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https://www.readbyqxmd.com/read/29344358/the-global-problem-of-childhood-diarrhoeal-diseases-emerging-strategies-in-prevention-and-management
#1
REVIEW
Margaret Mokomane, Ishmael Kasvosve, Emilia de Melo, Jeffrey M Pernica, David M Goldfarb
Acute diarrhoeal diseases remain a leading cause of global morbidity and mortality particularly among young children in resource-limited countries. Recent large studies utilizing case-control design, prospective sampling and more sensitive and broad diagnostic techniques have shed light on particular pathogens of importance and highlighted the previously under recognized impact of these infections on post-acute illness mortality and growth. Vaccination, particularly against rotavirus, has emerged as a key effective means of preventing significant morbidity and mortality from childhood diarrhoeal disease...
January 2018: Therapeutic Advances in Infectious Disease
https://www.readbyqxmd.com/read/29341498/review-article-sepsis-in-the-emergency-department-part-2-investigations-and-monitoring
#2
REVIEW
Amith Shetty, Stephen Pj Macdonald, Gerben Keijzers, Julian M Williams, Benjamin Tang, Bas de Groot, Kelly Thompson, John F Fraser, Simon Finfer, Rinaldo Bellomo, Jonathan Iredell
Sepsis is characterised by organ dysfunction resulting from infection, with no reliable single objective test and current diagnosis based on clinical features and results of investigations. In the ED, investigations may be conducted to diagnose infection as the cause of the presenting illness, identify the source, distinguish sepsis from uncomplicated infection (i.e. without organ dysfunction) and/ or risk stratification. Appropriate sample collection for microbiological testing remains key for subsequent confirmation of diagnosis and rationalisation of antimicrobials...
January 16, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29334366/modified-colistin-regimen-for-critically-ill-patients-with-acute-renal-impairment-and-continuous-renal-replacement-therapy
#3
Pierantonio Menna, Emanuela Salvatorelli, Alessia Mattei, Dario Cappiello, Giorgio Minotti, Massimiliano Carassiti
Colistin is a last resort antibiotic to treat multidrug-resistant Gram-negative bacteria infections. Colistin is administered intravenously in the form of its inactive prodrug colistin methanesulfonate (CMS). For patients with acute kidney impairment and continuous renal replacement therapy high extracorporeal clearance may cause a substantial removal of active colistin from the bloodstream, eventually decreasing its antibacterial efficacy. Currently recommended doses of CMS may therefore be inadequate for these patients...
December 22, 2017: Chemotherapy
https://www.readbyqxmd.com/read/29320720/simultaneous-emergence-and-rapid-spread-of-three-oxa-23-producing-acinetobacter-baumannii-st208-strains-in-intensive-care-units-confirmed-by-whole-genome-sequencing
#4
Qiong Chen, Jia-Wei Zhou, Jian-Zhong Fan, Sheng-Hai Wu, Li-Hui Xu, Yan Jiang, Zhi Ruan, Yun-Song Yu, Dao-Jun Yu, Xian-Jun Wang
Carbapenem-resistant Acinetobacter baumannii (CRAB) is a common nosocomial bacterial pathogen with limited treatment options. CRAB outbreaks are disastrous for critically ill patients. This study investigated carbapenemase-produced A. baumannii outbreaks in a tertiary hospital. Although multiple outbreaks were suggested by pulse-field gel electrophoresis, the genetic lineages and evolution between these isolates were not clear. To investigate the genomic epidemiology of these outbreaks and to reveal possible transmission routes, whole genome sequences (WGS) were compared and analyzed...
January 8, 2018: Infection, Genetics and Evolution
https://www.readbyqxmd.com/read/29317845/pyomyositis-in-the-setting-of-complicated-diverticulitis-case-report
#5
James Sun, David Leor Kashan, Jolita Marie Auguste, Akella Chendrasekhar
Pyomyositis is typically thought of as a disease of the tropics. However, it is becoming more prevalent in temperate regions, and may be underdiagnosed. Here, pyomyositis is encountered as a complication of perforated diverticulitis, which has not been previously reported. A 61-year-old Caucasian man initially presented in respiratory distress and was diagnosed with respiratory failure due to COPD exacerbation. The patient was taking high-dose prednisone, 60 mg daily for the past 2 years. Initially, he was afebrile, normotensive, tachycardic to 178 beats/minute and tachypneic to 28 breaths/minute, requiring noninvasive ventilation to maintain oxygenation...
2018: International Journal of General Medicine
https://www.readbyqxmd.com/read/29313072/-antibiotic-stewardship-measures-for-optimizing-prescription-of-anti-infective-agents
#6
REVIEW
C Lanckohr, H Bracht
Antibiotic stewardship (ABS) comprises a bundle of different interventions to improve anti-infective treatment in a hospital setting. An important component of ABS interventions is the interdisciplinary approach to infection management. Besides improving infrastructural aspects on a hospital level, including surveillance of the use of anti-infective agents and nosocomial infections, collation and interpretation of statistics on resistance and formulation of local treatment guidelines, ABS teams go to the wards and advise treating physicians on antibiotic therapy...
January 8, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29305389/before-narrative-episodic-reading-and-representations-of-chronic-pain
#7
Sara Wasson
This article suggests that some illness experience may require a reading practice less concerned with narrative coherence or self-authorship, and more interested in the value of textual fragments, episodes and moments considered outside a narrative framework. Chronic pain can pose multiple challenges to the narrative orientations celebrated in both 'survivorship' discourse and classic medical humanities scholarship. In its recalcitrance to cure, its often mysterious aetiology and its complex blend of somatic, interpersonal and affective elements, representations of chronic pain can require a richer vocabulary of temporality...
January 5, 2018: Medical Humanities
https://www.readbyqxmd.com/read/29304840/factors-influencing-adherence-to-tuberculosis-treatment-in-asmara-eritrea-a-qualitative-study
#8
Frezghi Hidray Gebreweld, Meron Mehari Kifle, Fitusm Eyob Gebremicheal, Leban Lebahati Simel, Meron Mebrahtu Gezae, Shewit Sibhatu Ghebreyesus, Yordanos Tesfamariam Mengsteab, Nebiat Ghirmay Wahd
BACKGROUND: Non-adherence to tuberculosis (TB) treatment is an important barrier for TB prevention and control. Poor adherence may result in prolonged disease infectiousness, drug resistance, relapse and death. The aim of this study was to assess factors influencing adherence to tuberculosis treatment in selected health facilities in Asmara, Eritrea. METHODS: A qualitative study which included in-depth interviews with 12 TB patients, three focus group discussions in selected health facilities in which one group comprised eight patients and key informant interviews with three health workers...
January 5, 2018: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/29304210/overview-of-antifungal-dosing-in-invasive-candidiasis
#9
Federico Pea, Russell E Lewis
In the past, most antifungal therapy dosing recommendations for invasive candidiasis followed a 'one-size fits all' approach with recommendations for lowering maintenance dosages for some antifungals in the setting of renal or hepatic impairment. A growing body of pharmacokinetic/pharmacodynamic research, however now points to a widespread 'silent epidemic' of antifungal underdosing for invasive candidiasis, especially among critically ill patients or special populations who have altered volume of distribution, protein binding and drug clearance...
January 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29288367/antimicrobial-resistance-and-antibiotic-stewardship-programs-in-the-icu-insistence-and-persistence-in-the-fight-against-resistance-a-position-statement-from-esicm-escmid-waaar-round-table-on-multi-drug-resistance
#10
Jan J De Waele, Murat Akova, Massimo Antonelli, Rafael Canton, Jean Carlet, Daniel De Backer, George Dimopoulos, José Garnacho-Montero, Jozef Kesecioglu, Jeffrey Lipman, Mervyn Mer, José-Artur Paiva, Mario Poljak, Jason A Roberts, Jesus Rodriguez Bano, Jean-François Timsit, Jean-Ralph Zahar, Matteo Bassetti
Antimicrobial resistance (AMR) is a clear and present danger to patients in any intensive care unit (ICU) around the world. Whereas AMR may affect any patient in the hospital, patients in the ICU are particularly at risk of acquiring AMR infections due to the intensity of the treatment, use of invasive devices, increased risk of transmission and exposure to antibiotics. AMR is present in every ICU, although prevalence is geographically different and AMR pathogens encountered are variable. Intensive care and infectious disease specialists from the European Society of Intensive Care Medicine, European Society of Microbiology and Infectious Diseases and World Alliance Against Antimicrobial Resistance, united in the ANTARCTICA (Antimicrobial Resistance in Critical Care) coalition, call for increased awareness and action among health care professionals to reduce AMR development in critically ill patients, to improve treatment of AMR infections and to coordinate scientific research in this high-risk patient population...
December 29, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29282231/involuntary-treatment-of-patients-with-life-threatening-anorexia-nervosa
#11
Patricia Westmoreland, Craig Johnson, Michael Stafford, Richard Martinez, Philip S Mehler
Anorexia nervosa has the highest mortality rate of any psychiatric illness. Predictors of mortality include chronicity of the illness, critically low body weight, and binging and purging behavior. Delusional beliefs body image, coupled with impaired judgment and cognition caused by starvation, often result in these patients adamantly resisting efforts to treat them. Guardianship, although useful in assisting with medical treatment decisions for patients with anorexia nervosa who are critically medically ill, is usually an inadequate intervention with respect to psychiatric treatment for these patients...
December 2017: Journal of the American Academy of Psychiatry and the Law
https://www.readbyqxmd.com/read/29258723/response-to-letter-to-the-editor-factors-associated-with-in-hospital-mortality-among-critically-ill-surgical-patients-with-multidrug-resistant-gram-negative-infections-methodological-issues
#12
Andrew S Jarrell, Rachel M Kruer, Loredana Diana Berescu, Peter J Pronovost, Julie B Trivedi
No abstract text is available yet for this article.
December 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29249812/uncovering-the-mechanisms-of-acinetobacter-baumannii-virulence
#13
REVIEW
Christian M Harding, Seth W Hennon, Mario F Feldman
Acinetobacter baumannii is a nosocomial pathogen that causes ventilator-associated as well as bloodstream infections in critically ill patients, and the spread of multidrug-resistant Acinetobacter strains is cause for concern. Much of the success of A. baumannii can be directly attributed to its plastic genome, which rapidly mutates when faced with adversity and stress. However, fundamental virulence mechanisms beyond canonical drug resistance were recently uncovered that enable A. baumannii and, to a limited extent, other medically relevant Acinetobacter species to successfully thrive in the health-care environment...
December 18, 2017: Nature Reviews. Microbiology
https://www.readbyqxmd.com/read/29239831/factors-associated-with-in-hospital-mortality-among-critically-ill-surgical-patients-with-multidrug-resistant-gram-negative-infections
#14
Andrew S Jarrell, Rachel M Kruer, Loredana Diana Berescu, Peter J Pronovost, Julie B Trivedi
PURPOSE: Multidrug-resistant (MDR) Gram-negative infection increases risk of mortality, other complications, and costs. The objective of this study was to determine the prevalence of and identify factors associated with in-hospital mortality among critically ill surgical patients. MATERIALS AND METHODS: This case-control study included critically ill surgical patients from 2011 to 2014 who had a carbapenem-resistant Enterobacteriaceae (CRE), MDR P. aeruginosa, or MDR Acinetobacter spp...
November 24, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29228133/regional-epidemiology-of-methicillin-resistant-staphylococcus-aureus-among-adult-intensive-care-unit-patients-following-state-mandated-active-surveillance
#15
Michael Y Lin, Mary K Hayden, Rosie D Lyles, Karen Lolans, Louis F Fogg, Alexander J Kallen, Stephen G Weber, Robert A Weinstein, William E Trick
Background: In 2007, Illinois became the first state in the United States to mandate active surveillance of methicillin-resistant Staphylococcus aureus (MRSA). The Illinois law applies to intensive care unit (ICU) patients; contact precautions are required for patients found to be MRSA-colonized. However, the effectiveness of a legislated "search and isolate" approach to reduce MRSA burden among critically ill patients is uncertain. We evaluated whether the prevalence of MRSA colonization declined in the 5 years after the start of mandatory active surveillance...
December 7, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29220754/association-of-high-mortality-with-extended-spectrum-%C3%AE-lactamase-esbl-positive-cultures-in-community-acquired-infections
#16
Sumit Ray, Dimple Anand, Sankalp Purwar, Arijit Samanta, Kaustubh V Upadhye, Prasoon Gupta, Debashis Dhar
PURPOSE: Infections due to multidrug resistant organisms have become a serious health concern worldwide. The present study was conducted to investigate the spectrum of microbial resistance pattern in the community and their effects on mortality. METHODS: A retrospective review and analysis of prospectively collected data was done of all patients admitted with diagnosis of sepsis in two tertiary care ICU's for a period of two years. Demographics, culture positivity, microbial spectrum, resistance pattern and outcome data were collected...
October 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29213079/human-cd26high-t-cells-elicit-tumor-immunity-against-multiple-malignancies-via-enhanced-migration-and-persistence
#17
Stefanie R Bailey, Michelle H Nelson, Kinga Majchrzak, Jacob S Bowers, Megan M Wyatt, Aubrey S Smith, Lillian R Neal, Keisuke Shirai, Carmine Carpenito, Carl H June, Michael J Zilliox, Chrystal M Paulos
CD8+ T lymphocytes mediate potent immune responses against tumor, but the role of human CD4+ T cell subsets in cancer immunotherapy remains ill-defined. Herein, we exhibit that CD26 identifies three T helper subsets with distinct immunological properties in both healthy individuals and cancer patients. Although CD26neg T cells possess a regulatory phenotype, CD26int T cells are mainly naive and CD26high T cells appear terminally differentiated and exhausted. Paradoxically, CD26high T cells persist in and regress multiple solid tumors following adoptive cell transfer...
December 6, 2017: Nature Communications
https://www.readbyqxmd.com/read/29202543/-experts-consensus-on-the-management-of-the-right-heart-function-in-critically-ill-patients
#18
X T Wang, D W Liu, H M Zhang, Y Long, X D Guan, H B Qiu, K J Yu, J Yan, H Zhao, Y Q Tang, X Ding, X C Ma, W Du, Y Kang, B Tang, Y H Ai, H W He, D C Chen, H Chen, W Z Chai, X Zhou, N Cui, H Wang, X Rui, Z J Hu, J G Li, Y Xu, Y Yang, B Ouyan, H Y Lin, Y M Li, X Y Wan, R L Yang, Y Z Qin, Y G Chao, Z Y Xie, R H Sun, Z Y He, D F Wang, Q Q Huang, D P Jiang, X Y Cao, R G Yu, X Wang, X K Chen, J F Wu, L N Zhang, M G Yin, L X Liu, S W Li, Z J Chen, Z Luo
To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29201114/once-versus-thrice-daily-colistin-in-critically-ill-ptients-with-multi-drug-resistant-infections
#19
Monireh Ghazaeian, Majid Mokhtari, Mehran Kouchek, MirMohammad Miri, Reza Goharani, Robabeh Ghodssi-Ghassemabadi, Mohammad Sistanizad
The aim of this study was to evaluate the procalcitonin (PCT) changes in two different high-dose colistin regimens in the treatment of multi-drug resistant MDR gram negative infections in ICU patients. This is a prospective study of adult ICU patients with bacteremia and ventilator associated pneumonia (VAP) caused by MDR gram negative pathogens. Patients were assigned to two colistin administration groups. Group A received 9 and group B received 3 million international units every 24 and 8 h respectively. Baseline characteristics and measurements of PCT concentrations at the start, the 3rd and the 5th day of the antibiotic therapy and their trends between the two groups were recorded and compared...
2017: Iranian Journal of Pharmaceutical Research: IJPR
https://www.readbyqxmd.com/read/29194526/bacterial-infections-after-burn-injuries-impact-of-multidrug-resistance
#20
Anne M Lachiewicz, Christopher G Hauck, David J Weber, Bruce A Cairns, David van Duin
Patients who are admitted to the hospital after sustaining a large burn injury are at high risk for developing hospital-associated infections. If patients survive the initial 72 hours after a burn injury, infections are the most common cause of death. Ventilator-associated pneumonia is the most important infection in this patient population. The risk of infections caused by multidrug-resistant bacterial pathogens increases with hospital length of stay in burn patients. In the first days of the postburn hospitalization, more susceptible, Gram-positive organisms predominate, whereas later more resistant Gram-negative organisms are found...
November 29, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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