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https://www.readbyqxmd.com/read/29123431/comparative-quality-measures-of-emergency-care-an-outcome-cockpit-proposal-to-survey-clinical-processes-in-real-life
#1
Susanne Burgemeister, Alexander Kutz, Antoinette Conca, Thomas Holler, Sebastian Haubitz, Andreas Huber, Ulrich Buergi, Beat Mueller, Philipp Schuetz
Background: Benchmarking of real-life quality of care may improve evaluation and comparability of emergency department (ED) care. We investigated process management variables for important medical diagnoses in a large, well-defined cohort of ED patients and studied predictors for low quality of care. Methods: We prospectively included consecutive medical patients with main diagnoses of community-acquired pneumonia, urinary tract infection (UTI), myocardial infarction (MI), acute heart failure, deep vein thrombosis, and COPD exacerbation and followed them for 30 days...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29109580/fosfomycin-susceptibility-in-multidrug-resistant-enterobacteriaceae-species-and-vancomycin-resistant-enterococci-urinary-isolates
#2
Linda B Ou, Lynn Nadeau
Background: Broad-spectrum antibiotics are often used to treat urinary tract infections (UTIs) due to drug-resistant species of Enterobacteriaceae and Enterococcus (e.g., organisms producing extended-spectrum β-lactamase [ESBL] or AmpC β-lactamase, as well as vancomycin-resistant enterococci [VRE]). However, this type of therapy can promote selection of resistant organisms and may necessitate venous access. Fosfomycin is an orally administered, single-dose antibiotic for the treatment of uncomplicated UTI...
September 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/29105337/risk-of-coronary-artery-lesions-in-young-infants-with-kawasaki-disease-need-for-a-new-diagnostic-method
#3
Kaoru Satoh, Yoko Wakejima, Maki Gau, Tomoyuki Kiguchi, Nozomi Matsuda, Reiko Takasawa, Kei Takasawa, Masato Nishioka, Masayuki Shimohira
AIM: To examine clinical characteristics of Kawasaki disease (KD) in infants younger than 3 months of age and to develop a method for detecting KD in febrile infants. METHOD: In a case-control study, we retrospectively collected clinical and laboratory data from 24 KD infants younger than 3 months of age out of 410 KD patients. We then compared younger infants with both older patients and febrile infants with respiratory syncytial virus (RSV) infection and urinary tract infections (UTI)...
November 3, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/29095750/the-use-of-regional-or-neuraxial-anesthesia-for-below-knee-amputations-may-reduce-the-need-for-perioperative-blood-transfusions
#4
Obaid Malik, Ethan Y Brovman, Richard D Urman
BACKGROUND AND OBJECTIVES: Amputations of the lower extremity remain a common procedure in a high-risk population. Perioperative morbidity and mortality reach as high as 14.1% in below-knee amputations. We aimed to determine whether regional, or neuraxial, anesthesia, when compared with general anesthesia (GA), would be associated with reduced perioperative morbidity and mortality. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program data set...
November 1, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29091946/maternal-urogenital-schistosomiasis-monitoring-disease-morbidity-by-simple-reagent-strips
#5
Oyetunde T Oyeyemi, Alexander B Odaibo
BACKGROUND: Urine analysis is one of the recommended antenatal guidelines for early diagnosis of pregnancy-associated complications. While in practice, urine analysis by dipstick had been used to provide useful information on other urinary tract infections, its applications for early detection of urogenital schistosomiasis in pregnant women is often times not given due attention in most endemic areas. Our study therefore assessed the performance of some common urinalysis parameters in the diagnosis of maternal urogenital schistosomiasis in endemic rural communities of Nigeria...
2017: PloS One
https://www.readbyqxmd.com/read/29079155/urinary-tract-infection-and-asymptomatic-bacteriuria-in-older-adults
#6
REVIEW
Nicolas W Cortes-Penfield, Barbara W Trautner, Robin L P Jump
Urinary tract infections (UTIs) are a significant cause of morbidity among older adults. However, antibiotic prescriptions for clinically suspected UTIs are often inappropriate. Health care providers frequently struggle to differentiate UTI from asymptomatic bacteriuria, particularly in patients presenting with nonspecific symptoms. Patients with baseline cognitive impairments that limit history-taking can be particularly challenging. This article reviews the epidemiology and pathogenesis of UTI in older adults...
December 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/29079154/breaking-the-chain-of-infection-in-older-adults-a-review-of-risk-factors-and-strategies-for-preventing-device-related-infections
#7
REVIEW
Gregory Schrank, Westyn Branch-Elliman
Device-related infections (DRIs) are a significant cause of morbidity and mortality among older adults. Indwelling devices (urinary catheters, percutaneous feeding tubes, and central venous catheters) are frequently used in this vulnerable population. Indwelling devices provide a portal of entry for pathogenic organisms to invade a susceptible host and cause infection and are an important target for infection prevention and antimicrobial stewardship efforts. Within the "Chain of Infection" that leads to DRIs in older adults, multiple opportunities exist to implement interventions that "break the links" and reduce colonization with multidrug-resistant organisms, reduce infections, and improve antimicrobial use...
December 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/29054298/antimicrobial-resistance-in-community-acquired-urinary-tract-infections-in-paris-in-2015
#8
D Chervet, O Lortholary, J-R Zahar, A Dufougeray, B Pilmis, H Partouche
BACKGROUND: Urinary tract infection (UTI) is one of the most frequent community-acquired infection. Escherichia coli resistance has been on the rise since 2000s. METHODS: We conducted a prospective multicenter cohort study including adults who had a positive urine cytobacteriological examination (UCBE) performed in our Parisian suburb laboratory platform from October 2014 to March 2015. RESULTS: A total of 1223 patients were included: 995 (81...
October 17, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29038707/prevalence-of-idiopathic-hypercalciuria-in-children-with-urinary-system-related-symptoms-attending-a-pediatric-hospital-in-bandar-abbas-in-2014
#9
Maryam Esteghamati, Kambiz Ghasemi, Marie Nami
BACKGROUND: Idiopathic hypercalciuria is a group of diseases which can be manifested with urinary symptoms. Its importance is due to high prevalence, recurrent infections, and stone formations which are often asymptomatic. OBJECTIVE: The objective of this study was to determine the prevalence of idiopathic hypercalciuria in children with urinary system related symptoms in Bandar Abbas in 2014. METHODS: This descriptive cross-sectional study was done in 2014 in a children's hospital in Bandar Abbas (southern Iran) on 321 children who were between 2 months to 14 years old...
September 2017: Electronic Physician
https://www.readbyqxmd.com/read/29032850/impact-of-penicillin-allergy-on-time-to-first-dose-of-antimicrobial-therapy-and-clinical-outcomes
#10
Erin L Conway, Ken Lin, John A Sellick, Kari Kurtzhalts, James Carbo, Michael C Ott, Kari A Mergenhagen
PURPOSE: The objective of this study was to evaluate the impact of a listed penicillin allergy on the time to first dose of antibiotic in a Veterans Affairs hospital. Additional clinical outcomes of patients with penicillin allergies were compared with those of patients without a penicillin allergy. METHODS: A retrospective chart review of veterans admitted through the emergency department with a diagnosis of pneumonia, urinary tract infection, bacteremia, and sepsis from January 2006 to December 2015 was conducted...
October 9, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28973289/early-postoperative-complications-for-elderly-patients-undergoing-single-level-decompression-for-lumbar-disc-herniation-ligamentous-hypertrophy-or-neuroforaminal-stenosis
#11
Arpan V Prabhu, Bryan A Lieber, Jenson K Henry, Nitin Agarwal, Monir Tabbosha, David O Okonkwo
BACKGROUND: Lumbar decompression for disc herniation is frequently performed on elderly patients, and this trend will continue as the population ages. Clinical reports on the complications of lumbar discectomy show good results and cost effectiveness in young or middle-aged patients. OBJECTIVE: To assess and compare the morbidity of single-level lumbar disc surgery for radicular pain in a cohort of patients greater than 80 yr of age to that of a middle-aged cohort...
July 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28971876/risk-factors-that-influence-the-empirical-treatment-of-patients-with-acute-pyelonephritis-a-cohort-study
#12
Pau Bosch-Nicolau, Vicenç Falcó, Belén Viñado, Antonia Andreu, Oscar Len, Benito Almirante, Carles Pigrau
Objectives. The aim of the current study is to compare community-acquired acute pyelonephritis (CA-APN) with healthcare-associated acute pyelonephritis (HCA-APN), describe outcomes and identify variables that could predict antimicrobial susceptibility.Methods. We conducted an observational study that included all consecutive episodes of acute pyelonephritis (APN) in adults during 2014 at a Spanish university-hospital. From each episode demographic data, co-morbidities, clinical presentation, microbiological data, antimicrobial therapy, and outcome were recorded...
October 2, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28956138/-influence-of-nosocomial-infections-on-activities-of-daily-living-in-acute-geriatric-inpatients
#13
Damaris Marzahn, Wolfgang Pfister, Anja Kwetkat
BACKGROUND: Nursing home residents and older hospitalized patients have a significantly higher risk to suffer from nosocomial infections (NI). It is still an unanswered question whether patients suffering from NI are at greater risk for deterioration of activities of daily living. MATERIAL AND METHODS: In a retrospective observational study, we evaluated the prevalence of NI during hospitalization of acute geriatric inpatients of the geriatric department at Jena University Hospital by patient records...
September 27, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28953954/epidemiological-clinical-diagnostic-and-economic-features-of-an-immigrant-population-of-chronic-schistosomiasis-sufferers-with-long-term-residence-in-a-non-endemic-country-north-metropolitan-area-of-barcelona-2002-2016
#14
Sílvia Roure, Lluís Valerio, Olga Pérez-Quílez, Gema Fernández-Rivas, Octavio Martínez-Cuevas, Albert Alcántara-Román, Diego Viasus, M Luisa Pedro-Botet, Miquel Sabrià, Bonaventura Clotet
BACKGROUND: Schistosomiasis, one of the neglected tropical diseases (NTD) listed by the WHO, is an acute and chronic parasitic disease caused by blood flukes (trematode worms) of the genus Schistosoma. Complications of long-term infestation include liver cirrhosis, bladder tumors and kidney failure. The objective of this study was to carry out a clinical and epidemiological characterization of a schistosomiasis-diagnosed immigrant population with long-term residencein the EU as well as to evaluate the diagnostic methods available to date...
2017: PloS One
https://www.readbyqxmd.com/read/28944509/diagnosis-and-treatment-of-patients-with-prostatic-abscess-in-the-post-antibiotic-era
#15
REVIEW
Anne Lenore Ackerman, Pooja S Parameshwar, Jennifer T Anger
We reviewed the pathogenesis, clinical presentation, treatment options and outcomes of prostatic abscess in the post-antibiotic era, focusing on how patient risk factors and the emergence of multidrug-resistant organisms influence management of the condition. A MEDLINE search for "prostate abscess" or "prostatic abscess" was carried out. Prostate abscess is no longer considered a consequence of untreated urinary infection; now, men with prostatic abscess are typically debilitated or immunologically compromised, with >50% of patients having diabetes...
September 24, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28939397/national-survey-of-emergency-physicians-concerning-home-based-care-options-as-alternatives-to-emergency-department-based-hospital-admissions
#16
Amy R Stuck, Christopher Crowley, James Killeen, Edward M Castillo
BACKGROUND: Emergency departments (EDs) in the United States play a prominent role in hospital admissions, especially for the growing population of older adults. Home-based care, rather than hospital admission from the ED, provides an important alternative, especially for older adults who have a greater risk of adverse events, such as hospital-acquired infections, falls, and delirium. OBJECTIVE: The objective of the survey was to understand emergency physicians' (EPs) perspectives on home-based care alternatives to hospitalization from the ED...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28923621/extended-spectrum-beta-lactamase-producing-enterobacteriaceae-related-urinary-tract-infection-in-kidney-transplant-recipients-risk-factors-treatment-and-long-term-outcome
#17
S Brakemeier, S I Taxeidi, B Zukunft, D Schmidt, J Gaedeke, M Dürr, S Hansen, K Budde
BACKGROUND: Prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) has risen in kidney transplant (KT) patients, with no long-term data so far on graft function or survival. METHODS: KT patients with ESBL-E-positive urine culture were retrospectively analyzed regarding initial adequate antimicrobial therapy, recurrent infection, transplant function, and survival compared with an ESBL-E-negative KT control cohort. RESULTS: ESBL-E-positive KT patients (n = 93) were older (55...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28914701/elevated-postvoid-residual-urine-volume-identifying-risk-factors-and-predicting-resolution-in-women-with-pelvic-organ-prolapse
#18
Amanda Ulrich, Patricia Davis, Katie Propst, David M OʼSullivan, Paul Tulikangas
OBJECTIVES: This study aims to identify risk factors for elevated preoperative postvoid residual (PVR) and persistently elevated postoperative PVR and to evaluate the resolution rate of elevated PVR urine volume in patients undergoing reconstructive surgery for pelvic organ prolapse (POP). METHODS: This was a retrospective cohort study comparing 50 women with elevated preoperative PVR (≥100 mL) and 50 women with normal PVR (<100 mL). Preoperative demographic, physical examination, urodynamic data, type of surgery performed, and postoperative trial of void data were collected...
October 17, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28857797/a-comparison-of-3-frailty-indices-in-predicting-morbidity-and-mortality-after-on-pump-aortic-valve-replacement
#19
Gary Esses, Evie Andreopoulos, Hung-Mo Lin, Shipra Arya, Stacie Deiner
BACKGROUND: Aortic valve replacement is a high-risk surgery (3%-5%, 30-day mortality) performed on approximately 30,000 elderly patients a year in the United States. Currently, preoperative risk assessment is based on a composite of medical examination and a subjective evaluation for frailty ("eyeball test"). Objective frailty assessment using validated indices has the potential to improve risk stratification. The purpose of this study was to (1) establish whether frailty can predict 30-day mortality and composite morbidity in patients undergoing aortic valve replacement and (2) compare the predictive ability of 3 frailty indices in this population...
August 29, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28838299/peculiarities-of-feline-hyperadrenocorticism-update-on-diagnosis-and-treatment
#20
Lara A Boland, Vanessa R Barrs
Practical relevance: Hyperadrenocorticism (HAC) is a relatively uncommon endocrinopathy of older cats, with a mean age at diagnosis of 10 years. In addition to pituitary-dependent and adrenal-dependent hypercortisolism, clinical signs of HAC can result from adrenal sex steroid-producing tumours. Clinical challenges: While HAC in cats has many similarities to canine HAC, there are key differences in presentation, diagnosis and response to therapy. Most, but not all, cats with HAC have concurrent diabetes mellitus, which is often insulin resistant...
September 2017: Journal of Feline Medicine and Surgery
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