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surveillance in Critical Care

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https://www.readbyqxmd.com/read/28416176/maternal-early-warning-systems-towards-reducing-preventable-maternal-mortality-and-severe-maternal-morbidity-through-improved-clinical-surveillance-and-responsiveness
#1
Lisa C Zuckerwise, Heather S Lipkind
Despite increasing awareness of obstetric safety initiatives, maternal mortality and severe maternal morbidity in the United States have continued to increase over the past 20 years. Since results from large-scale surveillance programs suggest that up to 50% of maternal deaths may be preventable, new efforts are focused on developing and testing early warning systems for the obstetric population. Early warning systems are a set of specific clinical signs or symptoms that trigger the awareness of risk and an urgent patient evaluation, with the goal of reducing severe morbidity and mortality through timely diagnosis and treatment...
April 14, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28414188/a-case-of-splenomegaly-in-cbl-syndrome
#2
Rachel R Coe, Margaret L McKinnon, Maja Tarailo-Graovac, Colin J Ross, Wyeth W Wasserman, Jan M Friedman, Paul C Rogers, Clara D M van Karnebeek
INTRODUCTION: We present a child with unexplained splenomegaly to highlight this feature as a presenting sign of the RASopathy CBL syndrome and to draw attention to the power and utility of next generation genomic sequencing for providing rapid diagnosis and critical information to guide care in the pediatric clinical setting. CLINICAL REPORT: A 7-year-old boy presented with unexplained splenomegaly, attention deficit hyperactivity disorder, mild learning difficulties, easy bruising, mild thrombocytopenia, and subtle dysmorphic features...
April 13, 2017: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/28411525/health-access-to-care-among-working-age-lower-income-adults-in-the-great-recession-disparities-across-race-and-ethnicity-and-geospatial-factors
#3
Samuel D Towne, Janice C Probst, James W Hardin, Bethany A Bell, Saundra Glover
In the United States (US) and elsewhere, residents of low resource areas face health-related disparities, and may experience different outcomes throughout times of severe economic flux. We aimed to identify individual (e.g. sociodemographic) and environmental (e.g. region, rurality) factors associated with self-reported health and forgone medical care due to the cost of treatment in the US across the Great Recession (2008-2009). We analyzed nationally representative data (2004-2010) using the Behavioral Risk Factor Surveillance System in the US...
April 6, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28402551/a-risk-prediction-score-for-acute-kidney-injury-in-the-intensive-care-unit
#4
Rakesh Malhotra, Kianoush B Kashani, Etienne Macedo, Jihoon Kim, Josee Bouchard, Susan Wynn, Guangxi Li, Lucila Ohno-Machado, Ravindra Mehta
Background.: Acute kidney injury (AKI) is common in critically ill patients and is associated with high morbidity and mortality. Early identification of high-risk patients provides an opportunity to develop strategies for prevention, early diagnosis and treatment of AKI. Methods.: We undertook this multicenter prospective cohort study to develop and validate a risk score for predicting AKI in patients admitted to an intensive care unit (ICU). Patients were screened for predictor variables within 48 h of ICU admission...
April 10, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28384858/antimicrobial-resistance-surveillance-among-intensive-care-units-of-a-tertiary-care-hospital-in-southern-india
#5
Kailash Moolchandani, Apurba Sankar Sastry, R Deepashree, Sujatha Sistla, B N Harish, Jharna Mandal
INTRODUCTION: Hospital Acquired Infections (HAIs) are the rising threat in the health care facilities across the globe. As most Intesive Care Unit (ICU) patients are frequently on broad spectrum antimicrobials, this induces selective antibiotic pressure which leads to development of Antimicrobial Resistance (AMR) among the microorganisms of ICUs. AIM: To study the occurrence of different types of HAIs in patients admitted to various ICUs of JIPMER and the AMR pattern of the bacterial pathogens isolated from them...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28370345/accuracy-of-birth-certificate-data-for-classifying-preterm-birth
#6
Molly J Stout, George A Macones, Methodius G Tuuli
BACKGROUND: Classifying preterm birth as spontaneous or indicated is critical both for clinical care and research, yet the accuracy of classification based on different data sources is unclear. We examined the accuracy of preterm birth classification as spontaneous or indicated based on birth certificate data. METHODS: This is a retrospective cohort study of 123 birth certificates from preterm births in Missouri. Correct classification of spontaneous or indicated preterm birth subtype was based on multi-provider (RN, MFM Fellow, MFM attending) consensus after full medical record review...
April 3, 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/28365652/interstage-home-monitoring-after-newborn-first-stage-palliation-for-hypoplastic-left-heart-syndrome-family-education-strategies
#7
Jo Ann Nieves, Karen Uzark, Nancy A Rudd, Jennifer Strawn, Anne Schmelzer, Nancy Dobrolet
Children born with hypoplastic left heart syndrome are at high risk for serious morbidity, growth failure, and mortality during the interstage period, which is the time from discharge home after first-stage hypoplastic left heart syndrome palliation until the second-stage surgical intervention. The single-ventricle circulatory physiology is complex, fragile, and potentially unstable. Multicenter initiatives have been successfully implemented to improve outcomes and optimize growth and survival during the interstage period...
April 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28352456/re-imagining-the-future-of-diagnosis-of-neglected-tropical-diseases
#8
REVIEW
Rosanna W Peeling, Debrah I Boeras, John Nkengasong
Neglected Tropical Diseases (NTDs) affect an estimated 1 billion people in 149 countries. The World Health Organization (WHO) prioritised 17 NTDs for control and elimination by 2020 and defined a Road Map to help countries reach these goals. Improved diagnostics for NTDs are essential for guiding treatment strategies at different thresholds of control, interruption of transmission, elimination and post-elimination surveillance. While substantial progress has been made in the last decade with chemotherapy, the same cannot be said of diagnostics, largely due to the perceived lack of a commercially viable market for NTD diagnostics...
2017: Computational and Structural Biotechnology Journal
https://www.readbyqxmd.com/read/28330486/relationships-between-structure-process-and-outcome-to-assess-quality-of-integrated-chronic-disease-management-in-a-rural-south-african-setting-applying-a-structural-equation-model
#9
Soter Ameh, Francesc Xavier Gómez-Olivé, Kathleen Kahn, Stephen M Tollman, Kerstin Klipstein-Grobusch
BACKGROUND: South Africa faces a complex dual burden of chronic communicable and non-communicable diseases (NCDs). In response, the Integrated Chronic Disease Management (ICDM) model was initiated in primary health care (PHC) facilities in 2011 to leverage the HIV/ART programme to scale-up services for NCDs, achieve optimal patient health outcomes and improve the quality of medical care. However, little is known about the quality of care in the ICDM model. The objectives of this study were to: i) assess patients' and operational managers' satisfaction with the dimensions of ICDM services; and ii) evaluate the quality of care in the ICDM model using Avedis Donabedian's theory of relationships between structure (resources), process (clinical activities) and outcome (desired result of healthcare) constructs as a measure of quality of care...
March 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28325583/optimizing-endometrial-cancer-follow-up-and-survivorship-care-for-rural-and-other-underserved-women-patient-and-provider-perspectives
#10
Teresa L Rutledge, Miria Kano, Dolores Guest, Andrew Sussman, Anita Y Kinney
OBJECTIVES: This study describes patient and provider attitudes on transitioning cancer surveillance visits and treatment of comorbid conditions to the primary care setting in a rural patient population as a strategy for minimizing financial and travel related barriers for patients while simultaneously enhancing quality and availability of health care options. METHODS: Focus group discussions and telephone interviews were conducted with endometrial cancer (EC) survivors and primary care providers (PCPs) to provide insights into post-treatment follow-up practices and the acceptability of transitioning follow-up to primary care setting utilizing a cancer survivorship care plan model...
March 18, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28275074/same-day-diagnostic-and-surveillance-data-for-tuberculosis-via-whole-genome-sequencing-of-direct-respiratory-samples
#11
Antonina A Votintseva, Phelim Bradley, Louise Pankhurst, Carlos Del Ojo Elias, Matthew Loose, Kayzad Nilgiriwala, Anirvan Chatterjee, E Grace Smith, Nicolas Sanderson, Timothy M Walker, Marcus R Morgan, David H Wyllie, A Sarah Walker, Tim E A Peto, Derrick W Crook, Zamin Iqbal
Routine full characterization of Mycobacterium tuberculosis (TB) is culture-based, taking many weeks. Whole-genome sequencing (WGS) can generate antibiotic susceptibility profiles to inform treatment, augmented with strain information for global surveillance; such data could be transformative if provided at or near point of care.We demonstrate a low-cost DNA extraction method for TB WGS direct from patient samples. We initially evaluated the method using the Illumina MiSeq sequencer (40 smear-positive respiratory samples, obtained after routine clinical testing, and 27 matched liquid cultures)...
March 8, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28266112/dental-caries-and-periodontal-diseases-in-the-ageing-population-call-to-action-to-protect-and-enhance-oral-health-and-well-being-as-an-essential-component-of-healthy-ageing-consensus-report-of-group-4-of-the-joint-efp-orca-workshop-on-the-boundaries-between
#12
Maurizio S Tonetti, Peter Bottenberg, Georg Conrads, Peter Eickholz, Peter Heasman, Marie-Charlotte Huysmans, Rodrigo López, Phoebus Madianos, Frauke Müller, Ian Needleman, Bente Nyvad, Philip M Preshaw, Iain Pretty, Stefan Renvert, Falk Schwendicke, Leonardo Trombelli, Gert-Jan van der Putten, Jacques Vanobbergen, Nicola West, Alix Young, Sebastian Paris
BACKGROUND: Over the last two decades, progress in prevention and treatment of caries and periodontal diseases has been translated to better oral health and improved tooth retention in the adult population. The ageing population and the increasing expectations of good oral health-related quality of life in older age pose formidable challenges to clinical care and healthcare systems. AIMS: The objective of this workshop was to critically review scientific evidence and develop specific recommendations to: (i) prevent tooth loss and retain oral function through prevention and treatment of caries and periodontal diseases later in life and (ii) increase awareness of the health benefits of oral health as an essential component of healthy ageing...
March 2017: Journal of Clinical Periodontology
https://www.readbyqxmd.com/read/28257317/pulmonary-infections-in-critical-intensive-care-rapid-diagnosis-and-optimizing-antimicrobial-usage
#13
Ivor S Douglas
PURPOSE OF REVIEW: Diagnosis of pulmonary infection, including hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) in the critically ill patient remains a common and therapeutically challenging diagnosis with significant attributable morbidity, mortality, and cost. Current clinical approaches to surveillance, early detection and, conventional culture-based microbiology are inadequate for optimal targeted antibiotic treatment and stewardship. Efforts to enhance diagnosis of HAP and VAP and the impact of these novel approaches on rational antimicrobial selection and stewardship are the focus of recent studies reviewed here...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28242790/factors-associated-with-early-mortality-among-patients-with-de-novo-metastatic-breast-cancer-a-population-based-study
#14
Ines Vaz-Luis, Nancy U Lin, Nancy L Keating, William T Barry, Eric P Winer, Rachel A Freedman
BACKGROUND: Although improvements in survival have been achieved for patients with metastatic breast cancer, some patients experience early death after diagnosis. PATIENTS AND METHODS: Using Surveillance, Epidemiology, and End Results data, we identified 26,538 patients with de novo metastatic breast cancer diagnosed between January 1, 2000 and June 30, 2011. We evaluated time trends for deaths at 1 and 6 months after diagnosis. We then restricted the cohort to patients diagnosed between 2010 and 2011 (n = 3,317), when human epidermal growth factor receptor 2 was routinely collected, and examined factors associated with early death...
April 2017: Oncologist
https://www.readbyqxmd.com/read/28240970/head-and-neck-cancer-survivorship-care-guideline-american-society-of-clinical-oncology-clinical-practice-guideline-endorsement-of-the-american-cancer-society-guideline
#15
Larissa Nekhlyudov, Christina Lacchetti, Nancy B Davis, Thomas Q Garvey, David P Goldstein, J Chris Nunnink, Jose I Ruades Ninfea, Andrew L Salner, Talya Salz, Lillian L Siu
Purpose This guideline provides recommendations on the management of adults after head and neck cancer (HNC) treatment, focusing on surveillance and screening for recurrence or second primary cancers, assessment and management of long-term and late effects, health promotion, care coordination, and practice implications. Methods ASCO has a policy and set of procedures for endorsing clinical practice guidelines that have been developed by other professional organizations. The American Cancer Society (ACS) HNC Survivorship Care Guideline was reviewed for developmental rigor by methodologists...
February 27, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28214419/recommendations-for-gonadotoxicity-surveillance-in-male-childhood-adolescent-and-young-adult-cancer-survivors-a-report-from-the-international-late-effects-of-childhood-cancer-guideline-harmonization-group-in-collaboration-with-the-pancaresurfup-consortium
#16
REVIEW
Roderick Skinner, Renee L Mulder, Leontien C Kremer, Melissa M Hudson, Louis S Constine, Edit Bardi, Annelies Boekhout, Anja Borgmann-Staudt, Morven C Brown, Richard Cohn, Uta Dirksen, Alexsander Giwercman, Hiroyuki Ishiguro, Kirsi Jahnukainen, Lisa B Kenney, Jacqueline J Loonen, Lilian Meacham, Sebastian Neggers, Stephen Nussey, Cecilia Petersen, Margarett Shnorhavorian, Marry M van den Heuvel-Eibrink, Hanneke M van Santen, William H B Wallace, Daniel M Green
Treatment with chemotherapy, radiotherapy, or surgery that involves reproductive organs can cause impaired spermatogenesis, testosterone deficiency, and physical sexual dysfunction in male pubertal, adolescent, and young adult cancer survivors. Guidelines for surveillance and management of potential adverse effects could improve cancer survivors' health and quality of life. Surveillance recommendations vary considerably, causing uncertainty about optimum screening practices. This clinical practice guideline recommended by the International Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCareSurFup Consortium, developed using evidence-based methodology, critically synthesises surveillance recommendations for gonadotoxicity in male childhood, adolescent, and young adult (CAYA) cancer survivors...
February 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28167543/carbapenem-mics-in-escherichia-coli-and-klebsiella-species-producing-extended-spectrum-%C3%AE-lactamases-in-critical-care-patients-from-2001-to-2009
#17
J Kristie Johnson, Gwen L Robinson, Lisa L Pineles, Adebola O Ajao, LiCheng Zhao, Jennifer S Albrecht, Anthony D Harris, Kerri A Thom, Jon P Furuno
Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae strains are increasing in prevalence worldwide. Carbapenem antibiotics are used as a first line of therapy against ESBL-producing Enterobacteriaceae We examined a cohort of critical care patients for gastrointestinal colonization with carbapenem-resistant ESBL-producing strains (CR-ESBL strains). We cultured samples from this cohort of patients for ESBL-producing Klebsiella spp. and Escherichia coli and then tested the first isolate from each patient for susceptibility to imipenem, doripenem, meropenem, and ertapenem...
April 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28160955/infection-in-the-critically-ill-older-adult
#18
REVIEW
Jennifer Manning, Jean E Cefalu
Many challenges exist in caring for older adults with infection in critical care environments. Older adults are at high risk due to diminished reserve, age-related changes, comorbidities, subtle clinical presentations, and institutionalization. Additional risks include infections, such as pneumonia, influenza, and nosocomial infections. Age-related changes contribute to the increased risk of infection in older adults. Nursing assessments should be tailored to the needs of the older patient. To improve health care outcomes in this population, nursing care of the critically ill older adult with infection should include comprehensive assessment, surveillance for risks, and strategies aimed to aggressively treat infection...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28152684/the-kaiser-permanente-breast-cancer-survivorship-national-clinical-algorithm-regional-variation-in-implementation-processes-strategies-within-an-integrated-health-care-system
#19
Erin Elizabeth Hahn, Joanne E Schottinger, Susan E Kutner, Mark B Littlewood
104 Background: Kaiser Permanente (KP) is an integrated healthcare system providing comprehensive services to over 10 million members. The KP Interregional Breast Care Leaders, a multidisciplinary clinician group, developed a comprehensive evidence/consensus-based algorithm for breast cancer survivors, the KP Breast Cancer Survivorship National Clinical Algorithm (BCSNCA). The BCSNCA is intended to reduce variation in medical and psychosocial surveillance and improve outcomes by providing guidance to locally implemented survivorship programs, ie, recommendations for surveillance, late effects management, and risk reduction...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28151799/survival-healthcare-utilization-and-end-of-life-care-among-older-adults-with-malignancy-associated-bowel-obstruction-comparative-study-of-surgery-venting-gastrostomy-or-medical-management
#20
Elizabeth J Lilley, John W Scott, Joel E Goldberg, Christy E Cauley, Jennifer S Temel, Andrew S Epstein, Stuart R Lipsitz, Brittany L Smalls, Adil H Haider, Angela M Bader, Joel S Weissman, Zara Cooper
OBJECTIVE: To compare survival, readmissions, and end-of-life care after palliative procedures compared with medical management for malignancy-associated bowel obstruction (MBO). BACKGROUND: MBO is a late complication of intra-abdominal malignancy for which surgeons are frequently consulted. Decisions about palliative treatments, which include medical management, surgery, or venting gastrostomy tube (VGT), are hampered by the paucity of outcomes data relevant to patients approaching the end of life...
February 1, 2017: Annals of Surgery
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