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Critical ill and resistency

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https://www.readbyqxmd.com/read/27923116/new-evidence-in-support-of-staging-approaches-in-schizophrenia-differences-in-clinical-profiles-between-first-episode-early-stage-and-late-stage
#1
Bruno Bertolucci Ortiz, Fernanda Dal Medico Eden, Aline Silva Rodrigues de Souza, Carla Agostinho Teciano, Daniela Malatesta de Lima, Cristiano Noto, Cinthia Hiroko Higuchi, Hugo Cogo-Moreira, Rodrigo Affonseca Bressan, Ary Gadelha
Few studies have examined the progression of symptom dimensions in schizophrenia patients over the course of the illness. The objective of this study was to investigate whether clinical and psychopathological differences exist between first-episode schizophrenia (FES) and multiple-episode patients in an inpatient setting. Patients (N=203) were evaluated using the Positive and Negative Syndrome Scale (PANSS) over time. Five different generalized estimating equations were built for the PANSS factors using the following as covariates: sex, patient's age, assessment time point (i...
November 18, 2016: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/27921433/-is-glucosis-only-basic-energy-substrate
#2
Luboš Sobotka
At present time glucose is primarily considered as basic energy substrate. Therefore, it is recommended to give amount of glucose which is necessary for oxidation and energy production. As critical illness is connected with so-called insulin resistance, it is recommended to reduce the glucose dose and maintain normal blood glucose. Glucose, however, may not only be the principal energy substrate but also the substrate necessary for many metabolic reactions, which are essential for normal reactivity and survival...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27919296/antimicrobial-resistance-in-salmonella-that-caused-foodborne-disease-outbreaks-united-states-2003-2012
#3
A C Brown, J E Grass, L C Richardson, A L Nisler, A S Bicknese, L H Gould
Although most non-typhoidal Salmonella illnesses are self-limiting, antimicrobial treatment is critical for invasive infections. To describe resistance in Salmonella that caused foodborne outbreaks in the United States, we linked outbreaks submitted to the Foodborne Disease Outbreak Surveillance System to isolate susceptibility data in the National Antimicrobial Resistance Monitoring System. Resistant outbreaks were defined as those linked to one or more isolates with resistance to at least one antimicrobial drug...
December 6, 2016: Epidemiology and Infection
https://www.readbyqxmd.com/read/27918901/clinical-utility-of-methicillin-resistant-staphylococcus-aureus-nasal-polymerase-chain-reaction-assay-in-critically-ill-patients-with-nosocomial-pneumonia
#4
Melanie N Smith, Michael J Erdman, Jason A Ferreira, Petra Aldridge, Christopher A Jankowski
PURPOSE: This study investigated the diagnostic performance characteristics of a methicillin-resistant Staphylococcus aureus (MRSA) nasal polymerase chain reaction (PCR) assay in critically ill patients with nosocomial pneumonia. MATERIALS AND METHODS: This retrospective, single-center study included adult patients admitted to an intensive care unit with suspected nosocomial pneumonia. Patients must have received an MRSA nasal PCR assay and respiratory culture within predetermined time intervals...
November 15, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27917707/management-of-pneumonia-in-the-pediatric-critical-care-unit-an-area-for-antimicrobial-stewardship
#5
Aimee M Dassner, David P Nicolau, Jennifer E Girotto
Pediatric pneumonia is one of the most common causes of childhood infection requiring hospitalization and is a substantial driver of antimicrobial use among hospitalized children. About 12-20% of pediatric patients hospitalized with community-acquired pneumonia (CAP) require critical care. Additionally, nosocomial pneumonias (i.e. hospital-acquired and ventilator-associated pneumonias) are responsible for 15-53% of hospital-associated infections and are the most common indication for empiric antibiotics in the pediatric intensive care unit...
December 4, 2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/27887595/antimicrobial-stewardship-of-chinese-ministry-of-health-reduces-multidrug-resistant-organism-isolates-in-critically-ill-patients-a-pre-post-study-from-a-single-center
#6
Xudong Ma, Jianfeng Xie, Yi Yang, Fengmei Guo, Zhiwei Gao, Hua Shao, Yingzi Huang, Congshan Yang, Haibo Qiu
BACKGROUND: China's Ministry of Health (MOH) has established a policy about the antimicrobial stewardship. To date, the effects of this policy on multidrug-resistant organism (MDRO) in critically ill patients are unknown. METHODS: A pre-post study was conducted on intensive care unit (ICU) patients from June 2010 to May 2011 and from June 2012 to May 2013. Bacterial cultures were conducted at ICU admission and discharge. In June 2011, our hospital started to administer the antimicrobial stewardship program of Chinese MOH...
November 25, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27880665/the-current-treatment-landscape-candidiasis
#7
Matteo Bassetti, Maddalena Peghin, Jean-Francois Timsit
The epidemiology of Candida species infection has changed over recent decades, influenced by local hospital-related factors, patient predisposing conditions and type of antifungal agents administered. A shift from Candida albicans as the predominant pathogen towards an increasing prevalence of the species Candida glabrata and Candida parapsilosis amongst critically ill patients has been documented. Changes in Candida species distribution may impact treatment recommendations due to differences in susceptibility to antifungal agents among species...
November 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27876075/chlorhexidine-bathing-and-health-care-associated-infections-among-adult-intensive-care-patients-a-systematic-review-and-meta-analysis
#8
Steven A Frost, Mari-Cris Alogso, Lauren Metcalfe, Joan M Lynch, Leanne Hunt, Ritesh Sanghavi, Evan Alexandrou, Kenneth M Hillman
BACKGROUND: Health care-associated infections (HAI) have been shown to increase length of stay, the cost of care, and rates of hospital deaths (Kaye and Marchaim, J Am Geriatr Soc 62(2):306-11, 2014; Roberts and Scott, Med Care 48(11):1026-35, 2010; Warren and Quadir, Crit Care Med 34(8):2084-9, 2006; Zimlichman and Henderson, JAMA Intern Med 173(22):2039-46, 2013). Importantly, infections acquired during a hospital stay have been shown to be preventable (Loveday and Wilson, J Hosp Infect 86:S1-70, 2014)...
November 23, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27851800/expression-and-function-of-interleukin-1%C3%AE-induced-neutrophil-gelatinase-associated-lipocalin-in-renal-tubular-cells
#9
Tadayoshi Konno, Rei Nakano, Ryo Mamiya, Hisashi Tsuchiya, Taku Kitanaka, Shinichi Namba, Nanako Kitanaka, Ken Okabayashi, Takanori Narita, Hiroshi Sugiya
Acute kidney injury (AKI) is characterized by a sudden loss of renal function. Early recognition of AKI, especially in critically ill patients, is essential for adequate therapy. Currently, neutrophil gelatinase-associated lipocalin (NGAL) is considered to be an effective biomarker of AKI; however, the regulation of its expression and function in renal tubular cells remains unclear. In this study, we investigated the regulation of the expression and function of NGAL in IL-1β-treated Madin-Darby canine kidney (MDCK) cells as a model of renal tubular cells...
2016: PloS One
https://www.readbyqxmd.com/read/27850279/640-duration-of-broad-spectrum-antimicrobials-in-the-critically-ill-and-development-of-new-resistance
#10
Besu Teshome, Scott Vouri, Nicholas Hampton, Marin Kollef, Scott Micek
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27846092/pilot-mechanistic-study-of-insulin-modulation-of-somatotrophic-hormones-inflammation-and-lipid-metabolism-during-critical-illness-in-children
#11
Ricardo G Branco, Pedro Celiny R Garcia, Jefferson P Piva, Geniara S Conrado, Felipe Cabral, Cecilia Korb, Humberto Fiori, Matteo Baldisserotto, Robert C Tasker
OBJECTIVES: To evaluate the mechanism of insulin modulation on somatotrophic response, inflammation, and lipid metabolism in critically ill children. DESIGN: Open-label randomized mechanistic study. SETTING: Two-center, tertiary PICU study. PATIENTS: Thirty critically ill children between 1 month and 14 years old, requiring mechanical ventilation and with evidence of two or more organ system failures. INTERVENTIONS: Randomized physiologic design of hyperinsulinemic-euglycemic clamp using continuous insulin infusion at 0...
November 11, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27836495/duration-of-systemic-inflammatory-response-syndrome-influences-serum-vancomycin-concentration-in-patients-with-sepsis
#12
Masayuki Chuma, Makoto Makishima, Toru Imai, Naohiro Tochikura, Takako Sakaue, Norikazu Kikuchi, Kosaku Kinoshita, Morio Kaburaki, Yoshikazu Yoshida
PURPOSE: Vancomycin (VCM) is used in the treatment of methicillin-resistant Staphylococcus aureus infection. The dosage of VCM must be adjusted by using therapeutic drug monitoring because of the drug's narrow therapeutic concentration window. Although optimal administration based on population pharmacokinetic (PPK) analysis and/or a Bayesian method has improved prediction accuracy, serum concentrations of VCM in patients with sepsis often deviate significantly from predicted values. We investigated factors influencing prediction errors with PPK analysis in VCM dosing...
November 8, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27836381/universal-protocol-for-the-rapid-automated-detection-of-carbapenem-resistant-gram-negative-bacilli-directly-from-blood-cultures-by-matrix-assisted-laser-desorption-ionisation-time-of-flight-mass-spectrometry-maldi-tof-ms
#13
Marina Oviaño, Katrin Sparbier, Maria José Barba, Markus Kostrzewa, Germán Bou
Detection of carbapenemase-producing bacteria directly from blood cultures is a major challenge, as patients with bacteraemia are critically ill. Early detection can be helpful for selection of the most appropriate antibiotic therapy as well as adequate control of outbreaks. In the current study, a novel matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF)-based method was developed for the rapid, automated detection of carbapenemase-producing Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii directly from blood cultures...
October 20, 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/27804246/polymyxin-b-immobilized-column-direct-hemoperfusion-for-adolescent-toxic-shock-syndrome
#14
Etsuro Nanishi, Yuichirou Hirata, Sooyoung Lee, Noriyuki Kaku, Kenta Momii, Kensuke Kubota, Hisanori Nishio, Yoshihiko Maehara, Toshiro Hara
Toxic shock syndrome (TSS) is a critical illness associated with toxin from Staphylococcus aureus. Despite recent advances in critical care, mortality remains high and additional effective therapy is required. We report an adolescent case of TSS successfully treated with direct hemoperfusion using polymyxin-B immobilized fiber (PMX-DHP). The patient with spina bifida also had ischial pressure ulcer, and developed TSS associated with methicillin-resistant S. aureus. Despite conventional treatment, the patient developed refractory shock, which was immediately improved with PMX-DHP...
October 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27802272/isoflurane-and-sevoflurane-induce-severe-hepatic-insulin-resistance-in-a-canine-model
#15
Stella P Kim, Josiane L Broussard, Cathryn M Kolka
INTRODUCTION: Anesthesia induces insulin resistance, which may contribute to elevated blood glucose and adverse post-operative outcomes in critically ill patients, and impair glycemic control in surgical patients with diabetes. However, little is known about the mechanisms by which anesthesia impairs insulin sensitivity. Here we investigate the effects of anesthesia on insulin sensitivity in metabolic tissues. METHODS: Hyperinsulinemic-euglycemic clamps were performed in 32 lean (control diet; n = 16 conscious versus n = 16 anesthetized) and 24 fat-fed (6 weeks fat-feeding; n = 16 conscious versus n = 8 anesthetized) adult male mongrel dogs in conjunction with tracer methodology to differentiate hepatic versus peripheral insulin sensitivity...
2016: PloS One
https://www.readbyqxmd.com/read/27801377/impact-of-colistin-initiation-delay-on-mortality-of-ventilator-associated-pneumonia-caused-by-a-baumannii
#16
Shaher Samrah, Yazan Bashtawi, Wail Hayajneh, Basima Almomani, Suleiman Momany, Yousef Khader
INTRODUCTION: There has been increased incidence and high mortality in cases with ventilator-associated pneumonia (VAP) caused by colistin-only-susceptible Acinetobacter baumannii (COS-AB). Colistin has emerged as a therapeutic option for VAP caused by multidrug-resistant Gram-negative organisms including COS-AB. A retrospective study was conducted to examine the impact of early versus late initiation of colistin on 30-day mortality of critically ill patients with VAP caused by COS-AB...
October 31, 2016: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/27799063/tuberculosis-care-strategies-and-their-economic-consequences-for-patients-the-missing-link-to-end-tuberculosis
#17
Belete Getahun, Moges Wubie, Getiye Dejenu, Tsegahun Manyazewal
BACKGROUND: While investment in the development of Tuberculosis (TB) treatment strategies is essential, it cannot be assumed that the strategies are affordable for TB patients living in countries with high economic constraints. This study aimed to determine the economic consequences of directly observed therapy for TB patients. METHODS: A cross-sectional cost-of-illness analysis was conducted between September to November 2015 among 576 randomly selected adult TB patients who were on directly observed treatment in 27 public health facilities in Addis Ababa, Ethiopia...
November 1, 2016: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/27790429/act-fast-as-time-is-less-high-faecal-carriage-of-carbapenem-resistant-enterobacteriaceae-in-critical-care-patients
#18
Sanjith Saseedharan, Manisa Sahu, Edwin Joseph Pathrose, Sarita Shivdas
INTRODUCTION: Carbapenem-resistant Enterobacteriaceae (CRE) are drug-resistant Gram-negative bacteria that are present in the community as well as in hospitals. Their infection and colonisation puts critically ill patients at high risk due to the drug-resistant nature of the strains and possible spreading of these organisms, even in a hospital environment. AIM: To examine the presence and types of Enterobacteriaceae species in patients admitted directly from the community...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27776162/incidence-clinical-outcome-and-risk-factors-of-intensive-care-unit-infections-in-the-lagos-university-teaching-hospital-luth-lagos-nigeria
#19
Anthony A Iwuafor, Folasade T Ogunsola, Rita O Oladele, Oyin O Oduyebo, Ibironke Desalu, Chukwudi C Egwuatu, Agwu U Nnachi, Comfort N Akujobi, Ita O Ita, Godwin I Ogban
BACKGROUND: Infections are common complications in critically ill patients with associated significant morbidity and mortality. AIM: This study determined the prevalence, risk factors, clinical outcome and microbiological profile of hospital-acquired infections in the intensive care unit of a Nigerian tertiary hospital. MATERIALS AND METHODS: This was a prospective cohort study, patients were recruited and followed up between September 2011 and July 2012 until they were either discharged from the ICU or died...
2016: PloS One
https://www.readbyqxmd.com/read/27761766/de-novo-synthesis-and-functional-analysis-of-polyphosphate-loaded-poly-ethylene-glycol-hydrogel-nanoparticles-targeting-pyocyanin-and-pyoverdin-production-in-pseudomonas-aeruginosa-as-a-model-intestinal-pathogen
#20
Yushu Yin, Georgia Papavasiliou, Olga Y Zaborina, John C Alverdy, Fouad Teymour
The human gastrointestinal tract is the primary site of colonization of multidrug resistant pathogens and the major source of life-threatening complications in critically ill and immunocompromised patients. Eradication measures using antibiotics carry further risk of antibiotic resistance. Furthermore, antibiotic treatment can adversely shift the intestinal microbiome toward domination by resistant pathogens. Therefore, approaches directed to prevent replacement of health promoting microbiota with resistant pathogens should be developed...
October 19, 2016: Annals of Biomedical Engineering
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