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Sample records for bacteraemia predicts one-year

  1. Predicting the Career Involvement of Women One Year After College Graduation.

    ERIC Educational Resources Information Center

    Lentz, Linda P.

    A 1980 study was conducted to determine those factors (educational background, career plans, family influence, parental background, and career salience) predictive of women's career involvement one year after college graduation. A second analysis further differentiated between the groups on the variable "commitment to working." Participants were…

  2. Derivation and validation of clinical prediction rules for reduced vancomycin susceptibility in Staphylococcus aureus bacteraemia.

    PubMed

    Han, J H; Bilker, W B; Edelstein, P H; Mascitti, K B; Lautenbach, E

    2013-01-01

    Reduced vancomycin susceptibility (RVS) may lead to poor clinical outcomes in Staphylococcus aureus bacteraemia. We conducted a cohort study of 392 patients with S. aureus bacteraemia within a university health system. The association between RVS, as defined by both Etest [vancomycin minimum inhibitory concentration (MIC) >1·0 μg/ml] and broth microdilution (vancomycin MIC ≥1·0 μg/ml), and patient and clinical variables were evaluated to create separate predictive models for RVS. In total, 134 (34·2%) and 73 (18·6%) patients had S. aureus isolates with RVS by Etest and broth microdilution, respectively. The final model for RVS by Etest included methicillin resistance [odds ratio (OR) 1·51, 95% confidence interval (CI) 0·97-2·34], non-white race (OR 0·67, 95% CI 0·42-1·07), healthcare-associated infection (OR 0·56, 95% CI 0·32-0·96), and receipt of any antimicrobial therapy ≤30 days prior to the culture date (OR 3·06, 95% CI 1·72-5·44). The final model for RVS by broth microdilution included methicillin resistance (OR 2·45, 95% CI 1·42-4·24), admission through the emergency department (OR 0·54, 95% CI 0·32-0·92), presence of an intravascular device (OR 2·24, 95% CI 1·30-3·86), and malignancy (OR 0·51, 95% CI 0·26-1·00). The availability of an easy and rapid clinical prediction rule for early identification of RVS can be used to help guide the timely and individualized management of these serious infections. PMID:22490228

  3. One-Year Real-Time Operational Prediction Intervals for Direct Normal Irradiance

    NASA Astrophysics Data System (ADS)

    Chu, Y.; Carreira Pedro, H. T.; Coimbra, C. F.

    2015-12-01

    This work describes an algorithm to generate intra-hour prediction intervals (PIs) for the highly-variable direct normal irradiance, which is the energy source for the concentrated solar power technologies. The prediction intervals are generated using a Multi-layer Stochastic-Learning Model (MSLM), which is developed based on methods such as: sky imaging techniques, support vector machine and artificial neural network. The MSLM is trained using one year of co-located, high-quality irradiance and sky image recording in Folsom, California. In addition to being validated with historical data, the algorithm has been generating operational PI forecasts in real-time for that observatory since July 1st 2014. In the real-time scenario, without re-training or significant maintenance, the hybrid model consistently provides valid PI (PICP > 92%) and outperforms the reference persistence model (PICP ~ 85%) regardless of weather condition. This work has great impact in the field of solar energy to potentially facilitate the level of solar penetration in the grid with significantly reduced integration costs.

  4. Risk Prediction of One-Year Mortality in Patients with Cardiac Arrhythmias Using Random Survival Forest

    PubMed Central

    Miao, Fen; Cai, Yun-Peng; Zhang, Yu-Xiao; Li, Ye; Zhang, Yuan-Ting

    2015-01-01

    Existing models for predicting mortality based on traditional Cox proportional hazard approach (CPH) often have low prediction accuracy. This paper aims to develop a clinical risk model with good accuracy for predicting 1-year mortality in cardiac arrhythmias patients using random survival forest (RSF), a robust approach for survival analysis. 10,488 cardiac arrhythmias patients available in the public MIMIC II clinical database were investigated, with 3,452 deaths occurring within 1-year followups. Forty risk factors including demographics and clinical and laboratory information and antiarrhythmic agents were analyzed as potential predictors of all-cause mortality. RSF was adopted to build a comprehensive survival model and a simplified risk model composed of 14 top risk factors. The built comprehensive model achieved a prediction accuracy of 0.81 measured by c-statistic with 10-fold cross validation. The simplified risk model also achieved a good accuracy of 0.799. Both results outperformed traditional CPH (which achieved a c-statistic of 0.733 for the comprehensive model and 0.718 for the simplified model). Moreover, various factors are observed to have nonlinear impact on cardiac arrhythmias prognosis. As a result, RSF based model which took nonlinearity into account significantly outperformed traditional Cox proportional hazard model and has great potential to be a more effective approach for survival analysis. PMID:26379761

  5. Bacteraemia predictive factors among general medical inpatients: a retrospective cross-sectional survey in a Japanese university hospital

    PubMed Central

    Fukui, Sayato; Uehara, Yuki; Fujibayashi, Kazutoshi; Takahashi, Osamu; Hisaoka, Teruhiko; Naito, Toshio

    2016-01-01

    Objectives The precise criteria for obtaining blood cultures have not been established; they depend on the physician's judgement. We examined clinical parameters to determine predictive factors of bacteraemia and the need for blood cultures among general medical inpatients. Design A retrospective cross-sectional survey. Setting A Japanese university hospital. Participants All general inpatients who had blood cultures taken from 1 January 2011 to 31 December 2012. Main Measures Clinical information at or just before blood culture sampling was extracted from medical charts. Factors potentially predictive of bacteraemia were analysed using Fisher's exact test, followed by multivariable logistic regression model analysis. Main Results A total of 200 patients (male: female=119:81, 64.3±19.1 years old) comprised this study; 57 (28.5%) had positive blood culture results. Multivariable logistic regression analysis revealed that age >60 years (OR=2.75, 95% CI 1.23 to 6.48, p=0.015), female sex (OR=2.21, 95% CI 1.07 to 4.67, p=0.038), pulse rate >90 bpm (OR=5.18, 95% CI 2.25 to 12.48, p<0.001) and neutrophil percentage >80% (OR=3.61, 95% CI 1.71 to 8.00, p=0.001) were independent risk factors for positive blood culture results. The area under the receiver operating characteristic curve analysis of this model was 0.796. Conclusions Our results emphasise the importance of taking blood cultures if the pulse rate is >90 bpm, in elderly patients and in women, and for ordering a differential white cell count. PMID:27388348

  6. Predicting One-Year Mortality in Peritoneal Dialysis Patients: An Analysis of the China Peritoneal Dialysis Registry

    PubMed Central

    Cao, Xue-Ying; Zhou, Jian-Hui; Cai, Guang-Yan; Tan, Ni-Na; Huang, Jing; Xie, Xiang-Cheng; Tang, Li; Chen, Xiang-Mei

    2015-01-01

    This study aims to investigate basic clinical features of peritoneal dialysis (PD) patients, their prognostic risk factors, and to establish a prognostic model for predicting their one-year mortality. A national multi-center cohort study was performed. A total of 5,405 new PD cases from China Peritoneal Dialysis Registry in 2012 were enrolled in model group. All these patients had complete baseline data and were followed for one year. Demographic and clinical features of these patients were collected. Cox proportional hazards regression model was used to analyze prognostic risk factors and establish prognostic model. A validation group was established using 1,764 new PD cases between January 1, 2013 and July 1, 2013, and to verify accuracy of prognostic model. Results indicated that model group included 4,453 live PD cases and 371 dead cases. Multivariate survival analysis showed that diabetes mellitus (DM), residual glomerular filtration rate (rGFR), , SBP, Kt/V, high PET type and Alb were independently associated with one-year mortality. Model was statistically significant in both within-group verification and outside-group verification. In conclusion, DM, rGFR, SBP, Kt/V, high PET type and Alb were independent risk factors for short-term mortality in PD patients. Prognostic model established in this study accurately predicted risk of short-term death in PD patients. PMID:26019685

  7. Brooding and reflection: Rumination predicts suicidal ideation at one-year follow up in a community sample

    PubMed Central

    Nolen-Hoeksema, Susan

    2010-01-01

    The cognitive processes underlying suicidal thinking and behavior are not well-understood. The present study examined brooding and reflection, two dimensions of rumination, as predictors of suicidal ideation among a community sample of 1,134 adults. Participants completed self-report measures of rumination and depression, and a semi-structured clinical interview that included an assessment of suicidal ideation, at baseline and one-year follow up. Brooding was more strongly related to degree of ideation at baseline than was reflection. However, both brooding and reflection predicted whether an individual thought about suicide at one-year follow up, even after adjusting for baseline suicidal ideation. Symptoms of depression mediated the relationship between brooding and ideation but not between reflection and ideation. Implications for the nature of thought processes that result in suicidal thinking are discussed. PMID:17825248

  8. Development of a metabolites risk score for one-year mortality risk prediction in pancreatic adenocarcinoma patients

    PubMed Central

    Fontana, Andrea; Mazza, Tommaso; Tavano, Francesca; Gioffreda, Domenica; Mattivi, Fulvio; Andriulli, Angelo; Vrhovsek, Urska; Pazienza, Valerio

    2016-01-01

    Purpose Survival among patients with adenocarcinoma pancreatic cancer (PDCA) is highly variable, which ranges from 0% to 20% at 5 years. Such a wide range is due to tumor size and stage, as well other patients' characteristics. We analyzed alterations in the metabolomic profile, of PDCA patients, which are potentially predictive of patient's one-year mortality. Experimental design A targeted metabolomic assay was conducted on serum samples of patients diagnosed with pancreatic cancer. Statistical analyses were performed only for those 27 patients with information on vital status at follow-up and baseline clinical features. Random Forest analysis was performed to identify all metabolites and clinical variables with the best capability to predict patient's mortality risk at one year. Regression coefficients were estimated from multivariable Weibull survival model, which included the most associated metabolites. Such coefficients were used as weights to build a metabolite risk score (MRS) which ranged from 0 (lowest mortality risk) to 1 (highest mortality risk). The stability of these weights were evaluated performing 10,000 bootstrap resamplings. Results MRS was built as a weighted linear combination of the following five metabolites: Valine (HR = 0.62, 95%CI: 0.11–1.71 for each standard deviation (SD) of 98.57), Sphingomyeline C24:1 (HR = 2.66, 95%CI: 1.30–21.09, for each SD of 20.67), Lysine (HR = 0.36, 95%CI: 0.03–0.77, for each SD of 51.73), Tripentadecanoate TG15 (HR = 0.25, 95%CI: 0.01–0.82, for each SD of 2.88) and Symmetric dimethylarginine (HR = 2.24, 95%CI: 1.28–103.08, for each SD of 0.62), achieving a very high discrimination ability (survival c-statistic of 0.855, 95%CI: 0.816–0.894). Such association was still present even after adjusting for the most associated clinical variables (confounders). Conclusions The mass spectrometry-based metabolomic profiling of serum represents a valid tool for discovering novel candidate biomarkers with

  9. Better Adherence to Treatment Recommendations in Heart Failure Predicts Improved Cognitive Function at a One Year Follow Up

    PubMed Central

    Alosco, Michael L.; Spitznagel, Mary Beth; Cohen, Ronald; Sweet, Lawrence H.; Josephson, Richard; Hughes, Joel; Rosneck, Jim; Gunstad, John

    2016-01-01

    Introduction Treatment non-adherence is common in heart failure and associated with poor health outcomes in this population. Recent cross-sectional work in heart failure and past work in other medical populations suggests cognitive function is a key determinant of patient’s ability to adhere to treatment recommendations. However, it is also possible that treatment adherence is an important modifier and predictor of cognitive function, though no study has examined this possibility and we sought to do so in a sample of heart failure patients. Methods 115 patients with heart failure self-reported adherence to treatment recommendations. The Modified Mini Mental State Examination (3MS), Trail Making Test parts A and B, and the California Verbal Learning Test-II (CVLT-II) assessed cognitive function. These procedures were performed at baseline and a 12-month follow-up. Results Global cognition and memory abilities improved over the 12-month period. Regression analyses controlling for baseline and medical and demographic factors showed better baseline treatment adherence predicted improved 12-month performances on the 3MS and CVLT-II. Adherence to medication and diet regimens and smoking abstinence emerged as the most important contributors. Conclusions Better treatment adherence predicted improved cognition one-year later in HF. Prospective studies that utilize objective assessments of treatment adherence are needed to confirm our findings and examine whether improved treatment adherence preserves cognitive function in heart failure. PMID:25352233

  10. One-Year Prediction of Pain Killer Use among At-Risk Older Teens and Emerging Adults

    ERIC Educational Resources Information Center

    Sussman, Steve; Rohrbach, Louise A.; Spruijt-Metz, Donna; Barnett, Elizabeth; Lisha, Nadra; Sun, Ping

    2012-01-01

    The leading substance of misuse among teens after tobacco, alcohol, and marijuana is the use of pain killers. Very few longitudinal studies on prediction of pain killer use have been conducted among teens. This study examined the 1-year prediction of self-reported last 30-day pain killer use controlling for baseline 30-day painkiller use among…

  11. Use of early indicators in rehabilitation process to predict one-year mortality in elderly hip fracture patients.

    PubMed

    Dubljanin-Raspopović, Emilija; Markovic Denić, Ljiljana; Marinković, Jelena; Grajić, Mirko; Tomanovic Vujadinović, Sanja; Bumbaširević, Marko

    2012-01-01

    Hip fractures remain one of the most devastating injuries in the elderly. Early prediction of outcome following hip fracture potentially results in more efficient health care. The aims of this study were to explore predictors of ambulation status at hospital discharge in patients ≥65 years of age operated on for fracture of the hip, and to investigate the impact of ambulation status at hospital discharge on 1-year mortality after hip fracture. We studied 344 patients who underwent surgery for hip fracture during a 12 month period. Multivariate regression analysis was used to explore predictive factors for ambulatory status at discharge, and 1-year mortality adjusted on important baseline variables. Cumulative 1-year mortality was significantly lower for patients in the ambulatory group when compared to patients in the non-ambulatory group. Patients who were older, had severe cognitive impairment, lower functional level before injury, and in whom postoperative delirium and pressure ulcers occurred had a higher chance of not recovering their gait ability at hospital discharge, and being dead 1 year after hip fracture. Inability to walk at hospital discharge and presence of delirium are independent predictors of 1-year mortality. Every effort should be made to assure early mobilisation after hip fracture surgery, and prevention, prompt recognition and treatment of postoperative complications is important in order to facilitate better short-and long-term outcome. PMID:23233176

  12. Clostridium tetani bacteraemia.

    PubMed

    Hallit, Rabih Riad; Afridi, Muhammad; Sison, Raymund; Salem, Elie; Boghossian, Jack; Slim, Jihad

    2013-01-01

    Tetanus is a neuromuscular disease in which Clostridium tetani exotoxin (tetanospasmin) produces muscle spasms, incapacitating its host. To our knowledge, C. tetani bacteraemia has never been reported in the literature. The ideal management of this entity remains unresolved given that there is no literature to guide the therapy. PMID:22977074

  13. Progress and prediction of occupational performance in women with distal radius fractures: a one-year follow-up.

    PubMed

    Nielsen, Tove Lise; Dekkers, Merete Klindt

    2013-03-01

    Abstract To describe the occupational performance and pain during the first year after a distal radius fracture, an observational follow-up study was performed among 37 mainly elderly Danish women. They were assessed at cast removal and reassessed at three and 12 months post-injury with COPM, DASH, and validated questions on pain. The number of performance problems fell from median 18 at cast removal to median 3 at 12 months. COPM performance and satisfaction scores improved significantly to 8.6 and 9.2 at 12 months. Also the DASH score improved significantly to 14.2 at 12 months. The largest improvements in occupational performance and disability took place within the first three months. Pain decreased significantly during the follow-up period. In spite of these positive results, at 12 months 78% of the women still had performance problems and 62% still had some degree of pain due to the fracture. At cast removal, a number of ≥10 performance problems at 12 months could be predicted in women with ≥20 performance problems (RR 2.41) or with a pain intensity described as "moderate" or worse (RR 3.71). The findings of this study suggest that occupational therapy services might still be of relevance perhaps as follow-up sessions through the first year post-injury. PMID:23216334

  14. One-year adherence to oral antihyperglycemic medication and risk prediction of patient outcomes for adults with diabetes mellitus

    PubMed Central

    Huber, Carola A.; Rapold, Roland; Brüngger, Beat; Reich, Oliver; Rosemann, Thomas

    2016-01-01

    Abstract Medication adherence is essential in preventing adverse intermediate outcomes, but little is known on hard outcomes. The aims of this study were to determine the 1-year adherence to oral antihyperglycemic drugs (OADs) and to predict the risk of subsequent health outcomes among (non)adherent patients with diabetes. Using a large Swiss healthcare claims database from 2011 to 2014, we identified all patients aged ≥18 years with diabetes and treated with at least 1 OAD prescription. Adherence to OADs was measured as the proportion of days covered (PDC) over 1 year and subdivided into 2 categories: adherent (PDC ≥ 80%), nonadherent (PDC < 80%). We estimated the relative risk of hospitalization and mortality at follow-up using multivariate Cox proportional hazard models. Based on a sample of 26,713 patients, adherence to OADs was quite low: 42% of the patients achieved a PDC of ≥80% during the 1-year observation period. A 7% reduction in the hospitalization risk and a 10% reduction in the risk of mortality could be observed in adherent patients compared to nonadherent patients (hazard ratio [HR], 0.93 [95% CI, 0.89–0.97]; HR, 0.90 [95% CI, 0.82–0.99]). Subgroup analysis showed that an intensified diabetes therapy had no significant influence on the risk of both outcomes in adherent patients. Poor medication adherence increases the risk of subsequent hospitalizations and premature mortality in patient with diabetes, regardless of disease severity and comorbidities. This emphasizes the need for an earlier identification of patients with poor medication adherence. The awareness of physicians and patients regarding the importance of adherence in diabetes treatment should be increased. PMID:27368004

  15. Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and Predicted

    PubMed Central

    Røe, Cecilie; Skandsen, Toril; Manskow, Unn; Ader, Tiina; Anke, Audny

    2015-01-01

    The aim of the present study was to evaluate mortality and functional outcome in old and very old patients with severe traumatic brain injury (TBI) and compare to the predicted outcome according to the internet based CRASH (Corticosteroid Randomization After Significant Head injury) model based prediction, from the Medical Research Council (MRC). Methods. Prospective, national multicenter study including patients with severe TBI ≥65 years. Predicted mortality and outcome were calculated based on clinical information (CRASH basic) (age, GCS score, and pupil reactivity to light), as well as with additional CT findings (CRASH CT). Observed 14-day mortality and favorable/unfavorable outcome according to the Glasgow Outcome Scale at one year was compared to the predicted outcome according to the CRASH models. Results. 97 patients, mean age 75 (SD 7) years, 64% men, were included. Two patients were lost to follow-up; 48 died within 14 days. The predicted versus the observed odds ratio (OR) for mortality was 2.65. Unfavorable outcome (GOSE < 5) was observed at one year follow-up in 72% of patients. The CRASH models predicted unfavorable outcome in all patients. Conclusion. The CRASH model overestimated mortality and unfavorable outcome in old and very old Norwegian patients with severe TBI. PMID:26688614

  16. Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and Predicted.

    PubMed

    Røe, Cecilie; Skandsen, Toril; Manskow, Unn; Ader, Tiina; Anke, Audny

    2015-01-01

    The aim of the present study was to evaluate mortality and functional outcome in old and very old patients with severe traumatic brain injury (TBI) and compare to the predicted outcome according to the internet based CRASH (Corticosteroid Randomization After Significant Head injury) model based prediction, from the Medical Research Council (MRC). Methods. Prospective, national multicenter study including patients with severe TBI ≥ 65 years. Predicted mortality and outcome were calculated based on clinical information (CRASH basic) (age, GCS score, and pupil reactivity to light), as well as with additional CT findings (CRASH CT). Observed 14-day mortality and favorable/unfavorable outcome according to the Glasgow Outcome Scale at one year was compared to the predicted outcome according to the CRASH models. Results. 97 patients, mean age 75 (SD 7) years, 64% men, were included. Two patients were lost to follow-up; 48 died within 14 days. The predicted versus the observed odds ratio (OR) for mortality was 2.65. Unfavorable outcome (GOSE < 5) was observed at one year follow-up in 72% of patients. The CRASH models predicted unfavorable outcome in all patients. Conclusion. The CRASH model overestimated mortality and unfavorable outcome in old and very old Norwegian patients with severe TBI. PMID:26688614

  17. Biomarkers in Exhaled Breath Condensate Are Not Predictive for Pulmonary Exacerbations in Children with Cystic Fibrosis: Results of a One-Year Observational Study

    PubMed Central

    van Horck, Marieke; Alonso, Ariel; Wesseling, Geertjan; de Winter—de Groot, Karin; van Aalderen, Wim; Hendriks, Han; Winkens, Bjorn; Rijkers, Ger; Jöbsis, Quirijn; Dompeling, Edward

    2016-01-01

    Background Cystic Fibrosis (CF) is characterized by chronically inflamed airways, and inflammation even increases during pulmonary exacerbations. These adverse events have an important influence on the well-being, quality of life, and lung function of patients with CF. Prediction of exacerbations by inflammatory markers in exhaled breath condensate (EBC) combined with early treatment may prevent these pulmonary exacerbations and may improve the prognosis. Aim To investigate the diagnostic accuracy of a set of inflammatory markers in EBC to predict pulmonary exacerbations in children with CF. Methods In this one-year prospective observational study, 49 children with CF were included. During study visits with an interval of 2 months, a symptom questionnaire was completed, EBC was collected, and lung function measurements were performed. The acidity of EBC was measured directly after collection. Inflammatory markers interleukin (IL)-6, IL-8, tumor necrosis factor α (TNF-α), and macrophage migration inhibitory factor (MIF) were measured using high sensitivity bead based flow immunoassays. Pulmonary exacerbations were recorded during the study and were defined in two ways. The predictive power of inflammatory markers and the other covariates was assessed using conditionally specified models and a receiver operating characteristic curve (SAS version 9.2). In addition, k-nearest neighbors (KNN) algorithm was applied (SAS version 9.2). Results Sixty-five percent of the children had one or more exacerbations during the study. The conditionally specified models showed an overall correct prediction rate of 55%. The area under the curve (AUC) was equal to 0.62. The results obtained with the KNN algorithm were very similar. Conclusion Although there is some evidence indicating that the predictors outperform random guessing, the general diagnostic accuracy of EBC acidity and the EBC inflammatory markers IL-6, IL-8, TNF-α and MIF is low. At present it is not possible to

  18. External validation of the Hospital-patient One-year Mortality Risk (HOMR) model for predicting death within 1 year after hospital admission

    PubMed Central

    van Walraven, Carl; McAlister, Finlay A.; Bakal, Jeffrey A.; Hawken, Steven; Donzé, Jacques

    2015-01-01

    Background: Predicting long-term survival after admission to hospital is helpful for clinical, administrative and research purposes. The Hospital-patient One-year Mortality Risk (HOMR) model was derived and internally validated to predict the risk of death within 1 year after admission. We conducted an external validation of the model in a large multicentre study. Methods: We used administrative data for all nonpsychiatric admissions of adult patients to hospitals in the provinces of Ontario (2003–2010) and Alberta (2011–2012), and to the Brigham and Women’s Hospital in Boston (2010–2012) to calculate each patient’s HOMR score at admission. The HOMR score is based on a set of parameters that captures patient demographics, health burden and severity of acute illness. We determined patient status (alive or dead) 1 year after admission using population-based registries. Results: The 3 validation cohorts (n = 2 862 996 in Ontario, 210 595 in Alberta and 66 683 in Boston) were distinct from each other and from the derivation cohort. The overall risk of death within 1 year after admission was 8.7% (95% confidence interval [CI] 8.7% to 8.8%). The HOMR score was strongly and significantly associated with risk of death in all populations and was highly discriminative, with a C statistic ranging from 0.89 (95% CI 0.87 to 0.91) to 0.92 (95% CI 0.91 to 0.92). Observed and expected outcome risks were similar (median absolute difference in percent dying in 1 yr 0.3%, interquartile range 0.05%–2.5%). Interpretation: The HOMR score, calculated using routinely collected administrative data, accurately predicted the risk of death among adult patients within 1 year after admission to hospital for nonpsychiatric indications. Similar performance was seen when the score was used in geographically and temporally diverse populations. The HOMR model can be used for risk adjustment in analyses of health administrative data to predict long-term survival among hospital patients

  19. [Bacteraemia and sepsis].

    PubMed

    Kern, W V

    2011-02-01

    Recent news in the field of bloodstream infection and sepsis relevant for the practitioner include the recommendation in the newly revised German sepsis guideline to introduce selective intestinal decontamination with non-absorbable antimicrobial substances for the prevention of secondary infections in ventilated patients. This intervention, however, remains controversial because there are indications of unfavourable effects (increased development of resistance), and because the effect size has been rather low. Other news indicate not only that procalcitonin can be reasonably used as an aid to determine the duration of antibiotic treatment in community-acquired respiratory infection and pneumonia. A procalcitonin-based algorithm can also be used in critical care patients to shorten the duration of antibiotic administration without worsening outcomes. Recent data indicate that E. coli and S. aureus continue to be the most frequent pathogens isolated in bloodstream infection. The proportion of E. coli strains producing extended-spectrum beta lactamase (ESBL) is increasing. New epidemiologic evidence shows that infections with this pathogen, resistant to many standard antibiotics, are associated with an increased mortality rate, similar to infections due to methicillin-resistant Staphylococcus aureus (MSRA). The incidence of MRSA bacteraemia in Germany can now be estimated better as it has become a notifiable infection. PMID:21271477

  20. Glycated Hemoglobin Independently Predicts Stroke Recurrence within One Year after Acute First-Ever Non-Cardioembolic Strokes Onset in A Chinese Cohort Study

    PubMed Central

    Wu, Shuolin; Shi, Yuzhi; Wang, Chunxue; Jia, Qian; Zhang, Ning; Zhao, Xingquan; Liu, Gaifen; Wang, Yilong; Liu, Liping; Wang, Yongjun

    2013-01-01

    Objective Hyperglycemia is related to stroke. Glycated hemoglobin (HbA1c) can reflect pre-stroke glycaemia status. However, the information on the direct association between HbA1c and recurrence after non-cardioembolic acute ischemic strokes is rare and there is no consistent conclusion. Methods The ACROSS-China database comprised of 2186 consecutive first-ever acute ischemic stroke patients with baseline HbA1c values. After excluding patients who died from non-stroke recurrence and patients lost to follow up, 1817 and 1540 were eligible for 3-month and 1-year analyses, respectively. Multivariate Cox regression was performed to evaluate the associations between HbA1c and 3-month and 1-year stroke recurrence. Results The HbA1c values at admission were divided into 4 levels by quartiles: Q1 (<5.5%); Q2 (5.5 to <6.1%); Q3 (6.1% to <7.2%); and Q4 (≥7.2%). The cumulative recurrence rates were 8.3% and 11.0% for 3 months and 1 year, respectively. In multivariate analyses, when compared with Q1, the adjusted hazard ratios (AHRs) were 2.83 (95% confidence interval (CI) 1.28-6.26) in Q3 and 3.71(95% CI 1.68-8.21) in Q4 for 3-month stroke recurrence; 3.30 (95% CI 1.31-8.34) in Q3 and 3.35 (95% CI 1.36-8.21) in Q4 for 1-year stroke recurrence. Adding fasting plasma glucose in the multivariate analyses did not modify the association: AHRs were 2.75 (95% CI 1.24-6.11) in Q3 and 3.67 (95% CI 1.59-8.53) in Q4 for 3-month analysis; AHRs were 3.08 (95% CI 1.10-8.64) in Q3 and 3.31(95% CI 1.35-8.14) in Q4 for 1-year analysis. Conclusions A higher “normal” HbA1c level reflecting pre-stroke glycaemia status independently predicts stroke recurrence within one year after non-cardioembolic acute ischemic stroke onset. HbA1c is recommended as a routine test in acute ischemic stroke patients. PMID:24236195

  1. A model to predict survival at one month, one year, and five years after liver transplantation based on pretransplant clinical characteristics.

    PubMed

    Thuluvath, Paul J; Yoo, Hwan Y; Thompson, Richard E

    2003-05-01

    Reliable models that could predict outcome of liver transplantation (LT) may guide physicians to advise their patients of immediate and late survival chances and may help them to optimize organ use. The objective of this study was to develop user-friendly models to predict short and long-term mortality after LT in adults based on pre-LT recipient characteristics. The United Network for Organ Sharing (UNOS) transplant registry (n = 38,876) from 1987 to 2001 was used to develop and validate the model. Two thirds of patients were randomized to develop the model (the modeling group), and the remaining third was randomized to cross-validate (the cross-validation group) it. Three separate models, using multivariate logistic regression analysis, were created and validated to predict survival at 1 month, 1 year, and 5 years. Using the total severity scores of patients in the modeling group, a predictive model then was created, and the predicted probability of death as a function of total score then was compared in the cross-validation group. The independent variables that were found to be very significant for 1 month and 1 year survival were age, body mass index (BMI), UNOS status 1, etiology, serum bilirubin (for 1 month and 1 year only), creatinine, and race (only for 5 years). The actual deaths in the cross-validation group followed very closely the predicted survival graph. The chi-squared goodness-of-fit test confirmed that the model could predict mortality reliably at 1 month, 1 year, and 5 years. We have developed and validated user-friendly models that could reliably predict short-term and long-term survival after LT. PMID:12740799

  2. Early insulin resistance predicts weight gain and waist circumference increase in first-episode psychosis--A one year follow-up study.

    PubMed

    Keinänen, Jaakko; Mantere, Outi; Kieseppä, Tuula; Mäntylä, Teemu; Torniainen, Minna; Lindgren, Maija; Sundvall, Jouko; Suvisaari, Jaana

    2015-12-01

    First-episode psychosis (FEP) is associated with weight gain during the first year of treatment, and risk of abdominal obesity is particularly increased. To identify early risk markers of weight gain and abdominal obesity, we investigated baseline metabolic differences in 60 FEP patients and 27 controls, and longitudinal changes during the first year of treatment in patients. Compared to controls at baseline, patients had higher low-density lipoprotein, triglyceride and apolipoprotein B levels, and lower levels of high-density lipoprotein and apolipoprotein A-I but no difference in body mass index or waist circumference. At 12-month follow-up, 60.6% of patients were overweight or obese and 58.8% had abdominal obesity. No significant increase during follow-up was seen in markers of glucose and lipid metabolism or blood pressure, but increase in C-reactive protein between baseline and 12-month follow-up was statistically significant. Weight increase was predicted by baseline insulin resistance and olanzapine use, while increase in waist circumference was predicted by baseline insulin resistance only. In conclusion, insulin resistance may be an early marker of increased vulnerability to weight gain and abdominal obesity in young adults with FEP. Olanzapine should be avoided as a first-line treatment in FEP due to the substantial weight increase it causes. In addition, the increase in the prevalence of overweight and abdominal obesity was accompanied by the emergence of low-grade systemic inflammation. PMID:26589392

  3. Prognostic Utility of Biomarkers in Predicting of One-Year Outcomes in Patients with Aortic Stenosis Treated with Transcatheter or Surgical Aortic Valve Implantation

    PubMed Central

    Parenica, Jiri; Nemec, Petr; Tomandl, Josef; Ondrasek, Jiri; Pavkova-Goldbergova, Monika; Tretina, Martin; Jarkovsky, Jiri; Littnerova, Simona; Poloczek, Martin; Pokorny, Petr; Spinar, Jindrich; Cermakova, Zdenka; Miklik, Roman; Malik, Petr; Pes, Ondrej; Lipkova, Jolana; Tomandlova, Marie; Kala, Petr

    2012-01-01

    Objectives The aim of the work was to find biomarkers identifying patients at high risk of adverse clinical outcomes after TAVI and SAVR in addition to currently used predictive model (EuroSCORE). Background There is limited data about the role of biomarkers in predicting prognosis, especially when TAVI is available. Methods The multi-biomarker sub-study included 42 consecutive high-risk patients (average age 82.0 years; logistic EuroSCORE 21.0%) allocated to TAVI transfemoral and transapical using the Edwards-Sapien valve (n = 29), or SAVR with the Edwards Perimount bioprosthesis (n = 13). Standardized endpoints were prospectively followed during the 12-month follow-up. Results The clinical outcomes after both TAVI and SAVR were comparable. Malondialdehyde served as the best predictor of a combined endpoint at 1 year with AUC (ROC analysis) = 0.872 for TAVI group, resp. 0.765 (p<0.05) for both TAVI and SAVR groups. Increased levels of MDA, matrix metalloproteinase 2, tissue inhibitor of metalloproteinase (TIMP1), ferritin-reducing ability of plasma, homocysteine, cysteine and 8-hydroxy-2-deoxyguanosine were all predictors of the occurrence of combined safety endpoints at 30 days (AUC 0.750–0.948; p<0.05 for all). The addition of MDA to a currently used clinical model (EuroSCORE) significantly improved prediction of a combined safety endpoint at 30 days and a combined endpoint (0–365 days) by the net reclassification improvement (NRI) and the integrated discrimination improvement (IDI) (p<0.05). Cystatin C, glutathione, cysteinylglycine, asymmetric dimethylarginine, nitrite/nitrate and MMP9 did not prove to be significant. Total of 14.3% died during 1-year follow-up. Conclusion We identified malondialdehyde, a marker of oxidative stress, as the most promising predictor of adverse outcomes during the 30-day and 1-year follow-up in high-risk patients with symptomatic, severe aortic stenosis treated with TAVI. The development of a clinical

  4. VALIDATION OF A MODIFIED-MULTIDIMENSIONAL PROGNOSTIC INDEX (m-MPI) INCLUDING THE MINI NUTRITIONAL ASSESSMENT SHORT-FORM (MNA-SF) FOR THE PREDICTION OF ONE-YEAR MORTALITY IN HOSPITALIZED ELDERLY PATIENTS

    PubMed Central

    SANCARLO, D.; D’ONOFRIO, G.; FRANCESCHI, M.; SCARCELLI, C.; NIRO, V.; ADDANTE, F.; COPETTI, M.; FERRUCCI, L.; FONTANA, L.; PILOTTO, A.

    2016-01-01

    Background The mortality prediction represents a key factor in the managing of elderly hospitalized patients. Since in older subjects mortality results from a combination of biological, functional, nutritional, psychological and environmental factors, a Multidimensional Prognostic Index (MPI) that predict short- and long-term mortality based on a standardized comprehensive geriatric assessment (CGA) has recently been developed and validated. Objective This study compares the accuracy in predicting the mortality of the MPI with a modified version of the MPI (m-MPI) that included the Mini Nutritional Assessment-Short Form (MNA-SF) instead of the standard MNA. Design This prospective study with a one-year follow-up included 4088 hospitalized patients aged 65 years and older. A standardized CGA that included information on functional (Activities of Daily Living, ADL and Instrumental-ADL), cognitive (Short Portable Mental Status Questionnaire), risk of pressure sore (Exton-Smith Scale), comorbidities (CIRS Index), medications, living status and nutritional status (MNA and MNA-SF) was used to calculate the MPI using a previously validated algorithm. Results Higher MPI values were significantly associated with higher mortality rates with a close agreement between the estimated and the observed mortality both after 1-month (MPI1=2.8% versus m-MPI1=2.8%, p=0.946; MPI2=8.9% versus m-MPI2=9%, p=0.904; MPI3=21.9% versus m-MPI3=21.9, p=0.978) and 1-year of follow-up (MPI1=10.8% versus m-MPI1=10.5%, p=0.686; MPI2=27.3% versus m-MPI2=28%, p=0.495; MPI3=52.8% versus m-MPI3=52.7%, p=0.945). The estimated areas under the receiver operating characteristics (ROC) curves suggested a clinically negligible difference between the two indices. Conclusion The m-MPI is as sensitive as the MPI in stratifying hospitalized elderly patients into groups at varying risk of short- and long-term mortality, but with fewer items. PMID:21369662

  5. Predictors of bacteraemia among febrile infants in Ibadan, Nigeria.

    PubMed

    Ayoola, Omolola O; Adeyemo, Adebowale A; Osinusi, Kikelomo

    2002-09-01

    Fever is a common complaint in infancy, and bacteraemia is one of the more serious causes of such fever. However, there exists scanty data on risk of bacteraemia among febrile infants of developing countries and what clinical predictors, if any, could identify those febrile infants with bacteraemia. To address this issue, 102 infants aged 1-12 month(s) attending the Children's Emergency Ward of University College Hospital, Ibadan, Nigeria, with rectal temperatures of > or = 38 degrees C and with a negative history of antimicrobial use for at least one week prior to presentation, were studied to identify clinical predictors of bacteraemia. Infants, meeting the eligibility criteria of the study, underwent a full clinical evaluation and had blood cultures done for aerobic organisms by standard methods. Over 38% of the infants had bacteraemia. Escherichia coli (35.9%), Staphylococcus aureus (33.3%), and Klebsiella spp. (10.3%) of positive cultures were commonly isolated. Three variables, age of < or = 6 months, restlessness, and a white cell count of >15,000/mm3, were significant independent predictors of bacteraemia. Each of these variables was associated with a 3-6-fold increase in risk of bacteraemia (age of < or = 6 months: odds ratio 3.2, p = 0.017; restlessness: odds ratio 6.3, p = 0.019; and white cell count of >15,000/mm3: odds ratio 5.4, p = 0.024). The variables, in combination, correctly classified 70% of the infants into 'bacteraemia' or 'no bacteraemia'. It is concluded that; in the setting of the study, about 4 in 10 febrile infants would have a positive blood culture for aerobic organisms and that age of < or = 6 months, restlessness, and a white cell count of > or = 15,000/mm3 are associated with a significantly increased risk of bacteraemia. Clinicians practising in such a setting need to be aware of the increased risk of bacteraemia in infants with these clinical features. PMID:12430758

  6. Cognitive Development: One-Year-Old

    MedlinePlus

    ... Español Text Size Email Print Share Cognitive Development: One-Year-Old Page Content Article Body As you ... range of activities, and she’ll select the ones that are challenging but not completely beyond her ...

  7. Anaerobic bacteraemia: a 10-year retrospective epidemiological survey.

    PubMed

    De Keukeleire, Steven; Wybo, Ingrid; Naessens, Anne; Echahidi, Fedoua; Van der Beken, Mieke; Vandoorslaer, Kristof; Vermeulen, Stefan; Piérard, Denis

    2016-06-01

    In order to identify current trends in anaerobic bacteraemia, a 10-year retrospective study was performed in the University Hospital Brussel, Belgium. All clinically relevant bacteraemia detected from 2004 until 2013 were included. Medical records were reviewed in an attempt to define clinical parameters that might be associated with the occurrence of anaerobic bacteraemia. 437 of the isolated organisms causing anaerobic bacteraemia were thawed, subcultured and reanalyzed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF). There were an average of 33 cases of anaerobic bacteraemia per year during 2004-2008 compared to an average of 27 cases per year during 2009-2013 (P = 0.017), corresponding to a decrease by 19% between the first and the latter period. Also, the total number of cases of anaerobic bacteraemia per 100,000 patient days decreased from 17.3 in the period from 2004 to 2008 to 13.7 in the period 2009 to 2013 (P = 0.023). Additionally, the mean incidence of anaerobic bacteraemia decreased during the study period (1.27/1000 patients in 2004 vs. 0.94/1000 patients in 2013; P = 0.008). In contrast, the proportion of isolated anaerobic bacteraemia compared to the number of all bacteraemia remained stable at 5%. Bacteroides spp. and Parabacteroides spp. accounted for 47.1% of the anaerobes, followed by 14.4% Clostridium spp., 12.6% non-spore-forming Gram-positive rods, 10.5% anaerobic cocci, 8.2% Prevotella spp. and other Gram-negative rods and 7.1% Fusobacterium spp. The lower gastrointestinal tract (47%) and wound infections (10%) were the two most frequent sources for bacteraemia, with the origin remaining unknown in 62 cases (21%). The overall mortality rate was 14%. Further studies focusing on the antimicrobial susceptibility and demographic background of patients are needed to further objectify the currently observed trends. PMID:26923749

  8. Predictors of in-hospital mortality in elderly patients with bacteraemia admitted to an Internal Medicine ward

    PubMed Central

    2011-01-01

    Background Infectious diseases are a common cause of increased morbidity and mortality in elderly patients. Bacteraemia in the elderly is a difficult diagnosis and a therapeutic challenge due to age-related vicissitudes and to their comorbidities. The main purpose of the study was to assess independent risk factors for in-hospital mortality among the elderly with bacteraemia admitted to an Internal Medicine Ward. Methods Overall, a cohort of 135 patients, 65 years of age and older, with bacteraemia were retrospectively studied. Data related to demographic information, comorbidities, clinical parameters on admission, source and type of infection, microorganism isolated in the blood culture, laboratory data and empirical antibiotic treatment was recorded from each patient. Multivariate logistic regression was performed to identify independent predictors of all-cause in-hospital mortality. Results Of these 135 patients, 45.9% were women. The most common infections in this group of patients were urinary tract infections (46.7%). The main microorganisms isolated in the blood cultures were Escherichia coli (14.9%), Methicillin-resistant Staphylococcus aureus (MRSA) (12.0%), non-MRSA (11.4%), Klebsiella pneumoniae (9.1%) and Enterococcus faecalis (8.0%). The in-hospital mortality was 22.2%. Independent prognostic factors associated with in-hospital mortality were age ≥ 85 years, chronic renal disease, bacteraemia of unknown focus and cognitive impairment at admission (OR, 2.812 [95% CI, 1.039-7.611; p = 0.042]; OR, 6.179 [95% CI, 1.840-20.748; p = 0.003]; OR, 8.673 [95% CI, 1.557-48.311; p = 0.014] and OR, 3.621 [95% CI, 1.226-10.695; p = 0.020], respectively). By multivariate analysis appropriate antibiotic therapy was not associated with lower odds of mortality. Conclusion Bacteraemia in the elderly has a high mortality rate. There are no set of signs or clinical features that can predict bacteraemia in the elderly. However, older age (≥ 85 years), chronic renal

  9. Bacteraemia due to tribe Proteeae: a review of 132 cases during a decade (1991-2000).

    PubMed

    Kim, Baek-Nam; Kim, Nam Joong; Kim, Mi-Na; Kim, Yang Soo; Woo, Jun-Hee; Ryu, Jiso

    2003-01-01

    To characterize the clinical features of bacteraemia due to tribe Proteeae, 132 cases among 130 patients from 1991 to 2000 were analysed. The organisms included the Proteus species in 63 cases (P. mirabilis in 41, P. penneri in 2 and P. vulgaris in 20), the Providencia species in 8 (P. rettgeri in 3 and P. stuartii 5) and Morganella morganii in 61. Morganella bacteraemia occurred more frequently in the hospital (70.5%). Biliary and hepatic diseases were predominant in cases with Morganella bacteraemia while cardiovascular, urological and neurological diseases were more common in cases with Proteus bacteraemia. Biliary drainage catheters had more frequently been placed in cases with Morganella bacteraemia (39.3%, p < 0.001), and urinary catheters more frequently in cases with Proteus bacteraemia (17.5%). Biliary infection was most common in cases with Morganella bacteraemia (49.2%), while urinary tract infection (UTI) was most common in cases with Proteus bacteraemia (47.6%). Mortality directly related to bacteraemia due to tribe Proteeae was 20.8% (22.6, 50.0 and 15.0% for Proteus, Providencia and Morganella bacteraemia, respectively). In conclusion, Morganella bacteraemia was most frequently associated with biliary infection, while Proteus bacteraemia was most frequently with UTI. Providencia bacteraemia was relatively uncommon and it can be associated with infections other than UTI. PMID:12693558

  10. SIRIO: One year of station keeping

    NASA Technical Reports Server (NTRS)

    Palutan, F.; Trumpy, S.

    1979-01-01

    The strategy followed in maintaining the station point and the results achieved are described. The method used for orbit determination is presented. Azimuth and elevation data from SHF antennas were used as input for the determination. An estimation of the uncertainty of the orbit was given and a comparison was made between determinations performed using the method here described and determinations performed using VHF ranging data. Also, the difference in using data from a single SHF station or two stations was shown. In the area of attitude determination, a study was carried out for predicting the spacecraft spin axis precession. The model used was explained and then the agreement between predicted and measured attitude outlined.

  11. The Danish Collaborative Bacteraemia Network (DACOBAN) database

    PubMed Central

    Gradel, Kim Oren; Schønheyder, Henrik Carl; Arpi, Magnus; Knudsen, Jenny Dahl; Østergaard, Christian; Søgaard, Mette

    2014-01-01

    The Danish Collaborative Bacteraemia Network (DACOBAN) research database includes microbiological data obtained from positive blood cultures from a geographically and demographically well-defined population serviced by three clinical microbiology departments (1.7 million residents, 32% of the Danish population). The database also includes data on comorbidity from the Danish National Patient Registry, vital status from the Danish Civil Registration System, and clinical data on 31% of nonselected records in the database. Use of the unique civil registration number given to all Danish residents enables linkage to additional registries for specific research projects. The DACOBAN database is continuously updated, and it currently comprises 39,292 patients with 49,951 bacteremic episodes from 2000 through 2011. The database is part of an international network of population-based bacteremia registries from five developed countries on three continents. The main purpose of the DACOBAN database is to study surveillance, risk, and prognosis. Sex- and age-specific data on background populations enables the computation of incidence rates. In addition, the high number of patients facilitates studies of rare microorganisms. Thus far, studies on Staphylococcus aureus, enterococci, computer algorithms for the classification of bacteremic episodes, and prognosis and risk in relation to socioeconomic factors have been published. PMID:25258557

  12. Fibrosis with Inflammation at One Year Predicts Transplant Functional Decline

    PubMed Central

    Park, Walter D.; Griffin, Matthew D.; Cornell, Lynn D.; Cosio, Fernando G.

    2010-01-01

    Lack of knowledge regarding specific causes for late loss of kidney transplants hampers improvements in long-term allograft survival. Kidney transplants with both interstitial fibrosis and subclinical inflammation but not fibrosis alone after 1 year have reduced survival. This study tested whether fibrosis with inflammation at 1 year associates with decline of renal function in a low-risk cohort and characterized the nature of the inflammation. We studied 151 living-donor, tacrolimus/mycophenolate-treated recipients without overt risk factors for reduced graft survival. Transplants with normal histology (n = 86) or fibrosis alone (n = 45) on 1-year protocol biopsy had stable renal function between 1 and 5 years, whereas those with both fibrosis and inflammation (n = 20) exhibited a decline in GFR and reduced graft survival. Immunohistochemistry confirmed increased interstitial T cells and macrophages/dendritic cells in the group with both fibrosis and inflammation, and there was increased expression of transcripts related to innate and cognate immunity. Pathway- and pathologic process–specific analyses of microarray profiles revealed that potentially damaging immunologic activities were enriched among the overexpressed transcripts (e.g., Toll-like receptor signaling, antigen presentation/dendritic cell maturation, IFN-γ–inducible response, cytotoxic T lymphocyte–associated and acute rejection–associated genes). Therefore, the combination of fibrosis and inflammation in 1-year protocol biopsies associates with reduced graft function and survival as well as a rejection-like gene expression signature, even among recipients with no clinical risk factors for poor outcomes. Early interventions aimed at altering rejection-like inflammation may improve long-term survival of kidney allografts. PMID:20813870

  13. Acute pyelonephritis and secondary bacteraemia caused by Veillonella during pregnancy.

    PubMed

    Yagihashi, Yusuke; Arakaki, Yoshitaka

    2012-01-01

    We report a case of pyelonephritis and secondary bacteraemia caused by Veillonella species during pregnancy. Veillonella is part of the normal flora from the oral cavity, gut and vagina. However, because Veillonella is usually isolated from cultures of clinical specimens as part of commensal flora, it is frequently regarded as a contaminant. In the present case, Veillonella was isolated from the patient's urine and blood samples that showed evidence of pyelonephritis and secondary bacteraemia. We found that ureteral stenting is an extremely effective therapeutic option for pregnant woman with hydronephrosis and clear signs and symptoms of urosepsis. PMID:23125301

  14. Acute pyelonephritis and secondary bacteraemia caused by Veillonella during pregnancy

    PubMed Central

    Yagihashi, Yusuke; Arakaki, Yoshitaka

    2012-01-01

    We report a case of pyelonephritis and secondary bacteraemia caused by Veillonella species during pregnancy. Veillonella is part of the normal flora from the oral cavity, gut and vagina. However, because Veillonella is usually isolated from cultures of clinical specimens as part of commensal flora, it is frequently regarded as a contaminant. In the present case, Veillonella was isolated from the patient's urine and blood samples that showed evidence of pyelonephritis and secondary bacteraemia. We found that ureteral stenting is an extremely effective therapeutic option for pregnant woman with hydronephrosis and clear signs and symptoms of urosepsis. PMID:23125301

  15. PNA-FISH assays for early targeted bacteraemia treatment.

    PubMed

    Parcell, B J; Orange, G V

    2013-11-01

    PNA-FISH S. aureus/CNS and GNR Traffic Light assays were compared with standard culture methods for identifying bacteraemia in 156 blood cultures from 131 patients. Results correlated with final culture results in 153 cultures. Retrospective case note review revealed that earlier targeted treatment would have occurred in 10.7% of cases. PMID:24055387

  16. Concurrent bacteraemia and malaria in febrile Nigerian infants.

    PubMed

    Ayoola, Omolola O; Adeyemo, Adebowale A; Osinusi, Kikelomo

    2005-01-01

    In the tropics, febrile illnesses are often presumed to be due to malaria, because of its endemicity, and treatment can lead to delay in diagnosis or failure to detect severe infections such as bacteraemia. This study sought to determine the prevalence of bacteraemia and malaria parasitaemia in febrile post-neonatal infants (age 1-12 months) at the University College Hospital, Ibadan, Nigeria, and the bacterial aetiological agents of bacteraemia in the infants. Therefore, 102 infants aged 1-12 months who presented with fever with a negative history of antimicrobial use in the week prior to presentation were evaluated and had blood cultures done for the detection of aerobic organisms by standard methods and blood films for malaria parasites. Bacteraemia was found in 38.2% of the infants, malaria parasitaemia was found in 46.1%. The most common organisms isolated were Escherichia coli (35.9%), Staphylococcus aureus (33.3%) and Klebsiella spp. (10.3%). Febrile children should be investigated for the presence of bacterial infection even if the blood film for malaria parasites is positive. Where laboratory facilities are not available, consideration should be given to the use of both anti-malarial therapy and empiric antibiotic therapy in the management of febrile infants, depending on the clinician's judgement. PMID:15712544

  17. Butyricimonas virosa bacteraemia and bowel disease: case report and review.

    PubMed

    Enemchukwu, C U; Ben-Faras, H; Gialanella, P; Szymczak, W A; Nosanchuk, J D; Madaline, T F

    2016-09-01

    Only two cases of human infection with the anaerobic Gram-negative bacillus Butyricimonas virosa have been previously reported. We describe the case of a 69-year-old man with B. virosa and diverticulitis, further supporting an association of bacteraemia with this pathogen to bowel disease. We also summarize the characteristics of the previously described cases. PMID:27408738

  18. 40 CFR 51.262 - Extension beyond one year.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Extension beyond one year. 51.262... Extension beyond one year. (a) Any compliance schedule or revision of it extending over a period of more than one year from the date of its adoption by the State agency must provide for legally...

  19. 40 CFR 51.262 - Extension beyond one year.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 2 2012-07-01 2012-07-01 false Extension beyond one year. 51.262... Extension beyond one year. (a) Any compliance schedule or revision of it extending over a period of more than one year from the date of its adoption by the State agency must provide for legally...

  20. 40 CFR 51.262 - Extension beyond one year.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 2 2011-07-01 2011-07-01 false Extension beyond one year. 51.262... Extension beyond one year. (a) Any compliance schedule or revision of it extending over a period of more than one year from the date of its adoption by the State agency must provide for legally...

  1. 40 CFR 51.262 - Extension beyond one year.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 2 2013-07-01 2013-07-01 false Extension beyond one year. 51.262... Extension beyond one year. (a) Any compliance schedule or revision of it extending over a period of more than one year from the date of its adoption by the State agency must provide for legally...

  2. When sepsis persists: a review of MRSA bacteraemia salvage therapy.

    PubMed

    Kullar, Ravina; Sakoulas, George; Deresinski, Stan; van Hal, Sebastiaan J

    2016-03-01

    MRSA bacteraemia (MRSAB), including infective endocarditis, carries a high mortality rate, with up to 50% of patients failing initial therapy with vancomycin and requiring salvage therapy. Persistent MRSAB can be difficult to successfully eliminate, especially when source control is not possible due to an irremovable focus or the bacteraemia still persists despite surgical intervention. Although vancomycin and daptomycin are the only two antibiotics approved by the US FDA for the treatment of patients with MRSAB as monotherapy, the employment of novel strategies is required to effectively treat patients with persistent MRSAB and these may frequently involve combination drug therapy. Treatment strategies that are reviewed in this manuscript include vancomycin combined with a β-lactam, daptomycin-based therapy, ceftaroline-based therapy, linezolid-based therapy, quinupristin/dalfopristin, telavancin, trimethoprim/sulfamethoxazole-based therapy and fosfomycin-based therapy. We recommend that combination antibiotic therapy be considered for use in MRSAB salvage treatment. PMID:26565015

  3. 40 CFR 761.219 - One-year exception reporting.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... PROHIBITIONS PCB Waste Disposal Records and Reports § 761.219 One-year exception reporting. (a) A disposer of PCB waste shall submit a One-year Exception Report to the EPA Regional Administrator for the Region in... disposal date when the following occurs: (1) The disposal facility receives PCBs or PCB Items on a...

  4. 40 CFR 761.219 - One-year exception reporting.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... PROHIBITIONS PCB Waste Disposal Records and Reports § 761.219 One-year exception reporting. (a) A disposer of PCB waste shall submit a One-year Exception Report to the EPA Regional Administrator for the Region in... disposal date when the following occurs: (1) The disposal facility receives PCBs or PCB Items on a...

  5. [Bordetella bronchiseptica recurrent bacteraemia in a patient with bone marrow transplantation].

    PubMed

    Echeverri-Toro, Lina; Arango, Andrés; Ospina, Sigifredo; Agudelo, Carlos

    2015-09-01

    We report a case of recurrent bacteraemia caused by Bordetella bronchiseptica in an immunocompromised patient with a history of allogenic bone marrow transplantation for myelodysplastic syndrome, who was admitted to hospital with febrile syndrome. Bordetella bronchiseptica is an uncommon human pathogen which mainly affects immunocompromised patients, being a rare cause of bacteraemia. PMID:26849691

  6. Lack of 1-3-B-D-glucan detection in adults with bacteraemia.

    PubMed

    Desjardins, Anne; Parize, Perrine; Angebault, Cécile; Lécuyer, Hervé; Lortholary, Olivier; Bougnoux, Marie-Elisabeth

    2015-05-01

    Bacteraemia was reported to be associated with false-positive 1→3-β-D-glucan (BG) assay results. We thus prospectively assessed the reactivity of the BG (Fungitell) in samples of 21 adults with bacteraemia: . BG was negative in all and is s therefore an unlikely cause of false positive BG in adults. PMID:25541560

  7. Corynebacterium minutissimum pyelonephritis with associated bacteraemia: a case report and review of literature.

    PubMed

    Ahmad, Nasir M; Ahmad, Khalid M

    2005-12-01

    We report a case of Corynebacterium minutissimum pyelonephritis with associated bacteraemia in an immunocompetent adult. The patient was successfully treated with a 14-day course of intravenous vancomycin. We review the clinical features of all the reported cases of invasive C. minutissimum infections with bacteraemia. PMID:16321644

  8. Community-onset bacteraemia of unknown origin: clinical characteristics, epidemiology and outcome.

    PubMed

    Hernandez, C; Cobos-Trigueros, N; Feher, C; Morata, L; De La Calle, C; Marco, F; Almela, M; Soriano, A; Mensa, J; Del Rio, A; Martinez, J A

    2014-11-01

    Bacteraemia of unknown origin is prevalent and has a high mortality rate. However, there are no recent reports focusing on this issue. From 2005 to 2011, all episodes of community onset bacteraemia of unknown origin (CO-BSI), diagnosed at a 700-bed university hospital were prospectively included. Risk factors for Enterobactericeae resistant to third-generation cephalosporins (3GCR-E), Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus spp, and predictors of mortality were assessed by logistic regression. Out of 4,598 consecutive episodes of CO-BSI, 745 (16.2 %) were of unknown origin. Risk factors for S. aureus were male gender (OR 2.26; 1.33-3.83), diabetes mellitus (OR 1.71; 1.01-2.91) and intravenous drug addiction (OR 17.24; 1.47-202); for P. aeruginosa were male gender (OR 2.19; 1.10-4.37) and health-care associated origin (OR 9.13; 3.23-25.83); for 3GCR-E was recent antibiotic exposure (OR 2.53; 1.47-4.35), while for enterococci, it was recent hospital admission (OR 3.02; 1.64-5.55). Seven and 30-day mortality were 8.1 % and 13.4 %, respectively. Age over 65 years (OR 2.13; 1.28-3.55), an ultimately or rapidly fatal underlying disease (OR 4.15; 2.23-7.60), bone marrow transplantation (OR 4.07; 1.24-13.31), absence of fever (OR 4.45; 2.25-8.81), shock on presentation (OR 10.48; 6.05-18.15) and isolation of S. aureus (OR 2.01; 1.00-4.04) were independently associated with mortality. In patients with bacteraemia of unknown origin, a limited number of clinical characteristics may be useful to predict its aetiology and to choose the appropriate empirical treatment. Although no modifiable prognostic factors have been found, management optimization of S. aureus should be considered a priority in this setting. PMID:24907852

  9. Bacteraemia and antibiotic-resistant pathogens in community acquired pneumonia: risk and prognosis.

    PubMed

    Torres, Antoni; Cillóniz, Catia; Ferrer, Miquel; Gabarrús, Albert; Polverino, Eva; Villegas, Santiago; Marco, Francesc; Mensa, Josep; Menéndez, Rosario; Niederman, Michael

    2015-05-01

    The sensitivity of blood cultures in the diagnosis of bacteraemia for community-acquired pneumonia is low. Recommendations, by guidelines, to perform blood cultures are discordant. We aimed to determine the incidence, microbial aetiology, risk factors and outcomes of bacteraemic patients with community-acquired pneumonia, including cases with antibiotic-resistant pathogens (ARP). A prospective, observational study was undertaken on consecutive adult patients admitted to the Hospital Clinic of Barcelona (Barcelona, Spain) with community-acquired pneumonia and blood cultures were obtained. Of the 2892 patients included, bacteraemia was present in 297 (10%) patients; 30 (10%) of whom had ARP (multidrug-resistant Streptococcus pneumoniae, methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and an extended spectrum of beta-lactamase producing Enterobacteriaceae). In multivariate analyses, pleuritic pain, C-reactive protein ≥21.6 mg·dL(-1) and intensive care unit admissions were independently associated with bacteraemia, while prior antibiotic treatment and pneumococcal vaccine were protective factors. The risk factors for ARP bacteraemia were previous antibiotics and C-reactive protein <22.2 mg·dL(-1), while pleuritic pain was the only protective factor in the multivariate analysis. Bacteraemia (excluding ARP), appropriate empiric treatment, neurological disease, arterial oxygen tension/inspiratory oxygen fraction <250, pneumonia severity index risk classes IV and V, and intensive care unit admission were independently associated with a 30-day hospital mortality in the multivariate analysis. Inappropriate therapy was more frequent in ARP bacteraemia, compared with other bacteraemias (27% versus 3%, respectively, p<0.001). Antibiotic therapy protected against bacteraemia, but increased specifically the risk of bacteraemia from ARP due to the inappropriate coverage of these pathogens. Identifying patients at risk of ARP bacteraemia would help in

  10. The National Special Education Alliance: One Year Later.

    ERIC Educational Resources Information Center

    Green, Peter

    1988-01-01

    The National Special Education Alliance (a national network of local computer resource centers associated with Apple Computer, Inc.) consists, one year after formation, of 24 non-profit support centers staffed largely by volunteers. The NSEA now reaches more than 1000 disabled computer users each month and more growth in the future is expected.…

  11. One-year clinical evaluation of bonded amalgam restorations.

    PubMed

    Mahler, D B; Engle, J H; Simms, L E; Terkla, L G

    1996-03-01

    Using one selected amalgam bonding agent, the authors evaluated bonded and unbonded restorations in clinical service. Based on postoperative sensitivity one to two weeks after placement and marginal fracture at one year, no difference was found between the bonded and unbonded restorations. Furthermore, some technical difficulties were experienced with use of the bonding agent. PMID:8819781

  12. Change in Neuropsychological Functioning over One Year in Youth at Clinical High Risk for Psychosis

    PubMed Central

    Woodberry, Kristen A.; McFarlane, William R.; Giuliano, Anthony J.; Verdi, Mary B.; Cook, William L.; Faraone, Stephen V.; Seidman, Larry J.

    2013-01-01

    Schizophrenia and related psychotic disorders are associated with significant neuropsychological (NP) impairments. Yet the onset and developmental evolution of these impairments remains incompletely characterized. This study examined NP functioning over one year in a sample of youth at clinical high risk (CHR) for psychosis participating in a treatment study. We assessed functioning across six cognitive domains at two time points in a sample of 53 CHR and 32 healthy comparison (HC) subjects. Linear regression of HC one-year scores was used to predict one-year performance for CHR from baseline scores and relevant demographic variables. We used raw scores and MANOVAs of the standardized residuals to test for progressive impairment over time. NP functioning of CHR at one year fell significantly below predicted levels. Effects were largest and most consistent for a failure of normative improvement on tests of executive function. CHR who reached the highest positive symptom rating (6, severe and psychotic) on the Structured Interview of Prodromal Syndromes after the baseline assessment (n = 10/53) demonstrated a particularly large (d= −1.89), although non-significant, discrepancy between observed and predicted one-year verbal memory test performance. Findings suggest that, although much of the cognitive impairment associated with psychosis is present prior to the full expression of the psychotic syndrome, some progressive NP impairments may accompany risk for psychosis and be greatest for those who develop psychotic level symptoms. PMID:23434505

  13. Equestrian injuries--a one year prospective study.

    PubMed Central

    McLatchie, G. R.

    1979-01-01

    A one year prospective study of equestrian injuries was carried out in an area where horse riding is a popular pursuit. 115 persons suffered injury--eighty females and thirty-five males of whom sixty were under fifteen years of age. No fatalities were recorded and there were 0.2 injuries per 100 rides. Most injuries were minor and to the musculo-skeletal system. Visceral and cerebral injuries were not common but the former were life threatening in all cases. It is concluded that young riders should be supervised. PMID:465903

  14. Fourth United States Microgravity Payload: One Year Report

    NASA Technical Reports Server (NTRS)

    Ethridge, E. C. (Compiler); Curreri, P. A. (Compiler); McCauley, D. E. (Compiler)

    1999-01-01

    This document reports the one year science results for the Fourth United States Microgravity Payload (USMP-4). The USMP-4 major experiments were on a support structure in the Space Shuttle's payload bay and operated almost completely by the Principal Investigators through telescience. The mission included a Glovebox where the crew performed additional experiments for the investigators. Together about eight major scientific experiments were performed, advancing the state of knowledge in fields such as low temperature physics, solidification, and combustion. The results demonstrate the range of quality science that can be conducted utilizing orbital laboratories in microgravity and provide a look forward to a highly productive Space Station era.

  15. Third United States Microgravity Payload: One Year Report

    NASA Technical Reports Server (NTRS)

    Currieri, P. A. (Compiler); McCauley, D. (Compiler); Walker, C. (Compiler)

    1998-01-01

    This document reports the one year science results for the Third United States Microgravity Payload (USMP-3). The USMP-3 major experiments were on a support structure in the Space Shuttle's payload bay and operated almost completely by the Principal Investigators through telescience. The mission included a Glovebox where the crew performed additional experiments for the investigators. Together about seven major scientific experiments were performed, advancing the state of knowledge in fields such as low temperature physics, solidification, and combustion. The results demonstrate the range of quality science that can be conducted utilizing orbital laboratories in microgravity and provide a look forward to a highly productive space station era.

  16. Second United States Microgravity Laboratory: One Year Report. Volume 1

    NASA Technical Reports Server (NTRS)

    Vlasse, M (Editor); McCauley, D. (Editor); Walker, C. (Editor)

    1998-01-01

    This document reports the one year science results for the important and highly successful Second United States Microgravity Laboratory (USML-2). The USML-2 mission consisted of a pressurized Spacelab module where the crew performed experiments. The mission also included a Glovebox where the crew performed additional experiments for the investigators. Together, about 36 major scientific experiments were performed, advancing the state of knowledge in fields such as fluid physics, solidification of metals, alloys, and semiconductors, combustion, and the growth of protein crystals. The results demonstrate the range of quality science that can be conducted utilizing orbital laboratories in microgravity and provide a look forward to a highly productive Space Station era.

  17. Second United States Microgravity Laboratory: One Year Report. Volume 2

    NASA Technical Reports Server (NTRS)

    Vlasse, M. (Editor); McCauley, D. (Editor); Walker, C. (Editor)

    1998-01-01

    This document reports the one year science results for the important and highly successful Second United States Microgravity Laboratory (USML-2). The USML-2 mission consisted of a pressurized Spacelab module where the crew performed experiments. The mission also included a Glovebox where the crew performed additional experiments for the investigators. Together, about 36 major scientific experiments were performed, advancing the state of knowledge in fields such as fluid physics, solidification of metals, alloys, and semiconductors, combustion, and the growth of protein crystals. The results demonstrate the range of quality science that can be conducted utilizing orbital laboratories in microgravity and provide a look forward to a highly productive Space Station era.

  18. Psychological Support Operations and the ISS One-Year Mission

    NASA Technical Reports Server (NTRS)

    Beven, G.; Vander Ark, S. T.; Holland, A. W.

    2016-01-01

    Since NASA began human presence on the International Space Station (ISS) in November 1998, crews have spent two to seven months onboard. In March 2015 NASA and Russia embarked on a new era of ISS utilization, with two of their crewmembers conducting a one-year mission onboard ISS. The mission has been useful for both research and mission operations to better understand the human, technological, mission management and staffing challenges that may be faced on missions beyond Low Earth Orbit. The work completed during the first 42 ISS missions provided the basis for the pre-flight, in-flight and post-flight work completed by NASA's Space Medicine Operations Division, while our Russian colleagues provided valuable insights from their long-duration mission experiences with missions lasting 10-14 months, which predated the ISS era. Space Medicine's Behavioral Health and Performance Group (BHP) provided pre-flight training, evaluation, and preparation as well as in-flight psychological support for the NASA crewmember. While the BHP team collaboratively planned for this mission with the help of all ISS international partners within the Human Behavior and Performance Working Group to leverage their collective expertise, the US and Russian BHP personnel were responsible for their respective crewmembers. The presentation will summarize the lessons and experience gained within the areas identified by this Working Group as being of primary importance for a one-year mission.

  19. Journal of Foot and Ankle Research, one year on

    PubMed Central

    Potter, Mike J; Menz, Hylton B; Borthwick, Alan M; Landorf, Karl B

    2009-01-01

    Journal of Foot and Ankle Research was launched one year ago, and a number of its key achievements are highlighted in this editorial. Although the journal is underpinned by professional bodies associated with the podiatry professions in the UK and Australasia, its content is aimed at the wider foot and ankle research community. Nevertheless, the journal's achievements over the past year reflect the development of research in the profession of podiatry. From this perspective, the journal may be viewed as contributing to the overall attainment of some of the profession's key goals and strategic aims over the last decade, across the UK and Australasia. The journal has also witnessed policy changes in the last year, and these are discussed - notably, the decision not to accept case reports for publication. We also report on a few of the key metrics, providing readers with a summary of the journal's performance over the last year. PMID:19906292

  20. MRP II (material requirements planning): one year later.

    PubMed

    Tull, W L; Norman, R L

    1994-08-01

    This article addresses the continued need for the behavior change process that must be managed long after materiel requirements planning (MRP II) implementation. Mason & Hanger, Pantex Plant is the final assembly and dismantlement facility for all United States nuclear weapons. On October 1, 1990, Mason & Hanger implemented a full production cutover to MRP II. One year later, following class A certification, the MRP II implementation team is still actively managing the change process through education and training programs and overall continuous improvement initiatives. Actual behavior change problems are identified together with the proven solutions implemented in a government-owned, contractor-operated facility environment. Performance measurements ranging from senior management planning to shop floor accomplishments and cost variance reports are shown as normal management tools used to identify target improvement areas. PMID:10135462

  1. [Pediamécum: one year of experience].

    PubMed

    Piñeiro Pérez, R; Martínez Fernández-Llamazares, C; Calvo Rey, C; Piñeiro Pérez, A P; Criado Vega, E A; Bravo Acuña, J; Cabrera García, L; Mellado Peña, M J

    2014-10-01

    In 2011, the Spanish Association of Pediatrics decided to support the most ambitious project of its newly created Committee for Medicinal Products: Pediamécum. This is the first free on-line database with information on medicinal products for pediatric use in Spain. The web page http://pediamecum.es/ started on December 17 December 2012. One year later, Pediamécum includes 580 registered drugs. The website achieved more than one million page views by the end of 2013. Because of the first anniversary of Pediamécum, a survey was performed to request the feeling of users. Four hundred eighty-three responses were obtained. Ninety-five percent believed that it is easy to navigate through the web, and 74% said that their doubts about the use of medicines in children were always resolved. The overall rating of Pediamécum is 7.5/10. The aims of Pediamécum are being accomplished; which is reflected essentially due to it becoming a useful tool for all professionals who care for children in their daily clinical practice. PMID:24857432

  2. Functional Outcomes: One Year after a Cardiac Arrest

    PubMed Central

    Raina, Ketki D.; Rittenberger, Jon C.; Holm, Margo B.; Callaway, Clifton W.

    2015-01-01

    Objective. The study aim was to characterize the time-course of recovery in impairments, activity limitations, participation restrictions, disability, and quality of life during the first year after cardiac arrest. Secondarily, the study described the associations between the instruments used to measure each of these domains. Methods. Measures of global disability (Cerebral Performance Category, CPC, Modified Rankin Scale, mRS), quality of life, activity limitations, participation restrictions, and affective and cognitive impairments were administered to 29 participants 1, 6, and 12 months after cardiac arrest. Results. Global measures of disability indicated recovery between one month and one year after cardiac arrest (mean CPC: 2.1 versus 1.69,  P < 0.05; mean mRS: 2.55 versus 1.83, P < 0.05). While global measures of disability were moderately associated with participation, they were poorly associated with other measures. The cohort endorsed depressive symptomatology throughout the year but did not have detectable cognitive impairment. Conclusions. Recovery from cardiac arrest is multifaceted and recovery continues for months depending upon the measures being used. Measures of global disability, reintegration into the community, and quality of life yield different information. Future clinical trials should include a combination of measures to yield the most complete representation of recovery after cardiac arrest. PMID:26421282

  3. One Year of FOS Measurements in CMS Experiment at CERN

    NASA Astrophysics Data System (ADS)

    Szillási, Zoltán; Buontempo, Salvatore; Béni, Noémi; Breglio, Giovanni; Cusano, Andrea; Laudati, Armando; Giordano, Michele; Saccomanno, Andrea; Druzhkin, Dmitry; Tsirou, Andromachi

    Results are presented on the activity carried out by our research group, in collaboration with the SME Optosmart s.r.l. (an Italian spin-off company), on the application of Fiber Optic Sensor (FOS) techniques to monitor high-energy physics (HEP) detectors. Assuming that Fiber Bragg Grating sensors (FBGs) radiation hardness has been deeply studied for other field of application, we have applied the FBG technology to the HEP research domain. We present here the experimental evidences of the solid possibility to use such a class of sensors also in HEP detector very complex environmental side conditions. In particular we present more than one year data results of FBG measurements in the Compact Muon Solenoid (CMS) experiment set up at the CERN, where we have monitored temperatures (within CMS core) and strains in different locations by using FBG sensors during the detector operation with the Large Hadron Collider (LHC) collisions and high magnetic field. FOS data and FOS readout system stability and reliability is demonstrated, with continuous 24/24 h 7/7d data taking under severe and complex side conditions.

  4. Shigella sonnei bacteraemia occurring in a young man with shigellosis.

    PubMed

    Huynh, Andrew; McGrath, Christian; Johnson, Douglas; Burrell, Louise M

    2015-01-01

    A 34-year-old man presented with a 6-day history of diarrhoea, abdominal cramps and fever. Blood cultures were initially reported as positive for Escherichia coli using matrix-assisted laser desorption/ionisation time of flight (MALDI-TOF) mass spectrometry. Contrast CT of the abdomen and pelvis revealed pancolitis and terminal ileal thickening. The patient was treated empirically with ampicillin, ciprofloxacin and metronidazole. Stool cultures were positive for Shigella sonnei. Subsequent testing on the initial blood culture correctly identified the organism as S. sonnei. On further questioning, the patient reported unprotected men who have sex with men (MSM) 3 months previously. His symptoms resolved during his 3-day admission, and he was discharged on 14 days of ciprofloxacin. He remains well. This case highlights that shigellosis is increasingly seen in MSM, with no history of travel, and may result in bacteraemia. This case also highlights the benefits (rapid identification of organisms) and limitations (inability to distinguish between E. coli and Shigella spp) of new technologies such as MALDI-TOF. PMID:25920737

  5. The Martian North Polar Cap in Summer - One Year Later

    NASA Technical Reports Server (NTRS)

    2001-01-01

    In the middle of January 2001, Mars Global Surveyor (MGS) completed one Mars year in its 380 km-high (236 mi) mapping orbit. The mapping orbit was originally achieved in late February 1999. In March of that year, MGS conducted a series of operations in preparation for full-up mapping, first calibrating its scientific instruments and then operating in a mode in which the high gain antenna was held fixed against the body of the spacecraft. During this Fixed High Gain Antenna period, 'contingency science' observations were made in case the high gain antenna failed to properly deploy. The wide angle view of the martian north polar cap shown on the left was acquired on March 13, 1999, during early northern summer. The image on the right was acquired almost exactly one Mars year later, on January 26, 2001. The light-toned surfaces are residual water ice that remains through the summer season. The nearly circular band of dark material surrounding the cap consists mainly of sand dunes formed and shaped by wind. The north polar cap is roughly 1100 kilometers (680 miles) across. Close inspection will show that there are differences in the frost cover between the two images (for example, in the upper center of each image, and on the left edge center). Although these changes appear small, they are in fact quite large--the change in frost covering is equivalent to the amount of frost that would be evaporated (in the case of areas that are darker) or deposited (in areas where frost is still on the ground) in almost 5 months. What gives rise to such large changes in the heat budget for the polar caps from one year to the next is not known. Changes in the coloration and brightness of the polar cap suggest dust, deposited perhaps by dust storms during critical periods of the year, may play an important role.

  6. The Two Micron All Sky Survey: One Year of Operations

    NASA Astrophysics Data System (ADS)

    Cutri, R. M.

    1998-05-01

    The Two Micron All Sky Survey (2MASS) began routine operations from its northern facility on Mt. Hopkins, AZ one year ago, and from its southern facility on Cerro Tololo, Chile in March of this year. At each site, 50-inch telescopes equipped with identical 3-channel cameras, are systematically imaging the sky in three near infrared wavelength bands, J (1.25mu m), H (1.65mu m) and K_s (2.17mu m). To date, over 10,000 deg(2) of sky have been observed. Ongoing processing and calibration of the survey image data produces three data products: 1) an Image Atlas that will eventually contain approximately one million 512x1024 pixel images (1 arcsec/pix) in the three colors, covering the full sky, 2) a highly complete and reliable catalog that will contain ~ 300 million point sources having SNR>10 photometry at J<=15.8, H<=15.1 and K_s<=14.3 mag. and an astrometric accuracy <0.5arcsec RMS, and 3) a catalog of approximately one million resolved sources, primarily galaxies, having SNR>10 photometric accuracy at J<=15.5, H<=14.8 and K_s<=13.5 mag. Incremental releases of these data products to the community are scheduled to begin in the Spring of 1999. A brief report on the current status and outlook for 2MASS will be given, along with analyses that demonstrate that the survey is achieving, if not exceeding its stated performance goals. Results of several pilot studies that are supporting 2MASS survey validation are presented as a preview of the tremendous scientific opportunities that will be available with the 2MASS databases. Key among these are investigations of the lowest mass objects in the solar neighborhood, probes of the structure of the Milky Way, and of the local universe, and the search for populations of extremely red active galactic nuclei.

  7. Stability of driving fear acquisition pathways over one year.

    PubMed

    Taylor, J E; Deane, F P; Podd, J V

    1999-10-01

    The present study was conducted in response to increasing concerns about the potential unreliability of retrospective accounts in assessing the origins of fears and phobias. Some investigators [e.g. Menzies, R.G., & Clarke, J.C. (1993). The etiology of fear of heights and its relationship to severity and individual response patterns. Behaviour Research and Therapy, 31, 355-365; Kirkby, K.C., Menzies, R.G., Daniels, B.A., & Smith, K.L. (1995). Aetiology of spider phobia: Classificatory differences between two origins instruments. Behaviour Research and Therapy, 33, 955-958; King, N.J., Gullone, E., & Ollendick, T.H. (1998). Etiology of childhood phobias: current status of Rachman's three pathways theory. Behaviour Research and Therapy, 36, 297-309.] have questioned the reliability of retrospective reports at a single assessment point, although the test-retest reliability of such accounts has yet to be examined. The aim of the present study was to conduct a one-year follow-up of the subclinical driving-fearful sample studied by Taylor and Deane [Taylor, J. E., & Deane, F. P. (1999). Acquisition and severity of driving-related fears. Behaviour Research and Therapy, 37, 435-449.] to primarily investigate, the stability of fear onset ascriptions and fear severity over time. 85 respondents completed a questionnaire which assessed fear origins, anxiety response patterns, and additional fear-relevant events occurring over the year. The results suggest that retrospective accounts of fear onset may be quite unstable over time, although this instability does not clearly appear to be related to intervening events, and limitations of the study make these results inconclusive. Fear-relevant negative thinking worsened over time, while physiological reactions and general anxiety remained relatively stable. The theoretical, methodological and clinical implications of the findings are discussed, along with suggestions for future research. PMID:10472710

  8. One Year of Data of Scimpi Borehole Measurements

    NASA Astrophysics Data System (ADS)

    Insua, T. L.; Moran, K.; Kulin, I.; Farrington, S.; Newman, J. B.; Riedel, M.; Scherwath, M.; Heesemann, M.; Pirenne, B.; Iturrino, G. J.; Masterson, W.; Furman, C.

    2014-12-01

    The Simple Cabled Instrument for Measuring Parameters In-Situ (SCIMPI) is a new subseafloor observatory designed to study dynamic processes in the subseabed using a simple and low-cost approach compared to a Circulation Obviation Retrofit Kit (CORK). SCIMPI was successfully installed at the Integrated Ocean Drilling Program (IODP) Site U1416 during IODP Expedition 341S in May 2013. SCIMPI is designed to measure pore pressure, temperature and electrical resistivity over time in a borehole. The first SCIMPI prototype comprises nine modules joined in a single array by flexible cables. Multiple floats keep the system taut against a sinker bar weight located on SCIMPI and resting on the bottom of the borehole. All the modules record temperature and electrical resistivity, and three are also equipped with pressure sensors. Currently, SCIMPI operates as an autonomous instrument with a data logger that is recovered using an ROV. The second recovery of the SCIMPI data logger took place during the Ocean Networks Canada maintenance cruise, Wiring the Abyss 2014, on May 25th, 2014. The pressure sensor data show a stable trend in which tidal effects are observed in through the one year deployment. The temperature measurements in all the modules became stable over time with smaller variations over the last several months. The only temperature sensor differing from this trend is the shallowest, located at 8 meters below seafloor. This module shows a sudden spike of ~20°C that on April 5th, 2014, an event that was repeated several times from April 25th until recovery of modules. The electrical resistivity sensors show variations over time that could be related to gas hydrate dynamics at the Site. Interpretation of these data is speculative at this time but borehole-sealing processes as well as the formation of gas hydrate are potential processes influencing the recordings. SCIMPI will soon be connected to Ocean Networks Canada's NEPTUNE observatory at Clayoquot Slope node to

  9. Functional decline in older adults one year after hospitalization.

    PubMed

    Helvik, Anne-Sofie; Selbæk, Geir; Engedal, Knut

    2013-01-01

    We studied the change in personal ability to perform the activities of daily living (P-ADL) one year after hospitalization (T2) of patients at least 65 years old at baseline (T1). The study included 363 (175 men) medical inpatients with age range 65-98 (mean 80.2, SD 7.5) years. Information was collected at baseline and at a 12 month follow-up using Lawton and Brody's physical self-maintenance scale (PSMS) (termed the P-ADL score), as the dependent variable, and the mini-mental state examination (MMSE), the hospital anxiety and depression scale (HAD) and the WHOQOL-BREF questionnaire as independent variables. For the total sample, the mean P-ADL was significantly worsened from T1 to T2 (mean change 0.5, SD 2.8; p<0.01). In a fully adjusted linear regression analysis, worsened P-ADL from T1 to T2 was independently associated with cognitive impairment at T1, increasing cognitive impairment from T1 to T2, the tendency to fall between T1 and T2, increase in depressive symptoms from T1 to T2, poor physical QOL at T1 and change toward a poorer QOL from T1 to T2. In conclusion, worse P-ADL at T2 was, independently of age and baseline P-ADL, associated with impaired cognitive function and QOL related to physical ability at baseline, as well as worsening depression, cognition and QOL from T1 to T2. Our findings highlight the importance of applying results from screening measures of cognitive function and emotional health when planning care for older people after hospitalization. PMID:23806790

  10. Transient bacteraemia due to Chryseobacterium indologenes in an immunocompetent patient: a case report and literature review.

    PubMed

    Esposito, Silvano; Russo, E; De Simone, G; Gioia, R; Noviello, S; Vitolo, M; Rega, M R; Massari, A; Posteraro, L

    2015-01-01

    A 51-year-old woman was admitted to the emergency unit with diffuse headache, visus reduction, and paraesthesias of the trigeminal area and the left hand. Three days after admission she showed shaking chills, vomiting, and sudden onset of fever (39·4°C). Blood cultures were performed soon after fever onset. Fever persisted for the whole day, decreasing slowly after 12 hours. No empirical antibiotic treatment was started in order to better define the diagnosis. Fever completely disappeared the day after. Two blood cultures for aerobes were positive for Chryseobacterium indologenes. The patient was discharged with the diagnosis of transient bacteraemia and transferred to the neurology unit for further investigations. C. indologenes infections are described in 31 studies with a total of 171 cases (pneumonia and bacteraemia being the most frequent). Our case is the first report of transient bacteraemia caused by C. indologenes in an immunocompetent, non-elderly patient without needing medical devices. PMID:25096711

  11. Lack of BCG vaccination and other risk factors for bacteraemia in severely malnourished children with pneumonia.

    PubMed

    Chisti, M J; Salam, M A; Ahmed, T; Shahid, A S M S B; Shahunja, K M; Faruque, A S G; Bardhan, P K; Hossain, M I; Islam, M M; Das, S K; Huq, S; Shahrin, L; Huq, E; Chowdhury, F; Ashraf, H

    2015-03-01

    We sought to examine the factors associated with bacteraemia and their outcome in children with pneumonia and severe acute malnutrition (SAM). All SAM children of either sex, aged 0-59 months, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh with radiologically confirmed pneumonia from April 2011 to July 2012 were enrolled (n = 405). Comparison was made between pneumonic SAM children with (cases = 18), and without (controls = 387) bacteraemia. The death rate was significantly higher in cases than controls (28% vs. 8%, P < 0·01). In logistic regression analysis, after adjusting for potential confounders, the SAM children with pneumonia and bacteraemia more often had a history of lack of bacillus Calmette-Guérin (BCG) vaccination (odds ratio 7·39, 95% confidence interval 1·67-32·73, P < 0·01). The results indicate the importance of continuation of BCG vaccination which may provide benefit beyond its primary purpose. PMID:24892696

  12. Risk factors and outcome for colistin-resistant Acinetobacter nosocomialis bacteraemia in patients without previous colistin exposure.

    PubMed

    Wang, Y-C; Lee, Y-T; Yang, Y-S; Chen, C-T; Chiu, C-H; Yin, T; Kuo, S-C; Chen, T-L; Lin, J-C; Wang, F-D; Fung, C-P; Chang, F-Y

    2015-08-01

    The clinical characteristics of patients with colistin-resistant Acinetobacter baumannii bacteraemia have been documented, but those of patients with bacteraemia caused by other Acinetobacter species remain unknown. Previous exposure to colistin has been shown to be associated with the emergence of colistin resistance, but may be not the only predisposing factor. In the current study, we highlight the risk and outcome of patients without previous exposure to colistin who acquired colistin-resistant Acinetobacter nosocomialis (ColRAN) bacteraemia. This 11-year single-centre retrospective study analysed 58 patients with ColRAN bacteraemia and 213 patients with colistin-susceptible A. nosocomialis (ColSAN) bacteraemia. Antimicrobial susceptibilities were determined with an agar dilution method. The clonal relationship of ColRAN isolates was determined with pulsed-field gel electrophoresis. A conjugation mating-out assay was conducted to delineate the potential transfer of colistin resistance genes. Multivariable analysis was performed to evaluate the risk factors for ColRAN bacteraemia. Chronic obstructive pulmonary disease (COPD) was independently associated with ColRAN bacteraemia (OR 3.04; 95% CI 1.45-6.37; p 0.003). Patients with ColRAN bacteraemia had higher APACHE II scores, but the two groups showed no significant differences in 14-day mortality (10.3% vs. 10.3%) or 28-day mortality (15.5% vs. 15.0%). ColRAN isolates had greater resistance than ColSAN isolates to all antimicrobial agents except for ciprofloxacin (0% vs. 6.6%). There were 16 different ColRAN pulsotypes, and two major clones were found. Colistin resistance did not transfer to colistin-susceptible A. baumannii or A. nosocomialis. These results show that COPD is an independent risk factor for acquisition of ColRAN bacteraemia. The mortality rates were similar between patients with ColRAN and ColSAN bacteraemia. PMID:25980356

  13. Clinical and microbiological profile of persistent coagulase-negative staphylococcal bacteraemia in neonates.

    PubMed

    Dimitriou, G; Fouzas, S; Giormezis, N; Giannakopoulos, I; Tzifas, S; Foka, A; Anastassiou, D E; Spiliopoulou, I; Mantagos, S

    2011-11-01

    An atypical pattern of coagulase-negative staphylococcal (CoNS) sepsis, characterized by persistence despite aggressive antibiotic therapy, has been described in neonates cared for in neonatal intensive-care units. Our aim was to analyse the clinical, microbiological and molecular determinants of this persistent CoNS bacteraemia. Neonates with late-onset CoNS bacteraemia were studied for a 2-year period. Demographic, clinical, laboratory, microbiological and molecular data were compared between neonates with persistent (≥3 consecutive positive blood cultures) and non-persistent CoNS bacteraemia. Twenty-nine infants with persistent and 43 with non-persistent bacteraemia were identified, with no significant differences regarding demographic and clinical characteristics between the two groups. Of a total of 170 CoNS isolates, 80 showed biofilm production (54 persistent and 26 non-persistent; p 0.013), whereas 127 were positive for the icaA and icaD genes (74 persistent and 53 non-persistent; p 0.598). Sixty ica-positive isolates did not produce slime, whereas 13 ica-negative isolates showed biofilm production. Endotracheal intubation and the presence of central vascular catheters were significant risk factors for persistent bacteraemia, but, in a logistic regression model, only biofilm production was significantly related to the persistent form of the disease (p 0.005). In this study, persistent CoNS sepsis in neonates requiring intensive care was not related to most of the known clinical risk factors, and it was associated with severe thrombocytopenia. Isolates associated with persistent bacteraemia were more likely to produce biofilm, independently of the presence of the ica operon. PMID:21463392

  14. Clinical consequences of using PNA-FISH in Staphylococcal bacteraemia.

    PubMed

    Laub, R R; Knudsen, J D

    2014-04-01

    To optimize patient treatment and rational use of antimicrobials, it is important to provide fast information on findings in blood-cultures (BCs). The purpose of this study was to evaluate the impact of using peptide nucleic acid fluorescence in situ hybridization (PNA-FISH) on positive BCs containing Gram-positive cocci in clusters to differentiate between Staphylococcus aureus (SA) and coagulase negative staphylococci (CoNS) on the prescribed antimicrobial therapy and on the number of contacts between microbiologist and clinician. All cases of positive BCs in our laboratory with SA or CoNS in the year 2011 were identified and the charts were reviewed retrospectively. The group of patients with BCs tested with PNA-FISH was compared to the group of patients with untested BCs. A total of 200 patients with SA and 725 patients with CoNS were included. The mean number of contacts was 0.82 when PNA-FISH showed CoNS and 1.39 when PNA-FISH was not done (p < 0.0001). More patients were recommended appropriate antimicrobial therapy for SA bacteraemia in the PNA-FISH group (98.0%) than in the non-PNA-FISH group (89.4 %) (p = 0.025). The percentage treated with dicloxacillin was 29.6 in the PNA-FISH group, and 8.2 in the non-PNA-FISH group (p = 0.0003). The use of PNA-FISH on BCs in this study was associated with more appropriate and narrow spectrum antimicrobial therapy for patients with SA in an area with low prevalence of methicillin-resistant SA, and a lower number of contacts between clinical microbiologist and clinician about BCs with CoNS as contaminants. PMID:24129501

  15. EDITORIAL: Celebrating one year of Environmental Research Letters

    NASA Astrophysics Data System (ADS)

    Kammen, Daniel M.

    2008-03-01

    The one-year anniversary is a critical milestone for a new journal. At that point there are enough articles published to begin to define the scope and readership, yet generally not enough of a track-record for the full community to regard the new entrant as a fixture and a source of 'must read' material. Environmental Research Letters (ERL) has set itself a particularly large and interesting challenge: to help connect the vast community of environmental researchers, practitioners, activists, and interested informed observers. ERL and its partner online resource base and community website, environmentalresearchweb, fills a major void: a single locus for rapid publication of peer-reviewed and highly interdisciplinary material spanning literally every aspect of environmental research and thought. The wide range of material that falls squarely into the purview of ERL—from restoration ecology to global change science and politics, to toxicology and environmental justice, to environmental and social impacts of energy conversion—illustrate just how diverse a 'community' we hope to serve. Thanks to an exceptional editorial staff and board, and a diverse range of fascinating contributed papers, ERL is off to a particularly fast start. ERL has both a small advisory board and a larger editorial board. The board serves several functions, beginning with the traditional one of taking the lead on reviews of papers in such a dizzying array of areas. This task alone is a challenge because of the commitment ERL has made to exceptionally rapid publication: a goal of 90 days from submission to online publication for accepted papers. This goal, which we have generally met, includes the publication of complementary (but not always complimentary) 500 1000 word commentaries on a number of papers. To accomplish this alone the editorial board, and the reviewers, have been heroic, and deserve a huge round of applause. IOP Publishing too, has been truly wonderful in making this happen

  16. EDITORIAL: Celebrating one year of Environmental Research Letters

    NASA Astrophysics Data System (ADS)

    Kammen, Daniel M.

    2008-03-01

    The one-year anniversary is a critical milestone for a new journal. At that point there are enough articles published to begin to define the scope and readership, yet generally not enough of a track-record for the full community to regard the new entrant as a fixture and a source of 'must read' material. Environmental Research Letters (ERL) has set itself a particularly large and interesting challenge: to help connect the vast community of environmental researchers, practitioners, activists, and interested informed observers. ERL and its partner online resource base and community website, environmentalresearchweb, fills a major void: a single locus for rapid publication of peer-reviewed and highly interdisciplinary material spanning literally every aspect of environmental research and thought. The wide range of material that falls squarely into the purview of ERL—from restoration ecology to global change science and politics, to toxicology and environmental justice, to environmental and social impacts of energy conversion—illustrate just how diverse a 'community' we hope to serve. Thanks to an exceptional editorial staff and board, and a diverse range of fascinating contributed papers, ERL is off to a particularly fast start. ERL has both a small advisory board and a larger editorial board. The board serves several functions, beginning with the traditional one of taking the lead on reviews of papers in such a dizzying array of areas. This task alone is a challenge because of the commitment ERL has made to exceptionally rapid publication: a goal of 90 days from submission to online publication for accepted papers. This goal, which we have generally met, includes the publication of complementary (but not always complimentary) 500 1000 word commentaries on a number of papers. To accomplish this alone the editorial board, and the reviewers, have been heroic, and deserve a huge round of applause. IOP Publishing too, has been truly wonderful in making this happen

  17. Frequency of methicillin-resistant Staphylococcus aureus nasal colonization among patients suffering from methicillin resistant Staphylococcus aureus bacteraemia

    PubMed Central

    Aslam, Nadia; Izhar, Mateen; Mehdi, Naima

    2013-01-01

    Objective: To determine rate of nasal colonization in Patients suffering from bacteraemia caused by methicillin resistant Staphylococcus aureus. Methods: This descriptive cross sectional study was carried out in a tertiary ca re, University Teaching Hospital (Shaikh Zayed Hospital, Lahore) from October 2010 to August 2011. Nasal swabs were taken from patients suffering from MRSA bacteraemia and were plated on mannitol salt agar plates to isolate Staphylococcus aureus (S. aureus) which were then tested for oxacillin susceptibility. Results: Nasal colonization was present in 52.5% of patients suffering from MRSA bacteraemia. Conclusion: Nasal colonization rates with MRSA were high among patients suffering from MRSA bacteraemia especially in those undergoing dialysis or surgical procedures. Therefore, screening and nasal decolonization should be practiced in hospitals. PMID:24550968

  18. First report of Actinomyces europaeus bacteraemia result from a breast abscess in a 53-year-old man

    PubMed Central

    Nielsen, H.L.

    2015-01-01

    This is the first report of Actinomyces europaeus bacteraemia in a 53-year-old man. The bacteraemia was the result of a breast abscess. Identification was established by matrix-assisted desorption ionization–time of flight mass spectrometry and confirmed by 16S rRNA gene sequencing. The patient was treated with surgical drainage and penicillin for 4 weeks; the patient did not experience any relapse during 6 months of follow-up. PMID:26110063

  19. Determinants of pain and functioning in knee osteoarthritis: a one-year prospective study

    PubMed Central

    Helminen, Eeva-Eerika; Sinikallio, Sanna H; Valjakka, Anna L; Väisänen-Rouvali, Rauni H; Arokoski, Jari PA

    2016-01-01

    Objective: To identify predictors of pain and disability in knee osteoarthritis. Design: A one-year prospective analysis of determinants of pain and functioning in knee osteoarthritis. Study setting: Primary care providers in a medium-sized city. Patients: A total of 111 patients aged from 35 to 75 with clinical symptoms and radiographic grading (Kellgren-Lawrence 2–4) of knee osteoarthritis who participated in a randomized controlled trial. Main measures: The outcome measures were self-reported pain and function, which were recorded at 0, 3 and 12 months. Disease-specific pain and functioning were assessed using the pain and function subscales of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. Generic physical and mental functioning were assessed using the RAND-36 subscales for function, and physical and mental component summary scores. Possible baseline predictors for these outcomes were 1) demographic, socioeconomic and disease-related variables, and 2) psychological measures of resources, distress, fear of movement and catastrophizing. Results: Multivariate linear mixed model analyses revealed that normal mood at baseline measured with the Beck Anxiety Inventory predicted significantly better results in all measures of pain (WOMAC P=0.02) and function (WOMAC P=0.002, RAND-36 P=0.002) during the one-year follow-up. Psychological resource factors (pain self-efficacy P=0.012, satisfaction with life P=0.002) predicted better function (RAND-36). Pain catastrophizing predicted higher WOMAC pain levels (P=0.013), whereas fear of movement (kinesiophobia) predicted poorer functioning (WOMAC P=0.046, RAND-36 P=0.024). Conclusions: Multiple psychological factors in people with knee osteoarthritis pain are associated with the development of disability and longer term worse pain. PMID:27496698

  20. Non-typhoidal Salmonella bacteraemia: Epidemiology, clinical characteristics and its' association with severe immunosuppression

    PubMed Central

    Dhanoa, Amreeta; Fatt, Quek Kia

    2009-01-01

    Background Non-typhoidal Salmonella (NTS) is increasingly recognized as an important pathogen associated with bacteraemia especially in immunosuppressed patients. However, there is limited data specifically describing the clinical characteristics and outcome amongst the immunosuppressed patients. Methods A total of 56,707 blood culture samples and 5,450 stool samples were received by the microbiology laboratory at a tertiary referral hospital in Malaysia, during a 4-year study period. Out of these samples, 55 non-duplicate NTS isolates were identified from blood and 121 from stool. A retrospective analysis of the 55 patients with NTS bacteraemia was then conducted to determine the predominant NTS serovars causing bacteraemia and its' blood invasive potential, epidemiological data, clinical characteristics and antimicrobial susceptibility. Patients were then grouped as immunosuppressed and non-immunosuppressed to determine the association of severe immunosuppression on clinical features. Data was analyzed using the Statistical Package for Social Sciences (SPSS version 15.0) using the non-parametric Mann-Whitney test, Fisher's exact test or Chi-squared test. The odds ratio (OR) and its 95% confidence intervals (CI) were calculated. The P-value < 0.05 (two-tailed) was taken as the level of significance. Results Out of 55 NTS bacteraemia cases identified, 81.8% (45/55) were community-acquired. Salmonella enterica serovar Enteritidis had the highest blood invasiveness. An extra-intestinal focus of infection was noted in 30.9% (17/55) of the patients, most commonly involving the lungs and soft tissue. 90.9% (50/55) of the patients had an underlying disease and 65.5% (36/55) of the patients had severe clinical immunosuppressive condition with malignancy and HIV being the most common. Immunosuppressed patients had higher mortality (P = 0.04), presented more commonly with primary bacteraemia (P = 0.023), leukopenia (P = 0.001) and opportunistic infections (P = 0.01). In

  1. One Year Medical Outcomes and ED Recidivism Following ED Observation for Cocaine-Associated Chest Pain

    PubMed Central

    Cunningham, Rebecca; Walton, Maureen A.; Weber, Jim Edward; O'Broin, Samantha; Tripathi, Shanti P; Maio, Ronald F.; Booth, Brenda M.

    2010-01-01

    Chest pain is the most common complaint among cocaine users who present to the ED seeking care and many hospital resources are applied to stratify cocaine users in regard to future cardiac morbidity and mortality. Little is known about the longitudinal cardiac and non cardiac medical outcomes of cocaine users who have been stratified to an ED observation period following their ED visit. Objectives to examine one-year cardiac outcomes in a low-intermediate risk sample of patients with cocaine- associated chest pain in an urban ED, as well as to examine ED recidivism one year for cardiac and non-cardiac complaints. Methods Prospective consecutive cohort study of patients (18–60 years) who presented to an urban Level 1 ED with cocaine-associated chest pain and were risk stratified to low-intermediate cardiac risk. Exclusion criteria: EKG suggestive of AMI, elevated serum cardiac markers, history of AMI or CABG, hemodynamic instability, unstable angina. Baseline interviews using validated measures of health functioning, and substance use were conducted during CPOU stay, and 3, 6, and 12 months. ED utilization during the study year was abstracted from medical chart. Zero-Inflated Poisson regression analyses were conducted to predict recurrent ED visits. Results 219 participants (73% participation) were enrolled, 65% returned to the ED post index visit; 23% returned for chest pain, of these 66% had a positive cocaine urine screen. No patient had an AMI within the one year follow up period. Patients with continued cocaine use were more likely to have a recurrent ED visit (p<0.001) but these repeat visits were most often related to musculoskeletal pain (21%), and injury (30%) rather than potential cardiac complaints. Conclusions Patients with cocaine-associated chest pain who are low to intermediate cardiac risk and complete a CPOU protocol have less then 1% rate of MI in the subsequent 12-months. PMID:18824277

  2. Vascular graft infections and role of PET/CT in patients with persistent bacteraemia.

    PubMed

    Shahani, Lokesh

    2015-01-01

    Prosthetic vascular graft infection although a rare complication of vascular reconstruction surgery; has been associated with significant morbidity and mortality. The author presents two patients with prosthetic aortic graft presenting as fever and methicillin sensitive Staphylococcus aureus bacteraemia without any other localising sign of infection. Both patients had a history of postoperative wound infection after their graft placement. Patients remained persistently bacteraemic on appropriate antimicrobial therapy making the clinician suspicious of a vascular graft infection. A [18 F] fluoro-2-deoxy-d glucose positron emission tomography associated to CT scan was used to identify the prosthetic vascular graft infection and since both patients were high-risk surgical candidates, a conservative medical approach was used. They were treated with 6 weeks of nafcillin and rifampin, followed by long-term doxycycline for suppression. This highlights the importance of considering vascular graft infection in patients with recurrent and persistent bacteraemia despite adequate therapy. PMID:25777486

  3. The Effect of Breastfeeding and Stimulation in the Home on Cognitive Development in One-Year-Old Infants

    ERIC Educational Resources Information Center

    Sloan, Seaneen; Stewart, Moira; Dunne, Laura

    2010-01-01

    Research on the effects of breastfeeding on child cognitive development has produced conflicting results, and many studies do not account for infant stimulation in the home. The aim of this study is to determine whether breastfeeding predicts enhanced cognitive development in one-year-old infants after controlling for the main socio-economic and…

  4. Streptococcus gallinaceus bacteraemia in an abattoir worker presenting with a febrile illness.

    PubMed

    Balm, Michelle N D; Truong, Han T; Choudhary, Anwar S; Robinson, Geoffrey M; Blackmore, Timothy K

    2006-07-01

    Streptococcus gallinaceus is a newly described species of viridans streptococci, previously only identified as causing disease in broiler chickens. This organism was recovered in pure culture from blood taken from a New Zealand abattoir worker presenting with a febrile illness. This first report of bacteraemia caused by S. gallinaceus in a human may help the understanding of the ecology of this recently described organism. PMID:16772426

  5. Staphylococcus aureus Bacteraemia in a Tropical Setting: Patient Outcome and Impact of Antibiotic Resistance

    PubMed Central

    Nickerson, Emma K.; Hongsuwan, Maliwan; Limmathurotsakul, Direk; Wuthiekanun, Vanaporn; Shah, Krupal R.; Srisomang, Pramot; Mahavanakul, Weera; Wacharaprechasgul, Therapon; Fowler, Vance G.; West, T. Eoin; Teerawatanasuk, Nitaya; Becher, Harald; White, Nicholas J.; Chierakul, Wirongrong; Day, Nicholas P.; Peacock, Sharon J.

    2009-01-01

    Background Most information on invasive Staphylococcus aureus infections comes from temperate countries. There are considerable knowledge gaps in epidemiology, treatment, drug resistance and outcome of invasive S. aureus infection in the tropics. Methods A prospective, observational study of S. aureus bacteraemia was conducted in a 1000-bed regional hospital in northeast Thailand over 1 year. Detailed clinical data were collected and final outcomes determined at 12 weeks, and correlated with antimicrobial susceptibility profiles of infecting isolates. Principal Findings Ninety-eight patients with S. aureus bacteraemia were recruited. The range of clinical manifestations was similar to that reported from temperate countries. The prevalence of endocarditis was 14%. The disease burden was highest at both extremes of age, whilst mortality increased with age. The all-cause mortality rate was 52%, with a mortality attributable to S. aureus of 44%. Methicillin-resistant S. aureus (MRSA) was responsible for 28% of infections, all of which were healthcare-associated. Mortality rates for MRSA and methicillin-susceptible S. aureus (MSSA) were 67% (18/27) and 46% (33/71), respectively (p = 0.11). MRSA isolates were multidrug resistant. Only vancomycin or fusidic acid would be suitable as empirical treatment options for suspected MRSA infection. Conclusions S. aureus is a significant pathogen in northeast Thailand, with comparable clinical manifestations and a similar endocarditis prevalence but higher mortality than industrialised countries. S. aureus bacteraemia is frequently associated with exposure to healthcare settings with MRSA causing a considerable burden of disease. Further studies are required to define setting-specific strategies to reduce mortality from S. aureus bacteraemia, prevent MRSA transmission, and to define the burden of S. aureus disease and emergence of drug resistance throughout the developing world. PMID:19180198

  6. 12 CFR 336.12 - One-year post-employment restriction.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false One-year post-employment restriction. 336.12... GENERAL POLICY FDIC EMPLOYEES One-Year Restriction on Post-Employment Activities of Senior Examiners § 336.12 One-year post-employment restriction. (a) Prohibition. An officer or employee of the FDIC...

  7. 12 CFR 336.12 - One-year post-employment restriction.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 5 2012-01-01 2012-01-01 false One-year post-employment restriction. 336.12... GENERAL POLICY FDIC EMPLOYEES One-Year Restriction on Post-Employment Activities of Senior Examiners § 336.12 One-year post-employment restriction. (a) Prohibition. An officer or employee of the FDIC...

  8. 12 CFR 336.12 - One-year post-employment restriction.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false One-year post-employment restriction. 336.12... GENERAL POLICY FDIC EMPLOYEES One-Year Restriction on Post-Employment Activities of Senior Examiners § 336.12 One-year post-employment restriction. (a) Prohibition. An officer or employee of the FDIC...

  9. 12 CFR 4.74 - One-year post-employment restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false One-year post-employment restrictions. 4.74... RESTRICTIONS FOR SENIOR EXAMINERS One-Year Restrictions on Post-Employment Activities of Senior Examiners § 4.74 One-year post-employment restrictions. An officer or employee of the OCC who serves as the...

  10. 12 CFR 4.74 - One-year post-employment restrictions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 1 2011-01-01 2011-01-01 false One-year post-employment restrictions. 4.74... RESTRICTIONS FOR SENIOR EXAMINERS One-Year Restrictions on Post-Employment Activities of Senior Examiners § 4.74 One-year post-employment restrictions. An officer or employee of the OCC who serves as the...

  11. 12 CFR 4.74 - One-year post-employment restrictions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 1 2013-01-01 2013-01-01 false One-year post-employment restrictions. 4.74... RESTRICTIONS FOR SENIOR EXAMINERS One-Year Restrictions on Post-Employment Activities of Senior Examiners § 4.74 One-year post-employment restrictions. An officer or employee of the OCC who serves as the...

  12. Case-case-control study on factors associated with vanB vancomycin-resistant and vancomycin-susceptible enterococcal bacteraemia

    PubMed Central

    2014-01-01

    Background Enterococci are a major cause of healthcare-associated infection. In Australia, vanB vancomycin-resistant enterococci (VRE) is the predominant genotype. There are limited data on the factors linked to vanB VRE bacteraemia. This study aimed to identify factors associated with vanB VRE bacteraemia, and compare them with those for vancomycin-susceptible enterococci (VSE) bacteraemia. Methods A case-case-control study was performed in two tertiary public hospitals in Victoria, Australia. VRE and VSE bacteraemia cases were compared with controls without evidence of enterococcal bacteraemia, but may have had infections due to other pathogens. Results All VRE isolates had vanB genotype. Factors associated with vanB VRE bacteraemia were urinary catheter use within the last 30 days (OR 2.86, 95% CI 1.09-7.53), an increase in duration of metronidazole therapy (OR 1.65, 95% CI 1.17-2.33), and a higher Chronic Disease Score specific for VRE (OR 1.70, 95% CI 1.05-2.77). Factors linked to VSE bacteraemia were a history of gastrointestinal disease (OR 2.29, 95% CI 1.05-4.99) and an increase in duration of metronidazole therapy (OR 1.23, 95% CI 1.02-1.48). Admission into the haematology/oncology unit was associated with lower odds of VSE bacteraemia (OR 0.08, 95% CI 0.01-0.74). Conclusions This is the largest case-case-control study involving vanB VRE bacteraemia. Factors associated with the development of vanB VRE bacteraemia were different to those of VSE bacteraemia. PMID:24973797

  13. Descriptive epidemiology of Escherichia coli bacteraemia in England, April 2012 to March 2014.

    PubMed

    Bou-Antoun, Sabine; Davies, John; Guy, Rebecca; Johnson, Alan P; Sheridan, Elizabeth A; Hope, Russell J

    2016-09-01

    We determined the incidence, risk factors and antimicrobial susceptibility associated with Escherichia coli bacteraemia in England over a 24 month period. Case data were obtained from the national mandatory surveillance database, with susceptibility data linked from LabBase2, a voluntary national microbiology database. Between April 2012 and March 2014, 66,512 E. coli bacteraemia cases were reported. Disease incidence increased by 6% from 60.4 per 100,000 population in 2012-13 to 63.5 per 100,000 population in 2013-14 (p < 0.0001). Rates of E. coli bacteraemia varied with patient age and sex, with 70.5% (46,883/66,512) of cases seen in patients aged ≥ 65 years and 52.4% (33,969/64,846) of cases in females. The most common underlying cause of bacteraemia was infection of the genital/urinary tract (41.1%; 27,328/66,512), of which 98.4% (26,891/27,328) were urinary tract infections (UTIs). The majority of cases (76.1%; 50,617/66,512) had positive blood cultures before or within two days of admission and were classified as community onset cases, however 15.7% (10,468/66,512) occurred in patients who had been hospitalised for over a week. Non-susceptibility to ciprofloxacin, third-generation cephalosporins, piperacillin-tazobactam, gentamicin and carbapenems were 18.4% (8,439/45,829), 10.4% (4,256/40,734), 10.2% (4,694/46,186), 9.7% (4,770/49,114) and 0.2% (91/42,986), respectively. Antibiotic non-susceptibility was higher in hospital-onset cases than for those presenting from the community (e.g. ciprofloxacin non-susceptibility was 22.1% (2,234/10,105) for hospital-onset vs 17.4% (5,920/34,069) for community-onset cases). Interventions to reduce the incidence of E. coli bacteraemia will have to target the community setting and UTIs if substantial reductions are to be realised. PMID:27608263

  14. Bacteraemia during Transurethral Resection of the Prostate: What Are the Risk Factors and Is It More Common than We Think?

    PubMed Central

    West, Robert; Bhattarai, Selina; Eardley, Ian; Sandoe, Jonathan A. T.

    2016-01-01

    The aim of this work was to investigate the microbial causes, incidence, duration, risk factors and clinical implications of bacteraemia occurring during transurethral resection of the prostate (TURP) surgery to better inform prophylaxis strategies. An ethically approved, prospective, cohort study of patients undergoing TURP was conducted. Clinical information and follow-up details were collected using standardized data collection sheets. Blood was obtained for culture at 6 different time points peri-procedure. Standard of care antibiotic prophylaxis was given prior to surgery. Bacteriuria was assessed in a pre-procedure urine sample. Histopathology from all prostate chips was assessed for inflammation and malignancy. 73 patients were consented and 276 blood samples obtained. No patients developed symptomatic bacteraemia during the procedure, 17 patients developed asymptomatic bacteraemia (23.2%). Enterococcus faecalis and Pseudomonas aeruginosa were the most common organisms cultured. 10 minutes after the start of the TURP, the odds ratio (OR) of developing bacteraemia was 5.38 (CI 0.97–29.87 p = 0.05), and 20 minutes after the start of the procedure, the OR was 6.46 (CI 1.12–37.24, p = 0.03), compared to before the procedure. We also found an association between the development of intra-operative bacteraemia and recent antibiotic use (OR 4.34, CI 1.14–16.62, p = 0.032), the presence of a urinary catheter (OR 4.92, CI 1.13–21.51, p = 0.034) and a malignant histology (OR 4.90, CI 1.30–18.46, p = 0.019). There was no statistical relationship between pre-operative urine culture results and blood culture results. This study shows that asymptomatic bacteraemia is commonly caused by TURP and occurs in spite of antibiotic prophylaxis. Our findings challenge the commonly held view that urine is the primary source of bacteraemia in TURP-associated sepsis and raise the possibility of occult prostatic infection as a cause of bacteraemia. More work will be needed to

  15. Preoperative administration of 0.2% chlorhexidine mouthrinse reduces the risk of bacteraemia associated with intra-alveolar tooth extraction.

    PubMed

    Ugwumba, Chinedu U; Adeyemo, Wasiu L; Odeniyi, Olalekan M; Arotiba, Godwin T; Ogunsola, Folasade T

    2014-12-01

    The aim of the study was to investigate the effect of preoperative 0.2% chlorhexidine mouthwash on the risk of bacteraemia following routine intra-alveolar tooth extraction. The study was a randomized controlled clinical study of 101 subjects who underwent intra-alveolar dental extractions under local anaesthesia. Subjects were randomly assigned to either chlorhexidine or a control group. The chlorhexidine group had 0.2% chlorhexidine mouthwash administered for 1 min before any dental manipulation, and the control group had a mouthrinse of sterile water. Blood samples were collected at baseline, 1 min and 15 min after the dental extractions. Subculture and further identification of the isolated bacteria were performed by conventional microbiological techniques. There was a statistically significant difference in the incidence of bacteraemia between the control group (52.4%) and chlorhexidine group (27.1%) (P = 0.012). Bacteraemia was most frequently detected at 1 min after extraction (33.3%). Of the 30 subjects who had positive blood culture at 1 min, bacteraemia persisted in 8 (26.7%) of the subjects after 15 min. Bacteria isolated included Staphylococcus aureus, Actinomycetes naesulendi, Prevotella species, Streptococcus spp., and Acinetobacter iwoffii. Routine use of 0.20% chlorhexidine mouthwash before dental extraction is recommended to reduce the risk of bacteraemia following tooth extraction. PMID:25028067

  16. 29 CFR 2530.200b-4 - One-year break in service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false One-year break in service. 2530.200b-4 Section 2530.200b-4... General Provisions § 2530.200b-4 One-year break in service. (a) Computation period. (1) Under sections 202... that an employee incurs a one-year break in service for a computation period or periods if the...

  17. 29 CFR 2530.200b-4 - One-year break in service.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false One-year break in service. 2530.200b-4 Section 2530.200b-4... General Provisions § 2530.200b-4 One-year break in service. (a) Computation period. (1) Under sections 202... that an employee incurs a one-year break in service for a computation period or periods if the...

  18. 29 CFR 2530.200b-4 - One-year break in service.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false One-year break in service. 2530.200b-4 Section 2530.200b-4... General Provisions § 2530.200b-4 One-year break in service. (a) Computation period. (1) Under sections 202... that an employee incurs a one-year break in service for a computation period or periods if the...

  19. 29 CFR 2530.200b-4 - One-year break in service.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false One-year break in service. 2530.200b-4 Section 2530.200b-4... General Provisions § 2530.200b-4 One-year break in service. (a) Computation period. (1) Under sections 202... that an employee incurs a one-year break in service for a computation period or periods if the...

  20. 29 CFR 2530.200b-4 - One-year break in service.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false One-year break in service. 2530.200b-4 Section 2530.200b-4... General Provisions § 2530.200b-4 One-year break in service. (a) Computation period. (1) Under sections 202... that an employee incurs a one-year break in service for a computation period or periods if the...

  1. One-year status of homeless mentally ill clients who completed a transitional residential program.

    PubMed

    Murray, R; Baier, M; North, C; Lato, M; Eskew, C

    1997-02-01

    Of 228 homeless, severely persistently mentally ill clients admitted within a 5 1/2 year period to a transitional residential program, 179 (79%) remained in contact with staff for at least one year post-discharge. Housing was maintained by 141 (78%) of the clients for at least one year. Entitlements increased from admission, to discharge, to one year post-discharge. Clients maintaining contact for at least one year post-discharge were likely to have participated in two or more day treatment programs during residence. Success of the Program may be partly attributed to the staff's vigilance in maintaining post-discharge client contact. PMID:9061262

  2. Empirical third-generation cephalosporin therapy for adults with community-onset Enterobacteriaceae bacteraemia: Impact of revised CLSI breakpoints.

    PubMed

    Hsieh, Chih-Chia; Lee, Chung-Hsun; Li, Ming-Chi; Hong, Ming-Yuan; Chi, Chih-Hsien; Lee, Ching-Chi

    2016-04-01

    Third-generation cephalosporins (3GCs) [ceftriaxone (CRO) and cefotaxime (CTX)] have remarkable potency against Enterobacteriaceae and are commonly prescribed for the treatment of community-onset bacteraemia. However, clinical evidence supporting the updated interpretive criteria of the Clinical and Laboratory Standards Institute (CLSI) is limited. Adults with community-onset monomicrobial Enterobacteriaceae bacteraemia treated empirically with CRO or CTX were recruited. Clinical information was collected from medical records and CTX MICs were determined using the broth microdilution method. Eligible patients (n=409) were categorised into de-escalation (260; 63.6%), no switch (115; 28.1%) and escalation (34; 8.3%) groups according to the type of definitive antibiotics. Multivariate regression revealed five independent predictors of 28-day mortality: fatal co-morbidities based on McCabe classification [odds ratio (OR)=19.96; P<0.001]; high Pitt bacteraemia score (≥4) at bacteraemia onset (OR=13.91; P<0.001); bacteraemia because of pneumonia (OR=5.45; P=0.007); de-escalation after empirical therapy (OR=0.28; P=0.03); and isolates with a CTX MIC≤1mg/L (OR=0.17; P=0.02). Of note, isolates with a CTX MIC≤8mg/L (indicated as susceptible by previous CLSI breakpoints) were not associated with mortality. Furthermore, clinical failure and 28-day mortality rates had a tendency to increase with increasing CTX MIC (γ=1.00; P=0.01). Conclusively, focusing on patients with community-onset Enterobacteriaceae bacteraemia receiving empirical 3GC therapy, the present study provides clinically critical evidence to validate the proposed reduction in the susceptibility breakpoint of CTX to MIC≤1mg/L. PMID:27005458

  3. C10X polymorphism in the CARD8 gene is associated with bacteraemia

    PubMed Central

    Asfaw Idosa, Berhane; Sahdo, Berolla; Balcha, Ermias; Kelly, Anne; Söderquist, Bo; Särndahl, Eva

    2014-01-01

    The NLRP3 inflammasome is an intracellular multi-protein complex that triggers caspase-1 mediated maturation of interleukin-1β (IL-1β); one of the most potent mediators of inflammation and a major cytokine produced during severe infections, like sepsis. However, the excessive cytokine levels seem to stage for tissue injury and organ failure, and high levels of IL-1β correlates with severity and mortality of sepsis. Instead, recent data suggest caspase-1 to function as a guardian against severe infections. CARD8 has been implied to regulate the synthesis of IL-1β via interaction to caspase-1. In recent years, polymorphism of CARD8 (C10X) per se or in combination with NLRP3 (Q705K) has been implicated with increased risk of inflammation. The aim was to investigate the correlation of these polymorphisms with severe blood stream infection. Human DNA was extracted from blood culture bottles that were found to be positive for microbial growth (i.e. patients with bacteraemia). Polymorphisms Q705K in the NLRP3 gene and C10X in the CARD8 gene were genotyped using TaqMan genotyping assay. The results were compared to healthy controls and to samples from patients with negative cultures. The polymorphism C10X was significantly over-represented among patients with bacteraemia as compared to healthy controls, whereas patients with negative blood culture were not associated with a higher prevalence. No association was observed with polymorphism Q705K of NLRP3 in either group of patients. Patients carrying polymorphism C10X in the CARD8 gene are at increased risk of developing bacteraemia and severe inflammation. PMID:25400921

  4. [Follow-up after non-typhoidal Salmonella bacteraemia is important due to risk of endovascular infection].

    PubMed

    Sydenham, Thomas Vognbjerg; Andersen, Åse Bengård

    2015-01-26

    An 81-year-old male with atherosclerosis had an episode of bacteraemia with Salmonella dublin six weeks prior to admission to hospital. He presented with confusion, fever and abdominal pain. Blood cultures revealed S. dublin, and an 18F-fluor deoxyglucose positron emission tomography/computed tomography showed aortitis. Ceftriaxon and ciprofloxacin was administered. The patient was not a candidate for surgery and two weeks later he died from multiple organ failure. Follow-up visits with blood cultures after the first bacteraemia episode might have allowed for earlier diagnosis of the relapse. PMID:25612984

  5. Flavimonas oryzihabitans (CDC group Ve-2) bacteraemia associated with Hickman catheters.

    PubMed

    Conlu, A; Rothman, J; Staszewski, H; Schoch, P E; Domenico, P; Quadri, S M; Cunha, B A

    1992-04-01

    Flavimonas oryzihabitans is a potential pathogen that may infect patients who have major medical illnesses, especially those who are undergoing surgery or have indwelling venous catheters in situ. Flavimonas oryzihabitans has been isolated from a wide range of body sites, and the portals of entry are major wounds or implanted foreign materials. We report two cases of F. oryzihabitans bacteraemia associated with the use of Hickman catheters for administration of the patients' chemotherapeutic agents. However, a common source for these infections could not be demonstrated. PMID:1350605

  6. Catheter-related bacteraemia and infective endocarditis caused by Kocuria species.

    PubMed

    Lai, C C; Wang, J Y; Lin, S H; Tan, C K; Wang, C Y; Liao, C H; Chou, C H; Huang, Y T; Lin, H I; Hsueh, P R

    2011-02-01

    We describe five patients with positive blood culture for Kocuria species. Three patients had catheter-related bacteraemia and one had infective endocarditis caused by Kocuria kristinae, and one had a K. marina isolate, which was considered to be a contaminant. Identification of the isolates was further confirmed by 16S rRNA gene sequence analysis. In conclusion, Kocuria species are an unusual cause of infection in immunocompromised patients. Accurate identification with molecular methods is imperative for the diagnosis of these unusual pathogens. PMID:20218989

  7. 12 CFR 4.74 - One-year post-employment restrictions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 1 2012-01-01 2012-01-01 false One-year post-employment restrictions. 4.74... FUNCTIONS, AVAILABILITY AND RELEASE OF INFORMATION, CONTRACTING OUTREACH PROGRAM, POST-EMPLOYMENT RESTRICTIONS FOR SENIOR EXAMINERS One-Year Restrictions on Post-Employment Activities of Senior Examiners §...

  8. 12 CFR 336.12 - One-year post-employment restriction.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 5 2013-01-01 2013-01-01 false One-year post-employment restriction. 336.12 Section 336.12 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF....12 One-year post-employment restriction. (a) Prohibition. An officer or employee of the FDIC...

  9. 12 CFR 336.12 - One-year post-employment restriction.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false One-year post-employment restriction. 336.12 Section 336.12 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF....12 One-year post-employment restriction. (a) Prohibition. An officer or employee of the FDIC...

  10. 77 FR 9664 - Funds for Leadership Training in Pediatric Dentistry's Current Grantees; One-Year Extension

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-17

    ... Dentistry's Current Grantees; One-Year Extension AGENCY: Health Resources and Services Administration (HRSA... Pediatric Dentistry's (T17) Current Grantees. SUMMARY: The Health Resources and Services Administration... a one-year project period. CFDA Number: 93.110. Current Project Period: 7/1/2007 through...

  11. Differences in American and Korean Evaluations of One-Year Age Differences

    ERIC Educational Resources Information Center

    Lim, Tae-Seop; Giles, Howard

    2007-01-01

    This study examined the extent to which a one-year difference in age can influence college students' reported communicative behaviours in both the USA and South Korea. Korean students differentiated themselves far more than their American counterparts from other students one-year older or younger than themselves. The former reported that students…

  12. The utility of procalcitonin in the prediction of serious bacterial infection in a tertiary paediatric intensive care unit.

    PubMed

    Sm, Matha; Sn, Rahiman; Bg, Gelbart; Td, Duke

    2016-09-01

    To determine utility of procalcitonin (PCT) for the prediction of bacterial infection in critically ill children, we analysed the relationship between serum PCT, cultures and other laboratory markers of bacterial sepsis or viral infection in a tertiary paediatric intensive care unit (PICU). The outcome measures were levels of PCT in proven bacteraemia, pneumonia and viral respiratory infection; and comparison of PCT to immature to total neutrophil ratio (ITR) in prediction of bacteraemia. In 420 children with suspected sepsis, 1,226 serum PCT levels were analysed. Children with bacteraemia had a higher median PCT (2.03 ng/ml, interquartile range [IQR] 0.67-42.4) than those who did not have bacteraemia (0.82 ng/ml, IQR 0.295-2.87) (P=0.033). PCT was a significant but only moderate predictor of bacteraemia (AUC 0.65). In 866 episodes of suspected sepsis where paired PCT and ITR were performed, the median ITR in children with bacteraemia was 0.19 ng/ml (IQR 0.04-0.35), and the median PCT was 6.5 ng/ml (IQR 0.71-61.8). PCT was a marginally better predictor of bacteraemia (AUC 0.69) than the ITR (AUC 0.66). In children with viral respiratory tract infection only, the median PCT was 1.26 ng/ml (0.35-5.5), and in those with likely bacterial pneumonia the median PCT was 0.80 ng/ml (IQR 0.28-1.70). In a heterogeneous population of children in a tertiary PICU, PCT measured at a single timepoint was a moderate predictor of proven bacteraemia. In our population PCT did not reliably identify localised bacterial infection or distinguish bacterial from viral respiratory infection. PMID:27608345

  13. Comparison of the detection of periodontal pathogens in bacteraemia after tooth brushing by culture and molecular techniques

    PubMed Central

    Figuero, Elena; González, Itziar; O´Connor, Ana; Diz, Pedro; Álvarez, Maximiliano; Herrera, David; Sanz, Mariano

    2016-01-01

    Background The prevalence and amounts of periodontal pathogens detected in bacteraemia samples after tooth brushing-induced by means of four diagnostic technique, three based on culture and one in a molecular-based technique, have been compared in this study. Material and Methods Blood samples were collected from thirty-six subjects with different periodontal status (17 were healthy, 10 with gingivitis and 9 with periodontitis) at baseline and 2 minutes after tooth brushing. Each sample was analyzed by three culture-based methods [direct anaerobic culturing (DAC), hemo-culture (BACTEC), and lysis-centrifugation (LC)] and one molecular-based technique [quantitative polymerase chain reaction (qPCR)]. With culture any bacterial isolate was detected and quantified, while with qPCR only Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans were detected and quantified. Descriptive analyses, ANOVA and Chi-squared tests, were performed. Results Neither BACTEC nor qPCR detected any type of bacteria in the blood samples. Only LC (2.7%) and DAC (8.3%) detected bacteraemia, although not in the same patients. Fusobacterium nucleatum was the most frequently detected bacterial species. Conclusions The disparity in the results when the same samples were analyzed with four different microbiological detection methods highlights the need for a proper validation of the methodology to detect periodontal pathogens in bacteraemia samples, mainly when the presence of periodontal pathogens in blood samples after tooth brushing was very seldom. Key words:Bacteraemia, periodontitis, culture, PCR, tooth brushing. PMID:26946197

  14. Vibrio cholerae non-O1 bacteraemia: description of three cases in the Netherlands and a literature review.

    PubMed

    Engel, Madelon F; Muijsken, Mariette A; Mooi-Kokenberg, Esther; Kuijper, Ed J; van Westerloo, David J

    2016-04-14

    Vibrio cholerae non-O1 serogroup (VCNO) bacteraemia is a severe condition with a high case-fatality rate. We report three cases diagnosed in the Netherlands, identified during a national microbiological congress, and provide a literature review on VCNO bacteraemia. A search strategy including synonyms for 'VCNO' and 'bacteraemia' was applied to PubMed, Medline, Web of Science and Embase databases. The three cases were reported in elderly male patients after fish consumption and/or surface water contact. The literature search yielded 82 case reports on 90 cases and six case series. Thirty case reports were from Asia (30/90; 33%), concerned males (67/90; 74%), and around one third (38/90; 42%) involved a history of alcohol abuse and/or liver cirrhosis The presenting symptom often was gastroenteritis (47/90; 52%) which occurred after seafood consumption in 32% of the cases (15/47).Aside from the most frequent symptom being fever, results of case series concurred with these findings. Published cases also included rare presentations e.g. endophthalmitis and neonatal meningitis. Based on the limited data available, cephalosporins seemed the most effective treatment. Although mainly reported in Asia, VCNO bacteraemia occurs worldwide. While some risk factors for VCNO were identified in this study, the source of infection remains often unclear. Clinical presentation may vary greatly and therefore a quick microbiological diagnosis is indispensable. PMID:27104237

  15. Persistent bacteraemia due to methicillin-resistant Staphylococcus aureus with reduced susceptibility to vancomycin in a patient with erythrodermic psoriasis.

    PubMed

    Bakri, Faris G; Al-Hommos, Nisreen Abu; Shehabi, Asem; Naffa, Randa G; Cui, Longzhu; Hiramatsu, Keiich

    2007-01-01

    A 49-y-old male with erythrodermic psoriasis developed persistent bacteraemia for 3 months due to methicillin-resistant Staphylococcus aureus despite antimicrobial therapy. The skin was the likely focus. Three consecutive isolates from the blood and 1 from the nose were identical and had vancomycin MIC of 4 mg/l. PMID:17464871

  16. 10 to 1: Bugs Win in NASA Study, One-Year Mission Video Miniseries Highlights Microbes

    NASA Video Gallery

    Bugs are winning out, and that’s a good thing according to NASA’s Human Research Program. As part of NASA’s One-Year Mission, researchers are studying how microbes living on astronauts’ skin, insid...

  17. One-Year Mortality in Older Patients with Cancer: Development and External Validation of an MNA-Based Prognostic Score

    PubMed Central

    Bourdel-Marchasson, Isabelle; Diallo, Abou; Bellera, Carine; Blanc-Bisson, Christelle; Durrieu, Jessica; Germain, Christine; Mathoulin-Pélissier, Simone; Soubeyran, Pierre; Rainfray, Muriel; Fonck, Mariane; Doussau, Adelaïde

    2016-01-01

    Purpose The MNA (Mini Nutritional Assessment) is known as a prognosis factor in older population. We analyzed the prognostic value for one-year mortality of MNA items in older patients with cancer treated with chemotherapy as the basis of a simplified prognostic score. Methods The prospective derivation cohort included 606 patients older than 70 years with an indication of chemotherapy for cancers. The endpoint to predict was one-year mortality. The 18 items of the Full MNA, age, gender, weight loss, cancer origin, TNM, performance status and lymphocyte count were considered to construct the prognostic model. MNA items were analyzed with a backward step-by-step multivariate logistic regression and other items were added in a forward step-by-step regression. External validation was performed on an independent cohort of 229 patients. Results At one year 266 deaths had occurred. Decreased dietary intake (p = 0.0002), decreased protein-rich food intake (p = 0.025), 3 or more prescribed drugs (p = 0.023), calf circumference <31cm (p = 0.0002), tumor origin (p<0.0001), metastatic status (p = 0.0007) and lymphocyte count <1500/mm3 (0.029) were found to be associated with 1-year mortality in the final model and were used to construct a prognostic score. The area under curve (AUC) of the score was 0.793, which was higher than the Full MNA AUC (0.706). The AUC of the score in validation cohort (229 subjects, 137 deaths) was 0.698. Conclusion Key predictors of one-year mortality included cancer cachexia clinical features, comorbidities, the origin and the advanced status of the tumor. The prognostic value of this model combining a subset of MNA items and cancer related items was better than the full MNA, thus providing a simple score to predict 1-year mortality in older patients with an indication of chemotherapy. PMID:26859298

  18. The Social Origins of Sustained Attention in One-Year-Old Human Infants.

    PubMed

    Yu, Chen; Smith, Linda B

    2016-05-01

    The ability to sustain attention is a major achievement in human development and is generally believed to be the developmental product of increasing self-regulatory and endogenous (i.e., internal, top-down, voluntary) control over one's attention and cognitive systems [1-5]. Because sustained attention in late infancy is predictive of future development, and because early deficits in sustained attention are markers for later diagnoses of attentional disorders [6], sustained attention is often viewed as a constitutional and individual property of the infant [6-9]. However, humans are social animals; developmental pathways for seemingly non-social competencies evolved within the social group and therefore may be dependent on social experience [10-13]. Here, we show that social context matters for the duration of sustained attention episodes in one-year-old infants during toy play. Using head-mounted eye tracking to record moment-by-moment gaze data from both parents and infants, we found that when the social partner (parent) visually attended to the object to which infant attention was directed, infants, after the parent's look, extended their duration of visual attention to the object. Looks to the same object by two social partners is a well-studied phenomenon known as joint attention, which has been shown to be critical to early learning and to the development of social skills [14, 15]. The present findings implicate joint attention in the development of the child's own sustained attention and thus challenge the current understanding of the origins of individual differences in sustained attention, providing a new and potentially malleable developmental pathway to the self-regulation of attention. PMID:27133869

  19. One year of vertical wind profiles measurements at a Mediterranean coastal site of South Italy

    NASA Astrophysics Data System (ADS)

    Calidonna, Claudia Roberta; Avolio, Elenio; Federico, Stefano; Gullì, Daniel; Lo Feudo, Teresa; Sempreviva, Anna Maria

    2015-04-01

    In order to develop wind farms projects is challenging to site them on coastal areas both onshore and offshore as suitable sites. Developing projects need high quality databases under a wide range of atmospheric conditions or high resolution models that could resolve the effect of the coastal discontinuity in the surface properties. New parametrizations are important and high quality databases are also needed for formulating them. Ground-based remote sensing devices such as lidars have been shown to be functional for studying the evolution of the vertical wind structure coastal atmospheric boundary layer both on- and offshore. Here, we present results from a year of vertical wind profiles, wind speed and direction, monitoring programme at a site located in the Italian Calabria Region, Central Mediterranean, 600m from the Thyrrenian coastline, where a Lidar Doppler, ZephIr (ZephIr ltd) has been operative since July 2013. The lidar monitors wind speed and direction from 10m up to 300m at 10 vertical levels with an average of 10 minutes and it is supported by a metmast providing: Atmospheric Pressure, Solar Radiation, Precipitation, Relative Humidity, Temperature,Wind Speed and Direction at 10m. We present the characterization of wind profiles during one year period according to the time of the day to transition periods night/day/night classified relating the local scale, breeze scale, to the large scale conditions. The dataset is also functional for techniques for short-term prediction of wind for the renewable energy integration in the distribution grids. The site infrastructure is funded within the Project "Infrastructure of High Technology for Environmental and Climate Monitoring" (I-AMICA) (PONa3_00363) by the Italian National Operative Program (PON 2007-2013) and European Regional Development Fund. Real-time data are show on http://www.i-amica.it/i-amica/?page_id=1122.

  20. Trio of stellar occultations by Pluto One Year Prior to New Horizons' Arrival

    NASA Astrophysics Data System (ADS)

    Pasachoff, Jay M.; Person, Michael J.; Bosh, Amanda S.; Gulbis, Amanda A. S.; Zuluaga, Carlos A.; Levine, Stephen; Osip, David J.; Schiff, Adam R.; Seeger, Christina H.; Babcock, Bryce A.; Rojo, Patricio; Kosiarek, Molly R.; Servajean, Elise

    2015-01-01

    Our campaign in July 2014 yielded three successful stellar occultations (~m=15, 17, and 18) of Pluto (~m=14), observed from telescopes in New Zealand, Australia, and Chile. Telescopes involved included Chile: Magellan's Clay (6.5 m), SOAR (4.1 m), Carnegie's DuPont (2.4 m); Australia: AAT (4 m); and Canterbury's Mt. John McLellan (1-m); as well as various smaller telescopes in Australia and Chile. One of the events was also observed, with negative results, from GROND on La Silla (2.2 m) and SMARTS's ANDICAM at CTIO (1.3 m). Though our observations were coordinated across continents, each successfully observed event was seen from only one site because of bad weather at the other sites. Two of the events were uniquely observed from Mt. John (Pasachoff et al., DPS 2014) and one, with only Chile sites in the predicted path, from the Clay (Person et al., DPS 2014). This last event was expected to be of the brightest star with the largest telescope we have ever observed for a Pluto occultation, but clouds arrived at the 6.5-m Clay 90 s before the predicted time; a 1% occultation was nonetheless seen and eventually, confirmed by Keck AO observations, to be of a 15th magnitude star previously hidden in the brightness of the 12th mag star. Our scientific conclusion is that as of these observations, one year before New Horizons' passage of Pluto, the atmosphere of Pluto remained robust and of the same size. Details on our analysis of the three events will be presented.Acknowledgments: This work was supported in part by NASA Planetary Astronomy grants to Williams College (NNX12AJ29G) and to MIT (NNX10AB27G), as well as grants from USRA (#8500-98-003) and Ames Research (#NAS2-97-01) to Lowell Observatory. A.R.S. was supported by NSF grant AST-1005024 for the Keck Northeast Astronomy Consortium REU, with partial support from U.S. DoD's ASSURE program. P.R. acknowledges support from FONDECYT through grant 1120299. J.M.P. thanks Andrew Ingersoll and Caltech Planetary Astronomy

  1. Baseline peripheral refractive error and changes in axial refraction during one year in a young adult population

    PubMed Central

    Hartwig, Andreas; Charman, William Neil; Radhakrishnan, Hema

    2015-01-01

    Purpose To determine whether the initial characteristics of individual patterns of peripheral refraction relate to subsequent changes in refraction over a one-year period. Methods 54 myopic and emmetropic subjects (mean age: 24.9 ± 5.1 years; median 24 years) with normal vision were recruited and underwent conventional non-cycloplegic subjective refraction. Peripheral refraction was also measured at 5° intervals over the central 60° of horizontal visual field, together with axial length. After one year, measurements of subjective refraction and axial length were repeated on the 43 subjects who were still available for examination. Results In agreement with earlier studies, higher myopes tended to show greater relative peripheral hyperopia. There was, however, considerable inter-subject variation in the pattern of relative peripheral refractive error (RPRE) at any level of axial refraction. Across the group, mean one-year changes in axial refraction and axial length did not differ significantly from zero. There was no correlation between changes in these parameters for individual subjects and any characteristic of their RPRE. Conclusion No evidence was found to support the hypothesis that the pattern of RPRE is predictive of subsequent refractive change in this age group. PMID:26188389

  2. Trends in relative weight over one year in low-income urban youth

    PubMed Central

    Lawman, Hannah G; Mallya, Giridhar; Veur, Stephanie Vander; McCoy, Tara; Colby, Lisa; Sanders, Tim; Wylie-Rosett, Judith; Foster, Gary D.

    2015-01-01

    Objective Recent cross-sectional data indicate the rates of childhood obesity are plateauing. Few large-scale longitudinal datasets exist, particularly in low-income and minority youth. The purpose of the current study was to describe longitudinal changes in relative weight among a large sample of low-income, minority youth over one year. Methods Participants were students from fifty-six schools in urban, low-income environments. There were 17,727 1st-6th graders (64% African American, 52% male) assessed at baseline and 13,305 youth (75.1%) were reassessed one-year later at follow-up. Measured height and weight were used to assess categorical (overweight, obesity, severe obesity) and continuous (BMI, percentile, z-score) measures of relative weight. Results Longitudinal data showed that over one year, BMI percentile (95% CI: −0.64 – −0.32,p<.001) and BMI z-score (95% CI: −0.02 – −0.01,p<.001) were significantly lower compared to baseline. The prevalence of overweight and obesity was stable over one year. Most (86.0%) youth remained in the same weight category as baseline, 6.8% improved weight category and 7.2% worsened weight category over one year. Conclusions These longitudinal data indicate that the relative weight of low-income, urban youth is showing signs of a small improvement over a one year follow-up period. The rates of childhood obesity, however, remain remarkably high and require continued, creative, public health efforts. PMID:25354706

  3. An adjusted one year sea surface heat and water budget for the Northwestern Mediterranean basin

    NASA Astrophysics Data System (ADS)

    Caniaux, Guy; Prieur, Louis; Giordani, Hervé

    2015-04-01

    The problem of heat and salt budget closure is an important subject in operational and research oceanography. The closure depends crucially on surface fluxes, as they are one of the most important processes in terms of the evolution of the heat and salt content in the oceanic top layers. However, in this problem, two points have to be considered. First, surface fluxes are affected by a variety of errors: those associated with the algorithms used for computing the turbulent fluxes, those due to the data used as input of bulk algorithms and the errors associated with the time and space resolution of the fluxes themselves. The second problem is that no surface flux dataset exists, that can be used as the truth, or as a reference, i.e. that can be used for closing observed heat and water budgets at various time and space scales. Here we address the question of adjusting surface heat and water fluxes so that they are in agreement with the evolution of the thermal and salt contents deduced from the extended dataset collected during the HyMex campaigns. These experiments were conducted in the North-western Mediterranean basin in 2012 and 2013. The method is based: (1) on the one-dimensional column modelling of the experimental area, by solving specific temperature and salinity equations and (2) on the optimization of adjustable coefficients with a genetic algorithm. The surface forcings, calculated from a mix of satellite retrievals, in-situ data, numerical weather prediction model observables and a bulk algorithm are also adjusted with the genetic algorithm. Finally, the adjusted fluxes allows to simulate the domain average sea surface temperature and salinity with errors less than 0.2 percent (or 0.03°C) and 0.08 percent (or 0.03 psu) respectively over one year. The adjusted fluxes are finally compared with various NWP models over the North-western Mediterranean basin and also locally with fluxes estimated at a mooring site (LION buoy).

  4. A napkin-associated outbreak of Burkholderia cenocepacia bacteraemia in haemodialysis patients.

    PubMed

    Lo Cascio, G; Bonora, M G; Zorzi, A; Mortani, E; Tessitore, N; Loschiavo, C; Lupo, A; Solbiati, M; Fontana, R

    2006-09-01

    This article reports a catheter-related outbreak of bacteraemia involving 38 patients in two haemodialysis units in Verona. Burkholderia cepacia complex strains were isolated from human blood and from an individually wrapped disinfection napkin that was contained in a commercially available, sterile dressing kit used to handle central venous catheters. Micro-organisms isolated from blood cultures and from the napkin were identified by standard procedures and confirmed as B. cenocepacia (genomovar III) by molecular analysis. Using pulsed-field gel electrophoresis analysis, the clinical isolates were indistinguishable or closely related to the B. cenocepacia isolated from the napkin. In conclusion, this study found that a contaminated commercial napkin soaked in quaternary ammonium, even when quality certified, was the source of infection. PMID:16859809

  5. Reduction in Staphylococcus aureus bacteraemia rates in patients receiving haemodialysis following alteration of skin antisepsis procedures.

    PubMed

    Stewart, B J; Gardiner, T; Perry, G J; Tong, S Y C

    2016-02-01

    This study examined all cases of Staphylococcus aureus bacteraemia (SAB) in the haemodialysis cohort at the Royal Darwin Hospital, Australia over a seven-year period. Midway through this period, antisepsis for arteriovenous fistulae (AVF) and central venous catheters (CVC) changed from 0.5% chlorhexidine solution to 2% chlorhexidine solution. Rates of SAB episodes were calculated using registry data. Trends in SAB over time were analysed using an interrupted regression analysis. Following the change to 2% chlorhexidine, average SAB rates decreased by 68%, and it is estimated that 0.111 cases of SAB/patient-year were prevented. CVC-related SAB rates remained low throughout. These results support the use of 2% chlorhexidine in skin antisepsis for patients with AVF. PMID:26778135

  6. Non-lethal Clostridium sordellii bacteraemia in an immunocompromised patient with pleomorphic sarcoma.

    PubMed

    Bonnecaze, Alex K; Stephens, Sarah Ellen Elza; Miller, Peter John

    2016-01-01

    Clostridium sordellii is a spore-forming anaerobic Gram-positive rod that has rarely been reported to cause disease in humans. Resultant mortality from infection is estimated at nearly 70% and is most often correlated with gynaecological procedures, intravenous drug abuse or trauma. C. sordellii infection often presents similarly to toxic shock syndrome (TSS); notable features of infection include refractory hypotension, haemoconcentration and marked leucocytosis. Although clinically similar to TSS, a notable difference is C. sordellii infections rarely involve fever. The organism's major toxins include haemorrhagic (TcsH) and lethal factor (TcsL), which function to disrupt cytoskeletal integrity. Current literature suggests treating C. sordelli infection with a broad-spectrum penicillin, metronidazole and clindamycin. We present a case of C. sordellii bacteraemia and septic shock in an immunocompromised patient who was recently diagnosed with pleomorphic gluteal sarcoma. Despite presenting in critical condition, the patient improved after aggressive hemodynamic resuscitation, source control and intravenous antibiotic therapy. PMID:27489063

  7. Staphylococcus aureus bacteraemia: evaluation of the role of transoesophageal echocardiography in identifying clinically unsuspected endocarditis.

    PubMed

    Incani, A; Hair, C; Purnell, P; O'Brien, D P; Cheng, A C; Appelbe, A; Athan, E

    2013-08-01

    Staphylococcus aureus bacteraemia (SAB) is an important cause of community and nosocomial sepsis, with a significant mortality rate. Infective endocarditis (IE) is a serious complication, occurring in up to 25 % of cases. Transoesophageal echocardiography (TOE) significantly improves the sensitivity of diagnosis. We compared the sensitivity and specificity of clinical evaluation alone in diagnosing IE. We evaluated all adult patients with SAB at our centre from 1998 to 2006 in order to determine what proportion of clinically unsuspected cases were diagnosed with IE on TOE. IE was defined according to modified Duke criteria. The median age of the patients was 68 years, 77 % were male and the majority of cases did not have a known pre-existing condition. Twenty-one percent were methicillin-resistant Staphylococcus aureus (MRSA). Intravascular device was the most common cause of bacteraemia. TOE was performed in 144 (100 %) of the cases. IE was suspected clinically in 15 % of cases, and the overall prevalence of possible or definite IE on TOE-inclusive Duke criteria was 29 % (n = 41). Following TOE, 22 (15 %) cases were reclassified as either possible or definite endocarditis. TOE detected a vegetation in 37 (90 %) of the 41 cases of IE. Nineteen (46 %) were not suspected clinically by Duke criteria. Sensitivity improved in the presence of pre-existing valve lesion or community acquisition. The overall in-hospital mortality was 10 %. There is a high incidence of endocarditis in SAB and a large percentage of cases are not evident on clinical grounds. TOE evaluation is indicated for all medically suitable adult patients with SAB in order to improve the detection of endocarditis. PMID:23417650

  8. A population-based study of aerococcal bacteraemia in the MALDI-TOF MS-era.

    PubMed

    Senneby, E; Göransson, L; Weiber, S; Rasmussen, M

    2016-05-01

    The purpose of this study was to determine the incidence of aerococcal bacteraemia in the MALDI-TOF MS-era, to describe the clinical presentation and to determine the MIC values of aerococci for ten antibiotics. Aerococci in blood cultures were identified through searches in the laboratory database for the years 2012-2014. MALDI-TOF MS, sequencing of the 16S rRNA gene and a PYR test were used for species identification. Patients' medical charts were systematically reviewed. Etests were used to determine MIC values. Seventy-seven patients were identified (Aerococcus urinae n = 49, Aerococcus viridans n = 14, Aerococcus sanguinicola n = 13 and Aerococcus christensenii n = 1) corresponding to incidences of 14 cases per 1,000,000 inhabitants per year (A. urinae) and 3.5 cases per 1,000,000 inhabitants per year (A. sanguinicola and A.viridans). A. urinae was in pure culture in 61 %, A. sanguinicola in 46 % and A. viridans in 36 % of the cases. The A. urinae and A. sanguinicola patients were old and many had urinary tract disorders, and a majority had a suspected urinary tract focus of the bacteraemia. Eighty percent of the A. urinae patients were men. Five A. urinae patients were diagnosed with infective endocarditis. Six patients died within 30 days. Most isolates had low MICs to penicillins and carbapenems. MALDI-TOF MS has led to an increased identification of aerococcal bacteremia. A. urinae remains the most common Aerococcus in blood cultures and in aerococcal IE. PMID:26838685

  9. Science Career Interests among High School Girls One Year after Participation in a Summer Science Program.

    ERIC Educational Resources Information Center

    Phillips, Katherine A.; Barrow, Lloyd H.; Chandrasekhar, Meera

    2002-01-01

    Introduces a residential summer program, the New Experiences for Women in Science and Technology (Newton) Academy, which was developed to encourage high school girls' interest in the physical sciences and engineering. Reports the results of a follow-up evaluative study of the 1998 Newton Academy participants one year after participation. (Contains…

  10. A Study on One Year Enrollments in Selected Vocational Centers in New Hampshire.

    ERIC Educational Resources Information Center

    Lister, Robert; Lichtenstein, Stephen

    A research study examined the extent and impact of one-year enrollments by 12th graders in 2-year secondary vocational programs in New Hampshire. Enrollment data from 1981-1982 and 1982-1983 school years from six rural Regional Centers were used for the sample. A review of current literature found that no other state has ever researched the…

  11. Predictors of Close Family Relationships over One Year among Homeless Young People

    ERIC Educational Resources Information Center

    Milburn, N.G.; Jane Rotheram-Borus, M.; Batterham, P.; Brumback, B.; Rosenthal, D.; Mallett, S.

    2005-01-01

    Predictors of perceived family bonds were examined among homeless young people who initially left home one year earlier. Newly homeless young people aged 12-20 years who had recently left home were recruited in Los Angeles County, United States (n=201) and Melbourne, Australia (n=124) and followed longitudinally at 3, 6, and 12 months (follow-up…

  12. Proposed Outline for a One-Year Certificate Program in Word Processing.

    ERIC Educational Resources Information Center

    Rosen, Arnold

    Two courses, Word Processing Concepts and Word Processing Workshop, are described as part of a proposed outline for a one-year certificate program in word processing (WP) to be offered at Nassau Community College. The other courses in the program are: first semester--intermediate typing, introduction to business, data processing, and English…

  13. Stigma and suicidal ideation among young people at risk of psychosis after one year.

    PubMed

    Xu, Ziyan; Mayer, Benjamin; Müller, Mario; Heekeren, Karsten; Theodoridou, Anastasia; Dvorsky, Diane; Metzler, Sibylle; Oexle, Nathalie; Walitza, Susanne; Rössler, Wulf; Rüsch, Nicolas

    2016-09-30

    Suicidality is common among individuals at risk of psychosis. Emerging findings suggest that mental illness stigma contributes to suicidality. However, it is unclear whether stigma variables are associated with suicidality among young people at risk of psychosis. This longitudinal study assessed perceived public stigma and the cognitive appraisal of stigma as a stressor (stigma stress) as predictors of suicidal ideation among individuals at risk of psychosis over the period of one year. One hundred and seventy-two participants between 13 and 35 years of age were included who were at high or ultra-high risk of psychosis or at risk of bipolar disorder. At one-year follow-up, data were available from 73 completers. In multiple logistic regressions an increase of stigma stress (but not of perceived stigma) over one year was significantly associated with suicidal ideation at one-year follow-up, controlling for age, gender, symptoms, comorbid depression and suicidal ideation at baseline. Interventions to reduce public stigma and stigma stress could therefore improve suicide prevention among young people at risk of psychosis. PMID:27419651

  14. Health-Related Quality of Life among Abused Women One Year after Leaving a Violent Partner

    ERIC Educational Resources Information Center

    Alsaker, Kjersti; Moen, Bente E.; Kristoffersen, Kjell

    2008-01-01

    This is the first follow up study measuring quality of life among abused women who have left their abusive partner. The women (n = 22) answered a questionnaire while staying at women's shelter and one year later. The aim was to examine long-term effects of intimate partner violence against women on health-related quality of life. Health-related…

  15. Learning to Become a Learning Professional: Reflections on One Year of Teaching

    ERIC Educational Resources Information Center

    Attard, Karl; Armour, Kathleen M.

    2005-01-01

    This research aims to study the ways in which a teacher learns through and about professional practice. Data presented here is drawn from one year of teaching and focuses on pedagogical practices, critical reflection upon those practices and the impact of the implementation of a new physical education syllabus in Maltese secondary schools. The…

  16. One Year Program to Train Developers in Public Education Systems. Final Report.

    ERIC Educational Resources Information Center

    New York Univ., NY. Inst. of Afro-American Affairs.

    The purpose of this program to train developers in public education systems was to construct and test a viable model that would fulfill its training goals in one year and which could also be replicated under similar conditions by comparable institutions. The model involved a part-time program which provided theoretical and experiential training…

  17. One Year Term Review as a Participating Guest in the Detonator and Detonation Physics Group

    SciTech Connect

    Lefrancois, A; Roeske, F; Tran, T; Lee, R S

    2006-02-06

    The one year stay was possible after a long administrative process, because of the fact that this was the first participating guest of B division as a foreign national in HEAF (High Explosives Application Facility) with the Detonator/Detonation Physics Group.

  18. Job Entry Level Competencies of a One Year Barber School Graduate. Final Report.

    ERIC Educational Resources Information Center

    Swerman, Richard A.; Wurtzel, Norbert K.

    To determine the competency level required of a one-year graduate from barber school and to obtain information that would enable vocational-technical schools to plan their curriculum to better meet student barber needs, a survey was conducted in Wisconsin of 629 barber shop managers, 75 journeymen, and 200 apprentices. Picked at random, these…

  19. 45 CFR 680.12 - One-year NSF post-employment restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Section 680.12 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NATIONAL SCIENCE FOUNDATION RULES OF PRACTICE AND STATUTORY CONFLICT-OF-INTEREST EXEMPTIONS Rules of Practice for the National Science Foundation § 680.12 One-year NSF post-employment...

  20. Toddlers' Expressive Vocabulary Outcomes after One Year of Parent-Child Home Program Services

    ERIC Educational Resources Information Center

    Manz, Patricia H.; Bracaliello, Catherine B.; Pressimone, Vanessa J.; Eisenberg, Rachel A.; Gernhart, Amanda C.; Fu, Qiong; Zuniga, Cesar

    2016-01-01

    This quasi-experimental study examined expressive vocabulary outcomes for Parent-Child Home Program (PCHP) toddlers, after one year of home-visiting services. First, this study applied Rasch modelling to establish the construct validity and reliability of a widely used expressive vocabulary measure, as modified for a sample of ethnic and…

  1. Early Contact and Infant-Mother Attachment at One-Year.

    ERIC Educational Resources Information Center

    Ottaviano, Christine M.; And Others

    This paper reports the effects of one hour of extra post-partum contact between mother and infant on the quality of the attachment observed when the infant was one year old. It was hypothesized that infants in the extra contact condition would be classified as securely attached while regular contact infants would be less frequently classified as…

  2. The One-Year Residency Program: An Alternative Path to the Master's Degree in Social Work.

    ERIC Educational Resources Information Center

    Salmon, Robert; Walker, Joel

    1981-01-01

    At Hunter College an alternative master's program for social workers who cannot give up employment for full-time study replaces the traditional scheduling with three flexible time periods: pre-fieldwork and post-fieldwork, part-time coursework, and one-year, four-day-a-week fieldwork experience in the place of employment. (MSE)

  3. A One-Year Study of the Development of Co-Teaching in Four Finnish Schools

    ERIC Educational Resources Information Center

    Takala, Marjatta; Uusitalo-Malmivaara, Lotta

    2012-01-01

    In this follow-up study, development of co-teaching was studied in four different schools in Helsinki, Finland. Teachers, altogether 54, 51 and 26, respectively, responded to an electronic questionnaire three times during one year. The attitudes towards co-teaching were positive although the frequency of co-teaching remained low. Co-teaching was…

  4. A One-Year Introductory Robotics Curriculum for Computer Science Upperclassmen

    ERIC Educational Resources Information Center

    Correll, N.; Wing, R.; Coleman, D.

    2013-01-01

    This paper describes a one-year introductory robotics course sequence focusing on computational aspects of robotics for third- and fourth-year students. The key challenges this curriculum addresses are "scalability," i.e., how to teach a robotics class with a limited amount of hardware to a large audience, "student assessment,"…

  5. Gram-negative bacteraemia; a multi-centre prospective evaluation of empiric antibiotic therapy and outcome in English acute hospitals.

    PubMed

    Fitzpatrick, J M; Biswas, J S; Edgeworth, J D; Islam, J; Jenkins, N; Judge, R; Lavery, A J; Melzer, M; Morris-Jones, S; Nsutebu, E F; Peters, J; Pillay, D G; Pink, F; Price, J R; Scarborough, M; Thwaites, G E; Tilley, R; Walker, A S; Llewelyn, M J

    2016-03-01

    Increasing antibiotic resistance makes choosing antibiotics for suspected Gram-negative infection challenging. This study set out to identify key determinants of mortality among patients with Gram-negative bacteraemia, focusing particularly on the importance of appropriate empiric antibiotic treatment. We conducted a prospective observational study of 679 unselected adults with Gram-negative bacteraemia at ten acute english hospitals between October 2013 and March 2014. Appropriate empiric antibiotic treatment was defined as intravenous treatment on the day of blood culture collection with an antibiotic to which the cultured organism was sensitive in vitro. Mortality analyses were adjusted for patient demographics, co-morbidities and illness severity. The majority of bacteraemias were community-onset (70%); most were caused by Escherichia coli (65%), Klebsiella spp. (15%) or Pseudomonas spp. (7%). Main foci of infection were urinary tract (51%), abdomen/biliary tract (20%) and lower respiratory tract (14%). The main antibiotics used were co-amoxiclav (32%) and piperacillin-tazobactam (30%) with 34% receiving combination therapy (predominantly aminoglycosides). Empiric treatment was inappropriate in 34%. All-cause mortality was 8% at 7 days and 15% at 30 days. Independent predictors of mortality (p <0.05) included older age, greater burden of co-morbid disease, severity of illness at presentation and inflammatory response. Inappropriate empiric antibiotic therapy was not associated with mortality at either time-point (adjusted OR 0.82; 95% CI 0.35-1.94 and adjusted OR 0.92; 95% CI 0.50-1.66, respectively). Although our study does not exclude an impact of empiric antibiotic choice on survival in Gram-negative bacteraemia, outcome is determined primarily by patient and disease factors. PMID:26577143

  6. Urbanicity and Paediatric Bacteraemia in Ghana—A Case-Control Study within a Rural-Urban Transition Zone

    PubMed Central

    Sothmann, Peter; Krumkamp, Ralf; Kreuels, Benno; Sarpong, Nimako; Frank, Clemens; Ehlkes, Lutz; Fobil, Julius; Gyau, Kennedy; Jaeger, Anna; Bosu, Benedicta; Marks, Florian; Owusu-Dabo, Ellis; Salzberger, Bernd; May, Jürgen

    2015-01-01

    Background Systemic bacterial infections are a major cause of paediatric febrile illness in sub-Saharan Africa. Aim of this study was to assess the effects of social and geographical determinants on the risk of bacteraemia in a rural-urban transition zone in Ghana. Methods Children below 15 years of age with fever were recruited at an outpatient department in the suburban belt of Kumasi, Ghana’s second largest city. Blood was taken for bacterial culture and malaria diagnostics. The socio-economic status of participants was calculated using Principle Component Analysis. A scale, based on key urban characteristics, was established to quantify urbanicity for all communities in the hospital catchment area. A case-control analysis was conducted, where children with and without bacteraemia were cases and controls, respectively. Results Bacteraemia was detected in 72 (3.1%) of 2,306 hospital visits. Non-typhoidal Salmonella (NTS; n = 24; 33.3%) and Salmonella typhi (n = 18; 25.0%) were the most common isolates. Logistic regression analysis showed that bacteraemia was negatively associated with urbanicity (odds ratio [OR] = 0.8; 95% confidence interval [CI]: 0.7–1.0) and socio-economic status (OR = 0.8; 95% CI: 0.6–0.9). Both associations were stronger if only NTS infections were used as cases (OR = 0.5; 95% CI: 0.3–0.8 and OR = 0.6; 95% CI: 0.4–1.0, respectively). Conclusions The results of this study highlight the importance of individual as well as community factors as independent risk factors for invasive bacterial infection (IBI) and especially NTS. Epidemiological data support physicians, public health experts and policy makers to identify disease prevention and treatment needs in order to secure public health in the transitional societies of developing countries. PMID:26418004

  7. Enhanced physical therapy for arm function after stroke: a one year follow up study.

    PubMed Central

    Sunderland, A; Fletcher, D; Bradley, L; Tinson, D; Hewer, R L; Wade, D T

    1994-01-01

    Ninety seven patients with stroke who had participated in a randomised trial of conventional physical therapy nu an enhanced therapy for arm function were followed up at one year. Despite the emphasis of the enhanced therapy approach on continued use of the arm in everyday life, the advantage seen for some patients with enhanced therapy at six months after stroke had diminished to a non-significant trend by one year. This was due to some late improvement in the conventional therapy group whereas the enhanced therapy group remained static or fell back slightly. It is recommended that trials should be conducted comparing very intensive therapy for the arm with controls without treatment. This would provide a model of the effects of therapy on intrinsic neural recovery that would be relevant to all areas of neurological rehabilitation. PMID:8021679

  8. Remembering All That and Then Some: Recollection of Autobiographical Memories after a One-Year Delay

    PubMed Central

    Campbell, Jenna; Nadel, Lynn; Duke, Devin; Ryan, Lee

    2013-01-01

    We previously showed that repeated retrievals of remote autobiographical memories over the course of one month led to an overall increase in reported detail (Nadel, Campbell & Ryan, 2007). The current study examined the retrieval of those same memories one year later in order to determine whether the level of detail remained stable or whether the memories returned to their original state. Participants reported even more details than they had recalled at least one year earlier, including new details that were reported for the first time. This finding was consistent across both multiple and single retrieval conditions suggesting that the critical factor leading to the increase in recall was the passage of time. These findings provide evidence for long-term effects of repeated retrieval on memory content. PMID:21678157

  9. 40 CFR 51.1005 - One-year extensions of the attainment date.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... in 40 CFR part 50, appendix N). (b) An area that fails to attain the PM2.5 NAAQS after receiving a 1... Implementation of PM2.5 National Ambient Air Quality Standards § 51.1005 One-year extensions of the attainment... the PM2.5 NAAQS by its attainment date may apply for an initial 1-year attainment date extension...

  10. 40 CFR 51.1005 - One-year extensions of the attainment date.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... in 40 CFR part 50, appendix N). (b) An area that fails to attain the PM2.5 NAAQS after receiving a 1... Implementation of PM2.5 National Ambient Air Quality Standards § 51.1005 One-year extensions of the attainment... the PM2.5 NAAQS by its attainment date may apply for an initial 1-year attainment date extension...

  11. 40 CFR 51.1005 - One-year extensions of the attainment date.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... in 40 CFR part 50, appendix N). (b) An area that fails to attain the PM2.5 NAAQS after receiving a 1... Implementation of PM2.5 National Ambient Air Quality Standards § 51.1005 One-year extensions of the attainment... the PM2.5 NAAQS by its attainment date may apply for an initial 1-year attainment date extension...

  12. Outcomes at One-Year Post Anastomosis from a National Cohort of Infants with Oesophageal Atresia

    PubMed Central

    Allin, Benjamin; Knight, Marian; Johnson, Paul; Burge, David

    2014-01-01

    Background and Aims We aimed to provide a contemporaneous assessment of outcomes at one-year post oesophageal atresia/tracheoesophageal fistula (OA-TOF) repair, focussing particularly on post-operative complications. It is generally accepted that oesophageal stricture is the most common complication and causes significant morbidity. We also aimed to assess the efficacy of prophylactic anti-reflux medication (PARM) in reducing stricture formation. Method A prospective, multi-centre cohort study of all infants live-born with oesophageal atresia in the United Kingdom and Ireland in 2008/9 was performed, recording clinical management and outcomes at one year. The effect of PARM on stricture formation in infants with the type-c anomaly was assessed using logistic regression analysis. Results 151 infants were live-born with oesophageal atresia in the defined reporting period, 126 of whom had the type-c anomaly. One-year follow-up information was returned for 105 infants (70%); the mortality rate was 8.6% (95% CI 4.7–14.3%). Post-operative complications included anastomotic leak (5.4%), recurrent fistula (3.3%) and oesophageal stricture (39%). Seventy-six (60%) of those with type-c anomaly were alive at one-year with returned follow-up, 57(75%) of whom had received PARM. Of these, 24 (42%) developed a stricture, compared to 4 (21%) of those who had not received PARM (adjusted odds ratio 2.60, 95% CI 0.71–9.46, p = 0.147). Conclusions This study provides a benchmark for current outcomes and complication rates following OA-TOF repair, with oesophageal stricture causing significant morbidity. The use of PARM appeared ineffective in preventing strictures. This study creates enough doubt about the efficacy of PARM in preventing stricture formation to warrant further investigation of its use with a randomised controlled trial. PMID:25153838

  13. The Role of Host and Microbial Factors in the Pathogenesis of Pneumococcal Bacteraemia Arising from a Single Bacterial Cell Bottleneck

    PubMed Central

    Furi, Leonardo; Braccini, Tiziana; Manso, Ana Sousa; Pammolli, Andrea; Wang, Bo; Vivi, Antonio; Tassini, Maria; van Rooijen, Nico; Pozzi, Gianni; Ricci, Susanna; Andrew, Peter W.; Koedel, Uwe; Moxon, E. Richard; Oggioni, Marco R.

    2014-01-01

    The pathogenesis of bacteraemia after challenge with one million pneumococci of three isogenic variants was investigated. Sequential analyses of blood samples indicated that most episodes of bacteraemia were monoclonal events providing compelling evidence for a single bacterial cell bottleneck at the origin of invasive disease. With respect to host determinants, results identified novel properties of splenic macrophages and a role for neutrophils in early clearance of pneumococci. Concerning microbial factors, whole genome sequencing provided genetic evidence for the clonal origin of the bacteraemia and identified SNPs in distinct sub-units of F0/F1 ATPase in the majority of the ex vivo isolates. When compared to parental organisms of the inoculum, ex-vivo pneumococci with mutant alleles of the F0/F1 ATPase had acquired the capacity to grow at low pH at the cost of the capacity to grow at high pH. Although founded by a single cell, the genotypes of pneumococci in septicaemic mice indicate strong selective pressure for fitness, emphasising the within-host complexity of the pathogenesis of invasive disease. PMID:24651834

  14. Non-typhoidal Salmonella bacteraemia in elderly patients: an increased risk for endovascular infections, osteomyelitis and mortality.

    PubMed

    Chen, P L; Lee, H C; Lee, N Y; Wu, C J; Lin, S H; Shih, H I; Lee, C C; Ko, W C; Chang, C M

    2012-11-01

    Non-typhoidal Salmonella (NTS) is a common pathogen causing foodborne infections, bacteraemia, and extra-intestinal focal infections (EFIs) in humans. The study compares the clinical characteristics of elderly patients with NTS bacteraemia with those of young adults. Of 272 adults with NTS bacteraemia identified in this study, 162 (59·6%) were aged ⩾55 years. EFIs were observed in 36% of the 162 patients. The most common EFIs in the elderly patients (⩾55 years) was mycotic aneurysm, followed by pulmonary infections and bone/joint infections. Elderly patients more often had chronic heart, lung, renal and malignant diseases, had more EFIs, and a higher 30-day mortality rate. Independent factors of 30-day mortality in elderly patients were solid-organ tumour [adjusted odds ratio (aOR) 4·4, P=0·003], mycotic aneurysm (aOR 3·7, P=0·023) and shock (aOR 12·1, P<0·0001). HIV infection, autoimmune diseases, and receipt of immunosuppressive therapy were more often observed in young patients. PMID:22261309

  15. The incidence of S. aureus bacteraemia in acute hospitals of the Mid-Western Area, Ireland, 2002-2004.

    PubMed

    Whyte, D; Monahan, R; Boyle, L; Slevin, B; FitzGerald, R; Barron, D; De Freitas, J; Kelleher, K

    2005-05-01

    Concerns about healthcare-associated infections and the global crisis in antimicrobial resistance has combined to accentuate the fears around so-called "superbugs". In Ireland there is no single agreed indicator regarded as a true measure of the level of methicillin resistant Staphylococcus aureus (MRSA) in hospitals. The objective of this study was to compare two crude measures of MRSA--the percentage of bacteraemia caused by MRSA and the incidence rate (per 1000 bed days used) of MRSA bacteraemia in six acute hospitals. We examined all blood cultures positive for S. aureus (methicillin sensitive and resistant) from 2002 to 2004 in the Health Service Executive (HSE) Mid-Western Area of Ireland. Hospital In-Patient Enquiry (HIPE) data was used to determine monthly in-patient bed days used. Of 245 patient episodes of bacteraemia, 119 were MRSA. The trends in the percentage of isolates that were MRSA and the incidence rate calculated were compared. The incidence rate appears to be a more reliable and robust indicator of MRSA in hospitals than the percentage. Despite many difficulties in interpreting indicators of MRSA they should not preclude the regular publication of data at least at regional level in Ireland. PMID:16077206

  16. Effects of a one year physical activity program on serum C Terminal Agrin Fragment (CAF) concentrations among mobility limited older adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    OBJECTIVES: C terminal Agrin Fragment (CAF) has been proposed as a potential circulating biomarker for predicting changes in physical function among older adults. To determine the effect of a one year PA intervention on changes in CAF concentrations and to evaluate baseline and longitudinal associat...

  17. A retrospective study of secondary bacteraemia in hospitalised adults with community acquired non-typhoidal Salmonella gastroenteritis

    PubMed Central

    2013-01-01

    Background The clinical significance of bacteraemia secondary to non-typhoidal Salmonella (NTS) gastroenteritis in hospitalised adults is uncertain. Methods Adults admitted to a hospital in Liverpool, UK, with NTS gastroenteritis were identified using hospital discharge data and laboratory records. Patients with known HIV infection were excluded. Risk factors for a complicated or fatal course were determined. Results Between 1982 and 2006 inclusive, 633 adults were identified. Serovars causing infection included Enteritidis (46.6%), Typhimurium (27.6%) and Virchow (4.9%). A blood culture was taken in 364 (57.5%) patients who were generally sicker than those who were not cultured. Bacteraemia was detected in 63 (17.3%) patients who had blood cultures taken (63/633 (10.0%) of all patients). Bacteraemia was more common in those aged ≥ 65 years (p < 0.001) and in those aged < 65 years who had an underlying chronic disease. A complicated course occurred in 91 (25.0%) patients who had had a blood culture taken (148/633 (23.4%) of all patients). Independent factors associated with a complicated or fatal course among the patients investigated with a blood culture were bacteraemia (Adjusted Odds Ratio 5.34, 95% CI 2.86–9.95); new onset confusion or coma (AOR 4.80, 95% CI 1.91–12.07); prolonged symptoms prior to admission (AOR 2.48, 95% CI 1.44–4.27); dehydration (AOR1.90, 95% CI 1.07–3.38); and absence of fever (AOR 0.56, 95% CI 0.32–0.95). The 30 day attributable case fatality for all patients was 1.5%. Conclusions In this study secondary bacteraemia, as well as other clinical factors, was independently associated with a complicated or fatal course in non-HIV infected adults admitted to hospital with NTS gastroenteritis. PMID:23446179

  18. Post-Tooth Extraction Bacteraemia: A Randomized Clinical Trial on the Efficacy of Chlorhexidine Prophylaxis

    PubMed Central

    Barbosa, Mario; Prada-López, Isabel; Álvarez, Maximiliano; Amaral, Barbas; de los Angeles, Casares-De-Cal María; Tomás, Inmaculada

    2015-01-01

    Objectives To investigate the development of post-extraction bacteraemia (PEB) after the prophylactic use of chlorhexidine (CHX). Patients and Methods A total of 201 patients who underwent a tooth extraction were randomly distributed into four groups: 52 received no prophylaxis (CONTROL), 50 did a mouthwash with 0.2% CHX before the tooth extraction (CHX-MW), 51 did a mouthwash with 0.2% CHX and a subgingival irrigation with 1% CHX (CHX-MW/SUB_IR) and 48 did a mouthwash with 0.2% CHX and a continuous supragingival irrigation with 1% CHX (CHX-MW/SUPRA_IR). Peripheral venous blood samples were collected at baseline, 30 seconds after performing the mouthwash and the subgingival or supragingival irrigation, and at 30 seconds and 15 minutes after completion of the tooth extraction. Blood samples were analysed applying conventional microbiological cultures under aerobic and anaerobic conditions performing bacterial identification of the isolates. Results The prevalences of PEB in the CONTROL, CHX-MW, CHX-MW/SUB_IR and CHX-MWSUPRA_IR groups were 52%, 50%, 55% and 50%, respectively, at 30 seconds and 23%, 4%, 10% and 27%, respectively, at 15 minutes. The prevalence of PEB at 15 minutes was significantly higher in the CONTROL group than in the CHX-MW group (23% versus 4%; p = 0.005). At the same time, no differences were found between CONTROL group and CHX-MW/SUB_IR or CHX-MW/SUPRA_IR groups. Streptococci (mostly viridans group streptococci) were the most frequently identified bacteria (69–79%). Conclusions Performing a 0.2% CHX mouthwash significantly reduces the duration of PEB. Subgingival irrigation with 1% CHX didn’t increase the efficacy of the mouthwash while supragingival irrigation even decreased this efficacy, probably due to the influence of these maneuvers on the onset of bacteraemia. Clinical Relevance These results confirm the suitability of performing a mouthwash with 0.2% CHX before tooth extractions in order to reduce the duration of PEB. This practice

  19. Radiographic Vertical Bone Loss Evaluation around Dental Implants Following One Year of Functional Loading

    PubMed Central

    Rasouli Ghahroudi, AAR.; Talaeepour, AR; Mesgarzadeh, A.; Rokn, AR.; Khorsand, A.; Mesgarzadeh, NN.; Kharazi Fard, MJ.

    2010-01-01

    Objective: Vertical bone loss evaluations in the Nobel Biocare Replace® Select Tapered ™ implant system in the human after one-year loading time. Materials and Methods: This retrospective cross-sectional study was performed on 31 patients (14 men, 17 women; mean age, 60.39 years) receiving 170 implants (mean, 5.48 for each patient) of Groovy and Non-groovy designs in the Nobel Biocare Replace® Select Tapered ™ system. The marginal bone loss was measured at mesial and distal aspects of the implants on OPG x-rays after one-year follow-up. The data regarding the patient’s gender, age, history of disease, smoking, bone type at implant location, loading time of prosthesis and implant, implant design, diameter and length were recorded by the patients’ records and interview. The data were subjected to multiple linear regression and Pearson coefficient ratio regarding different factors. Results: The mean (standard deviation) distal, mesial and overall bone loss was 0.688 mm (0.851), 0.665 mm (0.849) and 0.935 mm (0.905), respectively in the studied implants. No significant differences were found regarding implant location, bone quality at the implant region, implant design and bone graft reception. In addition, no significant correlation was found between the occurred bone loss and implant diameter, length and number of used splints. Conclusion: Due to the criteria mentioned for implant success in term of bone loss values after one-year loading time, Noble Biocare Replace® Select Tapered ™ implant system is an acceptable treatment option for implant restorations in this regard. PMID:21998781

  20. One-Year Outcomes of Aflibercept in Recurrent or Persistent Neovascular Age-Related Macular Degeneration

    PubMed Central

    Arcinue, Cheryl A.; Ma, Feiyan; Barteselli, Giulio; Sharpsten, Lucie; Gomez, Maria Laura; Freeman, William R.

    2014-01-01

    Purpose To evaluate 6-month and 1-year outcomes of every 8 weeks (Q8W) aflibercept in patients with resistant neovascular age-related macular degeneration (AMD). Design Retrospective, interventional, consecutive case series. Methods Retrospective review of patients with resistance (multiple recurrences or persistent exudation) to every 4 weeks (Q4W) ranibizumab or bevacizumab that were switched to Q8W aflibercept. Results Sixty-three eyes of 58 patients had a median of 13 (interquartile range (IQR), 7-22) previous anti Vascular Endothelial Growth Factor (anti-VEGF) injections. At 6-months after changing to aflibercept, 60.3% of eyes were completely dry, which was maintained up to one-year. The median maximum retinal thickness improved from 355 microns to 269 microns at 6 months (p<0.0001) and 248 microns at one year (p<0.0001). There was no significant improvement in ETDRS visual acuity at 6 months (p=0.2559) and one-year follow-up (p=0.1081) compared with baseline. The mean difference in ETDRS visual acuity compared to baseline at 6 months was −0.05 logMAR (+2.5 letters) and 0.04 logMAR at 1 year (−2 letters). Conclusion Sixty percent of eyes with resistant AMD while on Q4W ranibizumab or bevacizumab were completely dry after changing to Q8W aflibercept at the 6-month and 1-year follow-ups, but visual acuity did not significantly improve. Only a third of eyes needed to be switched from Q8W to Q4W aflibercept due to persistence of fluid; Q8W dosing of aflibercept without the initial 3 monthly loading doses may be a good alternative in a select group of patients who may have developed ranibizumab or bevacizumab resistance. PMID:25461263

  1. CPV Cell Characterization Following One-Year Exposure in Golden, Colorado: Preprint

    SciTech Connect

    Bosco, N.; Kurtz, S.

    2014-08-01

    A CPV module containing 30 III-V multijunction cells was operated on?sun for one year in Golden, Colorado. Each cell was characterized prior to and following exposure. A module power degradation of 10% was observed and found to be a result as an overall decrease in cell short circuit current and the presence of at least one shunted cell. A positive correlation between initial shunt current and an increase in shunt current following exposure was also found. Cell exfoliation was also observed and found to be coincident with the presence of water and/or charring of the cell package due to an off-sun event.

  2. Radiocesium levels measured in breast milk one year after the reactor accident at Chernobyl

    SciTech Connect

    Assimakopoulos, P.A.; Ioannides, K.G.; Pakou, A.A.; Lolis, D.; Zikopoulos, K.; Dusias, B.

    1989-01-01

    One hundred-two samples of colostral milk, collected during spring of 1987, approximately one year after the reactor accident at Chernobyl, were measured for radiocesium contamination. The data showed a normal-type distribution with a mean contamination concentration of 16.4 Bq L-1. A weak correlation of the data to the mothers' diet was established by taking into account four of the main staples in the area. The corresponding transfer coefficient was deduced with a value of fm = 0.06 +/- 0.03 d L-1. The resultant effective dose received by breast-feeding infants was estimated, on the average, as 0.012 mrem d-1.

  3. One Year Experience with Portable Back-Pressure Turbines in Los Azufres

    SciTech Connect

    Hiriart, Gerardo L.

    1983-12-15

    This paper contains the experience gained after one year operating five 5 MW portable, back-pressure, geothermal power plants at Los Azufres. A brief description of the field and te equipment is given. Cost figures of the whole installation and a list of what they believe are the advantages and disadvantages is also presented. The main conclusion is that the use of this type of turbogenerators is quite attractive in new undeveloped fields and also in countries with financial problems where initial capital cost investments must be kept as low as possible at the expenses of long term steam consumption.

  4. AERONET data investigation of the aerosol mixtures over Iasi area, One-year time scale overview

    NASA Astrophysics Data System (ADS)

    Cazacu, Mihai Marius; Timofte, Adrian; Unga, Florin; Albina, Bogdan; Gurlui, Silviu

    2015-03-01

    In order to analyze the troposphere dynamics under particular conditions in North-East region of Romania, various types of aerosols chemical compositions have been studied using complementary techniques. Thus, the seasonal trends of aerosols and its external influences have been studied using aerosol optical properties retrieved from Aerosol Robotic Network (AERONET). Complementary studies were taken into account by using several meteorological factors, computational models and meteorological data. Moreover, this paper presents optical properties analysis of different types of aerosols and the seasonal variability of them in one year of measurements. The major categories of aerosol types are evidenced, such as urban/industrial aerosol, biomass burning and mineral dust.

  5. Perceived wellbeing of patients one year post stroke in general practice - recommendations for quality aftercare

    PubMed Central

    2011-01-01

    Background Annually, 41,000 people in the Netherlands have strokes. This has multiple physical and psychosocial consequences. Most patients return home after discharge from hospital. Quality aftercare by general practitioners is important to support patients at home. The purpose of this study is to examine the wellbeing of patients who returned home immediately after discharge from hospital, one year post stroke, in comparison with the general Dutch population of the same age and to determine factors that could influence wellbeing. Methods All the stroke patients from the Department of Neurology, Martini Hospital Groningen in the period November 2006 to October 2007 were included. People aged under 65 years or with haemorrhaging were excluded. All the patients (N = 57) were interviewed at home using the following questionnaires: Barthel Index, SF-36, HADS, CSI and a questionnaire about their way of life. Results 31% of the patients in this study experienced a decrease in functional status after one year. Nevertheless, there was no significant difference between the median Barthel Index value at discharge from hospital and one year post stroke. ADL independence correlated with a better quality of life. The health-related quality of life was high. Stroke patients have almost the same quality of life as the 'average' Dutch elderly population. Where patients can no longer fully participate in society, their perceived quality of life is also lower. In this study there is an indication of a high prevalence of depression and anxiety disorders in stroke patients. This negatively affects the quality of life a year after stroke. Although caregiver strain was low for the partners of stroke patients, a reduced quality of life is correlated to greater burden. Conclusions This study provides valuable insight into the wellbeing of patients living at home one year post stroke. Physical functioning and quality of life are comparable to the general population of the same age, but

  6. [Idiopathic pulmonary haemosiderosis in a one-year-old girl with Down syndrome.

    PubMed

    Lewis, Anna Elisabeth; Høi-Hansen, Christina Engel; Buchvald, Frederik; Petersen, Werner

    2014-09-22

    Idiopathic pulmonary haemosiderosis (IPH) is a rare disease. We describe a girl with Down syndrome who had no major respiratory symptoms until one year of age, where recurrent airway infections and chronic anaemia of unknown aetiology developed. At 20 months of age she had intermittent haemo-ptysis, was investigated with computed tomography and broncho-alveolar lavage and was diagnosed with IPH. After treatment, respiratory symptoms and anaemia resolved and a positive impact on previously impaired growth and psychomotor development was seen. Paediatricians should consider IPH in children with recurrent respiratory symptoms and anaemia. PMID:25294331

  7. The Joint Information System - Résumé after One Year

    NASA Astrophysics Data System (ADS)

    Kienreich, I.; Hanslmeier, A.; Sosa, A.

    The Joint Information System (JIS) is a fully operable computing tool, which is a combination of a database and interactive web pages, reachable under the web address http://www.solarJIS.com. It is the first-rate aim of this tool to be a platform for all European solar physicists as well as for all other interested ones, which facilitates the access to information about institutes, groups and physicists which work in the field of solar physics. Now, one year after the start of JIS we want to give a brief summary of the success of this tool and discuss possible future plans.

  8. Invasive streptococcal infections in the era before the acquired immune deficiency syndrome: a 10 years' compilation of patients with streptococcal bacteraemia in North Yorkshire.

    PubMed

    Barnham, M

    1989-05-01

    Significant streptococcal (non-pneumococcal, non-enterococcal) bacteraemia was detected in 100 patients in two Health Districts of North Yorkshire in the decade 1978-1988. Patients with these infections accounted for 11% of the total 902 patients in the districts in whom bacteraemia was diagnosed during the period. Infection was most often seen with beta-haemolytic streptococci (52 patients) comprising Lancefield group A (Streptococcus pyogenes) (20 patients), group B (13), group C (5), group G (9), haemolytic Streptococcus milleri and non-groupable streptococci (5). The wide variety of serious infections included cellulitis, abscess, septicaemia, pneumonia, septic arthritis, necrotising fasciitis, acute endocarditis and mycotic aneurysm. Of these 52 patients, 21 (40%) died. alpha-Haemolytic streptococcal bacteraemia was diagnosed in 38 patients of whom 24 (63%) suffered from endocarditis and three (8%) died. Three of ten patients with non-haemolytic or anaerobic streptococcal bacteraemia died also. Six of the 100 patients with streptococcal bacteraemia had concomitant acute virus infections. Of the total 56 patients with infective endocarditis diagnosed in the districts during the period, streptococci were responsible in 30 (54%) of them. The predisposing factors, clinical features and outcome of the infections are described and discussed. PMID:2663996

  9. Mentally disordered offenders' daily occupations after one year of forensic care.

    PubMed

    Lindstedt, Helena; Grann, Martin; Söderlund, Anne

    2011-12-01

    Persons detained as mentally disordered offenders need support for transition from care to community life. Few systematic studies have been completed on the outcomes of standard forensic care. The aim was to investigate the target group's life conditions and daily occupations one year after care. In a follow-up design occupational performance (OP) and social participation (SP) were investigated at two time points. After informed consent 36 consecutively recruited participants reported OP using the Capability to Perform Daily Occupations, Self-Efficacy Scale, Importance scale, and Allen Cognitive Level Screen. SP was measured with the Manchester Short Assessment of Quality of Life, and Interview Schedule for Social Interaction. After one year 24 participants were still incarcerated, 11 were conditionally released, and one participant was discharged. The group were generally more satisfied and engaged in daily occupations than at admission. The study's attrition rate, 51%, is discussed. The conclusion and the clinical implications indicate that the target group need early, goal directed interventions in OP and SP for alterations in daily occupations. Furthermore, to increase the knowledge base concerning mentally disordered offenders, studies with research designs that have the potential to uncover changes in daily occupation and other measures for this target group are necessary. PMID:21073367

  10. Temporal Variability of Polybrominated Diphenyl Ether (PBDE) Serum Concentrations over One Year

    PubMed Central

    2015-01-01

    Polybrominated diphenyl ethers (PBDEs) are flame retardant chemicals used in consumer products. They are common contaminants in human serum and associated with adverse health effects. Our objectives were to characterize PBDE serum concentrations in a New England cohort and assess temporal variability of this exposure biomarker over a one-year period. We collected three repeated measurements at six-month intervals from 52 office workers from the greater Boston (MA, United States) area from 2010 to 2011. The intraclass correlation coefficient for BDEs 28, 47, 99, 100, and 153 ranged from 0.87 to 0.99, indicating that a single serum measurement can reliably estimate exposure over a one-year period. This was true for both lipid adjusted and nonlipid adjusted concentrations. The kappa statistics, quantifying the level of agreement of categorical exposure classification, based on medians, tertiles, or quartiles ranged from 0.67 to 0.90. Some congeners showed nonsignificant increases from sampling round 1 (winter) to round 2 (summer) and significant decreases from round 2 to round 3 (winter). This study highlights the high reliability of a single serum PBDE measurement for use in human epidemiologic studies. PMID:25383963

  11. Temporal variability of polybrominated diphenyl ether (PBDE) serum concentrations over one year.

    PubMed

    Makey, Colleen M; McClean, Michael D; Sjödin, Andreas; Weinberg, Janice; Carignan, Courtney C; Webster, Thomas F

    2014-12-16

    Polybrominated diphenyl ethers (PBDEs) are flame retardant chemicals used in consumer products. They are common contaminants in human serum and associated with adverse health effects. Our objectives were to characterize PBDE serum concentrations in a New England cohort and assess temporal variability of this exposure biomarker over a one-year period. We collected three repeated measurements at six-month intervals from 52 office workers from the greater Boston (MA, United States) area from 2010 to 2011. The intraclass correlation coefficient for BDEs 28, 47, 99, 100, and 153 ranged from 0.87 to 0.99, indicating that a single serum measurement can reliably estimate exposure over a one-year period. This was true for both lipid adjusted and nonlipid adjusted concentrations. The kappa statistics, quantifying the level of agreement of categorical exposure classification, based on medians, tertiles, or quartiles ranged from 0.67 to 0.90. Some congeners showed nonsignificant increases from sampling round 1 (winter) to round 2 (summer) and significant decreases from round 2 to round 3 (winter). This study highlights the high reliability of a single serum PBDE measurement for use in human epidemiologic studies. PMID:25383963

  12. Spurious One-Month and One-Year Periods in Visual Observations of Variable Stars

    NASA Astrophysics Data System (ADS)

    Percy, J. R.

    2015-12-01

    Visual observations of variable stars, when time-series analyzed with some algorithms such as DC-DFT in vstar, show spurious periods at or close to one synodic month (29.5306 days), and also at about a year, with an amplitude of typically a few hundredths of a magnitude. The one-year periods have been attributed to the Ceraski effect, which was believed to be a physiological effect of the visual observing process. This paper reports on time-series analysis, using DC-DFT in vstar, of visual observations (and in some cases, V observations) of a large number of stars in the AAVSO International Database, initially to investigate the one-month periods. The results suggest that both the one-month and one-year periods are actually due to aliasing of the stars' very low-frequency variations, though they do not rule out very low-amplitude signals (typically 0.01 to 0.02 magnitude) which may be due to a different process, such as a physiological one. Most or all of these aliasing effects may be avoided by using a different algorithm, which takes explicit account of the window function of the data, and/or by being fully aware of the possible presence of and aliasing by very low-frequency variations.

  13. Reliability of Laparoscopic Compared With Hysteroscopic Sterilization at One Year: A Decision Analysis

    PubMed Central

    Gariepy, Aileen M.; Creinin, Mitchell D.; Schwarz, Eleanor B.; Smith, Kenneth J.

    2011-01-01

    OBJECTIVE To estimate the probability of successful sterilization after hysteroscopic or laparoscopic sterilization procedure. METHODS An evidence-based clinical decision analysis using a Markov model was performed to estimate the probability of a successful sterilization procedure using laparoscopic sterilization, hysteroscopic sterilization in the operating room, and hysteroscopic sterilization in the office. Procedure and follow-up testing probabilities for the model were estimated from published sources. RESULTS In the base case analysis, the proportion of women having a successful sterilization procedure on first attempt is 99% for laparoscopic, 88% for hysteroscopic in the operating room and 87% for hysteroscopic in the office. The probability of having a successful sterilization procedure within one year is 99% with laparoscopic, 95% for hysteroscopic in the operating room, and 94% for hysteroscopic in the office. These estimates for hysteroscopic success include approximately 6% of women who attempt hysteroscopically but are ultimately sterilized laparoscopically. Approximately 5% of women who have a failed hysteroscopic attempt decline further sterilization attempts. CONCLUSIONS Women choosing laparoscopic sterilization are more likely than those choosing hysteroscopic sterilization to have a successful sterilization procedure within one year. However, the risk of failed sterilization and subsequent pregnancy must be considered when choosing a method of sterilization. PMID:21775842

  14. ATS-5 solar cell experiment results after one year in synchronous orbit

    NASA Technical Reports Server (NTRS)

    Anspaugh, B. E.

    1972-01-01

    The results of the ATS-5 solar cell experiment after one year in synchronous orbit are reported. A partial failure in the experimental electronics package has caused a loss of data from half the 80 experimental solar cells. Procedures for extracting data due to a partial spacecraft failure are described and discussed. Data from the remaining 40 solar cells, including 15 mounted on a thin flexible structure are analyzed. Data are corrected to a solar intensity of 140 mW/sq cm and a temperature of 25 C. It was found that after one year in synchronous orbit: (1) cells with 1.52-mm-thick coverslides did not show a clear-cut advantage over those with 0.15-mm coverslides, (2) cells with solderless grid lines are degrading at the same rate as are cells with solder-dipped grid lines, (3) cells not quite completely covered with coverslides suffered a large power loss in comparison to cells fully covered, (4) no clear-cut advantage of 10-cm cells over 2-cm cells has yet been observed, (5) cells mounted on the flexible panel with relatively little backshielding did not degrade any faster than those with substantial backshielding, and (6) the flight data in large part confirms the adequacy of the ground-based techniques used in our preflight radiation test program.

  15. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis.

    PubMed

    Kjeldsen-Kragh, J; Haugen, M; Borchgrevink, C F; Laerum, E; Eek, M; Mowinkel, P; Hovi, K; Førre, O

    1991-10-12

    Fasting is an effective treatment for rheumatoid arthritis, but most patients relapse on reintroduction of food. The effect of fasting followed by one year of a vegetarian diet was assessed in a randomised, single-blind controlled trial. 27 patients were allocated to a four-week stay at a health farm. After an initial 7-10 day subtotal fast, they were put on an individually adjusted gluten-free vegan diet for 3.5 months. The food was then gradually changed to a lactovegetarian diet for the remainder of the study. A control group of 26 patients stayed for four weeks at a convalescent home, but ate an ordinary diet throughout the whole study period. After four weeks at the health farm the diet group showed a significant improvement in number of tender joints, Ritchie's articular index, number of swollen joints, pain score, duration of morning stiffness, grip strength, erythrocyte sedimentation rate, C-reactive protein, white blood cell count, and a health assessment questionnaire score. In the control group, only pain score improved score. In the control group, only pain score improved significantly. The benefits in the diet group were still present after one year, and evaluation of the whole course showed significant advantages for the diet group in all measured indices. This dietary regimen seems to be a useful supplement to conventional medical treatment of rheumatoid arthritis. PMID:1681264

  16. Recurrent SDSE bacteraemia resulting in streptococcal toxic shock syndrome in a patient with Noonan syndrome.

    PubMed

    Suzuki, Kei; Nakamura, Akiko; Ishikura, Ken; Imai, Hiroshi

    2016-01-01

    A 19-year-old man with chronic lymphoedema due to Noonan syndrome presented at our hospital with septic shock and pain in his lower leg. Blood cultures were positive for Streptococcus dysgalactiae subsp equisimilis (SDSE), resulting in a diagnosis of cellulitis with toxic involvement. He was treated with ampicillin for 3 weeks. Although he did well for 6 weeks, septic shock recurred. Blood culture again revealed SDSE, with the strain being identical to the first episode, suggesting that this infection had relapsed. He was treated with ampicillin for 6 weeks and prophylactically with trimethoprim-sulfamethoxazole for 12 months. Although SDSE bacteraemia occurs commonly in elderly patients, findings in this patient showed that it can also develop in younger persons with predisposing factors. This case also indicates that SDSE has the potential to recur, despite generally sufficient antibiotic administration, and that patients who experience recurrent episodes may require prolonged treatment with antibiotics, including prophylaxis. PMID:27485878

  17. Mycotic pseudoaneurysm by vancomycin-intermediate Staphylococcus aureus: a rare cause of persistent bacteraemia.

    PubMed

    Mahfood Haddad, Toufik; Vallabhajosyula, Saraschandra; Sundaragiri, Pranathi Rao; Vivekanandan, Renuga

    2015-01-01

    Pseudoaneurysms are vessel wall ruptures, that are often mistaken for deep vein thrombosis (DVT). A middle-aged man presented with right leg pain, swelling and erythema. His history was significant for persistent Staphylococcus aureus bacteraemia. Ultrasound revealed subacute DVT and laboratory parameters were suggestive of sepsis. He was started on intravenous heparin and antimicrobials. Owing to persistent anaemia despite blood transfusion, MRI of the right thigh was obtained. It revealed a 13×17 cm superficial femoral artery infected mycotic pseudoaneurysm (MPA) with a fresh haematoma. The patient underwent arterial ligation and extensive debridement. Intraoperative cultures revealed daptomycin-resistant vancomycin-intermediate S. aureus (VISA) and he was managed with 6 weeks of intravenous ceftaroline. MPAs are most common in the femoral artery and form <1% of aneurysms. Therapy involves surgical debridement and prolonged antimicrobials. VISA causing MPA is associated with worse outcomes. We report the first time use of ceftaroline in the management of a VISA MPA. PMID:25833910

  18. Adjunctive rifampicin may improve outcomes in Staphylococcus aureus bacteraemia: a systematic review.

    PubMed

    Russell, Clark D; Lawson McLean, Aaron; Saunders, Christopher; Laurenson, Ian F

    2014-06-01

    Staphylococcus aureus bacteraemia (SAB) is associated with substantial morbidity and mortality. By surviving within leukocytes, S. aureus can evade both immunological defences and antimicrobial drugs, thus facilitating haematogenous dissemination. We performed a systematic review to determine whether antimicrobials with intracellular activity improve outcomes in SAB when used as an adjunct to β-lactam or glycopeptide monotherapy. The Pubmed/MEDLINE, Embase and Cochrane databases were systematically searched for eligible studies that reported on the use of first-line antimicrobials plus a single additional antimicrobial of interest in patients with SAB (any cause). Six relevant studies were identified, all reporting on rifampicin use. Four studies (three randomized controlled trials and one cohort) reported on adults with SAB, including 54 patients treated with adjunctive rifampicin and 44 standard-therapy controls. Estimated across all of these studies, adjunctive rifampicin was associated with trends towards reduced all-cause mortality and reduced clinical or bacteriological failure. The fifth study indicated that adjunctive rifampicin accelerates the resolution of persistent SAB in neonates. Data from the sixth study were considered flawed owing to differences in co-morbidities between groups. Limited data suggest that rifampicin-induced hepatitis is not clinically significant but that drug interactions are. In conclusion, adjunctive rifampicin may improve outcomes in SAB when used as an adjunct to β-lactam or glycopeptide monotherapy. PMID:24623637

  19. Encouraging primary care research: evaluation of a one-year, doctoral clinical epidemiology research course

    PubMed Central

    Liira, Helena; Koskela, Tuomas; Thulesius, Hans; Pitkälä, Kaisu

    2016-01-01

    Objective Research and PhDs are relatively rare in family medicine and primary care. To promote research, regular one-year research courses for primary care professionals with a focus on clinical epidemiology were started. This study explores the academic outcomes of the first four cohorts of research courses and surveys the participants’ perspectives on the research course. Design An electronic survey was sent to the research course participants. All peer-reviewed scientific papers published by these students were retrieved by literature searches in PubMed. Setting Primary care in Finland. Subjects A total of 46 research course participants who had finished the research courses between 2007 and 2012. Results Of the 46 participants 29 were physicians, eight nurses, three dentists, four physiotherapists, and two nutritionists. By the end of 2014, 28 of the 46 participants (61%) had published 79 papers indexed in PubMed and seven students (15%) had completed a PhD. The participants stated that the course taught them critical thinking, and provided basic research knowledge, inspiration, and fruitful networks for research. Conclusion A one-year, multi-professional, clinical epidemiology based research course appeared to be successful in encouraging primary care research as measured by research publications and networking. Activating teaching methods, encouraging focus on own research planning, and support from peers and tutors helped the participants to embark on research projects that resulted in PhDs for 15% of the participants. Key PointsClinical research and PhDs are rare in primary care in Finland, which has consequences for the development of the discipline and for the availability of clinical lecturers at the universities.A clinical epidemiology oriented, one-year research course increased the activity in primary care research. Focus on own research planning and learning the challenges of research with peers appeared to enhance the success of a doctoral

  20. Toxicological findings in fatal motor vehicle collisions in ontario, Canada: a one-year study.

    PubMed

    Woodall, Karen L; Chow, Betty L C; Lauwers, Albert; Cass, Dan

    2015-05-01

    Drug-impaired driving is a complex area of forensic toxicology due in part to limited data concerning the type of drugs involved and the concentrations detected. This study analyzed toxicological findings in drivers from fatal motor vehicle collisions (FMVCs) in Ontario, Canada, over a one-year period using a standardized protocol. Of the 229 cases included in the study, 56% were positive for alcohol and/or drugs. After alcohol, cannabis was the most frequently encountered substance (27%), followed by benzodiazepines (17%) and antidepressants (17%). There were differences in drugs detected by age but no marked difference in drugs detected between single and multiple FMVC's. Not all drugs detected were considered impairing either due to drug type, concentration or case history. The findings indicate the importance of comprehensive drug testing in FMVCs and highlight the need to consider a variety of factors, in addition to drug type and concentration, when assessing the role of drugs in driving impairment. PMID:25693690

  1. Tuberculosis in patients undergoing maintenance hemodialysis: one year follow up study from Nepal.

    PubMed

    Dhakal, S S; Bhattarai, L; Manandhar, D N; Devkota, K C; Sharma, S K; Bhatta, N

    2012-09-01

    In Nepal where tuberculosis is endemic and data regarding the prevalence of tuberculosis in patients undergoing maintenance haemodialysis is not known we tried to see the cumulative incidence of tuberculosis in these higher risk groups' patients. Forty patients were followed up for one year after initial screening for tuberculosis. Among forty patients 34 (85%) were male and 6 (15%) were female. During initial screening four patients had sputum positive tuberculosis and three more patients had sputum positive tuberculosis during follow up. Among nine patients with pleural effusion two patients had pulmonary tuberculosis. One patient had tubercular cervical lymphadenitis. Two patients died during follow up and the rest improved with anti tubercular treatment. So in the part of the world where tuberculosis is endemic patients undergoing maintenance haemodialysis should be screened for tuberculosis regularly. PMID:24047026

  2. One-year clinical experience with a fully digitized nuclear medicine department: organizational and economical aspects

    NASA Astrophysics Data System (ADS)

    Anema, P. C.; de Graaf, C. N.; Wilmink, J. B.; Hall, David R.; Hoekstra, A. G.; van Rijk, P. P.; Van Isselt, J. W.; Viergever, Max A.

    1991-07-01

    At the department of nuclear medicine of the University Hospital Utrecht a single-modality PACS has been operational since mid-1990. After one year of operation the functionality, the organizational and economical consequences, and the acceptability of the PACS were evaluated. The functional aspects reviewed were: viewing facilities, patient data management, connectivity, reporting facilities, archiving, privacy, and security. It was concluded that the improved quality of diagnostic viewing and the potential integration with diagnosis, reporting, and archiving are highly appreciated. The many problems that have occurred during the transition period, however, greatly influence the appreciation and acceptability of the PACS. Overall, it is felt that in the long term there will be a positive effect on the quality and efficiency of the work.

  3. Disaster mental health workers responding to Ground Zero: one year later.

    PubMed

    Daly, Erin Scott; Gulliver, Suzy Bird; Zimering, Rose T; Knight, Jeffrey; Kamholz, Barbara W; Morissette, Sandra B

    2008-04-01

    The current study examined anniversary reactions in mental health disaster relief workers following traumatic exposure at the site of the World Trade Center terrorist attacks. Despite relatively low levels of symptom reporting, workers endorsed an increase in both negative mood symptoms and functional impairment at the one-year anniversary of their traumatic exposure (compared to 6 months postexposure). For those individuals who met at least partial criteria for PTSD immediately following exposure, overall self-reported PTSD symptoms tended to increase from 6 to 12 months. This tendency resulted specifically from an increase in hyperarousal symptoms. Although few endorsed symptoms at clinical levels, our results demonstrate that disaster relief workers may experience an increase in symptomatology at the anniversary of their traumatic exposure. PMID:18404624

  4. U.S. announces one-year delay for visa waiver program change

    NASA Astrophysics Data System (ADS)

    The U.S. State Department has announced that it is delaying by one year a new rule affecting citizens from visa waiver program countries. The new rule, which was scheduled to go into effect on 1 October 2003, requires visitors from these countries to obtain non-immigrant visas to enter the United States if they do not have machine-readable passports. The announced delay means that this rule will now go into effect 26 October 2004 instead.The delay does not apply to five visa waiver countries—Andorra, Brunei, Liechtenstein, Luxembourg, and Slovenia—because most of the citizens of these nations already carry passports that are machine-readable.

  5. Summary results from the NASA Tech House one year live-in

    NASA Technical Reports Server (NTRS)

    Hamlet, I. L.

    1979-01-01

    The NASA Tech House was designed and constructed at the Langley Research Center, Hampton, Va., to demonstrate and evaluate new technology potentially applicable for conservation of energy and resources and for improvements in safety and security in a single-family residence. All technology items, including solar energy systems and a waste water reuse system, were evaluated under actual living conditions for a one-year period with a family of four living in the house in their normal life style. Results are presented which show overall savings in energy and resources compared to requirements for a defined similar conventional house under the same conditions. Also included are general operational experience and performance data for all the various items and systems of technology incorporated into the house design.

  6. Medical aspects of drug misuse during one year in a rehabilitation unit

    PubMed Central

    Scott, Robert T.A.

    1986-01-01

    The medical work in a voluntary drug rehabilitation unit near Glasgow was examined. During one year 174 residents were admitted of whom 103 (59%) developed illnesses which required medical treatment. The need for drug misusers to receive general medical services during and after drug misuse was confirmed. Although withdrawal from barbiturate misuse required the prescription of controlled drugs, opiate and other withdrawals were satisfactorily managed with psychological support and general care; substances which could be abused were not prescribed. Blood testing of 129 residents showed that 114 (88%) had evidence of previous hepatitis B infection, while only two had human immunodeficiency virus (HIV) antibody. The low prevalence of HIV antibody compared with the high prevalence that has been reported in Edinburgh suggests that the opportunity exists at the moment to limit the spread of acquired immune deficiency syndrome among Glasgow drug misusers. PMID:3656269

  7. Cementless Oxford unicompartmental knee replacement shows reduced radiolucency at one year.

    PubMed

    Pandit, H; Jenkins, C; Beard, D J; Gallagher, J; Price, A J; Dodd, C A F; Goodfellow, J W; Murray, D W

    2009-02-01

    We randomised 62 knees to receive either cemented or cementless versions of the Oxford unicompartmental knee replacement. The implants used in both arms of the study were similar, except that the cementless components were coated with porous titanium and hydroxyapatite. The tibial interfaces were studied with fluoroscopically-aligned radiographs. At one year there was no difference in clinical outcome between the two groups. Narrow radiolucent lines were seen at the bone-implant interfaces in 75% of cemented tibial components. These were partial in 43%, and complete in 32%. In the cementless implants, partial radiolucencies were seen in 7% and complete radiolucencies in none. These differences are statistically significant (p < 0.0001) and imply satisfactory bone ingrowth into the cementless implants. PMID:19190051

  8. [Comparison of the results of coronary angioplasty and stenting during one year following surgery].

    PubMed

    Simonenko, V B; Seĭdov, V G; Zakharov, S V; Evsiukov, V V; Liubchuk, I V

    2007-01-01

    The purpose of the study was to compare long-term results of angioplasty and coronary arterial stenting (CAS) depending on the initial degree of coronary arterial (CA) lesion according to morphological stenosis classification, as well as to evaluate the influence of re-stenosis on myocardial contractility dynamics, anginal recurrence rate, and exercise tolerance. The subjects, 228 men after angioplasty and 184 men after CAS with wire stents without drug coating, were included in the study between 1989 and 2005. Coronarography was repeated in 358 patients one year after surgery. The patients were divided into two groups. The first group consisted of 161 patients, to who 180 stents were implanted. The second group consisted of 197patients, in who 226 angioplasty procedures were performed. Data were processed using standard variational statistical methods, i.e. the calculation of mean values and standard deviation. Statistical calculations were carried out using Analysis ToolPak- VBA software of Microsoft Excel 2000. The study found that one year after either intervention the number of patients without anginal symptoms fell significantly compared with this number during the in-hospital period. In group 2 the frequency of restenosis was higher and the number of patients with anginal symptoms was significantly bigger than in group 1; the number of asymptomatic patients was significantly bigger in group 1. Initial morphological characteristics of CA lesion had a significant effect on the long-term frequency of restenosis following endovascular treatment. Restenosis was 2 to 2.5 times more frequent in patients with C type CA lesion vs. patients with A type regardless the method of endovascular intervention. The results of the study demonstrate the importance of taking into account initial morphological characteristics of CA lesion; CAS is more preferable than angioplasty, especially in patients with C type CA lesion. PMID:17520881

  9. One year of alendronate treatment lowers microstructural stresses associated with trabecular microdamage initiation.

    PubMed

    O'Neal, Jessica M; Diab, Tamim; Allen, Matthew R; Vidakovic, Brani; Burr, David B; Guldberg, Robert E

    2010-08-01

    Alendronate, an anti-remodeling agent, is commonly used to treat patients suffering from osteoporosis by increasing bone mineral density. Though fracture risk is lowered, an increase in microdamage accumulation has been documented in patients receiving alendronate, leading to questions about the potentially detrimental effects of remodeling suppression on the local tissue (material) properties. In this study, trabecular bone cores from the distal femur of beagle dogs treated for one year with alendronate, at doses scaled by weight to approximate osteoporotic and Paget's disease treatment doses in humans, were subjected to uniaxial compression to induce microdamage. Tissue level von Mises stresses were computed for alendronate-treated and non-treated controls using finite element analysis and correlated to microdamage morphology. Using a modified version of the Moore and Gibson classification for damage morphology, we determined that the von Mises stress for trabeculae exhibiting severe and linear microcrack patterns was decreased by approximately 25% in samples treated with alendronate compared with non-treated controls (p<0.01), whereas there was no reduction in the von Mises stress state for diffuse microdamage formation. Furthermore, an examination of the architectural and structural characteristics of damaged trabeculae demonstrated that severely damaged trabeculae were thinner, more aligned with the loading axis, and less mineralized than undamaged trabeculae in alendronate-treated samples (p<0.01). Similar relationships with damage morphology were found only with trabecular orientation in vehicle-treated control dogs. These results indicate that changes in bone's architecture and matrix properties associated with one year of alendronate administration reduce trabecular bone's ability to resist the formation of loading-induced severe and linear microcracks, both of which dissipate less energy prior to fracture than does diffuse damage. PMID:20483387

  10. One-year clinical experience of perampanel in Spain: a multicentre study of efficacy and tolerability.

    PubMed

    Garamendi-Ruiz, Iñigo; García-García, María Eugenia; Bertol-Alegre, Vicente; Mauri-Llerda, José Ángel; García-Morales, Irene; Garayoa-Irigoyen, Vanesa; Agúndez-Sarasola, Marta; De Toledo-Heras, María; García-Morales, Vanessa; García-Gomara, María José; Arcos-Sánchez, Carolina; Gago-Veiga, Ana; Escalza-Cortina, Inés; Rueda-Mena, Eliana; Muñoz-Fargas, Elena; Santos-Lasaosa, Sonia; Oliván-Usieto, José Antonio; Julián, Leyre Díaz de Cerio-; Gómez-Esteban, Juan Carlos; Marinas-Alejo, Ainhoa

    2016-06-01

    Perampanel, a non-competitive antagonist of the α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptors, is the most recent antiepileptic drug available in Spain, marketed in January 2014. It was initially approved by the European Medicines Agency as adjunctive treatment for partial-onset seizures in patients 12 years and older, but recently also for primary generalized tonic-clonic seizures. Although clinical trials provide essential information about the drug, they do not reflect daily clinical practice. This retrospective study shows the initial experience with perampanel in 11 Spanish hospitals during its first year post-commercialisation. All patients who started perampanel treatment were included, but efficacy and tolerability were only assessed in those patients with a minimum follow-up period of six months. In total, 256 patients were treated with perampanel before September 2014, and 253 had an observational period of one year. After six months, 216/256 patients (84%) continued on perampanel and 180/253 (71.1%) completed one year of treatment. The mean number of previous antiepileptic drugs used was 6.83 and the median number of concomitant antiepileptic drugs was 2. The mean perampanel dose was 7.06 mg and 8.26 mg at six and 12 months, respectively. The responder rate was 39.5% and 35.9% at both follow-up points, respectively. Adverse events were experienced by 91/253 (35.5%) and resulted in withdrawal in 37 (14.6%). The most common adverse events were somnolence, dizziness, and irritability. We found no significant differences between concomitant use of enzyme-inducing and non-inducing antiepileptic drugs, regarding efficacy, adverse effects, or withdrawals. Irritability was not influenced by concomitant use of levetiracetam, relative to other drugs, but was more frequently observed in patients with a history of psychiatric problems or learning disabilities. PMID:27238234

  11. One-year outcomes of conventional and accelerated collagen crosslinking in progressive keratoconus

    PubMed Central

    Chow, Vanissa W. S.; Chan, Tommy C. Y.; Yu, Marco; Wong, Victoria W. Y.; Jhanji, Vishal

    2015-01-01

    We compared one-year outcomes of conventional (3 mW/cm2, 365-nm ultraviolet-A light, 30 minutes) and accelerated (18 mW/cm2, 365-nm ultraviolet-A light, 5 minutes) collagen crosslinking (CXL) in patients with progressive keratoconus. Main outcome measures were change in keratometry, uncorrected visual acuity (UCVA), and best-corrected visual acuity (BCVA). Nineteen patients in each group completed 1-year follow-up. Preoperatively, there were no inter-group differences for age, keratometry, corneal thickness, and spherical equivalent (p > 0.127). One year postoperatively, maximum and minimum keratometry were flattened by 1.6 diopters (p < 0.023) and 2 diopters (p < 0.047) respectively after conventional CXL, and, 0.47 diopters (p = 0.471) and 0.19 diopters (p = 0.120) respectively after accelerated CXL. Association analysis showed significant negative association between baseline maximum keratometry and change in maximum keratometry after accelerated CXL (p = 0.002) but not after conventional CXL (p = 0.110). Corneal thickness was reduced significantly in both groups (p = 0.017). An improvement in UCVA (p < 0.001) and BCVA (p < 0.022) was noted in both groups along with a reduction in spherical equivalent postoperatively (p < 0.026). There were no inter-group differences for any of the parameters postoperatively (p > 0.184). Although no statistically significant differences were observed between both treatment modalities, a more effective topographic flattening was observed with conventional CXL as compared to accelerated CXL in this study. PMID:26404661

  12. Streptococcus Endophthalmitis Outbreak after Intravitreal Injection of Bevacizumab: One-year Outcomes and Investigative Results

    PubMed Central

    Goldberg, Roger A.; Flynn, Harry W.; Miller, Darlene; Gonzalez, Serafin; Isom, Ryan F.

    2013-01-01

    Purpose To report the one-year clinical outcomes of an outbreak of Streptococcus endophthalmitis after intravitreal injection of bevacizumab, including visual acuity outcomes, microbiological testing and compound pharmacy investigations by the Food and Drug Administration (FDA). Design Retrospective consecutive case series. Participants 12 eyes of 12 patients who developed endophthalmitis after receiving intravitreal bevacizumab prepared by a single compounding pharmacy. Methods Medical records of patients were reviewed; phenotypic and DNA analyses were performed on microbes cultured from patients and from unused syringes. An inspection report by the FDA based on site-visits to the pharmacy that prepared the bevacizumab syringes was summarized. Main Outcome Measures Visual acuity, interventions received, time-to-intervention; microbiological consistency; FDA inspection findings. Results Between July 5 and July 8, 2011, 12 patients developed endophthalmitis after intravitreal bevacizumab from syringes prepared by a single compounding pharmacy. All patients received initial vitreous tap and injection, and eight (67%) subsequently underwent pars plana vitrectomy (PPV). After twelve months follow-up, outcomes have been poor: 7 patients (58%) required evisceration or enucleation, and only one patient regained pre-injection visual acuity. Molecular testing using real time polymerase chain reaction, partial sequencing of the groEL gene, and multilocus sequencing of 7 housekeeping genes confirmed the presence of a common strain of Streptococcus mitis/oralis in vitreous specimens and seven unused syringes prepared by the compounding pharmacy at the same time. An FDA investigation of the compounding pharmacy noted deviations from standard sterile technique, inconsistent documentation, and inadequate testing of equipment required for safe preparation of medications. Conclusions In this outbreak of endophthalmitis, outcomes have been generally poor and PPV did not improve

  13. The Infant Aphakia Treatment Study Contact Lens Experience: One-Year Outcomes

    PubMed Central

    Russell, Buddy; Ward, Michael A.; Lynn, Michael; DuBois, Lindreth; Lambert, Scott R.

    2012-01-01

    Purpose We describe our experience correcting a cohort of infants with contact lenses in the Infant Aphakia Treatment Study (IATS). Materials and Methods Fifty-seven infants 1 to 6 months of age were randomized to contact lens wear. An examination under anesthesia was performed at the time of enrollment and at approximately 1 year of age. A traveling examiner assessed visual acuity at approximately 1 year of age. Results Forty-two treated eyes (74 %) were fitted with silicone elastomer (SE) contact lenses; twelve eyes (21 %) with rigid gas permeable (RGP) contact lenses and three eyes (5%) wore both lens types. Median visual acuity was +0.80 logMAR in both lens type-wearing groups. The mean (± SD) keratometric power of the treated eyes was 46.3 ± 2.8 D at baseline and 44.6 ± 2.3 D at one year of age for a mean decrease of 0.2 ± 0.2 D/mo. Keratometric astigmatism of treated eyes was 1.98 ± 1.37 D at baseline and 1.62 ± 0.98 D at one year of age for a mean decrease of 0.05 ± 0.2 D/mo. The mean RGP lens base curve at baseline was 47.62 D ±2.62 D vs 47.00 D ± 3.50 D at 12 months after surgery. Children wearing SE lenses required a mean of 10.9 replacements (range 2–24) compared to 16.8 replacements (range 8–32) for children wearing RGP lenses. Three adverse events occurred. Conclusions Contact lenses were worn successfully with relatively few adverse events by a cohort of infants with unilateral aphakia. The visual acuity results were identical independent of the contact lens material or modality. RGP lenses needed replacement more often than SE lenses. PMID:22669008

  14. [Biomedical information on the internet using search engines. A one-year trial].

    PubMed

    Corrao, Salvatore; Leone, Francesco; Arnone, Sabrina

    2004-01-01

    The internet is a communication medium and content distributor that provide information in the general sense but it could be of great utility regarding as the search and retrieval of biomedical information. Search engines represent a great deal to rapidly find information on the net. However, we do not know whether general search engines and meta-search ones are reliable in order to find useful and validated biomedical information. The aim of our study was to verify the reproducibility of a search by key-words (pediatric or evidence) using 9 international search engines and 1 meta-search engine at the baseline and after a one year period. We analysed the first 20 citations as output of each searching. We evaluated the formal quality of Web-sites and their domain extensions. Moreover, we compared the output of each search at the start of this study and after a one year period and we considered as a criterion of reliability the number of Web-sites cited again. We found some interesting results that are reported throughout the text. Our findings point out an extreme dynamicity of the information on the Web and, for this reason, we advice a great caution when someone want to use search and meta-search engines as a tool for searching and retrieve reliable biomedical information. On the other hand, some search and meta-search engines could be very useful as a first step searching for defining better a search and, moreover, for finding institutional Web-sites too. This paper allows to know a more conscious approach to the internet biomedical information universe. PMID:15032337

  15. Can Psychopathology at Age 7 Be Predicted from Clinical Observation at One Year? Evidence from the ALSPAC Cohort

    ERIC Educational Resources Information Center

    Allely, C. S.; Doolin, O.; Gillberg, C.; Gillberg, I. C.; Puckering, C.; Smillie, M.; McConnachie, A.; Heron, J.; Golding, J.; Wilson, P.

    2012-01-01

    One of the challenges of developmental psychopathology is to determine whether identifiable pathways to developmental disorders exist in the first months or years of life. Early identification of such disorders poses a similar challenge for clinical services. Using data from a large contemporary birth cohort, we examined whether psychopathology at…

  16. One-year Mortality after an Acute Coronary Event and its Clinical Predictors: The ERICO Study

    PubMed Central

    Santos, Itamar Souza; Goulart, Alessandra Carvalho; Brandão, Rodrigo Martins; Santos, Rafael Caire de Oliveira; Bittencourt, Márcio Sommer; Sitnik, Débora; Pereira, Alexandre Costa; Pastore, Carlos Alberto; Samesima, Nelson; Lotufo, Paulo Andrade; Bensenor, Isabela Martins

    2015-01-01

    Background Information about post-acute coronary syndrome (ACS) survival have been mostly short-term findings or based on specialized, cardiology referral centers. Objectives To describe one-year case-fatality rates in the Strategy of Registry of Acute Coronary Syndrome (ERICO) cohort, and to study baseline characteristics as predictors. Methods We analyzed data from 964 ERICO participants enrolled from February 2009 to December 2012. We assessed vital status by telephone contact and official death certificate searches. The cause of death was determined according to the official death certificates. We used log-rank tests to compare the probabilities of survival across subgroups. We built crude and adjusted (for age, sex and ACS subtype) Cox regression models to study if the ACS subtype or baseline characteristics were independent predictors of all-cause or cardiovascular mortality. Results We identified 110 deaths in the cohort (case-fatality rate, 12.0%). Age [Hazard ratio (HR) = 2.04 per 10 year increase; 95% confidence interval (95%CI) = 1.75–2.38], non-ST elevation myocardial infarction (HR = 3.82 ; 95%CI = 2.21–6.60) or ST elevation myocardial infarction (HR = 2.59; 95%CI = 1.38–4.89) diagnoses, and diabetes (HR = 1.78; 95%CI = 1.20‑2.63) were significant risk factors for all-cause mortality in the adjusted models. We found similar results for cardiovascular mortality. A previous coronary artery disease diagnosis was also an independent predictor of all-cause mortality (HR = 1.61; 95%CI = 1.04–2.50), but not for cardiovascular mortality. Conclusion We found an overall one-year mortality rate of 12.0% in a sample of post-ACS patients in a community, non-specialized hospital in São Paulo, Brazil. Age, ACS subtype, and diabetes were independent predictors of poor one‑year survival for overall and cardiovascular-related causes. PMID:25993485

  17. Ecthyma gangrenosum: a rare cutaneous manifestation caused by pseudomonas aeruginosa without bacteraemia in a leukaemic patient--a case report.

    PubMed

    Singh, T N; Devi, K M; Devi, K S

    2005-10-01

    Ecthyma gangrenosum is a rare and invasive cutaneous infection caused by Pseudomonas aeruginosa in the majority of cases, typically affecting immunocompromised patients, particularly those with neutropenia. We report a rare case of ecthyma gangrenosum in the absence of bacteraemia presenting as a solitary necrotic ulcer in a female patient with acute lymphoblastic leukaemia. A culture from the ecthyma lesion revealed the presence of Pesudomonas aeruginosa, but the results of repeated blood cultures were negative. The patient responded well to amikacin to which the isolate was susceptible in vitro. Considering high rate of mortality, early diagnosis and prompt effective treatment is mandatory. PMID:16327125

  18. Adjunctive rifampicin to reduce early mortality from Staphylococcus aureus bacteraemia (ARREST): study protocol for a randomised controlled trial

    PubMed Central

    2012-01-01

    Background Staphylococcus aureus bacteraemia is a common and serious infection, with an associated mortality of ~25%. Once in the blood, S. aureus can disseminate to infect almost any organ, but bones, joints and heart valves are most frequently affected. Despite the infection’s severity, the evidence guiding optimal antibiotic therapy is weak: fewer than 1,500 patients have been included in 16 randomised controlled trials investigating S. aureus bacteraemia treatment. It is uncertain which antibiotics are most effective, their route of administration and duration, and whether antibiotic combinations are better than single agents. We hypothesise that adjunctive rifampicin, given in combination with a standard first-line antibiotic, will enhance killing of S. aureus early in the treatment course, sterilise infected foci and blood faster, and thereby reduce the risk of dissemination, metastatic infection and death. Our aim is to determine whether adjunctive rifampicin reduces all-cause mortality within 14 days and bacteriological failure or death within 12 weeks from randomisation. Methods We will perform a parallel group, randomised (1:1), blinded, placebo-controlled trial in NHS hospitals across the UK. Adults (≥18 years) with S. aureus (meticillin-susceptible or resistant) grown from at least one blood culture who have received ≤96 h of active antibiotic therapy for the current infection and do not have contraindications to the use of rifampicin will be eligible for inclusion. Participants will be randomised to adjunctive rifampicin (600-900mg/day; orally or intravenously) or placebo for the first 14 days of therapy in combination with standard single-agent antibiotic therapy. The co-primary outcome measures will be all-cause mortality up to 14 days from randomisation and bacteriological failure/death (all-cause) up to 12 weeks from randomisation. 940 patients will be recruited, providing >80% power to detect 45% and 30% reductions in the two co

  19. Brief Tale of a Bacteraemia by Rhodococcus equi, With Concomitant Lung Mass: What Came First, the Chicken or The Egg?

    PubMed Central

    Savini, Vincenzo; Salutari, Prassede; Sborgia, Marco; Mancini, Iole; Masciarelli, Gioviana; Catavitello, Chiara; Astolfi, Daniela; D’Amario, Claudio; Fioritoni, Giuseppe; Spadaro, Antonio; D’Antonio, Domenico

    2011-01-01

    Rhodococcus equi is an uncommon Gram positive, variably acid-fast pathogen, that appears as hard to treat mostly owing to the establishment of intracellular niches. Lack of interpretive criteria for susceptibility testing may lead to under-reporting or overestimation of resistances, whereas knowledge about this pathogen’s clinical impact may be affected by erroneous phenotype-based characterization at a genus and species level. We present the case of a bacteraemia with a concomitant lung mass in a lymphoma patient, that further highlights the emergence of rhodococcal diseases as a matter for concern in the fields of infectious diseases and haematology. PMID:21625310

  20. A one-year study of streptococcal infections and their complications among Ethiopian children.

    PubMed Central

    Tewodros, W.; Muhe, L.; Daniel, E.; Schalén, C.; Kronvall, G.

    1992-01-01

    Post-streptococcal complications are known to be common among Ethiopian children. Little is known, however, about the epidemiology of beta-haemolytic streptococci in Ethiopia. A total of 816 children were studied during a one-year period: 24 cases of acute rheumatic fever (ARF), 44 chronic rheumatic heart disease (CRHD), 44 acute post streptococcal glomerulonephritis (APSGN), 143 tonsillitis, 55 impetigo, and 506 were apparently healthy children. Both ARF and APSGN occurred throughout the year with two peaks during the rainy and cold seasons. The female:male ratio among ARF patients was 1.4:1 and 1:1.9 among APSGN. The monthly carrier rate of beta-haemolytic streptococci group A varied from 7.5-39%, average being 17%. T type 2 was the most frequent serotype. Marked seasonal fluctuations were noted in the distribution of serogroups among apparently healthy children. Beta-haemolytic streptococci group A dominated during the hot and humid months of February-May. Strains were susceptible to commonly used antibiotics, except for tetracycline. PMID:1397112

  1. Ambulance diversion associated with reduced access to cardiac technology and increased one-year mortality.

    PubMed

    Shen, Yu-Chu; Hsia, Renee Y

    2015-08-01

    Ambulance diversion, which occurs when a hospital emergency department (ED) is temporarily closed to incoming ambulance traffic, is an important system-level interruption that causes delays in treatment and potentially lower quality of care. There is little empirical evidence investigating the mechanisms through which ambulance diversion might affect patient outcomes. We investigated whether ambulance diversion affects access to technology, likelihood of treatment, and ultimately health outcomes for Medicare patients with acute myocardial infarction in twenty-six California counties. We found that patients whose nearest hospital ED had significant ambulance diversions experienced reduced access to hospitals with cardiac technology. This led to a 4.6 percent decreased likelihood of revascularization and a 9.8 percent increase in one-year mortality compared to patients who did not experience diversion. Policy makers may wish to consider creating a policy to specifically manage certain time-sensitive conditions that require technological intervention during periods of ambulance diversion. PMID:26240239

  2. Direct Midline Diastema Closure with Composite Layering Technique: A One-Year Follow-Up.

    PubMed

    Korkut, Bora; Yanikoglu, Funda; Tagtekin, Dilek

    2016-01-01

    Objective. Maxillary anterior spacing is a common aesthetic complaint of patients. Midline diastema has a multifactorial etiology such as labial frenulum, microdontia, mesiodens, peg-shaped lateral incisors, agenesis, cysts, habits such as finger sucking, tongue thrusting, or lip sucking, dental malformations, genetics, proclinations, dental-skeletal discrepancies, and imperfect coalescence of interdental septum. Appropriate technique and material for effective treatment are based on time, physical, psychological, and economical limitations. Direct composite resins in diastema cases allow dentist and patient complete control of these limitations and formation of natural smile. Clinical Considerations. In this case report a maxillary midline diastema was closed with direct composite resin restorations in one appointment without any preparation. One bottle total etch adhesive was used and translucent/opaque composite resin shades were layered on mesial surfaces of the teeth that were isolated with rubber dam and Teflon bands. Finishing and polishing procedures were achieved by using polishing discs. Patient was informed for recalls for every 6 months. Conclusions. At one-year recall no sensitivities, discolorations, or fractures were detected on teeth and restorations. Direct composite resins seemed to be highly aesthetic and durable restorations that can satisfy patients as under the conditions of case presented. PMID:26881147

  3. High 5-hydroxymethylfurfural concentrations are found in Malaysian honey samples stored for more than one year.

    PubMed

    Khalil, M I; Sulaiman, S A; Gan, S H

    2010-01-01

    5-Hydroxymethylfurfural (HMF) content is an indicator of the purity of honey. High concentrations of HMF in honey indicate overheating, poor storage conditions and old honey. This study investigated the HMF content of nine Malaysian honey samples, as well as the correlation of HMF formation with physicochemical properties of honey. Based on the recommendation by the International Honey Commission, three methods for the determination of HMF were used: (1) high performance liquid chromatography (HPLC), (2) White spectrophotometry and (3) Winkler spectrophotometry methods. HPLC and White spectrophotometric results yielded almost similar values, whereas the Winkler method showed higher readings. The physicochemical properties of honey (pH, free acids, lactones and total acids) showed significant correlation with HMF content and may provide parameters that could be used to make quick assessments of honey quality. The HMF content of fresh Malaysian honey samples stored for 3-6 months (at 2.80-24.87 mg/kg) was within the internationally recommended value (80 mg/kg for tropical honeys), while honey samples stored for longer periods (12-24 months) contained much higher HMF concentrations (128.19-1131.76 mg/kg). Therefore, it is recommended that honey should generally be consumed within one year, regardless of the type. PMID:20595027

  4. Meta-iodobenzylguanidine (mIBG) scintigraphy: A one year experience

    SciTech Connect

    Baulieu, J.L.; Guilloteau, D.; Chambon, C.; Viel, C.; Baulieu, F.; Itti, R.; Pourcelot, L.; Besnard, J.C.

    1984-01-01

    During one year, mIBG scintigraphy was performed in 31 patients: group I (n=27): I-131 mIBG: 18 patients without pheochromocytoma, and 9 patients with proved pheochromocytoma; grout II (n=4): I-123 mIBG: two children without neuroblastoma and two children with proved neuroblastoma. Uptake in various organs or sites of activity was evaluated by an entire score varying from 0 to 3 according respectively to no visualization, visualization only from digitalized images, visualization on analogic images and predominant activity. Most of the organs appeared more visible in patients without pheochromocytoma. In patients with pheochromocytoma, the heart was not apparent on 48 hours views. In group I, pathologic examination resulted in eight true positives one false positive and one false negative. In group II, the neuroblastoma exhibited mIBG accumulation, while no abnormal uptake was observed in children without neuroblastoma. According to the final diagnosis, sensitivity was found to be .91 and specificity .95. The results confirm that mIBG is valuable for pheochromocytoma localization and suggest that I-123 mIBG could be useful in investigating neuroblastoma in children.

  5. Changes in teacher efficacy and beliefs during a one-year teacher preparation program

    NASA Astrophysics Data System (ADS)

    Lockman, Alison Schirmer

    This study attempted to further understanding of factors affecting the teacher efficacy beliefs of secondary science preservice teachers, and to develop a model relating teacher efficacy to beliefs about teaching and students. A mixed quantitative and qualitative methodology was utilized in order to track participants' beliefs both broadly and in depth throughout a one-year teacher preparation program. Results from this analysis revealed that preservice teachers at the end of the program had significantly higher personal science teaching efficacy beliefs than at the beginning of the program. No significant difference in science teaching outcome expectancy beliefs was found, although individual preservice teachers did develop alternate beliefs. Teacher efficacy beliefs were directly affected by three of Bandura's four sources of self-efficacy beliefs---Mastery experiences, vicarious experiences, and verbal persuasion---with the influence of each source of self-efficacy information appearing to change during the course of the teacher preparation program. No evidence was found that affective states by themselves had resulted in belief changes, although many of the other experiences were more powerful because they were accompanied by an emotional incident. Connections between teacher efficacy beliefs, beliefs about students, and beliefs about teaching were uncovered, as was the importance of content knowledge and pedagogical content knowledge on a teacher's sense of efficacy.

  6. One-year follow-up of two novel CBTs for adolescents with ADHD.

    PubMed

    Boyer, Bianca E; Geurts, Hilde M; Prins, Pier J M; Van der Oord, Saskia

    2016-03-01

    Long-term effects of two CBTs for adolescents with ADHD are explored: One aimed at improving planning skills (Plan My Life; PML), the other a solution-focused therapy (SFT) without focusing on planning skills. In a RCT, adolescents with ADHD (n = 159) were assigned to PML or SFT and improved significantly between pre- and posttest with large effect sizes Boyer et al (Eur Child Adolesc Psychiatry. doi: 10.1007/s00787-014-0661-5 ), with marginal differences in favor of PML. One-year follow-up data were gathered. Initial improvements remained stable or continued to improve from posttest to 1-year follow-up. 25.9 % of adolescents showed normalized functioning. However, no treatment differences were found. These results are consistent with the finding that treatment of ADHD improves long-term outcomes, but not to the point of normalization. Earlier found differences at 3-month follow-up in favor of PML disappeared, indicating that focusing treatment on planning skills is not necessary for improvement or that a more prolonged planning-focused treatment is needed. PMID:26433369

  7. Supernova 1987a: One year later: A summary of the La Thuile symposium

    SciTech Connect

    Schramm, D.N.

    1988-04-01

    The Conference reviewed what we have learned after one year from SN 1987a. In particular, new information continues to come in daily on the evolving spectra, including x-rays and ..gamma..-rays. We now know the light curve was indeed powered by /sup 56/Co decay. The neutrino data from IMB and Kamioka continues to be analyzed. It is fit very well by a standard collapse to a neutron star although some nagging problems with the angular distribution remain. Constraints on neutrino and other weakly interacting particle properties have been developed that rival or exceed terrestrial laboratory results. The question of the counts detected by the Mt. Blanc neutrino detector had new mysteries added at this meeting as reports of multiple coincidences with gravitational wave detectors at Maryland and Rome were presented. Future supernova rates were also discussed. It was argued that neutrino detection from a future supernova in our Galaxy might be the only way to prove that the ..nu../sub /tau// was the dominant matter of the Universe.

  8. Thyroglobulin antibodies and risk of readmission at one year in subjects with bipolar disorder.

    PubMed

    Barbero, Juan D; Garcia-Parés, Gemma; Llorens, Marta; Tost, Meritxell; Cobo, Jesús; Palao, Diego; Labad, Javier

    2014-09-30

    Thyroid autoimmunity has been proposed as an endophenotype for Bipolar Disorder (BD), although its relationship with clinical outcomes remains unclear. We aimed to determine whether thyroid autoimmune status (thyroperoxidase antibodies [TPO-Abs] and thyroglobulin antibodies [TG-Abs]) in BD is associated with a greater risk for readmission at one year. We studied 77 inpatients with BD admitted for an index manic or mixed episode. Serum thyroid antibodies (TPO-Abs and TG-Abs) were determined at admission. We compared the readmission risk at 1 year, based on patients׳ thyroid autoimmunity profile using survival analyses. Cox regression was used to control covariates. TG-Abs+ but not TPO-Abs+ was associated with a lower risk of relapse. The Kaplan-Meier mean estimated survival times were 341.6 days (CI95% 316.4-366.8) for the TG-Abs+ group and 261.9 days (CI95%: 221.8 to 302.0) for the TG-Abs- group. Cox proportional hazards regression indicated that subjects with TG-Abs+ were 3.7 (1/OR=1/0.27) times less likely to get admitted during the follow-up period than those with TG-Abs-. Our study suggests that an autoimmune biomarker in patients with BD (i.e., the presence of TG-Abs) is associated with a lower risk of psychiatric readmission after an index hospitalization for a manic or mixed episode. PMID:24913831

  9. Direct Midline Diastema Closure with Composite Layering Technique: A One-Year Follow-Up

    PubMed Central

    Korkut, Bora; Yanikoglu, Funda; Tagtekin, Dilek

    2016-01-01

    Objective. Maxillary anterior spacing is a common aesthetic complaint of patients. Midline diastema has a multifactorial etiology such as labial frenulum, microdontia, mesiodens, peg-shaped lateral incisors, agenesis, cysts, habits such as finger sucking, tongue thrusting, or lip sucking, dental malformations, genetics, proclinations, dental-skeletal discrepancies, and imperfect coalescence of interdental septum. Appropriate technique and material for effective treatment are based on time, physical, psychological, and economical limitations. Direct composite resins in diastema cases allow dentist and patient complete control of these limitations and formation of natural smile. Clinical Considerations. In this case report a maxillary midline diastema was closed with direct composite resin restorations in one appointment without any preparation. One bottle total etch adhesive was used and translucent/opaque composite resin shades were layered on mesial surfaces of the teeth that were isolated with rubber dam and Teflon bands. Finishing and polishing procedures were achieved by using polishing discs. Patient was informed for recalls for every 6 months. Conclusions. At one-year recall no sensitivities, discolorations, or fractures were detected on teeth and restorations. Direct composite resins seemed to be highly aesthetic and durable restorations that can satisfy patients as under the conditions of case presented. PMID:26881147

  10. KNEE SYNERGISM DURING GAIT REMAIN ALTERED ONE YEAR AFTER ACL RECONSTRUCTION

    PubMed Central

    LEPORACE, GUSTAVO; METSAVAHT, LEONARDO; PEREIRA, GLAUBER RIBEIRO; OLIVEIRA, LISZT PALMEIRA DE; CRESPO, BERNARDO; BATISTA, LUIZ ALBERTO

    2016-01-01

    ABSTRACT Objective: To compare the activation of the vastus lateralis (VL) and biceps femoris (BF) muscles during gait, as well VL/BF muscular co-contraction (MCC) between healthy (CG) and anterior cruciate ligament reconstructed (ACL-R) subjects. Methods: Nineteen subjects, ten controls and nine ACL-R patients had a VL and BF electromyogram (EMG) captured to calculate the MCC ratio. A Principal Component (PC) Analysis was applied to reduce the dimensionality effect of each of the MCC, VL and BF curves for both healthy and ACL reconstructed groups. The PC scores were used to calculate the standard distance (SD). SD values were employed in order to compare each dependent variable (MCC, VL and BF) between the two groups using unpaired t-test. Results: ACL-R group presented a lower VL activation at the beginning and at the end of the gait cycle, as compared to the control group. However, no difference was found for BF or VL/BF MCC. Conclusion: The gait analysis of ACL reconstructed patients demonstrated a persistent deficit in VL activation when compared to the control group, even one year after surgery. Level of Evidence III. Case Control Study PMID:27217814

  11. Effect of endurance training on lung function: a one year study

    PubMed Central

    Kippelen, P; Caillaud, C; Robert, E; Connes, P; Godard, P; Prefaut, C

    2005-01-01

    Objective: To identify in a follow up study airway changes occurring during the course of a sport season in healthy endurance athletes training in a Mediterranean region. Methods: Respiratory pattern and function were analysed in 13 healthy endurance trained athletes, either during a maximal exercise test, or at rest and during recovery through respiratory manoeuvres (spirometry and closing volume tests). The exercise test was conducted on three different occasions: during basic endurance training and then during the precompetition and competitive periods. Results: During the competitive period, a slight but non-clinically significant decrease was found in forced vital capacity (–3.5%, p = 0.0001) and an increase in slope of phase III (+25%, p = 0.0029), both at rest and after exercise. No concomitant reduction in expiratory flow rates was noticed. During maximal exercise there was a tachypnoeic shift over the course of the year (mean (SEM) breathing frequency and tidal volume were respectively 50 (2) cycles/min and 3.13 (0.09) litres during basic endurance training v 55 (3) cycles/min and 2.98 (0.10) litres during the competitive period; p<0.05). Conclusions: This study does not provide significant evidence of lung function impairment in healthy Mediterranean athletes after one year of endurance training. PMID:16118298

  12. The use of barytocalcite for carbon 14 immobilization: One-year leaching behavior

    NASA Astrophysics Data System (ADS)

    Massoni, Nicolas; Marcou, Céline; Rosen, Jérémy; Jollivet, Patrick

    2014-11-01

    The spent nuclear fuel reprocessing process is one of the anthropogenic sources of carbon-14, and since this element is highly mobile in the geosphere, its sequestration is necessary. Several phases and industrial solutions to immobilize this radionuclide have been studied, including the barytocalcite phase BaCa(CO3)2 at 8.08 wt.% of C, which has many advantages such as its low specific volume of carbon. Recently, different options to synthesize this phase have been reported. Here we report on the aqueous durability of barytocalcite, studied for one year with pure water at 30 °C, in order to complete the behavior studies. Unexpected leaching behavior was encountered: it had been supposed that barytocalcite would only leach slowly, but after 1 year, it was no longer present. It appears that its simple CaCO3 and BaCO3 constituents precipitated, though the overall carbon loss was low during the period studied. This research gives a new insight into the behavior of this phase regarding carbon-14 immobilization.

  13. Effect of Cystone® on Urinary Composition and Stone Formation Over a One Year Period

    PubMed Central

    Erickson, S. B.; Vrtiska, T. J.; Lieske, J. C.

    2014-01-01

    Kidney stones are a common problem for which inadequate prevention exists. We recruited ten recurrent kidney stone formers with documented calcium oxalate stones into a two phased study to assess safety and effectiveness of Cystone®, an herbal treatment for prevention of kidney stones. The first phase was a randomized double-blinded 12 week cross over study assessing the effect of Cystone® vs. placebo on urinary supersaturation. The second phase was an open label one year study of Cystone® to determine if renal stone burden decreased, as assessed by quantitative and subjective assessment of CT. Results revealed no statistically significant effect of Cystone® on urinary composition short (6 weeks) or long (52 weeks) term. Average renal stone burden increased rather than decreased on Cystone®. Therefore, this study does not support the efficacy of Cystone® to treat calcium oxalate stone formers. Future studies will be needed to assess effects on stone passage, or on other stone types. PMID:21419609

  14. Does surgical approach or prosthesis type affect hip joint loading one year after surgery?

    PubMed

    Wesseling, Mariska; Meyer, Christophe; Corten, Kristoff; Simon, Jean-Pierre; Desloovere, Kaat; Jonkers, Ilse

    2016-02-01

    Several approaches may be used for hip replacement surgery either in combination with conventional total hip arthroplasty (THA) or resurfacing hip arthroplasty (RHA). This study investigates the differences in hip loading during gait one year or more after surgery in three cohorts presenting different surgical procedures, more specific RHA placed using the direct lateral (RHA-DLA, n=8) and posterolateral (RHA-PLA, n=14) approach as well as THA placed using the direct anterior (THA-DAA, n=12) approach. For the DAA and control subjects, hip loading was also evaluated during stair ascent and descent to evaluate whether these motions can better discriminate between patients and controls compared to gait. Musculoskeletal modelling in OpenSim was used to calculate in vivo joint loading. Results showed that for all operated patients, regardless the surgical procedure, hip loading was decreased compared to control subjects, while no differences were found between patient groups. This indicates that THA via DAA results in similar hip loading as a RHA via DLA or PLA. Stair climbing did not result in more distinct differences in hip contact force magnitude between patients and controls, although differences in orientation were more distinct. However, patients after hip surgery did adjust their motion pattern to decrease the magnitude of loading on the hip joint compared to control subjects. PMID:27004636

  15. Primary success and one-year followup of percutaneous peripheral excimer laser angioplasty

    NASA Astrophysics Data System (ADS)

    Visona, Adriana; Liessi, Guido; Miserocchi, Luigi; Bonanome, Andrea; Lusiani, Luigi; Breggion, Giovanni; Pagnan, Antonio

    1992-08-01

    Excimer laser angioplasty was performed in 59 patients (44 males and 17 females, mean age 63 +/- 9 years, range 39 - 77) affected by peripheral vascular disease. Fifty patients had a total occlusion of the superficial femoral artery, three of the iliac artery, and one of the popliteal artery; seven patients showed a subocclusive stenosis of the superficial femoral artery. A commercial excimer laser (Technolas Max-10) was used at the Xenon-Chloride wavelength of 308 nm. The laser operated at 120 ns pulse length and at 20 Hz repetition rate. Applied energy fluence was 20 mJ/pulse. The energy was delivered through a multifiber catheter, which combines 12 (7F) or 18 (9F) fibers (260 micron diameter each), concentrically arranged. Balloon dilatation was associated in 51 patients. Successful recanalization was obtained in 59 out of 61 patients (97%). Failure to recanalize the occluded arteries occurred in two cases, and was due to dissection. Early thrombosis and reocclusion (within 48 hours) was observed in five patients. The cumulative patency rate was 56% at one year. On the basis of these results, excimer laser assisted angioplasty seems a feasible and safe procedure. However, this technique did not solve the restenosis problem. A wide application of excimer laser as a stand alone approach can be foreseen for treatment of peripheral vascular disease.

  16. Inflammatory Serum Protein Profiling of Patients with Lumbar Radicular Pain One Year after Disc Herniation.

    PubMed

    Moen, Aurora; Lind, Anne-Li; Thulin, Måns; Kamali-Moghaddam, Masood; Røe, Cecilie; Gjerstad, Johannes; Gordh, Torsten

    2016-01-01

    Earlier studies suggest that lumbar radicular pain following disc herniation may be associated with a local or systemic inflammatory process. In the present study, we investigated the serum inflammatory protein profile of such patients. All 45 patients were recruited from Oslo University Hospital, Ullevål, Norway, during the period 2007-2009. The new multiplex proximity extension assay (PEA) technology was used to analyze the levels of 92 proteins. Interestingly, the present data showed that patients with radicular pain 12 months after disc herniation may be different from other patients with regard to many measurable serum cytokines. Given a false discovery rate (FDR) of 0.10 and 0.05, we identified 41 and 13 proteins, respectively, which were significantly upregulated in the patients with severe pain one year after disc herniation. On the top of the list ranked by estimated increase we found C-X-C motif chemokine 5 (CXCM5; 217% increase), epidermal growth factor (EGF; 142% increase), and monocyte chemotactic protein 4 (MCP-4; 70% increase). Moreover, a clear overall difference in the serum cytokine profile between the chronic and the recovered patients was demonstrated. Thus, the present results may be important for future protein serum profiling of lumbar radicular pain patients with regard to prognosis and choice of treatment. We conclude that serum proteins may be measurable molecular markers of persistent pain after disc herniation. PMID:27293953

  17. Impediments to recovery in New Orleans' Upper and Lower Ninth Ward: one year after Hurricane Katrina.

    PubMed

    Green, Rebekah; Bates, Lisa K; Smyth, Andrew

    2007-12-01

    In the aftermath of Hurricane Katrina, a rapid succession of plans put forward a host of recovery options for the Upper and Lower Ninth Ward in New Orleans. Much of the debate focused on catastrophic damage to residential structures and discussions of the capacity of low-income residents to repair their neighbourhoods. This article examines impediments to the current recovery process of the Upper and Lower Ninth Ward, reporting results of an October 2006 survey of 3,211 plots for structural damage, flood damage and post-storm recovery. By examining recovery one year after Hurricane Katrina, and by doing so in the light of flood and structural damage, it is possible to identify impediments to recovery that may disproportionately affect these neighbourhoods. This paper concludes with a discussion of how pre- and post-disaster inequalities have slowed recovery in the Lower Ninth Ward and of the implications this has for post-disaster recovery planning there and elsewhere. PMID:18028156

  18. Inflammatory Serum Protein Profiling of Patients with Lumbar Radicular Pain One Year after Disc Herniation

    PubMed Central

    Moen, Aurora; Lind, Anne-Li; Thulin, Måns; Kamali-Moghaddam, Masood; Røe, Cecilie; Gordh, Torsten

    2016-01-01

    Earlier studies suggest that lumbar radicular pain following disc herniation may be associated with a local or systemic inflammatory process. In the present study, we investigated the serum inflammatory protein profile of such patients. All 45 patients were recruited from Oslo University Hospital, Ullevål, Norway, during the period 2007–2009. The new multiplex proximity extension assay (PEA) technology was used to analyze the levels of 92 proteins. Interestingly, the present data showed that patients with radicular pain 12 months after disc herniation may be different from other patients with regard to many measurable serum cytokines. Given a false discovery rate (FDR) of 0.10 and 0.05, we identified 41 and 13 proteins, respectively, which were significantly upregulated in the patients with severe pain one year after disc herniation. On the top of the list ranked by estimated increase we found C-X-C motif chemokine 5 (CXCM5; 217% increase), epidermal growth factor (EGF; 142% increase), and monocyte chemotactic protein 4 (MCP-4; 70% increase). Moreover, a clear overall difference in the serum cytokine profile between the chronic and the recovered patients was demonstrated. Thus, the present results may be important for future protein serum profiling of lumbar radicular pain patients with regard to prognosis and choice of treatment. We conclude that serum proteins may be measurable molecular markers of persistent pain after disc herniation. PMID:27293953

  19. Carbon dioxide and water vapour fluxes for one year above a temperate grazed grassland

    NASA Astrophysics Data System (ADS)

    Jaksic, V.; Kiely, G.; Albertson, J.; Scanlon, T.

    2003-04-01

    The Dripsey flux site in Cork, Ireland is a perennial ryegrass (C3 category) pasture and is grazed for approximately 8 to 10 months of the year. The lands are fertilised with approximately 200kg/ha/year of nitrogen. The flux tower monitoring carbon dioxide, water vapour and energy was established in June 2001 and we have continuous data since then. The site also includes streamflow hydrology and stream water chemistry. We present the results and analysis for carbon dioxide and water vapour for the year July 1, 2001 to July 1, 2002. The accumulated evapotranspiration amounts to 522mm/annum compared to 1600mm/annum of rainfall. The one year carbon sequestration is 3.9t/ha. The estimated carbon in the grass and silage is 3.6t/ha. This suggests that the soils in these pastures are a sink for approximately 0.3t carbon per hectare. This work is part of a five year (2002-2006) research project funded by the Irish Environmental Protection Agency.

  20. The impact of syphilis mass treatment one year later: self-reported behaviour change among participants.

    PubMed

    Rekart, Michael L; Wong, Thomas; Wong, Elsie; Hutchinson, Kylie; Ogilvie, Gina

    2005-08-01

    In 2000, syphilis mass treatment using oral azithromycin was delivered to at-risk British Columbians during a sex trade-related outbreak. The initiative included education, counselling and referral. This cross-sectional, observational study examines knowledge, attitudes and self-reported behaviour after one year among mass treatment participants compared with eligible non-participants. Participants self-reported positive changes: reduction in sexual partners overall (P=0.001) and for sex workers (P<0.01), decrease in unprotected oral sex (P=0.03), knowledge of asymptomatic syphilis (P=0.02), positive attitudes to mass treatment (P=0.02) and to the street nurses (P=0.01). Increased awareness was associated with increased condom use for vaginal sex overall (P=0.02) and for sex workers (P=0.03) and increased condom use for oral sex (P=0.05). There was no difference in syphilis incidence. Syphilis outbreak interventions that include education, support and referral can result in long-term positive behaviour changes. PMID:16105193

  1. Volume transport and mixing of the Faroe Bank Channel overflow from one year of moored measurements

    NASA Astrophysics Data System (ADS)

    Ullgren, J. E.; Darelius, E.; Fer, I.

    2015-10-01

    One-year long time series of current velocity and temperature from ten moorings deployed in the Faroe Bank Channel (FBC) are analysed to describe the structure and variability of the dense overflow plume on daily to seasonal time scales. Mooring arrays are deployed in two sections: located 25 km downstream of the main sill, in the channel that geographically confines the overflow plume at both edges (section C), and 60 km further downstream, over the slope (section S). At section C, the average volume transport of overflow waters (< 3 °C) from the Nordic Seas towards the Iceland Basin is 1.3 ± 0.3 Sv; at Section S, transport of modified overflow water (< 6 °C) is 1.8 ± 0.7 Sv. The volume transport through the slope section is dominated by mesoscale variability at 3-5 day time scale. A simplified view of along-path entrainment of a gravity current is not accurate for the FBC overflow. As the plume proceeds into the stratified ambient water, there is substantial detrainment from the deeper layer (bounded by the 3 °C isotherm), of comparable magnitude to the entrainment into the interfacial layer (between the 3 and 6 °C isotherms). Time series of gradient Richardson number suggests a quiescent plume core capped by turbulent near bottom and interfacial layers in the channel. At section S, in contrast, the entire overflow plume is turbulent. Based on a two-layer heat budget constructed for the overflow, mean diffusivities across the top of the bottom layer, and across the interfacial layer are (30 ± 15) × 10-4 m2 s-1 and (119 ± 43) × 10-4 m2 s-1, respectively.

  2. Callosal tissue loss in multiple system atrophy - a one year follow-up study

    PubMed Central

    Minnerop, M; Luders, E; Specht, K; Ruhlmann, J; Schimke, N; Thompson, PM; Chou, YY; Toga, AW; Abele, M; Wüllner, U; Klockgether, T

    2010-01-01

    Multiple system atrophy (MSA) is a neurodegenerative disease particularly affecting the basal ganglia, brainstem, cerebellum, and intermediolateral cell columns of the spinal cord but also the cerebral cortex. Clinically, cerebellar (MSA-C) and parkinsonian variants of MSA (MSA-P) are distinguished. We investigated 14 MSA patients (10 MSA-C, 4 MSA-P, men/women: 7/7, age: 61.1±3.3 years) and 14 matched controls (men/women: 7/7, age 58.6±5.1 years) with voxel-based morphometry (VBM) to analyze gray and white matter differences both at baseline and at follow-up, one year later. Baseline comparisons between patients and controls confirmed significantly less gray matter in MSA in the cerebellum and cerebral cortex, and significantly less white matter in the cerebellar peduncles and brainstem. Comparisons of tissue-loss profiles (i.e., baseline versus follow-up) between patients and controls, revealed white matter reduction in MSA along the middle cerebellar peduncles, reflecting degeneration of the ponto-cerebellar tract as a particularly prominent and progressive morphological alteration in MSA. Comparisons between baseline and follow-up, separately performed in patients and controls, revealed additional white matter reduction in MSA along the corpus callosum at follow-up. This was replicated through additional shape-based analyses indicating a reduced callosal thickness in the anterior and posterior midbody, extending posteriorly into the isthmus. Callosal atrophy may reflect a possibly disease-specific pattern of neurodegeneration and cortical atrophy respectively, fitting well with the predominant impairment of motor functions in MSA patients. PMID:20623690

  3. Radon and climatic multiparameter analysis: A one-year study on radon dynamics in a house

    SciTech Connect

    Genrich, V.

    1995-12-31

    Radon-reduction in private and public buildings is a current issue. Research has opened our eyes for the enormous fluctuations of the indoor radon level over longer observation periods. For generalizing the behavior radon in a building, care must be taken that the observation period is long enough, to mediate the pronounced climatic changes in the course of a year. The author has started a one-year observations, precisely logging up the radon level in a single family home. Six portable multiparameter-monitors, each equipped with a 0.6 liter PIC-detector (PIC = pulse ionization chamber), have been installed at different locations within the building and outdoors (incl. two soil-gas probes). Besides the radon concentration, in the same instruments the following parameters are logged cotinuously: relative humidity, differential pressure between basement and sub-slab area, soil impendance (indication water saturation) and wind speed on the roof. In the basement, the radon concentration varies between 61 Bq/m{sup 3} and 5408 Bq/m{sup 3} (mean: 1092 Bq/m{sup 3}.) By analyzing these records, the time sequence of the radon concentration can be characterized as a {open_quotes}mixture{close_quotes} of (periodic) circadian variations overlayed with (aperiodic) seasonal fluctuations. In this building, it turns out, that the pressure difference across the base plate is an important factor for radon entry as well as ventilation rate. It can be shown, that the pressure is closely related to the indoor-outdoor temperature difference. This relation was found to be non-linear. Other factors are attributed to the activities of the inhabitants. The paper points out correlations between radon and different climatic parameters mainly by using scatterplots and classical regression methods.

  4. One-Year Patency of Valvulotomized Vein Grafts Is Similar to That of Arterial Grafts.

    PubMed

    Monsefi, Nadejda; Zierer, Andreas; Honarpisheh, Gazal; Bauer, Ralf; Kerl, Matthias; Beiras-Fernandez, Andres; Moritz, Anton

    2016-04-01

    Background Inferior vein graft patency after coronary artery bypass grafting (CABG) is attributed to various factors. Venous valves may limit flow, cause thrombus formation, and diminish diastolic backflow. The aim of our study was to compare clinical outcome and midterm patency rate of valvulotomized vein grafts and arterial grafts in patients undergoing CABG. Methods Between 2007 and 2010, valvulotomized saphenous vein segments were used to graft the right coronary artery (RCA) in 147 patients undergoing CABG with mean 2.8 ± 1 arterial and 1.5 ± 0.6 venous anastomoses. Outcome, reintervention, and reoperation were assessed after 4 ± 1.6 years. Intraoperative bypass flow rate was measured before and after valvulotomy of venous bypass grafts in 12 patients. Patency of the grafts was assessed by means of multislice computed tomography (MSCT) in 45 patients. Results A total of 102 patients underwent isolated CABG and 45 had combined procedures. In-hospital mortality was 2%. At 4 years' clinical follow-up, 95% of the patients were asymptomatic. Five patients underwent recoronary angiography because of angina pectoris. The MSCT and reangiography patency rate of all valvulotomized saphenous vein grafts was 97.1 versus 95.8% of arterial grafts 18 ± 6 months postoperatively. Intraoperative measurements showed a significant increase (+20.2 mL/min; p = 0.01) of flow in the venous bypass grafts to the RCA after valvulotomy. There were no reoperations at the latest follow-up. Conclusion Patients with valvulotomized venous grafts had good clinical outcome. The one-year patency rate of those grafts is comparable to that of arterial grafts. However, long-term results and angiography studies will be needed to strengthen these findings. PMID:25866977

  5. Cardiovascular Risk Factors One Year After a Hypertensive Disorder of Pregnancy

    PubMed Central

    Rogers, Stephanie; Goldstein, Neal D.; Edwards, David G.; Weintraub, William S.

    2015-01-01

    Abstract Objective To identify differences in women's cardiovascular risk, independent of obesity, one year after delivery of a pregnancy complicated by a hypertensive disorder of pregnancy (HDP). Methods We compared traditional and novel cardiovascular risk factors of women recruited at delivery following the diagnosis of an HDP with those of women with uncomplicated pregnancies, at 3 months and 12–18 months postpartum. Measures included blood pressure, fasting lipids, inflammatory biomarkers, and measures of insulin resistance. Multiple linear regressions were used to adjust for body mass index (BMI) and other characteristics. Results We studied 71 subjects: 31 women with HDP and 40 with an uncomplicated pregnancy. There were no significant differences between groups for total cholesterol, HDL-c, LDL-c, triglycerides, HgbA1c, or homeostasis model assessment-estimated insulin resistance. Values for tumor necrosis factor-α were significantly higher in the HDP group (p<0.01), while those for interleukin-6 and c-reactive protein were not. A diagnosis of HDP was associated with a 9 mm Hg difference in systolic blood pressure at both 3 months and 1 year, after adjustment for age, BMI, race, family history of cardiovascular disease, tobacco use, and insurance. Conclusions Women with HDP had significantly higher blood pressure 3 months and 1 year after delivery, independent of obesity. There were no significant differences in lipids or measures of insulin resistance after adjusting for BMI. Elevated blood pressure may account for the observed associations between HDP and future cardiovascular disease. PMID:25247261

  6. Volume transport and mixing of the Faroe Bank Channel overflow from one year of moored measurements

    NASA Astrophysics Data System (ADS)

    Ullgren, Jenny E.; Darelius, Elin; Fer, Ilker

    2016-03-01

    One-year long time series of current velocity and temperature from eight moorings deployed in the Faroe Bank Channel (FBC) are analysed to describe the structure and variability of the dense overflow plume on daily to seasonal timescales. Mooring arrays were deployed in two sections: located 25 km downstream of the main sill, in the channel that geographically confines the overflow plume at both edges (section C), and 60 km further downstream, over the slope (section S). At section C, the average volume transport of overflow waters ( < 3 °C) from the Nordic Seas towards the Iceland Basin was 1.3 ± 0.3 Sv; at section S, transport of modified overflow water ( < 6 °C) was 1.7 ± 0.7 Sv. The volume transport through the slope section was dominated by mesoscale variability at 3-5-day timescales. A simplified view of along-path entrainment of a gravity current may not be accurate for the FBC overflow. As the plume proceeds into the stratified ambient water, there is substantial detrainment from the deeper layer (bounded by the 3 °C isotherm), of comparable magnitude to the entrainment into the interfacial layer (between the 3 and 6 °C isotherms). A time series of gradient Richardson numbers suggests a quiescent plume core capped by turbulent near bottom and interfacial layers in the channel. At section S, in contrast, the entire overflow plume is turbulent. Based on a two-layer heat budget constructed for the overflow, time mean vertical diffusivities across the top of the bottom layer and across the interfacial layer were (30 ± 15) × 10-4 and (120 ± 43) × 10-4 m2 s-1, respectively.

  7. One Year Post Collaborative Depression Care Trial Outcomes among Predominantly Hispanic Diabetes Safety Net Patients

    PubMed Central

    Ell, Kathleen; Katon, Wayne; Xie, Bin; Lee, Pey-Jiuan; Kapetanovic, Suad; Guterman, Jeffery; Chou, Chih-Ping

    2011-01-01

    Objective To determine sustained effectiveness in reducing depression symptoms and improving depression care one year following intervention completion. Method Of 387 low-income, predominantly Hispanic diabetes patients with major depression symptoms randomized to 12-month socio-culturally adapted collaborative care (psychotherapy and/or antidepressants, telephone symptom monitoring/relapse prevention) or enhanced usual care, 264 patients completed two-year follow-up. Depression symptoms (SCL-20, PHQ-9), treatment receipt, diabetes symptoms, and quality of life were assessed 24 months post-enrollment using intent-to-treat analyses. Results At 24 months, more intervention patients received ongoing antidepressant treatment (38% v 25%, chi-square=5.11, df=1, P=0.02); sustained depression symptom improvement (SCL-20<0.5 (adjusted OR=2.06, 95%CI=1.09–3.90, P=0.03), SCL-20 score (adjusted mean difference −0.22, P=0.001), and PHQ-9 ≥50% reduction (adjusted OR=1.87, 95%CI=1.05–3.32, P=0.03). Over 2 years, improved effects were found in significant study group by time interaction for SF-12 mental health, SDS functional impairment, diabetes symptoms, anxiety, and socioeconomic stressors (P=0.02 for SDS, P<0.0001 for all others); however, group differences narrowed over time and were no longer significant at 24 months. Conclusions Socio-culturally tailored collaborative care that included maintenance antidepressant medication, ongoing symptom monitoring and behavioral activation relapse prevention was associated with depression improvement over 24 months for predominantly Hispanic patients in primary safety net care. PMID:21774987

  8. The personality bases of ideology: a one-year longitudinal study.

    PubMed

    Sibley, Chris G; Duckitt, John

    2010-01-01

    The cross-lagged effects of the Big-Five personality dimensions on Social Dominance Orientation (SDO) and Right-Wing Authoritarianism (RWA) were examined over 1 year (N = 112). Consistent with the Dual Process Cognitive-Motivational Model, SDO and RWA exhibited markedly different personality bases. Low Agreeableness and unexpectedly high Extraversion predicted change in the motivational goal for group-based dominance and superiority (SDO), whereas Openness to Experience predicted change in the motivational goal for social cohesion and collective security (RWA). Neuroticism and Conscientiousness did not predict change in SDO or RWA over time. These findings extend previous cross-sectional (correlational) research and indicate that key dimensions of personality (primarily Agreeableness and Openness to Experience) are an important temporal antecedent of the group-based motivational goals underlying individual differences in prejudice. PMID:21058579

  9. Teacher Education, Book-Reading Practices, and Children's Language Growth across One Year of Head Start

    ERIC Educational Resources Information Center

    Gerde, Hope K.; Powell, Douglas R.

    2009-01-01

    Research Findings: An observational study of 60 Head Start teachers and 341 children (177 boys, 164 girls) enrolled in their classrooms found teachers' book-reading practices to predict growth in children's receptive vocabulary. Multilevel growth analyses indicated that children in classrooms where teachers used more book-focused utterances made…

  10. Impact of Relapse Predictors on Psychosocial Functioning of SUD Youth One Year after Treatment

    ERIC Educational Resources Information Center

    Anderson, Kristen G.; Ramo, Danielle E.; Schulte, Marya T.; Cummins, Kevin; Brown, Sandra A.

    2008-01-01

    This investigation examined how personal, environmental and substance use factors predicted psychosocial functioning for youth with alcohol and drug problems. Four hundred twenty-four adolescents (M = 15.9, SD = 1.3) completed comprehensive assessments, including personal characteristics (e.g., Axis I diagnosis, motivation, self-esteem),…

  11. Social Connectedness and One-Year Trajectories among Suicidal Adolescents Following Psychiatric Hospitalization

    ERIC Educational Resources Information Center

    Czyz, Ewa K.; Liu, Zhuqing; King, Cheryl A.

    2012-01-01

    This study examined the extent to which posthospitalization "change" in connectedness with family, peers, and nonfamily adults predicted suicide attempts, severity of suicidal ideation, and depressive symptoms across a 12-month follow-up period among inpatient suicidal adolescents. Participants were 338 inpatient suicidal adolescents, ages 13 to…

  12. Viral Etiology of Encephalitis in Children in Southern Vietnam: Results of a One-Year Prospective Descriptive Study

    PubMed Central

    Tan, Le Van; Qui, Phan Tu; Ha, Do Quang; Hue, Nguyen Bach; Bao, Lam Quoi; Cam, Bach Van; Khanh, Truong Huu; Hien, Tran Tinh; Vinh Chau, Nguyen Van; Tram, Tran Tan; Hien, Vo Minh; Nga, Tran Vu Thieu; Schultsz, Constance; Farrar, Jeremy; van Doorn, H. Rogier; de Jong, Menno D.

    2010-01-01

    Background Acute encephalitis is an important and severe disease in children in Vietnam. However, little is known about the etiology while such knowledge is essential for optimal prevention and treatment. To identify viral causes of encephalitis, in 2004 we conducted a one-year descriptive study at Children's Hospital Number One, a referral hospital for children in southern Vietnam including Ho Chi Minh City. Methodology/Principal Findings Children less than 16 years of age presenting with acute encephalitis of presumed viral etiology were enrolled. Diagnostic efforts included viral culture, serology and real time (RT)-PCRs. A confirmed or probable viral causative agent was established in 41% of 194 enrolled patients. The most commonly diagnosed causative agent was Japanese encephalitis virus (n = 50, 26%), followed by enteroviruses (n = 18, 9.3%), dengue virus (n = 9, 4.6%), herpes simplex virus (n = 1), cytomegalovirus (n = 1) and influenza A virus (n = 1). Fifty-seven (29%) children died acutely. Fatal outcome was independently associated with patient age and Glasgow Coma Scale (GCS) on admission. Conclusions/Significance Acute encephalitis in children in southern Vietnam is associated with high mortality. Although the etiology remains unknown in a majority of the patients, the result from the present study may be useful for future design of treatment and prevention strategies of the disease. The recognition of GCS and age as predictive factors may be helpful for clinicians in managing the patient. PMID:21049060

  13. Prognostic Value of Serum Caspase-Cleaved Cytokeratin-18 Levels before Liver Transplantation for One-Year Survival of Patients with Hepatocellular Carcinoma.

    PubMed

    Lorente, Leonardo; Rodriguez, Sergio T; Sanz, Pablo; Pérez-Cejas, Antonia; Padilla, Javier; Díaz, Dácil; González, Antonio; Martín, María M; Jiménez, Alejandro; Barrera, Manuel A

    2016-01-01

    Cytokeratin (CK)-18 is the major intermediate filament protein in the liver and during hepatocyte apoptosis is cleaved by the action of caspases; the resulting fragments are released into the blood as caspase-cleaved cytokeratin (CCCK)-18. Higher circulating levels of CCCK-18 have been found in patients with hepatocellular carcinoma (HCC) than in healthy controls and than in cirrhotic patients. However, it is unknown whether serum CCCK-18 levels before liver transplantation (LT) in patients with HCC could be used as a prognostic biomarker of one-year survival, and this was the objective of our study with 135 patients. At one year after LT, non-survivors showed higher serum CCCK-18 levels than survivors (p = 0.001). On binary logistic regression analysis, serum CCCK-18 levels >384 U/L were associated with death at one year (odds ratio = 19.801; 95% confidence interval = 5.301-73.972; p < 0.001) after controlling for deceased donor age. The area under the receiver operating characteristic (ROC) curve of serum CCCK-18 levels to predict death at one year was 77% (95% CI = 69%-84%; p < 0.001). The new finding of our study was that serum levels of CCCK-18 before LT in patients with HCC could be used as prognostic biomarker of survival. PMID:27618033

  14. Aetiology of Bacteraemia as a Risk Factor for Septic Shock at the Onset of Febrile Neutropaenia in Adult Cancer Patients

    PubMed Central

    Rosa, Regis Goulart; Goldani, Luciano Zubaran

    2014-01-01

    Septic shock (SS) at the onset of febrile neutropaenia (FN) is an emergency situation that is associated with high morbidity and mortality. The impact of the specific aetiology of bloodstream infections (BSIs) in the development of SS at the time of FN is not well established. The aim of this study was to evaluate the association between the aetiology of BSIs and SS at the time of FN in hospitalised adult cancer patients. This prospective cohort study was performed at a single tertiary hospital from October 2009 to August 2011. All adult cancer patients admitted consecutively to the haematology ward with FN were evaluated. A stepwise logistic regression was conducted to verify the association between the microbiological characteristics of BSIs and SS at the onset of FN. In total, 307 cases of FN in adult cancer patients were evaluated. There were 115 cases with documented BSI. A multivariate analysis showed that polymicrobial bacteraemia (P = 0.01) was associated with SS. The specific blood isolates independently associated with SS were viridans streptococci (P = 0.02) and Escherichia coli (P = 0.01). Neutropaenic cancer patients with polymicrobial bacteraemia or BSI by viridans streptococci or Escherichia coli are at increased risk for SS at the time of FN. PMID:24804223

  15. The first one year measurements at the Monte Portella (Italy) climate high altitude station

    NASA Astrophysics Data System (ADS)

    Aruffo, Eleonora; Di Carlo, Piero; D'Altorio, Alfonso; Busilacchio, Marcella; Biancofiore, Fabio; Giammaria, Franco; Del Grande, Francesco; Bonasoni, Paolo; Cristofanelli, Paolo; Vuillermoz, Elisa

    2014-05-01

    With the purpose of contributing in providing information about atmospheric composition baseline variability in the Mediterranean basin, an atmospheric station has been installed at a high mountain site in Central Italy (Monte Portella, 2401 m a.s.l.), on July 20th 2012. Monte Portella is not far from the Corno Grande (the highest peak of the Italian Appennines, 2912 m a.s.l.) and the Calderone, the southernmost glacier in Europe. This remote site is very interesting for the analysis of the atmospheric processes occurring in the free troposphere of the Mediterranean Basin since local emissions are not in its proximity; moreover, Cristofanelli et al. (2013) found that during the July 2009 the air masses reaching the site originate mainly from the Mediterranean basin, but also from the Continental Europe and from the Northern Italy and that different origins of the air masses impact differently on the ozone budget. This station is part of the SHARE (Station at High Altitude for Environmental Research) Project. The instrumentation until now available includes: a meteorological station (VAISALA Hydromet for measurements of Temperature, Pressure, Relative Humidity, Wind speed and direction, Solar Radiation and precipitation), ozone monitor (2B technologies, model 205), NO monitor (2B technologies, model 410), aerosol size distribution (OPC monitor multichannel, FAI instruments. In our study we will show the results of the first one year of continuous measurements collected. In particular, we will study the ozone trend as a function of meteorological parameter and, in detail, of the wind direction. We will show also the PM1 and PM10 annual trends individuating events of pollution transport in free troposphere and analyzing their dependence on different air masses origins. These analyses represent the first hints about atmospheric composition variability at high altitude in the central Italy. Reference Cristofanelli, P., Di Carlo, P., D'Altorio, A., Dari Salisburgo, C

  16. One year survival of ART and conventional restorations in patients with disability

    PubMed Central

    2014-01-01

    Background Providing restorative treatment for persons with disability may be challenging and has been related to the patient’s ability to cope with the anxiety engendered by treatment and to cooperate fully with the demands of the clinical situation. The aim of the present study was to assess the survival rate of ART restorations compared to conventional restorations in people with disability referred for special care dentistry. Methods Three treatment protocols were distinguished: ART (hand instruments/high-viscosity glass-ionomer); conventional restorative treatment (rotary instrumentation/resin composite) in the clinic (CRT/clinic) and under general anaesthesia (CRT/GA). Patients were referred for restorative care to a special care centre and treated by one of two specialists. Patients and/or their caregivers were provided with written and verbal information regarding the proposed techniques, and selected the type of treatment they were to receive. Treatment was provided as selected but if this option proved clinically unfeasible one of the alternative techniques was subsequently proposed. Evaluation of restoration survival was performed by two independent trained and calibrated examiners using established ART restoration assessment codes at 6 months and 12 months. The Proportional Hazard model with frailty corrections was applied to calculate survival estimates over a one year period. Results 66 patients (13.6 ± 7.8 years) with 16 different medical disorders participated. CRT/clinic proved feasible for 5 patients (7.5%), the ART approach for 47 patients (71.2%), and 14 patients received CRT/GA (21.2%). In all, 298 dentine carious lesions were restored in primary and permanent teeth, 182 (ART), 21 (CRT/clinic) and 95 (CRT/GA). The 1-year survival rates and jackknife standard error of ART and CRT restorations were 97.8 ± 1.0% and 90.5 ± 3.2%, respectively (p = 0.01). Conclusions These short-term results indicate that ART appears to be an

  17. Source apportionment of fine atmospheric particles in Marseille: a one year study

    NASA Astrophysics Data System (ADS)

    Marchand, Nicolas; Salameh, Dalia; Detournay, Anais; Wortham, Henri; Jaffrezo, Jean-Luc; Piot, Christine; Armengaud, Alexandre; Piga, Damien; Parra, Michael; Deveze, Magali

    2013-04-01

    Marseille is the second most populated city in France with more than one million inhabitants. With traffic of about 88 million tons (Mt) in 2011, Marseille is also the most important port of the Mediterranean Sea, and also in the vicinity of the large petrochemical and industrial area of Fos-Berre, located 40 km northwest of the metropolitan area. For these reasons, Marseille area represents a challenging case study for source apportionment exercises, combining an active photochemistry and multiple emission sources, including fugitive emissions from industrial sources and shipping. In order to develop strategies for controlling and reducing air pollution, there is a need of source apportionment studies in order to better understand the influence of the different sources of aerosol particles. Within the framework of the EU-MED APICE project (Common Mediterranean strategy and local practical Actions for the mitigation of Port, Industries and Cities Emissions ; www.apice-project.eu), sources of atmospheric particles in Marseille were evaluated for a one-year period by a long monitoring campaign conducted at two sampling sites. PM2.5 were collected continuously on a 24h-basis in an urban background site from July 2011 to July 2012 and on a 48h-basis for the Eastern dock from November 2011 to July 2012 using high volume samplers (DA80) operating at a flow rate of 30m3 h-1. In this work, two different source apportionment models were used to explain the chemical observations, and to investigate the sources of organic aerosol in Marseille. Two sources apportionment models were used and combined to quantify the contribution of the main aerosol particles sources: CMB (Chemical Mass Balance) and PMF (Positive Matrix Factorization). Both models were used with organic molecular markers and metals/trace elements. Both approaches are able to identify major sources, the combination of these two commonly used receptor models offer interesting perspective, especially when the

  18. One year of Seaglider dissolved oxygen concentration profiles at the PAP site

    NASA Astrophysics Data System (ADS)

    Binetti, Umberto; Kaiser, Jan; Heywood, Karen; Damerell, Gillian; Rumyantseva, Anna

    2015-04-01

    Oxygen is one of the most important variables measured in oceanography, influenced both by physical and biological factors. During the OSMOSIS project, 7 Seagliders were used in 3 subsequent missions to measure a multidisciplinary suite of parameters at high frequency in the top 1000 m of the water column for one year, from September 2012 to September 2013. The gliders were deployed at the PAP time series station (nominally at 49° N 16.5° W) and surveyed the area following a butterfly-shaped path. Oxygen concentration was measured by Aanderaa optodes and calibrated using ship CTD O2 profiles during 5 deployment and recovery cruises, which were in turn calibrated by Winkler titration of discrete samples. The oxygen-rich mixed layer deepens in fall and winter and gets richer in oxygen when the temperature decreases. The spring bloom did not happen as expected, but instead the presence of a series of small blooms was measured throughout spring and early summer. During the summer the mixed layer become very shallow and oxygen concentrations decreased. A Deep Oxygen Maximum (DOM) developed along with a deep chlorophyll maximum during the summer and was located just below the mixed layer . At this depth, phytoplankton had favourable light and nutrient conditions to grow and produce oxygen, which was not subject to immediate outgassing. The oxygen concentration in the DOM was not constant, but decreased, then increased again until the end of the mission. Intrusions of oxygen rich water are also visible throughout the mission. These are probably due to mesoscale events through the horizontal transport of oxygen and/or nutrients that can enhance productivity, particularly at the edge of the fronts. We calculate net community production (NCP) by analysing the variation in oxygen with time. Two methods have been proposed. The classical oxygen budget method assumes that changes in oxygen are due to the sum of air-sea flux, isopycnal advection, diapycnal mixing and NCP. ERA

  19. Musculoskeletal disorders among construction workers: a one-year follow-up study

    PubMed Central

    2012-01-01

    Background Work-related musculoskeletal disorders (MSDs) are an important cause of functional impairments and disability among construction workers. An improved understanding of MSDs in different construction occupations is likely to be of value for selecting preventive measures. This study aimed to survey the prevalence of symptoms of MSDs, the work-relatedness of the symptoms and the problems experienced during work among two construction occupations: bricklayers and supervisors. Methods We randomly selected 750 bricklayers and 750 supervisors resident in the Netherlands in December 2009. This sample was surveyed by means of a baseline questionnaire and a follow-up questionnaire one year later. The participants were asked about complaints of the musculoskeletal system during the last six months, the perceived work-relatedness of the symptoms, the problems that occurred during work and the occupational tasks that were perceived as causes or aggravating factors of the MSD. Results Baseline response rate was 37%, follow-up response was 80%. The prevalence of MSDs among 267 bricklayers and 232 supervisors was 67% and 57%, respectively. Complaints of the back, knee and shoulder/upper arm were the most prevalent among both occupations. Irrespective of the body region, most of the bricklayers and supervisors reported that their complaints were work-related. Complaints of the back and elbow were the most often reported among the bricklayers during work, whereas lower arm/wrist and upper leg complaints were the most often reported among the supervisors. In both occupations, a majority of the participants perceived several occupational physical tasks and activities as causes or aggravating factors for their MSD. Recurrent complaints at follow-up were reported by both bricklayers (47% of the complaints) and supervisors (31% of the complaints). Participants in both occupations report that mainly back and knee complaints result in additional problems during work, at the time

  20. Molecular characteristics of continuously released DOM during one year of root and leaf litter decomposition

    NASA Astrophysics Data System (ADS)

    Altmann, Jens; Jansen, Boris; Kalbitz, Karsten; Filley, Timothy

    2013-04-01

    Dissolved organic matter (DOM) is one of the most dynamic carbon pools linking the terrestrial with the aquatic carbon cycle. Besides the insecure contribution of terrestrial DOM to the greenhouse effect, DOM also plays an important role for the mobility and availability of heavy metals and organic pollutants in soils. These processes depend very much on the molecular characteristics of the DOM. Surprisingly the processes that determine the molecular composition of DOM are only poorly understood. DOM can originate from various sources, which influence its molecular composition. It has been recognized that DOM formation is not a static process and DOM characteristics vary not only between different carbon sources. However, molecular characteristics of DOM extracts have scarcely been studied continuously over a longer period of time. Due to constant molecular changes of the parent litter material or soil organic matter during microbial degradation, we assumed that also the molecular characteristics of litter derived DOM varies at different stages during root and needle decomposition. For this study we analyzed the chemical composition of root and leaf samples of 6 temperate tree species during one year of litter decomposition in a laboratory incubation. During this long-term experiment we measured continuously carbon and nitrogen contents of the water extracts and the remaining residues, C mineralization rates, and the chemical composition of water extracts and residues by Curie-point pyrolysis mass spectrometry with TMAH We focused on the following questions: (I) How mobile are molecules derived from plant polymers like tannin, lignin, suberin and cutin? (II) How does the composition of root and leaf derived DOM change over time in dependence on the stage of decomposition and species? Litter derived DOM was generally dominated by aromatic compounds. Substituded fatty acids as typically cutin or suberin derived were not detected in the water extracts. Fresh leaf and

  1. One-year analysis of Elekta CBCT image quality using NPS and MTF.

    PubMed

    Nakahara, Satomi; Tachibana, Masayuki; Watanabe, Yoichi

    2016-01-01

    The image quality (IQ) of imaging systems must be sufficiently high for image-guided radiation therapy (IGRT). Hence, users should implement a quality assurance program to maintain IQ. In our routine IQ tests of the kV cone-beam CT system (Elekta XVI), image noise was quantified by noise standard deviation (NSD), which was the standard deviation of CT numbers measured in a small area in an image of an IQ test phantom (Catphan), and the high spatial resolution (HSR) was evaluated by the number of line-pairs (LPN) visually recognizable in the image. We also measured the image uniformity, the low contrast resolution, and the distances of two points for geometrical accuracy. For this study, we did an additional evaluation of the XVI data for 12 monthly IQ tests by using noise power spectrum (NPS) for noise, modulation transfer function (MTF) for HSR, and CT number-to-density relationship. NPS was obtained by applying Fourier analysis in a small area on the uniformity test section of Catphan. The MTF analysis was performed by applying the Droege-Morin (D-M) method to the line-pair bar regions in the phantom. The CT number-to-density relationship was obtained for insert materials in the low-contrast test section of the phantom. All the quantities showed a noticeable change over the one-year period. Especially the noise level improved significantly after a repair of the imager. NPS was more sensitive to the IQ change than NSD. MTF could provide more quantitative and objective evaluation of HSR. The CT number was very different from the expected CT number, but the CT number-to-density curves were constant within 5% except for two months. Since the D-M method is easy to implement, we recommend using MTF instead of LPN even for routine QA. The IQ of the imaging systems was constantly changing; hence, IQ tests should be periodically performed. Additionally, we found the importance of IQ tests after every service work, including detector calibration as well as preventive

  2. Mortality in East African shorthorn zebu cattle under one year: predictors of infectious-disease mortality

    PubMed Central

    2013-01-01

    Background Infectious livestock diseases remain a major threat to attaining food security and are a source of economic and livelihood losses for people dependent on livestock for their livelihood. Knowledge of the vital infectious diseases that account for the majority of deaths is crucial in determining disease control strategies and in the allocation of limited funds available for disease control. Here we have estimated the mortality rates in zebu cattle raised in a smallholder mixed farming system during their first year of life, identified the periods of increased risk of death and the risk factors for calf mortality, and through analysis of post-mortem data, determined the aetiologies of calf mortality in this population. A longitudinal cohort study of 548 zebu cattle was conducted between 2007 and 2010. Each calf was followed during its first year of life or until lost from the study. Calves were randomly selected from 20 sub-locations and recruited within a week of birth from different farms over a 45 km radius area centered on Busia in the Western part of Kenya. The data comprised of 481.1 calf years of observation. Clinical examinations, sample collection and analysis were carried out at 5 week intervals, from birth until one year old. Cox proportional hazard models with frailty terms were used for the statistical analysis of risk factors. A standardized post-mortem examination was conducted on all animals that died during the study and appropriate samples collected. Results The all-cause mortality rate was estimated at 16.1 (13.0-19.2; 95% CI) per 100 calf years at risk. The Cox models identified high infection intensity with Theileria spp., the most lethal of which causes East Coast Fever disease, infection with Trypanosome spp., and helminth infections as measured by Strongyle spp. eggs per gram of faeces as the three important infections statistically associated with infectious disease mortality in these calves. Analysis of post-mortem data identified

  3. One year observation of water vapour isotopic composition at Ivittuut, Southern Greenland

    NASA Astrophysics Data System (ADS)

    Bonne, Jean-Louis; Masson-Delmotte, Valérie; Delmotte, Marc; Cattani, Olivier; Sodemann, Harald; Risi, Camille

    2013-04-01

    In September 2011, an automatic continuous water vapour isotopic composition monitoring instrument has been installed in the atmospheric station of Ivittuut (61.21° N, 48.17° W), southern Greenland. Precipitation has been regularly sampled on site at event to weekly scales and analysed in our laboratory for isotopic composition. Meteorological parameters (temperature, pressure, relative humidity, wind speed and direction) and atmospheric composition (CO2, CH4, Atmospheric Potential Oxygen) are also continuously monitored at Ivittuut. The meteorological context of our observation period will be assessed by comparison with the local climatology. The water vapour analyser is a Picarro Wavelength Scanned Cavity Ring-Down Spectrometer (WS-CRDS, model L2120i). It is automatically and regularly calibrated on the VSMOW scale using measurements of the isotopic composition of vaporized reference water standards using the Picarro Syringe Delivery Module (SDM). As measurements are sensitive to humidity level, an experimentally estimated calibration response function is used to correct our isotopic measurements. After data treatment, successive isotopic measurements of reference waters have a standard deviation of around 0.35 per mil for δ18O and 2.3 per mil for δD. Our instrumentation protocol and data quality control method will be presented, together with our one year δ18O, δD and d-excess measurements in water vapour and precipitation. The relationship between surface water vapour isotopic composition and precipitation isotopic composition will be investigated based on a distillation model. Specific difficulties linked to our low maintenance remote station will also be discussed. The processes responsible for the synoptic variability of Ivittuut water vapour isotopic composition will be investigated by comparing our observational dataset with (i) atmospheric back-trajectories and (ii) results from an isotopically-enabled atmospheric general circulation model (AGCM

  4. Influence of Comorbid Conditions on One-Year Outcomes in Non–ST-Segment Elevation Acute Coronary Syndrome

    PubMed Central

    Sanchis, Juan; Núñez, Julio; Bodí, Vicente; Núñez, Eduardo; García-Alvarez, Ana; Bonanad, Clara; Regueiro, Ander; Bosch, Xavier; Heras, Magda; Sala, Joan; Bielsa, Oscar; Llácer, Angel

    2011-01-01

    OBJECTIVE: To investigate comorbid conditions with prognostic influence in non–ST-segment elevation acute coronary syndrome (NSTEACS). PATIENTS AND METHODS: The study group consisted of a derivation cohort of 1017 patients (admitted from October 1, 2002, through October 1, 2008) and an external validation cohort of 652 patients (admitted from February 1, 2006, through September 30, 2009). Comorbid conditions, including risk factors and components of the Charlson comorbidity index (ChCI) and coronary artery disease–specific index, were recorded. The main outcome was one-year mortality. RESULTS: During follow-up, 103 patients died. After adjusting for variables associated with NSTEACS characteristics (base model), 5 comorbid conditions predicted mortality: severe or mild renal failure (hazard ratio [HR], 2.9 and HR, 1.6, respectively), dementia (HR, 3.1), peripheral artery disease (HR, 2.0), previous heart failure (HR, 2.6), and previous myocardial infarction (HR, 1.4). A simple comorbidity index (SCI) was developed using these variables, (per point: HR, 1.6; 95% confidence interval, 1.4-1.8; P=.0001). Adding the SCI, Charlson comorbidity index, or coronary artery disease–specific index to the base model resulted in a gain of 6.58%, 5.00%, and 4.04%, respectively, in discriminative ability (P=.001), without significant differences among the 3 indices. In patients with comorbid conditions, the highest risk period was in the first weeks after NSTEACS. The strength of the association between SCI and mortality rate was similar in the external validation cohort (HR, 1.3; 95% confidence interval, 1.1-1.6; P=.001). CONCLUSION: Renal dysfunction, dementia, peripheral artery disease, previous heart failure, and previous myocardial infarction are the comorbid conditions that predict mortality in NSTEACS. A simple index using these variables proved to be as accurate as the more complex comorbidity indices for risk stratification. In-hospital management of patients with

  5. [A 64-year-old woman with progressive gait disturbance and dementia for one year].

    PubMed

    Sugita, Y; Matsumine, H; Wakiya, M; Mori, H; Suda, K; Kondo, T; Mizuno, Y

    1998-09-01

    We report a 64-year-old Japanese woman who died one year after the onset of progressive gait disturbance and dementia. She noted a difficulty in holding a glass and hand tremor in June of 1996 when she was 63 years old. In July of 1996, she tended to lean toward left when she walked. She also noted truncal titubation. In November of 1996, she started to have visual hallucination and delusion in which she said "I see something is flying on the wall.", "Somebody has come into my room", and things like that. She was admitted to our service on November 22, 1996. On admission, she was alert and general physical examination was unremarkable. Neurologic examination revealed disturbance in recent memory. Hasegawa's dementia rating scale was 22/30. She showed vivid visual hallucination with colors in which she saw faces of dwarfs and angels, a space ship, and others. Higher cerebral functions were normal. She showed left oculomotor palsy which was a sequel of an aneurysm and subarachnoid hemorrhage nine years before. Otherwise cranial nerves were unremarkable. She showed ataxic gait, limb ataxia, truncal titubation, and postural hand tremor. She had no weakness and no muscle atrophy. Deep tendon reflexes were within normal limits. Plantar response was flexor. Sensation was intact. Laboratory examination was also unremarkable. Complete survey for occult malignancy was negative. CSF was under a normal pressure and cell count was 1/microliter, total protein 27 mg/dl, and sugar 68 mg/dl. Cranial CT scan was unremarkable. MRI was not obtained because of the presence of an aneurysm clip in the left internal carotid-posterior communication artery junction. She showed progressive deterioration in her mental function. By January 1997, she became unable to stand or walk with marked dementia. Repeated CSF exams and cranial CT scans were unremarkable. She suffered from several episodes of aspiration pneumonia. A trial of three days methylprednisolone pulse therapy was given starting on

  6. One year continuous soil gas monitoring above an EGR test site

    NASA Astrophysics Data System (ADS)

    Furche, Markus; Schlömer, Stefan; Faber, Eckhard; Dumke, Ingolf

    2010-05-01

    Setup and first results of an ongoing research activity are presented, which is funded by the German Geotechnologien program within in the joint project CLEAN (CO2 Large Scale Enhanced Gas Recovery in the Altmark Natural Gas Field). The task is to establish several soil gas monitoring stations above a partly exhausted gas field in the Altmark which will be used for an enhanced gas recovery (EGR) test by injecting CO2 into the reservoir. The aim is to optimize the monitoring technique including automatic data transfer and data exploitation and to understand mechanisms of natural variations of soil gas concentrations in the specific area. Furthermore the suitability of these measurements as a contribution to leakage detection shall be evaluated. A network of 13 gauging stations for the measurement of CO2 is working continuously for about one year. They are spread over an area of 8 x 3 km and are situated in direct vicinity of existing deep boreholes as the most likely locations for possible leakage. In addition one station is placed far outside the gasfield as a reference point. The technique applied to measure soil gas concentrations uses a gas stream circulating in a tube going down a shallow borehole where the circulating gas is in contact with the soil gas phase via a gas permeable membrane. Above surface, moisture is removed from the gas stream before it reaches several gas sensors for CO2. Besides these, several other parameters are determined as well, e.g. soil moisture and soil temperature, water level, gas flow and gas moisture. In addition a meteorological station gives information about precipitation, air humidity, temperature and pressure, global radiation, wind direction and velocity in the area. Data are continuously collected by dataloggers at each station (5 minutes interval), transferred via GSM routers to the BGR server in Hannover and are stored in a specially designed database. The database does not only contain the measurements but also

  7. Qualitative Evaluation of Cardiovascular Diseases Management in Family Medicine Team in One Year Level

    PubMed Central

    Beganlic, Azijada; Pavljasevic, Suzana; Kreitmayer, Sanda; Zildzic, Muharem; Softic, Albina; Selmanovic, Senada; Becarevic, Munevera

    2015-01-01

    Introduction: Cardiovascular diseases (CVD) are the leading death cause in modern world and are the most public health problem. WHO program for CVD contains: prevention, command and follow up of CVD in global level. Aim: Investigate CVD frequency in family medicine team in 2012.year (one year period of time) and qualitative management prevention and clinical services management quality of CVD together with recommended standards. Patients and methods: clinical revision of clinical standard practice patients with CVD was provided in Family medicine team in Public Health Centre Tuzla for the period of time from January 01 2012 - December 31 2012. For quality of realized services, AKAZ standards were based for: chapter 2. Health promotion and diseases prevention 2.5. preventive clinical services; chapter 3. Clinical services, standard 3.1. Coronary diseases and standard 3.2. TIA and Stroke. From CVD register next parameters had been used: age, gender, disease diagnose, therapy, blood pressure values, total cholesterol values, ß blockers therapy, anticoagulant therapy prescription, smoker status, stop smoking recommendation and influenza vaccination recommendation. Statistical approach: All results were taken in Excel program and statistically analyzed. Descriptive standard tests were taken with measurement of central tendency and dispersion. For significant differentials achieved with χ² chances relation was taken (Odds Ratio-OR) with 95% relevant security. All tests were leveled in statistical significant from 95% (p<0,05). Results: Considering total registered habitants number 1448 (males 624 females 824) total diseases of usually CVD in Team 1 family medicine 531 (36,67%). The most frequent disease was hypertension which was presented in 30,31% of registered patients but in total CVD illness was present in 82,67%. In relation with total patients number (531), female prevalence from CVD 345:186 males vs. 65%:35%; P=0,001 and was statistically significantly higher

  8. Analysis of occurrence of bacteraemia with pathogens from gastrointestinal tract in patients fed parenterally and enterally in the intensive care unit

    PubMed Central

    Różowicz, Aleksandra; Spychalska, Katarzyna; Nakonowska, Beata; Kupczyk, Kinga; Kusza, Krzysztof

    2016-01-01

    Introduction Bacterial translocation is a migration of microorganisms and their toxins from the intestinal lumen to the mesenteric lymph nodes, blood, and abdominal organs. It can lead to local inflammatory response and a potential increase in intestinal permeability leading to systemic infections and multiple organ failure. Enteral nutrition stimulates gastrointestinal motility, increases blood flow, and improves the integration of the intestinal barrier. Aim The impact of enteral (EN) and parenteral (PN) nutrition on occurrence of bacteraemia caused by pathogens from the gastrointestinal tract. Material and methods It was a retrospective analysis of medical documentation of 254 patients. Microbiological tests were analysed, assessing the presence of bacteraemia or sepsis pathogens from the gastrointestinal tract. In 52 patients gastrointestinal pathogens in blood were found: 29 patients were fed enterally (I group – EN and EN + PN) and 23 only parenterally (II group – PN). Results The mean length of stay in hospital until the occurrence of bacteraemia in group I was 14, and in group II it was 13 days. Mean time without EN was 4 days (first group) and 12 days (second group). Time of stay in ICU and mortality in the group of patients fed parenterally was observed: group I – 25 days, mortality 34%; group II – 37 days, mortality 56%. In the analysed group the EN and the length of the absence of this kind of feeding did not affect the occurrence of bacteraemia by gastrointestinal pathogens. Conclusions However, patients fed only parenterally who had bacteraemia required a longer stay in the ICU and had a higher rate of mortality than the patients with EN. PMID:27350841

  9. Trio of Stellar Occultations by Pluto One Year Prior to New Horizons' Arrival

    NASA Astrophysics Data System (ADS)

    Pasachoff, Jay M.; Person, Michael J.; Bosh, Amanda S.; Sickafoose, Amanda A.; Zuluaga, Carlos; Kosiarek, Molly R.; Levine, Stephen E.; Osip, David J.; Schiff, Avery; Seeger, Christina H.; Babcock, Bryce A.; Rojo, Patricio; Servajean, Elise

    2016-04-01

    We observed occultations by Pluto during a predicted series of events in 2014 July with the 1 m telescope of the Mt. John Observatory in New Zealand. The predictions were based on updated astrometry obtained in the previous months at the USNO, CTIO, and Lowell Observatories. We successfully detected occultations by Pluto of an R = 18 mag star on July 23 (14:23:32 ± 00:00:04 UTC to 14:25:30 ± 00:00:04 UTC), with a drop of 75% of the unocculted stellar signal, and of an R = 17 star on July 24 (11:41:30 ± 00:00:08 UTC to 11:43:28 ± 00:00:08 UTC), with a drop of 80% of the unocculted stellar signal, both with 20 s exposures with our frame-transfer Portable Occultation, Eclipse, and Transit System. Since Pluto had a geocentric velocity of 22.51 km s-1 on July 23 and 22.35 km s-1 on July 24, these intervals yield limits on the chord lengths (surface and lower atmosphere) of 2700 ± 130 km and 2640 ± 250 km, respectively, indicating that the events were near central, and therefore provide astrometric constraints on the prediction method. Our coordinated observations with the 4 m AAT in Australia on July 23 and the 6.5 m Magellan/Clay on Las Campanas, the 4.1 m Southern Astrophysical Research Telescope on Cerro Pachön, the 2.5 m DuPont on Las Campanas (LCO), the 0.6 m SARA-South on Cerro Tololo of the Southeastern Association for Research in Astronomy (SARA), the MPI/ESO 2.2 m on La Silla, and the 0.45 m Cerro Calán telescope and 0.36 telescope in Constitución in Chile on July 27 and 31, which would have provided higher-cadence observations for studies of Pluto’s atmosphere, were largely foiled by clouds, but led to detection with the LCO Magellan/Clay and DuPont Telescopes on July 31 of the grazing occultation of a previously unknown 15th-magnitude star, completing the trio of occultations successfully observed and reported in this paper.

  10. Substance use, medication adherence and outcome one year following a first episode of psychosis.

    PubMed

    Colizzi, Marco; Carra, Elena; Fraietta, Sara; Lally, John; Quattrone, Diego; Bonaccorso, Stefania; Mondelli, Valeria; Ajnakina, Olesya; Dazzan, Paola; Trotta, Antonella; Sideli, Lucia; Kolliakou, Anna; Gaughran, Fiona; Khondoker, Mizanur; David, Anthony S; Murray, Robin M; MacCabe, James H; Di Forti, Marta

    2016-02-01

    Both substance use and poor medication adherence are associated with poor outcome in psychosis. To clarify the contributions of substance use and poor medication adherence to poor outcome in the year following a first episode of psychosis, 205 patients were evaluated for use of tobacco, alcohol, cannabis and stimulants at their psychosis onset, and in a 1-year follow-up. Data on medication adherence and symptom remission were also collected. Patients had high rates of overall substance use before (37-65%) and after psychosis onset (45-66%). 44% showed poor medication adherence and 55% did not reach remission from psychosis. Nicotine dependence and cannabis use after psychosis onset significantly predicted both poor medication adherence and non-remission, and poor medication adherence mediated the effects of these substances on non-remission. In conclusion, medication adherence lies on the causal pathway between nicotine dependence and cannabis on the one hand and non-remission on the other. PMID:26718334