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Infectious Diseases for Residents

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60 papers 25 to 100 followers
M Jana Broadhurst, Tim J G Brooks, Nira R Pollock
Laboratory diagnosis of Ebola virus disease plays a critical role in outbreak response efforts; however, establishing safe and expeditious testing strategies for this high-biosafety-level pathogen in resource-poor environments remains extremely challenging. Since the discovery of Ebola virus in 1976 via traditional viral culture techniques and electron microscopy, diagnostic methodologies have trended toward faster, more accurate molecular assays. Importantly, technological advances have been paired with increasing efforts to support decentralized diagnostic testing capacity that can be deployed at or near the point of patient care...
October 2016: Clinical Microbiology Reviews
Ryan K Shields, Brian A Potoski, Ghady Haidar, Binghua Hao, Yohei Doi, Liang Chen, Ellen G Press, Barry N Kreiswirth, Cornelius J Clancy, M Hong Nguyen
Thirty-seven carbapenem-resistant Enterobacteriaceae (CRE)-infected patients were treated with ceftazidime-avibactam. Clinical success and survival rates at 30-days were 59% (22/37) and 76% (28/37), respectively. In 23% (5/22) of clinical successes, CRE infections recurred within 90-days. Microbiologic failure rate was 27% (10/37). Ceftazidime-avibactam resistance was detected in 30% (3/10) of microbiologic failures.
September 13, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Sebastian L Johnston, Matyas Szigeti, Mary Cross, Christopher Brightling, Rekha Chaudhuri, Timothy Harrison, Adel Mansur, Laura Robison, Zahid Sattar, David Jackson, Patrick Mallia, Ernie Wong, Christopher Corrigan, Bernard Higgins, Philip Ind, Dave Singh, Neil C Thomson, Deborah Ashby, Anoop Chauhan
Importance: Guidelines recommend against antibiotic use to treat asthma attacks. A study with telithromycin reported benefit, but adverse reactions limit its use. Objective: To determine whether azithromycin added to standard care for asthma attacks in adults results in clinical benefit. Design, Setting, and Participants: The Azithromycin Against Placebo in Exacerbations of Asthma (AZALEA) randomized, double-blind, placebo-controlled clinical trial, a United Kingdom-based multicenter study in adults requesting emergency care for acute asthma exacerbations, ran from September 2011 to April 2014...
September 19, 2016: JAMA Internal Medicine
Ji Young Yang, Minkyu Han, Younsuck Koh, Woo-Sung Kim, Jin-Woo Song, Yeon-Mok Oh, Sang-Do Lee, Sei Won Lee, Jae-Seung Lee, Chae-Man Lim, Chang-Min Choi, Jin-Won Huh, Sang-Bum Hong, Tae Sun Shim, Kyung-Wook Jo
BACKGROUND:  We investigated the effects of corticosteroids on the 90-day mortality outcomes in patients with pulmonary tuberculosis who were admitted to the intensive care unit (ICU) because of acute respiratory failure (ARF). METHODS:  The medical records of 124 patients who had pulmonary tuberculosis with ARF and were admitted to the ICU at our tertiary referral center in South Korea between March 1989 and December 2014 were retrospectively analyzed. The 90-day mortality rate in this population was analyzed after adjustments with the inverse probability of treatment weighted (IPTW) method...
September 8, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Naim Alkhouri, Nizar N Zein
Recent trials evaluated the safety and efficacy of two protease inhibitors, boceprevir (Victrelis) and telaprevir (Incivek), added to standard care with pegylated interferon and ribavirin, in patients with chronic hepatitis C virus (HCV) infection. These drugs open the door for triple therapy and other new therapies involving combinations of other direct-acting antiviral agents to become the new standard of care for this population.
March 2012: Cleveland Clinic Journal of Medicine
T Jake Liang, Marc G Ghany
No abstract text is available yet for this article.
May 16, 2013: New England Journal of Medicine
Hugo R Rosen
No abstract text is available yet for this article.
June 23, 2011: New England Journal of Medicine
Demetra Tsapepas, Mariana Chiles, Revekka Babayev, Maya K Rao, Manasvi Jaitly, David Salerno, Sumit Mohan
BACKGROUND: Trimethoprim-sulfamethoxazole (TMP-SMX) is a commonly prescribed antibiotic used at high doses for treatment of pneumocystis pneumonia and other infections. Trimethoprim is structurally related to the potassium-sparing diuretic amiloride and has been associated with hyperkalemia and hyponatremia through blocking of epithelial sodium channels in the distal nephron. The incidence of hyponatremia in hospitalized patients treated with high dose TMP-SMX is unknown. METHODS: We performed a single center retrospective chart review of all hospitalized patients who received high dose TMP-SMX (n=235) from January 2012 to July 2014...
August 16, 2016: American Journal of Medicine
Jason Phua, Nathan C Dean, Qi Guo, Win Sen Kuan, Hui Fang Lim, Tow Keang Lim
Mortality rates for severe community-acquired pneumonia (CAP) range from 17 to 48 % in published studies.In this review, we searched PubMed for relevant papers published between 1981 and June 2016 and relevant files. We explored how early and aggressive management measures, implemented within 24 hours of recognition of severe CAP and carried out both in the emergency department and in the ICU, decrease mortality in severe CAP.These measures begin with the use of severity assessment tools and the application of care bundles via clinical decision support tools...
August 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
Gabriel Levy Hara, Souha S Kanj, Leonardo Pagani, Lilian Abbo, Andrea Endimiani, Heiman F L Wertheim, Carlos Amábile-Cuevas, Pierre Tattevin, Shaheen Mehtar, Fernando Lopes Cardoso, Serhat Unal, Ian Gould
The Antibiotic Stewardship and Resistance Working Groups of the International Society for Chemotherapy propose ten key points for the appropriate use of antibiotics in hospital settings. (i) Get appropriate microbiological samples before antibiotic administration and carefully interpret the results: in the absence of clinical signs of infection, colonisation rarely requires antimicrobial treatment. (ii) Avoid the use of antibiotics to 'treat' fever: use them to treat infections, and investigate the root cause of fever prior to starting treatment...
September 2016: International Journal of Antimicrobial Agents
Georg Maschmeyer, Jannik Helweg-Larsen, Livio Pagano, Christine Robin, Catherine Cordonnier, Peter Schellongowski
The initiation of systemic antimicrobial treatment of Pneumocystis jirovecii pneumonia (PCP) is triggered by clinical signs and symptoms, typical radiological and occasionally laboratory findings in patients at risk of this infection. Diagnostic proof by bronchoalveolar lavage should not delay the start of treatment. Most patients with haematological malignancies present with a severe PCP; therefore, antimicrobial therapy should be started intravenously. High-dose trimethoprim/sulfamethoxazole is the treatment of choice...
September 2016: Journal of Antimicrobial Chemotherapy
John N Galgiani, Neil M Ampel, Janis E Blair, Antonino Catanzaro, Francesca Geertsma, Susan E Hoover, Royce H Johnson, Shimon Kusne, Jeffrey Lisse, Joel D MacDonald, Shari L Meyerson, Patricia B Raksin, John Siever, David A Stevens, Rebecca Sunenshine, Nicholas Theodore
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. Infectious Diseases Society of America 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.Coccidioidomycosis, also known as San Joaquin Valley fever, is a systemic infection endemic to parts of the southwestern United States and elsewhere in the Western Hemisphere...
September 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
William M Geisler, Apurva Uniyal, Jeannette Y Lee, Shelly Y Lensing, Shacondra Johnson, Raymond C W Perry, Carmel M Kadrnka, Peter R Kerndt
BACKGROUND: Urogenital Chlamydia trachomatis infection remains prevalent and causes substantial reproductive morbidity. Recent studies have raised concern about the efficacy of azithromycin for the treatment of chlamydia infection. METHODS: We conducted a randomized trial comparing oral azithromycin with doxycycline for the treatment of urogenital chlamydia infection among adolescents in youth correctional facilities, to evaluate the noninferiority of azithromycin (1 g in one dose) to doxycycline (100 mg twice daily for 7 days)...
December 24, 2015: New England Journal of Medicine
Colleen R Kelly, Alexander Khoruts, Christopher Staley, Michael J Sadowsky, Mortadha Abd, Mustafa Alani, Brianna Bakow, Patrizia Curran, Joyce McKenney, Allison Tisch, Steven E Reinert, Jason T Machan, Lawrence J Brandt
Background: To date, evidence for the efficacy of fecal microbiota transplantation (FMT) in recurrent Clostridium difficile infection (CDI) has been limited to case series and open-label clinical trials. Objective: To determine the efficacy and safety of FMT for treatment of recurrent CDI. Design: Randomized, controlled, double-blind clinical trial. ( NCT01703494). Setting: Two academic medical centers...
August 23, 2016: Annals of Internal Medicine
Robert E Kass, Brian S Caffo, Marie Davidian, Xiao-Li Meng, Bin Yu, Nancy Reid
No abstract text is available yet for this article.
June 2016: PLoS Computational Biology
Katherine E Fleming-Dutra, Rita Mangione-Smith, Lauri A Hicks
No abstract text is available yet for this article.
August 1, 2016: American Family Physician
Neil D Ritchie, Sharon C Irvine, Helps Alieen, Robb Fiona, Brian L Jones, R Andrew Seaton
INTRODUCTION: Antimicrobial stewardship has an important role in the control of Clostridium difficile infection (CDI) and antibiotic resistance. An important component of UK stewardship interventions is the restriction of broad-spectrum beta-lactam antibiotics and promotion of agents associated with a lower risk of CDI such as gentamicin. Whilst the introduction of restrictive antibiotic guidance has been associated with improvements in CDI and antimicrobial resistance evidence of the effect on outcome following severe infection is lacking...
August 13, 2016: QJM: Monthly Journal of the Association of Physicians
Somayeh Bahrami, Shahram Khademvatan, Mohammad Hossein Razi Jalali, Sepide Pourbaram
Leishmaniasis is a parasitic disease that is an important problem of public health worldwide. The aim of this study was to assess the cytotoxic effects of amiodarone (AMD) on Leishmania tropica (MHOM/AF/88/KK27) and L. major (MRHO/IR/75/ER) promastigotes and to observe the programmed cell death features. The colorimetric MTT assay was used to find L. tropica and L. major viability and the obtained results were expressed as 50% inhibitory concentration (IC50). Annexin-V FLUOS staining was performed to study the cell death properties of AMD using fluorescence-activated cell-sorting analysis...
June 2016: Pathogens and Global Health
Karen Bush, Patricia A Bradford
β-Lactams are the most widely used class of antibiotics. Since the discovery of benzylpenicillin in the 1920s, thousands of new penicillin derivatives and related β-lactam classes of cephalosporins, cephamycins, monobactams, and carbapenems have been discovered. Each new class of β-lactam has been developed either to increase the spectrum of activity to include additional bacterial species or to address specific resistance mechanisms that have arisen in the targeted bacterial population. Resistance to β-lactams is primarily because of bacterially produced β-lactamase enzymes that hydrolyze the β-lactam ring, thereby inactivating the drug...
2016: Cold Spring Harbor Perspectives in Medicine
Christopher R Polage, Clare E Gyorke, Michael A Kennedy, Jhansi L Leslie, David L Chin, Susan Wang, Hien H Nguyen, Bin Huang, Yi-Wei Tang, Lenora W Lee, Kyoungmi Kim, Sandra Taylor, Patrick S Romano, Edward A Panacek, Parker B Goodell, Jay V Solnick, Stuart H Cohen
IMPORTANCE: Clostridium difficile is a major cause of health care-associated infection, but disagreement between diagnostic tests is an ongoing barrier to clinical decision making and public health reporting. Molecular tests are increasingly used to diagnose C difficile infection (CDI), but many molecular test-positive patients lack toxins that historically defined disease, making it unclear if they need treatment. OBJECTIVE: To determine the natural history and need for treatment of patients who are toxin immunoassay negative and polymerase chain reaction (PCR) positive (Tox-/PCR+) for CDI...
November 2015: JAMA Internal Medicine
2016-08-28 11:06:48
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