keyword
MENU ▼
Read by QxMD icon Read
search

de-escalation

keyword
https://www.readbyqxmd.com/read/29149338/multiplex-respiratory-virus-testing-for-antimicrobial-stewardship-a-prospective-assessment-of-antimicrobial-use-and-clinical-outcomes-among-hospitalized-adults
#1
Makeda Semret, Ian Schiller, Barbara Ann Jardin, Charles Frenette, Vivian G Loo, Jesse Papenburg, Shelly A McNeil, Nandini Dendukuri
Background: Respiratory tract infections are frequent causes of hospitalization and initiation of empirical antimicrobial therapy. Testing for a broad panel of respiratory viruses has been advocated as a useful tool for antibiotic stewardship. We conducted a prospective observational study to assess the impact of rapid viral test results on antimicrobial prescriptions and clinical outcomes among hospitalized adults. Methods: Eight hundred patients admitted with respiratory symptoms were tested by a 12-virus respiratory panel (RVP) during 3 consecutive winters in Montreal, Canada...
November 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29147004/dose-de-escalation-to-the-normal-larynx-using-conformal-radiotherapy-reduces-toxicity-while-maintaining-oncologic-outcome-for-t1-t2-glottic-cancer
#2
Jun Won Kim, Hyung Kwon Byeon, Hong-Shik Choi, Ik Jae Lee
We evaluated the efficacy of dose de-escalation to the normal larynx using conformal radiotherapy (CRT) for T1/T2 glottic cancer. For conventional RT (2DRT, n = 38), the laryngeal box received a median equivalent dose in 2 Gy fractions (EQD2) of 66 Gy. For CRT (n = 42; 3D-CRT, 20; intensity-modulated RT, 22), clinical target volume (CTV)1 (gross tumor with a 3-mm margin) and CTV2 (laryngeal box) received median EQD2s of 66.6 Gy and 52.2 Gy, respectively. With a 71-month median follow-up, five-year local control and overall survival rates for 2DRT vs...
November 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29141775/impact-of-interventions-by-an-antimicrobial-stewardship-program-team-on-appropriate-antimicrobial-therapy-in-patients-with-bacteremic-urinary-tract-infection
#3
Mitsuru Yanai, Maiko Ogasawara, Yuta Hayashi, Kiyozumi Suzuki, Hiromichi Takahashi, Atsushi Satomura
BACKGROUND: Inappropriate antimicrobial therapy often leads to poor outcomes. This study aimed to evaluate the impact of an antimicrobial stewardship program (ASP) team on appropriate therapy, in patients with bacteremic urinary tract infection (UTI). PATIENTS AND METHODS: We retrospectively reviewed the interventions by the ASP team in 807 patients with bacteremic UTI. Interventions were divided into 3 groups: group A (conventional report), group B (conventional report and written alert on the chart), and group C (conventional report and oral recommendation with/without written alert)...
November 12, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29140939/infliximab-therapeutic-drug-monitoring-changes-clinical-decisions-in-a-virtual-biologics-clinic-for-inflammatory-bowel-disease
#4
Christian P Selinger, Marco V Lenti, Tanya Clark, Helen Rafferty, David Gracie, Alexander C Ford, Anthony OʼConnor, Tariq Ahmad, P John Hamlin
BACKGROUND: Virtual biologics clinics are often used to review patients with inflammatory bowel disease receiving biological therapy, with decisions whether to continue, switch, or stop therapy made based on review of symptoms, disease history, and investigations. We aimed to investigate whether therapeutic drug monitoring of infliximab (IFX) trough levels and anti-drug antibodies influences decision making within a virtual biologics clinic. METHODS: For all patients with inflammatory bowel disease receiving IFX maintenance therapy, 2 decisions were recorded in a preset format...
December 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29126649/is-dose-de-escalation-possible-in-sarcoma-patients-treated-with-enlarged-limb-sparing-resection
#5
Antonin Levy, Sylvie Bonvalot, Sara Bellefqih, Philippe Terrier, Axel Le Cesne, Cécile Le Péchoux
PURPOSE: To evaluate the impact of dose de-escalation in a large series of resected limbs soft tissue sarcomas (STS). METHODS: Data were retrospectively analysed from 414 consecutive patients treated for limb STS by enlarged surgery and radiotherapy at Gustave Roussy from 05/1993 to 05/2012. Radiotherapy (RT) dose level was decided by the multidisciplinary staff and depended upon the quality of surgery and margins size. RESULTS: RT was delivered prior (13%) or after (87%) surgery...
November 7, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29105102/impact-of-penicillin-allergy-on-empirical-carbapenem-use-in-gram-negative-bloodstream-infections-an-antimicrobial-stewardship-opportunity
#6
Majdi N Al-Hasan, Emily C Acker, Joseph E Kohn, P Brandon Bookstaver, Julie Ann Justo
OBJECTIVES: Retrospective matched cohort study evaluating association between penicillin allergy and empirical carbapenem use in gram-negative bloodstream infections (BSI) and utility of antimicrobial stewardship interventions in reducing carbapenem utilization. METHODS: Hospitalized adults with community-onset gram-negative BSI from January 1, 2010 to June 30, 2015 at two large community hospitals in Columbia, SC were identified. Antimicrobial stewardship interventions targeting penicillin allergy and carbapenem utilization were fully implemented in January 1, 2014...
November 3, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29100961/influence-of-hpv-status-on-survival-of-patients-with-tonsillar-carcinomas-tscc-treated-by-co2-laser-surgery-plus-risk-adapted-therapy-a-10-year-retrospective-single-centre-study
#7
Markus Hoffmann, Elgar Susanne Quabius, Silke Tribius, Stephan Gebhardt, Tibor Görögh, Jürgen Hedderich, Karen Huber, Jürgen Dunst, Petra Ambrosch
The positive prognostic value of HPV-infections in oropharyngeal squamous cell cancer (OSCC) patients has led to the initiation of prospective clinical trials testing the value of treatment de-escalation. It is unclear how to define patients potentially benefiting from de-escalated treatment, whether a positive smoking history impacts survival data and what kind of de-escalation might be best. Here, we investigate the effect of HPV-status, smoking habit and treatment design on overall survival (OS) and progression free survival (PFS) of 126 patients with tonsillar SCC (TSCC) who underwent CO2-laser-surgery and risk adapted adjuvant treatment...
November 1, 2017: Cancer Letters
https://www.readbyqxmd.com/read/29100202/the-support-control-continuum-an-investigation-of-staff-perspectives-on-factors-influencing-the-success-or-failure-of-de-escalation-techniques-for-the-management-of-violence-and-aggression-in-mental-health-settings
#8
Owen Price, John Baker, Penny Bee, Karina Lovell
BACKGROUND: De-escalation techniques are recommended to manage violence and aggression in mental health settings yet restrictive practices continue to be frequently used. Barriers and enablers to the implementation and effectiveness of de-escalation techniques in practice are not well understood. OBJECTIVES: To obtain staff descriptions of de-escalation techniques currently used in mental health settings and explore factors perceived to influence their implementation and effectiveness...
October 6, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29096949/effect-of-tight-control-management-on-crohn-s-disease-calm-a-multicentre-randomised-controlled-phase-3-trial
#9
Jean-Frederic Colombel, Remo Panaccione, Peter Bossuyt, Milan Lukas, Filip Baert, Tomas Vaňásek, Ahmet Danalioglu, Gottfried Novacek, Alessandro Armuzzi, Xavier Hébuterne, Simon Travis, Silvio Danese, Walter Reinisch, William J Sandborn, Paul Rutgeerts, Daniel Hommes, Stefan Schreiber, Ezequiel Neimark, Bidan Huang, Qian Zhou, Paloma Mendez, Joel Petersson, Kori Wallace, Anne M Robinson, Roopal B Thakkar, Geert D'Haens
BACKGROUND: Biomarkers of intestinal inflammation, such as faecal calprotectin and C-reactive protein, have been recommended for monitoring patients with Crohn's disease, but whether their use in treatment decisions improves outcomes is unknown. We aimed to compare endoscopic and clinical outcomes in patients with moderate to severe Crohn's disease who were managed with a tight control algorithm, using clinical symptoms and biomarkers, versus patients managed with a clinical management algorithm...
October 30, 2017: Lancet
https://www.readbyqxmd.com/read/29090866/tokyo-guidelines-2018-antimicrobial-therapy-for-acute-cholangitis-and-cholecystitis
#10
Harumi Gomi, Joseph S Solomkin, David Schlossberg, Kohji Okamoto, Tadahiro Takada, Steven M Strasberg, Tomohiko Ukai, Itaru Endo, Yukio Iwashita, Taizo Hibi, Henry A Pitt, Naohisa Matsunaga, Yoriyuki Takamori, Akiko Umezawa, Koji Asai, Kenji Suzuki, Ho-Seong Han, Tsann-Long Hwang, Yasuhisa Mori, Yoo-Seok Yoon, Wayne Shih-Wei Huang, Giulio Belli, Christos Dervenis, Masamichi Yokoe, Seiki Kiriyama, Takao Itoi, Palepu Jagannath, O James Garden, Fumihiko Miura, Eduardo de Santibañes, Satoru Shikata, Yoshinori Noguchi, Keita Wada, Goro Honda, Avinash Nivritti Supe, Masahiro Yoshida, Toshihiko Mayumi, Dirk J Gouma, Daniel J Deziel, Kui-Hin Liau, Miin-Fu Chen, Keng-Hao Liu, Cheng-Hsi Su, Angus C W Chan, Dong-Sup Yoon, In-Seok Choi, Eduard Jonas, Xiao-Ping Chen, Sheung Tat Fan, Chen-Guo Ker, Mariano Eduardo Giménez, Seigo Kitano, Masafumi Inomata, Shuntaro Mukai, Ryota Higuchi, Koichi Hirata, Kazuo Inui, Yoshinobu Sumiyama, Masakazu Yamamoto
Antimicrobial therapy is a mainstay of the management for patients with acute cholangitis and/or cholecystitis. Tokyo Guidelines 2018 (TG 18) provides recommendations for the appropriate for use of antimicrobials for community-acquired and healthcare-associated infections. The listed agents are for empirical therapy) provided before the infecting isolates are identified. Antimicrobial agents are listed by class-definitions and TG 18 Severity Grade I, II, and III subcategorized by clinical settings. In the era of emerging and increasing antimicrobial resistance, monitoring and updating local antibiograms is underscored...
November 1, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/29082552/patient-perspectives-on-barriers-and-enablers-to-the-use-and-effectiveness-of-de-escalation-techniques-for-the-management-of-violence-and-aggression-in-mental-health-settings
#11
Owen Price, John Baker, Penny Bee, Andrew Grundy, Anne Scott, Debbie Butler, Lindsey Cree, Karina Lovell
AIM: Investigate patient perspectives on barriers and enablers to the use and effectiveness of de-escalation techniques for aggression in mental health settings. BACKGROUND: De-escalation techniques are the recommended first-line intervention for the management of aggression in mental health settings internationally, yet use of higher-risk restrictive practices persists. This indicates de-escalation techniques are not used at optimum frequency and/or there are important factors limiting their use and effect...
October 30, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29076131/minimal-residual-disease-in-non-hodgkin-lymphoma-current-applications-and-future-directions
#12
REVIEW
Matthew L Chase, Philippe Armand
Non-Hodgkin Lymphomas (NHLs) are a heterogeneous group of tumours with distinct treatment paradigms, but in all cases the goal of treatment is to maximize quality and duration of remission while minimizing therapy-related toxicity. Identification of persistent disease or relapse is most often the trigger to intensify or re-initiate anti-neoplastic therapy, respectively. In the current era of NHL treatment, this determination is mostly based on imaging and clinical evaluations, tools with imperfect sensitivity and specificity...
October 26, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/29075740/long-term-functional-and-quality-of-life-outcomes-after-transoral-robotic-surgery-in-patients-with-oropharyngeal-cancer
#13
Virginie Achim, Rachel K Bolognone, Andrew D Palmer, Donna J Graville, Tyler J Light, Ryan Li, Neil Gross, Peter E Andersen, Daniel Clayburgh
Importance: In recent years, transoral robotic surgery (TORS) has emerged as a useful treatment for oropharyngeal squamous cell carcinoma (OPSCC). In appropriately selected patients, the use of TORS may allow avoidance of adjuvant chemotherapy and/or radiotherapy, thereby avoiding the long-term adverse effects of these therapies. Objective: To compare functional speech, swallowing, and quality-of-life outcomes longitudinally between those undergoing TORS only and those undergoing TORS and adjuvant radiotherapy (TORS+RT) or TORS and chemoradiotherapy (TORS+CRT)...
October 26, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29075371/promoting-workplace-safety-teaching-conflict-management-and-de-escalation-skills-in-graduate-medical-education
#14
Elizabeth D Rosenman, Marie C Vrablik, Paul W Charlton, Anne K Chipman, Rosemarie Fernandez
No abstract text is available yet for this article.
October 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29070498/impact-of-a-pharmacist-driven-methicillin-resistant-staphylococcus-aureus-surveillance-protocol
#15
Courtney Willis, Bryan Allen, Calvin Tucker, Kathleen Rottman, Kevin Epps
PURPOSE: Results of a study to evaluate the impact of a pharmacist-driven methicillin-resistant Staphylococcus aureus (MRSA) surveillance screening protocol are reported. METHODS: A retrospective single-center, quasi-experimental, pre-post cohort study was conducted to assess medication-use and clinical outcomes before and after implementation of a protocol allowing pharmacists to order nasal swabs and polymerase chain reaction (PCR) testing for MRSA in selected patients receiving vancomycin for pneumonia or acute exacerbation of chronic obstructive pulmonary disease (AECOPD)...
November 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29067203/prospective-study-evaluating-the-incidence-of-bacteraemia-and-bacteruria-in-afebrile-and-febrile-neutropaenic-dogs-undergoing-chemotherapy
#16
Kimberly Shaffer, Jonathan Bach, Ruthanne Chun
The purpose of this prospective study was to determine the incidence and character of bacteraemia and bacteruria in afebrile and febrile neutropaenic dogs undergoing cytotoxic chemotherapy. Fifty-five neutropaenic dogs presenting to the University of Wisconsin Veterinary Medical Teaching Hospital were enrolled for a total of 57 neutropaenic episodes. The overall incidence of bacteraemia was 12.3% (n = 7/57). Three afebrile dogs and four febrile dogs were bacteraemic; this difference was not significant (P = 0...
November 2016: Veterinary Medicine and Science
https://www.readbyqxmd.com/read/29054844/the-impact-of-de-escalation-of-antianginal-medications-on-health-status-after-percutaneous-coronary-intervention
#17
Mohammed Qintar, Arooge Towheed, Fengming Tang, Adam C Salisbury, P Michael Ho, J Aaron Grantham, John A Spertus, Suzanne V Arnold
BACKGROUND: Antianginal medications (AAMs) can be perceived to be less important after percutaneous coronary intervention (PCI) and may be de-escalated after revascularization. We examined the frequency of AAM de-escalation at discharge post-PCI and its association with follow-up health status. METHODS AND RESULTS: In a 10-center PCI registry, the Seattle Angina Questionnaire was assessed before and 6 months post-PCI. AAM de-escalation was defined as fewer AAMs at discharge versus admission or >25% absolute dose decrease...
October 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29052092/a-72-h-intervention-for-improvement-of-the-rate-of-optimal-antibiotic-therapy-in-patients-with-bloodstream-infections
#18
R Murri, F Taccari, T Spanu, T D'Inzeo, I Mastrorosa, F Giovannenze, G Scoppettuolo, G Ventura, C Palazzolo, M Camici, S Lardo, B Fiori, M Sanguinetti, R Cauda, M Fantoni
Antimicrobial stewardship programs are implemented to optimize the use of antibiotics and control the spread of antibiotic resistance. Many antimicrobial stewardship interventions have demonstrated significant efficacy in reducing unnecessary prescriptions of antibiotics, the duration of antimicrobial therapy, and mortality. We evaluated the benefits of a combination of rapid diagnostic tests and an active re-evaluation of antibiotic therapy 72 h after the onset of bloodstream infection (BSI). All patients with BSI from November 2015 to November 2016 in a 1100-bed university hospital in Rome, where an Infectious Disease Consultancy Unit (Unità di Consulenza Infettivologica, UDCI) is available, were re-evaluated at the bedside 72 h after starting antimicrobial therapy and compared to two pre-intervention periods: the UDCI was called by the ward physician for patients with BSI and the UDCI was called directly by the microbiologist immediately after a pathogen was isolated from blood cultures...
October 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29046178/a-psychiatric-formulary-for-long-duration-spaceflight
#19
Eric Friedman, Brian Bui
Behavioral health is essential for the safety, well-being, and performance of crewmembers in both human spaceflight and Antarctic exploration. Over the past five decades, psychiatric issues have been documented in orbital spaceflight. In Antarctica, literature suggests up to 5% of wintering crewmembers could meet criteria for a psychiatric illness, including mood disorders, stressor-related disorders, sleep-wake disorders, and substance-related disorders. Experience from these settings indicates that psychiatric disorders on deep space missions must be anticipated...
November 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29044920/co-responding-police-mental-health-programmes-service-user-experiences-and-outcomes-in-a-large-urban-centre
#20
Denise Lamanna, Gilla K Shapiro, Maritt Kirst, Flora I Matheson, Arash Nakhost, Vicky Stergiopoulos
As police officers are often the first responders to mental health crises, a number of approaches have emerged to support skilled police crisis responses. One such approach is the police-mental health co-responding team model, whereby mental health nurses and police officers jointly respond to mental health crises in the community. In the present mixed-method study, we evaluated outcomes of co-responding team interactions at a large Canadian urban centre by analysing administrative data for 2743 such interactions, and where comparison data were available, compared them to 16 226 police-only team responses...
October 17, 2017: International Journal of Mental Health Nursing
keyword
keyword
99265
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"