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https://www.readbyqxmd.com/read/28064542/antibiotic-treatment-patterns-costs-and-resource-utilization-among-patients-with-community-acquired-pneumonia-a-us-cohort-study
#1
Christopher J Llop, Edward Tuttle, Glenn S Tillotson, Kerry LaPlante, Thomas M File
OBJECTIVES: The current treatment options for patients with community-acquired pneumonia (CAP) often present a trade-off between the potential for treatment failure and safety concerns. We set out to investigate real-world outcomes associated with the use of currently available antimicrobial treatment options for CAP in both the outpatient and inpatient (non-intensive care unit [ICU]) settings. METHODS: This claims-based retrospective study included adult patients diagnosed with CAP and treated with antibiotic therapies, including any oral fluoroquinolone, macrolide, or beta-lactam monotherapy in the outpatient setting, and intravenous (IV) levofloxacin or IV azithromycin/ceftriaxone in the inpatient setting...
January 18, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28054290/treatment-of-hyponatremia-in-patients-with-acute-neurological-injury
#2
Theresa Human, Aaron M Cook, Brian Anger, Kathleen Bledsoe, Amber Castle, David Deen, Haley Gibbs, Christine Lesch, Norah Liang, Karen McAllen, Christopher Morrison, Dennis Parker, A Shaun Rowe, Denise Rhoney, Kiranpal Sangha, Elena Santayana, Scott Taylor, Eljim Tesoro, Gretchen Brophy
BACKGROUND: Little data exist regarding the practice of sodium management in acute neurologically injured patients. This study describes the practice variations, thresholds for treatment, and effectiveness of treatment in this population. METHODS: This retrospective, multicenter, observational study identified 400 ICU patients, from 17 centers, admitted for ≥48 h with subarachnoid hemorrhage (SAH), traumatic brain injury (TBI), intraparenchymal hemorrhage, or intracranial tumors between January 1, 2011 and July 31, 2012...
January 4, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28000150/atrial-fibrillation-following-aortic-valve-replacement-impact-of-perioperative-use-of-intravenous-%C3%AE-blocker
#3
Junki Yokota, Hiroyuki Nishi, Naosumi Sekiya, Mitsutomo Yamada, Toshiki Takahashi
OBJECTIVES: Despite recent advances in perioperative management, postoperative atrial fibrillation/flutter (POAF) remains the most common complication after cardiac surgery. Therefore, it is important to determine related risk factors to establish effective management. However, most studies have focused on patients undergoing coronary artery bypass grafting and little is known about POAF in those who receive aortic valve replacement (AVR). We investigated the relationship of clinical predictors with POAF in patients undergoing AVR...
December 20, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27999970/oral-30-glucose-provides-sufficient-sedation-in-newborns-during-mri
#4
H Evren Eker, Oya Yalcin Cok, Bilin Çetinkaya, Anis Aribogan
PURPOSE: Newborns are often sedated during MRI but sedation itself creates adverse events and management is more challenging in this environment. Oral glucose/sucrose administration has been studied in newborns during painful procedures; however, its effectiveness in keeping newborns sleepy and motionlessness during painless procedures has not been demonstrated. The objective of this study was to describe effectiveness of oral 30% glucose administration by comparing with intravenous midazolam sedation for newborns during MRI...
December 20, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27983872/recovery-of-dysphagia-symptoms-after-oral-endotracheal-intubation-in-ards-survivors-a-5-year-longitudinal-study
#5
Martin B Brodsky, Minxuan Huang, Carl Shanholtz, Pedro A Mendez-Tellez, Jeffrey B Palmer, Elizabeth Colantuoni, Dale M Needham
RATIONALE: Nearly 60% of patients who are intubated in intensive care units (ICUs) experience dysphagia after extubation, and approximately 50% of them aspirate. Little is known about dysphagia recovery time after patients are discharged from the hospital. OBJECTIVE: To determine factors associated with recovery from dysphagia symptoms after hospital discharge for acute respiratory distress syndrome (ARDS) survivors who received oral intubation with mechanical ventilation...
December 16, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27942054/effect-of-melatonin-on-duration-of-delirium-in-organophosphorus-compound-poisoning-patients-a-double-blind-randomised-placebo-controlled-trial
#6
H N Vijayakumar, K Ramya, Devika Rani Duggappa, Km Veeranna Gowda, K Sudheesh, S S Nethra, R S Raghavendra Rao
BACKGROUND AND AIMS: Organophosphate compound poisoning (OPCP) is associated with high incidence of delirium. Melatonin has been tried in the treatment of delirium and has shown a beneficial effect in OPCP. This study was conducted to know the effect of melatonin on duration of delirium and recovery profile in OPCP patients. METHODS: Double-blind randomised placebo control trial in which 56 patients of OPCP confirmed by history and syndrome of OPCP with low plasma pseudocholinesterase, aged >18 years and weighing between 50 and 100 kg, and Acute Physiology and Chronic Health Evaluation II score of <20 were studied...
November 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27928779/how-antibiotics-should-be-prescribed-to-hospitalized-elderly-patients-with-community-acquired-pneumonia
#7
Forest W Arnold
Elderly patients hospitalized with community-acquired pneumonia (CAP) should be administered antimicrobials in the emergency department prior to transfer to the ward or intensive care unit (ICU). For ward patients, a β-lactam with a macrolide or a respiratory fluoroquinolone alone should be given to cover typical and atypical pathogens. For ICU patients, a β-lactam with either a macrolide or a fluoroquinolone should be given. Other regimens are indicated if methicillin-resistant Staphylococcus aureus or Pseudomonas aeruginosa is a concern...
December 7, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27904627/antimicrobial-effects-of-chlorhexidine-matrica-drop-mouthwash-chamomile-extract-and-normal-saline-on-hospitalized-patients-with-endotracheal-tubes
#8
Maryam Azimi, Leila Jouybari, Shahram Moghadam, Ezatolah Ghaemi, Naser Behnampoor, Akram Sanagoo, Moslem Hesam
BACKGROUND: The functions and use of mouthwashes are variable depending on their type. Oral care in patients with endotracheal tubes is important to prevent side effects such as pneumonia. The aim of this study was to determine the antimicrobial effects of chlorhexidine, drop of Matrica mouthwash (chamomile extract), and normal saline on hospitalized patients with endotracheal tube in an intensive care unit (ICU). MATERIALS AND METHODS: In this clinical trial, 39 patients admitted to the ICU were selected by convenience sampling, were matched based on age and sex, and randomly assigned to three groups (chlorhexidine, Matrica, saline)...
September 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/27904542/the-effect-of-brushing-with-a-soft-toothbrush-and-distilled-water-on-the-incidence-of-ventilator-associated-pneumonia-in-the-intensive-care-unit
#9
Khadijeh Nasiriani, Fakhri Torki, Mohammad Hossein Jarahzadeh, Fahimeh Rashidi Maybodi
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common nosocomial infection, which results in longer hospitalization, increased treatment costs, and higher mortality rates. One major cause of VAP is colonization and microaspiration of oropharyngeal secretions following the formation of dental plaque, which is due to poor oral hygiene and failure to mechanically remove these microorganisms from the teeth. This study was conducted to determine the effect of brushing teeth with distilled water on the incidence of VAP in patients admitted to intensive care unit (ICU)...
2016: Tanaffos
https://www.readbyqxmd.com/read/27902412/staff-education-aimed-at-reducing-ventilator-associated-pneumonia
#10
Gurdal Yilmaz, Hava Aydin, Mustafa Aydin, Sedat Saylan, Hulya Ulusoy, Iftihar Koksal
Mechanical ventilation is a life-saving invasive procedure performed in intensive care units (ICUs) where critical patients are given advanced support. The purpose of this study was to assess the effect of personnel training on the incidence of ventilator-associated pneumonia (VAP). The study, performed prospectively in the ICU, was planned in two periods. In both periods, patient characteristics were recorded on patient data forms. In the second period, ICU physicians and assistant health personnel were given regular theoretical and practical training...
December 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27817758/a-comprehensive-study-of-costs-associated-with-recurrent-clostridium-difficile-infection
#11
Rodrigo Rodrigues, Grant E Barber, Ashwin N Ananthakrishnan
BACKGROUND Clostridium difficile infection (CDI) is the most common healthcare-associated infection and is associated with considerable morbidity. Recurrent CDI is a key contributing factor to this morbidity. Despite an estimated 83,000 recurrences annually in the United States, there are few accurate estimates of costs associated with recurrent CDI. OBJECTIVE We performed this study (1) to identify the health consequences of recurrent CDI including need for repeat hospitalization, intensive care unit (ICU) stay, and surgery; (2) to determine costs associated with recurrent CDI and identify determinants of such costs; and (3) to compare the outcomes and costs of recurrent CDI to those who develop reinfection...
February 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27806938/meta-analysis-of-ascorbic-acid-for-prevention-of-postoperative-atrial-fibrillation-after-cardiac-surgery
#12
William L Baker, Craig I Coleman
PURPOSE: Results of a systematic review and meta-analysis of published data on use of ascorbic acid to prevent postoperative atrial fibrillation (POAF) after cardiac surgery are presented. METHODS: MEDLINE and other sources were searched for reports on trials evaluating the effects of preoperative and/or postoperative use of ascorbic acid in patients undergoing cardiac surgery. For each study selected for meta-analysis, an assessment for risks of methodological bias was performed...
December 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27794150/periodontal-and-microbiological-profile-of-intensive-care-unit-inpatients
#13
Alessandra N Porto, Alvaro H Borges, Grace Rocatto, Fernanda Z Matos, Alexandre M Borba, F L Miranda Pedro, Suellen L Lima, Mateus R Tonetto, Matheus C Bandéca, A M Fabio Aranha
INTRODUCTION: The bidirectional relationship between the periodontal diseases and systemic diseases was attributed to the focal infection concept. The aims of this study were to assess the periodontal and microbiological profile of intensive care unit (ICU) inpatients submitted to orotracheal intubation, and classify them regarding gender, age group, ethnic, hospitalization reason and period, nosocomial infection occurrence, and death. MATERIALS AND METHODS: Inpatients were assessed, distributed into toothed and toothless groups...
October 1, 2016: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/27789776/chemotherapy-near-the-end-of-life-for-chinese-patients-with-solid-malignancies
#14
Jin Sheng, Ya-Xiong Zhang, Xiao-Bo He, Wen-Feng Fang, Yun-Peng Yang, Gui-Nan Lin, Xuan Wu, Ning Li, Jing Zhang, Lin-Zhu Zhai, Yuan-Yuan Zhao, Yan Huang, Ning-Ning Zhou, Hong-Yun Zhao, Li Zhang
INTRODUCTION: There are increasing concerns about the negative impacts of chemotherapy near the end of life (EOL). There is discrepancy among different countries about its use, and little is known about the real-world situation in China. PATIENTS AND METHODS: This retrospective study was conducted at six representative hospitals across China. Adult decedents with a record of advanced solid cancer and palliative chemotherapy were consecutively screened from 2010 through 2014...
October 27, 2016: Oncologist
https://www.readbyqxmd.com/read/27778318/oral-hygiene-care-for-critically-ill-patients-to-prevent-ventilator-associated-pneumonia
#15
REVIEW
Fang Hua, Huixu Xie, Helen V Worthington, Susan Furness, Qi Zhang, Chunjie Li
BACKGROUND: Ventilator-associated pneumonia (VAP) is defined as pneumonia developing in people who have received mechanical ventilation for at least 48 hours. VAP is a potentially serious complication in these patients who are already critically ill. Oral hygiene care (OHC), using either a mouthrinse, gel, toothbrush, or combination, together with aspiration of secretions, may reduce the risk of VAP in these patients. OBJECTIVES: To assess the effects of oral hygiene care on incidence of ventilator-associated pneumonia in critically ill patients receiving mechanical ventilation in hospital intensive care units (ICUs)...
October 25, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27738795/the-role-of-palliative-care-in-the-last-month-of-life-in-elderly-cancer-patients
#16
Tarek Assi, Elie El Rassy, Tony Ibrahim, Tania Moussa, Aline Tohme, Fadi El Karak, Fadi Farhat, Salma Faddoul, Marwan Ghosn, Joseph Kattan
INTRODUCTION: One major health care issue encountered in elderly cancer patients is the alteration of the quality of life. The purpose of our study is to evaluate the administration of chemotherapy in the last month of life (CLML) and to evaluate the impact of the palliative care consult (PCC) in the elderly patients. METHODS: We conducted a retrospective observational study that included elderly patients diagnosed with an end-stage cancer and who were deceased between the 1st of January 2012 and the 31st of December 2015...
February 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27733188/nurse-performed-screening-for-postextubation-dysphagia-a-retrospective-cohort-study-in-critically-ill-medical-patients
#17
Kay Choong See, Si Yu Peng, Jason Phua, Chew Lai Sum, Johncy Concepcion
BACKGROUND: Swallowing difficulties are common, and dysphagia occurs frequently in intensive care unit (ICU) patients after extubation. Yet, no guidelines on postextubation swallowing assessment exist. We aimed to investigate the safety and effectiveness of nurse-performed screening (NPS) for postextubation dysphagia in the medical ICU. METHODS: We conducted a retrospective cohort study of mechanically ventilated patients who were extubated in a 20-bed medical ICU...
October 12, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27716696/early-enteral-nutrition-therapy-in-congenital-cardiac-repair-postoperatively-a-randomized-controlled-pilot-study
#18
Manoj Kumar Sahu, Anuradha Singal, Ramesh Menon, Sarvesh Pal Singh, Alka Mohan, Mala Manral, Divya Singh, V Devagouru, Sachin Talwar, Shiv Kumar Choudhary
BACKGROUND AND OBJECTIVES: Adequate nutritional supplementation in infants with cardiac malformations after surgical repair is a challenge. Critically ill infants in the early postoperative period are in a catabolic stress. The mismatch between estimated energy requirement (EER) and the intake in the postoperative period is multifactorial, predisposing them to complications such as immune deficiency, more infection, and growth failure. This study aimed to assess the feasibility and efficacy of enriched breast milk feed on postoperative recovery and growth of infants after open heart surgery...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27665031/impact-and-feasibility-of-an-emergency-department-based-ventilator-associated-pneumonia-bundle-for-patients-intubated-in-an-academic-emergency-department
#19
Lawrence A DeLuca, Paul Walsh, Donald D Davidson, Lisa R Stoneking, Laurel M Yang, Kristi J H Grall, M Jessica Gonzaga, Wanda J Larson, Uwe Stolz, Dylan M Sabb, Kurt R Denninghoff
BACKGROUND: Ventilator-associated pneumonia (VAP) has been linked to emergency department (ED) intubation and length of stay (LOS). We assessed VAP prevalence in ED intubated patients, feasibility of ED VAP prevention, and effect on VAP rates. METHODS: This was a quality improvement initiative using a pre/post design. Phase 1 (PRE1) comprised patients before intensive care unit (ICU) bundle deployment. Phase 2 (PRE2) occurred after ICU but before ED deployment. Phase 3 (POST) included patients received VAP prevention starting at ED intubation...
September 21, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27637833/nutritionday-icu-a-7-year-worldwide-prevalence-study-of-nutrition-practice-in-intensive-care
#20
Itai Bendavid, Pierre Singer, Miriam Theilla, Michael Themessl-Huber, Isabella Sulz, Mohamed Mouhieddine, Christian Schuh, Bruno Mora, Michael Hiesmayr
INTRODUCTION: To determine the nutrition practice in intensive care units and the associated outcome across the world, a yearly 1 day cross sectional audit was performed from 2007 to 2013. The data of this initiative called "nutritionDay ICU" were analyzed. MATERIAL AND METHODS: A questionnaire translated in 17 languages was used to determine the unit's characteristics, patient's condition, nutrition condition and therapy as well as outcome. All the patients present in the morning of the 1 day prevalence study were included from 2007 to 2013...
August 9, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
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