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41 papers 0 to 25 followers
https://www.readbyqxmd.com/read/26445673/lactate-kinetics-in-sepsis-and-septic-shock-a-review-of-the-literature-and-rationale-for-further-research
#1
REVIEW
Jason Chertoff, Michael Chisum, Bryan Garcia, Jorge Lascano
Over the last two decades, there have been vast improvements in sepsis-related outcomes, largely resulting from the widespread adoption of aggressive fluid resuscitation and infection control. With increased understanding of the pathophysiology of sepsis, novel diagnostics and resuscitative interventions are being discovered. In recent years, few diagnostic tests like lactate have engendered more attention and research in the sepsis arena. Studies highlighting lactate's prognostic potential for mortality and other outcomes are ubiquitous and largely focus on the early stage of sepsis management, defined as the initial 6 h and widely referred to as the "golden hours...
2015: Journal of Intensive Care
https://www.readbyqxmd.com/read/26279970/cryptococcal-meningitis-diagnosis-and-management-update
#2
Mahsa Abassi, David R Boulware, Joshua Rhein
Recent advances in the diagnosis and management of cryptococcal meningitis are promising and have been improving long-term survival. Point of care testing has made diagnosing cryptococcal meningitis rapid, practical, and affordable. Targeted screening and treatment programs for cryptococcal antigenemia are a cost effective method for reducing early mortality on antiretroviral therapy (ART). Optimal initial management with amphotericin and flucytosine improves survival against alternative therapies, although amphotericin is difficult to administer and flucytosine is not available in middle or low income countries, where cryptococcal meningitis is most prevalent...
June 1, 2015: Current Tropical Medicine Reports
https://www.readbyqxmd.com/read/26772199/antimicrobial-resistance-in-the-intensive-care-unit-a-focus-on-gram-negative-bacterial-infections
#3
REVIEW
Shawn H MacVane
Bacterial infections are a frequent cause of hospitalization, and nosocomial infections are an increasingly common condition, particularly within the acute/critical care setting. Infection control practices and new antimicrobial development have primarily focused on gram-positive bacteria; however, in recent years, the incidence of infections caused by gram-negative bacteria has risen considerably in intensive care units. Infections caused by multidrug-resistant (MDR) gram-negative organisms are associated with high morbidity and mortality, with significant direct and indirect costs resulting from prolonged hospitalizations due to antibiotic treatment failures...
January 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/26810419/executive-summary-clinical-practice-guideline-for-the-management-of-candidiasis-2016-update-by-the-infectious-diseases-society-of-america
#4
REVIEW
Peter G Pappas, Carol A Kauffman, David R Andes, Cornelius J Clancy, Kieren A Marr, Luis Ostrosky-Zeichner, Annette C Reboli, Mindy G Schuster, Jose A Vazquez, Thomas J Walsh, Theoklis E Zaoutis, Jack D Sobel
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.
February 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/26921241/zika-virus
#5
REVIEW
Marina Basarab, Conor Bowman, Emma J Aarons, Ian Cropley
No abstract text is available yet for this article.
2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27029595/zika-virus
#6
REVIEW
Didier Musso, Duane J Gubler
Zika virus (ZIKV) is an arthropod-borne virus (arbovirus) in the genus Flavivirus and the family Flaviviridae. ZIKV was first isolated from a nonhuman primate in 1947 and from mosquitoes in 1948 in Africa, and ZIKV infections in humans were sporadic for half a century before emerging in the Pacific and the Americas. ZIKV is usually transmitted by the bite of infected mosquitoes. The clinical presentation of Zika fever is nonspecific and can be misdiagnosed as other infectious diseases, especially those due to arboviruses such as dengue and chikungunya...
July 2016: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/27023283/current-status-and-prospects-of-hiv-treatment
#7
REVIEW
Tomas Cihlar, Marshall Fordyce
Current antiviral treatments can reduce HIV-associated morbidity, prolong survival, and prevent HIV transmission. Combination antiretroviral therapy (cART) containing preferably three active drugs from two or more classes is required for durable virologic suppression. Regimen selection is based on virologic efficacy, potential for adverse effects, pill burden and dosing frequency, drug-drug interaction potential, resistance test results, comorbid conditions, social status, and cost. With prolonged virologic suppression, improved clinical outcomes, and longer survival, patients will be exposed to antiretroviral agents for decades...
June 2016: Current Opinion in Virology
https://www.readbyqxmd.com/read/27107491/procalcitonin-as-an-early-marker-of-the-need-for-invasive-respiratory-or-vasopressor-support-in-adults-with-community-acquired-pneumonia
#8
Wesley H Self, Carlos G Grijalva, Derek J Williams, Alison Woodworth, Robert A Balk, Sherene Fakhran, Yuwei Zhu, D Mark Courtney, James Chappell, Evan J Anderson, Chao Qi, Grant W Waterer, Christopher Trabue, Anna M Bramley, Seema Jain, Kathryn M Edwards, Richard G Wunderink
BACKGROUND: Predicting the need for intensive care among adults with community-acquired pneumonia (CAP) remains challenging. METHODS: Using a multicenter prospective cohort study of adults hospitalized with CAP, we evaluated the association of serum procalcitonin (PCT) concentration at hospital presentation with the need for invasive respiratory or vasopressor support (IRVS), or both, within 72 h. Logistic regression was used to model this association, with results reported as the estimated risk of IRVS for a given PCT concentration...
October 2016: Chest
https://www.readbyqxmd.com/read/25716293/%C3%AE-lactam-and-%C3%AE-lactamase-inhibitor-combinations-in-the-treatment-of-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-time-for-a-reappraisal-in-the-era-of-few-antibiotic-options
#9
REVIEW
Patrick N A Harris, Paul A Tambyah, David L Paterson
The spread of extended-spectrum β-lactamase (ESBL) genes in Enterobacteriaceae such as Escherichia coli or Klebsiella spp is a major challenge to modern medical practice. Carbapenems are the treatment of choice for serious infections caused by ESBL producers; however, carbapenem resistance has increased globally. ESBL producers might be susceptible to β-lactam-β-lactamase inhibitor (BLBLI) combination antibiotics such piperacillin-tazobactam or amoxicillin-clavulanate. These drugs are frequently avoided in serious infections caused by ESBL producers because of the inoculum effect in-vitro (especially for piperacillin-tazobactam), animal data suggesting inferior efficacy when compared with carbapenems, concerns about pharmacokinetic-pharmacodynamic drug target attainment with standard doses, and poor outcomes shown in some observational studies...
April 2015: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27886201/cryptococcal-meningitis-epidemiology-immunology-diagnosis-and-therapy
#10
REVIEW
Peter R Williamson, Joseph N Jarvis, Anil A Panackal, Matthew C Fisher, Síle F Molloy, Angela Loyse, Thomas S Harrison
HIV-associated cryptococcal meningitis is by far the most common cause of adult meningitis in many areas of the world that have high HIV seroprevalence. In most areas in Sub-Saharan Africa, the incidence of cryptococcal meningitis is not decreasing despite availability of antiretroviral therapy, because of issues of adherence and retention in HIV care. In addition, cryptococcal meningitis in HIV-seronegative individuals is a substantial problem: the risk of cryptococcal infection is increased in transplant recipients and other individuals with defects in cell-mediated immunity, and cryptococcosis is also reported in the apparently immunocompetent...
January 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/27932390/official-american-thoracic-society-infectious-diseases-society-of-america-centers-for-disease-control-and-prevention-clinical-practice-guidelines-diagnosis-of-tuberculosis-in-adults-and-children
#11
David M Lewinsohn, Michael K Leonard, Philip A LoBue, David L Cohn, Charles L Daley, Ed Desmond, Joseph Keane, Deborah A Lewinsohn, Ann M Loeffler, Gerald H Mazurek, Richard J O'Brien, Madhukar Pai, Luca Richeldi, Max Salfinger, Thomas M Shinnick, Timothy R Sterling, David M Warshauer, Gail L Woods
BACKGROUND: Individuals infected with Mycobacterium tuberculosis (Mtb) may develop symptoms and signs of disease (tuberculosis disease) or may have no clinical evidence of disease (latent tuberculosis infection [LTBI]). Tuberculosis disease is a leading cause of infectious disease morbidity and mortality worldwide, yet many questions related to its diagnosis remain. METHODS: A task force supported by the American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America searched, selected, and synthesized relevant evidence...
January 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28035690/%C3%AE-lactam-therapy-for-methicillin-susceptible-staphylococcus-aureus-bacteremia-a-comparative-review-of-cefazolin-versus-antistaphylococcal-penicillins
#12
REVIEW
Julius Li, Kelly L Echevarria, Kristi A Traugott
Methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia is associated with high morbidity and mortality. Traditionally, antistaphylococcal penicillins (ASPs) have been considered the agents of choice for the treatment of MSSA bacteremia. Vancomycin has been demonstrated to have poorer outcomes in several studies and is only recommended for patients with severe penicillin allergies. Although cefazolin is considered as an alternative to the ASPs for patients with nonsevere penicillin allergies, cefazolin offers several pharmacologic advantages over ASPs, such as more convenient dosing regimens, and antimicrobial stewardship programs are increasingly using cefazolin as the preferential agent for MSSA infections as part of cost-saving initiatives...
March 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/27104951/empiric-piperacillin-tazobactam-versus-carbapenems-in-the-treatment-of-bacteraemia-due-to-extended-spectrum-beta-lactamase-producing-enterobacteriaceae
#13
Tat Ming Ng, Wendy X Khong, Patrick N A Harris, Partha P De, Angela Chow, Paul A Tambyah, David C Lye
Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are a common cause of bacteraemia in endemic countries and may be associated with high mortality; carbapenems are considered the drug of choice. Limited data suggest piperacillin-tazobactam could be equally effective. We aimed to compare 30-day mortality of patients treated empirically with piperacillin-tazobactam versus a carbapenem in a multi-centre retrospective cohort study in Singapore. Only patients with active empiric monotherapy with piperacillin-tazobactam or a carbapenem were included...
2016: PloS One
https://www.readbyqxmd.com/read/25186838/the-impact-of-serial-lactate-monitoring-on-emergency-department-resuscitation-interventions-and-clinical-outcomes-in-severe-sepsis-and-septic-shock-an-observational-cohort-study
#14
Matthew Dettmer, Christopher V Holthaus, Brian M Fuller
Monitoring in the setting of critical illness must be linked to beneficial therapy to affect clinical outcome. Elevated serum lactate is associated with an increase in mortality in emergency department (ED) patients with severe sepsis and septic shock. The reduction of lactate levels toward normal during acute resuscitation is associated with improved clinical outcomes. The majority of data demonstrating the interventions used to achieve a reduction in lactate levels and the associated clinical outcomes have been obtained during protocolized randomized trials...
January 2015: Shock
https://www.readbyqxmd.com/read/26821106/sepsis-kills-early-intervention-saves-lives
#15
MULTICENTER STUDY
Anthony R Burrell, Mary-Louise McLaws, Mary Fullick, Rosemary B Sullivan, Doungkamol Sindhusake
OBJECTIVE: To implement a statewide program for the early recognition and treatment of sepsis in New South Wales, Australia. SETTING: Ninety-seven emergency departments in NSW hospitals. INTERVENTION: A quality improvement program (SEPSIS KILLS) that promoted intervention within 60 minutes of recognition, including taking of blood cultures, measuring serum lactate levels, administration of intravenous antibiotics, and fluid resuscitation. MAIN OUTCOME MEASURES: Time to antibiotics and fluid resuscitation; mortality rates and length of stay...
February 1, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27540380/mutual-interference-between-cytomegalovirus-and-reconstitution-of-protective-immunity-after-hematopoietic-cell-transplantation
#16
REVIEW
Matthias J Reddehase
Hematopoietic cell transplantation (HCT) is a therapy option for aggressive forms of hematopoietic malignancies that are resistant to standard antitumoral therapies. Hematoablative treatment preceding HCT, however, opens a "window of opportunity" for latent Cytomegalovirus (CMV) by releasing it from immune control with the consequence of reactivation of productive viral gene expression and recurrence of infectious virus. A "window of opportunity" for the virus represents a "window of risk" for the patient. In the interim between HCT and reconstitution of antiviral immunity, primarily mediated by CD8(+) T cells, initially low amounts of reactivated virus can expand exponentially, disseminate to essentially all organs, and cause multiple organ CMV disease, with interstitial pneumonia (CMV-IP) representing the most severe clinical manifestation...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27217054/sepsis-pathophysiology-and-clinical-management
#17
REVIEW
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...
May 23, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/25410372/recurrent-urinary-tract-infections-in-women
#18
REVIEW
Abdullatif Aydin, Kamran Ahmed, Iftikhar Zaman, Muhammad Shamim Khan, Prokar Dasgupta
INTRODUCTION AND HYPOTHESIS: Recurrent urinary tract infections (UTIs) are more common in women and are frequently defined as ≥2 episodes in the last 6 months or ≥3 episodes in the last 12 months. In a primary care setting, 53 % of women above the age of 55 years and 36 % of younger women report a recurrence within 1 year. Thus, management and prevention of recurrent UTI is of utmost significance. This review aims to highlight the latest research in prevention strategies and suggest a management pathway...
June 2015: International Urogynecology Journal
https://www.readbyqxmd.com/read/27568789/british-hiv-association-guidelines-on-the-use-of-vaccines-in-hiv-positive-adults-2015
#19
Anna Maria Geretti, Gary Brook, Claire Cameron, David Chadwick, Neil French, Robert Heyderman, Antonia Ho, Michael Hunter, Shamez Ladhani, Mark Lawton, Eithne MacMahon, John McSorley, Anton Pozniak, Alison Rodger
No abstract text is available yet for this article.
August 2016: HIV Medicine
https://www.readbyqxmd.com/read/19339714/effect-of-early-versus-deferred-antiretroviral-therapy-for-hiv-on-survival
#20
MULTICENTER STUDY
Mari M Kitahata, Stephen J Gange, Alison G Abraham, Barry Merriman, Michael S Saag, Amy C Justice, Robert S Hogg, Steven G Deeks, Joseph J Eron, John T Brooks, Sean B Rourke, M John Gill, Ronald J Bosch, Jeffrey N Martin, Marina B Klein, Lisa P Jacobson, Benigno Rodriguez, Timothy R Sterling, Gregory D Kirk, Sonia Napravnik, Anita R Rachlis, Liviana M Calzavara, Michael A Horberg, Michael J Silverberg, Kelly A Gebo, James J Goedert, Constance A Benson, Ann C Collier, Stephen E Van Rompaey, Heidi M Crane, Rosemary G McKaig, Bryan Lau, Aimee M Freeman, Richard D Moore
BACKGROUND: The optimal time for the initiation of antiretroviral therapy for asymptomatic patients with human immunodeficiency virus (HIV) infection is uncertain. METHODS: We conducted two parallel analyses involving a total of 17,517 asymptomatic patients with HIV infection in the United States and Canada who received medical care during the period from 1996 through 2005. None of the patients had undergone previous antiretroviral therapy. In each group, we stratified the patients according to the CD4+ count (351 to 500 cells per cubic millimeter or >500 cells per cubic millimeter) at the initiation of antiretroviral therapy...
April 30, 2009: New England Journal of Medicine
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