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https://www.readbyqxmd.com/read/28527874/pressor-support-during-a-jarisch-herxheimer-reaction-after-initiation-of-treatment-for-weil-s-disease
#1
Randi Connor-Schuler, Anee Khan, Nikhil Goyal, Erin Zimny
We present a case of Weil's disease complicated by a Jarisch-Herxheimer reaction (JHR) after initiation of antibiotics while in the emergency department requiring invasive monitoring and vasopressor support. The case is followed by a brief review of the JHR which is rarely observed with treatment of leptospirosis. A healthy 28-year-old female who recently returned from the Caribbean presented to the emergency department with flu-like symptoms. The patient appeared jaundiced with conjunctival suffusion and was ultimately treated with the appropriate antibiotics for leptospirosis in the ED...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28527528/awareness-knowledge-and-interest-in-interventional-radiology-among-final-year-medical-students-in-england
#2
P A Atiiga, M Drozd, R Veettil
AIM: To investigate awareness, knowledge, and interests in interventional radiology (IR) among final year students. MATERIALS AND METHODS: Three hundred and fifty-nine anonymous questionnaires were distributed to final year medical students at two medical institutions in England. A total of 220 students (61%) responded. RESULTS: In the present study, 167 students (75.9%) correctly identified that interventional radiologists perform angioplasty and stenting of arteries...
May 17, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28526171/chlorhexidine-gluconate-or-polyhexamethylene-biguanide-disc-dressing-to-reduce-the-incidence-of-central-line-associated-bloodstream-infection-a-feasibility-randomized-controlled-trial-the-clabsi-trial
#3
J Webster, E Larsen, N Marsh, A Choudhury, P Harris, C M Rickard
BACKGROUND: A number of antimicrobial-impregnated discs to prevent central-line-associated bloodstream infection (CLABSI) are marketed but it is unclear which disc is most effective. AIM: To investigate the feasibility and safety of comparing two antimicrobial-impregnated discs to prevent CLABSI. METHODS: A single-centre, parallel group, randomized controlled trial was conducted in a 929-bed tertiary referral hospital. Hospital inpatients requiring a peripherally inserted central catheter were randomized to chlorhexidine gluconate (CHG) or polyhexamethylene biguanide (PHMB) disc dressing group...
April 16, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28505056/relationship-between-psychological-safety-and-reporting-nonadherence-to-a-safety-checklist
#4
Heather M Gilmartin, Paula Langner, Madhura Gokhale, Katerine Osatuke, Rachael Hasselbeck, Thomas M Maddox, Catherine Battaglia
Patient safety checklists are ubiquitous in health care. Nurses bear significant responsibility for ensuring checklist adherence. To report nonadherence to a checklist and stop an unsafe procedure, a workplace climate of psychological safety is needed. Thus, an analysis of organizational data was conducted to examine the relationship between psychological safety and reports of nonadherence to the central line bundle checklist. Results showed varied perceptions of psychological safety but no relationship with nonadherence...
May 12, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28501899/is-there-a-july-effect-in-pediatric-neurosurgery
#5
Yimo Lin, Rory R Mayer, Terence Verla, Jeffrey S Raskin, Sandi Lam
PURPOSE: The belief that July, when resident physicians' training year begins, may be associated with increased risk of patient morbidity and mortality is known as the "July effect." This study aimed to compare complication rates after pediatric neurosurgical procedures in the first versus last academic quarters in two national datasets. METHODS: Data were extracted from the National Surgical Quality Improvement Program-Pediatrics (NSQIP-P) database for year 2012 for 30-day complication events and the Kids' Inpatient Database (KID) for year 2012 for in-hospital complication events after pediatric neurosurgical procedures...
May 13, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28501098/alterations-in-intestinal-microbiota-relate-to-intestinal-failure-associated-liver-disease-and-central-line-infections
#6
Panliang Wang, Ying Wang, Lina Lu, Weihui Yan, Yijing Tao, Kejun Zhou, Jie Jia, Wei Cai
BACKGROUND: The gut microbiota plays a vital role in modulating the metabolic and immune functions of the intestines. We aimed to analyze the dysbiosis of microbiota in infants with short bowel syndrome (SBS) with different complications. PROCEDURE: We included 26 fecal samples from 18 infants with SBS during parenteral nutrition. The samples were categorized into three groups: asymptomatic, parenteral nutrition-associated liver disease (PNALD), and central line-associated bloodstream infection (CLABSI)...
May 3, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28492861/vena-cava-filter-use-in-trauma-and-rates-of-pulmonary-embolism-2003-2015
#7
Alan D Cook, Brian W Gross, Turner M Osler, Katelyn J Rittenhouse, Eric H Bradburn, Steven R Shackford, Frederick B Rogers
Importance: Vena cava filter (VCF) placement for pulmonary embolism (PE) prophylaxis in trauma is controversial. Limited research exists detailing trends in VCF use and occurrence of PE over time. Objective: To analyze state and nationwide temporal trends in VCF placement and PE occurrence from 2003 to 2015 using available data sets. Design, Setting, and Participants: A retrospective trauma cohort study was conducted using data from the Pennsylvania Trauma Outcome Study (PTOS) (461 974 patients from 2003 to 2015), the National Trauma Data Bank (NTDB) (5 755 095 patients from 2003 to 2014), and the National (Nationwide) Inpatient Sample (NIS) (24 449 476 patients from 2003 to 2013) databases...
May 10, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28488105/single-incision-versus-conventional-technique-for-tunneled-central-line-placement-in-children
#8
Daniel Ashton, Darshan Variyam, J Alberto Hernandez, Sheena Pimpalwar, Shireen Hayatghaibi, Kamlesh Kukreja
PURPOSE: A single-incision technique for tunneled central venous access has been described. This study evaluates whether single-incision technique in children is comparable to the conventional method, with regard to procedure time, fluoroscopy time, and complication rate. MATERIALS AND METHODS: This is a retrospective review of 303 internal jugular vein tunneled central catheter placements whose age ranged from newborn to 17 years (median 1.7 years) by pediatric interventional radiologists from January 2014 through December 2015...
May 9, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28482161/gamification-and-microlearning-for-engagement-with-quality-improvement-gameqi-a-bundled-digital-intervention-for-the-prevention-of-central-line-associated-bloodstream-infection
#9
Benjamin Orwoll, Shelley Diane, Duncan Henry, Lisa Tsang, Kristin Chu, Carrie Meer, Kevin Hartman, Arup Roy-Burman
Central line-associated bloodstream infections (CLABSIs) cause major patient harm, preventable through attention to line care best practice standards. The objective was to determine if a digital self-assessment application (CLABSI App), bundling line care best practices with social gamification and in-context microlearning, could engage nurses in CLABSI prevention. Nurses caring for children with indwelling central venous catheters in 3 high-risk units were eligible to participate. All other units served as controls...
May 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28475786/infection-prevention-practices-in-japan-thailand-and-the-united-states-results-from-national-surveys
#10
Sarah L Krein, M Todd Greene, Anucha Apisarnthanarak, Fumie Sakamoto, Yasuharu Tokuda, Tomoko Sakihama, Karen E Fowler, David Ratz, Sanjay Saint
Background: Numerous evidence-based practices for preventing device-associated infections are available, yet the extent to which these practices are regularly used in acute care hospitals across different countries has not been compared, to our knowledge. Methods: Data from hospital surveys conducted in Japan, the United States, and Thailand in 2012, 2013, and 2014, respectively, were evaluated to determine the use of recommended practices to prevent central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infection (CAUTI)...
May 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28471906/utility-of-ultrasound-guidance-for-central-venous-access-in-children
#11
Chen He, Rebecca Vieira, Jennifer R Marin
BACKGROUND: Placement of a central venous catheter (CVC) in a pediatric patient is an important skill for pediatric emergency medicine physicians but can be challenging and time consuming. Ultrasound (US) guidance has been shown to improve success of central line placement in adult patients. OBJECTIVES: This article aims to review the literature and evaluate the benefit of US guidance in the placement of CVCs, specifically in pediatric emergency department patients, and to review the procedure...
May 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28468901/0-2-chlorhexidine-acetate-as-skin-disinfectant-prevents-skin-lesions-in-extremely-preterm-infants-a-preliminary-report
#12
Lisanne M A Janssen, Alma Tostmann, Joost Hopman, Kian D Liem
OBJECTIVE: The skin disinfectant '0.5% chlorhexidine gluconate in 70% alcohol' (0.5% CHG-70% alc) may cause skin lesions in extremely preterm infants (gestational age <26 weeks). In April 2013, 0.2% chlorhexidine gluconate solution in acetate (0.2% CHG-acetate) was introduced as skin disinfectant for extremely preterm infants in our neonatal intensive care units. We aimed to compare the incidence of skin lesions and central line-associated bloodstream infection (CLABSI) among extremely preterm infants when using 0...
May 3, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28439517/incidence-and-risk-factors-for-organ-space-infection-after-radiofrequency-assisted-hepatectomy-or-ablation-of-liver-tumors-in-a-single-center-more-than-meets-the-eye
#13
Ioannis Karavokyros, Stamatios Orfanos, Anastasios Angelou, Antonia Meropouli, Dimitrios Schizas, John Griniatsos, Emmanouil Pikoulis
INTRODUCTION: Surgical site infections (SSIs) and especially organ/space infection (O/SI) after resection or ablation of liver tumors are associated with increased morbidity and mortality. A secondary blood stream infection (BSI) is considered an O/SI but the exact prevalence is unknown. We aimed to investigate the incidence of O/SI and BSIs in a cohort of consecutive patients after liver resection or ablation, to seek for a possible connection between them and to search for potential risk factors...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28434459/becoming-parent-and-nurse-high-fidelity-simulation-in-teaching-ambulatory-central-line-infection-prevention-to-parents-of-children-with-cancer
#14
Carol E Heiser Rosenberg, Mary F Terhaar, Judith A Ascenzi, Anna Walbert, K Michelle Kokoszka, Julianne S Perretta, Marlene R Miller
BACKGROUND: Ambulatory central-line infections in children with cancer are life-threatening. Infections are two to three times more frequent in outpatients than inpatients, for whom evidence-based bundles have decreased morbidity. Most cancer care now takes place at home, where parents perform many of the same tasks as nurses. However, parents often feel stressed and unprepared. To address this, high-fidelity simulation, which has been effective for teaching novice nurses, was evaluated for parent central-line education...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28431848/epidemiology-of-device-associated-infections-in-an-intensive-care-unit-of-a-teaching-hospital-in-nepal-a-prospective-surveillance-study-from-a-developing-country
#15
Narayan Prasad Parajuli, Subhash Prasad Acharya, Santosh Dahal, Jaya Prasad Singh, Shyam Kumar Mishra, Hari Prasad Kattel, Basista Prasad Rijal, Bharat Mani Pokhrel
BACKGROUND: Device-associated health care-acquired infections (DA-HAIs) in intensive care unit patients are a major cause of morbidity, mortality, and increased health care costs. METHODS: A prospective, structured clinicomicrobiological surveillance was carried out for 3 common DA-HAIs: ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) present in the patients of an intensive care unit of a teaching hospital in Nepal...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28425261/central-line-associated-blood-stream-infections-characteristics-and-risk-factors-for-mortality-over-a-5-5-year-period
#16
Aynur Atilla, Zahide Doğanay, Hale Kefeli Çelik, Mehmet Derya Demirağ, Sırrı S Kiliç
BACKGROUND/AIM: Central line-associated bloodstream infections (CLABSIs) are associated with substantial morbidity and mortality and the infection rates vary in a wide range1397645907(high: 62.5%; low: 20%) in developing countries. We aimed to investigate the characteristics and the risk factors for mortality in patients with CLABSIs in intensive care units (ICUs) and provide the relevant data. MATERIALS AND METHODS: The electronic medical records database and file records obtained through active surveillance by an infection control committee of a hospital were screened to identify patients with CLABSIs hospitalized from January 2008 through July 2013...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28419013/standardizing-best-nursing-practice-for-implanted-ports-applying-evidence-based-professional-guidelines-to-prevent-central-line-associated-bloodstream-infections
#17
Susanne B Conley, Paula Buckley, Lisa Magarace, Candace Hsieh, Lillian Vitale Pedulla
Nearly 3 million central vascular access devices (CVADs) are used in the United States each year. These devices are an important advance in health care and essential to oncology patients. However, CVADs are the most frequent cause of central line-associated bloodstream infections (CLABSIs). CLABSI can be prevented when evidence-based practices are followed consistently over time. Professional organizations establish valid standards and guidelines to guide CVAD practice. This article identifies strategies implemented at a comprehensive ambulatory cancer center to integrate professional evidence-based standards and guidelines for implanted port care into nursing practice at the point of care...
May 2017: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/28416559/a-novel-non-antibiotic-nitroglycerin-based-catheter-lock-solution-for-the-prevention-of-intraluminal-central-venous-catheter-infections-in-cancer-patients
#18
Anne-Marie Chaftari, Ray Hachem, Ariel Szvalb, Mahnaz Taremi, Bruno Granwehr, George Michael Viola, Amin Sapna, Andrew Assaf, Numan Yazan, Pankil Shah, Ketevan Gasitashvili, Elizabeth Natividad, Ying Jiang, Rebecca Slack, Ruth Reitzel, Joel Rosenblatt, Elie Mouhayar, Issam Raad
Background: For long-term central lines (CL), the lumen is the major source of central line associated bloodstream infections (CLABSI). Current standard of care for maintaining catheter patency includes flushing the CL with saline or heparin. Neither agent has any antimicrobial activity. Furthermore heparin may enhance staphylococcal biofilm formation. We evaluated the safety and efficacy of a novel non-antibiotic catheter lock solution for the prevention of CLABSI.Patients and Methods: Between November 2015, and February 2016, we enrolled 60 patients with hematologic malignancies who had peripherally inserted central catheter (PICC) to receive the study lock solution...
April 17, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28413891/safety-of-peripherally-inserted-central-catheters-during-pregnancy-a-retrospective-study
#19
Laura Jacques, Megan Foeller, Rahmouna Farez, Kristina Kaljo, Melodee Nugent, Pippa Simpson, Timothy Klatt
PURPOSE: We investigated the incidence of complications associated with peripherally inserted central line catheters, inserted using a standardized technique, during pregnancy and the postpartum period. MATERIALS AND METHODS: A retrospective case series was performed that included all pregnant and postpartum women who received peripherally inserted central catheters (PICCs) at a single institution between 2006 and 2014. Patient demographics and data on infectious, mechanical and thrombotic complications were collected...
April 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28411947/central-line-associated-bloodstream-infections-in-the-nicu-successes-and-controversies-in-the-quest-for-zero
#20
Renée E Mobley, Matthew J Bizzarro
Central line-associated bloodstream infections (CLABSI) are among the most common healthcare-acquired infections in the neonatal intensive care unit (NICU) population and are associated with an increased risk of morbidity and mortality, as well as increased healthcare costs, and duration of hospitalization. Over the past decade, numerous local, statewide, and national quality improvement initiatives have resulted in a significant reduction in CLABSI rates. The majority of successful initiatives have utilized similar strategies to implement and sustain their efforts, including education of NICU staff in the principles of quality improvement, creation and implementation of central line insertion and maintenance bundles and methods for assessing compliance, formation of dedicated central line insertion and maintenance teams, and utilization of reliable and effective methods for collecting, analyzing, and displaying data...
April 12, 2017: Seminars in Perinatology
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