- Management of patients with septic shock due to Candida infection. [Journal Article]
- HPHosp Pract (1995) 2018 Sep 20; :1-8
- Septic shock represents a serious complication occurring between 6% and 30% of all hospitalized patients; Candida septic shock represents a challenge for clinicians due to the absence of specific ris...
Septic shock represents a serious complication occurring between 6% and 30% of all hospitalized patients; Candida septic shock represents a challenge for clinicians due to the absence of specific risk factors, diagnostic tests, and management. Identification of specific risk factors and use of biomarkers are useful tools considering that differentiation of Candida from bacterial septic shock is demanding. Early effective antifungal treatment, preferably with echinocandins with an adequate source control, represents the best approach for improving survival of patients with septic shock due to Candida. Given the importance of adequate therapy and source control in septic shock attributable to Candida clinical strategies and pathways are needed. This review will focus on epidemiology of septic shock in patients with invasive candidiasis with special attention to diagnostic pathways and treatment strategies.
- Biomarkers in early treatment of invasive candidiasis. [Journal Article]
- HPHosp Pract (1995) 2018 Sep 08; :1-4
- Infection control measures to prevent hospital transmission of candida. [Journal Article]
- HPHosp Pract (1995) 2018 Aug 13
- Invasive candida infections are the most important causes of invasive nosocomial infections in intensive care units and in risky groups such as immunosuppressed patients. These infections lead to und...
Invasive candida infections are the most important causes of invasive nosocomial infections in intensive care units and in risky groups such as immunosuppressed patients. These infections lead to undesirable consequences such as increased morbidity and mortality in patients, prolongation of hospital stay, and increased hospital costs. In recent years, the incidence of non-albicans Candida spp.'s has increased. Unfortunately, some of these species are naturally resistant to first line antifungals. In addition, biofilm formation on the central venous catheter and invasive devices may cause treatment failure. The age of the patients, co-morbid diseases, the units where they are treated, the antibiotics and antifungals that used for the treatment and invasive devices are risk factors for invasive candida infections. Some of these risk factors can be reduced by the behavior of health-care workers. The most important goal is to take precautions before the occurrence of invasive candida infections. Infection control measures to prevent hospital transmission of candida are very important. Compliance with hand hygiene before and after contact with the patient is the most important step to prevent the spreading of Candida spp. Observation of maximal barrier precautions during invasive catheterization is another important clause of this aim. Avoiding unnecessary invasive devices, antibiotics and parenteral nutrition is also important to reduce the colonization of candida.
- Impact of a pharmacist-driven pharmacovigilance system in a secondary hospital in the Gauteng Province of South Africa. [Journal Article]
- HPHosp Pract (1995) 2018 Aug 09
- CONCLUSIONS: The results showed the benefits of pharmacist-driven interventions on HCPs' knowledge and awareness of PV and the number of the ADRs reported. Hospital management and policy makers should consider the important role pharmacists can play in improving rational and safe use of medicines among inpatients, based on appropriate training of HCPs and proper systems. As a result, help achieve the standards established by the Department of Health in South Africa.
- Insight to the growing utilizations of high flow nasal oxygen therapy over non-invasive ventilation in community teaching hospital: alternative or complementary?In response to: Mihaela S. Stefan, Patrick Eckert, Bogdan Tiru, Jennifer Friderici, Peter K. Lindenauer & Jay S. Steingrub (2018) High flow nasal oxygen therapy utilization: 7-year experience at a community teaching hospital, Hospital Practice, 46:2, 73-76, DOI: 10.1080/21548331.2018.1438739. [Journal Article]
- HPHosp Pract (1995) 2018 Aug 21; :1-2
- Candidemia in the patient with malignancy. [Journal Article]
- HPHosp Pract (1995) 2018 Aug 13; :1-7
- Invasive fungal infections are a common life-threatening disease and a major cause of morbidity, particularly in patients with malignancies, and Candida spp. is the most common isolated fungi in bloo...
Invasive fungal infections are a common life-threatening disease and a major cause of morbidity, particularly in patients with malignancies, and Candida spp. is the most common isolated fungi in bloodstream. Candidemia is the focus of this review, which covers an approach to diagnosis and treatment, with an emphasis on patients with malignancies. Acute leukemia, lymphoma, or myelodysplastic syndrome are the most common hematological malignancies associated with candidemia, while among solid tumors, gastrointestinal cancer has the majority of fungemia cases. Epidemiologic trends show there is a discrepancy between malignancies, where there is an important prevalence of non-albicans Candida in hematological malignancy patients. Diagnosis is challenging, and a high index of suspicion is required to select at-risk patients for early empiric therapy with the goal of reducing mortality. There is an increased effort to improve understanding of individualized approaches to the patient based on precision medicine and to improve diagnosis in the future. The basis of treatment is prompt therapy with echinocandins and target therapy based on susceptibility and minimum inhibitory concentrations (MICs).
- Hospitalization costs of cystic fibrosis in the United States: a retrospective analysis. [Journal Article]
- HPHosp Pract (1995) 2018 Aug 09; :1-11
- CONCLUSIONS: Hospitalizations contribute significantly to the economic burden of CF. As inpatient costs in CF vary by patient, clinical, and hospital characteristics, healthcare decision makers need to utilize a targeted approach in different age groups to reduce hospital admission rates and the overall economic burden of CF.
- Economic burden of hospital admissions for patients with acute bacterial skin and skin structure infections in the United States. [Journal Article]
- HPHosp Pract (1995) 2018 Aug 21; :1-9
- CONCLUSIONS: Admissions for ABSSSI impose a substantial cost to US hospitals, with half of costs attributable to room costs. When extrapolated to all US patients admitted to the hospital for ABSSSI during 2014, had OPAT guidelines been universally followed, admissions may have been reduced by 14%, thereby saving US hospitals $161 million.
- Major bleeding with apixaban in atrial fibrillation: patient characteristics, management, and outcomes. [Journal Article]
- HPHosp Pract (1995) 2018 Aug 09; :1-5
- CONCLUSIONS: Patients with major bleeding were elderly and frequently on inappropriate concomitant antiplatelet therapy. The majority of patients were managed with PRBC transfusion. More than half of patients had anticoagulation therapy held at discharge. Concerns with prescribing and patient management were identified leading to recommendations for improving the safe use of apixaban therapy.
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- Prevalence of chronic kidney disease using estimated glomerular filtration rate among diabetes patients attending a tertiary clinic in Botswana. [Journal Article]
- HPHosp Pract (1995) 2018 Aug 14; :1-7
- CONCLUSIONS: The prevalence of CKD by estimated eGFR was low compared to most previous studies. However, half of patients with CKD are not documented resulting in the potential for prescription errors and drug toxicity. A substantial number of our patients had uncontrolled hypertension and poor glycemic control. Older age, low level of education and longer duration of DM were associated with CKD. There is a need to carry out prospective studies to determine the association and role of glycemic and blood pressure control in CKD causation among patients with DM in Botswana.