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https://www.readbyqxmd.com/read/28810235/obesity-as-a-conditioning-factor-for-high-altitude-diseases
#1
Rocío San Martin, Julio Brito, Patricia Siques, Fabiola León-Velarde
Obesity, a worldwide epidemic, has become a major health burden because it is usually accompanied by an increased risk for insulin resistance, diabetes, hypertension, cardiovascular diseases, and even some kinds of cancer. It also results in associated increases in healthcare expenditures and labor and economic consequences. There are also other fields of medicine and biology where obesity or being overweight play a major role, such as high-altitude illnesses (acute mountain sickness, hypoxic pulmonary hypertension, and chronic mountain sickness), where an increasing relationship among these two morbid statuses has been demonstrated...
August 16, 2017: Obesity Facts
https://www.readbyqxmd.com/read/28803549/comparative-gut-microbiota-and-resistome-profiling-of-intensive-care-patients-receiving-selective-digestive-tract-decontamination-and-healthy-subjects
#2
Elena Buelow, Teresita D J Bello González, Susana Fuentes, Wouter A A de Steenhuijsen Piters, Leo Lahti, Jumamurat R Bayjanov, Eline A M Majoor, Johanna C Braat, Maaike S M van Mourik, Evelien A N Oostdijk, Rob J L Willems, Marc J M Bonten, Mark W J van Passel, Hauke Smidt, Willem van Schaik
BACKGROUND: The gut microbiota is a reservoir of opportunistic pathogens that can cause life-threatening infections in critically ill patients during their stay in an intensive care unit (ICU). To suppress gut colonization with opportunistic pathogens, a prophylactic antibiotic regimen, termed "selective decontamination of the digestive tract" (SDD), is used in some countries where it improves clinical outcome in ICU patients. Yet, the impact of ICU hospitalization and SDD on the gut microbiota remains largely unknown...
August 14, 2017: Microbiome
https://www.readbyqxmd.com/read/28803496/management-of-multidrug-resistant-pseudomonas-aeruginosa-in-the-intensive-care-unit-state-of-the-art
#3
Alberto Enrico Maraolo, Marco Cascella, Silvia Corcione, Arturo Cuomo, Salvatore Nappa, Guglielmo Borgia, Francesco Giuseppe De Rosa, Ivan Gentile
Pseudomonas aeruginosa (PA) is one of the most important causes of healthcare-related infections among Gram-negative bacteria. The best therapeutic approach is controversial, especially for multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains as well as in the setting of most severe patients, such as in the intensive care unit (ICU). Areas covered: This article addresses several points. First, the main microbiological aspects of PA, focusing on its wide array of resistance mechanisms. Second, risk factors and the worse outcome linked to MDR-PA infection...
August 14, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28789637/perceptions-practices-and-health-seeking-behaviour-constrain-je-aes-interventions-in-high-endemic-district-of-north-india
#4
Sanjay Chaturvedi, Neha Sharma, Manish Kakkar
BACKGROUND: Acute Encephalitis Syndrome (AES) and Japanese Encephalitis (JE) stay as poorly understood phenomena in India. Multiple linkages to determinants such as poverty, socio-economic status, gender, environment, and population distribution, make it a greater developmental issue than just a zoonotic disease. METHODS: A qualitative study was conducted to map knowledge, perceptions and practices of community and health systems level stakeholders. Seventeen interviews with utilizers of AES care, care givers from human and veterinary sectors, Non-governmental Organizations (NGOs), and pig owners and 4 Focused Group Discussions (FGDs) with farmers, community leaders, and students were conducted in an endemic north Indian district-Kushinagar...
August 8, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28779834/inhaled-antibiotics-for-ventilator-associated-infections
#5
REVIEW
Lucy B Palmer
Multidrug-resistant organisms are creating a challenge for physicians treating the critically ill. As new antibiotics lag behind the emergence of worsening resistance, intensivists in countries with high rates of extensively drug-resistant bacteria are turning to inhaled antibiotics as adjunctive therapy. These drugs can provide high concentrations of drug in the lung that could not be achieved with intravenous antibiotics without significant systemic toxicity. This article summarizes current evidence describing the use of inhaled antibiotics for the treatment of bacterial ventilator-associated pneumonia and ventilator-associated tracheobronchitis...
September 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28774702/candida-and-invasive-mould-diseases-in-non-neutropenic-critically-ill-patients-and-patients-with-haematological-cancer
#6
REVIEW
A L Colombo, J N de Almeida Júnior, Monica A Slavin, Sharon C-A Chen, Tania C Sorrell
Critically ill patients and patients with haematological cancer are HIV-negative populations at high risk of invasive fungal infections. In intensive-care units, candidaemia and intra-abdominal candidiasis predominate, but aspergillosis has emerged as a lethal, under-recognised cause of pneumonia. In patients with haematological malignancies or who have undergone stem-cell transplantations, pulmonary disease due to aspergillus and other mould diseases predominate. In this Series paper, we provide an update on risk assessment, new diagnostic strategies, and therapeutic approaches...
July 31, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28758623/risk-factors-and-predictors-of-carbapenem-resistant-pseudomonas-aeruginosa-and-acinetobacter-baumannii-mortality-in-critically-ill-bacteraemic-patients-over-a-6-year-period-2010-15-antibiotics-do-matter
#7
Matthaios Papadimitriou-Olivgeris, Fotini Fligou, Anastasia Spiliopoulou, Kyriaki Koutsileou, Fevronia Kolonitsiou, Aikaterini Spyropoulou, Anastasia Zotou, Markos Marangos, Evangelos D Anastassiou, Myrto Christofidou, Iris Spiliopoulou
PURPOSE: Acinetobacter baumannii and Pseudomonas aeruginosa provoke serious infections, especially in intensive care unit (ICU) patients. METHODOLOGY: The risk factors and predictors of mortality for P. aeruginosa (n=84; 46 carbapenem-resistant) and A. baumannii (n=129; all carbapenem-resistant) bloodstream infections (BSIs) in an ICU were evaluated. Antibiotic susceptibility testing was performed using the agar disk diffusion method according to EUCAST guidelines...
July 31, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28754148/nosocomial-bacterial-infections-and-their-antimicrobial-susceptibility-patterns-among-patients-in-ugandan-intensive-care-units-a-cross-sectional-study
#8
Peter Agaba, Janat Tumukunde, J V B Tindimwebwa, Arthur Kwizera
BACKGROUND: The intensive care unit (ICU) admits critically ill patients requiring advanced airway, respiratory, cardiac and renal support. Despite the highly-specialized interventions, the mortality and morbidity is still high due to a number of reasons including nosocomial infections, which are the most likely complications in hospitalized patients with the rates being highest among ICU patients. METHODS: In this cross-sectional study of 111 adult patients admitted to 2 of the ICUs in Uganda, we set out to describe the commonest bacterial infections, their antimicrobial susceptibility patterns and factors associated with development of a nosocomial infection...
July 28, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28748088/modeling-risk-for-developing-drug-resistant-bacterial-infections-in-an-mdr-naive-critically-ill-population
#9
Rajiv Sonti, Megan E Conroy, Elena M Welt, Yi Hu, George Luta, Daniel B Jamieson
PURPOSE: To create a model predictive of an individual's risk of developing a de novo multidrug-resistant (MDR) infection while in the intensive care unit (ICU). METHODS: This is a case-control study in which 189 ICU patients diagnosed with their first infection with an MDR organism were compared on the basis of demographic, past medical and clinical variables to randomly selected ICU patients without such an infection, era-matched in a 2:1 ratio. A prediction tool was derived using multivariate logistic regression...
July 2017: Therapeutic Advances in Infectious Disease
https://www.readbyqxmd.com/read/28717834/characterizing-the-adherence-profiles-of-virulent-vibrio-parahaemolyticus-isolates
#10
Alisha M Aagesen, Sureerat Phuvasate, Yi-Cheng Su, Claudia C Häse
The human pathogen Vibrio parahaemolyticus is a leading cause of seafood-borne illness in the USA, and infections with V. parahaemolyticus typically result from eating raw or undercooked oysters. V. parahaemolyticus has been shown to be highly resistant to oyster depuration, suggesting that the bacterium possesses specific mechanisms or factors for colonizing oysters and persisting during depuration. In this study, we characterized eight different V. parahaemolyticus strains for differences in resistance to oyster depuration, biofilm formation, and motility...
July 17, 2017: Microbial Ecology
https://www.readbyqxmd.com/read/28716451/multidrug-resistant-pseudomonas-aeruginosa-lower-respiratory-tract-infections-in-the-intensive-care-unit-prevalence-and-risk-factors
#11
Trang D Trinh, Evan J Zasowski, Kimberly C Claeys, Abdalhamid M Lagnf, Shravya Kidambi, Susan L Davis, Michael J Rybak
Intensive care unit (ICU) admission is a risk for multidrug-resistant (MDR) Pseudomonas aeruginosa, but factors specific to critically ill pneumonia patients are not fully characterized. Objective was to determine risk factors associated with MDR P. aeruginosa pneumonia among ICU patients. This was a retrospective case-control study of P. aeruginosa pneumonia in the ICU; cystic fibrosis and colonizers were excluded. Risk factors included comorbid conditions and prior healthcare exposure (anti-pseudomonal antibiotics, hospitalizations, nursing home, P...
September 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28716359/predictors-of-polymyxin-b-treatment-failure-in-gram-negative-healthcare-associated-infections-among-critically-ill-patients
#12
Bahiah Ismail, Mohd Nazri Shafei, Azian Harun, Saedah Ali, Mahamarowi Omar, Zakuan Zainy Deris
BACKGROUND: With increasing prevalence and spread of multidrug resistant Gram-negative infections, parenteral polymyxins resurged in clinical practice. The primary aim of the study was to determine the predictors of treatment failure and in-hospital mortality among critically ill patients treated with polymyxin B. METHODS: Demographic data, underlying diseases, procedures and details on polymyxin B therapy were retrospectively analyzed in a cohort of 84 patients who received intravenous polymyxin B in an intensive care unit from 2010 to 2014...
June 29, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28716301/discrete-%C3%AE-adrenergic-mechanisms-regulate-early-and-late-erythropoiesis-in-erythropoietin-resistant-anemia
#13
Shirin Hasan, Michael J Mosier, Andrea Szilagyi, Richard L Gamelli, Kuzhali Muthumalaiappan
BACKGROUND: Anemia of critical illness is resistant to exogenous erythropoietin. Packed red blood cells transfusions is the only treatment option, and despite related cost and morbidity, there is a need for alternate strategies. Erythrocyte development can be divided into erythropoietin-dependent and erythropoietin-independent stages. We have shown previously that erythropoietin-dependent development is intact in burn patients and the erythropoietin-independent early commitment stage, which is regulated by β1/β2-adrenergic mechanisms, is compromised...
July 14, 2017: Surgery
https://www.readbyqxmd.com/read/28710148/energy-protein-carbohydrate-and-lipid-intakes-and-their-effects-on-morbidity-and-mortality-in-critically-ill-adult-patients-a-systematic-review
#14
REVIEW
Anna Patkova, Vera Joskova, Eduard Havel, Miroslav Kovarik, Monika Kucharova, Zdenek Zadak, Miloslav Hronek
The guidelines for nutritional support in critically ill adult patients differ in various aspects. The optimal amount of energy and nutritional substrates supplied is important for reducing morbidity and mortality, but unfortunately this is not well known, because the topic is complex and every patient is individual. The aim of this review was to gather recent pertinent information concerning the nutritional support of critically ill patients in the intensive care unit (ICU) with respect to the energy, protein, carbohydrate, and lipid intakes and the effect of their specific utilization on morbidity and mortality...
July 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28708679/transpulmonary-pressure-describes-lung-morphology-during-decremental-positive-end-expiratory-pressure-trials-in-obesity
#15
Jacopo Fumagalli, Lorenzo Berra, Changsheng Zhang, Massimiliano Pirrone, Roberta R De Santis Santiago, Susimeire Gomes, Federico Magni, Glaucia A B Dos Santos, Desmond Bennett, Vinicius Torsani, Daniel Fisher, Caio Morais, Marcelo B P Amato, Robert M Kacmarek
OBJECTIVES: Atelectasis develops in critically ill obese patients when undergoing mechanical ventilation due to increased pleural pressure. The current study aimed to determine the relationship between transpulmonary pressure, lung mechanics, and lung morphology and to quantify the benefits of a decremental positive end-expiratory pressure trial preceded by a recruitment maneuver. DESIGN: Prospective, crossover, nonrandomized interventional study. SETTING: Medical and Surgical Intensive Care Units at Massachusetts General Hospital (Boston, MA) and University Animal Research Laboratory (São Paulo, Brazil)...
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28706391/utility-of-a-novel-chromogenic-medium-as-a-screening-method-in-the-detection-of-carbapenemase-producing-enterobacteriaceae
#16
Anusha Chaturvedi, Gunjiganur Shankarappa Banashankari
INTRODUCTION: With the emergence of multidrug resistant Gram-negative bugs, there is an urgent need for rapid detection of these resistant organisms. AIM: This study was performed to assess the utility of a novel chromogenic medium in the detection of carbapenemase producing Enterobacteriaceae from various clinical specimens. MATERIALS AND METHODS: A total of 202 isolates of Enterobacteriaceae, which were resistant to meropenem (10 μg) disc by standard disc diffusion method, were analyzed over a period of 6 months...
July 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28694235/clinical-benefits-of-antimicrobial-de-escalation-in-adults-with-community-onset-monomicrobial-escherichia-coli-klebsiella-species-and-proteus-mirabilis-bacteremia
#17
Ching-Chi Lee, Jiun-Ling Wang, Chung-Hsun Lee, Yuan-Pin Hung, Ming-Yuan Hong, Hung-Jen Tang, Wen-Chien Ko
The clinical benefits of an antimicrobial de-escalation strategy were compared with those of a no-switch strategy in bacteremic patients. Adults with community-onset monomicrobial Escherichia coli, Klebsiella species and Proteus mirabilis bacteremia treated empirically using broad-spectrum beta-lactams, including third-generation cephalosporins (GCs), fourth-GC or carbapenems, were treated definitively with first- or second-GCs (de-escalation group), the same regimens as empirical antibiotics (no-switch group), or antibiotics with a broader-spectrum than empirical antibiotics (escalation group)...
July 8, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28693606/combined-use-of-serum-1-3-%C3%AE-d-glucan-and-procalcitonin-for-the-early-differential-diagnosis-between-candidaemia-and-bacteraemia-in-intensive-care-units
#18
Daniele Roberto Giacobbe, Malgorzata Mikulska, Mario Tumbarello, Elisa Furfaro, Marzia Spadaro, Angela Raffaella Losito, Alessio Mesini, Gennaro De Pascale, Anna Marchese, Marco Bruzzone, Paolo Pelosi, Michele Mussap, Alexandre Molin, Massimo Antonelli, Brunella Posteraro, Maurizio Sanguinetti, Claudio Viscoli, Valerio Del Bono
BACKGROUND: This study aimed to assess the combined performance of serum (1,3)-β-D-glucan (BDG) and procalcitonin (PCT) for the differential diagnosis between candidaemia and bacteraemia in three intensive care units (ICUs) in two large teaching hospitals in Italy. METHODS: From June 2014 to December 2015, all adult patients admitted to the ICU who had a culture-proven candidaemia or bacteraemia, as well as BDG and PCT measured closely to the time of the index culture, were included in the study...
July 10, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28689868/evaluation-of-haemodialysis-as-a-protective-technique-for-preventing-high-daily-dose-amikacin-nephrotoxicity-an-experimental-study-in-an-ovine-model
#19
Céline Pouzot-Nevoret, Mathieu Magnin, Jean-Yves Ayoub, Laurent Bourguignon, Pascal Maire, Damien Wertz, Isabelle Goy-Thollot, Anthony Barthélemy, Emmanuel Boselli, Bernard Allaouchiche, Jeanne Marie Bonnet-Garin
Changes in pharmacokinetic parameters of critically ill patients make the treatment of infections challenging, particularly when multidrug-resistant bacteria are involved. The aim of this study was to evaluate the ability of haemodialysis to reduce the exposure to high dose amikacin and prevent nephrotoxicity. Amikacin 50 mg/kg was administered intravenously to six adult sheep once-daily for four days. The sheep were divided into two groups according to the implementation (group 1) or not (group 2) of haemodialysis...
July 6, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28687210/antimicrobial-stewardship-approaches-in-the-intensive-care-unit
#20
REVIEW
Sarah B Doernberg, Henry F Chambers
Antimicrobial stewardship programs aim to monitor, improve, and measure responsible antibiotic use. The intensive care unit (ICU), with its critically ill patients and prevalence of multiple drug-resistant pathogens, presents unique challenges. This article reviews approaches to stewardship with application to the ICU, including the value of diagnostics, principles of empirical and definitive therapy, and measures of effectiveness. There is good evidence that antimicrobial stewardship results in more appropriate antimicrobial use, shorter therapy durations, and lower resistance rates...
September 2017: Infectious Disease Clinics of North America
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