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https://www.readbyqxmd.com/read/28646647/successful-maintenance-of-key-physiological-parameters-in-preterm-lambs-treated-with-ex%C3%A2-vivo-uterine-environment-therapy-for-a-period-of-1-week
#1
Haruo Usuda, Shimpei Watanabe, Yuichiro Miura, Masatoshi Saito, Gabrielle C Musk, Judith Rittenschober-Böhm, Hideyuki Ikeda, Shinichi Sato, Takushi Hanita, Tadashi Matsuda, Alan H Jobe, John P Newnham, Sarah J Stock, Matthew W Kemp
BACKGROUND: Extremely preterm infants born at the border of viability (22-24 weeks' gestation) have high rates of death and lasting disability. Ex vivo uterine environment therapy is an experimental neonatal intensive care strategy that provides gas exchange using parallel membranous oxygenators connected to the umbilical vessels, sparing the extremely preterm cardiopulmonary system from ventilation-derived injury. OBJECTIVE: In this study, we aimed to refine our ex vivo uterine environment therapy platform to eliminate fetal infection and inflammation, while simultaneously extending the duration of hemodynamically stable ex vivo uterine environment therapy to 1 week...
June 20, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28644831/inflammatory-and-vascular-placental-lesions-are-associated-with-neonatal-amplitude-integrated-eeg-recording-in-early-premature-neonates
#2
Dorit Paz-Levy, Letizia Schreiber, Offer Erez, Sharon Goshen, Justin Richardson, VIadimir Drunov, Orna Staretz Chacham, Eilon Shany
INTRODUCTION: Placental histologic examination can assist in revealing the mechanism leading to preterm birth. Accumulating evidence suggests an association between intrauterine pathological processes, morbidity and mortality of premature infants, and their long term outcome. Neonatal brain activity is increasingly monitored in neonatal intensive care units by amplitude integrated EEG (aEEG) and indices of background activity and sleep cycling patterns were correlated with long term outcome...
2017: PloS One
https://www.readbyqxmd.com/read/28644310/predictors-of-mortality-in-cirrhosis-inpatients-with-clostridium-difficile-infection
#3
Elliot Z Smith, Patrick G Northup, Curtis K Argo
BACKGROUND: Clostridium difficile is a bacterial pathogen associated with significant morbidity and mortality in patients with cirrhosis. GOALS: Our primary aim is to identify variables that are predictive of poor outcomes in cirrhosis patients with C. difficile infection (CDI). We also aim to further characterize the risk factors for developing CDI and risk of mortality in this patient population. STUDY: A total of 200 subjects with a diagnosis of cirrhosis and CDI were matched to 200 cirrhosis inpatients without CDI...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28643291/-more-than-expectorant-new-scientific-data-on-ambroxol-in-the-context-of-the-treatment-of-bronchopulmonary-diseases
#4
Manuel Plomer, Justus de Zeeuw
BACKGROUND: Ambroxol has been established for decades in the treatment of acute and chronic respiratory diseases. In 2015, the European Medicines Agency reassessed the clinical benefit-risk ratio of the drug. OBJECTIVE: What new scientific data on ambroxol, which are relevant to the treatment of bronchopulmonary diseases, are available? METHOD: The review is based on a systematic literature research in medline with the search term "ambroxol" during the publication period 2006-2015...
June 2017: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/28643188/impact-of-appropriateness-of-empiric-therapy-on-outcomes-in-community-onset-bacteremia-by-extended-spectrum-%C3%AE-lactamase-producing-escherichia-coli-and-klebisella-pneumoniae-definitively-treated-with-carbapenems
#5
E-J Joo, D A Park, N R Lee, S-Y Moon, J-K Choi, J-H Ko, K R Peck
Despite a significant increase of bloodstream infection caused by extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae in the community-setting, information regarding clinical outcomes of inappropriate empiric therapy (IAT) in patients with those infections is limited. A multicenter-retrospective cohort study was conducted in four hospitals. A total of 249 adults were identified to have community-onset bacteremia caused by ESBL-producing Escherichia coli and Klebsiella pneumoniae, and definitively treated with carbapenems...
June 23, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28642147/the-role-of-tigecycline-in-the-management-of-clostridium-difficile-infection-a-retrospective-cohort-study
#6
Eliza Manea, Jesús Sojo-Dorado, Raluca E Jipa, Serban N Benea, Jesús Rodríguez-Baño, Adriana Hristea
OBJECTIVE: We aimed to compare the outcomes of patients with C.difficile infection (CDI) treated either with tigecycline associated with vancomycin, or with vancomycin alone. METHODS: This single-centre retrospective cohort study included all adults hospitalized from September 2014 through August 2015 for symptomatic, incident CDI confirmed by polymerase chain reaction for C.difficile toxin in stools. The primary outcome was the rate of favourable outcome, defined as a composite of clinical response (resolution of symptoms without need for additional CDI therapy) and achieving discharge without CDI-related surgery or intensive care; a secondary outcome was CDI recurrence...
June 19, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28642120/transfusion-challenges-in-hematology-oncology-and-hematopoietic-stem-cell-transplant-literature-review-and-local-experience
#7
REVIEW
Mohamed Elemary, Jerard Seghatchian, Julie Stakiw, Mark Bosch, Waleed Sabry, Hadi Goubran
Transfusion medicine plays a vital role in the supportive care of patients receiving therapy for hematology, oncology and hematopoietic stem cell transplants (HSCT). With advances in therapy with more intensive chemotherapy or radiotherapy, patients usually develop cytopenias and need frequent transfusion support with packed red blood cells, granulocyte transfusion or platelets to support them until they recover from the effect of therapy. HSCT poses unique challenges for transfusion medicine, since transplant recipients may require substantial transfusion support due to cytopenias associated with toxic medications, decreased marrow reserve, infection or their malignancy...
June 3, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28642012/evaluation-of-a-device-combining-an-inferior-vena-cava-filter-and-a-central-venous-catheter-for-preventing-pulmonary-embolism-among-critically-ill-trauma-patients
#8
Victor F Tapson, Joshua P Hazelton, John Myers, Claudia Robertson, Ramyar Gilani, Julie A Dunn, Marko Bukur, Martin A Croce, Ann Peick, Sonlee West, Lawrence Lottenberg, Jay Doucet, Preston R Miller, Bruce Crookes, Rajesh R Gandhi, Chasen A Croft, Anthony Manasia, Brian A Hoey, Howard Lieberman, Oscar D Guillamondegui, Victor Novack, Gregory Piazza, Samuel Z Goldhaber
PURPOSE: To evaluate efficacy and safety of a novel device that combines an inferior vena cava (IVC) filter and central venous catheter (CVC) for prevention of pulmonary embolism (PE) in critically ill patients. MATERIALS AND METHODS: In a multicenter, prospective, single-arm clinical trial, the device was inserted at the bedside without fluoroscopy and subsequently retrieved before transfer from the intensive care unit (ICU). The primary efficacy endpoint was freedom from clinically significant PE or fatal PE 72 hours after device removal or discharge, whichever occurred first...
June 20, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28639999/the-neutrophil-to-lymphocyte-ratio-in-bordetella-pertussis-infection
#9
Anusha Ganeshalingham, Justin Wilde, Brian J Anderson
Twin infants with pertussis demonstrated contrasting differential white cell counts and clinical course. A change towards increased neutrophil production, which is associated with increased mortality, may be more easily recognized by serial documentation of the neutrophil-to-lymphocyte ratio. A ratio that is greater than one may indicate evolving life-threatening pertussis allowing early transfer to a pediatric intensive care unit.
June 20, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28638850/probiotic-lactobacillus-species-strengthen-intestinal-barrier-function-and-tight-junction-integrity-in-experimental-necrotizing-enterocolitis
#10
Brian P Blackwood, Carrie Y Yuan, Douglas R Wood, Joseph D Nicolas, Justyna S Grothaus, Catherine J Hunter
Necrotizing enterocolitis (NEC) is a serious intestinal disease that occurs in newborn infants. It is associated with major morbidity and affects 5% of all infants admitted to neonatal intensive care units. Probiotics have variable efficacy in preventing necrotizing enterocolitis. Tight junctions (TJ) are protein complexes that maintain epithelial barrier integrity. We hypothesized that the probiotics Lactobacillus rhamnosus and Lactobacillus plantarum strengthen intestinal barrier function, promote TJ integrity, and protect against experimental NEC...
April 2017: J Probiotics Health
https://www.readbyqxmd.com/read/28638594/high-burden-of-antimicrobial-resistance-among-gram-negative-bacteria-causing-healthcare-associated-infections-in-a-critical-care-unit-of-nepal
#11
Narayan Prasad Parajuli, Subhash Prasad Acharya, Shyam Kumar Mishra, Keshab Parajuli, Basista Prasad Rijal, Bharat Mani Pokhrel
BACKGROUND: Healthcare associated infections (HCAI) and antimicrobial resistance are principal threats to the patients of intensive care units and are the major determining factors for patient outcome. They are associated with increased morbidity, mortality, excess hospitalization and financial costs. The present study is an attempt to investigate the spectrum and antimicrobial resistance of bacterial isolates involved in healthcare associated infections (HCAI) in the patients of a critical care unit at a tertiary care university hospital in Kathmandu, Nepal...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28637911/discovery-of-specific-antigens-that-can-predict-microfilarial-intensity-in-loa-loa-infection
#12
Papa M Drame, Sasisekhar Bennuru, Thomas B Nutman
Antigen-based immunoassays are currently needed for point-of-care quantification of Loa loa microfilariae (mf). Coupling transcriptomic approaches with bioinformatic analysis, we have identified 11 specific putative proteins (coding mRNAs) with potential utility as biomarkers of patent (mf (+) ) L. loa infection. We successfully developed antigen capture immunoassays to quantify 2 (LOAG_14221 and LOAG_15846) of these proteins in individual plasma/sera. Of the 2 quantifiable circulating biomarkers, LOAG_14221 showed the highest degree of specificity, particularly with a monoclonal antibody-based immunoassay...
June 21, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28634525/pseudomembranous-aspergillar-tracheobronchitis-in-a-non-neutropenic-critically-ill-patient-in-the-intensive-care-unit
#13
Sameen Khalid, Fnu Asad-Ur -Rahman, Aamer Abbass, Sigfredo Aldarondo, Khalid Abusaada
Invasive aspergillosis is an important cause of morbidity and mortality among immunocompromised patients. Prolonged neutropenia is the most common risk factor. It has rarely been reported to occur in non-neutropenic critically ill patients in the intensive care unit setting. Mortality rate in this group has been reported to be as high as 92%. We report a case of tracheobronchial aspergillosis in a non-neutropenic critically ill patient to highlight the fact that critically ill patients admitted in the intensive care unit can develop opportunistic infections such as invasive aspergillosis even in the absence of classic risk factors and prior history of immunosuppression...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28633679/multistate-modeling-to-analyze-nosocomial-infection-data-an-introduction-and-demonstration
#14
Martin Wolkewitz, Maja von Cube, Martin Schumacher
OBJECTIVE Multistate and competing risks models have become an established and adequate tool with which to quantify determinants and consequences of nosocomial infections. In this tutorial article, we explain and demonstrate the basics of these models to a broader audience of professionals in health care, infection control, and hospital epidemiology. METHODS Using a publicly available data set from a cohort study of intensive care unit patients, we show how hospital infection data can be displayed and explored graphically and how simple formulas are derived under some simplified assumptions for illustrating the basic ideas behind multistate models...
June 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28632834/-bladder-fungus-ball-by-candida-tropicalis-a-pediatric-case-report
#15
Ecil Santos, Mónica Mercado, Antonio Luévanos, Pedro Martínez, Martín Guerrero
Vesical fungus ball is a mobile, oval and echogenic mass as a result of accumulation of long and wide numerous hyphae. Fungal urinary tract infection incidence has increased notoriously and there are isolated yeast in 7 to 8% of urine cultures. Different species of Candida are cause of urinary tract infection. Epidemiologically, the first isolated pathogen is Candida albicans, followed by Candida tropicalis. Bladder poll has been documented as the most important risk factor for candiduria in critical patients into intensive care...
April 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28632822/-strategies-to-reduce-infections-and-antibiotic-use-and-its-effects-in-a-neonatal-care-unit
#16
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/28631639/prevalence-of-clostridium-difficile-infection-among-the-patients-attending-a-tertiary-care-teaching-hospital
#17
Lavanya Segar, Joshy M Easow, Sreenivasan Srirangaraj, Mohammad Hanifah, Noyal M Joseph, K S Seetha
BACKGROUND: Clostridium difficile, a most important nosocomial enteric pathogen, is recognized globally as responsible for antibiotic-associated diarrhea and colitis. It is associated with considerable morbidity and mortality due to widespread use of antibiotics. AIMS: The study was done to determine the prevalence of C. difficile infection (CDI) among the patients attending a tertiary care teaching hospital in Puducherry. SETTINGS AND DESIGN: We performed a prospective cohort study in Mahatma Gandhi Medical College and Research Institute...
April 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28630239/an-unusual-case-of-escherichia-coli-o157-h7-infection-with-pseudomembranous-colitis-like-lesions-associated-with-haemolytic-uraemic-syndrome-and-neurological-sequelae
#18
James Kennedy, Lauren Simmonds, Robert Orme, Warren Doherty
A 75-year-old man was admitted with abdominal pain and fresh rectal bleeding. Significantly, he had no risk factors for Clostridium difficile infection. An abdominal CT demonstrated colonic thickening, and flexible sigmoidoscopy identified pseudomembranous colitis-like lesions. After initial treatment as C. difficile colitis, a stool sample revealed Escherichia coli O157:H7 infection. Antibiotic therapy was stopped due to the risk of lysis-mediated toxin release, but unfortunately, the patient continued to deteriorate...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28630186/loss-of-c-5-sterol-desaturase-activity-results-in-increased-resistance-to-azole-and-echinocandin-antifungals-in-a-clinical-isolate-of-candida-parapsilosis
#19
Jeffrey M Rybak, C Michael Dickens, Josie E Parker, Kelly Caudle, Kayihura Manigaba, Sarah G Whaley, Andrew Nishimoto, Arturo Luna-Tapia, Sujoy Roy, Qing Zhang, Katherine S Barker, Glen E Palmer, Thomas R Sutter, Ramin Homayouni, Nathan P Wiederhold, Steven L Kelly, P David Rogers
Among emerging non-albicans Candida species, C. parapsilosis is of particular concern as a cause of nosocomial bloodstream infections in neonatal and intensive care unit patients. While fluconazole and echinocandins are considered effective treatment of such infections, recent reports of fluconazole and echinocandin resistance in C. parapsilosis indicate a growing problem. The present study describes a novel mechanism of antifungal resistance in this organism affecting the susceptibility of azole and echinocandin antifungals in a clinical isolate obtained from a patient with prosthetic valve endocarditis...
June 19, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28629754/improving-compliance-with-surgical-antibiotic-prophylaxis-guidelines-a-multicenter-evaluation
#20
Cristiane Schmitt, Rubia Aparecida Lacerda, Ruth Natalia Teresa Turrini, Maria Clara Padoveze
BACKGROUND: Improving surgical antibiotic prophylaxis (SAP) use is an important element in the control of antimicrobial resistance. However, compliance with SAP guidelines is unsatisfactory. This study investigated the level of compliance with SAP guidelines in neurosurgery, and institutional characteristics associated with compliance. METHODS: This study assessed surgeries in 9 Brazilian hospitals. Medical record reviews and a structured questionnaire were used to assess compliance and to describe institutional characteristics...
June 16, 2017: American Journal of Infection Control
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