prior to the quality improvement (QI) initiative (pre-QI phase)...
February 2, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29393567/acute-kidney-injury-but-not-sepsis-is-associated-with-higher-procedure-related-bleeding-in-patients-with-decompensated-cirrhosis
#20
Adelina Hung, Guadalupe Garcia-Tsao
BACKGROUND: Bleeding after low-risk invasive procedures can be life-threatening or can lead to further complications in decompensated cirrhosis patients. In unstratified cohorts of hospitalized patients with cirrhosis, the rate of procedure-related bleeding is low despite abnormal coagulation parameters. Our objective was to identify patients with decompensated cirrhosis at a high risk of developing procedure-related bleeding in whom the value of pre-procedure transfusions could be assessed...
February 2, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
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