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https://www.readbyqxmd.com/read/29780817/clinical-profile-and-outcome-of-patients-with-acute-kidney-injury-requiring-hemodialysis-two-years-experience-at-a-tertiary-hospital-in-rwanda
#1
Grace Igiraneza, Benedicte Ndayishimiye, Menelas Nkeshimana, Vincent Dusabejambo, Onyema Ogbuagu
Introduction: Acute kidney injury (AKI) requiring renal replacement therapy is associated with high mortality. The study assessed the impact of the introduction of hemodialysis (HD) on outcomes of patients with AKI in Rwanda. Methods: A single center retrospective study that evaluated the clinical profile and survival outcomes of patients with AKI requiring HD [AKI-D] at a tertiary hospital in Rwanda. Data was collected on patients who received HD for AKI from September 2014 to December 2016...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29778659/sepsis-3-septic-shock-criteria-and-associated-mortality-among-infected-hospitalized-patients-assessed-by-a-rapid-response-team
#2
Shannon M Fernando, Peter M Reardon, Bram Rochwerg, Nathan I Shapiro, Donald M Yealy, Andrew J E Seely, Jeffrey J Perry, Douglas P Barnaby, Kyle Murphy, Peter Tanuseputro, Kwadwo Kyeremanteng
BACKGROUND: Rapid Response Teams (RRTs) respond to deteriorating hospitalized patients, and help determine subsequent management, including Intensive Care Unit (ICU) admission. In such patients with sepsis and septic shock, the Sepsis-3 clinical criteria have a potential role in detection, risk-stratification, and prognostication, though their accuracy in comparison to the Systemic Inflammatory Response Syndrome (SIRS)-based septic shock criteria are unknown. We sought to evaluate prognostic accuracy of the Sepsis-3 criteria for in-hospital mortality among infected hospitalized patients with acute deterioration...
May 17, 2018: Chest
https://www.readbyqxmd.com/read/29777456/distal-bowel-re-feeding-in-patients-with-proximal-jejunostomy
#3
Anand Nagar, Siddharth Mehrotra, Amitabh Yadav, Vivek Mangla, Shailendra Lalwani, Naimish Mehta, Samiran Nundy
BACKGROUND: Patients who have a proximal jejunostomy are difficult to manage because of their high stoma output which results in fluid and electrolyte imbalance with repeated hospital admissions and the necessity for expensive parenteral nutrition (PN). There are few reports on the use of re-feeding of the proximal effluents in this situation. METHODS: We here relate our experience with this manoeuvre in 35 patients between Jan 2010 and Feb 2016 who had stomas less than 120 cm away from the duodenojejunal flexure...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29776828/septic-acute-kidney-injury-patients-in-emergency-department-the-risk-factors-and-its-correlation-to-serum-lactate
#4
Yin-Chou Hsu, Chih-Wei Hsu
BACKGROUND: Acute kidney injury (AKI) is a common complication in septic patients, imposing a heavy burden of illness in terms of morbidity and mortality. Serum lactate is a widely used marker predicting the severity of sepsis. A paucity of research has investigated septic AKI in emergency departments (EDs) and its correlation with initial serum lactate level. This study aimed at identifying risk factors for septic AKI and clarifying the link between initial serum lactate level and septic AKI in ED patients...
May 15, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29768465/stopping-the-effective-non-fluoroquinolone-antibiotics-at-day-7-vs-continuing-until-day-14-in-adults-with-acute-pyelonephritis-requiring-hospitalization-a-randomized-non-inferiority-trial
#5
Pavankumar Rudrabhatla, Surendran Deepanjali, Jharna Mandal, Rathinam Palamalai Swaminathan, Tamilarasu Kadhiravan
OBJECTIVE: To evaluate whether stopping the effective antibiotic treatment following clinical improvement at Day 7 (Truncated treatment) would be non-inferior to continued treatment until Day 14 (Continued treatment) in patients with acute pyelonephritis (APN) requiring hospitalization treated with non-fluoroquinolone (non-FQ) antibiotics. METHODS: Hospitalized adult men and non-pregnant women with culture-confirmed APN were eligible for participation after they had clinically improved following empirical or culture-guided treatment with intravenous non-FQ antibiotic(s)...
2018: PloS One
https://www.readbyqxmd.com/read/29766446/prognostic-significance-of-post-operative-morbidity-severity-score-after-potentially-curative-d2-gastrectomy-for-carcinoma
#6
Arfon Powell, Alexandra Harriet Coxon, Neil Patel, David Chan, Adam Christian, Wyn Lewis
BACKGROUND: Survival and relapse after gastric cancer surgery are largely attributed to tumor biology and surgical radicality; yet, other prognostic factors have been reported, including respiratory sepsis and anastomotic leakage, but not global morbidity severity score (MSS). The hypothesis tested was that MSS would be associated with both disease-free (DFS) and overall survival (OS). METHODS: Consecutive 373 patients undergoing potentially curative surgery for gastric adenocarcinoma between 2004 and 2016 in a UK cancer network were studied...
May 15, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29763777/incorporation-of-point-of-care-ultrasound-into-morning-round-is-associated-with-improvement-in-clinical-outcomes-in-critically-ill-patients-with-sepsis
#7
Zhonghua Chen, Yucai Hong, Junru Dai, Lifeng Xing
OBJECTIVES: Point-of-care ultrasound (POCUS) has been widely used in the intensive care unit (ICU). However, it is largely unknown whether the use of POCUS is associated with improved patient-important outcomes. The study aimed to investigate whether incorporation of POCUS during morning round on a routine basis was able to improve clinical outcomes in critically ill patients with sepsis. DESIGN: It was a prospective observational study. SETTING: A tertiary care emergency intensive care unit...
May 11, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29761674/screening-arab-israeli-pregnant-women-for-group-b-streptococcus-by-the-amplivue-gbs-assay-are-the-rates-higher-than-the-national-average
#8
Marwan Hakim, Adel Jabour, Miriam Anton, Meggie Hakim, Sahar Kheirallah
BACKGROUND: The recommendation of the U.S. Centers for Disease Control and Prevention regarding universal screening for Group B Streptococcus (GBS) at 35-37 weeks gestational age in pregnancy is not accepted in Israel. The National Council for Obstetrics, Neonatology and Genetics recommends intrapartum prophylaxis, mainly based on risk factors, to prevent early neonatal GBS infection. This policy is based on past studies demonstrating low colonization rates of the bacteria in Israeli pregnant women and very low neonatal sepsis rates...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29756072/managing-antibiotics-wisely-a-quality-improvement-programme-in-a-tertiary-neonatal-unit-in-the-uk
#9
Vasiliki Makri, Gemma Davies, Stephanie Cannell, Katherine Willson, Lucy Winterson, Joanna Webb, Amit Kandhari, Maha Mansour, Joanne Thomas, Geraint Morris, Jean Matthes, Sujoy Banerjee
Microbial resistance to antibiotics is a serious global health problem compounded by antibiotic overuse and limited investment in new antibiotic research. Inappropriate perinatal antibiotic exposure is increasingly linked to lifelong adverse outcomes through its impact on the developing microbiome. Antibiotic stewardship may be the only effective preventative strategy currently available. As the first tertiary neonatal unit in the UK to collaborate in an international quality improvement programme (QIP) with Vermont Oxford Network (VON), we present the results of our antibiotic stewardship initiative...
2018: BMJ open quality
https://www.readbyqxmd.com/read/29754879/congenital-pyloric-atresia-nine-new-cases-single-center-experience-of-the-long-term-follow-up-and-the-lessons-learnt-over-a-decade
#10
Monal Kansra, V Shankar Raman, Kamal Kishore, Sanat Khanna, Bipin Puri, Abhishek Sharma
BACKGROUND: Congenital pyloric atresia (CPA) is a rare anomaly with an incidence of 1 in 100,000 live births. Depending on the type of anomaly patients can either present in the neonatal period or later in life with subtle nonspecific signs and symptoms. We present our institute's experience in handling these cases over the last decade and highlight lessons learnt. MATERIALS AND METHODS: We retrospectively reviewed records of patients diagnosed with CPA and managed at our centre between Jan 2006 to June 2016...
April 14, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29751278/pregnancy-related-acute-kidney-injury-requiring-dialysis-as-an-indicator-of-severe-adverse-maternal-morbidity-at-a-tertiary-center-in-southwest-nigeria
#11
Ibraheem O Awowole, Oluseyi S Omitinde, Fatiu A Arogundade, Sekinah B Bola-Oyebamiji, Olumide A Adeniyi
OBJECTIVE: Despite being a Critical Intervention in the WHO Near-miss concept, the indications and clinical outcomes of patients with Pregnancy-Related Acute Kidney Injury (PRAKI) requiring dialysis at the Obafemi Awolowo University Teaching Hospitals Complex, Nigeria remain unknown. This retrospective review was conducted to facilitate counselling, prognostication and introduction of preventative measures by providing contemporary data on the aetiology and clinical outcomes of women with PRAKI...
May 2, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29746455/enterovirus-and-parechovirus-surveillance-united-states-2014-2016
#12
Glen R Abedi, John T Watson, W Allan Nix, M Steven Oberste, Susan I Gerber
Infections caused by enteroviruses (EV) and parechoviruses (PeV), members of the Picornaviridae family, are associated with various clinical manifestations, including hand, foot, and mouth disease; respiratory illness; myocarditis; meningitis; and sepsis; and can result in death. The genus Enterovirus includes four species of enterovirus (A-D) known to infect humans, and the genus Parechovirus includes one species (A) that infects humans. These species are further divided into types, some of which are associated with specific clinical manifestations...
May 11, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29742584/predictive-validity-of-sepsis-3-definitions-and-sepsis-outcomes-in-critically-ill-patients-a-cohort-study-in-49-icus-in-argentina
#13
Elisa Estenssoro, Vanina S Kanoore Edul, Cecilia I Loudet, Javier Osatnik, Fernando G Ríos, Daniela N Vázquez, Mario O Pozo, Bernardo Lattanzio, Fernando Pálizas, Francisco Klein, Damián Piezny, Paolo N Rubatto Birri, Graciela Tuhay, Anatilde Díaz, Analía Santamaría, Graciela Zakalik, Arnaldo Dubin
OBJECTIVES: The new Sepsis-3 definitions have been scarcely assessed in low- and middle-income countries; besides, regional information of sepsis outcomes is sparse. Our objective was to evaluate Sepsis-3 definition performance in Argentina. DESIGN: Cohort study of 3-month duration beginning on July 1, 2016. SETTINGS: Forty-nine ICUs. PATIENTS: Consecutive patients admitted to the ICU with suspected infection that triggered blood cultures and antibiotic administration...
May 8, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29735827/molecular-characterisation-for-clonality-and-transmission-dynamics-of-an-outbreak-of-klebsiella-pneumoniae-amongst-neonates-in-a-tertiary-care-centre-in-south-india
#14
Chaitra Shankar, Manish Kumar, Ashtawarthani Baskaran, Miracle Magdelene Paul, Nithya Ponmudi, Sridhar Santhanam, Joy Sarojini Michael, Balaji Veeraraghavan
Purpose: Sepsis is a significant cause of morbidity and mortality amongst neonates. Klebsiella pneumoniae is a common cause of nosocomial outbreaks causing bacteraemia and having potential of acquiring plasmids enhancing antimicrobial resistance. In the present study, we investigate K. pneumoniae outbreak causing bacteraemia amongst neonates over a span of 2 months. Isolates were characterised for antimicrobial resistance, virulence, molecular typing for clonality and plasmid typing for transmission dynamics, and patient outcome was investigated...
January 2018: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29732457/a-computable-definition-of-sepsis-facilitates-screening-and-performance-improvement-tracking
#15
Lauren J Alessi, Holly R Warmus, Erin K Schaffner, Sajel Kantawala, Joseph Carcillo, Johanna Rosen, Christopher M Horvat
Background: Sepsis kills almost 5,000 children annually, accounting for 16% of pediatric health care spending in the United States. Objectives: We sought to identify sepsis within the Electronic Health Record (EHR) of a quaternary children's hospital to characterize disease incidence, improve recognition and response, and track performance metrics. Methods: Methods are organized in a plan-do-study-act cycle. During the "plan" phase, electronic definitions of sepsis (blood culture and antibiotic within 24 hours) and septic shock (sepsis plus vasoactive medication) were created to establish benchmark data and track progress with statistical process control...
March 2018: Pediatric Quality & Safety
https://www.readbyqxmd.com/read/29732433/bowel-injury-in-lumbar-spine-surgery-a-review-of-the-literature
#16
REVIEW
Ioannis Siasios, Kunal Vakharia, Asham Khan, Joshua E Meyers, Samantha Yavorek, John Pollina, Vassilios Dimopoulos
Although rarely documented in the medical literature, bowel perforation injury can be a severe complication of spine surgery. Our goal was to review current literature regarding this complication and study possible methods of avoidance. We conducted a literature search in the PubMed database between January 1960 and March 2016 using the terms abrasion, bowels, bowel, complication, injury, intestine, intra-abdominal sepsis/shock, perforation, lumbar, spine, surgery, visceral. Diagnostic criteria, outcomes, risk factors, surgical approach, and treatment strategy were the parameters extracted from the search results and used for review...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29727410/improved-diagnosis-and-treatment-of-bone-and-joint-infections-using-an-evidence-based-treatment-guideline
#17
Rachel D Quick, John Williams, Marisol Fernandez, Hilton Gottschalk, Peter Cosgrove, Kyle Kahlden, Kathryn Merkel, Lynn Thoreson, Patrick Boswell, Sarmistha B Hauger
BACKGROUND: Our institution created a multidisciplinary guideline for treatment of acute hematogenous osteomyelitis (AHO) and septic arthritis (SA) in response to updates in evidence-based literature in the field and existing provider variability in treatment. This guideline aims to improve the care of these patients by standardizing diagnosis and treatment and incorporating up to date evidence-based research into practice. The primary objective of this study is to compare cases before versus after the implementation of the guideline to determine concrete effects the guideline has had in the care of patients with AHO and SA...
May 2, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29727368/platelet-transfusion-practices-in-critically-ill-children
#18
Marianne E Nellis, Oliver Karam, Elizabeth Mauer, Melissa M Cushing, Peter J Davis, Marie E Steiner, Marisa Tucci, Simon J Stanworth, Philip C Spinella
OBJECTIVES: Little is known about platelet transfusions in pediatric critical illness. We sought to describe the epidemiology, indications, and outcomes of platelet transfusions among critically ill children. DESIGN: Prospective cohort study. SETTING: Multicenter (82 PICUs), international (16 countries) from September 2016 to April 2017. PATIENTS: Children ages 3 days to 16 years prescribed a platelet transfusion in the ICU during screening days...
May 4, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29726931/comparable-perioperative-outcomes-and-mid-term-survival-in-prosthetic-valve-endocarditis-and-native-valve-endocarditis
#19
Makoto Mori, Kayoko Shioda, Max Jordan Nguemeni Tiako, Syed Usman Bin Mahmood, Abeel A Mangi, James J Yun, Umer Darr, Philip Yi Kit Pang, Arnar Geirsson
OBJECTIVES: Cardiac surgery for prosthetic valve endocarditis (PVE) represents one of the highest risk surgeries with in-hospital mortality of 20%. Given the complex nature of the operation, the operative outcome is likely strongly susceptible to the surgeon's experience and centre case volume, as measurements often are not apparent in large observational studies. We sought to evaluate operative outcomes and mid-term survival of patients with PVE compared with those of native valve endocarditis (NVE) at a tertiary care hospital...
May 2, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29720475/comparison-of-qsofa-with-current-emergency-department-tools-for-screening-of-patients-with-sepsis-for-critical-illness
#20
Robert M Rodriguez, John C Greenwood, Thomas J Nuckton, Bryan Darger, Frances S Shofer, Dawn Troeger, Soo Y Jung, Kelly G Speich, Joel Valencia, J Hope Kilgannon, Danny Fernandez, Brigitte M Baumann
OBJECTIVE: We sought to compare the quick sequential organ failure assessment (qSOFA) to systemic inflammatory response syndrome (SIRS), severe sepsis criteria and lactate levels for their ability to identify ED patients with sepsis with critical illness. METHODS: We conducted this multicenter retrospective cohort study at five US hospitals, enrolling all adult patients admitted to these hospitals from their EDs with infectious disease-related illnesses from 1 January 2016 to 30 April 2016...
May 2, 2018: Emergency Medicine Journal: EMJ
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