Search Our Scientific Publications & Authors

JMIR Res Protoc 2019 Feb 14;8(2):e12272. Epub 2019 Feb 14.

Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, United States.

Background: Bacteriuria, either asymptomatic (ASB) or symptomatic, urinary tract infection (UTI), is common in persons with spinal cord injury (SCI). Current Veterans Health Administration (VHA) guidelines recommend a screening urinalysis and urine culture for every veteran with SCI during annual evaluation, even when asymptomatic, which is contrary to other national guidelines. Our preliminary data suggest that a positive urine culture (even without signs or symptoms of infection) drives antibiotic use. Read More

Am Surg 2018 Oct;84(10):1705-1709

Division of Trauma and Acute Care Surgery, LAC+USC Medical Center, Los Angeles, California, USA.

Focused assessment with Sonography for trauma (FAST) examination is essential to trauma triage. We sought to determine whether FASTs completed early in sequencing portend worse outcomes. A two-year review (2014-2015) of all trauma activations at our Level I trauma center was performed. Read More

Antimicrob Resist Infect Control 2019 4;8:28. Epub 2019 Feb 4.

10Department of Essential Medicines and Health Products, World Health Organization (WHO), Avenue Appia 20, 1211 Geneva 27, Switzerland.

Background: Effective use of microbiology test results may positively influence patient outcomes and limit the use of broad-spectrum antibiotics. However, studies indicate that their potential is not fully utilized. We investigated microbiology test ordering practices and the use of test results for antibiotic decision-making in hospitals. Read More

J Environ Manage 2019 Feb 6;236:269-279. Epub 2019 Feb 6.

Office of Research and Development, National Risk Management Research Laboratory, U.S. Environmental Protection Agency, 26 W. Martin Luther King Drive, Cincinnati, OH, 45268, USA. Electronic address:

Coastal tidal wetlands are well recognized for the key ecosystem services they provide such as flood protection, water quality improvement, and carbon sequestration. In the southeastern United States, some communities rely on coastal wetlands for the management of secondarily treated effluents in forested and emergent wetlands. Advocates for this practice have argued that wetlands can assimilate nitrogen from wastewater, which can improve cypress-tupelo swamp productivity, and enhance marsh accretion rates to mitigate the effects of sea level rise. Read More

PLoS Med 2019 Feb 5;16(2):e1002733. Epub 2019 Feb 5.

School of Health Care Management, Shandong University, Jinan, China.

Background: Inappropriate antibiotic prescribing causes widespread serious health problems. To reduce prescribing of antibiotics in Chinese primary care to children with upper respiratory tract infections (URTIs), we developed an intervention comprising clinical guidelines, monthly prescribing review meetings, doctor-patient communication skills training, and education materials for caregivers. We previously evaluated our intervention using an unblinded cluster-randomised controlled trial (cRCT) in 25 primary care facilities across two rural counties. Read More

Ir Med J 2019 Jan 15;112(1):852. Epub 2019 Jan 15.

Rotunda Hospital, Dept. of Obstetrics and Gynaecology, Parnell Square, Dublin 1

This paper summarises results of a survey of obstetricians in Ireland regarding their technique, management, and education on episiotomy and Obstetric Anal Sphincter Injury (OASIS). An anonymous survey was emailed to all obstetricians and gynaecologists in Ireland, including trainees between January and September 2017. The response rate was 45% (155/343) with 111 out of 144 (77%) reported clinical experience as part of their training and 92 (64%) attended an OASIS workshop or classroom teaching. Read More

BMC Surg 2019 Feb 4;19(1):17. Epub 2019 Feb 4.

Department of Hepatobiliary Surgery, the Second Affiliated Hospital, Nanchang University, No. 1, mingde road, Nanchang, Jiang xi, China.

Background: Hepatic portal vein gas (HPVG) is a rare acute abdomen, which is not an independent disease. Meanwhile, HPVG combined with appendicitis has been rarely reported. We found only a similar report by looking for literature, but no intestinal necrosis occurred. Read More

Public Health 2019 Feb 1;168:92-101. Epub 2019 Feb 1.

School of Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa.

Objectives: Self-medication with antibiotics (SMA) is a practice of global concern with a higher incidence within the low- and middle-income countries (LMICs). Despite worldwide efforts to control and promote the rational use of antibiotics, the continuing practice of SMA systematically exposes individuals and communities to the risk of antibiotic resistance and a host of other antibiotic side-effects. This systematic scoping review maps evidence on the factors influencing SMA in these settings. Read More

Food Chem Toxicol 2019 Jan 30;125:462-466. Epub 2019 Jan 30.

Hacettepe University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, 06100, Ankara, Turkey.

Veterinary medicines, especially antibiotics, are among the most important components related to animal feed production. Generally, the main use of antibiotics in animals is for the treatment and prevention of diseases and growth promotion. Antibiotic usage in animals may result antibiotic residues in foodstuffs such as milk, egg and meat. Read More

Trop Med Health 2019 25;47:11. Epub 2019 Jan 25.

SATREPS Project for Parasitic Diseases, Vientiane, Lao PDR.

Background: Malaria is a major health problem in Lao People's Democratic Republic (Lao PDR) with high transmission in remote and forest areas, particularly in the South. The military is at risk of malaria infection especially those deployed in forest areas. This study determined the prevalence of malaria infection and assessed knowledge, perception, and preventive and treatment behavior regarding malaria among military personnel in two southern provinces in Lao PDR. Read More

Luminescence 2019 Jan 28. Epub 2019 Jan 28.

Ministry of Education Key Laboratory of Analysis and Detection for Food Safety, Fujian Provincial Key Laboratory of Analysis and Detection for Food Safety, Department of Chemistry, Fuzhou University, Fuzhou, Fujian, P. R. China.

Foodborne contaminants widely exist in foods, which can lead to various foodborne diseases and food safety issues. The development of quick, sensitive and universal analytical approaches for foodborne contaminants is imperative. Electrochemiluminescent functional nucleic acids (ECL FNAs)-based sensors are a series of sensing devices using FNAs as the recognition elements and ECL as the transducer. Read More

Eur J Med Chem 2019 Jan 17;166:32-47. Epub 2019 Jan 17.

Department of Bioorganic Chemistry, Faculty of Chemistry, Adam Mickiewicz University, Umultowska 89b, 61‒614 Poznań, Poland. Electronic address:

Despite some progress in recent years, the fight against parasitic diseases still remains a great challenge. Parasitic diseases affect primarily (but not exclusively) the poorest people living in underdeveloped regions of the world. The distribution of parasitoses are linked to tropical and subtropical climate conditions, to population growth and to impoverishment. Read More

Cureus 2018 Nov 13;10(11):e3588. Epub 2018 Nov 13.

Emergency Medicine, Saint John Regional Hospital, Saint John, CAN.

Introduction Published national guidelines on chronic obstructive pulmonary disease (COPD) highlight the importance of oxygen therapy, bronchodilators, corticosteroids, and appropriate antibiotics during acute exacerbations of COPD (AECOPD). We wished to assess how the implementation of local COPD guidelines affects emergency department (ED) staff awareness, knowledge, the use of such guidelines, and patient outcomes, including treatment failure and rates of return to the ED. Methods This study was conducted at a tertiary hospital ED. Read More

Viruses 2019 Jan 24;11(2). Epub 2019 Jan 24.

Laboratory of Applied Biotechnology, Department of Biotechnology, Ghent University, Valentin Vaerwijckweg 1, B-9000 Ghent, Belgium.

The therapeutic potential of phages has been considered since their first identification more than a century ago. The evident concept of using a natural predator to treat bacterial infections has, however, since then been challenged considerably. Initially, the vast success of antibiotics almost eliminated the study of phages for therapy. Read More

IUBMB Life 2019 Jan 23. Epub 2019 Jan 23.

Department of Biology, Indian Institute of Science Education and Research, Tirupati, India.

Propelled by the overuse and inappropriate use of antibiotics, antimicrobial resistance is now widespread in the environment, leaving us with limited drugs for treating a large number of resistant pathogens. The use of bacteriophages that kill bacteria has come up as a viable alternative to circumvent the antimicrobial resistance crisis, and phage therapy-based approaches are fast advancing in recent times. In this minireview, we try to describe the advantages associated with phage therapy and update the latest developments in the field including the clinical trials that are underway. Read More

Can J Physiol Pharmacol 2019 Jan 19:1-8. Epub 2019 Jan 19.

b Centre de recherche de Centre Hospitalier Universitaire de Sherbrooke (CRCHUS) and Department of Obstetrics and Gynecology, Université de Sherbrooke, Quebec, QC J1H 5N4, Canada.

Childhood obesity is a predictor of adult obesity and has its roots in the pre-pregnancy or pregnancy period. This review presents an overview of the prenatal risk factors for childhood obesity, which were categorized into 2 groups: biological risk factors (maternal pre-pregnancy body mass index, gestational weight gain, diabetes in pregnancy, and caesarean section), and environmental and behavioural risk factors (maternal smoking and exposure to obesogens, maternal dietary patterns, maternal intestinal microbiome and antibiotics exposure, and maternal psychosocial stress). Identifying modifiable predisposing prenatal factors for obesity will inform further development of inventions to prevent obesity over the life course, and future directions for research and intervention are discussed. Read More

Intensive Care Med 2019 Feb 18;45(2):172-189. Epub 2019 Jan 18.

Medical ICU, La Source Hospital, CHR Orléans, Orléans, France.

The massive consumption of antibiotics in the ICU is responsible for substantial ecological side effects that promote the dissemination of multidrug-resistant bacteria (MDRB) in this environment. Strikingly, up to half of ICU patients receiving empirical antibiotic therapy have no definitively confirmed infection, while de-escalation and shortened treatment duration are insufficiently considered in those with documented sepsis, highlighting the potential benefit of implementing antibiotic stewardship programs (ASP) and other quality improvement initiatives. The objective of this narrative review is to summarize the available evidence, emerging options, and unsolved controversies for the optimization of antibiotic therapy in the ICU. Read More

Clin Microbiol Rev 2019 Apr 16;32(2). Epub 2019 Jan 16.

School of Biological Sciences, Monash University, Clayton, Victoria, Australia

SUMMARYAntibiotic resistance is arguably the biggest current threat to global health. An increasing number of infections are becoming harder or almost impossible to treat, carrying high morbidity, mortality, and financial cost. The therapeutic use of bacteriophages, viruses that infect and kill bacteria, is well suited to be part of the multidimensional strategies to combat antibiotic resistance. Read More

JAMA Netw Open 2018 Aug 3;1(4):e181662. Epub 2018 Aug 3.

Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill.

Importance: Substandard and falsified medicines burden health systems by diverting resources to ineffective or harmful therapies, causing medical complications and prolonging illnesses. However, the prevalence and economic impact of poor-quality medicines is unclear.

Objective: To conduct a systematic review and meta-analysis to assess the prevalence and estimated economic burden of substandard and falsified essential medicines in low- and middle-income countries. Read More

Vet Microbiol 2019 Feb 17;229:59-71. Epub 2018 Dec 17.

School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, 6150, Australia.

Across all bacterial species the continuing reduction in susceptibility to antimicrobial agents is a critical and increasing threat for disease control. This mini-review outlines the extent of this problem amongst anaerobic intestinal spirochaetes of the genus Brachyspira, of which there are currently nine officially recognised species. These include some important pathogens that may cause colitis with diarrhoea and/or dysentery in various mammalian and avian species, but most notably in pigs and in adult chickens. Read More

Can J Rural Med 2019 Jan-Mar;24(1):7-12

Primary Healthcare Research Unit, Discipline of Family Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.

Introduction: The Canadian island of Newfoundland has a long history of fishing; however, no study to date has developed a regional profile of fishhook injuries on its east coast.

Methods: To this end, we conducted a retrospective review of fishhook injuries at all Newfoundland East coast emergency departments from 2013 to 2015. Patient presentations were reviewed for the date of arrival, sex of the patient, location of fishhook injury, tetanus immunisation status, anaesthetic utilisation, diagnostic imaging, antibiotic management and technique of removal. Read More

Surg Neurol Int 2018 11;9:251. Epub 2018 Dec 11.

Clinical Professor of Neurological Surgery, School of Medicine, State University of N.Y. at Stony Brook, and Chief of Neurosurgical Spine/Education at NYU Winthrop Hospital, Mineola, NY 11501, USA.

Background: Multiple measures prior to spine surgery may reduce the risks of postoperative surgical site infections (SSIs).

Methods: The incidence of SSI following spinal surgery (including reoperations and readmissions) may be markedly reduced by performing less extensive procedures and avoiding fusion where feasible. Preoperative testing up to 3 weeks postoperatively should include other studies to limit the perioperative SSI risk; cardiac stress tests (e. Read More

BMJ Qual Saf 2019 Jan 12. Epub 2019 Jan 12.

Department of Medicine, University of Chicago, Chicago, Illinois, USA.

Background: There is limited literature about physician handoffs between the intensive care unit (ICU) and the ward, and best practices have not been described. These patients are uniquely vulnerable given their medical complexity, diagnostic uncertainty and reduced monitoring intensity. We aimed to characterise the structure, perceptions and processes of ICU-ward handoffs across three teaching hospitals using multimodal methods: by identifying the handoff components involved in communication failures and describing common processes of patient transfer. Read More

Int J Mol Sci 2019 Jan 6;20(1). Epub 2019 Jan 6.

Istituto di Patologia Speciale Medica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy.

Bacteriocins are bactericidal peptides, ribosomally synthesized, with an inhibitory activity against diverse groups of undesirable microorganisms. Bacteriocins are produced by both gram-positive and gram-negative bacteria, and to a lesser extent by some archaea. Bacteriophages are viruses that are able to infect bacterial cells and force them to produce viral components, using a lytic or lysogenic cycle. Read More

J Clin Immunol 2019 Jan 4;39(1):90-98. Epub 2019 Jan 4.

Department of Allergy and Clinical Immunology, Cleveland Clinic, Cleveland, OH, USA.

Purpose: Primary immunodeficiency (PID) represents disorders with a spectrum of clinical presentations. The medical community seeks clinical features to prompt evaluation for immunodeficiency given improved prognosis with early identification. We hoped to identify clinical characteristics that would improve the diagnostic accuracy of the widely disseminated Jeffrey Modell Foundation warning signs for immunodeficiency. Read More

Am J Emerg Med 2018 Dec 29. Epub 2018 Dec 29.

Department of Emergency Medicine, Rutgers New Jersey Medical School, United States of America. Electronic address:

Background: Emergency Department (ED) patients presenting with spontaneous epistaxis who have anterior nasal packing are routinely prescribed systemic prophylactic antibiotics in spite of the lack of supporting evidence-based literature. Although there is literature that discusses infection rates with nasal packing for epistaxis and prophylactic antibiotics prescribing practices of otolaryngologists, this is the first study to our knowledge that examines the practices of emergency physicians.

Objectives: The main objective of this study was to compare the infection rate between patients who were and were not prescribed prophylactic systemic antibiotics for anterior nasal packing in spontaneous epistaxis and to examine current management practices of antibiotic prescribing for these patients. Read More

BMJ Open Qual 2018 1;7(4):e000483. Epub 2018 Dec 1.

Antimicrobial Stewardship Program, Saskatchewan Health Authority, Regina, Saskatchewan, Canada.

Objective: To determine if an educational intervention can decrease the inappropriate antibiotic treatment of long-term care (LTC) residents with asymptomatic bacteriuria (ASB).

Design: Prospective chart audit between May and July 2017.

Setting: Seven LTC facilities in Regina, Saskatchewan, Canada. Read More

BMC Infect Dis 2018 Dec 27;18(1):697. Epub 2018 Dec 27.

Ohio State University Wexner Medical Center, Columbus, USA.

Background: Timely initiation of antibiotics within one hour of prescription is one of the recommended antibiotic stewardship interventions when managing patients with pneumonia in the emergency department. Effective implementation of this intervention depends on effective communication, a well-established coordination process and availability of resources. Understanding what may influence this aspect of care by using process mapping is an important component when planning for improvement interventions. Read More

J Nurs Care Qual 2018 Dec 21. Epub 2018 Dec 21.

Department of Critical Care Medicine, UPMC Hamot, Erie, Pennsylvania (Drs Raines and Sevilla Berrios); and Department of Acute/Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania (Drs Raines and Guttendorf).

Background: The quick-Sequential Organ Failure Assessment (qSOFA) criteria are recommended for identifying non-intensive care unit (ICU) patients at risk for sepsis but are underutilized.

Local Problem: We hypothesized that education on recognizing sepsis using qSOFA criteria and empowering nurses to trigger rapid response team (RRT) calls based on positive qSOFA scores would reduce time to recognition and time to intervention and improve treatment compliance in non-ICU patients.

Methods: The methods involved a descriptive retrospective review of 60 sepsis patients (30 pre- and 30 posteducation) to determine sepsis recognition time (qSOFA-to-RRT); time-to-sepsis interventions (reported as median [interquartile range] hours); and percent compliance with interventions. Read More

Antibiotics (Basel) 2018 Dec 22;8(1). Epub 2018 Dec 22.

Institute of Development Studies, University of Sussex, Brighton BN1 NRE, UK.

This review identifies evidence on supply-side interventions to change the practices of antibiotic prescribers and gatekeepers in low- and middle-income countries (LMICs). A total of 102 studies met the inclusion criteria, of which 70 studies evaluated interventions and 32 provided insight into prescribing contexts. All intervention studies were from human healthcare settings, none were from animal health. Read More

Molecules 2018 Dec 22;24(1). Epub 2018 Dec 22.

Institute of Comparative Medicine, College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China.

Antibiotic resistance mediated by bacterial enzymes constitutes an unmet clinical challenge for public health, particularly for those currently used antibiotics that are recognized as "last-resort" defense against multidrug-resistant (MDR) bacteria. Inhibitors of resistance enzymes offer an alternative strategy to counter this threat. The combination of inhibitors and antibiotics could effectively prolong the lifespan of clinically relevant antibiotics and minimize the impact and emergence of resistance. Read More

Nutrients 2018 Dec 21;11(1). Epub 2018 Dec 21.

Gansu Key Laboratory of Biomonitoring and Bioremediation for Environmental Pollution, School of Life Science, Lanzhou University, Tianshuinanlu #222, Lanzhou 730000, Gansu, China.

Various environmental contaminants including heavy metals, pesticides and antibiotics can contaminate food and water, leading to adverse effects on human health, such as inflammation, oxidative stress and intestinal disorder. Therefore, remediation of the toxicity of foodborne contaminants in human has become a primary concern. Some probiotic bacteria, mainly have received a great attention due to their ability to reduce the toxicity of several contaminants. Read More

Emerg Med Australas 2019 02 20;31(1):97-104. Epub 2018 Dec 20.

St Vincent's Hospital, Melbourne, Victoria, Australia.

Objective: To improve asthma care in a complex, low resource, developing country setting. This observational study was carried out in a challenging low-income real-life setting in the ED at Modilon Hospital, Papua New Guinea. The only government hospital in Madang Province, with 258 beds, it provides medical care to a population of nearly 700 000 people of whom 40% live on less than US$1. Read More

Int J Pediatr Otorhinolaryngol 2019 Jan 19;116:135-140. Epub 2018 Oct 19.

The Royal Brisbane and Women's Hospital, Brisbane, Australia; The University of Queensland Centre for Clinical Research, Herston, Australia. Electronic address:

Otitis media (OM) is one of the most common infectious diseases in children and the leading cause for medical consultations and antibiotic prescription in this population. The burden of disease associated with OM is greater in developing nations and indigenous populations where the associated hearing loss contributes to poor education and employment outcomes. Current treatment and prevention is largely focused on vaccination and antibiotics. Read More

Biotechnol Lett 2019 Feb 12;41(2):221-230. Epub 2018 Dec 12.

School of Mechanical Engineering, Korea University of Technology and Education, Cheonan, Chungnam, 31253, South Korea.

Antibiotic susceptibility test (AST) is an umbrella term for techniques to determine the susceptibility of bacteria to antibiotics. The antibiotic-resistant bacteria are a major threat to public health and a directed therapy based on accurate AST results is paramount in resistance control. Here we have briefly covered the progress of conventional, molecular, and automated AST tools and their limitations. Read More

Environ Res 2019 Feb 26;169:483-493. Epub 2018 Nov 26.

Guangdong Provincial Key Laboratory of Soil and Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, China; State Environmental Protection Key Laboratory of Integrated Surface Water-Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, China. Electronic address:

The extensive use of antibiotics leading to the rapid spread of antibiotic resistance poses high health risks to humans, but to date there is still lack of a quantitative model to properly assess the risks. Concerns over the health risk of antibiotic residues in the environment are mainly (1) the potential hazard of ingested antibiotic residues in the environment altering the human microbiome and promoting emergence and selection for bacteria resistance inhabiting the human body, and (2) the potential hazard of creating a selection pressure on environmental microbiome and leading to reservoirs of antibiotic resistance in the environment. We provide a holistic view of health risk assessment of antibiotic resistance associated with antibiotic residues in the environment in contrast with that of the antibiotic resistant bacteria and discuss the main knowledge gaps and the future research that should be prioritized to achieve the quantitative risk assessment. Read More

Appl Clin Inform 2018 Oct 5;9(4):869-874. Epub 2018 Dec 5.

UPMC St. Margaret, Pittsburgh, Pennsylvania, United States.

Background:  Sepsis is a serious medical condition that can lead to organ dysfunction and death. Research shows that each hour delay in antibiotic administration increases mortality. The Surviving Sepsis Campaign Bundles created standards to assist in the timely treatment of patients with suspected sepsis to improve outcomes and reduce mortality. Read More

J Trauma Acute Care Surg 2018 Dec 3. Epub 2018 Dec 3.

Professor of Medicine and Emergency Medicine, Department of Emergency Medicine (and Department of Medicine, Division of Infectious Diseases), Olive View-UCLA Medical Center, 14445 Olive View Drive, North Annex, Sylmar, CA 91342.

Background: Meta-analyses and a recent guideline acknowledge that conservative management of uncomplicated appendicitis with antibiotics can be successful for patients who wish to avoid surgery. However, guidance as to specific management does not exist.

Methods: PUBMED and EMBASE search of trials describing methods of conservative treatment was conducted according to PRISMA guidelines. Read More

J Rural Health 2018 Nov 28. Epub 2018 Nov 28.

Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut.

Purpose: The Centers for Medicare and Medicaid Services (CMS) and the American College of Emergency Physicians (ACEP) developed national quality measures for emergency department (ED) sepsis care. Like care for many conditions, meeting sepsis quality metrics can vary between settings. We sought to examine and compare sepsis care quality in rural vs urban hospital-based EDs. Read More

Antimicrob Resist Infect Control 2018 19;7:138. Epub 2018 Nov 19.

1School of Medical Laboratory Science, Jimma University, Jimma, Ethiopia.

Background: The rates of resistant microorganisms which complicate the management of healthcare associated infections (HAIs) are increasing worldwide and getting more serious in developing countries. The objective of this study was to describe microbiological features and resistance profiles of bacterial pathogens of HAIs in Jimma University Medical Center (JUMC) in Ethiopia.

Methods: Institution based cross sectional study was carried out on hospitalized patients from May to September, 2016 in JUMC. Read More

Clin Interv Aging 2018 30;13:2201-2213. Epub 2018 Oct 30.

Centre for Education and Research on Ageing, Concord Repatriation General Hospital, Concord, NSW, Australia.

Background: Aspiration pneumonia is a common problem in older people with high mortality and increasing prevalence.

Objective: The aims of this paper were to systematically review the literature on the antibacterial treatment of aspiration pneumonia in elderly patients and identify the microbiology of aspiration pneumonia.

Materials And Methods: EMBASE, MEDLINE, and Cochrane databases were systematically searched for studies that examined the clinical efficacy of antibiotic treatment in elderly patients with aspiration pneumonia. Read More

Braz Dent J 2018 Jul-Aug;29(4):395-399

School of Dentistry, University of Leeds, Leeds, UK.

Antibiotics do not cure toothache. This headline message of the United Kingdom's (UK) Dental Antimicrobial Stewardship (AMS) toolkit's posters and leaflets is aimed at patients; clinicians are expected to know this already. Evidence based clinical guidelines exist to set clear standards for good clinical practice yet there are barriers to compliance. Read More

Clin Pract Cases Emerg Med 2018 Nov 16;2(4):294-296. Epub 2018 Oct 16.

Geisinger Health, Department of Emergency Medicine, Danville, Pennsylvania.

We present a case report and review of the literature of rib osteomyelitis in a pediatric patient presenting to the emergency department (ED) with fever and increased work of breathing. The patient was seen on a return visit to the ED after discharge with presumed viral illness approximately 12 hours prior. On the second ED visit, there was concern for occult bacteremia, and work-up ultimately revealed a subperiosteal abscess with rib osteomyelitis, a rare etiology for fever in the pediatric patient. Read More

Front Microbiol 2018 1;9:2597. Epub 2018 Nov 1.

Department of Biophysics, Panjab University, Chandigarh, India.

Celiac disease (CD) is an autoimmune disorder of the small intestine, caused by gluten induced inflammation in some individuals susceptible to genetic and environmental influences. To date, pathophysiology of CD in relation to intestinal microbiota is not known well. This review relies on contribution of intestinal microbiome and oral microbiome in pathogenesis of CD based on their interactions with gluten, thereby highlighting the role of upper gastrointestinal microbiota. Read More

Prehosp Emerg Care 2018 Nov 15:1-30. Epub 2018 Nov 15.

Objective: To inform the future development of a pediatric prehospital sepsis tool, we sought to 1) describe the characteristics, emergent care, and outcomes for children with septic shock who are transported by emergency medicine services (EMS) and compare them to those self-transported; and 2) determine the EMS capture rate of common sepsis screening parameters and the concordance between the parameters documented in the EMS record and in the emergency department (ED) record.

Methods: This is a retrospective cohort study of children ages 0 through 21 years who presented to a pediatric ED with septic shock between 11/2013 and 06/2016. Data, collected by electronic and manual chart review of EMS and ED records, included demographics, initial vital signs in both records, ED triage level, site of initial ED care, ED disposition, ED therapeutic interventions, outcomes and times associated with processes. Read More

Hong Kong Med J 2018 Dec 14;24(6):571-578. Epub 2018 Nov 14.

Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Shatin, Hong Kong.

Introduction: Emergency departments (EDs) play an important role in the early identification and management of sepsis. Little is known about local EDs' processes of care for sepsis, adoption of international recommendations, and the impact of the new Sepsis-3 definitions.

Methods: Structured telephone interviews based on the United Kingdom Sepsis Trust 'Exemplar Standards for the Emergency Management of Sepsis' were conducted from January to August 2017 with nominated representatives of all responding public hospital EDs in Hong Kong, followed by a review of hospital/departmental sepsis guidelines by the investigators. Read More

Postgrad Med 2019 Jan 30;131(1):8-18. Epub 2018 Nov 30.

b Center for Pelvic Medicine, LLC , Rosemont , PA , USA.

Bacterial vaginosis (BV) affects approximately one third of women in the United States. While often asymptomatic, BV infection may be accompanied by serious health consequences, such as preterm birth and pelvic inflammatory disease, and may facilitate acquisition of sexually transmitted infections. Identifying appropriate patients for screening, such as pregnant women, women planning pregnancy, and women with multiple and/or new sexual partners, is imperative for treatment. Read More

Curr Clin Pharmacol 2018 Nov 12. Epub 2018 Nov 12.

Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, (JIPMER), Puducherry. India.

Aim Multiple drug intolerance syndrome (MDIS) is a unique clinical entity distinct from other drug hypersensitivity syndromes. The aim of this review was to critically appraise the various aspects of MDIS. Methods A review was conducted to search for the causes, mechanism, clinical features, and management of MDIS. Read More

Glob Public Health 2018 Nov 8:1-14. Epub 2018 Nov 8.

b Department of Emergency Medicine , University of Illinois at Chicago, College of Medicine , Chicago , IL , USA.

To identify factors precipitating antibiotic misuse and discuss how to promote safe antibiotics use and curb antibiotic resistance. Antibiotic misuse is a significant problem globally, leading to increased antibiotic resistance. Many socio-cultural factors facilitate antibiotic misuse: patient and provider beliefs about antibiotics, inadequate regulation, poor health literacy, inadequate healthcare provider training, and sub-optimal diagnostic capability. Read More

Allergy Asthma Proc 2018 Nov;39(6):420-429

From Education Division, The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire.

The majority of patients for elective surgery and with a history of penicillin allergy are placed on alternative prophylactic antibiotic therapies, which have been associated with the emergence of multidrug-resistant pathogens and increased morbidity and mortality rates. However, self-reporting of penicillin allergy alone may overestimate the prevalence of penicillin allergy in the population. To assess the effects of preoperative antibiotic allergy testing protocols in reducing the use of non-beta-lactam antibiotics. Read More