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antibiotics end of life

Chris Moore, Jenna Bulger, Matt Morgan, Timothy Driscoll, Alison Porter, Saiful Islam, Mike Smyth, Gavin Perkins, Bernadette Sewell, Timothy Rainer, Prabath Nanayakkara, Chukwudi Okolie, Susan Allen, Greg Fegan, Jan Davies, Theresa Foster, Nick Francis, Fang Gao Smith, Gemma Ellis, Tracy Shanahan, Robin Howe, Helen Snooks
Background: Sepsis is a common condition which kills between 36,000 and 64,000 people every year in the UK. Early recognition and management of sepsis has been shown to reduce mortality and improve the health and well-being of people with sepsis. Paramedics frequently come into contact with patients with sepsis and are well placed to provide early diagnosis and treatment.We aim to determine the feasibility of undertaking a fully powered randomised controlled trial (RCT) to test the clinical and cost-effectiveness of paramedics obtaining blood cultures from and administering IV antibiotics to patients with sepsis, so we can make a decision about whether to proceed to a fully powered randomised controlled trial, which will answer questions regarding safety and effectiveness for patients and benefit to the National Health Service (NHS)...
2018: Pilot and Feasibility Studies
Nastaran Meschi, Steffen Fieuws, Anke Vanhoenacker, Olaf Strijbos, Dominique Van der Veken, Constantinus Politis, Paul Lambrechts
OBJECTIVES: The aim of this study was to investigate the impact of the adjunct of leukocyte- and platelet-rich fibrin (LPRF) to root-end surgery (RES) on the patients' quality of life during the first week post RES. MATERIALS AND METHODS: Patients in need of RES were recruited for an open randomized controlled clinical trial (RCT) with a 2 × 2 factorial design. They were randomly allocated to the test (+LPRF) and control (-LPRF) group. Each group was subsequently divided into two strata: with or without an occlusive membrane (Bio-Gide®, Geistlich Biomaterials, Switzerland; BG)...
March 9, 2018: Clinical Oral Investigations
Claudia Burrello, Federica Garavaglia, Fulvia Milena Cribiù, Giulia Ercoli, Silvano Bosari, Flavio Caprioli, Federica Facciotti
The gut mucosa is continuously exposed to a vast community of microorganisms, collectively defined as microbiota, establishing a mutualistic relationship with the host and contributing to shape the immune system. Gut microbiota is acquired at birth, and its composition is relatively stable during the entire adult life. Intestinal dysbiosis, defined as a microbial imbalance of gut bacterial communities, can be caused by several factors, including bacterial infections and antibiotic use, and has been associated with an increased risk to develop or exacerbate immune-mediated pathologies, such as allergic reactions, asthma, and inflammatory bowel diseases...
2018: Frontiers in Medicine
Hiroaki Watanabe, Takuya Odagiri, Yasuyuki Asai
CONTEXT: Acute suppurative sialadenitis (hereafter referred to as sialadenitis) is accompanied by pain and fever and can diminish the quality of life (QOL) in end-stage cancer patients; however, its incidence is not clear. OBJECTIVES: We conducted this study to elucidate the incidence of sialadenitis in end-stage cancer patients. METHODS: Retrospective review, observational study based on patients' medical records SUBJECTS: 726 consecutive cancer patients who died on the palliative care unit of our hospital between April 2012 and November 2016 were included...
February 14, 2018: Journal of Pain and Symptom Management
Eric Cornelis Theodorus Geijteman, Marcella van der Graaf, Frederika E Witkamp, Sanne van Norden, Bruno H Stricker, Carin C D van der Rijt, Agnes van der Heide, Lia van Zuylen
OBJECTIVES: Burdensome and futile interventions with the aim of prolonging life should be avoided in dying patients. However, current clinical practice has hardly been investigated.We examined the number and type of diagnostic and therapeutic medical interventions in hospitalised patients with cancer in their last days of life. In addition, we investigated if physician awareness of impending death affected the use of these interventions. METHODS: Questionnaire study and medical record study...
February 9, 2018: BMJ Supportive & Palliative Care
Jessica Eden Miller, Chunsen Wu, Lars Henning Pedersen, Nicholas de Klerk, Jørn Olsen, David P Burgner
Background: The early life microbiome contributes to immune development. Antibiotics during pregnancy alter the microbiome and may influence disease risks in the offspring. We investigated the relationship between maternal antibiotic exposure before and during pregnancy, and risk of childhood hospitalization with infection. Methods: We used population-based Danish national databases for pregnancies between 1995 and 2009. Infants were followed from birth until their first infection-related hospitalization, death, 14th birthday, emigration or end-2009...
February 4, 2018: International Journal of Epidemiology
Melanie R Meister, Joshua I Rosenbloom, Jerry L Lowder, Alison G Cahill
Importance: Obstetric anal sphincter injuries (OASISs) complicate up to 11% of vaginal deliveries; obstetricians must be able to recognize and manage these technically challenging injuries. Objective: The aim of this study was to share our approach for management of these challenging complications of childbirth based on a multidisciplinary collaboration between general obstetrician-gynecologists, maternal fetal medicine specialists, and female pelvic medicine and reconstructive surgeons established at our institution...
January 2018: Obstetrical & Gynecological Survey
Sarah A Servid, Brie N Noble, Erik K Fromme, Jon P Furuno
OBJECTIVES: To better understand the clinical intentions for antibiotic prescribing upon discharge from acute care to hospice care. DESIGN: Retrospective cohort study. SETTING: Five hundred forty-four-bed academic, acute-care, tertiary referral hospital in Portland, Oregon. PARTICIPANTS: Adults (≥18) who received an outpatient prescription for antibiotics on discharge from an acute care hospital to hospice care between January 1, 2009 and December 31, 2011 (N = 149)...
January 18, 2018: Journal of the American Geriatrics Society
Lynda Doward, Henrik Svedsater, Diane Whalley, Rebecca Crawford, David Leather, James Lay-Flurrie, Nick Bosanquet
This study investigated patient perceptions, experiences and management of COPD throughout the SLS COPD study. Follow-up interviews were conducted with 400 patients who completed SLS COPD; a mixed-methods approach was used to collect quantitative and qualitative information. Structured interviews using closed-ended questions were conducted with 360 patients, detailing aspects of background/lifestyle information and COPD. Extended interviews containing open-ended questions on perceptions of COPD and quality of life (QoL) in addition to the closed-ended questions were completed by 40 further patients...
December 15, 2017: NPJ Primary Care Respiratory Medicine
Marius Vital, André Karch, Dietmar H Pieper
Given the key role of butyrate for host health, understanding the ecology of intestinal butyrate-producing communities is a top priority for gut microbiota research. To this end, we performed a pooled analysis on 2,387 metagenomic/transcriptomic samples from 15 publicly available data sets that originated from three continents and encompassed eight diseases as well as specific interventions. For analyses, a gene catalogue was constructed from gene-targeted assemblies of all genes from butyrate synthesis pathways of all samples and from an updated reference database derived from genome screenings...
November 2017: MSystems
Yilun Sun, Rachael L Huskey, Li Tang, Hiroto Inaba, Aditya H Gaur, Raul Ribeiro, Jeffrey E Rubnitz, Joshua Wolf
Children and adolescents with acute myeloid leukemia (AML) are at risk of life-threatening bacterial infections, especially with viridans group streptococci. Primary antibacterial prophylaxis with vancomycin-based regimens reduces this risk but might increase the risks of renal or liver toxicity or Clostridium difficile infection (CDI). A retrospective review of data for patients treated for newly diagnosed AML at St. Jude Children's Research Hospital between 2002 and 2008 was conducted. Nephrotoxicity was classified according to pediatric risk, injury, failure, loss, and end-stage renal disease (pRIFLE) criteria and hepatotoxicity according to Common Terminology Criteria for Adverse Events (CTCAE) criteria...
March 2018: Antimicrobial Agents and Chemotherapy
Maxime Bataillard, Marie-Noëlle Beyens, Geneviève Mounier, Delphine Vergnon-Miszczycha, Haleh Bagheri, Pascal Cathebras
BACKGROUND/AREA OF UNCERTAINTY: Statins, which reduce cardiovascular risk in both primary and secondary prevention, are one of the most widely prescribed therapeutic classes in the world. Usually well-tolerated, statin-associated muscle symptoms are a well-known adverse effect. Fusidic acid (FA) is a bacteriostatic antibiotic of interest in the treatment of methicillin-resistant Staphylococcus aureus infections. Cases of rhabdomyolysis, sometimes fatal, have been reported after coprescription of FA and a statin...
November 9, 2017: American Journal of Therapeutics
Ian A Yang, Juliet L Brown, Johnson George, Sue Jenkins, Christine F McDonald, Vanessa M McDonald, Kirsten Phillips, Brian J Smith, Nicholas A Zwar, Eli Dabscheck
Chronic obstructive pulmonary disease (COPD) is characterised by persistent respiratory symptoms and chronic airflow limitation, and is associated with exacerbations and comorbidities. Advances in the management of COPD are updated quarterly in the national COPD guidelines, the COPD-X plan, published by Lung Foundation Australia in conjunction with the Thoracic Society of Australia and New Zealand and available at Main recommendations: Spirometry detects persistent airflow limitation (post-bronchodilator FEV1/FVC < 0...
November 20, 2017: Medical Journal of Australia
Alexander Tin Han Yu, Tony Cun, Esther Benamu, Cybele Renault
Staphylococcus aureusbacteraemia (SAB) remains a complex disease with a high associated morbidity and mortality, especially when it is able to establish an occult nidus safe from antimicrobial eradication. Without rapid identification and intervention, the nidus can cause persistent relapse of disease, morbidity and mortality. Having a high clinical suspicion for the foci of occult S. aureus is important, and awareness of potential sites of infection is critical and can be life-saving.We present a unique case of a 65-year-old man with end-stage renal disease receiving haemodialysis who developed septic shock from SAB...
November 8, 2017: BMJ Case Reports
Debra M Ferrailo, Analia Veitz-Keenan
Data sourcesThe authors searched the following electronic databases: the Cochrane Oral Health Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline Ovid and Embase Ovid. The US National Registry of Clinical Trials ( and the World Health Organisation (WHO) International Clinical Trials Registry Platform were searched for ongoing trials. There were no restrictions regarding language and publication date. The authors hand-searched the reference lists of the studies retrieved and key journals in the field of endodontics...
October 27, 2017: Evidence-based Dentistry
Cheryl Brohard
PURPOSE/OBJECTIVES: To test the efficacy of a novel intervention to facilitate advance care planning.
. DESIGN: Exploratory, quasiexperimental pilot study with two independent groups.
. SETTING: A large hospice located in the southwestern United States. 
. SAMPLE: A convenience sample of 50 participants with terminal cancer enrolled in hospice.
. METHODS: An autobiographical memory (ABM) intervention used the participants' experiences with cancer and end of life for the purpose of directing advance care planning...
November 1, 2017: Oncology Nursing Forum
Ali Mardassi, Senda Turki, Rim Lahiani, Hajer Mbarek, Sonia Benzarti, Hédi Gharsallah
INTRODUCTION: Necrotizing otitis externa remains a severe and sometimes life-threatening disease in diabetic patient. Many therapeutic approaches have been described but what about the real benefit of hyperbaric oxygenotherapy in the management of this disease? METHODS: The authors reported a retrospective study about 42 patients treated for necrotizing external otitis over a period of 9 years (2006 to 2014). The patients were treated either by only antibiotherapy (23 cases) or with both antibiotherapy and hyperbaric oxygenotherapy (19 cases)...
December 2016: La Tunisie Médicale
Valerie Waters, Felix Ratjen
BACKGROUND: The antibiotics used to treat pulmonary infections in people with cystic fibrosis are typically chosen based on the results of antimicrobial susceptibility testing performed on bacteria traditionally grown in a planktonic mode (grown in a liquid). However, there is considerable evidence to suggest that Pseudomonas aeruginosa actually grows in a biofilm (or slime layer) in the airways of people with cystic fibrosis with chronic pulmonary infections. Therefore, choosing antibiotics based on biofilm rather than conventional antimicrobial susceptibility testing could potentially improve response to treatment of Pseudomonas aeruginosa in people with cystic fibrosis...
October 5, 2017: Cochrane Database of Systematic Reviews
Victoria B Chou, Ingrid K Friberg, Mervyn Christian, Neff Walker, Henry B Perry
BACKGROUND: Evidence has been accumulating that community health workers (CHWs) providing evidence-based interventions as part of community-based primary health care (CBPHC) can lead to reductions in maternal, neonatal and child mortality. However, investments to strengthen and scale-up CHW programs still remain modest. METHODS: We used the Lives Saved Tool (LiST) to estimate the number of maternal, neonatal and child deaths and stillbirths that could be prevented if 73 countries effectively scaled up the population coverage of 30 evidence-based interventions that CHWs can deliver in these high-burden countries...
December 2017: Journal of Global Health
Rituparna Maiti, Chandra Sekhar Sirka, M A Ashique Rahman, Anand Srinivasan, Sansita Parida, Debasish Hota
BACKGROUND: Acne vulgaris is a multifactorial disorder which is ideally treated with combination therapy with topical retinoids and antibiotics. OBJECTIVES: The present study was conducted to compare the efficacy and safety of tazarotene plus clindamycin against adapalene plus clindamycin in facial acne vulgaris. METHODS: This study is a randomized, open-label, parallel design clinical trial conducted on 60 patients with facial acne at the outpatient dermatology department in a tertiary healthcare center...
November 2017: Clinical Drug Investigation
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