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Sepsis care

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https://www.readbyqxmd.com/read/28650938/outbreak-caused-by-escherichia-coli-o18-k1-h7-sequence-type-95-in-a-neonatal-intensive-care-unit-in-barcelona-spain
#1
Emma Sáez-López, Jordi Bosch, Maria Dolors Salvia, Dietmar Fernández-Orth, Virginio Cepas, Mario Ferrer-Navarro, Josep Figueras-Aloy, Jordi Vila, Sara M Soto
BACKGROUND: Escherichia coli is one of the most frequent causes of late-onset neonatal sepsis. The aim of this study was to characterize an outbreak of neonatal sepsis occurring in the neonatal intensive care unit (NICU) of the Hospital Clinic of Barcelona from April to August 2013. METHODS: After presentation of the index case, all E. coli isolates from previously hospitalized neonates, health care workers, and neonates admitted to the NICU from April to October 2013 were tested for K1 antigen positivity and epidemiologically compared by pulse-field gel electrophoresis...
June 23, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28650528/urinary-diversions-in-low-resource-settings
#2
Jeffrey P Wilkinson
Obstetric fistula is a devastating consequence of poorly attended childbirth which occurs almost exclusively in low resource settings. Most women with fistula can be cured or significantly improved by one or more vaginal surgeries. The last resort for women with otherwise incurable obstetric fistula is urinary diversion. The ileal conduit urinary diversion was the procedure considered by the authors of the accompanying article (Walker et al BJOG). Under optimal conditions, any urinary diversion is fraught with numerous potential risks...
June 26, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28648651/the-impact-of-functional-status-on-the-outcomes-of-endovascular-lower-extremity-revascularization-for-critical-limb-ischemia-in-the-elderly
#3
Isidore Dinga Madou, Martin D Slade, Kristine C Orion, Timur Sarac, Cassius Iyad Ochoa Chaar
INTRODUCTION: Functional status is an important predictor of outcomes after infrainguinal bypass surgery. There is little data on the effect of functional status on the outcomes of endovascular LE interventions, especially in the elderly frail population. METHODS: This is a retrospective analysis of the American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) files for the years 2011-2013 to assess the impact of functional status on outcome after endovascular intervention for critical limb ischemia...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647272/outcomes-of-preterm-infants-following-discussions-about-withdrawal-or-withholding-of-life-support
#4
Jennifer James, David Munson, Sara B DeMauro, John C Langer, April R Dworetz, Girija Natarajan, Margarita Bidegain, Christine A Fortney, Ruth Seabrook, Betty R Vohr, Jon E Tyson, Edward F Bell, Brenda B Poindexter, Seetha Shankaran, Rosemary D Higgins, Abhik Das, Barbara J Stoll, Haresh Kirpalani
OBJECTIVES: To describe the frequency of postnatal discussions about withdrawal or withholding of life-sustaining therapy (WWLST), ensuing WWLST, and outcomes of infants surviving such discussions. We hypothesized that such survivors have poor outcomes. STUDY DESIGN: This retrospective review included registry data from 18 centers of the National Institute of Child Health and Human Development Neonatal Research Network. Infants born at 22-28 weeks of gestation who survived >12 hours during 2011-2013 were included...
June 21, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28645546/post-sepsis-cognitive-impairment-and-associated-risk-factors-a-systematic-review
#5
REVIEW
Allan J C Calsavara, Vandack Nobre, Tatiana Barichello, Antonio L Teixeira
INTRODUCTION: Post-sepsis cognitive impairment is one of the major sequelae observed in survivors of sepsis. This cognitive impairment can be global or may affect specific domains. A better understanding of these deficits and associated risk factors could influence the care of patients with sepsis. OBJECTIVE: To perform a systematic review to investigate the presence of cognitive impairment and its associated risk factors among patients who survived sepsis. METHODS: The search was conducted in MEDLINE (1966 to March 2017) and EMBASE (1988 to March 2017)...
June 20, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28643487/proenkephalin-neutrophil-gelatinase-associated-lipocalin-and-estimated-glomerular-filtration-rates-in-patients-with-sepsis
#6
Hanah Kim, Mina Hur, Seungho Lee, Rossella Marino, Laura Magrini, Patrizia Cardelli, Joachim Struck, Andreas Bergmann, Oliver Hartmann, Salvatore Di Somma
BACKGROUND: Proenkephalin (PENK) has been suggested as a novel biomarker for kidney function. We investigated the diagnostic and prognostic utility of plasma PENK in comparison with neutrophil gelatinase-associated lipocalin (NGAL) and estimated glomerular filtration rates (eGFR) in septic patients. METHODS: A total of 167 septic patients were enrolled: 99 with sepsis, 37 with septic shock, and 31 with suspected sepsis. PENK and NGAL concentrations were measured and GFR was estimated by using the isotope dilution mass spectrometry traceable-Modification of Diet in Renal Disease (MDRD) Study and three Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations: CKD-EPI(Cr), CDK-EPI(CysC), and CKD-EPI(Cr-CysC)...
September 2017: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/28642139/clinical-characteristics-and-epidemiology-of-sepsis-in-the-neonatal-intensive-care-unit-in-the-era-of-multi-drug-resistant-organisms-a-retrospective-review
#7
Dawood Yusef, Tala Shalakhti, Samah Awad, Hana'a Algharaibeh, Wasim Khasawneh
BACKGROUND: Sepsis in the neonatal intensive care unit (NICU) remains one of the most significant causes of morbidity and mortality, especially for preterm newborns. Multi-drug resistant organisms (MDROs) are emerging as important pathogens that cause neonatal sepsis in NICU. Therefore, studying the epidemiology, clinical features, and outcome caused by MDROs vs. non-MDROs, and identifying risk factors that may predispose patients to sepsis by MDROs are important. METHODS: Episodes of blood culture-proven sepsis (age: 0-90 days) in the NICU at our institution from January 2012 to December 2015 were retrospectively reviewed...
June 9, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28641717/soluble-cd14-subtype-a-new-biomarker-in-predicting-the-outcome-of-critically-ill-septic-patients
#8
Giovanni Matera, Angela Quirino, Cinzia Peronace, Pio Settembre, Vito Marano, Maria T Loria, Nadia Marascio, Luisa Galati, Giorgio S Barreca, Aida Giancotti, Bruno Amantea, Maria C Liberto, Alfredo Focà
BACKGROUND: We evaluated the role of presepsin (soluble CD14 subtype, sCD14-ST) in predicting the outcome of critically ill septic patients in parallel with procalcitonin and C-reactive protein. METHODS: This study was an observational, prospective study that enrolled 58 surgical and medical intensive care unit patients with suspected sepsis. All studied subjects were retrospectively stratified into survivors and nonsurvivors based on 28 days survival and according to microbiological results in blood culture positive and negative groups...
June 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28640135/hospitalization-with-hypoglycemia-in-patients-without-diabetes-mellitus-a-retrospective-study-using-a-national-inpatient-database-in-japan-2008-2012
#9
Akahito Sako, Hideo Yasunaga, Hiroki Matsui, Kiyohide Fushimi, Hidetaka Hamasaki, Hisayuki Katsuyama, Tetsuro Tsujimoto, Atsushi Goto, Hidekatsu Yanai
We aimed to examine prevalence, patient characteristics, etiology, and clinical outcomes of hospitalized patients who had hypoglycemia without a diagnosis of diabetes mellitus, using a Japanese nationwide database.This was a retrospective observational study using a national database of acute-care inpatients in Japan. Nondiabetic patients aged ≥15 years who were hospitalized for hypoglycemia were eligible. We estimated the annual numbers of hospitalized cases in Japan. We also investigated the patient characteristics, and risk factors of in-hospital mortality...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28637738/the-reanimation-low-immune-status-markers-realism-project-a-protocol-for-broad-characterisation-and-follow-up-of-injury-induced-immunosuppression-in-intensive-care-unit-icu-critically-ill-patients
#10
Mary-Luz Rol, Fabienne Venet, Thomas Rimmele, Virginie Moucadel, Pierre Cortez, Laurence Quemeneur, David Gardiner, Andrew Griffiths, Alexandre Pachot, Julien Textoris, Guillaume Monneret
INTRODUCTION: The host response to septic shock is dynamic and complex. A sepsis-induced immunosuppression phase has recently been acknowledged and linked to bad outcomes and increased healthcare costs. Moreover, a marked suppression of the immune response has also been partially described in patients hospitalized in intensive care unit (ICU) for severe trauma or burns. It has been hypothesized that immune monitoring could enable identification of patients who might most benefit from novel, adjunctive immune-stimulating therapies...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28635463/an-overview-of-the-evidence-based-practice-process-for-novice-researchers
#11
Emma Rowles, Amanda McNaughton
This article explores how nurses can use evidence-based practice to critique and evaluate the rationale and evidence for specific nursing procedures or practices. Through the development of a focused research question and search strategy, nurses can select and critique relevant research articles to answer the research question, which can support the provision of optimal practice and high-quality care. This article demonstrates the process of evidence-based practice, with the aim of increasing novice researchers' confidence in applying this process in practice...
June 21, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28635374/sepsis-favors-high-on-clopidogrel-platelet-reactivity
#12
Karolina Akinosoglou, Angelos Perperis, Spyridoula Theodoraki, Dimitrios Alexopoulos, Charalambos Gogos
High-on-treatment platelet reactivity (HPR) is associated with ischemic events in patients on antiplatelet therapy with a history of cardiovascular disease. On the other hand, recent data have associated sepsis with adverse cardiovascular events in patients admitted with bacteremia or respiratory infection. We aimed to assess P2Y12-mediated platelet reactivity (PR) during sepsis and recovery in patients under clopidogrel. This was a prospective observational study. Incoming patients presenting with signs/symptoms of sepsis already on a maintenance dose of clopidogrel of 75 mg qd for cardiovascular events were included in this study...
June 21, 2017: Platelets
https://www.readbyqxmd.com/read/28633658/nucleated-red-blood-cells-critical-illness-survivors-and-postdischarge-outcomes-a-cohort-study
#13
Steven W Purtle, Clare M Horkan, Takuhiro Moromizato, Fiona K Gibbons, Kenneth B Christopher
BACKGROUND: Little is known about risk factors associated with out-of-hospital outcomes in survivors of critical illness. We hypothesized that the presence of nucleated red blood cells in patients who survived critical care would be associated with adverse outcomes following hospital discharge. METHODS: We performed a two-center observational cohort study of patients treated in medical and surgical intensive care units in Boston, Massachusetts. All data were obtained from the Research Patient Data Registry at Partners HealthCare...
June 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28633556/oxidative-stress-and-dna-damage-in-newborns-born-to-mothers-with-hyperglycemia-%C3%A2-a-prospective-cohort-study
#14
K Dulasi Durga, B Adhisivam, G Vidya, B Vishnu Bhat, Bobby Zachariahc, Chand Parkashd
BACKGROUND: Hyperglycemic mothers have increased oxidative stress during pregnancy which can adversely affect the outcome in their neonates Objectives: To measure the oxidative stress and DNA damage in newborns born to mothers with hyperglycemia and correlate their immediate outcome with the amount of oxidative stress and DNA damage. METHODS: This prospective cohort study conducted in a tertiary care teaching hospital, south India included 3 groups - newborns born to pregestational diabetic mothers (PGDM), gestational diabetic mothers (GDM) and euglycemic mothers with 24 newborns in each...
June 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28632822/-strategies-to-reduce-infections-and-antibiotic-use-and-its-effects-in-a-neonatal-care-unit
#15
Soledad Urzúa, Marcela Ferrés, Patricia García, Amparo Sánchez, Matías Luco
INTRODUCTION: Late onset sepsis (LOS) remains an important cause of morbidity and mortality in neonatal intensive care units (NICU). The empirical use of vancomycin and other broad spectrum antibiotics is very frequent and is associated with the emergence of resistant agents, infection by gram-negative bacilli (GNB), fungal infections and increased morbidity and mortality. OBJECTIVE: To evaluate the impact of 5 intervention protocols designed to reduce infections and promote the rational use of antibiotics (AB) in a single NICU...
April 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28632072/maternal-obesity-obstetric-interventions-and-post-partum-anaemia-increase-the-risk-of-post-partum-sepsis-a-population-based-cohort-study-based-on-swedish-medical-health-registers
#16
Daniel Axelsson, Marie Blomberg
BACKGROUND: The objective was to estimate whether maternal obesity and/or obstetric interventions are associated with diagnosed maternal post-partum sepsis. METHODS: A retrospective observational cohort study including all deliveries in Sweden between 1997 and 2012 (N = 1,558,752). Cases of sepsis (n = 376) were identified by International Classification of Diseases, (ICD-10) codes A40, A41 and O 85 in the Medical Birth Register and the National Patient Register...
June 20, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28631494/a-study-on-preterm-births-during-2013-2015-shiraz-iran
#17
Elham Jaberi, Mirkazemi Roksana
Preterm birth is the leading cause of neonatal and infant mortality and a substantial portion of neonatal morbidities. The perinatal mortality and morbidity statistics in developing countries are inadequate. In this study, we assessed prevalence and health outcomes of preterm deliveries in tertiary care university hospitals. A retrospective study of hospital records of premature babies born in all the five governmental tertiary care settings during the time interval of 2013-2015 in Shiraz was conducted. Result of this study showed that there was an overall 127...
June 20, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28631201/seven-esophageal-perforation-cases-after-aortic-replacement-stenting-for-thoracic-aortic-dissection-or-aneurysm
#18
Yoshihisa Yaguchi, Yoshimasa Kumata, Masahiro Horikawa, Takashi Kiyokawa, Tsuyoshi Inaba, Ryoji Fukushima
BACKGROUND: Esophageal perforation after aortic replacement/stenting for aortic dissection or aneurysm is a rare but severe complication. However, its cause, standard treatment, and prognosis are unclear. We analyzed the treatment and outcome retrospectively from seven cases experienced at our hospital. CASE PRESENTATION: The median age of the patients was 70 years (range, 41-86), and six of the seven cases were male. As the first treatment, aortic replacement techniques were performed in five, and thoracic endovascular aortic repair (TEVAR) procedure was performed in two...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28630844/multifocal-septic-arthritis-secondary-to-infective-endocarditis-a-rare-case-report
#19
Pavandeep Soor, Nikhil Sharma, Chandra Rao
INTRODUCTION: Infective endocarditis (IE) is a rare cause of septic arthritis. We report a patient who presented with multifocal septic arthritis as a result of IE, which is an extremely rare condition. CASE REPORT: This 69-year-old gentleman presented to the emergency department (ED) with a 3-day history of acute right knee pain. Initial investigations demonstrated chondrocalcinosis on knee radiographs, acute renal failure with rhabdomyolysis and a CRP of 520. After treatment with intravenous fluid rehydration and analgesia, the knee aspiration grew a Group B Streptococcus, and the patient underwent arthroscopic washout...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630687/emerging-antimicrobial-resistance-in-early-and-late-onset-neonatal-sepsis
#20
Lamiaa Mohsen, Nermin Ramy, Dalia Saied, Dina Akmal, Niveen Salama, Mona M Abdel Haleim, Hany Aly
BACKGROUND: Compared to developed countries, the use of antimicrobials in Egypt is less regulated and is available over the counter without the need for prescriptions. The impact of such policy on antimicrobial resistance has not been studied. This study aimed to determine the prevalence of early and late onset sepsis, and the frequency of antimicrobial resistance in a major referral neonatal intensive care unit (NICU). METHODS: The study included all neonates admitted to the NICU over a 12-month period...
2017: Antimicrobial Resistance and Infection Control
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