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https://www.readbyqxmd.com/read/28863048/causes-and-management-of-postrenal-transplant-diarrhea-an-underappreciated-cause-of-transplant-associated-morbidity
#1
Ho Sik Shin, Anil Chandraker
PURPOSE OF REVIEW: This review highlights the current literature on both infectious and noninfectious diarrhea in renal transplant recipients and provides a diagnostic algorithm for the evaluation of posttransplant diarrhea. RECENT FINDINGS: Renal transplant recipients share certain predisposing characteristics for the development of posttransplant diarrhea, including a generalized immunosuppressed state and exposure to polypharmacy, most notably broad-spectrum antimicrobial therapy...
August 31, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28505028/cytomegalovirus-disease-in-hematopoietic-stem-cell-transplant-patients-current-and-future-therapeutic-options
#2
Shigeo Fuji, Hermann Einsele, Markus Kapp
PURPOSE OF REVIEW: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has become one of the standard treatment for hematological diseases. Although the clinical outcome has improved significantly during the last decades, the morbidity and mortality after allo-HSCT are still obstacles to cure. Out of major morbidities, opportunistic virus infections such as cytomegalovirus (CMV) infection are important complications, in particular in patients who received human leukocyte antigen-mismatched HSCT...
August 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28520621/outbreaks-in-the-adult-icus
#3
Hasan M Al-Dorzi, Yaseen M Arabi
PURPOSE OF REVIEW: Infectious disease outbreaks in the critical care setting are common and serious consequence. This article reviews and summarizes recent outbreaks in the adult ICUs. RECENT FINDINGS: Outbreaks of multidrug-resistant bacteria, fungi, and emerging viruses in ICUs from different countries are common. Outbreak investigation relies on epidemiologic methods, microbiologic studies, and molecular typing methods. Overuse of antibiotics, gaps in implementing infection prevention measures, and contaminated environment are common causes of ICU outbreaks...
August 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28542092/approach-to-skin-and-soft-tissue-infections-in-non-hiv-immunocompromised-hosts
#4
Victoria E Burke, Fred A Lopez
PURPOSE OF REVIEW: Skin and soft tissue infections are frequent contributors to morbidity and mortality in the immunocompromised host. This article reviews the changing epidemiology and clinical manifestations of the most common cutaneous pathogens in non-HIV immunocompromised hosts, including patients with solid organ transplants, stem cell transplants, solid tumors, hematologic malignancies, and receiving chronic immunosuppressive therapy for inflammatory disorders. RECENT FINDINGS: Defects in the innate or adaptive immune response can predispose the immunocompromised host to certain cutaneous infections in a predictive fashion...
August 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28661410/approach-to-adenovirus-infections-in-the-setting-of-hematopoietic-cell-transplantation
#5
Yeon Joo Lee, Susan E Prockop, Genovefa A Papanicolaou
PURPOSE OF REVIEW: To review risk-based pre-emptive treatment for adenovirus (ADV) based on quantitative PCR (qPCR) and to provide an update on clinical trials of brincidofovir (BCV) and ADV-specific cytotoxic T lymphocytes (ADV-CTLs). RECENT FINDINGS: ADV qPCR in various body compartments enables distinction of clinically significant infection and assessment of treatment responses. Plasma ADV qPCR monitoring and aggressive pre-emptive treatment is recommended for high-risk patients...
August 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28859351/new-laboratory-tools-for-emerging-bacterial-challenges
#6
Pierre-Edouard Fournier, Michel Drancourt, Didier Raoult
Since its creation, the Méditerranée-Infection foundation has aimed at optimizing the management of infectious diseases and surveying the local and global epidemiology. This pivotal role was permitted by the development of rational sampling, point-of-care tests, and extended automation as well as new technologies, including mass spectrometry for colony identification, real-time genomics for isolate characterization, and the development of versatile and permissive culture systems. By identifying and characterizing emerging microbial pathogens, these developments provided significant breakthroughs in infectious diseases...
August 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28859352/new-approaches-to-prevent-healthcare-associated-infection
#7
Philippe Brouqui, Sophia Boudjema, Alberto Soto Aladro, Eric Chabrière, Olga Florea, Hoa Nguyen, Jean Charles Dufour
Healthcare-associated infection (HCAI) in hospitals mainly results from unsolved but well-identified causes such as hand hygiene, overuse of catheters, and to a lesser extent, the airborne transmission of infectious agents caused by the misuse of respiratory precautions. The aims of the Institut Hospitalo-Universitaire Méditerranée Infection are to develop new approaches to fight HCAIs. Among them, new technologies that allow for the traceability of care and good practices reminders have been developed concomitantly to an anthropological approach, facilitating acceptability by healthcare workers...
August 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28570301/clinical-examination-for-diagnosing-circulatory-shock
#8
Bart Hiemstra, Ruben J Eck, Frederik Keus, Iwan C C van der Horst
PURPOSE OF REVIEW: In the acute setting of circulatory shock, physicians largely depend on clinical examination and basic laboratory values. The daily use of clinical examination for diagnostic purposes contrasts sharp with the limited number of studies. We aim to provide an overview of the diagnostic accuracy of clinical examination in estimating circulatory shock reflected by an inadequate cardiac output (CO). RECENT FINDINGS: Recent studies showed poor correlations between CO and mottling, capillary refill time or central-to-peripheral temperature gradients in univariable analyses...
August 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28759466/the-current-status-of-biomarkers-for-the-diagnosis-of-nosocomial-pneumonias
#9
Jorge I F Salluh, Vicente C Souza-Dantas, Pedro Póvoa
PURPOSE OF REVIEW: Nosocomial pneumonia is a frequent and severe nosocomial infection divided in two distinct groups: hospital-acquired pneumonia and ventilator-associated pneumonia (VAP). In this context, the VAP is notoriously difficult to diagnose clinically, resulting from the lack of a 'gold standard' method of diagnosis. RECENT FINDINGS: The use of biomarkers may potentially improve the early diagnosis of infections allowing earlier and better identification and treatment...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28759468/the-evaluation-of-critically-ill-transplant-patients-with-infectious-diarrhea
#10
Diana F Florescu
PURPOSE OF REVIEW: The review summarizes the epidemiology, risk factors, clinical presentation, diagnosis and management of the most important etiologic agents of infectious diarrhea in critically ill transplant recipients. RECENT FINDINGS: Diarrhea, frequently caused by infectious pathogens, can cause significant morbidity and mortality in transplant recipients. Diarrhea can lead to severe dehydration, acute renal failure, medication toxicity, rejection, graft-versus-host disease and impairs patients' quality of life...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28759469/what-is-new-in-the-prevention-of-nosocomial-pneumonia-in-the-icu
#11
Michael Klompas
PURPOSE OF REVIEW: To summarize and contextualize recent evidence on preventing ventilator-associated pneumonia (VAP). RECENT FINDINGS: Many centers continue to report dramatic decreases in VAP rates after implementing ventilator bundles. Interpreting these reports is complicated, however, by the subjectivity and lack of specificity of VAP definitions. More objective data suggest VAP rates may not have meaningfully changed over the past decade. If so, this compels us to re-examine and revise the prevention bundles we have been using to prevent VAP...
July 29, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28777158/pneumonia-with-bacterial-and-viral-coinfection
#12
Kelly Cawcutt, Andre C Kalil
PURPOSE OF REVIEW: We aim to review the epidemiology of pneumonia with bacterial and viral coinfection, the pathogenesis and clinical impact of coinfection along with the current state of treatment and outcomes. RECENT FINDINGS: Emphasis is given to the pathogenesis of bacterial and viral co-infection including specific highlighting on influenza, rhinovirus, respiratory syncytial virus and cytomegalovirus. Updates on the current state of diagnosis and management are included, as well as on areas where future research can be directed to improve patient clinical outcomes regarding viral and bacterial coinfection...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28858915/how-to-translate-the-new-hospital-acquired-and-ventilator-associated-pneumonia-guideline-to-the-bedside
#13
Mario F Perez, Mark L Metersky, Andre C Kalil
PURPOSE OF REVIEW: Hospital-acquired pneumonia and ventilator-associated pneumonia remain significant causes of morbidity, mortality, and financial burden in the United States and around the globe. Although guidelines for the management of patients with these conditions have been available for several years, implementation remains challenging. Here, we review the most common barriers faced by clinicians in implementing the current guidelines and offer suggestions for improved adherence...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28858916/reducing-catheter-associated-urinary-tract-infections-in-the-icu
#14
Priya Sampathkumar
PURPOSE OF REVIEW: Patients in the ICU are at higher risk for catheter-associated urinary tract infection (CAUTI) due to more frequent use of catheters and lower threshold for obtaining urine cultures. This review provides a summary of CAUTI reduction strategies that are specific to the intensive care setting. RECENT FINDINGS: The surveillance definition for CAUTI is imprecise and measures catheter-associated bacteriuria rather than true infection. Alternatives have been proposed, but CAUTI rates measured by this definition are currently required to be reported to the Centers for Medicare and Medicaid Services and high CAUTI rates can result in financial penalties...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28233189/cardiac-imaging-of-infective-endocarditis-echo-and-beyond
#15
REVIEW
Bernard Iung, François Rouzet, Eric Brochet, Xavier Duval
PURPOSE OF REVIEW: The visualization of cardiac lesions is a major component of the diagnosis of infective endocarditis (IE). We review the usefulness of different cardiac imaging techniques for the diagnosis and management of IE. RECENT FINDINGS: Transthoracic echocardiography is indicated in all cases of suspected IE. Transesophageal echocardiography is used in most patients due to its higher sensitivity. When diagnosis remains doubtful, in particular for IE on foreign material, multislice computed tomography and nuclear medicine techniques, i...
February 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28233190/infectious-complications-of-novel-multiple-sclerosis-therapies
#16
REVIEW
S N Levin, T B Kaplan
PURPOSE OF REVIEW: Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system most often characterized by clinical relapses and periods of remission. RECENT FINDINGS: The past decade has seen a dramatic increase in disease-modifying therapies for MS. Fourteen FDA-approved immunomodulatory drugs are currently available, and more medications are in development. A growing number of reported opportunistic infections, including progressive multifocal leukoencephalopathy (PML), highlight the serious complications of these new drugs and the need for specific screening guidelines...
February 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28251509/indications-of-surgery-in-infective-endocarditis
#17
REVIEW
Aref A Bin Abdulhak, Imad M Tleyjeh
PURPOSE OF THE REVIEW: Infective endocarditis (IE) is a serious disease with significant morbidity and mortality. Valve surgery is fundamental in the standard of care of selected IE patients. Indeed, valve surgery can be a lifesaving procedure in critically ill endocarditis patients. Our goal from this review is to discuss the indications of surgery in IE population and international cardiac societies' guideline recommendations. RECENT FINDINGS: Though IE is an uncommon disease, its incidence is noted to be on rise in some parts of the world, and the disease is expected to continue to be a major health problem...
March 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28251511/herpes-simplex-encephalitis-an-update
#18
REVIEW
John W Gnann, Richard J Whitley
PURPOSE OF REVIEW: The goal of this review is to provide an update on current thinking regarding herpes simplex encephalitis (HSE), emphasizing new information about pathogenesis, diagnosis, and immune responses. Specific questions to be addressed are the following: (1) Is there a genetic predisposition to HSE? (2) What clinical approaches have the greatest impact on improving the long-term outcomes in patients with HSE? And (3) are there immune-mediated mechanisms that may account for relapsing HSE? RECENT FINDINGS: Toll-like receptor 3 (TLR 3) plays an important role in innate immune responses, including generation of interferons...
March 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28365884/de-escalating-antibiotic-use-in-the-inpatient-setting-strategies-controversies-and-challenges
#19
REVIEW
J Daniel Markley, Shaina Bernard, Gonzalo Bearman, Michael P Stevens
PURPOSE OF REVIEW: Antibiotic de-escalation (ADE) is widely accepted as an integral strategy to curtail the global antibiotic resistance crisis. However, there is significant uncertainty regarding the ideal ADE strategy and its true impact on antibiotic resistance. Rapid diagnostic testing has the potential to enhance ADE strategies. Herein, we aim to discuss the current strategies, controversies, and challenges of ADE in the inpatient setting. RECENT FINDINGS: A consensus definition of ADE remains elusive at this time...
April 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28551712/extracardiac-imaging-of-infective-endocarditis
#20
REVIEW
Xavier Duval, Bernard Iung
PURPOSE OF REVIEW: This review analyzes recent studies evaluating the diagnostic and therapeutic impacts of systematic extracardiac imaging techniques in patients with suspected or proven infective endocarditis. RECENT FINDINGS: Extracardiac imaging techniques are more and more frequently used to establish infective endocarditis (IE) diagnosis in doubtful situations. They also help in evaluating the risk-benefit balance of therapeutic strategies and particularly valvular surgery which is performed in approximately 50% of patients...
July 2017: Current Infectious Disease Reports
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