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Article ; Online: Amikacin treatment in urinary tract infection patients: evaluating the risk of acute kidney injury - a retrospective cohort study.

Dagan, Avner / Epstein, Danny / Neuberger, Ami / Isenberg, Jonathan

Journal of chemotherapy (Florence, Italy)

2024 , Page(s) 1–5

Abstract: The rise in ESBL-producing and carbapenem-resistant Gram-negative bacterial infections is alarming. Aminoglycosides remain attractive for treating urinary tract infections (UTIs). However, aminoglycosides-associated acute kidney injury (AKI) raises ... ...

Abstract	The rise in ESBL-producing and carbapenem-resistant Gram-negative bacterial infections is alarming. Aminoglycosides remain attractive for treating urinary tract infections (UTIs). However, aminoglycosides-associated acute kidney injury (AKI) raises concerns, especially in patients with underlying renal impairment. We conducted a retrospective cohort study to evaluate the risk of AKI in patients with UTI empirically treated with amikacin. Among 395 patients (median age 41.9 years [IQR 28.3-67.1], 342 [86.6%] female), 162 (41.0%) received amikacin and 233 (59.0%) were empirically treated with other antibiotics. AKI incidence was low (5.6%) and not associated with amikacin exposure (OR 0.56, 95% CI 0.22-1.43,
Language	English
Publishing date	2024-02-19
Publishing country	England
Document type	Journal Article
ZDB-ID	1036294-0
ISSN	1973-9478 ; 1120-009X
ISSN (online)	1973-9478
ISSN	1120-009X
DOI	10.1080/1120009X.2024.2319454
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Zs.A 2701: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 387: Show issues

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Article ; Online: Percutaneous Dilatational Tracheostomy in Patients Receiving Dual Antiplatelet Therapy.

Noy, Roee / Shkedy, Yotam / Simchon, Omri / Gvozdev, Natalia / Epstein, Danny

JAMA otolaryngology-- head & neck surgery

2024 Volume 150, Issue 3, Page(s) 273–275

MeSH term(s)	Humans ; Tracheostomy ; Platelet Aggregation Inhibitors/therapeutic use ; Health Services ; Dilatation
Chemical Substances	Platelet Aggregation Inhibitors
Language	English
Publishing date	2024-01-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2701825-8
ISSN	2168-619X ; 2168-6181
ISSN (online)	2168-619X
ISSN	2168-6181
DOI	10.1001/jamaoto.2023.4365
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Ul II Zs.87: Show issues

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Article ; Online: Safety of Percutaneous Dilatational Tracheostomy in Critically Ill Patients with Liver Cirrhosis.

Noy, Roee / Macsi, Flóra / Shkedy, Yotam / Simchon, Omri / Gvozdev, Natalia / Epstein, Danny

European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes

2024

Abstract: Introduction: Percutaneous Dilatational Tracheostomy (PDT) is a safe and cost-effective alternative to surgical tracheostomy. Cirrhotic patients often require ICU admission and prolonged mechanical ventilation. Patients with liver cirrhosis (LC) are ... ...

Abstract	Introduction: Percutaneous Dilatational Tracheostomy (PDT) is a safe and cost-effective alternative to surgical tracheostomy. Cirrhotic patients often require ICU admission and prolonged mechanical ventilation. Patients with liver cirrhosis (LC) are known to have coagulopathy and relatively safe and simple procedures such as tracheostomy may be associated with high complication rates, specifically high bleeding rates. Current guidelines are unable to make a specific recommendation on the safety of PDT among cirrhotic patients. We aimed to evaluate the safety of PDT in critically ill patients with LC. Methods: A retrospective chart review identified critically ill patients who underwent PDT between 1/2012 and 3/2023. The study group was defined as all patients with a diagnosis of LC. The primary outcome was early (7-day) bleeding, categorized as minor or major. Secondary outcomes were PDT-related and 30-day all-cause mortality. Propensity score matching was performed to adjust the imbalances between the groups. Results: A total of 1,628 were included in the analysis. Thirty-three of them (2.0%) had LC. In the LC group, only one patient (3.0%, 95% CI 0.0%-15.8%) developed early bleeding. Intra-operative, early, late bleeding, and PDT-related mortality rates did not differ significantly between those with LC and those without. Conclusion: This retrospective cohort study indicates that PDT can be safely performed in critically ill cirrhotic patients, without significantly increasing the risk of bleeding complications.
Language	English
Publishing date	2024-04-29
Publishing country	Switzerland
Document type	News
ZDB-ID	205700-1
ISSN	1421-9921 ; 0014-312X
ISSN (online)	1421-9921
ISSN	0014-312X
DOI	10.1159/000539106
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Article ; Online: Safe bronchodilator treatment in mechanically ventilated COVID-19 patients: A single center experience.

Miller, Asaf / Epstein, Danny

Journal of critical care

2020 Volume 58, Page(s) 56–57

Keywords	covid19
Language	English
Publishing date	2020-04-21
Publishing country	United States
Document type	Letter
ZDB-ID	632818-0
ISSN	1557-8615 ; 0883-9441
ISSN (online)	1557-8615
ISSN	0883-9441
DOI	10.1016/j.jcrc.2020.04.010
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Zs.A 2152: Show issues

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Article ; Online: Survival Under the Rubble After the 2023 Earthquake in Turkey.

Epstein, Danny / Shavit, Itai / Peretz, Lidor / Almog, Ofer / Romain, Marc / King, Daniel / Mayo, Ami

Pediatrics

2023 Volume 152, Issue 5

MeSH term(s)	Humans ; Earthquakes ; Turkey ; Disasters
Language	English
Publishing date	2023-10-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2023-062746
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Um IV Zs.131: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 357: Show issues

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Article ; Online: IV Sodium Ferric Gluconate Complex in Patients Hospitalized Due to Acute Decompensated Heart Failure and Iron Deficiency.

Borreda, Itay / Zukermann, Robert / Epstein, Danny / Marcusohn, Erez

Journal of cardiovascular pharmacology and therapeutics

2022 Volume 27, Page(s) 10742484211055639

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Acute Disease ; Administration, Intravenous ; Aged ; Aged, 80 and over ; Female ; Ferric Compounds/administration & dosage ; Ferric Compounds/therapeutic use ; Heart Failure/complications ; Heart Failure/drug therapy ; Hematinics/administration & dosage ; Hematinics/therapeutic use ; Humans ; Iron Deficiencies/complications ; Iron Deficiencies/drug therapy ; Israel ; Male ; Patient Readmission/statistics & numerical data ; Retrospective Studies
Chemical Substances	Ferric Compounds ; Hematinics ; ferric gluconate (W108RK810P)
Language	English
Publishing date	2022-03-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	1329372-2
ISSN	1940-4034 ; 1074-2484
ISSN (online)	1940-4034
ISSN	1074-2484
DOI	10.1177/10742484211055639
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Zs.A 4895: Show issues

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Article ; Online: Correlations between high sensitive troponin I and acute myocarditis extent in cardiac magnetic resonance imaging.

Marcusohn, Erez / Barbara, Ameer / Epstein, Danny / Massalha, Samia / Zukermann, Robert

Journal of cardiovascular medicine (Hagerstown, Md.)

2023 Volume 24, Issue 6, Page(s) 334–339

Abstract: Purpose: To assess the correlation between high sensitive troponin I (HsTnI) levels and myocardial damage on cardiac magnetic resonance (CMR) represented by late gadolinium enhancement (LGE) percentage in patients diagnosed with myocarditis.: Methods!# ...

Abstract	Purpose: To assess the correlation between high sensitive troponin I (HsTnI) levels and myocardial damage on cardiac magnetic resonance (CMR) represented by late gadolinium enhancement (LGE) percentage in patients diagnosed with myocarditis. Methods: Retrospective analysis of consecutive patients who underwent CMR following a suspected diagnosis of acute myocarditis, comparing CMR findings viewed as LGE percentage and HsTnI levels. Results: Between February 2016 and December 2021, 101 patients underwent CMR for suspected myocarditis in Rambam Medical Center. Seventy-six (75.2%) patients with a documented diagnosis of acute myocarditis in the medical records based on clinical history and lab work were included in the final analysis. The median age was 30 years [interquartile range (IQR) 22,42] and 62 patients (81.6%) were male. Thirty-four patients (44.7%) had a history of fever and 26 (34.2%) had upper respiratory tract symptoms. The median maximal HsTnI was 3935 ng/l (1165,10 380) and the median C-reactive protein (CRP) was 7.97 mg/l (2.35,19.28). The median LGE percentage was 4.65% (2.6,8.5) and ventricular ejection fraction 60% (56.00,64.75).Linear association was found between LGE (%) and maximal HsTnI (ng/l) value with r = 0.49 ( P < 0.001). After including only patients in whom the CMR was performed within 5 days of the maximal HsTnI the correlation improved to r = 0.67 ( P < 0.001). Conclusions: HsTnI is an indicator for myocardial damage extent resulting from inflammation in patients with acute myocarditis.
MeSH term(s)	Humans ; Male ; Adult ; Female ; Myocarditis/diagnosis ; Troponin I ; Retrospective Studies ; Contrast Media ; Magnetic Resonance Imaging, Cine/methods ; Gadolinium ; Magnetic Resonance Imaging ; Predictive Value of Tests
Chemical Substances	Troponin I ; Contrast Media ; Gadolinium (AU0V1LM3JT)
Language	English
Publishing date	2023-04-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2223461-5
ISSN	1558-2035 ; 1558-2027
ISSN (online)	1558-2035
ISSN	1558-2027
DOI	10.2459/JCM.0000000000001468
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Zs.A 5210: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 559: Show issues

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Article ; Online: Admission Hypocalcemia and the Need for Endoscopic and Clinical Interventions among Patients with Upper Gastrointestinal Bleeding.

Korytny, Alex / Mazzawi, Fares / Marcusohn, Erez / Klein, Amir / Epstein, Danny

European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes

2023 Volume 64, Issue 4, Page(s) 398–405

Abstract: Introduction: Calcium is an essential co-factor in the coagulation cascade, and hypocalcemia is associated with adverse outcomes in bleeding patients, including trauma patients, women with postpartum hemorrhage, and patients with intracranial hemorrhage. ...

Abstract	Introduction: Calcium is an essential co-factor in the coagulation cascade, and hypocalcemia is associated with adverse outcomes in bleeding patients, including trauma patients, women with postpartum hemorrhage, and patients with intracranial hemorrhage. In this retrospective, single-center, cohort study, we aimed to determine whether admission-ionized calcium (Ca++) is associated with higher rates of therapeutic interventions among patients presenting with acute nonvariceal upper gastrointestinal bleeding (NV-UGIB). Methods: Adult patients admitted due to NV-UGIB between January 2009 and April 2020 were identified. The primary outcome was defined as a need for clinical intervention (two or more packed cell transfusions, need for endoscopic, surgical, or angiographic intervention). Univariate and multivariable logistic regression analyses were performed to determine whether Ca++ was an independent predictor of the need for therapeutic interventions. Propensity score matching was performed to adjust the imbalances of covariates between the groups. Results: A total of 434 patients were included, of whom 148 (34.1%) had hypocalcemia (Ca++ <1.15 mmol/L). Patients with hypocalcemia were more likely to require therapeutic interventions than those without hypocalcemia (48.0% vs. 18.5%, p < 0.001). Specifically, patients with hypocalcemia were more likely to require endoscopic intervention for control of bleeding (25.0% vs. 15.7%, p = 0.03) and multiple packed cell transfusions (6.8% vs. 0.3%, p < 0.001). Additionally, they had significantly longer hospital stay (5.0 days [IQR 3.0-8.0] vs. 4.0 days [IQR 3.0-6.0], p = 0.01). After adjusting for multiple covariates, Ca++ was an independent predictor of the need for therapeutic intervention (aOR 1.62, 95% confidence interval [CI] 1.22-2.14, p < 0.001). The addition of Ca++ to the Modified Glasgow Blatchford score improved its accuracy in the prediction of therapeutic intervention from AUC of 0.68 (95% CI 0.63-0.72) to 0.72 (95% CI 0.67-0.76), p = 0.02. After incorporation of the propensity score, the results did not change significantly. Conclusion: These findings suggest that hypocalcemia is common and is associated with an adverse clinical course in patients with NV-UGIB. Measurement of Ca++ on admission may facilitate risk stratification in these patients. Trials are needed to assess whether the correction of hypocalcemia will lead to improved outcomes.
MeSH term(s)	Adult ; Humans ; Female ; Cohort Studies ; Retrospective Studies ; Hypocalcemia/therapy ; Calcium ; Risk Assessment ; Gastrointestinal Hemorrhage/surgery
Chemical Substances	Calcium (SY7Q814VUP)
Language	English
Publishing date	2023-10-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	205700-1
ISSN	1421-9921 ; 0014-312X
ISSN (online)	1421-9921
ISSN	0014-312X
DOI	10.1159/000534522
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Article ; Online: The role of single positron emission computed tomography imaging in the diagnosis of brain death whenever Trans-cranial Doppler fails to support it: A retrospective cohort study.

Gutgold, Amichai / Shorbaji, Nadeem / Epstein, Danny / Honen, Sarit / Diab, Tarek / Keidar, Zohar / Miller, Asaf

Clinical transplantation

2023 Volume 37, Issue 6, Page(s) e15003

Abstract: Objective: Although there is widespread acceptance of the concept of brain death/death by neurologic criteria (BD/DNC), there is marked variability in the use of ancillary tests worldwide. Transcranial Doppler (TCD) is a useful ancillary test for brain ... ...

Abstract	Objective: Although there is widespread acceptance of the concept of brain death/death by neurologic criteria (BD/DNC), there is marked variability in the use of ancillary tests worldwide. Transcranial Doppler (TCD) is a useful ancillary test for brain death confirmation because it is safe, noninvasive, and done at the bedside. However, it is considered less sensitive than Single Photon Emission Computed Tomography (SPECT) Tc-HMPAO (99 m). This study aims to test the yield of brain perfusion SPECT testing after a TCD has demonstrated some level of intracranial blood flow among patients fulfilling clinical criteria for BD/DNC. Methods: This was a single-center retrospective cohort study of all the patients fulfilling clinical criteria for BD/DNC who underwent brain perfusion SPECT after an intracerebral circulatory arrest was not confirmed by TCD between July 2016 and January 2022. Results: TCD was an initial ancillary test performed in 252 patients (99.6%) fulfilling clinical criteria for BD/DNC. A complete circulatory arrest was demonstrated in 228 (90.5%) patients. Brain perfusion SPECT was performed in the remaining 24 patients. The absence of cerebral perfusion consistent with BD/DNC was found in 21 cases (87.5%). BD/DN could not be confirmed in three patients (12.5%). Conclusions: SPECT testing has a high diagnostic yield when TCD fails to confirm a suspected diagnosis of BD/DNC. Combining these two modalities may be an optimal strategy for BD/DNC diagnosis when this is required by local regulations or when confounding factors interfere with the performance of a complete clinical assessment.
MeSH term(s)	Humans ; Brain Death/diagnosis ; Retrospective Studies ; Electrons ; Brain/diagnostic imaging ; Tomography, Emission-Computed
Language	English
Publishing date	2023-04-30
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	639001-8
ISSN	1399-0012 ; 0902-0063
ISSN (online)	1399-0012
ISSN	0902-0063
DOI	10.1111/ctr.15003
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Zs.A 2204: Show issues

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Article ; Online: Impact of radiological surveillance for major blood vessels on complications of percutaneous dilatational tracheostomy: A retrospective cohort study.

Noy, Roee / Shkedy, Yotam / Simchon, Omri / Gvozdev, Natalia / Roimi, Michael / Miller, Asaf / Epstein, Danny

American journal of otolaryngology

2023 Volume 45, Issue 2, Page(s) 104146

Abstract: Purpose: Percutaneous dilatational tracheostomy (PDT) is the preferred method for managing long-term ventilator-dependent patients in ICUs. This study aimed to evaluate the association between preprocedural screening (ultrasound Doppler [USD] or ... ...

Abstract	Purpose: Percutaneous dilatational tracheostomy (PDT) is the preferred method for managing long-term ventilator-dependent patients in ICUs. This study aimed to evaluate the association between preprocedural screening (ultrasound Doppler [USD] or computed tomography [CT]) for major neck blood vessels and complications in ICU patients undergoing PDT. Materials and methods: This was a retrospective cohort study of patients who underwent PDT between 2012 and 2023 at a tertiary referral center. We performed a multivariable analysis and created a propensity-matched cohort. The primary outcome was bleeding within the first seven days after PDT. Secondary outcomes included early and late PDT complications and PTD-related mortality. Results: A total of 1766 consecutive critically ill patients hospitalized at a tertiary academic hospital were evaluated for PDT. Of these, 881 (49.9 %) underwent only physical examination before PDT, while 885 (50.1 %) underwent additional imaging (CT/USD). A higher proportion of patients in the imaging group were referred to open surgery due to suspected major blood vessels interfering with the procedure (6.2 % vs. 3.0 %, p = 0.001). Among the 1685 patients who underwent PDT, there was no significant difference in the rate of early bleeding between the physical examination group and the imaging group (4.6 % vs. 6.3 %, p = 0.12). Similarly, the overall early complication rates (5.5 % vs. 7.6 %, p = 0.08), late complication rates (1.6 % vs. 2.2 %, p = 0.42), and PDT-related mortality rates (0.7 % vs. 0.6 %, p = 0.73) did not exhibit significant differences between the two groups. In a propensity score-matched cohort, results remained consistent. Conclusions: Physical examination can effectively identify major neck blood vessels without increasing the risk of bleeding during and after PDT.
MeSH term(s)	Humans ; Tracheostomy/adverse effects ; Tracheostomy/methods ; Retrospective Studies ; Hemorrhage/epidemiology ; Hemorrhage/etiology ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Intensive Care Units
Language	English
Publishing date	2023-12-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	604541-8
ISSN	1532-818X ; 0196-0709
ISSN (online)	1532-818X
ISSN	0196-0709
DOI	10.1016/j.amjoto.2023.104146
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