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Infectious diseases

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33 papers 25 to 100 followers
Lawrence R Schiller, Darrell S Pardi, Joseph H Sellin
Chronic diarrhea is a common problem affecting up to 5% of the population at a given time. Patients vary in their definition of diarrhea, citing loose stool consistency, increased frequency, urgency of bowel movements, or incontinence as key symptoms. Physicians have used increased frequency of defecation or increased stool weight as major criteria and distinguish acute diarrhea, often due to self-limited, acute infections, from chronic diarrhea, which has a broader differential diagnosis, by duration of symptoms; 4 weeks is a frequently used cutoff...
August 2, 2016: Clinical Gastroenterology and Hepatology
Brendan J McMullan, David Andresen, Christopher C Blyth, Minyon L Avent, Asha C Bowen, Philip N Britton, Julia E Clark, Celia M Cooper, Nigel Curtis, Emma Goeman, Briony Hazelton, Gabrielle M Haeusler, Ameneh Khatami, James P Newcombe, Joshua Osowicki, Pamela Palasanthiran, Mike Starr, Tony Lai, Clare Nourse, Joshua R Francis, David Isaacs, Penelope A Bryant
Few studies are available to inform duration of intravenous antibiotics for children and when it is safe and appropriate to switch to oral antibiotics. We have systematically reviewed antibiotic duration and timing of intravenous to oral switch for 36 paediatric infectious diseases and developed evidence-graded recommendations on the basis of the review, guidelines, and expert consensus. We searched databases and obtained information from references identified and relevant guidelines. All eligible studies were assessed for quality...
August 2016: Lancet Infectious Diseases
Andre C Kalil, Mark L Metersky, Michael Klompas, John Muscedere, Daniel A Sweeney, Lucy B Palmer, Lena M Napolitano, Naomi P O'Grady, John G Bartlett, Jordi Carratalà, Ali A El Solh, Santiago Ewig, Paul D Fey, Thomas M File, Marcos I Restrepo, Jason A Roberts, Grant W Waterer, Peggy Cruse, Shandra L Knight, Jan L Brozek
It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.These guidelines are intended for use by healthcare professionals who care for patients at risk for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), including specialists in infectious diseases, pulmonary diseases, critical care, and surgeons, anesthesiologists, hospitalists, and any clinicians and healthcare providers caring for hospitalized patients with nosocomial pneumonia...
September 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Konrad Reinhart, Michael Meisner
Infection and/or sepsis biomarkers should help to make the diagnosis and thus initiate therapy earlier, help to differentiate between infectious and sterile inflammation, allow the use of more-specific antimicrobials, shorten the time of antimicrobial use, and ideally identify distinct phenotypes that may benefit from specific adjunctive sepsis therapies. Procalcitonin (PCT) was proposed as a sepsis and infection marker more than 15 years ago. Meanwhile, PCT has been evaluated in various clinical settings. In this review the present use of PCT on the ICU and in critically ill patients is summarized, included it's role for diagnosis of severe sepsis and septic shock and antibiotic stewardship with PCT...
April 2011: Critical Care Clinics
Matthew W Semler, Todd W Rice
Sepsis is a common and life-threatening inflammatory response to severe infection treated with antibiotics and fluid resuscitation. Despite the central role of intravenous fluid in sepsis management, fundamental questions regarding which fluid and in what amount remain unanswered. Recent advances in understanding the physiologic response to fluid administration, and large clinical studies examining resuscitation strategies, fluid balance after resuscitation, colloid versus crystalloid solutions, and high- versus low-chloride crystalloids, inform the current approach to sepsis fluid management and suggest areas for future research...
June 2016: Clinics in Chest Medicine
Tate Gisslen, Manuel Alvarez, Casey Wells, Man-Ting Soo, Donna S Lambers, Christine L Knox, Jareen K Meinzen-Derr, Claire A Chougnet, Alan H Jobe, Suhas G Kallapur
OBJECTIVE: To determine whether exposure to acute chorioamnionitis and fetal inflammation caused short-term adverse outcomes. DESIGN: This is a prospective observational study: subjects were mothers delivering at 32-36 weeks gestation and their preterm infants at a large urban tertiary level III perinatal unit (N=477 infants). Placentae and fetal membranes were scored for acute histological chorioamnionitis based on the Redline criteria. Fetal inflammation was characterised by histological diagnosis of funisitis (umbilical cord inflammation), increased cord blood cytokines measured by ELISA, and activation of the inflammatory cells infiltrating the placenta and fetal membranes measured by immunohistology...
March 23, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Andrea Lo Vecchio, Jorge Amil Dias, James A Berkley, Chris Boey, Mitchell B Cohen, Sylvia Cruchet, Ilaria Liguoro, Eduardo Salazar Lindo, Bhupinder Sandhu, Philip Sherman, Toshiaki Shimizu, Alfredo Guarino
OBJECTIVE: Acute gastroenteritis (AGE) is a major cause of child mortality and morbidity. This study aimed at systematically reviewing clinical practice guidelines (CPGs) on AGE to compare recommendations and provide the basis for developing single universal guidelines. METHODS: CPGs were identified by searching MEDLINE, Cochrane-Library, National Guideline Clearinghouse and Web sites of relevant societies/organizations producing and/or endorsing CPGs. RESULTS: The definition of AGE varies among the 15 CPGs identified...
August 2016: Journal of Pediatric Gastroenterology and Nutrition
Jeffrey E Gotts, Michael A Matthay
Sepsis, severe sepsis, and septic shock represent increasingly severe systemic inflammatory responses to infection. Sepsis is common in the aging population, and it disproportionately affects patients with cancer and underlying immunosuppression. In its most severe form, sepsis causes multiple organ dysfunction that can produce a state of chronic critical illness characterized by severe immune dysfunction and catabolism. Much has been learnt about the pathogenesis of sepsis at the molecular, cell, and intact organ level...
2016: BMJ: British Medical Journal
Jean-Louis Vincent, Matteo Bassetti, Bruno François, George Karam, Jean Chastre, Antoni Torres, Jason A Roberts, Fabio S Taccone, Jordi Rello, Thierry Calandra, Daniel De Backer, Tobias Welte, Massimo Antonelli
Infections occur frequently in critically ill patients and their management can be challenging for various reasons, including delayed diagnosis, difficulties identifying causative microorganisms, and the high prevalence of antibiotic-resistant strains. In this review, we briefly discuss the importance of early infection diagnosis, before considering in more detail some of the key issues related to antibiotic management in these patients, including controversies surrounding use of combination or monotherapy, duration of therapy, and de-escalation...
2016: Critical Care: the Official Journal of the Critical Care Forum
Ryszard Lauterbach, Barbara Wilk, Agata Bocheńska, Joanna Hurkała, Renata Radziszewska
BACKGROUND: Previously, we found that plasma protein C (PC) activity ≤10% significantly increased the probability of the occurrence of death during neonatal sepsis. Accordingly, if the activity of plasma PC declined during the course of sepsis to ≤10%, we administered a nonactivated PC zymogen to increase a PC activity. The aim of that retrospective analysis was to explore treatment effects of PC zymogen supplementation in septic infants, with plasma PC activity ≤10%. METHODS: A database was used to locate 85 newborns treated with PC from among 458 analyzed infants with confirmed sepsis...
September 2016: Pediatric Infectious Disease Journal
Ana Alarcon, Miriam Martinez-Biarge, Fernando Cabañas, Jose Quero, Alfredo García-Alix
BACKGROUND: Congenital cytomegalovirus (cCMV) can cause brain inflammation/destruction and teratogenic effects. The only validated neuroimaging prognostic categorization for symptomatic cCMV available is based on destructive lesions seen on computed tomography (CT). OBJECTIVE: The aim of this study was to establish the predictive ability of a comprehensive neonatal neuroimaging scale in symptomatic cCMV. METHODS: Twenty-six infants were studied by neonatal cranial ultrasound scans (US; n = 25), CT (n = 11) and magnetic resonance imaging (MRI; n = 9)...
June 24, 2016: Neonatology
Elena C Cavallaro, Kar-Kate Liang, Mark D Lawrence, Kevin D Forsyth, Dani-Louise Dixon
BACKGROUND: Hospitalization with bronchiolitis is linked to the development of early childhood chronic wheeze and asthma. Viral etiology and severity of inflammation are potential contributing factors. Previously we observed reduced airway neutrophil infiltration in breastfed bronchiolitic infants, with a corresponding reduction in disease severity. This study aimed to examine whether respiratory viral etiology and co-infection alters the pattern of neutrophil influx, and the inflammatory mediator profile, resulting in epithelial damage in bronchiolitis...
July 13, 2016: Pediatric Pulmonology
Borja Gomez, Santiago Mintegi, Silvia Bressan, Liviana Da Dalt, Alain Gervaix, Laurence Lacroix
BACKGROUND: A sequential approach to young febrile infants on the basis of clinical and laboratory parameters, including procalcitonin, was recently described as an accurate tool in identifying patients at risk for invasive bacterial infection (IBI). Our aim was to prospectively validate the Step-by-Step approach and compare it with the Rochester criteria and the Lab-score. METHODS: Prospective study including infants ≤90 days with fever without source presenting in 11 European pediatric emergency departments between September 2012 and August 2014...
August 2016: Pediatrics
Leigh-Anne Cioffredi, Ravi Jhaveri
IMPORTANCE: Management of febrile children is an intrinsic aspect of pediatric practice. Febrile children account for 15% of emergency department visits and outcomes range from the presence of serious bacterial infection to benign self-limited illness. OBSERVATIONS: Studies from 1979 to 2015 examining febrile infants and children were included in this review. Management of febrile infants younger than 90 days has evolved considerably in the last 30 years. Increased rates of Escherichia coli urinary tract infections, increasing resistance to ampicillin, and advances in viral diagnostics have had an effect on the approach to caring for these patients...
August 1, 2016: JAMA Pediatrics
Gaurav Kwatra, Marianne C Cunnington, Elizabeth Merrall, Peter V Adrian, Margaret Ip, Keith P Klugman, Wing Hung Tam, Shabir A Madhi
BACKGROUND: The most important risk factor for early-onset (babies younger than 7 days) invasive group B streptococcal disease is rectovaginal colonisation of the mother at delivery. We aimed to assess whether differences in colonisation drive regional differences in the incidence of early-onset invasive disease. METHODS: We did a systematic review of maternal group B streptococcus colonisation studies by searching MEDLINE, Embase, Pascal Biomed, WHOLIS, and African Index Medicus databases for studies published between January, 1997, and March 31, 2015, that reported the prevalence of group B streptococcus colonisation in pregnant women...
September 2016: Lancet Infectious Diseases
Jane M Lavelle, Mercedes M Blackstone, Mary Kate Funari, Christine Roper, Patricia Lopez, Aileen Schast, April M Taylor, Catherine B Voorhis, Mira Henien, Kathy N Shaw
BACKGROUND AND OBJECTIVES: Urinary tract infection (UTI) screening in febrile young children can be painful and time consuming. We implemented a screening protocol for UTI in a high-volume pediatric emergency department (ED) to reduce urethral catheterization, limiting catheterization to children with positive screens from urine bag specimens. METHODS: This quality-improvement initiative was implemented using 3 Plan-Do-Study-Act cycles, beginning with a small test of the proposed change in 1 ED area...
July 2016: Pediatrics
Sandeep Patil, Sourabh Dutta, Savita Verma Attri, Pallab Ray, Praveen Kumar
BACKGROUND: It is common clinical practice to repeat serum C reactive protein (CRP) estimation in the first 48 h after starting empirical antibiotics for neonatal sepsis. The change in CRP is believed to indicate whether the empirical antibiotics are appropriate or not, but there is little evidence to support this practice. METHODS: This was a nested case-control study on neonates with suspected sepsis (clinical signs+baseline CRP >10 mg/L). We drew samples for serum CRP at baseline and at 24, 36 and 48 h after starting empirical antibiotics and stored them at -20°C...
April 29, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Kimberly Horner, Masaki Yamada, Giulio Zuccoli, Stacy Rosenberg, Stephanie Greene, Kishore Vellody, Noel S Zuckerbraun
A 34-day-old previously healthy boy born full term presented to the emergency department with fever at home (38.1°C), fussiness, and decreased oral intake for 1 day. He was difficult to console at home. He had decreased oral intake without emesis, diarrhea, or a change in urine output. He did not have rhinorrhea, cough, or increased work of breathing noted by parents. He lived at home with his parents and 13-year-old brother, did not attend day care, and had no sick contacts. On examination, he was fussy but consolable...
January 2016: Pediatrics
Sharon E Mace, Seth R Gemme, Jonathan H Valente, Barnet Eskin, Katherine Bakes, Deena Brecher, Michael D Brown
No abstract text is available yet for this article.
May 2016: Annals of Emergency Medicine
Paul L Aronson, Cary Thurm, Derek J Williams, Lise E Nigrovic, Elizabeth R Alpern, Joel S Tieder, Samir S Shah, Russell J McCulloh, Fran Balamuth, Amanda C Schondelmeyer, Evaline A Alessandrini, Whitney L Browning, Angela L Myers, Mark I Neuman
BACKGROUND: Differences among febrile infant institutional clinical practice guidelines (CPGs) may contribute to practice variation and increased healthcare costs. OBJECTIVE: Determine the association between pediatric emergency department (ED) CPGs and laboratory testing, hospitalization, ceftriaxone use, and costs in febrile infants. DESIGN: Retrospective cross-sectional study in 2013. SETTING: Thirty-three hospitals in the Pediatric Health Information System...
June 2015: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
2016-05-29 01:00:19
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