Streptococcal Infection Outbreak'Evolving '
This news item outlines how twelve patients have now died in mid Essex in an outbreak of invasive Group A Streptococcus. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 5, 2019 Category: Consumer Health News Source Type: news

Live attenuated influenza vaccine (Fluenz Tetra): PGD template - 2019 to 2020 flu season
This PGD template supports the administration of live attenuated influenza vaccine (Fluenz Tetra) as part of the national seasonal influenza vaccination programme. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 5, 2019 Category: Consumer Health News Source Type: news

Syphilis
This article outlines the diagnosis, staging, pharmacological management and contact tracing of syphilis. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 5, 2019 Category: Consumer Health News Source Type: news

Enteral lactoferrin for the treatment of sepsis and necrotizing enterocolitis in neonates
This review did not identify any eligible trials evaluating lactoferrin for the treatment of neonatal sepsis or necrotizing enterocolitis. Authors'state currently there is no evidence to support or refute the use of enteral lactoferrin for these indications. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 5, 2019 Category: Consumer Health News Source Type: news

Personalised care for veterans in England: A guide for clinical commissioning groups and local authorities
This document sets out a new personalised care approach for those veterans who have a long term physical, mental or neurological health condition or disability. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 3, 2019 Category: Consumer Health News Source Type: news

Statistics on Smoking, England - 2019
This report aims to present a broad picture of health issues relating to smoking in England and covers topics such as smoking prevalence, habits, behaviours and attitudes among adults and school children smoking-related ill health and mortality and smoking-related costs. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 3, 2019 Category: Consumer Health News Source Type: news

Too clean or not too clean? The Case for Targeted Hygiene in the Home and Everyday Life
This report outlines a more focused approach to hygiene – Targeted Hygiene – which sustains exposure to the beneficial microbes required for a healthy microbiome and prevents infections which need treatment with antibiotics that can adversely affect the microbiome. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 3, 2019 Category: Consumer Health News Source Type: news

RCPCH Prevention Vision for Child Health
Report highlights that primary prevention beginning before birth is crucial to the success of the NHS Long Term Plan and improvements in service provision will only provide a sticking plaster if the circumstances in which the country's poorest children grow up do not improve. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 3, 2019 Category: Consumer Health News Source Type: news

ADASS Budget Survey 2019
Stark report from the Directors of Adult Social Services in England highlights the financial and human consequences of under-resourcing and a failure on the part of successive governments to reform the funding system resulting in escalating crisis in social care. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 3, 2019 Category: Consumer Health News Source Type: news

Behind the headlines: Widely used class of drugs linked to dementia
This assessment is based on press reports highlighting a study which reported anticholinergic medicines were associated with an increased risk of developing dementia, depending on the dose and duration of use. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 3, 2019 Category: Consumer Health News Source Type: news

A citizen-led approach to health and care: Lessons from the Wigan Deal
This report discusses'asset-based'working in which public services build on strengths and assets of individuals/communities to improve outcomes. A key part of the process has been closer working between NHS, voluntary sector and others to establish common strategies. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 3, 2019 Category: Consumer Health News Source Type: news

Intravenous flucloxacillin treatment is associated with a high incidence of hypokalaemia
Retrospective cohort study (n=161; mean age 70 years) found that hypokalaemia occurred significantly more often in patients receiving flucloxacillin vs ceftriaxone (42% vs 14%). Moreover, follow ‐up potassium levels were significantly lower during flucloxacillin therapy. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 27, 2019 Category: Consumer Health News Source Type: news

Headtohead oral prophylactic antibiotic therapy for chronic obstructive pulmonary disease
Review (2 RCTs; n= 391) found very limited evidence to support a difference in efficacy or safety between different classes or regimens of prophylactic antibiotic, given for 12 to 13 weeks for COPD. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 27, 2019 Category: Consumer Health News Source Type: news

Antimicrobial central venous catheters do not reduce infections in pre-term babies
Expert commentary states CVCs impregnated with antimicrobials (n=430) are no better than standard CVCs (n=431). Time from allocation to first bloodstream infection was similar (HR 1.11, p=0 · 63) and 46/430 (10%) or 44/431 (11%) babies developed bloodstream infection, respectively. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 27, 2019 Category: Consumer Health News Source Type: news

Hidden no more: dementia and disability
This report seeks to highlight the human impact that this has on people living with dementia. It focuses on themes of equality, non-discrimination, participation and inclusion. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 26, 2019 Category: Consumer Health News Source Type: news

Beyond the NHS: addressing the root causes of poor health
This report argues that a radical change of direction is required and focuses on how to develop and deliver a social model of health. It claims that the greatest socio-economic challenges of our time – from poor-quality housing to knife crime, from skills'deprivation to in-work poverty and homelessness – are also our greatest health challenges. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 26, 2019 Category: Consumer Health News Source Type: news

Healthcare standards for children and young people in secure settings.
These updated standards take a pathway and multi-professional approach, following the young person's journey through a secure setting. They are intended to help healthcare professionals, commissioners, service providers, regulators, managers and governors ensure that young people in secure settings receive the care they need to improve their health outcomes. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 26, 2019 Category: Consumer Health News Source Type: news

Insights from the spread of the primary care home.
This report looks at factors that contributed to the spread of the'primary care home', a type of primary care network, from concept to more than 200 sites in a few years. It identifies factors that enabled the spread of primary care homes, as well as the factors that made the spread harder and provides insights that can inform health and care transformation efforts. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 26, 2019 Category: Consumer Health News Source Type: news

Adaptations without delay
This document is intended to address delays in the delivery of all types of home adaptations. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 26, 2019 Category: Consumer Health News Source Type: news

Telephone counselling for smoking cessation
Review of 104 trials (total n=111,653) found moderate ‐certainty evidence that proactive telephone counselling aids smokers who seek help from quitlines, and moderate‐certainty evidence that proactive telephone counselling increases quit rates in smokers in other settings. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 25, 2019 Category: Consumer Health News Source Type: news

Home care and end-of-life hospital admissions: a retrospective interview study in English primary and secondary care
Qualitative study (in depth interviews with 30 healthcare professionals and 3 next-of-kin) found that hospital admission was considered by healthcare staff when there was insufficient nursing provision, or where family support was challenged. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 25, 2019 Category: Consumer Health News Source Type: news

NHS waiting times for elective and cancer treatment
This parliamentary report discusses current NHS waiting times for cancer referrals and reports the percentage of patients treated within waiting times standards continues to get worse for both elective and cancer treatment. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 25, 2019 Category: Consumer Health News Source Type: news

Ignoring the Alarms follow-up: Too many avoidable deaths from eating disorders
Inquiry found a serious lack of training for doctors about eating disorders and recommend that GMC use its influence to ensure medical schools improve outcomes in relation to eating disorders. There was also lack of precise information about prevalence of eating disorders. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 25, 2019 Category: Consumer Health News Source Type: news

Posthospital Fall Injuries and 30-Day Readmissions in Adults 65 Years and Older
Retrospective study (n=8,382,074) found posthospital fall-related injuries (FRIs) were leading readmission (RA) diagnosis, particularly for patients originally admitted with FRI (12.9%) or cognitive impairment (16.0%). Targeting this group has potential to reduce RAs/improve care (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 25, 2019 Category: Consumer Health News Source Type: news

The acceptability of addressing alcohol consumption as a modifiable risk factor for breast cancer: a mixed method study within breast screening services and symptomatic breast clinics
Study found low levels of alcohol (AC) health literacy and numeracy. In 205 women and 33 NHS staff, AC was identified as breast cancer (BC) risk factor by 19.5% and 48.5%, respectively.Both groups had concerns about how to talk about AC and BC risk factors in non-stigmatising way (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 25, 2019 Category: Consumer Health News Source Type: news

A content analysis of tobacco and alcohol audio-visual content in a sample of UK reality TV programmes
This study reports tobacco, and especially alcohol, content is common in reality TV. The popularity of these programmes with young people, and consequent exposure to tobacco and alcohol imagery, represents a potentially major driver of smoking and alcohol consumption. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 25, 2019 Category: Consumer Health News Source Type: news

Making a difference: Housing and health: a case for investment
An extensive body of evidence now exists showing the critical importance that good housing has on health and well-being and its impact across the life-course. Poor housing is associated with poor physical and mental health and causes, or contributes to, many preventable diseases and injuries including respiratory and cardiovascular diseases and cancer. More needs to be done to realise the type of population health improvement required to sustainably change the health and well-being outcomes of the people of Wales and pivotal to this is a truly integrated health, care and housing relationship. (Source: Current Awareness Ser...
Source: Current Awareness Service for Health (CASH) - June 24, 2019 Category: Consumer Health News Source Type: news

Adopt AWaRe: Handle antibiotics with care
This new international campaign aims to reduce antimicrobial resistance and ensure access. It indicates which antibiotics to use for common or serious infections, which ones should be used sparingly or preserved, and which should be used only as a last resort. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 20, 2019 Category: Consumer Health News Source Type: news

Quantitative capillary refill time predicts sepsis in patients with suspected infection in the emergency department: an observational study.
This study was performed to compare the predictive ability of the quantitative capillary refill time (Q-CRT) as a new rapid index versus the quick sequential organ failure assessment (qSOFA) score and the systemic inflammatory response syndrome (SIRS) score for sepsis screening in the emergency department. In this study, Q-CRT/qSOFA combination had better sensitivity than the qSOFA score alone and better specificity than the SIRS score alone. There was no significant difference in accuracy between Q-CRT/qSOFA combination and the qSOFA score or lactate concentration. The ability of the Q-CRT to predict sepsis may be similar...
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Secondary analysis of the WOMAN trial to explore the risk of sepsis after invasive treatments for postpartum hemorrhage.
To examine the association between the use of invasive treatments for postpartum hemorrhage and the risk of sepsis and severe sepsis. In this secondary data analysis, certain invasive treatments for postpartum hemorrhage appear to increase the risk of sepsis. Further research is needed to confirm this finding and investigate the role of prophylactic antibiotics during these procedures. The harms and benefits of such interventions must be carefully weighed, both in treatment guidelines and during individual patient management. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Informatics and interaction: Applying human factors principles to optimize the design of clinical decision support for sepsis.
In caring for patients with sepsis, the current structure of electronic health record systems allows clinical providers access to raw patient data without imputation of its significance. There are a wide range of sepsis alerts in clinical care that act as clinical decision support tools to assist in early recognition of sepsis; however, there are serious shortcomings in existing health information technology for alerting providers in a meaningful way. Little work has been done to evaluate and assess existing alerts using implementation and process outcomes associated with health information technology displays, specificall...
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Elevated CTRP1 Plasma Concentration Is Associated with Sepsis and Pre-Existing Type 2 Diabetes Mellitus in Critically Ill Patients.
This study demonstrates significantly elevated levels of CTRP1 in critically ill patients, particularly with sepsis, and links circulating CTRP1 to inflammatory and metabolic disturbances. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Clinical and Demographic Parameters of Patients Treated Using a Sepsis Protocol.
The purpose of this study was to investigate potential differences by sex in the demographic and clinical characteristics of patients treated utilizing a sepsis electronic bundle order set. Risk factors for in-hospital mortality were also assessed. Women were more likely to have a genitourinary cause of sepsis and less likely to arrive by ambulance. Risk factors of in-hospital mortality were older age, arrival by ambulance, and an ESI level of 1 or 2, but not sex. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Circulating microRNAs as biomarkers for Sepsis secondary to pneumonia diagnosed via Sepsis 3.0.
This study aims to investigate the diagnostic and prognostic values of miRNAs in sepsis secondary to pneumonia. MiR-223-3p could be utilized to predict sepsis secondary to pneumonia. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Trends and Outcomes in Sepsis Hospitalizations With and Without Atrial Fibrillation: A Nationwide Inpatient Analysis.
Atrial fibrillation is frequently seen in sepsis-related hospitalizations. However, large-scale contemporary data from the United States comparing outcomes among sepsis-related hospitalizations with versus without atrial fibrillation are limited. The aim of our study was to assess the frequency of atrial fibrillation and its impact on outcomes of sepsis-related hospitalizations. The presence of atrial fibrillation among sepsis-related hospitalizations is a marker of poor prognosis and increased mortality. Although we observed rising trends in sepsis and sepsis-atrial fibrillation-related hospitalizations during the study p...
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Hypertonic Saline in Human Sepsis: A Systematic Review of Randomized Controlled Trials.
The role of hypertonic saline in sepsis remains unclear because clinical data are limited and the balance between beneficial and adverse effects is not well defined. In our meta-analysis of studies in patients with sepsis, hypertonic saline reduced the volume of fluid needed to achieve the same hemodynamic targets but did not affect survival. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Time course of fluid responsiveness in sepsis: the fluid challenge revisiting (FCREV) study.
This study shows that 51.3% of initial responders have a persistent response to fluid 30 min after the beginning of fluid infusion and only 41.3% have a transient response highlighting that fluid responsiveness is time dependent. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Association between increased arterial stiffness and clinical outcomes in patients with early sepsis: a prospective observational cohort study.
This study aims to investigate arterial stiffness in early sepsis and its association with clinical outcomes. Patients with severe sepsis and septic shock admitted to intensive care have higher arterial stiffness than in the general population. No convincing association was found between pulse wave velocity at admission and the progression of multiple organ or cardiovascular failure, although the group with pulse wave velocity> 24.7 m/s had shorter survival time. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Immune function testing in sepsis patients receiving sodium selenite.
We examined in a longitudinal study the role of sodium selenite in sepsis patients in strengthening the immune performance in whole blood samples using immune functional assays. Selenium has long been an adjuvant therapy in treating sepsis. Recently, it was proven to not have beneficial effects on the mortality outcome. Using data from our center in this sub-cohort study, we identified no relative improvement in cytokine release of stimulated blood immune cells ex vivo from patients with selenium therapy over a three-week period. This offers a potential explanation for the lack of beneficial effects of selenium in sepsis p...
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Influence of systemic hemodynamics on microcirculation during sepsis.
During sepsis, improvement of hemodynamic may not be related to improvement of microcirculation. The aim of this study was to investigate influence of systemic circulation on microcirculation in septic ICU patients. DAP was the only independent determinant of resStO2 in septic patients. Fluid challenges may improve microcirculation. CVP did not influence resStO2. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Impact of a qSOFA-based triage procedure on antibiotic timing in ED patients with sepsis: A prospective interventional study.
It has not been investigated whether the quick sepsis-related organ failure assessment score (qSOFA), a new bedside tool for early sepsis detection, may help accelerating antibiotic initiation in ED patients with sepsis. A qSOFA-based triage procedure does not improve antibiotic timing and outcomes in patients with sepsis admitted to a high-volume ED. The qSOFA value at triage was poorly sensitive for early sepsis detection. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Derivation, Validation, and Potential Treatment Implications of Novel Clinical Phenotypes for Sepsis.
Sepsis is a heterogeneous syndrome. Identification of distinct clinical phenotypes may allow more precise therapy and improve care. In this retrospective analysis of data sets from patients with sepsis, 4 clinical phenotypes were identified that correlated with host-response patterns and clinical outcomes, and simulations suggested these phenotypes may help in understanding heterogeneity of treatment effects. Further research is needed to determine the utility of these phenotypes in clinical care and for informing trial design and interpretation. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Monocyte Distribution Width: A Novel Indicator of Sepsis-2 and Sepsis-3 in High-Risk Emergency Department Patients.
This study evaluated the diagnostic accuracy of peripheral blood monocyte distribution width alone and in combination with WBC count for early sepsis detection in the emergency department. An monocyte distribution width value of greater than 20.0 U is effective for sepsis detection, based on either Sepsis-2 criteria or Sepsis-3 criteria, during the initial emergency department encounter. In tandem with WBC, monocyte distribution width is further predicted to enhance medical decision making during early sepsis management in the emergency department. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Renal protection in sepsis: Is hypertonic sodium (lactate) the solution?
Hypertonic sodium solutions are useful for minimizing secondary brain injury from cerebral edema but also attractive for “small-volume” resuscitation in severe hypovolemia and shock because they rapidly mobilize endogenous water from the intracellular reservoir, thereby reducing endothelial cell volume and restoring microcirculation. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

An overview of positive cultures and clinical outcomes in septic patients: a sub-analysis of the Prehospital Antibiotics Against Sepsis (PHANTASi) trial
Sepsis remains one of the most important causes of morbidity and mortality worldwide. In approximately 30-50% of cases of suspected sepsis, no pathogen is isolated, disabling the clinician to treat the patient with targeted antimicrobial therapy. Studies investigating the differences in the patient outcomes between culture-positive and culture-negative sepsis patients have only been conducted in subgroups of sepsis patients and results are ambiguous. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Risk Factors for Myocardial Infarction and Stroke Among Sepsis Survivors: A Competing Risks Analysis.
Predictors for post-sepsis myocardial infarction (MI) and stroke are yet to be identified due to the competing risk of death. Baseline comorbidities and sources of infection were associated with an increased risk of post-sepsis MI and stroke. The identified risk factors may help physicians select a group of patients with sepsis who may benefit from preventive measures, antiplatelet treatment, and other preventive measures for post-sepsis MI and stroke. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Safety of vitamin C in sepsis: a neglected topic.
Although vitamin C is essentially a nontoxic vitamin; however, it is important to be aware regarding the safety of high doses before the wide clinical use. Minor side effects of vitamin C have been reported, many being reported in earlier studies. High doses of vitamin C (up to 1.5 g/kg three times a week as intravenously) were safe in cancer patients with normal renal function and perfect glucose-6-phosphate dehydrogenase activity. As the dose and duration of administration of vitamin C in sepsis are lower and shorter than those used in cancer patients, it seems that it is relatively safe for this population. In ongoing t...
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

The glycocalyx: a novel diagnostic and therapeutic target in sepsis
The glycocalyx is a gel-like layer covering the luminal surface of vascular endothelial cells. It is comprised of membrane-attached proteoglycans, glycosaminoglycan chains, glycoproteins, and adherent plasma proteins. The glycocalyx maintains homeostasis of the vasculature, including controlling vascular permeability and microvascular tone, preventing microvascular thrombosis, and regulating leukocyte adhesion. In this review, we first analyze the underlying mechanisms of glycocalyx degradation in sepsis. Second, we demonstrate how the blood and urine levels of glycocalyx components are associated with patient outcomes. Th...
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

The clinical efficacy of intravenous IgM-enriched immunoglobulin (pentaglobin) in sepsis or septic shock: a meta-analysis with trial sequential analysis
Sepsis is characterized by a complex immune response. This meta-analysis evaluated the clinical effectiveness of intravenous IgM-enriched immunoglobulin (IVIgGM) in patients with sepsis and septic shock. Administration of IVIgGM to adult septic patients may be associated with reduced mortality. Treatment effects tended to be smaller or less consistent when including only those studies deemed adequate for each indicator. The available evidence is not clearly sufficient to support the widespread use of IVIgGM in the treatment of sepsis. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news

Interleukin 28 is a potential therapeutic target for sepsis.
This study defines IL-28 as a detrimental mediator during sepsis and identifies a potential therapeutic target for the immune therapy in sepsis. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 19, 2019 Category: Consumer Health News Source Type: news