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Sample records for bacteraemia predicts one-year

  1. Readmission after Colectomy for Cancer Predicts One-Year Mortality

    PubMed Central

    Greenblatt, David Yu; Weber, Sharon M.; O’Connor, Erin S.; LoConte, Noelle K.; Liou, Jinn-Ing; Smith, Maureen A.

    2010-01-01

    Objectives Early hospital readmission is a common and costly problem in the Medicare population. In 2009, the Centers for Medicaid and Medicare Services began mandating hospital reporting of disease-specific readmission rates. We sought to determine the rate and predictors of readmission after colectomy for cancer, as well as the association between readmission and mortality. Methods Medicare beneficiaries who underwent colectomy for stage I-III colon adenocarcinoma from 1992–2002 were identified from the SEER-Medicare database. Multivariate logistic regression identified predictors of early readmission and one-year mortality. Odds ratios were adjusted for multiple factors, including measures of comorbidity, socioeconomic status, and disease severity. Results Of 42,348 patients who were discharged, 4,662 (11.0%) were readmitted within 30 days. The most common causes of rehospitalization were ileus/obstruction and infection. Significant predictors of readmission included male gender, comorbidity, emergent admission, prolonged hospital stay, blood transfusion, ostomy, and discharge to nursing home. Readmission was inversely associated with hospital procedure volume, but not surgeon volume. After adjusting for potential confounding variables, the predicted probability of one-year mortality was 16% for readmitted patients, compared to 7% for those not readmitted. This difference in mortality was significant for all stages of cancer. Conclusions Early readmission after colectomy for cancer is common and due in part to modifiable factors. There is a remarkable association between readmission and one-year mortality. Early readmission is therefore an important quality-of-care indicator for colon cancer surgery. These findings may facilitate the development of targeted interventions that will decrease readmissions and improve patient outcomes. PMID:20224370

  2. Childhood aerobic fitness predicts cognitive performance one year later.

    PubMed

    Chaddock, Laura; Hillman, Charles H; Pontifex, Matthew B; Johnson, Christopher R; Raine, Lauren B; Kramer, Arthur F

    2012-01-01

    Aerobically fit children outperform less fit peers on cognitive control challenges that involve inhibition, cognitive flexibility, and working memory. The aim of this study was to determine whether, compared with less fit children, more fit 9- and 10-year-old pre-adolescents exhibit superior performance on a modified compatible and incompatible flanker task of cognitive control at the initial time of fitness testing and approximately one year later. We found that more fit children demonstrated increased flanker accuracy at both test sessions, coupled with a superior ability to flexibly allocate strategies during task conditions that required different amounts of cognitive control, relative to less fit children. More fit children also gained a speed benefit at follow-up testing. Structural MRI data were also collected to investigate the relationship between basal ganglia volume and task performance. Bilateral putamen volumes of the dorsal striatum and globus pallidus volumes predicted flanker performance at initial and follow-up testing one year later. The present findings suggest that childhood aerobic fitness and basal ganglia volumes relate to cognitive control at the time of fitness testing and may play a role in cognitive performance in the future. We hope that this research will encourage public health and educational changes that will promote a physically active lifestyle in children.

  3. Predicting Performance of One-Year MBA Students

    ERIC Educational Resources Information Center

    Fish, Lynn A.; Wilson, F. Scott

    2007-01-01

    Although several studies have been performed, Graduate Admissions programs are still encountering difficulties uncovering criteria that will predict academic success in their programs. Researchers have analyzed Executive, full and part-time MBA programs and can only conclude that undergraduate grade point average and the GMAT are significant…

  4. Predicting Performance of One-Year MBA Students

    ERIC Educational Resources Information Center

    Fish, Lynn A.; Wilson, F. Scott

    2007-01-01

    Although several studies have been performed, Graduate Admissions programs are still encountering difficulties uncovering criteria that will predict academic success in their programs. Researchers have analyzed Executive, full and part-time MBA programs and can only conclude that undergraduate grade point average and the GMAT are significant…

  5. [Usefulness of biomarkers to predict bacteraemia in patients with infection in the emergency department].

    PubMed

    Julián-Jiménez, A; Candel, F J; González-Del Castillo, J

    2017-03-08

    Between all patients attended in the Emergency Department (ED), 14.3% have an infectious disease diagnosis. Blood cultures (BC) are obtained in 14.6% of patients and have a profitability of 20%, whereas 1% are considered as contaminated and 1-3% of positive cultures correspond to discharge patients ("hidden bacteraemia"). The highest number of confirmed bacteraemias comes from the samples of patients with urinary tract infections, followed by community-acquired pneumonia. The suspicion and detection of bacteraemia have an important diagnostic and prognostic significance and could modify some important making-decisions (admission, BC request, administration of appropriate and early antimicrobial, etc). Therefore, finding a predictive model of bacteraemia useful and applicable in ED has become the objective of many authors that combine different clinical, epidemiological and analytical variables, including infection and inflammatory response biomarkers (IIRBM), as they significantly increase the predictive power of such models. The aim of this review is to highlight the evidence showed in recent published articles, to clarify existing controversies, and to compare the accuracy of the most important IIRBM to predict bacteremia in patients attended due to infection in the ED. Finally, to generate different recommendations that could help to define the role of IIRBM in improving the indication to obtaining BC, as well as in immediate decision-making in diagnosis and treatment (early and adequate antibiotic treatment, complementary tests, other microbiological samples, hemodynamic support measures, need for admission, etc.).

  6. Using Alcohol Expectancies to Predict Adolescent Drinking Behavior after One Year.

    ERIC Educational Resources Information Center

    Christiansen, Bruce A.; And Others

    1989-01-01

    Examined power of expectancies measured in early adolescents to predict self-reported drinking onset and drinking behavior measured one year later. Results showed that five of seven expectancy scores readily discriminated between nonproblem drinkers and those subsequently beginning problem drinkers and accounted for large portion of variance in…

  7. A one-year mortality clinical prediction rule for patients with heart failure.

    PubMed

    Escobar, Antonio; García-Pérez, Lidia; Navarro, Gemma; Bilbao, Amaia; Quiros, Raul

    2017-06-19

    To create and validate a clinical prediction rule which is easy to manage, reproducible and that allows classifying patients admitted for heart failure according to their one-year mortality risk. A prospective cohort study carried out with 2565 consecutive patients admitted with heart failure in 13 hospitals in Spain. The derivation cohort was made up of 1283 patients and 1282 formed the validation cohort. In the derivation cohort, we carried out a multivariate logistic model to predict one-year mortality. The performance of the derived predictive risk score was externally validated in the validation cohort, and internally validated by K-fold cross-validation. The risk score was categorized into four risk levels. The mean age was 77.2years, 49.7% were female and there were 611 (23.8%) deaths in the follow-up period. The variables included in the predictive model were: age≥75, systolic blood pressure<135, New York Heart Association class III-IV, heart valve disease, dementia, prior hospitalization, haemoglobin<13, sodium<136, urea≥86, length of stay≥14 and Physical dimension of Minnesota Living with Heart Failure questionnaire. The AUC for the risk score were 0.73 and 0.70 in the derivation and validation cohorts, respectively, and 0.73 in the K-fold cross-validation. The percentage of mortality ranged from 8.08% in the low-risk to 58.20% in the high-risk groups (p<0.0001; AUC, 0.72). This model based on routinely available data, for admitted patients and with a follow-up at one year is a simple and easy-to-use tool for improving management of patients with heart failure. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  8. Prediction factors of recurrent ischemic events in one year after minor stroke.

    PubMed

    Zhang, Changqing; Zhao, Xingquan; Wang, Chunxue; Liu, Liping; Ding, Yuchuan; Akbary, Fauzia; Pu, Yuehua; Zou, Xinying; Du, Wanliang; Jing, Jing; Pan, Yuesong; Wong, Ka Sing; Wang, Yongjun; Wang, Yilong

    2015-01-01

    The risk of a subsequent stroke following a minor stroke is high. However, there are no effective rating scales to predict recurrent stroke following a minor one. Therefore, we assessed the risk factors associated with recurrent ischemic stroke or transient ischemic attack (TIA) within one year of minor stroke onset in order to identify possible risk factors. Eight hundred and sixty-three non-cardioembolic ischemic stroke patients in the Chinese IntraCranial AtheroSclerosis Study that presented with minor stroke, defined as an admission National Institutes of Health stroke scale (NIHSS) score of ≤3, were consecutively enrolled in our study. Clinical information and imaging features upon admission, and any recurrent ischemic stroke or TIA within one year was recorded. Cox regression was used to identify risk factors associated with recurrent ischemic stroke or TIA within the year following stroke onset. A total of 50 patients (6.1%) experienced recurrent ischemic stroke or TIA within one year of minor stroke onset. Multivariate Cox regression model identified lower admission NIHSS score (HR, 1.75; 95% CI, 1.32 to 2.33; P<0.0001), history of coronary heart disease (HR, 2.62; 95% CI, 1.17 to 5.86; P = 0.02), severe stenosis or occlusion of large cerebral artery (HR, 4.68; 95% CI, 1.87 to 11.7; P = 0.001), and multiple acute cerebral infarcts (HR, 2.61; 95% CI, 1.01 to 6.80; P = 0.05) as independent risk factors for recurrent ischemic stroke or TIA within one year. Some minor stroke patients are at higher risk for recurrent ischemic stroke or TIA. Urgent and intensified therapy may be reasonable in these patients.

  9. Parent Discrimination Predicts Mexican-American Adolescent Psychological Adjustment One Year Later

    PubMed Central

    Gonzales, Nancy A.; Fuligni, Andrew J.

    2016-01-01

    This study examined whether Mexican-American parent’s experiences with discrimination are related to adolescent psychological adjustment over time. The extent to which associations between parent discrimination and adolescent adjustment vary as a function of parent’s ethnic socialization of their children was also examined. Participants included 344 high school students from Mexican or Mexican-American backgrounds (primarily second generation; ages 14 – 16 at Wave 1) and their primary caregivers who completed surveys in a two-year longitudinal study. Results revealed that parent discrimination predicted internalizing symptoms and self-esteem among adolescents, one year later. Additionally, adolescents were more likely to report low self-esteem in relation to parents’ increased experiences of discrimination when parents conveyed ethnic socialization messages to them. PMID:27224903

  10. 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.

  11. Sleep disruption frequency in rheumatoid arthritis: perceived stress predicts poor outcome over one year.

    PubMed

    Treharne, G J; Lyons, A C; Hale, E D; Douglas, K M J; Goodchild, C E; Booth, D A; Kitas, G D

    2007-03-01

    Sleep is an important daily process that can be disrupted by chronic illnesses including rheumatoid arthritis (RA). We tested whether demographic, medical and psychological factors act as predictors of change in frequency of sleep disruption associated with RA. A cohort of 129 White British people with RA (mean duration of RA 7.19 years; mean age 55.40 years; 75% women) was followed for one year. Self-report questionnaires were employed to record demographic information and assess participants' sleep disruption (on a 4-point frequency scale), morning stiffness (duration), pain and fatigue (visual analogue scales), impact of disability, anxiety, depression, stress, coping, illness perceptions and self-efficacy. Hospital notes were reviewed for duration of RA, antidepressant use and comorbidity. Participants were split into those with sleep disruption that was consistently infrequent or decreasing in frequency (n = 56; 43%) and those with sleep disruption that was consistently frequent or increasing in frequency (n = 73; 57%). Results of a logistic regression demonstrated that greater perceived stress at baseline predicted sleep disruption that was consistently frequent or increasing in frequency over the year. Change in sleep disruption frequency was not predicted by any other assessed variable. Perceived stress at the end of the year was not predicted by change in frequency of sleep disruption. Self-reported frequency of sleep disruption among people with RA relates to perceived stress. Psychoeducational programmes that help people with RA manage their stress may be a non-pharmacological method of improving sleep quality and therefore merits testing in specific interventional studies.

  12. Skilful predictions of the winter North Atlantic Oscillation one year ahead

    NASA Astrophysics Data System (ADS)

    Dunstone, Nick; Smith, Doug; Scaife, Adam; Hermanson, Leon; Eade, Rosie; Robinson, Niall; Andrews, Martin; Knight, Jeff

    2016-11-01

    The winter North Atlantic Oscillation is the primary mode of atmospheric variability in the North Atlantic region and has a profound influence on European and North American winter climate. Until recently, seasonal variability of the North Atlantic Oscillation was thought to be largely driven by chaotic and inherently unpredictable processes. However, latest generation seasonal forecasting systems have demonstrated significant skill in predicting the North Atlantic Oscillation when initialized a month before the onset of winter. Here we extend skilful dynamical model predictions to more than a year ahead. The skill increases greatly with ensemble size due to a spuriously small signal-to-noise ratio in the model, and consequently larger ensembles are projected to further increase the skill in predicting the North Atlantic Oscillation. We identify two sources of skill for second-winter forecasts of the North Atlantic Oscillation: climate variability in the tropical Pacific region and predictable effects of solar forcing on the stratospheric polar vortex strength. We also identify model biases in Arctic sea ice that, if reduced, may further increase skill. Our results open possibilities for a range of new climate services, including for the transport, energy, water management and insurance sectors.

  13. Predicting Performance of MBA Students: Comparing the Part-Time MBA Program and the One-Year Program

    ERIC Educational Resources Information Center

    Fish, Lynn A.; Wilson, F. Scott

    2009-01-01

    While predictor variables for success in MBA programs vary between schools, are they different within the same business school? At an AACSB-accredited school, although the curriculum and professors are essentially the same between the One-Year MBA and Part-Time MBA programs, the significant factors to predict success in each program are not.…

  14. Predicting Performance of MBA Students: Comparing the Part-Time MBA Program and the One-Year Program

    ERIC Educational Resources Information Center

    Fish, Lynn A.; Wilson, F. Scott

    2009-01-01

    While predictor variables for success in MBA programs vary between schools, are they different within the same business school? At an AACSB-accredited school, although the curriculum and professors are essentially the same between the One-Year MBA and Part-Time MBA programs, the significant factors to predict success in each program are not.…

  15. Can psychopathology at age 7 be predicted from clinical observation at one year? Evidence from the ALSPAC cohort.

    PubMed

    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 age seven can be predicted from clinician observation at one year. Two groups of clinical raters observed videos of caregiver-infant interaction. Neither group of raters could reliably identify any precursors of later development of psychopathology in the one-year-old infants in this setting. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Prediction of one-year mortality by five different frailty instruments: A comparative study in hospitalized geriatric patients.

    PubMed

    Ritt, M; Bollheimer, L C; Sieber, C C; Gaßmann, K G

    2016-01-01

    Data comparing the ability of different major frailty instruments for predicting mortality in hospitalized geriatric patients are scare. 307 patients ≥65years who were hospitalized on geriatric wards were included in this prospective analysis. A fifty-item frailty index (FI), a ten-domain+co-morbidity frailty index based on a standardized comprehensive geriatric assessment (FI-CGA), the nine category Clinical Frailty Scale (CFS-9), the CSHA rules-based frailty definition (CSHA-RBFD), and the frailty phenotype (FP) were assessed during the patients' hospital stays. Patients were followed up over a one-year period. Follow-up data after one year could be obtained from 305 out of the 307 participants. Sixty two participants (20.3%) had died after that time. The FI, FI-CGA, CFS-9, CSHA-RBFD, and FP could all discriminate between patients who died and those who survived during follow-up (areas under the ROC curves: 0.805, 0.808, 0.852, 0.703 and 0.757, all P<0.001, respectively). The CFS-9 showed a better discriminative ability for one-year mortality compared to the FI, FI-CGA, CSHA-RBFD, and FP (all P<0.05, respectively). The FI and the FI-CGA did not differ in their discriminative ability for one-year mortality (P=0.440). The CSHA-RBFD and the FP demonstrated a comparable discriminative ability (P=0.241) and, when compared to the CFS-9, FI, and FI-CGA, an inferior discriminative ability for one-year mortality (all P<0.05, respectively). Among those frailty instruments that were evaluated, the CFS-9 emerged as the most powerful for prediction of one-year mortality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Predicting one-year mortality in peritoneal dialysis patients: an analysis of the China Peritoneal Dialysis Registry.

    PubMed

    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.

  18. Neonatal imitation predicts infant rhesus macaque (Macaca mulatta) social and anxiety-related behaviours at one year

    PubMed Central

    Kaburu, Stefano S. K.; Paukner, Annika; Simpson, Elizabeth A.; Suomi, Stephen J.; Ferrari, Pier F.

    2016-01-01

    The identification of early markers that predict the development of specific social trajectories is critical to understand the developmental and neurobiological underpinnings of healthy social development. We investigated, in infant rhesus macaques (Macaca mulatta), whether newborns’ capacity to imitate facial gestures is a valid predictive marker for the emergence of social competencies later in development, at one year of age. Here we first assessed whether infant macaques (N = 126) imitate lipsmacking gestures (a macaque affiliative expression) performed by a human experimenter in their first week of life. We then collected data on infants’ social interactions (aggression, grooming, and play) and self-scratching (a proxy indicator of anxiety) at 11–14 months when infants were transferred into a new enclosure with a large social group. Our results show that neonatal imitators exhibit more dominant behaviours, are less anxious, and, for males only, spend more time in play at one year old. These findings suggest that neonatal imitation may be an early predictor of infant sociality and may help identify infants at risk of neurodevelopmental social deficits. PMID:27725768

  19. Poor Self-Reported Sleep Quality Predicts Mortality within One Year of Inpatient Post-Acute Rehabilitation among Older Adults

    PubMed Central

    Martin, Jennifer L.; Fiorentino, Lavinia; Jouldjian, Stella; Mitchell, Michael; Josephson, Karen R.; Alessi, Cathy A.

    2011-01-01

    Study Objective: To evaluate the association between self-reported sleep quality among older adults during inpatient post-acute rehabilitation and one-year survival. Design: Prospective, observational cohort study. Setting: Two inpatient post-acute rehabilitation sites (one community and one Veterans Administration). Participants: Older patients (aged ≥ 65 years, n = 245) admitted for inpatient post-acute rehabilitation. Interventions: None. Measurements and Results: Within one year of post-acute rehabilitation, 57 participants (23%) were deceased. Cox proportional hazards models showed that worse Pittsburgh Sleep Quality Index (PSQI) total scores during the post-acute care stay were associated with increased mortality risk when controlling for amount of rehabilitation therapy received, comorbidities, and cognitive functioning (Hazard ratio [95% CI] = 1.11 [1.02-1.20]). Actigraphically estimated sleep was unrelated to mortality risk. Conclusions: Poorer self-reported sleep quality, but not objectively estimated sleep parameters, during post-acute rehabilitation was associated with shorter survival among older adults. This suggests self-reported poor sleep may be an important and potentially modifiable risk factor for negative outcomes in these vulnerable older adults. Studies of interventions to improve sleep quality during inpatient rehabilitation should therefore be undertaken, and the long-term health benefits of improved sleep should be explored. Citation: Martin JL; Fiorentino L; Jouldjian S; Mitchell M; Josephson KR; Alessi CA. Poor self-reported sleep quality predicts mortality within one year of inpatient post-acute rehabilitation among older adults. SLEEP 2011;34(12):1715-1721. PMID:22131610

  20. Longitudinal Prediction of the One-Year Course of Preschool ADHD Symptoms: Implications for Models of Temperament-ADHD Associations

    PubMed Central

    Martel, Michelle M.; Gremillion, Monica L.; Roberts, Bethan A.; Zastrow, Brittany L.; Tackett, Jennifer L.

    2014-01-01

    Despite the fact that Attention-Deficit/Hyperactivity Disorder (ADHD) is often conceptualized as an extreme trait, there remains controversy about the best way to understand associations between temperament traits and ADHD. The current study examines longitudinal associations between temperament traits and ADHD during early childhood in order to critically examine vulnerability and spectrum models of trait—ADHD associations. Study participants were 109 children between the ages of 3 and 6 and their primary caregivers and teachers/daycare providers, community-recruited for ADHD-related problems. Primary caregivers completed the Kiddie Disruptive Behavior Disorders Schedule semi-structured diagnostic interview at the initial appointment and one year later. At the initial appointment, primary caregivers completed the Child Behavior Questionnaire as a measure of child temperament traits. Results from the initial time point indicated that high neuroticism and high surgency were associated with inattentive and hyperactive-impulsive ADHD symptoms, and low effortful control was associated with hyperactive-impulsive ADHD symptoms. However, none of these traits predicted the one-year course of ADHD symptoms. Results are more consistent with a spectrum (vs. vulnerability) model of trait-psychopathology associations, suggesting that traits, but may not influence longitudinal course during early childhood. PMID:25598568

  1. Longitudinal Prediction of the One-Year Course of Preschool ADHD Symptoms: Implications for Models of Temperament-ADHD Associations.

    PubMed

    Martel, Michelle M; Gremillion, Monica L; Roberts, Bethan A; Zastrow, Brittany L; Tackett, Jennifer L

    2014-07-01

    Despite the fact that Attention-Deficit/Hyperactivity Disorder (ADHD) is often conceptualized as an extreme trait, there remains controversy about the best way to understand associations between temperament traits and ADHD. The current study examines longitudinal associations between temperament traits and ADHD during early childhood in order to critically examine vulnerability and spectrum models of trait-ADHD associations. Study participants were 109 children between the ages of 3 and 6 and their primary caregivers and teachers/daycare providers, community-recruited for ADHD-related problems. Primary caregivers completed the Kiddie Disruptive Behavior Disorders Schedule semi-structured diagnostic interview at the initial appointment and one year later. At the initial appointment, primary caregivers completed the Child Behavior Questionnaire as a measure of child temperament traits. Results from the initial time point indicated that high neuroticism and high surgency were associated with inattentive and hyperactive-impulsive ADHD symptoms, and low effortful control was associated with hyperactive-impulsive ADHD symptoms. However, none of these traits predicted the one-year course of ADHD symptoms. Results are more consistent with a spectrum (vs. vulnerability) model of trait-psychopathology associations, suggesting that traits, but may not influence longitudinal course during early childhood.

  2. 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

  3. Better adherence to treatment recommendations in heart failure predicts improved cognitive function at a one-year follow-up.

    PubMed

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

    2014-01-01

    Treatment nonadherence is common in heart failure (HF) and is associated with poor health outcomes in this population. Recent cross-sectional work in heart failure and past work in other medical populations suggest that cognitive function is a key determinant of a 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. A total of 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. Global cognition and memory abilities improved over the 12-month period. Regression analyses controlling for baseline and medical and demographic factors showed that 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. 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.

  4. Low insulin resistance after surgery predicts poor GH suppression one year after complete resection for acromegaly: a retrospective study.

    PubMed

    Edo, Naoki; Morita, Koji; Suzuki, Hisanori; Takeshita, Akira; Miyakawa, Megumi; Fukuhara, Noriaki; Nishioka, Hiroshi; Yamada, Shozo; Takeuchi, Yasuhiro

    2016-05-31

    Remission of acromegaly is defined as a nadir in GH <1.0 ng/mL during a 75-g oral glucose tolerance test (75gOGTT) and insulin-like growth factor-1 (IGF-1) normalization. Recently, a lower cut-off value for GH nadir (<0.4 ng/mL) has been proposed. We retrospectively evaluated the prevalence and clinical characteristics of postoperative cases with normalized IGF-1 levels and a GH nadir of 0.4-1.0 ng/mL one year after complete resection of GH-secreting pituitary adenoma (GHoma). We included 110 cases of acromegaly with complete adenoma resection, no preoperative treatment, preoperative glycosylated hemoglobin <6.5%, preoperative basal plasma glucose <126 mg/dL, GH nadir <1.0 ng/mL during a 75gOGTT, and normalized IGF-1 at the first postoperative year evaluation, whereupon patients were divided into two groups: control (GH nadir <0.4 ng/mL) and high GH (GH nadir >0.4 ng/mL). Clinical parameters, including measures of insulin secretion and resistance, were compared between groups. The high GH group included 10 patients (9.1%) and had a lesser level of insulin resistance immediately following surgery and at the first postoperative year evaluation. On single regression analysis, insulin resistance immediately following surgery was predictive of and correlated with the GH nadir at the first postoperative year evaluation. The GH nadir at the first postoperative year evaluation may be insufficient in patients with normalized IGF-1 with low insulin resistance immediately following complete resection of GHoma. Careful evaluation is needed to assess remission in such patients.

  5. Prediction of psychological functioning one year after the predictive test for Huntington's disease and impact of the test result on reproductive decision making.

    PubMed

    Decruyenaere, M; Evers-Kiebooms, G; Boogaerts, A; Cassiman, J J; Cloostermans, T; Demyttenaere, K; Dom, R; Fryns, J P; Van den Berghe, H

    1996-09-01

    For people at risk for Huntington's disease, the anxiety and uncertainty about the future may be very burdensome and may be an obstacle to personal decision making about important life issues, for example, procreation. For some at risk persons, this situation is the reason for requesting predictive DNA testing. The aim of this paper is two-fold. First, we want to evaluate whether knowing one's carrier status reduces anxiety and uncertainty and whether it facilitates decision making about procreation. Second, we endeavour to identify pretest predictors of psychological adaptation one year after the predictive test (psychometric evaluation of general anxiety, depression level, and ego strength). The impact of the predictive test result was assessed in 53 subjects tested, using pre- and post-test psychometric measurement and self-report data of follow up interviews. Mean anxiety and depression levels were significantly decreased one year after a good test result; there was no significant change in the case of a bad test result. The mean personality profile, including ego strength, remained unchanged one year after the test. The study further shows that the test result had a definite impact on reproductive decision making. Stepwise multiple regression analyses were used to select the best predictors of the subject's post-test reactions. The results indicate that a careful evaluation of pretest ego strength, depression level, and coping strategies may be helpful in predicting post-test reactions, independently of the carrier status. Test result (carrier/ non-carrier), gender, and age did not significantly contribute to the prediction. About one third of the variance of post-test anxiety and depression level and more than half of the variance of ego strength was explained, implying that other psychological or social aspects should also be taken into account when predicting individual post-test reactions.

  6. Prediction of psychological functioning one year after the predictive test for Huntington's disease and impact of the test result on reproductive decision making.

    PubMed Central

    Decruyenaere, M; Evers-Kiebooms, G; Boogaerts, A; Cassiman, J J; Cloostermans, T; Demyttenaere, K; Dom, R; Fryns, J P; Van den Berghe, H

    1996-01-01

    For people at risk for Huntington's disease, the anxiety and uncertainty about the future may be very burdensome and may be an obstacle to personal decision making about important life issues, for example, procreation. For some at risk persons, this situation is the reason for requesting predictive DNA testing. The aim of this paper is two-fold. First, we want to evaluate whether knowing one's carrier status reduces anxiety and uncertainty and whether it facilitates decision making about procreation. Second, we endeavour to identify pretest predictors of psychological adaptation one year after the predictive test (psychometric evaluation of general anxiety, depression level, and ego strength). The impact of the predictive test result was assessed in 53 subjects tested, using pre- and post-test psychometric measurement and self-report data of follow up interviews. Mean anxiety and depression levels were significantly decreased one year after a good test result; there was no significant change in the case of a bad test result. The mean personality profile, including ego strength, remained unchanged one year after the test. The study further shows that the test result had a definite impact on reproductive decision making. Stepwise multiple regression analyses were used to select the best predictors of the subject's post-test reactions. The results indicate that a careful evaluation of pretest ego strength, depression level, and coping strategies may be helpful in predicting post-test reactions, independently of the carrier status. Test result (carrier/ non-carrier), gender, and age did not significantly contribute to the prediction. About one third of the variance of post-test anxiety and depression level and more than half of the variance of ego strength was explained, implying that other psychological or social aspects should also be taken into account when predicting individual post-test reactions. PMID:8880572

  7. One-year temporal stability and predictive and incremental validity of the body, eating, and exercise comparison orientation measure (BEECOM) among college women.

    PubMed

    Fitzsimmons-Craft, Ellen E; Bardone-Cone, Anna M

    2014-01-01

    This study examined the one-year temporal stability and the predictive and incremental validity of the Body, Eating, and Exercise Comparison Measure (BEECOM) in a sample of 237 college women who completed study measures at two time points about one year apart. One-year temporal stability was high for the BEECOM total and subscale (i.e., Body, Eating, and Exercise Comparison Orientation) scores. Additionally, the BEECOM exhibited predictive validity in that it accounted for variance in body dissatisfaction and eating disorder symptomatology one year later. These findings held even after controlling for body mass index and existing measures of social comparison orientation. However, results regarding the incremental validity of the BEECOM, or its ability to predict change in these constructs over time, were more mixed. Overall, this study demonstrated additional psychometric properties of the BEECOM among college women, further establishing the usefulness of this measure for more comprehensively assessing eating disorder-related social comparison.

  8. Predictive Factors of One-Year Mortality in a Cohort of Patients Undergoing Urgent-Start Hemodialysis

    PubMed Central

    Magalhães, Luciene P.; dos Reis, Luciene M.; Graciolli, Fabiana G.; Pereira, Benedito J.; de Oliveira, Rodrigo B.; de Souza, Altay A. L.; Moyses, Rosa M.; Elias, Rosilene M.; Jorgetti, Vanda

    2017-01-01

    Background Chronic kidney disease (CKD) affects 10–15% of adult population worldwide. Incident patients on hemodialysis, mainly those on urgent-start dialysis at the emergency room, have a high mortality risk, which may reflect the absence of nephrology care. A lack of data exists regarding the influence of baseline factors on the mortality of these patients. The aim of this study was to evaluate the clinical and laboratory characteristics of this population and identify risk factors that contribute to their mortality. Patients and methods We studied 424 patients who were admitted to our service between 01/2006 and 12/2012 and were followed for 1 year. We analyzed vascular access, risk factors linked to cardiovascular disease (CVD) and mineral and bone disease associated with CKD (CKD-MBD), and clinical events that occurred during the follow-up period. Factors that influenced patient survival were evaluated by Cox regression analysis. Results The patient mean age was 50 ± 18 years, and 58.7% of them were male. Hypertension was the main cause of primary CKD (31.8%). Major risk factors were smoking (19.6%), dyslipidemia (48.8%), and CVD (41%). Upon admission, most patients had no vascular access for hemodialysis (89.4%). Biochemical results showed that most patients were anemic with high C-reactive protein levels, hypocalcemia, hyperphosphatemia, elevated parathyroid hormone and decreased 25-hydroxy vitamin D. At the end of one year, 60 patients died (14.1%). These patients were significantly older, had a lower percentage of arteriovenous fistula in one year, and low levels of 25-hydroxy vitamin D. Conclusions The combined evaluation of clinical and biochemical parameters and risk factors revealed that the mortality in urgent-start dialysis is associated with older age and low levels of vitamin D deficiency. A lack of a permanent hemodialysis access after one year was also a risk factor for mortality in this population. PMID:28045952

  9. Predictive Factors of One-Year Mortality in a Cohort of Patients Undergoing Urgent-Start Hemodialysis.

    PubMed

    Magalhães, Luciene P; Dos Reis, Luciene M; Graciolli, Fabiana G; Pereira, Benedito J; de Oliveira, Rodrigo B; de Souza, Altay A L; Moyses, Rosa M; Elias, Rosilene M; Jorgetti, Vanda

    2017-01-01

    Chronic kidney disease (CKD) affects 10-15% of adult population worldwide. Incident patients on hemodialysis, mainly those on urgent-start dialysis at the emergency room, have a high mortality risk, which may reflect the absence of nephrology care. A lack of data exists regarding the influence of baseline factors on the mortality of these patients. The aim of this study was to evaluate the clinical and laboratory characteristics of this population and identify risk factors that contribute to their mortality. We studied 424 patients who were admitted to our service between 01/2006 and 12/2012 and were followed for 1 year. We analyzed vascular access, risk factors linked to cardiovascular disease (CVD) and mineral and bone disease associated with CKD (CKD-MBD), and clinical events that occurred during the follow-up period. Factors that influenced patient survival were evaluated by Cox regression analysis. The patient mean age was 50 ± 18 years, and 58.7% of them were male. Hypertension was the main cause of primary CKD (31.8%). Major risk factors were smoking (19.6%), dyslipidemia (48.8%), and CVD (41%). Upon admission, most patients had no vascular access for hemodialysis (89.4%). Biochemical results showed that most patients were anemic with high C-reactive protein levels, hypocalcemia, hyperphosphatemia, elevated parathyroid hormone and decreased 25-hydroxy vitamin D. At the end of one year, 60 patients died (14.1%). These patients were significantly older, had a lower percentage of arteriovenous fistula in one year, and low levels of 25-hydroxy vitamin D. The combined evaluation of clinical and biochemical parameters and risk factors revealed that the mortality in urgent-start dialysis is associated with older age and low levels of vitamin D deficiency. A lack of a permanent hemodialysis access after one year was also a risk factor for mortality in this population.

  10. PREDICT: a diagnostic accuracy study of a tool for predicting mortality within one year: who should have an advance healthcare directive?

    PubMed

    Richardson, Philip; Greenslade, Jaimi; Shanmugathasan, Sulochana; Doucet, Katherine; Widdicombe, Neil; Chu, Kevin; Brown, Anthony

    2015-01-01

    CARING is a screening tool developed to identify patients who have a high likelihood of death in 1 year. This study sought to validate a modified CARING tool (termed PREDICT) using a population of patients presenting to the Emergency Department. In total, 1000 patients aged over 55 years who were admitted to hospital via the Emergency Department between January and June 2009 were eligible for inclusion in this study. Data on the six prognostic indicators comprising PREDICT were obtained retrospectively from patient records. One-year mortality data were obtained from the State Death Registry. Weights were applied to each PREDICT criterion, and its final score ranged from 0 to 44. Receiver operator characteristic analyses and diagnostic accuracy statistics were used to assess the accuracy of PREDICT in identifying 1-year mortality. The sample comprised 976 patients with a median (interquartile range) age of 71 years (62-81 years) and a 1-year mortality of 23.4%. In total, 50% had ≥1 PREDICT criteria with a 1-year mortality of 40.4%. Receiver operator characteristic analysis gave an area under the curve of 0.86 (95% confidence interval: 0.83-0.89). Using a cut-off of 13 points, PREDICT had a 95.3% (95% confidence interval: 93.6-96.6) specificity and 53.9% (95% confidence interval: 47.5-60.3) sensitivity for predicting 1-year mortality. PREDICT was simpler than the CARING criteria and identified 158 patients per 1000 admitted who could benefit from advance care planning. PREDICT was successfully applied to the Australian healthcare system with findings similar to the original CARING study conducted in the United States. This tool could improve end-of-life care by identifying who should have advance care planning or an advance healthcare directive. © The Author(s) 2014.

  11. 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…

  12. 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…

  13. Predicting Grief Reactions One Year Following a Mass University Shooting: Evaluating Dose-Response and Contextual Predictors.

    PubMed

    Smith, Andrew J; Layne, Christopher M; Coyle, Patrick; Kaplow, Julie B; Brymer, Melissa J; Pynoos, Robert S; Jones, Russell T

    2017-10-10

    This study identifies risk factors for grief following a mass school shooting. Participants (N = 1,013) completed online questionnaires 3-4 months (Time 1) and 1 year (Time 2) post-shootings. We tested models predicting Time 2 grief reactions, exploring direct and indirect predictive effects of exposure variables (physical and social proximity) through hypothesized peritraumatic mediators (peritraumatic perceived threat to self or others) while controlling for Time 1 grief and posttraumatic stress (PTS) reactions, pretrauma vulnerabilities. Findings demonstrate that closer social proximity predicted higher levels of Time 2 grief, directly and indirectly through increasing peritraumatic perceived threat to others' safety. Physical proximity and peritraumatic threat to self did not predict Time 2 grief reactions. Implications for grief screening instruments and theory building research through identifying risk factors and causal mechanisms are discussed.

  14. A multivariate analysis and statistical model for predicting visual acuity and keratometry one year after cross-linking for keratoconus.

    PubMed

    Wisse, Robert P L; Godefrooij, Daniël A; Soeters, Nienke; Imhof, Saskia M; Van der Lelij, Allegonda

    2014-03-01

    To investigate putative prognostic factors for predicting visual acuity and keratometry 1 year following corneal cross-linking (CXL) for treating keratoconus. Prospective cohort study. This study included all consecutively treated keratoconus patients (102 eyes) in 1 academic treatment center, with minimal 1-year follow-up following CXL. Primary treatment outcomes were corrected distance visual acuity (logMAR CDVA) and maximum keratometry (K(max)). Univariable analyses were performed to determine correlations between baseline parameters and follow-up measurements. Correlating factors (P ≤ .20) were then entered into a multivariable linear regression analysis, and a model for predicting CDVA and K(max) was created. Atopic constitution, positive family history, and smoking were not independent factors affecting CXL outcomes. Multivariable analysis identified cone eccentricity as a major factor for predicting K(max) outcome (ß coefficient = 0.709, P = .02), whereas age, sex, and baseline keratometry were not independent contributors. Posttreatment visual acuity could be predicted based on pretreatment visual acuity (ß coefficient = -0.621, P < .01, R(2) = 0.45). Specifically, a low visual acuity predicts visual improvement. A prediction model for K(max) did not accurately estimate treatment outcomes (R(2) = 0.15). Our results confirm the role of cone eccentricity with respect to the improvement of corneal curvature following CXL. Visual acuity outcome can be predicted accurately based on pretreatment visual acuity. Age, sex, and K(max) are debated as independent factors for predicting the outcome of treating keratoconus with CXL. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. One-year prediction of pain killer use among at-risk older teens and emerging adults.

    PubMed

    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 1186 alternative high school youth in California. Among demographic, behavioral, psychosocial, and environmental predictors, a multivariable model indicated that: (a) relatively higher levels of baseline pain killer use; (b) white ethnicity; (c) relatively lower levels of depressive symptoms (contrary to previous studies); and (d) those who live with both parents were more likely to report use of pain killer medications in the next year. It is speculated that those with relatively greater access to pain medication, within an at-risk social environment, are those who will use it later on.

  16. The Development of a Predictive Model for One-Year Freshman Retention Rate: A Macro-Approach. AIR 1999 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Antley, Huey W.

    This study investigated whether the one-year retention rate for the cohort of full-time, baccalaureate-degree-seeking, first-time freshmen could be predicted from institutional and aggregate cohort characteristics, including institutional type and control, institutional size, cohort size, average entrance exam score, percentage of part-time…

  17. [Predictive factors for visual outcome after corneal collagen crosslinking treatment in progressive keratoconus: One-year refractive and topographic results].

    PubMed

    De Angelis, F; Rateau, J; Destrieux, C; Patat, F; Pisella, P-J

    2015-09-01

    To assess the effects of preoperative patient characteristics on clinical outcomes of corneal collagen crosslinking (CXL) in patients with progressive keratoconus. Fifty-four eyes of 41 patients underwent CXL for progressive keratoconus between June 2011 and December 2012. Corneal topography (Orbscan(®)) was assessed at 1, 3, and 6 months and 1 year after CXL treatment and compared with preoperative data. A significant improvement in 1-year postoperative best-corrected visual acuity (BCVA) (0.16±0.21 LogMar preoperatively versus 0.09±0.16 LogMar postoperatively, P=0.007) and in 3mm topographic central irregular astigmatism (P=0.04) was demonstrated with CXL. No significant change was noted for refractive astigmatism (P=0.69), or for 1-year postoperative Kmax (48.4 D±4.1 at baseline versus 48.5 D±4.1 postoperatively, P=0.46). Predictive factors for BVCA improvement were low preoperative BCVA, high refractive astigmatism and advanced keratoconus. Predictive factors for stability of postoperative Kmax values were early keratoconus, and central cone ("nipple" morphology of the cone mainly located in the central 3mm of the cornea). This retrospective study confirms the efficacy of CXL for progressive keratoconus, from a refractive as well as topographic standpoint. While cone localization or its eccentricity seems to explain the variability of CXL efficacy reported in the literature, cone severity appears to be the main predictive factor for a lack of topographic stability after CXL treatment but must be weighted by the preferential localization of the cone (3 or 5mm central corneal zone). Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. Evaluation of Timed Up and Go Test as a tool to measure postoperative function and prediction of one year walking ability for patients with hip fracture.

    PubMed

    Nygard, Heid; Matre, Kjell; Fevang, Jonas Meling

    2016-05-01

    To evaluate if the Timed Up and Go Test is a useful tool to measure postoperative function and to predict one-year results of rehabilitation in patients operated owing to hip fracture. Prospective cohort study. The department of orthopaedic surgery at five hospitals in Norway. Patients were assessed five days postoperatively and after one year. A total of 684 patients over 60 years with trochanteric or subtrochanteric hip fractures were included. A total of 171 (25%) patients died within a year and 373 (73% of patients still alive) attended follow-up one year after surgery. Timed Up and Go Test and walking ability. A total of 258 (38%) patients passed the postoperative Timed Up and Go Test. A total of 217 (56%) patients with a prefracture independent outdoor walking ability, passed the test. The average Timed Up and Go Test score was 71 seconds. A total of 171 (25%) patients could not rise from a chair without assistance; 8% of the patients with cognitive impairment, and 8% of those admitted from nursing homes, were able to pass the postoperative Timed Up and Go Test. The sensitivity and specificity of the Timed Up and Go Test in predicting walking ability one year after the operation were low. At one year follow-up, 38% of the patients not able to perform the postoperative Timed Up and Go Test, passed the test. A total of 81 (21%) patients did not use any walking-aid, 17 of them did not pass the postoperative Timed Up and Go Test. The Timed Up and Go Test performed the fifth postoperative day was not a suitable tool to assess functional mobility for the majority of the patients with hip fractures in our study. Neither was the postoperative Timed Up and Go Test a suitable tool to predict the walking ability one year after the operation. © The Author(s) 2015.

  19. Evaluation of Timed Up and Go Test as a tool to measure postoperative function and prediction of one year walking ability for patients with hip fracture

    PubMed Central

    Nygard, Heid; Matre, Kjell; Fevang, Jonas Meling

    2015-01-01

    Objective: To evaluate if the Timed Up and Go Test is a useful tool to measure postoperative function and to predict one-year results of rehabilitation in patients operated owing to hip fracture. Design: Prospective cohort study. Setting: The department of orthopaedic surgery at five hospitals in Norway. Patients were assessed five days postoperatively and after one year. Subjects: A total of 684 patients over 60 years with trochanteric or subtrochanteric hip fractures were included. A total of 171 (25%) patients died within a year and 373 (73% of patients still alive) attended follow-up one year after surgery. Main measures: Timed Up and Go Test and walking ability. Results: A total of 258 (38%) patients passed the postoperative Timed Up and Go Test. A total of 217 (56%) patients with a prefracture independent outdoor walking ability, passed the test. The average Timed Up and Go Test score was 71 seconds. A total of 171 (25%) patients could not rise from a chair without assistance; 8% of the patients with cognitive impairment, and 8% of those admitted from nursing homes, were able to pass the postoperative Timed Up and Go Test. The sensitivity and specificity of the Timed Up and Go Test in predicting walking ability one year after the operation were low. At one year follow-up, 38% of the patients not able to perform the postoperative Timed Up and Go Test, passed the test. A total of 81 (21%) patients did not use any walking-aid, 17 of them did not pass the postoperative Timed Up and Go Test. Conclusion: The Timed Up and Go Test performed the fifth postoperative day was not a suitable tool to assess functional mobility for the majority of the patients with hip fractures in our study. Neither was the postoperative Timed Up and Go Test a suitable tool to predict the walking ability one year after the operation. PMID:26109590

  20. Prediction of Mental Health Services Use One Year After Regular Referral to Specialized Care Versus Referral to Stepped Collaborative Care.

    PubMed

    van Orden, Mirjam; Leone, Stephanie; Haffmans, Judith; Spinhoven, Philip; Hoencamp, Erik

    2017-04-01

    Referral to collaborative mental health care within the primary care setting is a service concept that has shown to be as effective as direct referral to specialized mental health care for patients with common mental disorders. Additionally it is more efficient in terms of lower mental health services use. This post-hoc analysis examines if treatment intensity during 1-year of follow-up can be predicted prospectively by baseline characteristics. With multilevel multivariate regression analyses baseline characteristics were examined as potential predictors of visit counts. Results showed that only the enabling factors service concept and referral delay for treatment had a significant association with mental health visit counts, when outcome was dichotomized in five or more visits. Inclusion of the outcome variable as a count variable confirmed the predictive value of service concept and referral delay, but added marital status as a significant predictor. Overall, enabling factors (service concept and referral delay) seem to be important and dominant predictors of mental health services use.

  1. Suicidal Ideation of Psychiatrically Hospitalized Adolescents has One-Year Predictive Validity for Suicide Attempts in Girls Only

    PubMed Central

    Jiang, Qingmei; Czyz, Ewa K.; Kerr, David C. R.

    2016-01-01

    Clinicians commonly incorporate adolescents’ self-reported suicidal ideation into formulations regarding adolescents’ risk for suicide. Data are limited, however, regarding the extent to which adolescent boys’ and girls’ reports of suicidal ideation have clinically significant predictive validity in terms of subsequent suicidal behavior. This study examined psychiatrically hospitalized adolescent boys’ and girls’ self-reported suicidal ideation as a predictor of suicide attempts during the first year following hospitalization. A total of 354 adolescents (97 boys; 257 girls; ages 13–17 years) hospitalized for acute suicide risk were evaluated at the time of hospitalization as well as 3, 6, and 12 months later. Study measures included the Suicidal Ideation Questionnaire-Junior, Multidimensional Anxiety Scale for Children, Children’s Depression Rating Scale-Revised, Beck Hopelessness Scale, Youth Self-Report, and Personal Experiences Screen Questionnaire. The main study outcome was presence and number of suicide attempt(s) in the year after hospitalization, measured by the Diagnostic Interview Schedule for Children. Results indicated a significant interaction between suicidal ideation, assessed during first week of hospitalization, and gender for the prediction of subsequent suicide attempts. Suicidal ideation was a significant predictor of subsequent suicide attempts for girls, but not boys. Baseline history of multiple suicide attempts was a significant predictor of subsequent suicide attempts across genders. Results support the importance of empirically validating suicide risk assessment strategies separately for adolescent boys and girls. Among adolescent boys who have been hospitalized due to acute suicide risk, low levels of self-reported suicidal ideation may not be indicative of low risk for suicidal behavior following hospitalization. PMID:23996157

  2. Clinical predictors and clinical prediction rules to estimate initial patient risk for infective endocarditis in Staphylococcus aureus bacteraemia: a systematic review and meta-analysis.

    PubMed

    Bai, A D; Agarwal, A; Steinberg, M; Showler, A; Burry, L; Tomlinson, G A; Bell, C M; Morris, A M

    2017-05-06

    We conducted a meta-analysis to summarize diagnostic properties of risk factors and clinical prediction rules for diagnosing infective endocarditis (IE) in Staphylococcus aureus bacteraemia (SAB). We searched MEDLINE, Embase, and the Cochrane Database from inception to 6 January 2016 to identify studies evaluating risk factors and clinical prediction rules for IE in SAB patients. Pooled estimates of diagnostic properties for main risk factors were calculated using a bivariate random effects model. Of 962 articles identified, 30 studies were included. These involved 16 538 SAB patients including 1572 IE cases. Risk factors with positive likelihood ratio (PLR) greater than 5 included embolic events (PLR 12.7, 95% CI 9.2-17.7), pacemakers (PLR 9.7, 95% CI 3.7-21.2), history of previous IE (PLR 8.2, 95% CI 3.1-22.0), prosthetic valves (PLR 5.7, 95% CI 3.2-9.5), and intravenous drug use (PLR 5.2, 95% CI 3.8-6.9). The only clinical factor with negative likelihood ratio (NLR) less than 0.5 was documented clearance of bacteraemia within 72 hours (NLR range 0.32-0.35). Of the nine published clinical prediction rules for ruling out IE, five had an NLR below 0.1. SAB patients with high-risk features (embolic events, pacemakers, prosthetic valves, previous IE, or intravenous drug use) should undergo a trans-esophageal echocardiography (TEE) for IE. Clinical prediction rules show promise in safely ruling out endocarditis, but require validation in future studies. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  3. Caregiver burden and emotional problems in partners of stroke patients at two months and one year post-stroke: Determinants and prediction.

    PubMed

    Kruithof, Willeke J; Post, Marcel W M; van Mierlo, Maria L; van den Bos, Geertrudis A M; de Man-van Ginkel, Janneke M; Visser-Meily, Johanna M A

    2016-10-01

    (a) To determine levels of and factors explaining partners' burden, anxiety and depressive symptoms at two months post-stroke, (b) to predict partners' burden, anxiety and depressive symptoms at one year post-stroke based on patient and partner characteristics available at two months post-stroke. Prospective cohort study. Partners of stroke patients (N=183) were included. Main outcome measures were the Caregiver Strain Index and the Hospital Anxiety and Depression Scale. Many partners experienced high burden, anxiety and depressive symptoms. At two months post-stroke, these outcomes were associated with the partner variables: age, relationship satisfaction, pro-active coping, self-efficacy, everyday social support, burden, anxiety and depressive symptoms; and the patient variables: stroke severity and depressive symptoms. Partner outcomes at one year post-stroke were mainly predicted by the level of these outcomes at two months post-stroke. Partner outcomes at two months post-stroke predict to a large degree partner outcomes at one year post-stroke. Measuring partners' burden and anxiety and depressive symptoms in the post-acute phase is recommended to trace partners at risk of long-term burden and emotional problems. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Planning predicts dental service attendance and the effect is moderated by dental anxiety and educational status: findings from a one-year prospective study.

    PubMed

    Pakpour, Amir H; Gellert, Paul; Asefzadeh, Saeed; Sniehotta, Falko F

    2014-07-01

    The aim of this study was to investigate whether planning a dental appointment is a predictor of actual dental visits over a one-year period when controlling for past attendance, demographic factors, and dental health beliefs. In addition, the planning-attendance association was explored to determine whether dental anxiety and educational status moderated this relationship. A total of N = 1,422 adults with a mean age of M = 44.4 (SD = 11.0) years and resident in Iran participated in a prospective study over a one-year period. The primary outcome was self-reported dental appointment attendance at one-year follow-up, which was validated using clinical records. Action planning, coping planning, health beliefs, age, dental insurance, income, dental health status, dental anxiety, and years of education were assessed at baseline by self-report questionnaire. Data were analysed using multivariate logistic regression. Action planning and coping planning were significantly associated with dental appointment attendance at one-year follow-up. Planning a dental appointment was more predictive of dental appointment attendance for people with higher levels of education and lower dental anxiety. The findings of this study suggest that implementation of the behaviour change technique planning into routine dental practice may have the potential to increase dental appointment attendance rates. © 2014 The International Association of Applied Psychology.

  5. 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.

  6. [Trapidil after one year].

    PubMed

    Agus, G B

    1993-05-01

    Present knowledge about cerebral limb ischemia has pointed out the importance of a versatile pharmacological approach, which considers not only the hydraulic aspect of the problem through a vasodilating action, but also all the hemorheologic and hemocoagulative implications, which seem to characterize the pathology itself. For about one year Trapidil has been entering the therapeutic treatments for arterio-vascular diseases in Italy; this drug was already known and tested abroad. Trapidil has shown a more complete antithrombocytic activity than other antiaggregating drugs; as a matter of fact it inhibits the formation of TXA2 through a mechanism of receptorial antagonism and at the same time it favours an increase of prostacyclina from the arterial walls. Moreover this drug is provided with a selective inhibition of the mitogenic effects of PDGF, which occurs for the block of the receptorial binding of this factor at the level of the myointimal cells. In conclusion, in some experimental models Trapidil seems to be able to improve the hemoreologic properties of the blood. Some different clinical studies have demonstrated the therapeutic effectiveness of Trapidil. In the treating of claudication and of the pain during the rest in AOCP, we want to report two studies which have shown a general improving either of the free interval of run or a reduction of the pain. In particular the polycentric study of Bonavita has examined 200 patients afflicted with AOCP at II and III stage, who were divided into three treatment groups: Trapidil, ticlopidina and picotamide.

  7. Efficacy of the Revised NIOSH Lifting Equation to Predict Risk of Low-Back Pain Associated With Manual Lifting: A One-Year Prospective Study

    PubMed Central

    Lu, Ming-Lun; Waters, Thomas R.; Krieg, Edward; Werren, Dwight

    2015-01-01

    Objective The objective was to evaluate the efficacy of the Revised National Institute for Occupational Safety and Health (NIOSH) lifting equation (RNLE) to predict risk of low-back pain (LBP). Background In 1993, NIOSH published the RNLE as a risk assessment method for LBP associated with manual lifting. To date, there has been little research evaluating the RNLE as a predictor of the risk of LBP using a prospective design. Methods A total of 78 healthy industrial workers' baseline LBP risk exposures and self-reported LBP at one-year follow-up were investigated. The composite lifting index (CLI), the outcome measure of the RNLE for analyzing multiple lifting tasks, was used as the main risk predictor. The risk was estimated using the mean and maximum CLI variables at baseline and self-reported LBP during the follow-up. Odds ratios (ORs) were calculated using a logistic regression analysis adjusted for covariates that included personal factors, physical activities outside of work, job factors, and work-related psychosocial characteristics. Results The one-year self-reported LBP incidence was 32.1%. After controlling for history of prior LBP, supervisory support, and job strain, the categorical mean and maximum CLI above 2 had a significant relationship (OR = 5.1–6.5) with self-reported LBP, as compared with the CLI below or equal to 1. The correlation between the continuous CLI variables and LBP was unclear. Conclusions The CLI > 2 threshold may be useful for predicting self-reported LBP. Research with a larger sample size is needed to clarify the exposure–response relationship between the CLI and LBP. PMID:24669544

  8. One-year evolution of ulnar somatosensory potentials after trauma in 365 tetraplegic patients: early prediction of potential upper limb function.

    PubMed

    Kuhn, Fabian; Halder, Pascal; Spiess, Martina Rebekka; Schubert, Martin

    2012-07-01

    Early prediction of hand function is crucial for efficient rehabilitation of cervical spinal cord injury (cSCI). This study investigated correlations between ulnar somatosensory evoked potentials (ulnar SSEPs) and functional outcome of hand function following acute traumatic cervical cord injury. Neurological assessment of sensory scores and hand function were compared with five ulnar SSEP categories of similar persistence and quality in 365 patients throughout the first year after cSCI. Of the 365 patients, 218 (68%) exhibited ulnar SSEP potentials at any one stage during the year, and in 147 patients (40.3%) ulnar SSEPs were obtainable at every assessment stage. While ulnar SSEP latency and amplitude assessments remained largely unchanged over time in the majority of patients, hand function improved remarkably during the first year following cSCI. One year outcome of hand function was predetermined by ulnar SSEP category due to distinct differences in the ulnar SSEP parameters. Additionally, an early prognostic group allocation by ulnar SSEP criteria at the first assessment stage within 4 weeks after spinal trauma allowed reliable prediction of hand function outcome after 1 year. We conclude that early assessment of ulnar SSEP as a non-invasive and objective neurophysiological test is a valuable marker of prospective hand function and independence 1 year after cSCI. This could be most relevant for planning neurorehabilitation, and in prospective clinical SCI trials.

  9. 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

  10. High-sensitivity troponin T for prediction of left ventricular function and infarct size one year following ST-elevation myocardial infarction.

    PubMed

    Reinstadler, Sebastian Johannes; Feistritzer, Hans-Josef; Klug, Gert; Mair, Johannes; Tu, Alexander Minh-Duc; Kofler, Markus; Henninger, Benjamin; Franz, Wolfgang-Michael; Metzler, Bernhard

    2016-01-01

    Data relating high-sensitivity cardiac troponin T (hs-cTnT) to long-term myocardial function and infarct size in patients after ST-elevation myocardial infarction (STEMI) are lacking. We aimed to evaluate the use of early hs-cTnT concentrations for prediction of myocardial function and infarct size assessed by cardiac magnetic resonance imaging (CMR) one year following STEMI. Sixty-six patients, revascularized by primary percutaneous coronary intervention (PCI) for first-time STEMI, were enrolled in this observational study. Serial hs-cTnT, creatine kinase (CK), high-sensitivity C-reactive protein (hs-CRP) and lactate dehydrogenase (LDH) levels were measured on admission, 6 h, 12 h, and 24 h post-PCI. Patients underwent CMR within the first week and 12months thereafter. Except for admission hs-cTnT, all single time point and peak hs-cTnT concentrations showed significant correlations with left ventricular ejection fraction (LVEF: r=-0.404 to -0.517, all ps<0.01) and infarct size (IS: r=0.421 to 0.700, all ps<0.01) at baseline and follow-up. The area under the curve (AUC) of peak hs-cTnT was 0.82 (95% CI 0.71-0.92) for the prediction of decreased LVEF (<55%) and 0.89 (95% CI 0.81-0.97) for the prediction of large IS (>8%) at 12months. The combination of all four biomarkers resulted in an AUC of 0.82 and 0.92 for the prediction of reduced LVEF and large IS at 12months, respectively (both ps>0.05). In stable STEMI patients successfully revascularized by primary PCI, serial and peak concentrations of hs-cTnT are closely correlated to long-term LVEF and IS. Combination of hs-cTnT with CK, hs-CRP, or LDH did not add any significant prognostic value as compared with hs-cTnT alone. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Predictive factors of emergency hospitalisation in Alzheimer's patients: results of one-year follow-up in the REAL.FR Cohort.

    PubMed

    Balardy, L; Voisin, T; Cantet, C; Vellas, B

    2005-01-01

    To determine the predictive factors of hospitalisation in patients with Alzheimer's disease followed in the REAL.FR cohort. A French multicentre prospective study (REAL.FR) following 516 patients who had mild to moderate AD at inclusion. Analysis of the data after one year of follow-up. 139 (26,9%) of the 516 initial AD patients were hospitalized during the 1 year of follow-up. After bivariate analysis, the principal predictive factors of hospitalisation were high scores on the Reisberg scale (> or = 5: P = 0.0149) and the CDR (1: P = 0.0289; 2 or 3: P = 0.0078); > or = 2 intercurrent diseases (P = 0.00104); > or = 3 other treatments (not including specific treatments for AD) (P = 0.0026); BMI (kg/m2) between 25 and 30 (P = 0.0147); impossibility of single-leg stance (P = 0.02); > or = 1 disabilities on the ADL (P = 0.0009) and > or = 2 disabilities on the IADL (P = 0.0017); use of medical services (P = 0.0236) and of non-medical services (P = 0.0403); delirium or hallucinations (P = 0.0135), depression (P = 0.0014), or disinhibited behaviour (P = 0.0030); the gravity and frequency of behavioural symptoms (NPI freq x grav > or = 11 (median), P = 0.0012); and lastly, a score of > or = 20 for subjective caregiver burden on the Zarit scale (P < 0.0001). Multivariate analysis revealed an association between the risk of hospitalisation and the following variables : the type of centre to which the patient was admitted (neurological, psychiatric or geriatric), impaired orientation on the MMS, BMI, the number of disabilities on the ADL, and caregiver burden as evaluated by the Zarit scale. At inclusion, patients with more severe cognitive disorders, poor nutritional status and those who were the most dependent for basic activities of daily living were already at greater risk of hospitalisation. Exhaustion of the informal caregiver was an independent and supplementary predictive factor of hospitalisation.

  12. Factors associated to recurrent wheezing in infants under one year of age in the province of Salamanca, Spain: Is intervention possible? A predictive model.

    PubMed

    Pellegrini-Belinchón, J; Lorente-Toledano, F; Galindo-Villardón, P; González-Carvajal, I; Martín-Martín, J; Mallol, J; García-Marcos, L

    2016-01-01

    Wheezing is a very common problem in infants in the first months of life. The objective of this study is to identify risk factors that may be acted upon in order to modify the evolution of recurrent wheezing in the first months of life, and to develop a model based on certain factors associated to recurrent wheezing in nursing infants capable of predicting the probability of developing recurrent wheezing in the first year of life. The sample was drawn from a cross-sectional, multicentre, descriptive epidemiological study based on the general population. A total of 1164 children were studied, corresponding to a questionnaire response rate of 71%. The questionnaire of the Estudio Internacional de Sibilancias en Lactantes (EISL) was used. Multiple logistic regression analysis was used to estimate the probability of developing recurrent wheezing and to quantify the contribution of each individual variable in the presence of the rest. Infants presenting eczema and attending nursery school, with a mother who has asthma, smoked during the third trimester of pregnancy, and did not consume a Mediterranean diet during pregnancy were found to have a probability of 79.7% of developing recurrent wheezing in the first year of life. In contrast, infants with none of these factors were seen to have a probability of only 4.1% of developing recurrent wheezing in the first year of life. These results in turn varied according to modifications in the risk or protective factors. The mathematical model estimated the probability of developing recurrent wheezing in infants under one year of age in the province of Salamanca (Spain), according to the risk or protective factors associated to recurrent wheezing to which the infants are or have been exposed. Copyright © 2015 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  13. One year outcome in mild to moderate head injury: the predictive value of acute injury characteristics related to complaints and return to work

    PubMed Central

    van der Naalt, J; van Zomeren, A H; Sluiter, W; Minderhoud, J

    1999-01-01

    OBJECTIVES—To determine the prognostic value of characteristics of acute injury and duration of post-traumatic amnesia (PTA) for long term outcome in patients with mild to moderate head injury in terms of complaints and return to work.
METHODS—Patients with a Glasgow coma score (GCS) on admission of 9-14 were included. Post-traumatic amnesia was assessed prospectively. Follow up was performed at 1, 3, 6, and 12 months after injury. Outcome was determined by the Glasgow outcome scale (GOS) 1 year after injury and compared with a more detailed outcome scale (DOS) comprising cognitive and neurobehavioural aspects.
RESULTS—Sixty seven patients were included, mean age 33.2 (SD 14.7) years and mean PTA 7.8 (SD 7.3) days. One year after injury, 73% of patients had resumed previous work although most (84%) still reported complaints. The most frequent complaints were headache (32%), irritability (34%), forgetfulness and poor concentration (42%), and fatigue (45%). According to the GOS good recovery (82%) or moderate disability (18%) was seen. Application of the DOS showed more cognitive (40%) and behavioural problems (48%), interfering with return to work. Correlation between the GOS and DOS was high (r=0.87, p<0.01). Outcome correlated with duration of PTA (r=−0.46) but not significantly with GCS on admission (r=0.19). In multiple regression analysis, PTA and the number of complaints 3 months after injury explained 49% of variance on outcome as assessed with the GOS, and 60% with the DOS.
CONCLUSIONS—In mild to moderate head injury outcome is determined by duration of PTA and not by GCS on admission. Most patients return to work despite having complaints. The application of a more detailed outcome scale will increase accuracy in predicting outcome in this category of patients with head injury.

 PMID:10071101

  14. Bacteraemia caused by Campylobacter spp.

    PubMed Central

    Ladrón de Guevara, C; Gonzalez, J; Peña, P

    1994-01-01

    The genus Campylobacter has become increasingly recognised as the cause of various infections. Campylobacter jejuni and C coli cause acute gastroenteritis in man all over the world. C jejuni enteritis can lead to bacteraemia, but its actual incidence remains unknown. Seven cases of bacteraemia caused by C jejuni or C coli are reported, from the blood of seven patients: five immune deficient adults; a newborn baby; and a patient who had had abdominal surgery. Patients who develop diarrhoea as a result of Campylobacter infection are at risk of bacteraemia thereafter. PMID:8132835

  15. Paediatric bacteraemias in tropical Australia.

    PubMed

    Er, Jeremy; Wallis, Peter; Maloney, Samuel; Norton, Robert

    2015-04-01

    Bacteraemias in children are an important cause of morbidity and mortality. Knowledge of local epidemiology and trends is important to inform practitioners of likely pathogens in the sick child. This study aimed to determine trends over time in pathogenic organisms causing paediatric bacteraemia in North Queensland and to audit a hospital's blood culture results with respect to contamination rate. This was a retrospective review of 8385 blood cultures collected from children attending a tertiary centre in North Queensland over a 10-year period (2001-2010). There were 696 positive blood cultures (8.3%) with 70 different bacterial species detected. Gram-positive and Gram-negative bacteria accounted for 48.6% and 51.4% of isolates, respectively. Overall, bacteraemia accounted for 4.7 per 1000 admissions. The rate of contamination was 60.6% among positive blood cultures and 5.0% for all blood cultures sampled. These results were compared with previous published reports. Notable differences were seen in the frequencies of Salmonella and group A Streptococcus bacteraemias in North Queensland when compared with other reports. There was also a decline in vaccine-preventable infections such as S. pneumoniae and an increasing trend of community-acquired MRSA bacteraemia. This study has demonstrated the unique profile of causative pathogens of paediatric bacteraemias in tropical Australia. In light of the increasing prevalence of MRSA, empiric treatment for sepsis for children in this region needs to be reconsidered. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  16. Predictive value of antinuclear antibodies in autoimmune diseases classified by clinical criteria: Analytical study in a specialized health institute, one year follow-up

    PubMed Central

    Soto, María Elena; Hernández-Becerril, Nidia; Perez-Chiney, Ada Claudia; Hernández-Rizo, Alfredo; Telich-Tarriba, José Eduardo; Juárez-Orozco, Luis Eduardo; Melendez, Gabriela; Bojalil, Rafael

    2013-01-01

    Introduction: Determination of antinuclear antibodies (ANA) by indirect immunofluorescence (IIF) is usually the initial test for the diagnosis of systemic rheumatic diseases (SRD). Assigning predictive values to positive and negative results of the test is vital because lack of knowledge about ANAs and their usefulness in classification criteria of SRD leads to inappropriate use. Methods: Retrospective study, ANA tests requested by different specialties, correlation to patients' final diagnosis. Results: The prevalence of autoimmune disease was relatively low in our population yielding a low PPV and a high NPV for the ANA test. 40% of the patients had no clinical criteria applied prior to test. Coexistence of two or more autoimmune disorders affects prevalence and predictive values. Conclusion: Application of the test after careful evaluation for clinical criteria remarkably improves the positive likelihood ratio for the diagnosis. PMID:26623249

  17. Anxiety in predicting suicide-related symptom of typhoon disaster victims: a one-year follow-up study in southern Taiwan.

    PubMed

    Chang, Mei-Chung; Chen, Po-Fei; Lung, For-Wey

    2012-12-01

    The aim of this study was to screen those at high risk of psychological distress in areas affected by typhoon Morakot, which hit Taiwan on August 7th, 2009. Screening was conducted a year later to assess the changes in psychiatric symptoms and investigate the factors which may be predictive of psychological distress and suicide ideation. One-hundred and fifty-two participants were collected at the first screening and 125 a year later. The five-item Brief Symptom Rating Scale was used to measure the level of psychological distress. Our results showed the prevalence of psychological distress immediately post-disaster was 2.4% and increased to 4.0% the next year. The level of anxiety post-disaster could predict continuous psychological distress and the development of suicidal ideation a year later. Traumatic events prior to the typhoon were not associated with the level of psychological distress a year after the disaster. Difference was found in the level of hostility immediately post-disaster and a year later. Our follow-up study found anxiety was the only indicator which predicted psychological distress a year later, and hostility was a transient state which was lower a year after the disaster. Policy-makers and future programs should focus on high anxiety cases post-disaster to prevent mental symptom and suicide ideation development.

  18. Early changes in serum type II collagen biomarkers predict radiographic progression at one year in inflammatory arthritis patients after biologic therapy.

    PubMed

    Mullan, Ronan H; Matthews, Clare; Bresnihan, Barry; FitzGerald, Oliver; King, Lindsay; Poole, A Robin; Fearon, Ursula; Veale, Douglas J

    2007-09-01

    To investigate whether short-term changes in serum biomarkers of type II collagen degradation (C2C) and types I and II collagen degradation (C1,2C), as well as the biomarker for the synthesis of type II procollagen (CPII) can predict radiographic progression at 1 year following initiation of biologic therapy in patients with inflammatory arthritis. Serum levels of biomarkers were measured at baseline and at 1, 3, 6, 9, and 12 months after initiation of biologic therapy. A composite score reflecting changes from baseline in all 3 biomarkers (DeltaCOL) was calculated. Associations with clinical responses according to the 28-joint count Disease Activity Score and with radiographic progression according to the modified Sharp/van der Heijde score (SHS) were assessed. The 1-year increase in the SHS correlated with the 1-month change in C2C results (r = 0.311, P = 0.028) and the DeltaCOL score (r = 0.342, P = 0.015). Radiographic progression was predicted by increases in serum C2C at 1 month (P = 0.031). The DeltaCOL score was significantly associated with 1-year radiographic progression after 1 (P = 0.022), 3 (P = 0.015), 6 (P = 0.048), and 9 (P = 0.019) months of therapy. Clinical remission was predicted by 1-month decreases in serum levels of C2C (P = 0.008) and C1,2C (P = 0.036). By regression analysis, 1-month changes in C2C, C1,2C, and CPII levels were independently associated with, and correctly predicted radiographic outcome in, 88% of the patients. Short-term changes in serum levels of collagen biomarkers following initiation of biologic therapy may better predict long-term clinical and radiographic outcomes. These collagen biomarkers may therefore be valuable new early indicators of short-term biologic treatment efficacy in clinical trials and in individual patients with inflammatory erosive arthritis.

  19. 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. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Vulvar puritus for one year.

    PubMed

    Madnani, Nina A; Bhalerao-Gandhi, Ashwini; Khan, Kaleem J

    2010-10-15

    A 60-year-old menopausal female presented with vulvar itching for one year. She had noticed a whitish lesion on the vulva that slowly increased in size over the year. She had been unsuccessfully treated with oral fluconazole and topical clotrimazole-mometasone combinations and the plaque had gradually spread to involve the clitoris and peri-urethral area. She was neither diabetic nor hypertensive and had no other systemic complaints. Examination revealed a well-defined non-tender whitish plaque situated on her left labia minora and clitoris (Figure 1). A swab from the plaque did not grow any organism. Routine blood chemistry including a VDRL and HIV ELIZA were within normal limits. A punch biopsy from the lesion was taken and histopathology findings were as seen in (Figures 2 and 3).

  1. A case of Bacillus cereus bacteraemia.

    PubMed

    Barnham, M; Taylor, A J

    1977-07-01

    A case is presented of Bacillus cereus bacteraemia in a patient receiving hepatic perfusion with 5-fluorouracil (5FU) for metastasis from a carcinoma of the breast. The literature concerning systemic B. cereus infections is briefly reviewed.

  2. Does improvement in self-management skills predict improvement in quality of life and depressive symptoms? A prospective study in patients with heart failure up to one year after self-management education.

    PubMed

    Musekamp, Gunda; Schuler, Michael; Seekatz, Bettina; Bengel, Jürgen; Faller, Hermann; Meng, Karin

    2017-02-15

    Heart failure (HF) patient education aims to foster patients' self-management skills. These are assumed to bring about, in turn, improvements in distal outcomes such as quality of life. The purpose of this study was to test the hypothesis that change in self-reported self-management skills observed after participation in self-management education predicts changes in physical and mental quality of life and depressive symptoms up to one year thereafter. The sample comprised 342 patients with chronic heart failure, treated in inpatient rehabilitation clinics, who received a heart failure self-management education program. Latent change modelling was used to analyze relationships between both short-term (during inpatient rehabilitation) and intermediate-term (after six months) changes in self-reported self-management skills and both intermediate-term and long-term (after twelve months) changes in physical and mental quality of life and depressive symptoms. Short-term changes in self-reported self-management skills predicted intermediate-term changes in mental quality of life and long-term changes in physical quality of life. Intermediate-term changes in self-reported self-management skills predicted long-term changes in all outcomes. These findings support the assumption that improvements in self-management skills may foster improvements in distal outcomes.

  3. One-Year Outcomes of Endovascular Aneurysm Repair in High-Risk Patients Using the Endurant Stent-Graft: Comparison of the ASA Classification and SVS/AAVS Medical Comorbidity Grading System for the Prediction of Mortality and Adverse Events.

    PubMed

    Dijkstra, Martijn L; van Sterkenburg, Steven M M; Lardenoye, Jan-Willem; Zeebregts, Clark J; Reijnen, Michel M P J

    2016-08-01

    To evaluate the outcome and survival of patients with extensive comorbid conditions after endovascular aneurysm repair (EVAR) and objectify which of 2 medical comorbidity classifications is more accurate in predicting adverse outcomes. All 1263 patients (mean age 73.1 years; 1129 men) treated using the Endurant Stent Graft system and entered in the prospective global postmarketing ENGAGE registry (ClinicalTrials.gov identifier NCT00870051) were grouped using the American Society of Anesthesiologists (ASA) classification and the Society for Vascular Surgery/American Association for Vascular Surgery (SVS/AAVS) medical comorbidity grading system. Patients assigned to ASA III and IV and SVS/AAVS 2 and 3 categories were considered high risk. Primary outcome was 1-year all-cause mortality. Secondary outcomes included technical and clinical success, major adverse events (MAE), aneurysm rupture, endoleaks, and secondary endovascular procedures. One-year follow-up of the entire ENGAGE cohort was the endpoint of the study. A total of 1263 patients were included. The overall technical success rate was high, the lowest being 97.4% in the ASA I group. The overall 30-day and 1-year Kaplan-Meier survival estimates were 98.7% and 92.5%, respectively. All cause 1-year mortality was higher in the ASA III and IV groups, but this did not reach statistical significance (5.2% and 5.7% for ASA I and II vs 9.0% and 9.9% for ASA III and IV, p=0.12). In the SVS/AAVS groups, 1-year all-cause mortality significantly increased with the SVS/AAVS score to 11.3% in the SVS/AAVS 3 group (p=0.002). There were significantly more MAEs in the SVS/AAVS 3 group at 1 year (p<0.001 for group 1 vs 3 and group 2 vs 3). Endovascular aneurysm repair has evolved, and high technical success and low mortality and morbidity can be achieved in high-risk patients. When treating high-risk patients, the perioperative risks should always be weighed against the expected gains. In contrast to the ASA classification, the

  4. Development and Validation of a Prediction Rule for Benefit and Harm of Dual Antiplatelet Therapy Beyond One Year after Percutaneous Coronary Intervention: An Analysis from the Randomized Dual Antiplatelet Therapy Study

    PubMed Central

    Yeh, Robert W.; Secemsky, Eric A.; Kereiakes, Dean J.; Normand, Sharon-Lise T.; Gershlick, Anthony H.; Cohen, David J.; Spertus, John A.; Steg, Philippe Gabriel; Cutlip, Donald E.; Rinaldi, Michael J.; Camenzind, Edoardo; Wijns, William; Apruzzese, Patricia K.; Song, Yang; Massaro, Joseph M.; Mauri, Laura

    2017-01-01

    Importance Dual antiplatelet therapy after percutaneous coronary intervention (PCI) reduces ischemia at the expense of increased bleeding. Objective To develop a clinical decision tool to identify patients expected to derive benefit vs. harm from continuing thienopyridine beyond one year after PCI. Design/Setting From DAPT Study data, a prediction rule was derived stratifying patients into groups to distinguish ischemic and bleeding risk 12–30 months after PCI. Validation was internal via bootstrap resampling and external within the Patient Related OuTcomes with Endeavor versus Cypher stenting (PROTECT) trial. Participants Derivation group: 11,648 randomized DAPT Study patients from 11 countries (August 2009–May 2014). Validation group: 8,709 randomized PROTECT trial patients from 36 countries (June 2007–July 2014). Exposure 12 months open-label thienopyridine plus aspirin; 18 months randomized continued thienopyridine plus aspirin vs. placebo plus aspirin. Main Outcome Measure Ischemia (stent thrombosis or myocardial infarction [MI]) and bleeding (GUSTO moderate/severe) 12–30 months after PCI. Results Among the derivation population (mean age 61.3 years, 25.2% female), ischemia occurred in 348 (3.0%) and bleeding in 215 (1.8%). Derivation cohort models predicting ischemia and bleeding had c-statistics of 0.70 and 0.68, respectively. The prediction rule assigned 1 point each for MI at presentation, prior MI or PCI, diabetes, stent diameter <3 mm, smoking, and paclitaxel-eluting stent; 2 points each for history of congestive heart failure/low ejection fraction and vein graft intervention; −1 point for age 65–<75; and −2 points for age ≥ 75. For patients with high scores (≥ 2, n=5917), continued thienopyridine (vs. placebo) was associated with reduced ischemic events (2.7% vs. 5.7%, risk difference [RD] −3.0%, 95% CI −4.1% to −2.0%, p<0.001), compared to those with low scores (<2, n=5731, 1.7% vs. 2.3%, RD −0.7%, 95% CI −1.4% to 0.09%, p=0

  5. The role of echocardiography in Staphylococcus aureus bacteraemia at Auckland City Hospital.

    PubMed

    Gow, Nicholas; Lowe, Boris S; Freeman, Joshua; Roberts, Sally

    2015-06-12

    Current guidelines recommend echocardiography in all episodes of Staphylococcus aureus bacteraemia (SAB). This study aimed to determine whether a very low-risk group of patients with SAB could be found in whom echocardiography was of no incremental diagnostic value for the diagnosis of infective endocarditis. Using the ANZCOSS dataset, we identified 574 eligible episodes of adult SAB at Auckland District Health Board (ADHB) between 2007 and 2012, and retrospectively obtained additional microbiological and clinical data. Prevalence of IE was determined using the modified Duke's criteria for diagnosis of IE. Multivariate logistic regression analysis was used to determine whether risk factors were independently associated with IE, and we also assessed their negative predictive value (NPV). Transthoracic and/or transoesophageal echocardiography was performed in 370 (65%) episodes of SAB. The prevalence of clinically definite and clinically possible IE was 5.6% and 8.5%, respectively. Thirty day all-cause mortality was 11.7%. The factors with the highest NPV when absent in hospital-acquired SAB were non central venous line-associated bacteraemia (100%), persistent bacteraemia (96%), and presence of a prosthetic valve or cardiac rhythm management (CRM) device (95%). When none of these three criteria were present the NPV was 100% (99-100%). A group of very low risk patients was found in our study: central line-associated SAB without prosthetic valves / CRM devices and without persistent bacteraemia. These patients had no episodes of IE and echocardiography is of no incremental diagnostic benefit.

  6. Bacteraemia in Intensive Care Unit: Clinical, Bacteriological, and Prognostic Prospective Study

    PubMed Central

    Lachhab, Zineb; Kasouati, Jalal; Doghmi, Nouafal; Ben Lahlou, Yassine; Lemnouer, Abdelhay; Elouennass, Mostafa

    2017-01-01

    Objectives. We conducted a one-year observational study from December 2012 to November 2013 to describe the epidemiology of bacteraemia in intensive care units (ICU) of Mohammed V Military Teaching Hospital of Rabat (Morocco). Methods. The study consisted of monitoring all blood cultures coming from intensive care units and studying the bacteriological profile of positive blood cultures as well as their clinical significance. Results. During this period, a total of 46 episodes of bacteraemia occurred, which corresponds to a rate of 15,4/1000 patients. The rate of nosocomial infections was 97% versus 3% for community infections. The most common source of bacteraemia was the lungs in 33%, but no source was identified in 52% of the episodes. Gram negative organisms were isolated in 83,6% of the cases with Acinetobacter baumannii being the most frequent. Antibiotic resistance was very high with 42,5% of extended-spectrum beta-lactamases (ESBLs) in Enterobacteriaceae and 100% of carbapenemase in Acinetobacter baumannii. The antibiotherapy introduced in the first 24 hours was adequate in 72% of the cases. Conclusions. Bloodstream infections in ICU occur most often in patients over 55 years, with hypertension and diabetes. The bacteria involved are mainly Gram negative bacteria multiresistant to antibiotics. Early administration of antibiotics significantly reduces patients mortality. PMID:28408938

  7. Clinical outcomes of bacteraemia in cellulitis of the leg.

    PubMed

    Tay, E-Y; Thirumoorthy, T; Pang, S-M; Lee, H-Y

    2014-08-01

    Infections of the blood are associated with high mortality and morbidity. In cellulitis, the utility of blood cultures remains controversial because of their relatively low bacterial yield. However, some important but less well studied aspects include risk factors for bacteraemia, the effects of bacteraemia on the length of hospitalization and on morbidity and mortality rates. To determine the incidence of bacteraemia in cellulitis in an inpatient cohort; to identify risk factors for bacteraemia in cellulitis; and to assess length of hospitalization stay, rate of recurrence of cellulitis, and mortality in patients with cellulitis and bacteraemia. Records of 214 patients diagnosed with cellulitis were reviewed. Blood cultures, length of hospitalization stay, rate of recurrence of cellulitis, mortality, coexistent dermatoses and local factors predisposing to cellulitis and comorbidities were analyzed. The incidence of bacteraemia was 10.8%. Mean duration of hospitalization was longer (P < 0.01) and recurrence (P < 0.01) was higher in patients with bacteraemia. There was no difference in mortality between patients with and patients without bacteraemia (P = 0.47). Risk factors for bacteraemia included lymphoedema (P < 0.01), presence of an ipsilateral orthopaedic implant (P < 0.01), total white blood cell (WBC) count > 13.5 × 10(6) μL (P < 0.01, liver cirrhosis (P = 0.02) and chronic kidney disease (P = 0.04). Blood cultures should be performed for patients with cellulitis who have factors increasing the risk of bacteraemia, such as presence of lymphoedema, ipsilateral orthopaedic device implantation, leucocytosis of > 13.5 × 10(6) μL, liver cirrhosis or chronic kidney disease, and other forms of immunosuppression. Bacteraemia in cases of cellulitis of the leg is a prognostic factor for increased length of hospitalization stay and recurrence of cellulitis. © 2014 British Association of Dermatologists.

  8. The ADS Abstract Service: One Year Old

    NASA Astrophysics Data System (ADS)

    Grant, C. Stern; Kurtz, M. J.; Eichhorn, G.

    1994-05-01

    One year after its initial release the ADS Abstract Service has become quite widely used. More than 1000 different people use it per month, making about 20,000 queries and obtaining a couple of hundred thousand pieces of bibliographic information. In February a WWW connection was released, it has been heavily used. The collaboration with SIMBAD, released in January, allows one to make complex queries about work on particular objects. For example one may search for all papers which SIMBAD says are about M87, and which contain the words ``globular cluster'' in the abstract, thus getting the 65 papers on the M87 globular cluster system. One can also look for papers which have the words ``M87 globular clusters'' in the abstract, but are not listed in SIMBAD; this obtains another 19 papers, mostly conference procedings, about the M87 globular cluster system. The figure shows the list of non-SIMBAD papers.

  9. Thrombocytopaenia during methicillin-sensitive Staphylococcus aureus bacteraemia.

    PubMed

    Forsblom, E; Tielinen, I; Ruotsalainen, E; Järvinen, A

    2016-12-23

    The prognostic impact of thrombocytopaenia in Staphylococcus aureus bacteraemia (SAB) has previously been determined at bacteraemia onset only and relevant pre-bacteraemic thrombocytopaenia predisposing parameters have not been accounted for. We evaluated the prognostic impact of low thrombocyte count in SAB excluding pre-bacteraemic factors potentially causing thrombocytopaenia. This was a multicentre retrospective analysis of methicillin-sensitive SAB (MS-SAB) patients. Thrombocyte count was determined at blood culture collection and at days 3 and 7. Thrombocytopaenia was defined as a thrombocyte count less than 150 ×10(9)/L. Patients with chronic alcoholism, liver diseases and haematologic malignancies were excluded. Altogether, 495 patients were identified. Thrombocytopaenia at blood culture and at day 3 associated to endocarditis (p < 0.05 and p < 0.01) and defervescence (p < 0.001 and p < 0.01). Mortality at 90 days was higher for patients with thrombocytopaenia at blood culture collection (26 vs. 16%, p < 0.05), at day 3 (32 vs. 13%, p < 0.01) and at day 7 (50 vs. 14%, p < 0.001). In receiver operating characteristic analyses, thrombocytopaenia predicted a poor outcome at blood culture collection (p < 0.05), at day 3 (p < 0.001) and at day 7 (p < 0.001). When accounting for all prognostic parameters, thrombocytopaenia at day 3 [hazard ratio (HR), 1.83; p = 0.05] demonstrated a trend towards poor outcome, whereas thrombocytopaenia at day 7 (HR, 3.64; p < 0.001) associated to poor outcome. Thrombocytopaenia at blood culture collection was not a prognostic parameter when all prognostic factors were taken into account. However, thrombocytopaenia at day 3 indicated a poor outcome and thrombocytopaenia at day 7 was a significant independent negative prognostic marker that has not been previously reported in SAB.

  10. Human daily rhythms measured for one year.

    PubMed

    Binkley, S; Tome, M B; Crawford, D; Mosher, K

    1990-08-01

    Four human subjects recorded their wake-up and to-sleep times for one year each. The data were plotted to display individual circadian rhythms and the data were analyzed statistically. First, individuals had characteristic patterns in which visible changes in the patterns were observed mainly when time zones were changed because of travel. Second, the months with the latest wake-up and latest to-sleep times concentrated around the winter solstice; the months with the earliest wake-up and earliest to-sleep times concentrated around the fall equinox. Third, new moon versus full moon days were not different. Fourth, one-hour changes between standard and daylight savings time in the USA were reflected by near one-hour changes in two subjects, but not in a third. Fifth, weekend delays in wake-up time (0.8-1.6 hours), weekend delays in to-sleep time (0.1-0.5 hours), and shorter weekend awake time (0.8-1.3 hours) were observed. Sixth, throughout the year, wake-up times were close to the time of sunrise, but to-sleep times were several hours past sunset.

  11. The Paris agreement: one year after

    NASA Astrophysics Data System (ADS)

    Jouzel, J.

    2016-12-01

    Even if there is an important gap between the nationally determined contributions and the 2°C objective - of the order of 15 gigatonnes CO2 equivalent in 2030 - the agreement adopted in Paris last december (COP21) is largely considered as a success. This can be explained by the fact that this agreement - now signed by practically all countries - comes after the partial failure of the Kyoto protocol (COP3) - which has not been ratified by the US, the first emitting country in the late nineties - and the lack of ambition of the Copenhagen agreement (COP15). One year after COP21, the COP of « decision » and a few weeks after COP22, the COP of « action » to be held in Marrakech, it will be interesting to see if the Paris momentum has been kept. Is the ratification of the agreement, which requires 55 countries representing at least 55 of global emissions, under way ? Are there signs of stabilization of greenhouse gas emissions and some hope of increased ambition in terms of reduction of emissions after 2020 ? The 1°5 °C objective which will be the focus of an IPCC special report to be published in 2018 will also be discussed.

  12. Special report... Norplant -- one year later.

    PubMed

    1991-12-20

    One year after the introduction of Norplant in the US, issues of cost and forced use have arisen. Approved in December 1990, the contraceptive implant is already being used by some 100,000 American women. Its high cost, however, will apparently bar many women from using Norplant. The Norplant system itself--6 capsules and an inserter--costs a provider $350. This does not include the fees for a physical examination, counseling, insertion, and removal. According to Wyeth-Ayerst, the pharmaceutical company that distributes Norplant, the median fee for the implant and insertion is $580. While the company has declined to provide Norplant at a reduced cost to clinics serving low-income patients, Wyeth has established the Norplant Foundation to help distribute the method among poor women. The foundation, however, has yet to announce the criteria for qualification. Realizing the benefits of the implants, 48 states have made Norplant part of their state Medicaid programs, and 35 health maintenance organizations (HMOs) have decided to provide the method. Nonetheless, women whose incomes do not qualify them for Medicaid and who cannot afford a private physician must pay the full cost. Most family planning clinics cannot afford to subsidize the cost of Norplant, since that money would allow them to provide oral contraceptives or IUDs to many more women. At the same time, the some have suggested providing incentives for certain groups of women--teenagers, welfare mothers, drug or child abusers--do use Norplant. In fact, one California judge ordered a woman convicted of child abuse to have Norplant inserted. In Kansas and Louisiana, legislators introduced bills "encouraging" low-income women to use Norplant (the bills were defeated). The article finds both of these issues troubling.

  13. Effects of One Year of Spaceflight on Neurocognitive Function

    NASA Technical Reports Server (NTRS)

    Seidler, R. D.; Mulavara, A. P.; Koppelmans, V.; Kofman, I. S.; Cassady, K.; Yuan , P.; De Dios, Y. E.; Gadd, N.; Riascos, R. F.; Wood, S. J.; hide

    2017-01-01

    It is known that spaceflight adversely affects human sensorimotor function. With interests in longer duration deep space missions it is important to understand microgravity dose-response relationships. NASA's One Year Mission project allows for comparison of the effects of one year in space with those seen in more typical six month missions to the International Space Station. In the Neuromapping project we are performing structural and functional magnetic resonance brain imaging to identify the relationships between changes in neurocognitive function and neural structural alterations following a six month International Space Station mission. Our central hypothesis is that measures of brain structure, function, and network integrity will change from pre- to post-spaceflight. Moreover, we predict that these changes will correlate with indices of cognitive, sensory, and motor function in a neuroanatomically selective fashion. Our interdisciplinary approach utilizes cutting edge neuroimaging techniques and a broad-ranging battery of sensory, motor, and cognitive assessments that are conducted pre-flight, during flight, and post-flight to investigate potential neuroplastic and maladaptive brain changes in crewmembers following long-duration spaceflight. With the one year mission we had one crewmember participate in all of the same measures pre-, per- and post-flight as in our ongoing study. During this presentation we will provide an overview of the magnitude of changes observed with our brain and behavioral assessments for the one year crewmember in comparison to participants that have completed our six month study to date.

  14. 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.

  15. 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

  16. Colovesical fistula presenting as Listeria monocytogenes bacteraemia

    PubMed Central

    2015-01-01

    We present a case of colovesical fistula presenting with a clinical syndrome of urosepsis subsequently demonstrated to be due to Listeria monocytogenes bacteraemia. The patient had a history of previous rectal cancer with a low anterior resection and a covering ileostomy that had been reversed 6 months prior to this presentation. L. monocytogenes was also isolated among mixed enteric organisms on urine culture. There were no symptoms or signs of acute gastrointestinal listeriosis or meningoencephalitis. This unusual scenario prompted concern regarding the possibility of communication between bowel and bladder, which was subsequently confirmed with CT and a contrast enema. The patient recovered well with intravenous amoxicillin and to date has declined surgical management of his colovesical fistula. This case illustrates the importance of considering bowel pathology when enteric organisms such as Listeria are isolated from unusual sites. PMID:25827919

  17. 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.

  18. Impact of appropriate empirical antibiotic treatment on recurrence and mortality in patients with bacteraemia: a population-based cohort study.

    PubMed

    Gradel, Kim O; Jensen, Ulrich S; Schønheyder, Henrik C; Østergaard, Christian; Knudsen, Jenny D; Wehberg, Sonja; Søgaard, Mette

    2017-02-06

    Data on the impact of empirical antibiotic treatment (EAT) on patient outcome in a population-based setting are sparse. We assessed the association between EAT and the risk of recurrence within one year, short-term- (2-30 days) and long-term (31-365 days) mortality in a Danish cohort of bacteraemia patients. A cohort study including all patients hospitalized with incident bacteraemia during 2007-2008 in the Copenhagen City and County areas and the North Denmark Region. EAT was defined as the antibiotic treatment given at the 1(st) notification of a positive blood culture. The definition of recurrence took account of pathogen species, site of infection, and time frame and was not restricted to homologous pathogens. The vital status was determined through the civil registration system. Association estimates between EAT and the outcomes were estimated by Cox and logistic regression models. In 6483 eligible patients, 712 (11%) had a recurrent episode. A total of 3778 (58%) patients received appropriate EAT, 1290 (20%) received inappropriate EAT, while EAT status was unrecorded for 1415 (22%) patients. The 2-30 day mortality was 15.1%, 17.4% and 19.2% in patients receiving appropriate EAT, inappropriate EAT, and unknown EAT, respectively. Among patients alive on day 30, the 31-365 day mortality was 22.3% in patients given appropriate EAT compared to 30.7% in those given inappropriate EAT. Inappropriate EAT was independently associated with recurrence (HR 1.25; 95% CI = 1.03-1.52) and long-term mortality (OR 1.35; 95% CI = 1.10-1.60), but not with short-term mortality (OR 0.85; 95% CI = 0.70-1.02) after bacteraemia. Our data indicate that appropriate EAT is associated with reduced incidence of recurrence and lower long-term mortality following bacteraemia.

  19. Device-related sources of bacteraemia in English hospitals--opportunities for the prevention of hospital-acquired bacteraemia.

    PubMed

    Coello, R; Charlett, A; Ward, V; Wilson, J; Pearson, A; Sedgwick, J; Borriello, P

    2003-01-01

    Between 1997 and 2001, 17 teaching and 56 non-teaching acute English hospitals conducted hospital-wide surveillance of hospital-acquired bacteraemia (HAB) using a standard protocol drawn up by the Nosocomial Infection National Surveillance Scheme (NINSS). The sources of organisms, the incidence of device-related HAB, and the distribution of HABs from individual device-related sources by specialty and type of hospital were determined for 6,956 HABs in order to identify where resources should best be targeted to reduce these infections. The overall incidence of HAB was higher in teaching than in non-teaching hospitals: 5.39 and 2.83 HABs per 1,000 patients at risk, respectively (P<0.001). Device-related sources were responsible for 52.4 and 43.2% of all HABs in teaching and non-teaching hospitals, respectively (P<0.001), and central lines were the commonest source, causing 38.3% of HABs in teaching versus 22.3% in non-teaching hospitals (P<0.001). In teaching hospitals, general intensive care units (ICUs), haematology, special care baby units (SCBUs), nephrology, and oncology accounted for only 6.1% of the population surveyed, but had the highest incidence of HAB, and contributed 47.8% of 2091 HABs and 56.9% of 1,095 device-related bacteraemias. Of 623 device-related bacteraemias in these high-risk specialties, 554 (88.9%) were from central lines. Thus, in teaching hospitals, resources should be targeted primarily at the prevention of central line-related bacteraemia in these five high-risk specialties, and the surveillance should include data on central line use. In non-teaching hospitals, nearly two thirds (63.3%) of 4,865 HABs and 60.7% of 2,103 device-related bacteraemias were from a few specialties with a low incidence of bacteraemia, but large numbers of patients, namely general medicine, general surgery, geriatric medicine and urology. These specialties accounted for 50.5% of the population surveyed. Central lines were the most common source of bacteraemia in

  20. Epidemiology of Staphylococcus aureus bacteraemia at a tertiary children's hospital in Cape Town, South Africa.

    PubMed

    Naidoo, Reené; Nuttall, James; Whitelaw, Andrew; Eley, Brian

    2013-01-01

    Staphylococcus aureus is an important pathogen in paediatric patients with bloodstream infections. The epidemiology of S. aureus bacteraemia, however, has not been well documented in children in South Africa. A retrospective study was conducted at a children's hospital in Cape Town, South Africa, to investigate the epidemiology of S. aureus bacteraemia from 2007-2011. The incidence, clinical presentation, risk factors, management and outcomes of methicillin sensitive S. aureus (MSSA) and methicillin resistant S. aureus (MRSA) bacteraemia were compared. Over the five year study period, 365 episodes of S. aureus bacteraemia were identified. The annual incidence was 3.28 cases per 1000 hospital admissions. MRSA was responsible for 26% of S. aureus bacteraemia and 72% of nosocomial infections. Only six possible cases of community-acquired MRSA infections were described. MSSA bacteraemia was more likely to present as pulmonary and bone or joint infections, while bacteraemia without a source was the most common presentation with MRSA.  Infants, children with malnutrition, and residents of long-term care facilities were at highest risk for MRSA bacteraemia. The overall case fatality rate for S. aureus bacteraemia was 8.8% over five years, with MRSA being the only significant risk factor for mortality. The incidence of S. aureus bacteraemia and MRSA bacteraemia in children has remained stable over the past five years. MRSA is a predominantly nosocomial pathogen in children with S. aureus bacteraemia in Cape Town, South Africa.

  1. The Danish Collaborative Bacteraemia Network (DACOBAN) database.

    PubMed

    Gradel, Kim Oren; Schønheyder, Henrik Carl; Arpi, Magnus; Knudsen, Jenny Dahl; Ostergaard, 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.

  2. Staphylococcal bacteraemia, fusidic acid, and jaundice.

    PubMed

    Humble, M W; Eykyn, S; Phillips, I

    1980-06-21

    Fusidic acid was used to treat 131 out of 250 patients with staphylococcal bacteraemia over 10 years. Other antimicrobial agents were given to the 119 remaining patients. Thirty-seven patients were already jaundiced before antibiotic treatment was started. Jaundice developed during treatment in 38 out of 112 patients given fusidic acid (34%) and in two out of 101 patients given other antimicrobials. The incidence of jaundice was higher in patients given fusidic acid intravenously (48%) rather than by mouth (13%). Jaundice appeared within 48 hours after the administration of fusidic acid in 93% of these cases. When the drug was stopped serum bilirubin concentrations fell to normal values within four days in those patients in whom they had been previously normal and who survived the bacteraemic episode. Fusidic acid was associated with increasing jaundice in 13 of 19 patients (68%) already jaundiced before it was given. In six out of 32 patients who developed jaundice while receiving intravenous fusidic acid serum alkaline phosphatase activity was raised suggestive of cholestatic jaundice. The mechanism in the remaining patients was unknown. Fusidic acid, particularly the intravenous preparation, in invaluable in treating severe staphylococcal infection but should be used with caution in patients with abnormal liver function. Patients receiving intravenous fusidic acid should be given the oral form of the drug as soon as their clinical condition permits.

  3. Counselling for burnout in Norwegian doctors: one year cohort study

    PubMed Central

    Gude, Tore; Tyssen, Reidar; Aasland, Olaf G

    2008-01-01

    Objective To investigate levels and predictors of change in dimensions of burnout after an intervention for stressed doctors. Design Cohort study followed by self reported assessment at one year. Setting Norwegian resource centre. Participants 227 doctors participating in counselling intervention, 2003-5. Interventions Counselling (lasting one day (individual) or one week (group based)) aimed at motivating reflection on and acknowledgement of the doctors’ situation and personal needs. Main outcome measures Levels of burnout (Maslach burnout inventory) and predictors of reduction in emotional exhaustion investigated by linear regression. Results 185 doctors (81%, 88 men, 97 women) completed one year follow-up. The mean level of emotional exhaustion (scale 1-5) was significantly reduced from 3.00 (SD 0.94) to 2.53 (SD 0.76) (t=6.76, P<0.001), similar to the level found in a representative sample of 390 Norwegian doctors. Participants had reduced their working hours by 1.6 hours/week (SD 11.4). There was a considerable reduction in the proportion of doctors on full time sick leave, from 35% (63/182) at baseline to 6% (10/182) at follow-up and a parallel increase in the proportion who had undergone psychotherapy, from 20% (36/182) to 53% (97/182). In the whole cohort, reduction in emotional exhaustion was independently associated with reduced number of work hours/week (β=0.17, P=0.03), adjusted for sex, age, and personality dimensions. Among men “satisfaction with the intervention” (β=0.25, P=0.04) independently predicted reduction in emotional exhaustion. Conclusions A short term counselling intervention could contribute to reduction in emotional exhaustion in doctors. This was associated with reduced working hours for the whole cohort and, in men, was predicted by satisfaction with the intervention. PMID:19001492

  4. 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 enforceable...

  5. 40 CFR 761.219 - One-year exception reporting.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 31 2014-07-01 2014-07-01 false One-year exception reporting. 761.219... 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...

  6. Prevalence of community-acquired bacteraemia in Guinea-Bissau: an observational study.

    PubMed

    Isendahl, Joakim; Manjuba, Cristovão; Rodrigues, Amabelia; Xu, Weiping; Henriques-Normark, Birgitta; Giske, Christian G; Nauclér, Pontus

    2014-12-20

    The burden of bloodstream infections is insufficiently studied in children in Africa and many healthcare facilities lack the capacity to identify invasive disease. Often studies have been limited to febrile patients or patients admitted to hospital. Blood cultures and malaria diagnostics was performed on 372 consecutive children presenting with tachycardia and/or fever to a referral paediatric emergency department in Bissau, Guinea-Bissau. Bacterial species detection, antimicrobial susceptibility testing and molecular typing were performed. The capacity of clinical parameters to identify bacteraemia was evaluated. The prevalence of bloodstream infection was 12% (46/372) and in 46% (21/46) of the infections the child was non-febrile at presentation to the hospital. The predictive value for bacteraemia was poor for all assessed clinical parameters. Staphylococcus aureus accounted for 54% (26/48) of the isolates followed by non-typhoidal Salmonella, 10% (5/48), Streptococcus pneumoniae, 8% (4/48), and Salmonella Typhi, 6% (3/48). Among S. aureus there was a large diversity of spa types and 38% produced Pantone-Valentine leukocidin. Antibiotic resistance was low, however two out of three Klebsiella pneumoniae isolates produced extended-spectrum beta-lactamases. Malaria was laboratory confirmed in only 5% of the children but 64% (237/372) received a clinical malaria diagnosis. Bacteraemia was common irrespective of the presence of fever among children presenting to the hospital. The high prevalence of Staphylococcus aureus may be due to contamination. There is an imminent need to improve microbiological diagnostic facilities and to identify algorithms that can identify children at risk of bloodstream infections in Africa.

  7. Procalcitonin is useful in identifying bacteraemia among children with pneumonia.

    PubMed

    Nascimento-Carvalho, Cristiana M; Cardoso, Maria-Regina A; Barral, Aldina; Araújo-Neto, César A; Guerin, Sylvie; Saukkoriipi, Annika; Paldanius, Mika; Vainionpää, Raija; Lebon, Pierre; Leinonen, Maija; Ruuskanen, Olli; Gendrel, Dominique

    2010-09-01

    Empirical antibiotic use is prescribed in managing children with pneumonia worldwide. We assessed the usefulness of procalcitonin (PCT) and interferon-alpha (IFN-alpha) in differentiating viral from bacterial pneumonia. Among 159 hospitalized children, pneumonia was diagnosed based on clinical complaints plus pulmonary infiltrate. Aetiology was investigated for 9 viruses and 4 atypical and 3 typical bacteria. PCT and IFN-alpha were measured in the serum sample collected on admission. Eight patients had bacteraemic infections, 38 had non-bacteraemic typical infections, and 19 patients had atypical bacterial infections. Viral and unknown aetiology was established in 57 (36%) and 34 (21%) cases, respectively. Three patients with bacterial infection without collected blood culture were excluded. IFN-alpha (IU/ml) was detectable in 20 (13%) cases. The difference among median PCT values of the bacteraemic (4.22; 1.56-7.56), non-bacteraemic typical bacterial (1.47; 0.24-4.07), atypical bacterial (0.18; 0.06-1.03) and only viral (0.65; 0.11-2.22) subgroups was significant (p = 0.02). PCT was > or =2 ng/ml in 52 (33%) cases. The presence of IFN-alpha was associated with PCT <2 ng/ml (90% vs. 64%, p = 0.02). The negative predictive value (95% confidence interval) of PCT > or =2 ng/ml was 95% (89-100%), 89% (78-100%), 93% (85-100%) for differentiation of bacteraemic from viral, atypical bacterial and non-bacteraemic typical bacterial infection, respectively, and 58% (49-68%) for differentiation between bacterial and viral infection. PCT may be useful in identifying bacteraemia among children hospitalized with community-acquired pneumonia. IFN-alpha was uncommonly detected.

  8. Staphylococcus aureus bacteraemia: 400 episodes in St Thomas's Hospital.

    PubMed

    Gransden, W R; Eykyn, S J; Phillips, I

    1984-01-28

    Four hundred episodes of Staphylococcus aureus bacteraemia occurred in St Thomas's Hospital from 1969 to 1983, accounting for 17.5% of all episodes of bacteraemia. The mortality was 24%, half attributable to underlying disease, and was highest in patients over 50. Almost 60% of the bacteraemias were acquired in hospital, and the source of the organism was generally obvious, with vascular access sites the most common (37%). Bone and joint infections accounted for 11.5% of episodes and endocarditis for 7%. Most staphylococci were resistant to penicillin only; three isolates were resistant to methicillin and five to fusidic acid. Microbiologists seldom influenced directly the choice of initial antibiotic treatment (though this usually conformed to the hospital's antibiotic prescribing policy) but had considerable influence over definitive treatment, usually cloxacillin or flucloxacillin alone or in combination with fusidic acid. S aureus bacteraemia is easy to identify and treat, though underlying disease may influence the outcome. Efforts should be made to prevent the largely iatrogenic disease.

  9. Bacillus cereus bacteraemia: comparison between haematologic and nonhaematologic patients.

    PubMed

    Tusgul, S; Prod'hom, G; Senn, L; Meuli, R; Bochud, P-Y; Giulieri, S G

    2017-01-01

    Bacillus cereus bacteraemia can be severe, especially among patients with haematologic malignancy. We retrospectively reviewed first episodes of true B. cereus bacteraemia (more than one positive bottle plus signs of infection) at our institution between 1997 and 2013 with the aim to compare haematologic versus nonhaematologic patients and analyse episodes with complicated outcome. Among 56 episodes of positive-blood cultures for B. cereus, 21 were considered significant. Median age was 54 years (range 23-82 years). Ten patients (48%) had a haematologic malignancy; all were neutropenic at the time of B. cereus bacteraemia. Nonhaematologic patients were either intravenous drug users (n = 3, 14%), polytraumatized (n = 3, 14%) or had multiple chronic comorbidities (n = 5, 24%). Most episodes were hospital acquired (15, 71%). Sources of bacteraemia were intravascular catheter (n = 11, 52%), digestive tract (n = 6, 29%), drug injection (n = 3, 14%) and wound (n = 1, 5%). Adequate antibiotic therapy was provided to 18 patients (86%) during a median of 17 days (range 2-253 days). The intravascular catheter was removed in eight cases (42%). Three haematologic patients had a complicated course with neurologic complications (meningoencephalitis and cerebral abscesses). Complications appeared to be associated with catheter infection (100% of complicated cases vs. 29% of noncomplicated cases). In conclusion, B. cereus bacteraemia can have a complicated course in a subset of patients, mainly those with haematologic malignancy. Catheter infection may be associated with a worse outcome with frequent neurologic complications.

  10. 40 CFR 761.219 - One-year exception reporting.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Section 761.219 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES... 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...

  11. One year of United Kingdom Meteor Observation Network

    NASA Astrophysics Data System (ADS)

    Kacerek, Richard; Campbell-Burns, Peter

    2014-01-01

    United Kingdom Meteor Observation Network (UKMON) began data gathering in April 2012 with its first station placed in Ash Vale, Surrey. This contribution shows our progress of building a network in the UK during one year.

  12. The effect of community-acquired bacteraemia on return to workforce, risk of sick leave, permanent disability pension and death: a Danish population-based cohort study.

    PubMed

    Dalager-Pedersen, Michael; Koch, Kristoffer; Thomsen, Reimar Wernich; Schønheyder, Henrik Carl; Nielsen, Henrik

    2014-01-29

    Little is known about the prognosis of community-acquired bacteraemia (CAB) in workforce adults. We assessed return to workforce, risk for sick leave, disability pension and mortality within 1 year after CAB in workforce adults compared with blood culture-negative controls and population controls. Population-based cohort study. North Denmark, 1996-2011. We used population-based healthcare registries to identify all patients aged 20-58 years who had first-time blood cultures obtained within 48 h of medical hospital admission, and who were part of the workforce (450 bacteraemia exposed patients and 6936 culture-negative control patients). For each bacteraemia patient, we included up to 10 matched population controls. Return to workforce, risk of sick leave, permanent disability pension and mortality within 1 year after bacteraemia. Regression analyses were used to compute adjusted relative risks (RRs) with 95% CIs. One year after admission, 78% of patients with CAB, 85.7% of culture-negative controls and 96.8% of population controls were alive and in the workforce, and free from sick leave or disability pension. Compared with culture-negative controls, bacteraemia was associated with an increased risk for long-term sick leave (4-week duration, 40.2% vs 23.9%, adjusted RR, 1.51; CI 1.34 to 1.70) and an increased risk for mortality (30-day mortality, 4% vs 1.4%, adjusted RR, 2.34, CI 1.22 to 4.50; 1-year mortality, 8% vs 3.9%, adjusted RR, 1.73; CI 1.18 to 2.55). Bacteraemia patients had a risk for disability pension similar to culture-negative controls (2.7% vs 2.6%, adjusted RR, 0.99, CI 0.48 to 2.02) but greater than population controls (adjusted RR, 5.20; 95% CI 2.16 to 12.50). CAB is associated with long duration of sick leave and considerable mortality in working-age adults when compared with blood culture-negative controls, and an increased 1-year risk for disability pension when compared with population controls.

  13. Splenic abscess with Clostridium novyi bacteraemia and sepsis.

    PubMed

    Vleminckx, W G; Diltoer, M W; Spapen, H D; Pierard, D; De Mey, J; Delvaux, G R; Huyghens, L P

    1997-03-01

    Splenic abscess is an uncommon entity and usually results in the death of the patient when left undiagnosed. A case is presented where bacteraemia with an anaerobic Gram-positive bacillus was associated with splenic abscess. Despite treatment with splenectomy and antibiotics the patient developed a multiple organ dysfunction syndrome (MODS) and died. Of particular interest was the isolation of Clostridium novyi type A from the blood in a patient without gas gangrene but with splenic suppuration.

  14. Campylobacter bacteraemia: 16 years of experience in a single centre.

    PubMed

    Hussein, Khetam; Raz-Pasteur, Ayelet; Shachor-Meyouhas, Yael; Geffen, Yuval; Oren, Ilana; Paul, Mical; Kassis, Imad

    2016-01-01

    Campylobacter bacteraemia (CB) is rare and usually occurs in immune-compromised patients. In this study we examined the incidence and epidemiology of CB in one institution over 15.5 years. The medical records of all the consecutive patients with CB admitted to our hospital from 2000 to 2015 were retrospectively reviewed. Clinical characteristics, microbiologic and outcome data were collected. During the study period, 65 patients with CB were identified. The majority of the patients were middle aged and immune-compromised. Campylobacter jejuni was the most commonly identified species (33/47, 70%). The main underlying conditions were haematological malignancies (43%) and chronic liver disease (14%). Fifty-seven percent of the patients were receiving immunosuppressive therapy at the time of bacteraemia. The most common presenting symptoms were fever (85%), diarrhoea (40%), abdominal pain (40%), and nausea and vomiting (40%). Of the isolates tested, 97% were susceptible to macrolides, and only 35% were susceptible to quinolones. Susceptibility to quinolones decreased over the years. Most patients did not receive adequate empiric antibiotic treatment (81.5%) and about 20% never received directed therapy. Mortality and relapse rates were low (5% each). There was no association between adequate empirical or definitive antibiotic therapy and adverse outcomes. The main predisposing factor for Campylobacter bacteraemia in our cohort was immunosuppression. Prognosis was generally favourable regardless of appropriateness of antibiotic therapy.

  15. Successful treatment of recurrent Helicobacter fennelliae bacteraemia by selective digestive decontamination with kanamycin in a lung cancer patient receiving chemotherapy

    PubMed Central

    Nagamatsu, Maki; Tomida, Junko; Kawamura, Yoshiaki; Yamamoto, Kei; Mawatari, Momoko; Kutsuna, Satoshi; Takeshita, Nozomi; Hayakawa, Kayoko; Kanagawa, Shuzo; Mezaki, Kazuhisa; Hashimoto, Masao; Ishii, Satoru; Ohmagari, Norio

    2016-01-01

    Introduction: Helicobacter fennelliae is an enterohepatic Helicobacter species causing bacteraemia in immunocompromised hosts. Only a few cases of recurrent H. fennelliae bacteraemia have been reported in Japan and there are no guidelines regarding antimicrobial treatment for H. fennelliae infection. Case presentation: H. fennelliae bacteraemia was observed in a patient receiving platinum-based chemotherapy for lung cancer. To prevent recurrence, the patient received antibiotic therapy with cefepime, amoxicillin and doxycycline for 6 weeks, which is similar to the therapy for Helicobacter cinaedi bacteraemia. Bacteraemia recurred despite the long-term antibiotic therapy. We hypothesized that the H. fennelliae bacteraemia originated from endogenous infection in the intestinal tract due to the long-term damage of the enteric mucosa by platinum-based drugs and performed selective digestive decontamination (SDD) with kanamycin. Bacteraemia did not recur after SDD. Conclusion: Our observations indicate that clinicians should be aware of possible recurrent H. fennelliae bacteraemia, which could be effectively prevented by SDD with kanamycin. PMID:28348791

  16. Musculoskeletal clinic in general practice: study of one year's referrals.

    PubMed Central

    Peters, D; Davies, P; Pietroni, P

    1994-01-01

    BACKGROUND. A musculoskeletal clinic, staffed by a general practitioner trained in osteopathy, medical acupuncture and intralesional injections, was set up in an inner London general practice in 1987. AIM. A retrospective study was undertaken of one year's referrals to the clinic in 1989-90 to determine how general practitioners were using the clinic in terms of problems referred; consultation patterns of patients attending the clinic and 12 months after initially being seen; and how access to the clinic influenced referrals to relevant hospital departments. METHOD. Day sheets were studied which recorded information on demographic characteristics of patients referred to the clinic and their problems, diagnoses made, duration of symptoms, number and range of treatments given, and recurrence of problems. Use of secondary referral sources was also examined. RESULTS. During the study year 154 of 3264 practice patients were referred to the musculoskeletal clinic, and attended a mean of 3.5 times each. Of all the attenders 64% were women and 52% were 30-54 years old. Eighty one patients (53%) presented with neck, back or sciatic pain. A specific traumatic, inflammatory or other pathological process could be ascribed to only 19% of patients. Regarding treatment, 88% of patients received osteopathic manual treatment or acupuncture, or a combination of these treatments and 4% received intralesional injections. Nine patients from the clinic (6%) were referred to an orthopaedic specialist during the year, two with acute back pain. Referrals to orthopaedic specialists by the practice as a whole were not significantly lower than the national average, although the practice made fewer referrals to physiotherapy and rheumatology departments than national figures would have predicted. Seventeen patients (11%) returned to the clinic with a recurrence of their main complaint within a year of their initial appointment; second courses of treatment were usually brief. CONCLUSION. The

  17. The Class of 1993: One Year after Graduation.

    ERIC Educational Resources Information Center

    Barkume, Megan

    1998-01-01

    The data presented here on 1993 college graduates show 92% were in the labor force and 26% in continuing education one year after graduation. Charts depict employment by major field: biological sciences, business/management, education, engineering, health care, history, humanities, math/physical sciences, psychology, public affairs, and social…

  18. 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.…

  19. 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.…

  20. Completion of One Year Bioventing Test, Buildings 1639 and 1812

    DTIC Science & Technology

    2007-11-02

    The Air Force Center for Environmental Excellence (AFCEE) one-year bioventing test and evaluation projects at Buildings 1639 and 1812 have been...These decreases are best explained by the reduction of contaminant levels as the bioventing continued. For Building 1812, the oxygen levels at

  1. One-year mortality after severe COPD exacerbation in Bulgaria.

    PubMed

    Mekov, Evgeni; Slavova, Yanina; Tsakova, Adelina; Genova, Marianka P; Kostadinov, Dimitar T; Minchev, Delcho; Marinova, Dora; Boyanov, Mihail A

    2016-01-01

    One-year mortality in COPD patients is reported to be between 4% and 43%, depending on the group examined. To examine the one-year mortality in COPD patients after severe exacerbation and the correlation between mortality and patients' characteristics and comorbidities. A total of 152 COPD patients hospitalized for severe exacerbation were assessed for vitamin D status, diabetes mellitus (DM), arterial hypertension (AH), and metabolic syndrome (MS). Data were gathered about smoking status and number of exacerbations in previous year. CAT and mMRC questionnaires were completed by all patients. Pre- and post-bronchodilatory spirometry was performed. One-year mortality was established from national death register. One-year mortality is 7.2%. DM, MS, and VD are not predictors for one-year mortality. However there is a trend for increased mortality in patients with AH (9.5% vs. 2.1%, p = 0.107). There is increased mortality in patients with mMRC > 2 (11.1 vs. 0%, p = 0.013). The presence of severe exacerbation in the previous year is a risk factor for mortality (12.5% vs. 1.4%, p = 0.009). There is a trend for increased mortality in the group with FEV1 < 50% (11.5 vs. 4.4%, p = 0.094). Cox regression shows 3.7% increase in mortality rate for 1% decrease in FEV1, 5.2% for 1% decrease in PEF, 7.8% for one year age increase and 8.1% for 1 CAT point increase (all p < 0.05). This study finds relatively low one-year mortality in COPD patients after surviving severe exacerbation. Grade C and FEV1 > 80% may be factors for good prognosis. Risk factors for increased mortality are age, FEV1 value, severe exacerbation in previous year and reduced quality of life.

  2. Epidemiology of Staphylococcus aureus Bacteraemia at a Tertiary Children’s Hospital in Cape Town, South Africa

    PubMed Central

    Naidoo, Reené; Nuttall, James; Whitelaw, Andrew; Eley, Brian

    2013-01-01

    Background Staphylococcus aureus is an important pathogen in paediatric patients with bloodstream infections. The epidemiology of S. aureus bacteraemia, however, has not been well documented in children in South Africa. Methods A retrospective study was conducted at a children’s hospital in Cape Town, South Africa, to investigate the epidemiology of S. aureus bacteraemia from 2007-2011. The incidence, clinical presentation, risk factors, management and outcomes of methicillin sensitive S. aureus (MSSA) and methicillin resistant S. aureus (MRSA) bacteraemia were compared. Results Over the five year study period, 365 episodes of S. aureus bacteraemia were identified. The annual incidence was 3.28 cases per 1000 hospital admissions. MRSA was responsible for 26% of S. aureus bacteraemia and 72% of nosocomial infections. Only six possible cases of community-acquired MRSA infections were described. MSSA bacteraemia was more likely to present as pulmonary and bone or joint infections, while bacteraemia without a source was the most common presentation with MRSA.  Infants, children with malnutrition, and residents of long-term care facilities were at highest risk for MRSA bacteraemia. The overall case fatality rate for S. aureus bacteraemia was 8.8% over five years, with MRSA being the only significant risk factor for mortality. Conclusion The incidence of S. aureus bacteraemia and MRSA bacteraemia in children has remained stable over the past five years. MRSA is a predominantly nosocomial pathogen in children with S. aureus bacteraemia in Cape Town, South Africa. PMID:24167621

  3. 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

  4. Recurrent bacteraemia by 2 different Bacillus cereus strains related to 2 distinct central venous catheters.

    PubMed

    Koch, Andrea; Arvand, Mardjan

    2005-01-01

    A 14-y-old girl with osteosarcoma developed 3 episodes of catheter-related bacteraemia by Bacillus cereus. After removal of the first and insertion of a second Hickman catheter, further episodes of B. cereus bacteraemia occurred. PFGE analysis revealed that bacteraemic episodes related to each catheter were caused by a distinct B. cereus strain.

  5. Non-toxigenic Vibrio cholerae bacteraemia: case report and review of the literature.

    PubMed

    Marek, Aleksandra; Inkster, Teresa; Anderson, Eleanor; Jenkins, Claire; Boyd, John; Kerr, Stuart; Cowden, John

    2013-09-01

    Vibrio cholerae is a serious public health problem worldwide, but in the UK, V. cholerae infections are rare. Here, we report a case of V. cholerae bacteraemia in an elderly patient. To our knowledge, this is the first non-travel-related V cholerae bacteraemia in the UK.

  6. An investigation of the frequency of bacteraemia following dental extraction, tooth brushing and chewing.

    PubMed

    Maharaj, Breminand; Coovadia, Yacoob; Vayej, Ahmed C

    2012-07-01

    We conducted a study to determine the frequency of bacteraemias following dental extraction and common oral procedures, namely tooth brushing and chewing, and the relationship between bacteraemia and oral health in black patients. Positive blood cultures were detected in 29.6% of patients after dental extraction, in 10.8% of patients after tooth brushing and in no patients after chewing. No relationship between the state of oral health, which was assessed using the plaque and gingival indices, and the incidence of bacteraemia was found. The duration of bacteraemia was less than 15 minutes. One patient had a positive blood culture prior to dental extraction; his oral health status was poor. Our study confirmed that bacteraemia occurs after tooth brushing.

  7. Hygroscopic Expansion of Aesthetic Restorative Materials: One-Year Report

    PubMed Central

    Emamieh, S.; Ghasemi, A.; Torabzadeh, H.

    2011-01-01

    Objective: To measure the long-term linear hygroscopic expansion (LHE) of several materials using bulked and layered techniques. Materials and Methods: Seven materials were used; Fuji Cap II, Fuji II LC, Photac-Fil Aplicap, Vitremer, Dyract, Tetric and Z100. Ten specimens (6×4 mm) were made for each material using layered and bulked techniques (each group comprises five specimens). The specimens were stored in distilled water at 37°C. The length of each specimen was measured immediately after preparation, 24 hours, one week, one month, three months, six months, nine months and one year. This was used to calculate the percentage change in the length of materials. The mean LHE and standard deviation were calculated. Repeated measure analysis and paired sample t-test were used. Results: The type of material and time had a significant effect on LHE. Fuji Cap II and Fuji II LC exhibited no significant changes after one-year and one month, respectively. However, layered specimens of Photac-Fil Aplicap and Tetric showed constant expansion until six month, whereas bulked specimens reached the constant length at three months. Constant expansion was obtained for layered and bulked specimens of Dyract and Z100 at six month. Layered specimens of Vitremer showed no significant differences except between 24 hours and one year measurements. But in bulked specimens, the results at nine months and one year were significantly different from those obtained at three months and before. Conclusion: Fuji II showed no significant LHE and resin-modified glass ionomer cements (RMGICs) exhibited the highest LHE. Dyract maintained an intermediate LHE in comparison with RMGIC and composite resin. PMID:21998804

  8. Completion of One Year Bioventing Test, Sites 3 and 18

    DTIC Science & Technology

    2007-11-02

    The Air Force Center for Environmental Excellence (AFCEE) one-year bioventing test and evaluation project at Sites 3 and 18 have been completed...and benzene, toluene, ethylbenzene, and xylenes (BTEX). Based on results from your sites and 109 other sites currently under operation, bioventing is...the criteria in the AFCEE Test Plan and Technical Protocol for a Field Treatability Test for Bioventing , May 1992, including Addendum One, February 1994.

  9. Completion of One Year Bioventing Test, Building 7705

    DTIC Science & Technology

    2007-11-02

    The Air Force Center for Environmental Excellence (AFCEE) one-year bioventing test and evaluation project at Building 7705 has been completed. Figure...reduction of contaminant levels as the bioventing continued. Table 2 provides a summary of initial and final soil and soil gas analytical results for...sites currently under operation, bioventing is cost-effectively remediating fuel contamination in a reasonable time frame. We recommend its

  10. 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

  11. Polyclonal outbreak of Burkholderia cepacia complex bacteraemia in haemodialysis patients.

    PubMed

    Magalhães, M; Doherty, C; Govan, J R W; Vandamme, P

    2003-06-01

    We report a polyclonal outbreak of bacteraemia involving 24 patients at a haemodialysis facility in Recife (Brazil). During the outbreak period (4 June to 11 July, 2001), three Burkholderia cepacia complex strains were isolated from human blood and from various water samples collected at different sites in the haemodialysis unit and from dialysate fluids. Out of 14 patients with positive blood cultures, six were infected by Burkholderia cepacia complex bacteria: three with Burkholderia cepacia genomovar III, two with a first strain of Burkholderia vietnamiensis, and one with the Burkholderia cepacia genomovar III strain and a second B. vietnamiensis strain.

  12. 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.

  13. 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.

  14. Fourth United States Microgravity Payload: One Year Report

    NASA Technical Reports Server (NTRS)

    Ethridge, Edwin C. (Compiler); Curreri, Peter 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. One year of Kamchatka volcanoes live observation with VIIRS Nightfire

    NASA Astrophysics Data System (ADS)

    Trifonov, Grigory; Zhizhin, Mikhail; Melnikov, Dmitry; Poyda, Alexey

    2017-04-01

    The work presents new pipeline architecture and one year worth of usage experience of volcanic activity monitoring with VIIRS Nightfire. Multispectral nighttime volcanic activity monitoring system was deployed in Kamchatka in early spring of 2016 and the accumulated time series of detections open up the discussion on sensitivity and fault tolerance of the software. Several significant events of volcanic nature have occurred in the region. Their parameters are summarized and their monitoring results are related to the ground observations. The work discusses perspectives of addition of the new JPSS-1 satellite and nighttime M11 SWIR spectral band.

  16. Field Test: Results from the One Year Mission

    NASA Technical Reports Server (NTRS)

    Reschke, M. F.; Kozlovskaya, I. B.; Kofman, I. S.; Tomilovskaya, E. S.; Cerisano, J. M.; Rosenberg, M. J. F.; Bloomberg, J. J.; Stenger, M. B.; Lee, S. M. C.; Laurie, S. S.; Rukavishnikov, I. V.; Fomina, E. V.; Wood, S. J.; Mulavara, A. P.; Feiveson, A. H.; Fisher, E. A.; Phillips, T.; Ribeiro, C.; Taylor, L. C.; Miller, C. A.; Gadd, N. E.; Peters, B. T.; Kitov, V. V.; Lysova, N. Yu; Holden, K. L.; De Dios, Y.

    2017-01-01

    The One Year Mission was designed to aid in determining the effect that extending the duration on orbit aboard the International Space Station (ISS) would have on a number of biological and physiological systems. Two crewmembers were selected to participate in this endeavor, one U.S. On-Orbit Segment (USOS) astronaut and one Russian cosmonaut. The Neuroscience and Cardiovascular and Vision Laboratories at the Johnson Space Center and the Sensory-Motor and Countermeasures Division within the Institute for Biomedical Problems were selected to investigate vestibular, sensorimotor and cardiovascular function with the two long-duration crewmembers using the established methodology developed for the Field Test (FT).

  17. 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.

  18. One Year's Experience with the CORVUS™ Omninet Local Area Network

    PubMed Central

    Johannes, R. S.

    1984-01-01

    Local Area Network [LAN] technology as an approach to office automation is well recognized. In May 1983, we installed the first components of Corvus Systems Omninet™ in the Gastroenterology division at the Johns Hopkins Hospital. The intent of the project was to determine whether a micro-computer based LAN could provide both the office support functions and the biomedical research support functions needed by our division at a cost affordable to an eight member division. Now, after one year of experience with Omninet, we are reporting the systems hardware, software, the costs, benefits and drawbacks.

  19. Global Positions and Velocities from One Year of GPS Data

    NASA Technical Reports Server (NTRS)

    Heflin, M. B.; Blewitt, G.; Jefferson, D.; Vigue, Y.; Webb, F.; Zumberge, J.; Argus, D.; Gipson, J.; Ma, C.; Clark, T.

    1993-01-01

    A generalized no-fiducial approach has been developed to obtain global positions and velocities without fixing any individual position or velocity components. The method used can be applied to any global geodetic technique and proceeds in three general steps. First, daily solutions derived with weak constraints are combined to yield one global set of positions and velocities. Second, 14 minimal constraints are applied to remove uncertainties due to the loosely defined reference frame. Third, transformation from one reference frame to another is accomplished with a 14 parameter transformation. One year of daily FLINN solutions, each made with data from about 40 sites, have been combined to yield our best fit global model...

  20. 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.

  1. 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.

  2. [Traumatic response experiences: one year after Typhoon Morakot].

    PubMed

    Chen, Chih-Hui; Chi, Mei-Ting; Huang, Hui-Man; Sun, Fan-Ko

    2012-06-01

    Disaster-related mental health problems have been a focus of recent international scholarly interest. Typhoon Morakot caused exceptional destruction in Southern Taiwan, and victims suffered physically, psychologically and financially in its aftermath. This study investigates the post-traumatic response and coping behaviors of victims one year after Typhoon Morakot. Researchers used a phenomenological method with purposive sampling and interviewed 10 Typhoon Morakot victims. Data were collected using deep, semi-structured interviews. All interview sessions were tape-recorded. Researchers used Colaizzi's seven-step phenomenological method to analyze data. Three common themes emerged in subjects following their disaster experiences. The first was residual traumatic response, including fear of continued flooding, fear of future flood recurrence, indifference in responses, and living on alert; The second was insecurity in daily life due to changed surroundings, including anxiety and a heavy sense of loss; The third was conformity in coping behaviors, including shifting attention away from the disaster, turning to a pluralistic support system, having an optimistic outlook on life, and living in the moment. Investigating traumatic response experiences and coping behaviors one year after the Typhoon Morakot disaster can help guide healthcare professionals to promote evidence-based health and nursing services. Findings also provide information to healthcare providers essential to improving nursing quality for victims of disasters.

  3. The changing aetiology of paediatric bacteraemia in England and Wales, 1998-2007.

    PubMed

    Henderson, Katherine L; Johnson, Alan P; Muller-Pebody, Berit; Charlett, André; Gilbert, Ruth; Sharland, Mike

    2010-02-01

    Bacteraemia in children is a potentially life-threatening condition. The objective of this study was to determine trends in the aetiology of bacteraemia in children aged 1 month-15 years in England and Wales by collecting data voluntarily reported by National Health Service hospital microbiology laboratories. Over the 10-year period 1998-2007, a total of 51 788 bacteraemia cases involving 105 genera/species of bacteria were reported. Total annual reports of bacteraemia increased from 4125 to 6916, with a mean increase of 6.5 % per year (95 % CI: 1.3-12.1 %). In 2007, just over half the cases were accounted for by four groups of organisms: coagulase-negative staphylococci (28 %), Staphylococcus aureus (10 %), non-pyogenic streptococci (9 %) and Streptococcus pneumoniae (7 %). These organisms along with a further 13 species/genera accounted for 90 % of the cases. The commonest Gram-negative organisms were Neisseria meningitidis and Escherichia coli, which each accounted for 5 % of total bacteraemia reports in 2007. There was a significant decrease in reports of bacteraemia due to the three vaccine-preventable pathogens Haemophilus influenzae, N. meningitidis and Strep. pneumoniae, following the introduction of each vaccine programme or catch-up campaign. This study identified the commonest causes of bacteraemia in children in England and Wales, and highlighted the shifts in trends observed over time.

  4. Clinical and microbiological features of bacteraemia with Aerococcus urinae.

    PubMed

    Senneby, E; Petersson, A C; Rasmussen, M

    2012-06-01

    Aerococcus urinae is a Gram-positive bacterium that can cause invasive infection, including infectious endocarditis (IE), mainly in older men. A. urinae is often misclassified in routine diagnostic laboratories. Through searches in the laboratory databases we identify 16 isolates of A. urinae causing bacteraemia during a 6-year period in southern Sweden, indicating that bacteraemia with A. urinae occurs in at least three cases per million inhabitants per year. The identity of isolates was confirmed by sequencing of the 16S rRNA genes and antibiotic susceptibility testing identified two ciprofloxacin-resistant isolates. A. urinae was the only significant pathogen isolated in all cases. Fifteen of the 16 patients were male, 15/16 were more than 70 years old, and 12/16 had underlying urological conditions. Though a urinary tract focus was suspected in the majority of cases, the bacterium was rarely found in urinary samples. Nine patients fulfilled the criteria for severe sepsis and an additional four fulfilled the criteria for sepsis. Only one fatality was recorded. Patients were treated mainly with beta-lactam antibiotics but fluoroquinolones and clindamycin were also used. Three cases of IE were diagnosed and these were complicated by spondylodiscitis in one case and by septic embolization to the brain in one case. An increased awareness of A. urinae is crucial to establishing its role as an important pathogen in older men with urinary tract disease.

  5. Outbreak of Pseudomonas aeruginosa bacteraemia in a haematology department.

    PubMed

    Rasmussen, Benjamin Schnack; Christensen, Nikolas; Sørensen, Jan; Rosenvinge, Flemming S; Kolmos, Hans Jørn; Skov, Marianne N

    2015-04-01

    Infection by Pseudomonas aeruginosa represents a major cause of morbidity and mortality among immunocompromised patients. In Denmark, an increase in P. aeruginosa isolates from blood cultures from a haematology department prompted a hygienic audit in 2007. Blood cultures that tested positive for P. aeruginosa were collected from the laboratory information system (MADS, Skejby Hospital, Aarhus, Denmark). Environmental samples were obtained from shower heads in the department. The genotype was established by pulse field gel electrophoresis (PFGE). An audit was conducted during the outbreak and 12 months later. The audits were conducted by the method of direct observation. Several PFGE types were involved with no clear association to isolates from environmental samples. The audit revealed poor hygiene related to the handling of central venous catheters. After optimising catheter hygiene, the number of P. aeruginosa bacteraemia cases fell significantly. Since no clear association between patient and environmental genotype was established, it was suspected that central venous catheters were the main portal of entry. This was further supported by a simultaneous decline in bacteraemia cases with coagulase-negative staphylococci. Though several hygienic precautions were taken, the increased focus on disinfection of hubs and injection ports was presumably the more important element. not relevant. not relevant.

  6. Secondary bacteraemia in adult patients with prolonged dengue fever.

    PubMed

    Premaratna, R; Dissanayake, D; Silva, F H D S; Dassanayake, M; de Silva, H J

    2015-03-01

    Although dengue management guidelines do not advice on use of antibiotics in dengue shock syndrome, unrecognised bactraemia is likely to contribute to morbidity and mortality. To assess the occurance of secondary bacteraemia in adult patients with prolonged dengue fever. A prospective study was conducted recruiting patients with confirmed acute dengue infection who had prolonged fever (>5 days). Two sets of blood cultures were taken in such patients prior to institution of antibiotic therapy. Demographic, clinical, haematological and biochemical parameters were recorded. Development of ascites and pleural effusions were detected using ultrasonography. Fourty patients (52.5% males) with a mean age of 29.8 years (SD 13.6) were studied. The average duration of fever was 7.9 days (SD 1.8). Ten patients (25%) had bacterial isolates in their blood cultures; Staphylococcus aureus (n=2), coliforms (n=3), pseudomonas (n=1) and 4 had mixed growths. The culture positive group had severe body aches at admission and higher fever, third space fluid accumulation, a significant drop in platelets and a higher CRP. A quarter of dengue patients with prolonged fever had a bacterial isolate. Culture positive patients appeared more ill with body aches and had higher degrees of fever during the latter part of the illness. Increased vascular permeability may predispose to bacterial seepage into blood. Although white cell count is not helpful in detecting bacteraemia, low platelet count and elevation of CRP seem to be helpful.

  7. Bacteraemia in ventricular assist devices: a common complication that need not affect clinical outcomes.

    PubMed

    Rosenfeldt, Franklin L; Kwa, Lachlan J; Porapakkham, Pramote; Rajadurai, Suraindra; Jones, Kylie; van de Merwe, Juliana; Billah, Baki; Porapakkham, Pornwalee; Esmore, Donald S; Halvorsen, Dag S; Aguirre, Victor J; Spelman, Denis W

    2014-03-01

    Ventricular assist device (VAD) implantation has become an effective option for patients with severe heart failure. However, device-related infections remain a significant problem. The aim of this study was to describe the incidence and microbiological aetiology of bacteraemia in patients with VADs, and to assess the impact of bacteraemia on clinical outcomes. A retrospective study was conducted of patients having VAD implantation at the Alfred Hospital (Melbourne, Australia) from October 1990 to July 2009. Medical records and microbiology databases were reviewed. Patients who were supported with a VAD for 72h or more were evaluated for demographic data, VAD type, the occurrence of bacteraemia and clinical outcomes. During the 19-year period, 135 VAD patients (89 Thoratec PVAD, 10 Novacor, and 36 Ventrassist) supported for a total duration of 17,304 (median 74) support days were included. Sixty-one patients (45%) developed VAD-associated bacteraemia, an incidence of 5.6 episodes per 1000 support days. The incidence of bacteraemia per 1000 days of support was similar for the three devices used: Thoratec PVAD, Novacor and Ventrassist VADs (7.8±0.8, 5.2±1.5 and 3.4±0.5, respectively, p=0.74). Staphylococcus aureus was the most common pathogen (25%). The rates of death on device, survival to transplant, recovery with explant and outcomes after transplantation, including 30-day mortality, median survival time and incidence of cerebrovascular accidents were not significantly impacted upon by bacteraemia. Bacteraemia is common in VAD patients. However, the incidence of VAD-associated bacteraemia is independent of device type and with aggressive antimicrobial therapy; clinical outcomes need not be affected by the bacteraemia. Copyright © 2013 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  8. Real-time PCR of the 16S-rRNA gene in the diagnosis of neonatal bacteraemia.

    PubMed

    Ohlin, Andreas; Bäckman, Anders; Björkqvist, Maria; Mölling, Paula; Jurstrand, Margaretha; Schollin, Jens

    2008-10-01

    To evaluate a real-time PCR assay for the diagnosis of neonatal bacteraemia. Two hundred ninety-five plasma samples from 288 newborns with suspected neonatal sepsis were collected prospectively for the purpose of polymerase chain reaction (PCR)-based bacterial detection. A real-time PCR targeting the bacterial gene for 16S-rRNA gene combined with four specific probes designed to detect Gram-negative bacteria, Staphylococcus aureus and coagulase-negative staphylococci (CoNS) was developed. All samples positive in the universal PCR were further sequenced for bacterial identification. When applied to a material from 50 patients with positive blood culture and 245 patients with negative blood culture, the universal PCR showed a sensitivity of 42% (28-57), a specificity of 95% (92-97), a positive predictive value of 64% (45-80), and a negative predictive value of 89% (84-92) (95% confidence intervals in brackets). A new real-time PCR technique was for the first time applied to a well-defined prospectively and consecutively enrolled material of newborns with suspected sepsis, combining the benefits of real-time PCR with specific probes and sequencing. The method managed to detect bacteraemia with high specificity even though the sensitivity was low. Factors causing the low sensitivity are identified and further strategies to develop the method are described.

  9. 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

  10. Clinically Significant Weight Gain One Year After Occupational Back Injury

    PubMed Central

    Keeney, Benjamin J.; Fulton-Kehoe, Deborah; Wickizer, Thomas M.; Turner, Judith A.; Chan, Kwun Chuen Gary; Franklin, Gary M.

    2014-01-01

    Objective To examine the incidence of clinically significant weight gain one year after occupational back injury, and risk factors for that gain. Methods A cohort of Washington State workers with wage-replacement benefits for back injuries completed baseline and 1-year follow-up telephone interviews. We obtained additional measures from claims and medical records. Results Among 1,263 workers, 174 (13.8%) reported clinically significant weight gain (≥7%) 1 year after occupational back injury. Women and workers who had >180 days on wage replacement at 1 year were twice as likely (adjusted OR=2.17, 95% CI=1.54–3.07; adjusted OR=2.40, 95% CI=1.63–3.53, respectively; both P<0.001) to have clinically significant weight gain. Conclusions Women and workers on wage replacement >180 days may be susceptible to clinically significant weight gain following occupational back injury. PMID:23247606

  11. Deaths from trauma in Auckland: a one year study.

    PubMed

    Smeeton, W M; Judson, J A; Synek, B J; Sage, M D; Koelmeyer, T D; Cairns, F J

    1987-06-10

    We report a one year prospective study of all deaths from trauma in the Auckland region. Data was collected on the circumstances of death from coroner's, police and hospital records. All cases had autopsies and the injuries were scored using the abbreviated injury scale (AIS) system. The group of 236 had a median age of 27 years and 73% were under the age of 45. Seventy-two percent were male. Blunt trauma, predominantly the result of road crashes, accounted for 89% of the fatalities. Most deaths occurred at the site of injury and only 37% survived to reach hospital. Cases were audited if death occurred without a critical or unsurvivable injury. Thirteen cases were considered to be potentially salvageable if medical treatment had been optimal. The implications for the organisation of prehospital and inhospital trauma care are discussed.

  12. A one year experience with the multislice helical CT.

    PubMed

    Rigauts, H

    1999-12-01

    New detector morphology and increased computer power have led to a second leap in CT technology. With multislice helical CT, four slices per rotation are reconstructed resulting in a 3 to 6 times reduction of the examination time. During our one-year experience with the multislice CT, we have learnt that the major advantage of the technique is the possibility to cover a large volume with thin slices. Combination of both makes it possible to scan an entire anatomic region during the optimal enhancement phase (after i.v. contrast injection) with a high spatial resolution. New diagnostic possibilities can be explored by CT together with improved and more detailed post-processing tools.

  13. Contra Costa County's one-year experience with gasohol

    SciTech Connect

    Gibbs, L.M.; Gilbert, B.J.

    1981-01-01

    Starting August 1, 1979, a one-year gasohol test was conducted by Contra Costa County. A total of 30 county pool cars were on test - 15 on gasohol and 15 similar cars on gasoline as a control group. Findings were as follows. There were no fuel-related maintenance problems in either the gasohol or gasoline groups of cars. Cool weather driveability for the gasohol cars was the same or better than gasoline cars. No vapor lock or other hot driveability problems were reported for either fuel. Fuel economy of the gasohol cars was about 5% poorer than that of the gasoline cars. Fuel system deposits with gasohol were increased and differed in character compared to gasoline. Also, the gasohol carburetors showed more inlet needle valve tip wear. However, to date, the observed deposits and wear with gasohol have not caused any apparent problems.

  14. [Acute osteomyelitis and septic arthritis in children: one year experience].

    PubMed

    Timsit, S; Pannier, S; Glorion, C; Chéron, G

    2005-01-01

    To describe bacteriologic epidemiology of bone and joint infections, a total of 52 osteomyelitis, 52 arthritis and 20 osteoarthritis of children aged one month to 15 years during a one-year period (2001) were included in a retrospective unicentric review. The mean age was 3,9 +/-3,6 years. Fever and pain were the most common clinical symptoms. The site of infection was single in 95%, involving lower extremities in 80%. Bone scintigraphy was abnormal in 71% of osteomyelitis. Positive cultures was obtained in 29% of all cases (blood cultures: 20%, aspiration cultures: 29%), but in 42% of cases which have both blood and aspiration cultures. Thirty-six bacteria were identified: 19 Staphylococcus (14 aureus), ten Streptococcus (four pneumoniae), three Salmonella, three Kingella kingae, one Moraxella. All the isolates were susceptible to the empiric antibiotic therapy. Outcome was good in 100% of osteomyelitis and in 96% of arthritis.

  15. Unemployment and psychological distress one year after childbirth in France.

    PubMed

    Saurel-Cubizolles, M J; Romito, P; Ancel, P Y; Lelong, N

    2000-03-01

    To analyse the relation between unemployment and the psychological distress of mothers one year after childbirth. Multicentric survey concerning births occurring between September 1993 and July 1994. In France: two maternity units in the Parisian area and one in Champagne-Ardennes, in the east of France, comprising both urban and rural areas. Primipara and secondipara women were interviewed three times: at birth by a face to face interview, five months and 12 months after the birth, by postal questionnaires, with a 83% response rate for the two postal questionnaires. The analysis includes 632 women who answered all three stages of the survey. Psychological distress was mainly assessed one year after birth by the 12-item General Health Questionnaire. After adjustment for unwanted pregnancy, marital conflicts, marital status, hospitalisation of the baby during the last year, lack of confiding relationship, depressive or anxious troubles before pregnancy, age, educational level and parity, unemployed women had an excess of psychological distress compared with employed women (OR = 1.87; 95% CI = 1.12, 3.13). The ratios for housewives were very close to those of employed women. Among the unemployed women, 60% had recently been without a job, since a few months before or after the birth. An excess of psychological distress among unemployed compared with employed women was observed in all social groups defined by the current or last occupation, but with various extents. Psychological distress was specially linked to the employment status in the group of women with the more qualified occupations. Even after a birth, when women are very much involved in their maternal role, those seeking a job have worse mental health than those in a stable situation, either employed or housewives. In France, the unemployment rate among young women is high. It is specially important that social regulations protecting employment during and after pregnancy are adequately applied. Employers

  16. Pseudomonas aeruginosa bacteraemia in an adult with cystic fibrosis and acute appendicitis.

    PubMed

    Gilchrist, Francis J; Doherty, Catherine J; Govan, John R; Webb, A Kevin; Jones, Andrew M

    2011-12-01

    Despite their high bacterial load, bacteraemia is rare in patients with cystic fibrosis (CF). We report an adult with CF who developed Pseudomonas aeruginosa bacteraemia during an episode of acute appendicitis. The Pseudomonas aeruginosa isolated from the blood culture was confirmed by molecular typing to be the same transmissible strain responsible for the patient's chronic pulmonary infection. We hypothesise that this patient's bacteraemia was caused by Pseudomonas aerunginosa in swallowed sputum, crossing the inflamed appendiceal wall and entering the blood stream. Copyright © 2011 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  17. Fatigue in intensive care survivors one year after discharge.

    PubMed

    Spadaro, Savino; Capuzzo, Maurizia; Valpiani, Giorgia; Bertacchini, Sara; Ragazzi, Riccardo; Dalla Corte, Francesca; Terranova, Simona; Marangoni, Elisabetta; Volta, Carlo Alberto

    2016-10-18

    Fatigue has not been investigated in long-term Intensive Care Unit (ICU) survivors. This study aimed to assess fatigue through a specific instrument, namely the Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F) scale, in ICU survivors one year after hospital discharge. A secondary aim was to compare the findings of FACIT-F with those of the Vitality domain (VT) of the 36-item Short-Form Health Survey (SF-36). This prospective cohort study was performed on 56 adult patients with a Length Of Stay (LOS) in ICU longer than 72 h. At one year after hospital discharge, FACIT-F and SF-36 questionnaires were administered to consenting patients by direct interview. FACIT-F was measured as raw (range 0-52), and FACIT-F-trans value (range 0-100). Past medical history, and demographic and clinical ICU-related variables were collected. The patients' median age was 67.5, Simplified Acute Physiology Score II 31, and LOS in ICU 5 days. The median raw FACIT-F of the patients was 41, and Cronbach's α was 0.937. The correlation coefficient between FACIT-F-trans and VT of SF-36 was 0.660 (p < 0.001). Both FACIT-F and VT were related to dyspnoea scale (p = 0.01). A Bland-Altman plot of VT vs FACIT-F-trans showed a bias of -0.8 with 95 % limits of agreement from 35.7 to -34.1. The linear regression between differences and means was 0.639, suggesting a significant proportional bias. The 13-item FACIT-F questionnaire is valid to assess fatigue of long-term ICU survivors. VT of SF-36 relates to FACIT-F, but consists of only four items assessing two positive and two negative aspects. FACIT-F grasps the negative aspects of fatigue better than VT. Specific tools assess specific conditions better that general tools. ClinicalTrials.gov: NCT02684877 .

  18. Unemployment and psychological distress one year after childbirth in France

    PubMed Central

    Saurel-Cubizolles, M.; Romito, P.; Ancel, P.; Lelong, N.

    2000-01-01

    STUDY OBJECTIVE—To analyse the relation between unemployment and the psychological distress of mothers one year after childbirth.
DESIGN—Multicentric survey concerning births occurring between September 1993 and July 1994.
SETTING—In France: two maternity units in the Parisian area and one in Champagne-Ardennes, in the east of France, comprising both urban and rural areas.
PARTICIPANTS—Primipara and secondipara women were interviewed three times: at birth by a face to face interview, five months and 12 months after the birth, by postal questionnaires, with a 83% response rate for the two postal questionnaires. The analysis includes 632 women who answered all three stages of the survey.
MEASUREMENTS—Psychological distress was mainly assessed one year after birth by the 12-item General Health Questionnaire.
RESULTS—After adjustment for unwanted pregnancy, marital conflicts, marital status, hospitalisation of the baby during the last year, lack of confiding relationship, depressive or anxious troubles before pregnancy, age, educational level and parity, unemployed women had an excess of psychological distress compared with employed women (OR = 1.87; 95%CI = 1.12, 3.13). The ratios for housewives were very close to those of employed women. Among the unemployed women, 60% had recently been without a job, since a few months before or after the birth. An excess of psychological distress among unemployed compared with employed women was observed in all social groups defined by the current or last occupation, but with various extents. Psychological distress was specially linked to the employment status in the group of women with the more qualified occupations.
CONCLUSION—Even after a birth, when women are very much involved in their maternal role, those seeking a job have worse mental health than those in a stable situation, either employed or housewives. In France, the unemployment rate among young women is high. It is specially important

  19. Football injuries in Oslo: a one-year study.

    PubMed Central

    Maehlum, S.; Daljord, O. A.

    1984-01-01

    All football injuries treated at the Emergency Department, Oslo City Hospital, 1329 patients, 1167 males and 162 females, were recorded for one year, accounting for 28.4% of all sports injuries. Most injuries seen were in the 15-19 years age group in females and 20-24 years age group in males; 68% of the females and 42% of the males (p less than 0.001) were below 20 years of age, and 87% of the injuries occurred in competitive football. During matches, 695 players were injured giving an incidence of 34.5 injuries/10,000 player matches. The injuries occurred all year with a peak in June. Sprains accounted for 41% of the injuries, 23% were contusions and 19% fractures. Most injuries (59%) affected the legs. Hospital admission was required for three females and 57 males. The football injuries required 1966 consultations and necessitated that 349 patients had to stay away from work for a total of 6137 days. PMID:6487944

  20. [Gestrinone in pelvic endometriosis. A one-year evaluation].

    PubMed

    Cervantes Villarreal, E; García Zamarripa, H R; Herrera Prado, E; Barrón Vallejo, J

    1995-08-01

    The therapeutical effectiveness of gestrinone in endometriosis treatment, as well as its long term side effects, were evaluated. Prospective, clinical trial. At "Dr. Alejandro Castanedo Kimball" Hospital (PEMEX). Salamanca, Guanajuato. México. Thirty women with laparoscopically confirmed endometriosis, were studied. Subjects received 2.5 mg. of gestrinone two times per week for 6 months. Laparoscopy was performed before treatment, and clinical response was determined by second laparoscopy after 6 months. The pregnancy rate, frequency of side effects and recurrence of symptoms were determined. Median total endometriosis scores and symptoms decreased significantly after treatment. Four pregnancies were observed after treatment. The principal side effects were: ponderal increase, changes in the voice and hirsutism. However, the side effects disappeared after one year of clinical survey. The results indicate that gestrinone is effective in the treatment of pelvic endometriosis. In despite of a clear benefic effect on stage of the disease and symptoms; the use of gestrinone should weigh the risk-benefit (cost versus metabolic side effects) of treatment.

  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.

  2. [Bacteraemia due to Escherichia coli producing extended-spectrum beta-lactamases (ESBL): clinical relevance and today's insights].

    PubMed

    García-Hernández, Ana Maria; García-Vázquez, Elisa; Hernández-Torres, Alicia; Ruiz, Joaquín; Yagüe, Genoveva; Herrero, José Antonio; Gómez, Joaquín

    2011-06-01

    Antibiotic resistance is an old problem with new face as the rate of infections due to multidrug resistant bacteria is higher everyday and the number of new antibiotics to overwhelm the problem is becoming smaller. E. coli is the most frequent agent causing nosocomial or community-acquired bacteraemia being in our country 10% of them extended-spectrum beta-lactamases (ESBL) producing E. coli isolates. Nowadays the number of community- acquired or health-related infections caused by these ESBL producing E. coli is increasing. CTX-M has also become the most frequent ESBL compared to other enzymes. The role of these enzymes as a virulence factor increasing mortality in patients with bacteraemia due to E. coli is not well defined. The relevance of ESBL-E. coli seems to be related with the higher frequency of inadequate treatment and therefore the importance of identifying factors or features that might predict that the patient's infection is due to one of these isolates. In terms of prevention and control of infection measures, the role of patient's isolation is not clear but a proper prescription of antibiotics and antibiotic control policies are probably important to reduce the problem.

  3. Hepatic abscess-associated Clostridial bacteraemia presenting with intravascular haemolysis and severe hypertension

    PubMed Central

    Lim, Andrew George; Rudd, Kristina Elizabeth; Halliday, Melissa; Hess, John Rider

    2016-01-01

    Summary Clostridium perfringens bacteraemia is a potentially fatal condition, and its early identification is paramount to maximise chances of survival. Prompt recognition of intravascular haemolysis, a known complication of C. perfringens bacteraemia, can help guide clinical decision-making before microbiology data becomes available. We present a novel finding of severe hypertension in a fatal case of Clostridial bacteraemia with massive haemolysis. A 58-year-old man with no known medical history presented to the emergency department with malaise, fever and hypertension. He developed abdominal pain and a hepatic abscess was identified on CT imaging. Within 4 h of presentation, he developed massive intravascular haemolysis, extreme hypertension, pulmonary oedema and respiratory failure. He died less than 8 h after presentation. His blood cultures subsequently grew C. perfringens. This case underscores the importance of early recognition of intravascular haemolysis complicating C. perfringens bacteraemia, and discusses the rare complication of hypertensive emergency in this setting. PMID:26823354

  4. Hepatic abscess-associated Clostridial bacteraemia presenting with intravascular haemolysis and severe hypertension.

    PubMed

    Lim, Andrew George; Rudd, Kristina Elizabeth; Halliday, Melissa; Hess, John Rider

    2016-01-28

    Clostridium perfringens bacteraemia is a potentially fatal condition, and its early identification is paramount to maximise chances of survival. Prompt recognition of intravascular haemolysis, a known complication of C. perfringens bacteraemia, can help guide clinical decision-making before microbiology data becomes available. We present a novel finding of severe hypertension in a fatal case of Clostridial bacteraemia with massive haemolysis. A 58-year-old man with no known medical history presented to the emergency department with malaise, fever and hypertension. He developed abdominal pain and a hepatic abscess was identified on CT imaging. Within 4 h of presentation, he developed massive intravascular haemolysis, extreme hypertension, pulmonary oedema and respiratory failure. He died less than 8 h after presentation. His blood cultures subsequently grew C. perfringens. This case underscores the importance of early recognition of intravascular haemolysis complicating C. perfringens bacteraemia, and discusses the rare complication of hypertensive emergency in this setting. 2016 BMJ Publishing Group Ltd.

  5. Epidemiological investigation of Pseudomonas aeruginosa nosocomial bacteraemia isolates by PCR-based DNA fingerprinting analysis.

    PubMed

    Liu, Y; Davin-Regli, A; Bosi, C; Charrel, R N; Bollet, C

    1996-11-01

    Between July 1994 and March 1995, 64 isolates of Pseudomonas aeruginosa were implicated in bacteraemia in 25 cancer patients in five wards of two hospitals. These, together with 24 environmental isolates and one isolate from a bacteraemia in a non-cancer patient were examined by three PCR-based DNA fingerprinting methods: random amplified polymorphic DNA (RAPD), enterobacterial-repetitive intergenic consensus (ERIC)-PCR, and 16S-23S spacer region-based RAPD. These methods were reproducible, discriminatory and showed close agreement; all indicated that 47 isolates that had caused bacteraemia in 19 cancer patients were indistinguishable. Seventeen other isolates that had caused bacteraemia in 10 cancer patients were discriminated into eight further groups, and the 24 environmental and non-cancer patient isolates into further distinct groups. No environmental source of the epidemic strain was found, but it was suspected that the outbreak was related to infusion implants.

  6. 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

  7. The 2015 Nepal earthquake disaster: lessons learned one year on.

    PubMed

    Hall, M L; Lee, A C K; Cartwright, C; Marahatta, S; Karki, J; Simkhada, P

    2017-04-01

    The 2015 earthquake in Nepal killed over 8000 people, injured more than 21,000 and displaced a further 2 million. One year later, a national workshop was organized with various Nepali stakeholders involved in the response to the earthquake. The workshop provided participants an opportunity to reflect on their experiences and sought to learn lessons from the disaster. One hundred and thirty-five participants took part and most had been directly involved in the earthquake response. They included representatives from the Ministry of Health, local and national government, the armed forces, non-governmental organizations, health practitioners, academics, and community representatives. Participants were divided into seven focus groups based around the following topics: water, sanitation and hygiene, hospital services, health and nutrition, education, shelter, policy and community. Facilitated group discussions were conducted in Nepalese and the key emerging themes are presented. Participants described a range of issues encountered, some specific to their area of expertize but also more general issues. These included logistics and supply chain challenges, leadership and coordination difficulties, impacts of the media as well as cultural beliefs on population behaviour post-disaster. Lessons identified included the need for community involvement at all stages of disaster response and preparedness, as well as the development of local leadership capabilities and community resilience. A 'disconnect' between disaster management policy and responses was observed, which may result in ineffective, poorly planned disaster response. Finding time and opportunity to reflect on and identify lessons from disaster response can be difficult but are fundamental to improving future disaster preparedness. The Nepal Earthquake National Workshop offered participants the space to do this. It garnered an overwhelming sense of wanting to do things better, of the need for a Nepal-centric approach

  8. PROSPERO at one year: an evaluation of its utility

    PubMed Central

    2013-01-01

    Background PROSPERO, an international prospective register of systematic review protocols in health and social care, was launched in February 2011. After one year of operation we describe access and use, explore user experience and identify areas for future improvement. Methods We collated administrative data and web statistics and conducted an online survey of users’ experiences. Results On 21 February 2012, there were 1,076 registered users and 359 registration records published on PROSPERO. The database usage statistics demonstrate the international interest in PROSPERO with high access around the clock and around the world. Based on 232 responses from PROSPERO users (response rate 22%), almost all respondents found joining and navigation was easy or very easy (99%); turn round time was good or excellent (96%); and supporting materials provided were helpful or very helpful (80%). The registration fields were found by 80% to be relevant to their review; 99% rated their overall experience of registering with PROSPERO as good or excellent. Most respondents (81%) had a written protocol before completing the registration form and 19% did not. The majority, 136 (79%), indicated they completed the registration form in 60 minutes or less. Of those who expressed an opinion, 167 (87%) considered the time taken to be about right. Conclusions The first year of PROSPERO has shown that registration of systematic review protocols is feasible and not overly burdensome for those registering their reviews. The evaluation has demonstrated that, on the whole, survey respondents are satisfied and the system allows registration of protocol details in a straightforward and acceptable way. The findings have prompted some changes to improve user experience and identified some issues for future consideration. PMID:23320413

  9. 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.

  10. Risk factors for methicillin-resistant Staphylococcus aureus bacteraemia differ depending on the control group chosen

    PubMed Central

    POGORZELSKA-MAZIARZ, M.; FURUYA, E. Y.; LARSON, E. L.

    2014-01-01

    SUMMARY Methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia cause significant morbidity and mortality in hospitalized patients. Using a nested case-control design, 204 MRSA bacteraemia cases were compared to 301 unmatched methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia controls and were matched 1:2 with non-infected controls. The independent risk factors for MRSA bacteraemia compared to MSSA bacteraemia were older age (P=0·048), major organ transplant during current hospital stay (P=0·016) and quinolone use (P=0·016). Cases were more likely than non-infected controls to have renal failure (P=0·003), cirrhosis (P=0·013), and a central venous catheter (P=0·003) after controlling for other risk factors. This large case-control study made it possible to assess risk factors for MRSA bacteraemia using two sets of controls and showed that risk factors differed greatly depending on the control group chosen. These results confirm the need for careful selection of appropriate control groups and the need to carefully adjust for underlying severity of illness. PMID:23425708

  11. Fever presentation and associated factors in patients with healthcare-associated bacteraemia.

    PubMed

    Lu, Shu-Hua; Yu, Po-Jui; Dai, Yu-Tzu

    2016-02-01

    Bacteraemia is a systemic infection associated with strong febrile immune reactions. Fever definitions, fever intensity and other factors might affect the recognition, management and prognosis of patients with bacteraemia. A prospective observational design was used to study 412 consecutive Taiwanese patients with healthcare-associated bacteraemia. The study variables were fever intensity, factors related to fever intensity, the association of physical function to thermogenic capacity and the sensitivity of three definitions of fever for identifying patients with bacteraemia. Age, Charlson comorbidity index (CCI) score, chills and pathogen types were predictors of fever intensity. Barthel index score, CCI score and pathogen types were predictors of chills, an indicator of thermogenic capacity. The sensitivity of three fever definitions (basal body temperature plus 1°C, ≥ 38°C and ≥ 38.3°C) to identify patients with bacteraemia was 93.3%, 83.5% and 71.4%, respectively. Clinicians can target patients with factors associated with blunted febrile response to bacteraemia for closer monitoring.

  12. Failure within one year following subtotal lumbar discectomy.

    PubMed

    Wera, Glenn D; Marcus, Randall E; Ghanayem, Alexander J; Bohlman, Henry H

    2008-01-01

    Reherniation within the first year following subtotal lumbar discectomy is a rare but noteworthy event. We performed a retrospective, case-controlled study to evaluate the clinical outcomes after early recurrent lumbar disc reherniation. The records of 1320 patients who had undergone primary subtotal lumbar discectomy were analyzed retrospectively by an independent reviewer. Patients with documented reherniation within twelve months were evaluated with regard to the location of the reherniation, the neurologic status, the rate of reoperation, and the subjective outcome. Patients were evaluated on the basis of a physical examination and a review of medical records. Disc morphology, anular competence, and the presence of free fragments were categorized with use of a modified five-part Carragee classification system. The mean duration of follow-up for this group was 52.6 months. Clinical outcomes were assessed with use of the Oswestry score and the modified criteria of McNab. Twenty-nine historical control patients who had undergone uncomplicated subtotal lumbar discectomy were selected. We identified fourteen recurrent lumbar disc herniations within one year after the index procedure. All fourteen patients had radicular pain and weakness prior to, and complete relief of radiculopathy after, the index procedure. All reherniations occurred at the same level as the index procedure, but eight occurred in a different direction than the original herniation. All patients underwent reexploration and discectomy, and two underwent single-level posterolateral arthrodesis. Two patients underwent a third procedure. The average Oswestry score at the time of the latest follow-up was 6.4 for the recurrent herniation group, compared with 6.9 for the controls. The outcomes according to the modified McNab criteria were not significantly different between the groups, with the numbers available. The mean duration of follow-up after the second discectomy was 52.6 months. The rate of early

  13. Fatal poisonings in Oslo: a one-year observational study

    PubMed Central

    2010-01-01

    Background Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated. Methods Fatal and non-fatal acute poisonings in subjects aged ≥16 years in Oslo (428 198 inhabitants) were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic), and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning. Results In Oslo, during the one-year period studied, 103 subjects aged ≥16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years). In 92 cases (89%), death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases), followed by ethanol (9%), tricyclic anti-depressants (TCAs) (4%), benzodiazepines (4%), and zopiclone (4%). Seventy-one (69%) were evaluated as accidental deaths and 32 (31%) as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04). Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91), 14% (95% C.I., 0.04-0.33), and 10% (95% C.I., 0.02-0.27), respectively. Conclusions Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental deaths

  14. The effect of prepartum antibiotics on the type of neonatal bacteraemia: insights from the MRC ORACLE trials.

    PubMed

    Gilbert, R E; Pike, K; Kenyon, S L; Tarnow-Mordi, W; Taylor, D J

    2005-06-01

    We analysed the type of bacteraemia before discharge from Neonatal Intensive Care Units in babies born to women randomised to the MRC ORACLE Trials. There was no evidence for an effect of oral antibiotics given prior to delivery on bacteraemia due to gram negative or enterococci bacteria, but Group B streptococcal (GBS) bacteraemia was significantly reduced in women with preterm prelabour rupture of the membranes (1.58% to 0.55%, relative risk 0.34; 95% CI: 0.17-0.70). There was no detectable effect in women in spontaneous preterm labour with intact membranes as the risk of GBS bacteraemia in their babies was very small regardless of treatment.

  15. The role of adipokines as prognostic factors of one-year mortality in hip fracture patients.

    PubMed

    Gulin, T; Kruljac, I; Kirigin Biloš, L S; Gulin, M; Grgurević, M; Borojević, M

    2017-08-01

    This study investigated the impact of anthropometric parameters, adiponectin, leptin, homeostatic model assessment for insulin resistance (HOMA-IR), beta-isomerised C-terminal telopeptide of collagen type I (β-CTX), and routine biochemical tests on one-year mortality in hip fracture patients. We found that male patients with high adiponectin, leptin, and β-CTX levels had a 5-fold increase in all-cause one-year mortality. Several predictors of one-year hip fracture mortality have been identified including advanced age, male sex, low bone mineral density, and preexisting comorbidities. However, the impact of metabolic parameters on hip fracture mortality remains unknown. The aim of this study was to examine the effect of serum leptin and adiponectin levels, as well as other metabolic parameters on all-cause one-year hip fracture mortality. This prospective study included 236 patients of all ages with non-traumatic hip fractures. Anthropometric parameters, adiponectin, leptin, HOMA-IR, β-CTX, and routine biochemical tests were recorded at admission and correlated with one-year mortality by using multivariate Cox proportional hazard models. The median patient age was 82 (75-87) years, and one-year mortality rate was 28.4%. In univariate analysis, adiponectin, age, β-CTX, and renal function were associated with mortality. However, in a multivariate model, male gender, high β-CTX, adiponectin, and leptin were independently associated with increased mortality. Thus, we constructed a nomogram that included all the latter variables in addition to age. The nomogram predicted mortality with a sensitivity of 74.8% (66.0-82.3) and specificity of 74.4% (57.9-87.0), and had an area under the curve of 0.784. Patients that scored <9.2 had a mortality of 10.1%, while those with >9.2 had a mortality of 49.2% (relative risk 5.4, 95% CI 2.8-10.2, P < 0.001). Male patients with high adiponectin, leptin, and β-CTX levels have a 5-fold increase in all-cause one-year mortality

  16. Prevalence of mutans streptococci in one-year-old children.

    PubMed

    Grindefjord, M; Dahllof, G; Wikner, S; Hojer, B; Modeer, T

    1991-10-01

    Colonization with mutans streptococci was studied in 1095 1-year-old children living in suburban Stockholm. During a scheduled vaccination appointment at a child health centre, a bacterial sample was obtained from the child's tongue and a structured questionnaire was completed by the accompanying parent. Six percent of the subjects were colonized with mutans streptococci. The variables most strongly correlated with presence of mutans streptococci were: non-Swedish background, consumption of sugar-containing beverages at night and total consumption of sugar-containing beverages. The results indicate that, by the age of 1 year, maternally influenced behaviour patterns such as dietary habits that may predispose to early colonization of mutans streptococci are already established. Such early colonization with mutans streptococci may predict high caries risk in the primary dentition.

  17. One Year Survival in Nigerians with Peripartum Cardiomyopathy

    PubMed Central

    Karaye, Kamilu M.; Lindmark, Krister; Henein, Michael Y.

    2016-01-01

    Background: Peripartum cardiomyopathy (PPCM) is common in North-Western Nigeria. This study aimed to describe the 1-year survival and left ventricular reverse remodeling (LVRR) in a group of patients with PPCM from three referral hospitals in Kano, Nigeria. Methods: PPCM was defined according to recommendations of the Heart Failure (HF) Association of the European Society of Cardiology Working Group on PPCM. LVRR was defined as absolute increase in left ventricular ejection fraction (LVEF) by ≥10.0% and decrease in left ventricular (LV) end-diastolic dimension indexed to body surface area ≤33.0 mm/m2, while recovered LV systolic function as LVEF ≥55%, at 12 months follow-up. Results: A total of 54 newly diagnosed PPCM patients with mean age of 26.6 ± 6.7 years, presented with classical features of predominantly left-sided HF and 33 of them qualified for follow-up. Of the 17 survivors at 12 months, 8 patients (47.1%) satisfied the criteria for LVRR, of whom 5 (29.4%) had recovered LV systolic function (LVEF ≥55%), but LVRR was not predicted by any variable in the regression models. The prevalence of normal LV diastolic function increased from 11.1% at baseline to 35.3% at 12 months (P = 0.02). At 1-year follow-up, 41.4% of patients had died (two-thirds of them within the first 6 months), but mortality was not predicted by any variable including LVRR. Conclusions: In Kano, PPCM patients had modest LVRR but high mortality at 1-year. Further studies should be carried out to identify reasons for the high mortality and how to curb it. PMID:27512533

  18. Theories beyond the standard model, one year before the LHC

    NASA Astrophysics Data System (ADS)

    Dimopoulos, Savas

    2006-04-01

    Next year the Large Hadron Collider at CERN will begin what may well be a new golden era of particle physics. I will discuss three theories that will be tested at the LHC. I will begin with the supersymmetric standard model, proposed with Howard Georgi in 1981. This theory made a precise quantitative prediction, the unification of couplings, that has been experimentally confirmed in 1991 by experiments at CERN and SLAC. This established it as the leading theory for physics beyond the standard model. Its main prediction, the existence of supersymmetric particles, will be tested at the large hadron collider. I will next overview theories with large new dimensions, proposed with Nima Arkani-Hamed and Gia Dvali in 1998. This links the weakness of gravity to the presence of sub-millimeter size dimensions, that are presently searched for in experiments looking for deviations from Newton's law at short distances. In this framework quantum gravity, string theory, and black holes may be experimentally investigated at the large hadron collider. I will end with the recent proposal of split supersymmetry with Nima Arkani-Hamed. This theory is motivated by the possible existence of an enormous number of ground states in the fundamental theory, as suggested by the cosmological constant problem and recent developments in string theory and cosmology. It can be tested at the large hadron collider and, if confirmed, it will lend support to the idea that our universe and its laws are not unique and that there is an enormous variety of universes each with its own distinct physical laws.

  19. Serotonin transporter binding as a possible predictor of one-year remission in major depressive disorder.

    PubMed

    Miller, Jeffrey M; Oquendo, Maria A; Ogden, R Todd; Mann, J John; Parsey, Ramin V

    2008-10-01

    Lower serotonin transporter (5-HTT) binding (BP(P)=f(P)B(avail)/K(D)) is reported during a major depressive episode (MDE) compared to healthy controls. Higher 5-HTT binding in the diencephalon has previously been associated with acute response to antidepressant treatment. We assessed baseline 5-HTT binding as a predictor of one-year remission from a MDE, examining binding in brain regions implicated in the pathophysiology of major depressive disorder (MDD). 5-HTT binding was quantified using positron emission tomography (PET) with [(11)C]McN5652 in 19 currently depressed subjects with MDD and 41 healthy controls. Depressed subjects received open, naturalistic antidepressant treatment. Remission status was determined one year after PET scan and treatment initiation. Significant differences in 5-HTT binding among the three groups (healthy controls, remitters, and non-remitters) were observed in a linear mixed-effects model. Post hoc, non-remitters had lower 5-HTT binding than controls in midbrain, amygdala, and anterior cingulate. Remitters did not differ significantly from controls or non-remitters in 5-HTT binding. Remitters did not differ from non-remitters in clinical characteristics apart from greater family history of depression among non-remitters. A logistic regression model fit to determine the capacity of baseline 5-HTT binding to predict remission status at one year yielded a coefficient that was suggestive but not significant (p=0.057). The small sample size and heterogeneous treatments received reduced statistical power to detect differences in binding based on clinical outcome. Lower pretreatment 5-HTT binding may be predictive of non-remission from major depression following one year of naturalistic antidepressant treatment. Future studies using standardized treatment are warranted.

  20. Bacteraemia before, during and after tooth extraction in horses in the absence of antimicrobial administration.

    PubMed

    Kern, I; Bartmann, C P; Verspohl, J; Rohde, J; Bienert-Zeit, A

    2017-03-01

    Transient bacteraemia can occur during tooth extraction in humans, and dogs and can lead to severe infectious sequelae. Several case reports describe distant site infections following equine tooth extraction, but the occurrence of bacteraemia during dental surgery has not been evaluated in the horse. To determine if transient bacteraemia occurs during tooth extraction in horses, describe isolated organisms and compare these with those found in the diseased teeth. Prospective, observational study. Blood was collected aseptically for blood culture before, during and after oral extraction of incisor, canine or cheek teeth from 20 adult horses undergoing dental extraction that had not received antimicrobial agents for at least 4 weeks prior to surgery. Bacteria found in blood cultures were compared with those found in swab samples obtained from the extracted teeth. Eighteen of 20 horses had positive blood cultures at one or more time points. Streptococcus spp., Actinomyces spp., Fusobacterium spp. and Prevotella spp. were most commonly found. Bacterial genera isolated from swab samples of extracted teeth largely corresponded with those identified in blood cultures. This study was limited by its use of only conventional bacterial culture, the lack of statistical analysis to explore associations between gingiva score and the occurrence of bacteraemia, and the lack of an age-matched control group of horses not undergoing exodontia. Transient bacteraemia of oral origin commonly occurs during dental extraction in horses. As none of the horses developed complications associated with bacteraemia during the observation period after surgery, the significance of this bacteraemia remains uncertain. The Summary is available in Chinese - see Supporting Information. © 2016 EVJ Ltd.

  1. 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

  2. One-year outcomes of minor and subsyndromal depression in older primary care patients.

    PubMed

    Lyness, Jeffrey M; Chapman, Benjamin P; McGriff, Joanne; Drayer, Rebecca; Duberstein, Paul R

    2009-02-01

    Despite the high prevalence and morbidity of minor and subsyndromal depression in primary care elderly people, there are few data to identify those at highest risk of poor outcomes. The goal of this observational cohort study was to characterize the one-year outcomes of minor and subsyndromal depression, examining the predictive strength of a range of putative risks including clinical, functional and psychosocial variables. Patients aged > or = 65 years were recruited from primary care medicine and family medicine practices. Of 750 enrollees, 484 (64.5%) completed baseline and one-year follow-up assessments of depression diagnosis (major depression vs. minor and subsyndromal depression vs. non-depressed) by the Structured Clinical Interview for DSM-IV, depressive symptom severity (Hamilton Rating Scale for Depression), and validated measures of other predictors. Patients with baseline minor and subsyndromal depression were more depressed than the non-depressed group at follow-up: They had a 7.0-fold (95% CI 4.5-10.8) risk of developing major depression, and a one-year adjusted Hamilton Depression Score of 11.0 (95% CI 10.2-11.8) compared with 7.8 (95% CI 7.1-8.5) for the non-depressed group; these outcomes were less severe than those of the major depression group. Independent predictors of depression outcomes included race, psychiatric and physical functioning, and social support. Minor and subsyndromal depression are likely to persist, and pose an elevated risk of worsening over one year. Clinicians and preventive interventions researchers should focus on modifiable risks, such as psychiatric functioning or social support, in elders suffering clinically significant depressive symptoms.

  3. Bacteraemia caused by non-freundii, non-koseri Citrobacter species in Taiwan.

    PubMed

    Lai, C-C; Tan, C-K; Lin, S-H; Liu, W-L; Liao, C-H; Huang, Y-T; Hsueh, P-R

    2010-12-01

    This study analysed the clinical characteristics of bacteraemia due to unusual Citrobacter species. All non-freundii and non-koseri Citrobacter isolates were identified to species level by two commercial identification methods and 16S rRNA gene sequence analysis. A total of 306 patients with Citrobacter spp. bacteraemia were identified from January 2000 through December 2009. Four patients (1.3%) had C. braakii bacteraemia, and one had C. amalonaticus and C. sedlakii sepsis, respectively. Misidentification as non-freundii and non-koseri Citrobacter spp., which occurred in eight isolates with the Phoenix automated system PMIC/ID-30 and three with the Vitek II system, occurred in five of six infection episodes. Among the six patients with bacteraemia caused by non-freundii and non-koseri Citrobacter spp., five (83.3%) had healthcare-associated infection and five (83.3%) infections were secondary to intra-abdominal infection. Cancer and liver cirrhosis were the commonest underlying diseases. An attributable mortality was 33.3%. Antimicrobial susceptibility testing showed that the resistance patterns varied among different Citrobacter species. Non-freundii and non-koseri Citrobacter species are difficult to identify and are a rare cause of intra-abdominal infections with secondary healthcare-associated bacteraemia in immunocompromised patients.

  4. Non-O1, non-O139 Vibrio cholerae bacteraemia: case report and literature review.

    PubMed

    Deshayes, S; Daurel, C; Cattoir, V; Parienti, J-J; Quilici, M-L; de La Blanchardière, A

    2015-01-01

    Non-O1, non-O139 Vibrio cholerae (NOVC) are increasingly frequently observed ubiquitous microorganisms occasionally responsible for intestinal and extra-intestinal infections. Most cases involve self-limiting gastroenteritis or ear and wound infections in immunocompetent patients. Bacteraemia, which have been described in patients with predisposing factors, are rare and poorly known, both on the clinical and therapeutic aspects. We describe a case of NOVC bacteraemia and a systematic literature review in PubMed conducted up to November 2014 using a combination of the following search terms: "Vibrio cholerae non-O1" and "bacter(a)emia". The case was a 70 year-old healthy male subject returning from Senegal and suffering from NOVC bacteraemia associated with liver abscesses. Disease evolution was favourable after 2 months' therapy (ceftriaxone then ciprofloxacin). Three hundred and fifty cases of NOVC bacteraemia have been identified in the literature. The majority of patients were male (77 %), with a median age of 56 years and presenting with predisposing conditions (96 %), such as cirrhosis (55 %) or malignant disease (20 %). Diarrhoea was inconstant (42 %). Mortality was 33 %. The source of infection, identified in only 25 % of cases, was seafood consumption (54 %) or contaminated water (30 %). Practitioners should be aware of these infections, in order to warn patients with predisposing conditions, on the risk of ingesting raw or undercooked seafood or bathing in potentially infected waters.

  5. Prospective study of bacteraemia in acute haemorrhagic diarrhoea syndrome in dogs.

    PubMed

    Unterer, S; Lechner, E; Mueller, R S; Wolf, G; Straubinger, R K; Schulz, B S; Hartmann, K

    2015-03-21

    In dogs with idiopathic acute haemorrhagic diarrhoea syndrome (AHDS), a serious loss of intestinal mucosal barrier integrity occurs. However, the incidence of bacterial translocation in dogs with idiopathic AHDS is not known. Thus, the objectives of this prospective study were to identify the incidence of bacteraemia, to evaluate the frequency of septic events and the influence of bacteraemia on various clinical and laboratory parameters, duration of hospitalisation and survival of dogs with idiopathic AHDS. The study included 87 dogs with idiopathic AHDS. Twenty-one healthy dogs served as control group. To evaluate clinical significance of bacterial translocation, blood culture results were compared between patients and controls. Clinical and laboratory parameters were compared between patients with positive and negative blood cultures. There was no significant difference in either incidence of bacteraemia between patients with idiopathic AHDS (11 per cent) and controls (14 per cent) or in severity of clinical signs, laboratory parameters, duration of hospitalisation or mortality between blood culture-positive and culture-negative dogs with idiopathic AHDS. The results of this study suggest that the incidence of bacteraemia in dogs with idiopathic AHDS is low and not different from that of healthy control dogs. Bacteraemia does not influence the clinical course or survival and thus antibiotic treatment is not indicated to prevent sepsis. British Veterinary Association.

  6. Clinical and Microbiological Determinants of Outcome in Staphylococcus aureus Bacteraemia.

    PubMed

    Price, James; Baker, Gillian; Heath, Ian; Walker-Bone, Karen; Cubbon, Marc; Curtis, Sally; Enright, Mark C; Lindsay, Jodi; Paul, John; Llewelyn, Martin

    2010-01-01

    Staphylococcus aureus bacteraemia (SAB) is commonly complicated by metastatic infection or relapse after treatment. Objectives. The study aim was to determine the role of bacterial, host, and management factors in development of complicated SAB. Methods. A prospectively-conducted observational study gathered data on predisposition, management and outcome of 100 consecutive SAB cases. Antibiotic susceptibilities and genetic lineage of bacterial isolates were determined. Further clinical and microbiological data were gathered on two retrospective series from 1999-2000 (n = 57) and 2004 (n = 116). Results. In the prospective cases, 27% met our definition of complicated disease. Expressed as RR and 95% CI, complicated disease was associated with diabetes (1.58, 1.00-2.48), injecting-drug use (5.48, 0.88-33.49), community-onset of symptoms (1.4, 1.02-1.92), and symptom duration >/=48 hours prior to starting effective antibiotic therapy (2.10, 1.22-3.61). Uncomplicated disease was associated with the presence of a central line (0.69, 0.55-0.88) and prompt removal of a primary focus (0.71, 0.57-0.90). Neither methicillin resistance nor genetic lineage was associated with complicated disease, but methicillin resistance was associated with higher mortality. Conclusions. This study demonstrates that clinical rather than microbial factors are the major determinants of SAB outcome and underscores the importance of early treatment.

  7. [Bacteraemia in children in Iceland 1994-2005].

    PubMed

    Arnason, Sigurdur; Thors, Valtýr Stefánsson; Gudnason, Thórólfur; Kristinsson, Karl G; Haraldsson, Asgeir

    2008-07-01

    Positive blood cultures from children suggest serious bloodstream infections. Quick medical response with targeted therapy is important, taking the child's age and medical history into account. Antibiotic therapy and vaccination programs must be based on accurate knowledge of the prevalence and antibiotic susceptibility of the bacteria. The aim of this study was to investigate epidemiological parameters associated with positive blood cultures in children in Iceland from September 20th 1994 to March 16th 2005. All positive bacterial blood cultures from children 0-18 years of age identified at the Department of Clinical Microbiology of the Landspitali University Hospital during the study period. Age and sex of the children, bacterial aetiology, date of collection and results of antimicrobial susceptibility tests were registered. The children were divided into four age groups: neonates (< or =30 days of age), infants (30 days to one year), preschool age (1-6 y) and school age (6-18 y). The blood cultures were classified as definite contamination, probable contamination, probable infection and definite infection. During the study period 1253 positive blood cultures were obtained from 974 children; 647 from boys and 606 from girls. Most of the blood cultures were from children less than one year old (594; 47.4%) of which 252 were neonates (42.4% of all children <1 y of age). Coagulase negative staphylococci were the most commonly isolated organisms (37%). Of positive blood cultures considered definite infections Streptococcus pneumoniae was the most common (21.7%) followed by Staphylococcus aureus (19.8%) and Neisseria meningitidis (15.2%). N. meningitidis C was not isolated in children after a meningococcal C vaccination was launched in 2002. The most common pneumococcal serotypes/serogroups were 23, 6B, 7, 19 and 14. Macrolide resistance was common in pneumococci (19%) and group A haemolytic streptococci (33%). The results provide important information for empirical

  8. Polymorphism of the C-reactive protein gene is associated with mortality in bacteraemia.

    PubMed

    Eklund, Carita; Huttunen, Reetta; Syrjänen, Jaana; Laine, Janne; Vuento, Risto; Hurme, Mikko

    2006-01-01

    C-reactive protein (CRP) is an important molecule in the defence against bacterial infections. To discover if variation in the CRP gene is associated with clinical outcome of bacteraemia, we investigated 147 microbiologically verified bacteraemia patients (mean age 59 y, range 19-93 y) and determined whether CRP -717A>G, +1059G>C or +1444C>T single nucleotide polymorphisms (SNPs) were associated with clinical outcome of bacteraemia and/or CRP concentration caused by Staphylococcus aureus, Streptococcus pneumoniae, beta-haemolytic streptococci or Escherichia coli. The patients were genotyped for CRP gene polymorphisms, CRP was measured and clinical outcomes were recorded. The CRP -717A>G, a promoter region polymorphism was strongly associated with mortality from Streptococcus pneumoniae but did not correlate with plasma CRP concentration. These results suggest that mortality from Streptococcus pneumoniae may be associated with polymorphism of the promoter region of the CRP gene.

  9. Early post-transplant neopterin associated with one year survival and bacteremia in liver transplant recipients.

    PubMed

    Oweira, Hani; Lahdou, Imad; Daniel, Volker; Hofer, Stefan; Mieth, Markus; Schmidt, Jan; Schemmer, Peter; Opelz, Gerhard; Mehrabi, Arianeb; Sadeghi, Mahmoud

    2016-01-01

    Bacterial infections are the most common complications, and the major cause of mortality after liver transplantation (Tx). Neopterin, a marker of immune activation, is produced in monocyte/macrophages in response to inflammation. The aim of our study was to investigate whether early post-operation serum levels of neopterin were associated with post-transplant bacteremia and mortality in liver transplant recipients. We studied 162 of 262 liver Tx patients between January 2008 and February 2011 of whom pre- and early post-Tx sera samples were available. Pre- and early post-operative risk factors of infection and mortality were evaluated in 45 bacteremic patients and 117 non-bacteremic patients. During one-year follow-up, 28 of 262 patients died because of graft failure, septicemia and other diseases. Post-Tx serum neopterin on day 10 (p<0.001) were significantly higher in bacteriemic patients than in patients without bacteremia. Logistic regression analyses showed that day 10 post-Tx neopterin serum level ⩾40 nmol/l has a predictive value (OR=6.86: p<0.001) for bacteremia and mortality (OR=3.47: p=0.021). Our results suggest that early post-Tx neopterin serum levels are very sensitive predictive markers of one-year post-Tx bacteremia and mortality in liver Tx recipients. Copyright © 2015 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

  10. 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.

  11. Impact of diabetes and poor glycaemic control on risk of bacteraemia with haemolytic streptococci groups A, B, and G.

    PubMed

    Thomsen, Reimar Wernich; Riis, Anders Hammerich; Kjeldsen, Sia; Schønheyder, Henrik Carl

    2011-07-01

    Diabetes has been associated with bacteraemia due to haemolytic streptococci but epidemiological evidence is limited. We conducted a 15-year population-based case-control study of all adults with first-time bacteraemia with groups A, B, and G haemolytic streptococci and matched population controls. The study setting was Northern Denmark between 1992 and 2006. We computed odds ratios (ORs) for streptococcal bacteraemia according to diabetes and glycaemic control, using regression analysis for confounder adjustment. We identified 397 adult patients with bacteraemia due to haemolytic streptococci (median age 67 years, 51% women), of which 63 (17%) had diabetes. Persons with diabetes had a 2.1-fold increased risk of streptococcal bacteraemia compared with population controls (adjusted odds ratio (OR) 2.1; 95% confidence interval (CI), 1.5-2.9). For persons with type 1 diabetes, the adjusted OR was 14.8 (2.4-91.2). Longer diabetes duration and poor glycaemic control conferred higher risk estimates: adjusted OR 1.5 (0.8-3.0) for HbA(1c) level <7%, and OR 3.6 (1.6-8.1) for HbA(1c) level ≥9%. The association between diabetes and HS bacteraemia was independent of the underlying foci of infection and was strongest for group B streptococcal bacteraemia (OR 3.5; 1.8-7.0) and for group G streptococcal bacteraemia (OR 2.6; 1.6-4.4). There was no clear increase in risk for group A streptococcal bacteraemia (OR 1.2; 0.7-2.2). Diabetes is a strong risk factor for group B and group G, but not group A, haemolytic streptococcal bacteraemia. The risk increase is particularly high for type 1 diabetes, long diabetes duration, and poor long-term glycaemic control. Copyright © 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  12. Community-acquired bacteraemia in a rural area: predominant bacterial species and antibiotic resistance.

    PubMed

    Nimri, L F; Batchoun, R

    2004-10-01

    The invasion of the bloodstream represents one of the most important sequelae of infection. This study was conducted over an 18-month period to determine the predominant bacterial agents of a community-acquired bacteraemia seen at health centres in a rural area of Jordan, and their antibiotic susceptibilities. Blood samples were collected and cultured from 215 patients who presented with fever and presumed diagnosis of a bacteraemia. Isolates were identified and tested for antibiotic susceptibility. The variables included the age and sex of the patients, aetiology, sources of the bacteraemia, risk factors, treatment and outcome. One hundred and twenty-six (58.6%) blood cultures were positive. Children less than 14 years old accounted for 34.9% of these, and 38% were from patients that were more than 50 years old. The most frequent aetiologic agents were Staphylococcus aureus, followed by Brucella melitensis and Streptococcus pneumoniae. A wide range of resistance to commonly used antimicrobial agents and multidrug resistance was documented in 44.4% of the isolates. The most frequent sources of the bacteraemia were urinary (15.9%), respiratory (14.3%), no source of the bacteraemia identified (primary bacteraemia) (13.5%), gastrointestinal (12.7%) and soft-tissue infection (7.9%). No identifiable risk factor for infection could be determined in 34% of the patients. The predominant pathogens identified and the relatively high prevalence of antibiotic resistance of the isolates are most probably due to the nature and lifestyle of this rural population and the use of empiric treatment. Characteristics permitting recognition of patients with such strains would aid infection control efforts in the community.

  13. Resistance profiles and risk factors of resistant microorganisms in bacteraemia of abdominal origin.

    PubMed

    Martín Jaramago, J; Armero Ibáñez, R; Camarena Miñana, J J; Morales Suárez-Varela, M

    2017-04-20

    The presence of resistant microorganisms is a major cause of failure in initial empirical antimicrobial therapy. The objectives of this study are to determine the resistance profile of microorganisms that cause bacteraemia of abdominal origin and to identify whether the previous use of antibiotics and the place of acquisition of bacteraemia are risk factors associated with the presence of resistant organisms. A clinical, observational, epidemiological, retrospective cohort study was conducted with all the adult patients admitted to a university hospital from 2011-2013. Antimicrobial resistance profiles were described and a 95% confidence interval chi-square test was used to determine whether the variables studied were risk factors in the isolation of resistant microorganisms. Of the 1245 patients with bacteraemia, 212 (17%) presented bacteraemia of abdominal origin. The resistance profile highlights the incidence of methicillin resistant Staphylococcus aureus (50%), coagulase-negative staphylococci resistant to linezolid (20.58%), enterococci resistant to vancomycin (3.12%), Escherichia coli resistant to third-generation cephalosporins (9.9%) and fluoroquinolones (35.64%), Klebsiella pneumoniae resistant to third-generation cephalosporins (8.33%), Pseudomonas aeruginosa resistant to fluoroquinolones and carbapenem (25% and 25% respectively) and Acinetobacter baumanii resistant to fluoroquinolones and carbapenem (100% and 100% respectively), Candida albicans resistant to fluconazole (11.11%), single Candida krusei isolate resistant to fluconazole and Candida parapsilosis resistant to echinocandins (12.5%). In our study, previous use of antibiotics had a statistically significant association with the isolation of resistant microorganisms (P=.013) but not the place of acquisition of bacteraemia (P=.239). Establishing the incidence of resistant organisms can improve empirical antimicrobial therapy in patients with bacteraemia of abdominal origin. Previous use of

  14. Does hospital cleanliness correlate with methicillin-resistant Staphylococcus aureus bacteraemia rates?

    PubMed

    Green, D; Wigglesworth, N; Keegan, T; Wilcox, M H

    2006-10-01

    Publicly available data for all National Health Service hospitals in England were used to examine whether there is a link between hospital cleanliness and rates of meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia. It was not possible to demonstrate a consistent relationship between hospital cleanliness, as measured by weighted Patient Environment Action Team (PEAT) scores, and the incidence of MRSA bacteraemia. The large sizes of the data sets make it unlikely that a true correlation was missed. While a high standard of hospital cleanliness is a worthwhile goal, it is not helpful to repeatedly link MRSA control measures with improvements in standards of environmental cleanliness.

  15. A case of Ignatzschineria bacteraemia in an unconscious man from the Netherlands

    PubMed Central

    Janssen, Frank; van Westreenen, Harro

    2016-01-01

    Introduction: Ignatzschineria species were previously known as Schineria species and are well known inhabitants of the larvae of the parasitic fly Wohlfahrtia magnifica. Case presentation: We report a case of Ignatzschineria species bacteraemia in a Dutch patient with a wound infested with maggots. Conclusion: In the past, these bacteria have been isolated from Wohlfahrtia magnifica, a fly not indigenous to The Netherlands. Other fly larvae such as the blowfly larvae probably infested the wound and harboured this Ignatzschineria strain which subsequently caused this bacteraemia. A two-week course of amoxicillin/clavulanic acid was given with good clinical response. PMID:28348762

  16. Enhanced surveillance of meticillin-resistant Staphylococcus aureus bacteraemia in a London teaching hospital.

    PubMed

    Jeyaratnam, D; Edgeworth, J D; French, G L

    2006-08-01

    In 2001, the UK Department of Health introduced mandatory surveillance of meticillin-resistant Staphylococcus aureus (MRSA) bacteraemias (blood-culture-positive episodes) in English hospitals. We performed enhanced surveillance in their hospital between April 2001 and March 2003 to determine the epidemiology of MRSA bacteraemia across different specialities. There were 267 MRSA-blood-culture-positive episodes, giving a rate of 0.37 per 1000 occupied bed-days (OBD). Thirty-three (12.4%) episodes were false positives due to contaminants and 15 (5.6%) originated in the community or at another institution. Thirty-one (11.6%) episodes were in outpatients or occurred after recent discharge and were designated 'hospital associated'. The remaining 188 cases were clinically significant hospital-acquired episodes in inpatients, with a rate of 0.26 per 1000 OBDs. The highest rates were in the intensive therapy unit (ITU; 2.74 per 1000 OBDs) and the high-dependency unit (HDU; 1.68 per 1000 OBDs). Fifty-five non-ITU, non-HDU episodes occurred in patients who had been discharged from ITU or HDU prior to the development of bacteraemia but during the same admission. The number of MRSA bacteraemias related to ITU/HDU suggests that these wards may be hubs of MRSA infection. Haematology, oncology and renal (HOR) patients had the greatest number of hospital-associated episodes. The most common source of MRSA bacteraemia was a vascular access device (VAD) (108 episodes, 57%, 64% of which were central lines). The high bacteraemia rates in ITU, HDU and HOR patients were associated with high usage of VADs. The majority of episodes occurred in patients who were newly colonized with MRSA after admission. Thus, in this hospital, VADs and stays in ITU or HDU are important risk factors for bacteraemia, and VAD care and prevention of cross-infection are priorities for intervention. We recommend that the mandatory national surveillance scheme should collect additional data on MRSA bacteraemia to

  17. Characteristics of cefazolin inoculum effect-positive methicillin-susceptible staphylococcus aureus infection in a multicentre bacteraemia cohort.

    PubMed

    Song, K-H; Jung, S-I; Lee, S; Park, S; Kiem, S M; Lee, S H; Kwak, Y G; Kim, Y K; Jang, H-C; Kim, Y-S; Kim, H-I; Kim, C J; Park, K-H; Kim, N J; Oh, M-D; Kim, H B

    2017-02-01

    Cefazolin treatment failure has been observed in high-inoculum infections caused by methicillin-susceptible Staphylococcus aureus (MSSA) with a cefazolin inoculum effect (CIE). However, data on the characteristics and risk factors for the acquisition of CIE-positive MSSA infection are scarce. CIE positivity was measured as an MIC ≥ 16 μg/ml with a high inoculum (∼5 × 10(7) CFU/ml). The blaZ gene type was assessed through sequence analysis. The clinical characteristics and risk factors for the acquisition of CIE-positive MSSA infection were assessed. The association between the antimicrobial susceptibility profile and CIE positivity was evaluated. A total of 303 MSSA bacteraemia cases and their corresponding isolates were collected from ten hospitals: 61 (20.1 %) isolates showed a positive CIE; 254 (83.8 %) were positive for the blaZ gene. No significant association was found between CIE positivity and the site of infection. Metastatic cancer (aOR 2.86, 95 % CI, 1.10-7.48) and recent (≤1 month) close contact with a chronically ill patient (aOR 4.69, 95 % CI, 1.76-12.50) were identified as significant risk factors for CIE-positive MSSA infection through multivariate analyses. Resistances to clindamycin (OR 3.55, 95 % CI, 1.62-7.80) and erythromycin (OR 5.00, 95 % CI, 2.50-9.99) were associated with CIE positivity, presenting high specificity (92.9 %) and a negative predictive value (82.3 %). CIE-positive MSSA constituted approximately one-fifth of MSSA bacteraemia cases. Although CIE positivity was not clinically discernible, CIE positivity was associated with clindamycin or erythromycin susceptibility. Therefore, our findings suggest that cefazolin can be used in the treatment of high-inoculum MSSA infection if the isolates are susceptible to clindamycin or erythromycin.

  18. 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.

  19. 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

  20. Glucocorticoid insensitive asthma: a one year clinical follow up pilot study

    PubMed Central

    Demoly, P.; Jaffuel, D.; Mathieu, M.; Sahla, H.; Godard, P.; Michel, F.; Bousquet, J.

    1998-01-01

    BACKGROUND—Glucocorticoid resistant or insensitive asthmatic subjects are usually defined as patients whose baseline pre-bronchodilation forced expiratory volume in one second (FEV1) of less than 70-80% predicted improves significantly in response to β2 agonists but by less than 15% following 1-2 weeks of 40 mg prednisolone daily. Since there is little long term clinical information on these patients, a one year prospective study was performed to assess whether glucocorticoid sensitivity may vary over time.
METHODS—Nineteen severe asthmatic subjects were studied and received 40 mg prednisolone daily for seven days. Prednisolone was given for a further seven days in glucocorticoid insensitive asthmatics and then stopped. Patients were followed up for one year and the glucocorticoid test was repeated on five patients in each group six months later.
RESULTS—Eleven patients were classified as glucocorticoid insensitive and eight as glucocorticoid sensitive on day 7. The demographic characteristics of the patients were similar in both groups. Four glucocorticoid insensitive patients became responsive after one further week of prednisolone treatment. Six months later, four of five glucocorticoid sensitive patients and three of five previously glucocorticoid insensitive patients were glucocorticoid sensitive.
CONCLUSIONS—Glucocorticoid sensitivity varies over time.

 PMID:10195080

  1. One-year mortality in patients with bone and soft tissue sarcomas as an indicator of delay in presentation.

    PubMed

    Nandra, R; Hwang, N; Matharu, G S; Reddy, K; Grimer, R

    2015-09-01

    For many cancers, one-year mortality following diagnosis is a reflection of either advanced stage at diagnosis, multiple co-morbidities and/or complications of treatment. One-year mortality has not been reported for soft tissue or bone sarcomas. This study reports 1-year sarcoma mortality data over a 25-year period, investigates prognostic factors and considers whether a delay in presentation affects 1-year mortality. A total of 4,945 newly diagnosed bone sarcoma and soft tissue sarcoma patients were identified from a prospectively maintained, single institution oncology database. Of these, 595 (12%) died within 1 year of diagnosis. Both patient factors and tumour characteristics available at diagnosis were analysed for effect. There was significant variation in one-year mortality between different histological subtypes. There has been no significant change in mortality rate during the last 25 years (mean: 11.7%, standard deviation: 2.8 percentage points). Soft tissue sarcoma patients who survived over one year reported a longer duration of symptoms preceding diagnosis than those who died (median: 26 vs 20 weeks, p<0.001). Prognostic factors identified in both bone and soft tissue sarcomas mirrored those for mid to long-term survival, with high tumour stage, large tumour size, metastases at diagnosis and increasing age having the greatest predictive effect. One-year mortality in bone and soft tissue sarcoma patients is easy to measure, and could be a proxy for late presentation and therefore a potential performance indicator, similar to other cancers. It is possible to predict the risk of one-year mortality using factors available at diagnosis. Death within one year does not correlate with a long history but is associated with advanced disease at diagnosis.

  2. 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…

  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. Slower Walking Speed Forecasts Increased Postoperative Morbidity and One-Year Mortality Across Surgical Specialties

    PubMed Central

    Robinson, Thomas N; Wu, Daniel S; Sauaia, Angela; Dunn, Christina L; Stevens-Lapsley, Jennifer E; Moss, Marc; Stiegmann, Greg V; Gajdos, Csaba; Cleveland, Joseph C; Inouye, Sharon K

    2013-01-01

    Objective The purpose of this study was to determine the relationship between the timed up-and-go test and postoperative morbidity and one-year mortality, and to compare the timed up-and-go to the standard-of-care surgical risk calculators for prediction of postoperative complications. Methods In this prospective cohort study, patients 65 years and older undergoing elective colorectal and cardiac operations with a minimum of one-year follow-up were included. The timed up-and-go test was performed preoperatively. This timed test starts with the subject standing from a chair, walking ten feet, returning to the chair, and ends after the subject sits. Timed up-and-go results were grouped: Fast≤10 sec, Intermediate=11-14 sec, Slow≥15 sec. Receiver operating characteristic curves were used to compare the three timed-up-and-go groups to current standard-of-care surgical risk calculators at forecasting postoperative complications. Results This study included 272 subjects (mean age of 74±6 years). Slower timed up-and-go was associated with an increased postoperative complications following colorectal (fast-13%, intermediate-29% and slow-77%;p<0.001) and cardiac (fast-11%, intermediate-26% and slow-52%;p<0.001) operations. Slower timed up-and-go was associated with increased one-year mortality following both colorectal (fast-3%, intermediate-10% and slow-31%;p=0.006) and cardiac (fast-2%, intermediate-3% and slow-12%;p=0.039) operations. Receiver operating characteristic area under curve of the timed up-and-go and the risk calculators for the colorectal group was 0.775 (95% CI:0.670,0.880) and 0.554 (95% CI:0.499,0.609), and for the cardiac group was 0.684 (95% CI:0.603,0.766) and 0.552 (95% CI:0.477,0.626). Conclusions Slower timed up-and-go forecasted increased postoperative complications and one-year mortality across surgical specialties. Regardless of operation performed, the timed up-and-go compared favorably to the more complex risk calculators at forecasting

  5. Some Predictive Antecedents of Specific Learning Disability: A Preliminary One Year Follow-UP.

    ERIC Educational Resources Information Center

    Satz, Paul; Friel, Janette

    Based on a conceptualization of specific learning disability within a developmental rather than disease model, the longitudinal research project attempted to assess early indices of later reading disability. Kindergarten boys (N equals 474) were tested at the beginning of the school year on a number of developmental and neuro-psychological tests…

  6. Laboratory nutritional parameters predict one-year mortality in elderly patients with intertrochanteric fracture.

    PubMed

    Lu, Jun; Chen, Yuan-Yuan; Zhang, Lin; Li, Yong-Gang; Wang, Chen

    2016-01-01

    背景和目的:观察术前营养相关的血液指标对中国65 岁以上股骨粗隆间骨折 患者内固定术后一年死亡率的预测价值。方法和研究设计:将入院时患者血 清白蛋白水平及全血淋巴细胞计数作为评价患者营养状况的主要指标,共174 例高龄股骨粗隆间骨折患者纳入了本项研究并进行了营养评估,采用单变量分 析方法比较营养指标的性别差异,采用多变量logistic 回归分析评估不同指标 对患者术后一年死亡率的预测价值。结果:术前平均白蛋白水平为31.0 g/L, 其中73%的患者低于正常水平35 g/L;术前平均淋巴细胞计数水平为1.19×109 cells/L,其中81%的患者低于正常水平1.50×109 cells/L。不同性别患者的白蛋 白和淋巴细胞计数没有显著差异,接受手术治疗并获得最终随访的149 例患 者,总体死亡率为31%,其中男性患者为35%,女性患者为29%。相对于死 亡的患者,存活的患者更年轻、术前具有更高的白蛋白、淋巴细胞计数和血钙 水平。然而多因素回归分析显示只有白蛋白水平和淋巴细胞计数是预测患者一 年内死亡的独立危险因素。受试者操作特征曲线显示白蛋白和淋巴细胞计数两 项指标的临界值分别为29.5 g/L 和0.925×109 cells/L。结论:营养不良在中国 高龄股骨粗隆间骨折人群中是一个普遍现象。患者入院时的血清白蛋白水平和 血液淋巴细胞计数对患者术后一年的死亡率具有预测价值。.

  7. ENSO prediction one year in advance using western North Pacific sea surface temperatures

    NASA Astrophysics Data System (ADS)

    Wang, Shih-Yu; L'Heureux, Michelle; Chia, Hsin-Hsing

    2012-03-01

    We present evidence that the de-trended, boreal winter sea surface temperature anomalies (SSTA) in the western North Pacific (WNP) are a skillful predictor for the development of the El Niño-Southern Oscillation (ENSO) by the following winter. The WNP shares some similarities with the Meridional Mode (MM) located in the subtropical central and eastern North Pacific: both are linked to off-equatorial SSTA and low-level wind anomalies, and both appear to be strongly related to wintertime variability in the North Pacific Oscillation (NPO). However, in contrast with the MM, the WNP is associated with an opposite-signed SSTA dipole located off southeastern Asia and in the western tropical Pacific, which is accompanied by equatorial winds that may influence the level of oceanic Kelvin wave activity that precedes ENSO events.

  8. Daptomycin versus linezolid for the treatment of vancomycin-resistant enterococcal bacteraemia: implications of daptomycin dose.

    PubMed

    Chuang, Y-C; Lin, H-Y; Chen, P-Y; Lin, C-Y; Wang, J-T; Chang, S-C

    2016-10-01

    Treatment options for vancomycin-resistant enterococci (VRE) bloodstream infection are limited. Studies comparing daptomycin or linezolid in treating VRE bloodstream infection have conflicting results and suggest daptomycin underdosing. The responses to different daptomycin doses have not been studied. We conducted a multicentre prospective cohort study to compare linezolid and daptomycin (≥6 mg/kg) for the treatment of VRE bloodstream infection. The primary outcome was 14-day mortality. We used multivariate logistic regression analysis for outcome analysis and a generalized additive model for dose-dependent response estimation. Two hundred twelve patients were included (daptomycin, n = 141; linezolid, n = 71). All-cause 14-day mortality was higher in the daptomycin group (36.9% vs. 21.1%; p 0.03). After adjusting for confounders in logistic regression, mortality was lower in the linezolid group (adjusted odds ratio (aOR), 0.45; 95% confidence interval (CI), 0.21-0.96; p 0.04). The generalized additive model showed that higher-dose daptomycin (≥9 mg/kg) was associated with better survival than lower-dose daptomycin (6-9 mg/kg). Logistic regression showed that linezolid (aOR, 0.36; 95% CI, 0.17-0.79; p 0.01) and higher-dose daptomycin (aOR, 0.26; 95% CI, 0.09-0.74; p 0.01) independently predicted lower mortality compared to lower-dose daptomycin. Linezolid was not superior to higher-dose daptomycin in terms of mortality (aOR, 1.40; 95% CI, 0.45-4.37; p 0.57). Higher-dose daptomycin had lower mortality than lower-dose daptomycin. Despite higher mortality for lower-dose daptomycin than linezolid, linezolid conferred no survival benefit compared to higher-dose daptomycin. Our findings suggest that the recommended daptomycin dose is suboptimal for treating VRE bacteraemia.

  9. Differential characteristics of bacteraemias according to age in a community hospital.

    PubMed

    Toyas, C; Aspiroz, C; Martínez-Álvarez, R M; Ezpeleta, A I; Arazo, P; Ferrando, J C

    To describe the characteristics of bacteraemias, according to age, in a community hospital. A prospective study of bacteraemias was conducted in 2011. The patients were classified into 3 age groups: younger than 65 years, 65 to 79, and 80 or older. The study collected variables on the patients and episodes. The study analysed 233 bacteraemias in 227 patients (23.8% in those younger than 65 years; 38.3% in the 65 to 79 age group; and 37.9% in the 80 years or older group). The most common underlying disease in all the groups was diabetes mellitus. In the most elderly patients, the Charlson index was highest, there was a lower proportion of exogenous factors, and almost 25% were severely dependent (Barthel index<20). Escherichia coli was the most common germ, and the main focus was urological. The patients aged 80 years or older had predominantly healthcare-associated infections, less severe symptoms (sepsis) (66.3%) and higher mortality (29.1%) compared with the younger patients. The very elderly patients with bacteraemia presented fewer exogenous factors, greater comorbidity and a poorer functional situation. The most common focus was urological and the origin was healthcare related. Despite their less severe clinical presentation, these patients' mortality was greater, and their degree of dependence was a highly relevant independent risk factor. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  10. Acute stress response and recovery after whiplash injuries. A one-year prospective study.

    PubMed

    Kongsted, Alice; Bendix, Tom; Qerama, Erisela; Kasch, Helge; Bach, Flemming W; Korsholm, Lars; Jensen, Troels S

    2008-05-01

    Chronic whiplash-associated disorder (WAD) represents a major medical and psycho-social problem. The typical symptomatology presented in WAD is to some extent similar to symptoms of post traumatic stress disorder. In this study we examined if the acute stress reaction following a whiplash injury predicted long-term sequelae. Participants with acute whiplash-associated symptoms after a motor vehicle accident were recruited from emergency units and general practitioners. The predictor variable was the sum score of the impact of event scale (IES) completed within 10 days after the accident. The main outcome-measures were neck pain and headache, neck disability, general health, and working ability one year after the accident. A total of 737 participants were included and completed the IES, and 668 (91%) participated in the 1-year follow-up. A baseline IES-score denoting a moderate to severe stress response was obtained by 13% of the participants. This was associated with increased risk of considerable persistent pain (OR=3.3; 1.8-5.9), neck disability (OR=3.2; 1.7-6.0), reduced working ability (OR=2.8; 1.6-4.9), and lowered self-reported general health one year after the accident. These associations were modified by baseline neck pain intensity. It was not possible to distinguish between participants who recovered and those who did not by means of the IES (AUC=0.6). In conclusion, the association between the acute stress reaction and persistent WAD suggests that post traumatic stress reaction may be important to consider in the early management of whiplash injury. However, the emotional response did not predict chronicity in individuals.

  11. 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 who...

  12. 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 who...

  13. 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 who...

  14. Association between Enterococcus bacteraemia and death in neutropenic patients with haematological malignancies.

    PubMed

    Todeschini, Giuseppe; Tecchio, Cristina; Borghero, Carlo; D'Emilio, Anna; Pegoraro, Enrico; de Lalla, Fausto; Benedetti, Paolo; Spolaore, Paolo; Pellizzer, Giampietro

    2006-10-01

    Fatality rates and prognostic factors for mortality due to Enterococcus spp. bacteraemia have not yet been fully defined in the setting of neutropenic patients affected with haematological malignancies. We have performed a retrospective, multi-centre cohort study on 98 episodes of Enterococcus bacteraemia occurring in patients hospitalised from January 1984 to December 2001 at the oncohaematology units in two tertiary-care hospitals (Verona Hospital and Vicenza Hospital, in north-east Italy). E. faecalis was isolated in 52 cases (53%), E. faecium in 39 (39.8%), E. avium in four, E. durans in one, and untyped Enterococcus spp. in two other cases; vancomycin resistance was detected in 15 (15.3%) isolates. A global mortality rate of 41.8% (41/98 cases) was revealed; Enterococcus spp. bacteraemia was associated with a fatal outcome in 29/98 cases (29.5%). The following variables were independently associated with an increased risk of death by multivariate analysis of survival: age > or =50 years (OR 3.74; 95% CI 1.35-10.32), pneumonia (OR 4.70; 95% CI 1.67-13.20), and shock (OR 13.7; 95% CI 1.23-152.43), while the initial phase of haematological disease (responsive to chemotherapy) appeared to be protective (OR 0.23; 95% CI 0.008-0.64, P level 0.005); however, pneumonia alone (OR 7.2, 95% CI 2.52-20.88) was independently associated with fatal outcome by multivariate analysis for death related to enterococcal bacteraemia. In our experience, the poor outcome proper to enterococcal bacteraemia appears to be directly related to underlying disease, patient's age, presence of pneumonia and shock; in contrast, severe neutropaenia, antibiotic resistance, and species of Enterococcus do not appear to affect the fatality rate significantly.

  15. [One year follow up of successful coronary angioplasty in non selected patients].

    PubMed

    Dighero T, Humberto; Wajner A, Jacobo; Puentes R, Angel; Zepeda M, Flavio; Bellet P, Augusto; Donoso P, Hernán; Guillem V, Arturo; Aranda C, Waldo

    2006-11-01

    Re-stenosis after percutaneous coronary angioplasty (PTCA) is related to clinical and angiographic features. To describe the clinical and angiographic characteristic of our patients with coronary cardiopathy subjected to PTCA and the predictor factors for re-stenosis. We gathered the clinical and angiographic characteristics of all patients who underwent a successful PTCA of a native coronary artery. All patients had a clinical assessment one year after the procedure. Patients were classified in Group 1, if they did not have angina or coronary events after the angioplasty or Group 2, if they had angina or a coronary event after the procedure. Only Group 2 patients were subjected to a coronary angiogram. We collected 383 PTCA procedures. Follow up information was obtained in 92.2%. Three hundred forty two patients (89.3%) were assessed one year the procedure. Nine patients (2.3%) died of a cardiovascular cause. Ninety patients (26.3%) were classified in Group 2. In 65 patients, angiographic re-stenosis was demonstrated (19%). Re-stenosis occurred in 36 and 13% of patients with an without Diabetes Mellitus, respectively (p <0.01). The other clinical predictor variables were a history of myocardial infarction (p =0.007), obesity (p =0.041) and hypercholesterolemia (p =0.050). None of the angiographic characteristics predicted restenosis. Stents were protective factors against restenosis (15.6% in stented lesions vs 25.4% in nonstented; p =0.01). Re-stenosis after angioplasty occurred in 19% of our patients with angina or coronary events. The clinical variables associated with a higher risk of re-stenosis were diabetes (the main risk factor), previous myocardial infarction, obesity and hypercholesterolemia. Angiographic variables were not associated with re-stenosis. The use of stents decreases the incidence of re-stenosis in all groups).

  16. One year negative appendicectomy rates at a district general hospital: A Retrospective Cohort Study.

    PubMed

    Lim, Jeffrey; Pang, Queenie; Alexander, Roderick

    2016-07-01

    There is no defined 'acceptable' Negative Appendicectomy Rate (NAR) in the UK. Despite advances in radiology and predictive scoring systems, appendicitis remains a clinical diagnosis but inevitably some patients will have an entirely normal appendix removed. We sought to define our local practice and results. A one year retrospective observational study was performed in our institution on all appendicectomies performed on an emergency basis. Cases were identified with the hospital electronic theatre record system and histopathology reports were retrieved and analysed. 390 patients were identified over a one year period and split into two groups. Group A (n = 128) was defined as those patients who had no evidence of appendiceal pathology or tissue, giving a NAR of 32.8%. Group B (n = 262) comprised patients whose appendices had any histopathological finding other than normal. Our NAR was not found to be significantly different when compared to a recent large published series (p = 0.711). Within six months, Group A had 19 (14.8%) emergency readmissions compared to 25 (9.54%) in Group B. This was not found to be statistically significant on Fisher's exact testing (p = 1.00). Our NAR of 32.8% is higher than expected but comparable to those previously published. Although this did not have a significant impact on patient morbidity as shown by our re-admission rates, revision of our current policy to remove the appendix should no other pathology be identifiable may improve outcomes. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Perceived resilience: Examining impacts of the deepwater horizon oil spill one-year post-spill.

    PubMed

    Shenesey, Jessica W; Langhinrichsen-Rohling, Jennifer

    2015-05-01

    Scant research has focused on resilient responding to disasters such as oil spills a year or more after the event. One year after the BP Deepwater Horizon oil spill, this study assessed perceived resilience, relations between resiliency and psychological symptoms, and the degree to which self-reported resiliency was associated with reduced psychological symptoms after accounting for differences in economic impact sustained by Gulf Coast residents. Participants were 812 adults (64% women, mean age 50) of 2 Alabama coastal communities. Participants were administered a telephone survey 1-year post-spill assessing self-perceptions of impact factors (e.g., economic and social), resilience, coping, and depressive and PTSD symptoms. Most participants perceived themselves as resilient (n = 739). As expected, lower perceived resilience was associated with greater ongoing depressive and PTSD symptoms. Spill-related economic impact predicted greater depressive and PTSD symptoms; however, perceived resilience predicted significant variance in psychological symptoms after taking into account spill-related economic impact. Improving individuals' sense of resiliency may help mitigate psychosocial and mental health effects over time.

  18. Achromobacter bacteraemia outbreak in a paediatric onco-haematology department related to strain with high surviving ability in contaminated disinfectant atomizers.

    PubMed

    Hugon, E; Marchandin, H; Poirée, M; Fosse, T; Sirvent, N

    2015-02-01

    Achromobacter spp. are Gram-negative bacilli from aqueous environments, occasionally involved in bacteraemia in immunocompromised hosts and in outbreaks. We describe the characteristics of an achromobacter bacteraemia outbreak in a paediatric onco-haematology department. Throughout a one-year period, 16 blood cultures from seven patients were positive for Achromobacter sp. All patients were immunocompromised, febrile, and central venous catheter (CVC) holders. A microbiological study was performed in patients' rooms, completed with an analysis of the disinfectant atomizers (didecyl diammonium chloride 0.25%, Surfanios, DMA). In total, 41 clinical and environmental strains were analysed by enterobacterial repetitive intergenic consensus (ERIC) polymerase chain reaction (PCR), repetitive PCR, and random amplified polymorphic DNA (RAPD)-PCR, and pulsed-field gel electrophoresis (PFGE). The bactericidal activity of DMA was studied on two Achromobacter sp. representative strains and one Pseudomonas aeruginosa reference strain, comparing biofilm and planktonic growth models. The seven patients, including two severe cases, were successfully treated by systemic antimicrobial therapy and/or catheter removal. The 25 environmental isolates were recovered with the following chronology: hospital filtered tap water, disinfectant atomizers, and patients' rooms. All environmental, patient, and atomizer strains had identical PCR and PFGE patterns. The disinfectant susceptibility assay revealed that the strain isolated from the atomizers had high survival abilities in biofilm conditions and remained resistant to DMA after short contact periods. The use of disinfectant atomizers associated with the survival of Achromobacter in the atomizer pipes may explain the contamination and colonization of the CVC. Control measures (non-atomizer containers and use of sterile water) allowed the eradication of the source and the outbreak control. Copyright © 2014. Published by Elsevier Ltd.

  19. Early warning score: a dynamic marker of severity and prognosis in patients with Gram-negative bacteraemia and sepsis.

    PubMed

    Albur, Mahableshwar; Hamilton, Fergus; MacGowan, Alasdair P

    2016-04-12

    Early Warning Score (EWS) is a physiological composite score of six bedside vital parameters, routinely used in UK hospitals. We evaluated the prognostic ability of EWS in Gram-negative bacteraemia causing sepsis. We prospectively evaluated EWS as a marker of severity and prognosis in adult patients with Gram-negative bacteraemia. All adult patients with Gram-negative bacteraemia admitted to our tertiary Teaching hospital of the National Health Service in England were enrolled over 1 year period. The highest daily EWS score was recorded from 7 days before to 14 days after the date of onset of bacteraemia. The primary outcome was 28-day mortality. A total of 245 consecutive adult patients with Gram-negative bacteraemia with sepsis were enrolled. On multivariate analysis, following variables were associated with death for every single unit change (odds ratio in the brackets): higher age (1.05), lower mean arterial pressure (1.03), lower serum bicarbonate (1.08), higher EWS (1.27), higher SOFA score (1.36), hospital-onset of infection (5.43) and need for vasopressor agents (16.4). EWS on day 0, 1, 2, and average 14-day score were significantly higher in patients who died by 28 days from the onset of bacteraemia [95 % CI 0.4-0.6] p < 0.001. A stepwise rise in EWS and failure of improvement in EWS by 2 points 48 h after the onset of bacteraemia were associated with poor outcome. EWS is a simple and cost-effective bedside tool for the assessment of severity and prognosis of sepsis caused by Gram-negative bacteraemia.

  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. Obesity and smoking are factors associated with poor prognosis in patients with bacteraemia

    PubMed Central

    Huttunen, Reetta; Laine, Janne; Lumio, Jukka; Vuento, Risto; Syrjänen, Jaana

    2007-01-01

    Background Bacteraemia is still a major cause of case fatality in all age groups. Our aim was to identify the major underlying conditions constituting risk factors for case fatality in bacteraemia patients. Methods The study involved 149 patients (79 male and 70 female) with bacteraemia caused by Staphylococcus aureus (S. aureus) (41 patients), Streptococcus pneumoniae (Str. pneumoniae) (42 patients), β-hemolytic streptococcae (β-hml str.) (23 patients) and Eschericia coli (E. coli) (43 patients). Underlying diseases, alcohol and tobacco consumption and body mass index (BMI) were registered. Laboratory findings and clinical data were registered on admission and 6 consecutive days and on day 10–14. Case fatality was studied within 30 days after positive blood culture. Associations between underlying conditions and case fatality were studied in univariate analysis and in a multivariate model. Results Nineteen patients (12.8%) died of bacteraemia. We found obesity (p = 0.002, RR 9.8; 95% CI 2.3 to 41.3), smoking (p < 0.001, RR 16.9; 95% CI 2.1 to 133.5), alcohol abuse (p = 0.008, RR 3.9; 95% CI 1.3 to 11.28), COPD (p = 0.01, RR 8.4; 95% CI 1.9 to 37.1) and rheumatoid arthritis (p = 0.045, RR 5.9; 95% CI 1.2 to 28.8) to be significantly associated with case fatality in bacteraemia in univariate model. The median BMI was significantly higher among those who died compared to survivors (33 vs. 26, p = 0.003). Obesity and smoking also remained independent risk factors for case fatality when their effect was studied together in a multivariate model adjusted with the effect of alcohol abuse, age (continuos variable), sex and causative organism. Conclusion Our results indicate that obesity and smoking are prominent risk factors for case fatality in bacteraemic patients. Identification of risk factors underlying fatal outcome in bacteraemia may allow targeting of preventive efforts to individuals likely to derive greatest potential benefit. PMID:17349033

  2. Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients.

    PubMed

    Cuervo, Guillermo; Camoez, Mariana; Shaw, Evelyn; Dominguez, María Ángeles; Gasch, Oriol; Padilla, Belén; Pintado, Vicente; Almirante, Benito; Molina, José; López-Medrano, Francisco; Ruiz de Gopegui, Enrique; Martinez, José A; Bereciartua, Elena; Rodriguez-Lopez, Fernando; Fernandez-Mazarrasa, Carlos; Goenaga, Miguel Ángel; Benito, Natividad; Rodriguez-Baño, Jesús; Espejo, Elena; Pujol, Miquel

    2015-10-30

    The aim of the study was to determine clinical and microbiological differences between patients with methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia (CRB) undergoing or not undergoing haemodialysis, and to compare outcomes. Prospective multicentre study conducted at 21 Spanish hospitals of patients with MRSA bacteraemia diagnosed between June 2008 and December 2009. Patients with MRSA-CRB were selected. Data of patients on haemodialysis (HD-CRB) and those not on haemodialysis (non-HD-CRB) were compared. Among 579 episodes of MRSA bacteraemia, 218 (37.7%) were CRB. Thirty-four (15.6%) were HD-CRB and 184 (84.4%) non-HD-CRB. All HD-CRB patients acquired the infection at dialysis centres, while in 85.3% of the non-HD-CRB group the infection was nosocomial (p < .001). There were no differences in age, gender or severity of bacteraemia (Pitt score); comorbidities (Charlson score ≥ 4) were higher in the HD-CRB group than in the non-HD-CRB group (73.5% vs. 46.2%, p = .003). Although there were no differences in VAN-MIC ≥ 1.5 mg/L according to microdilution, using the E-test a higher rate of VAN-MIC ≥ 1.5 mg/L was observed in HD-CRB than in non-HD-CRB patients (63.3% vs. 44.1%, p = .051). Vancomycin was more frequently administered in the HD-CRB group than in the non-HD-CRB group (82.3% vs. 42.4%, p = <.001) and therefore the appropriate empirical therapy was significantly higher in HD-CRB group (91.2% vs. 73.9%, p = .029). There were no differences with regard to catheter removal (79.4% vs. 84.2%, p = .555, respectively). No significant differences in mortality rate were observed between both groups (Overall mortality: 11.8% vs. 27.2%, p = .081, respectively), but there was a trend towards a higher recurrence rate in HD-CRB group (8.8% vs. 2.2%, p = .076). In our multicentre study, ambulatory patients in chronic haemodialysis represented a significant proportion of cases of MRSA catheter-related bacteraemia. Although

  3. Functional status and quality of life after community-acquired bacteraemia: a matched cohort study.

    PubMed

    Dalager-Pedersen, M; Thomsen, R W; Schønheyder, H C; Nielsen, H

    2016-01-01

    Severe bacterial infections may have a prolonged negative effect on subsequent functional status and health-related quality of life. We studied hospitalized patients for changes in functional status and quality of life within 1 year of community-acquired bacteraemia in comparison to blood-culture-negative controls. In a prospectively conducted matched cohort study at Aalborg University Hospital, north Denmark, during 2011-2014, we included 71 medical inpatients with first-time community-acquired bacteraemia. For each bacteraemia patient, we matched one blood-culture-negative inpatient control on age and gender. Functional status and quality of life before and after hospitalization were assessed by Barthel-20 and EuroQol-5D questionnaires. We computed the 3-month and 1-year risk for any deterioration in Barthel-20 score and EuroQol-5D index score, and for a deterioration of ≥10 points in EuroQol-5D visual analogue scale score, and used regression analyses to assess adjusted risk ratios (RR) with 95% CIs. Compared with controls, bacteraemia was associated with an increased 3-month risk for deterioration in functional status as assessed by Barthel-20 score (14% versus 3% with deterioration, adjusted RR 5.1; 95% CI 1.2-22.3). The difference was less after 1 year (11% versus 7% with deterioration, adjusted RR 1.6; 95% CI 0.5-4.5). After 3 months, quality of life had become worse in 37% of bacteraemia patients and 28% of controls by EuroQol-5D index score (adjusted RR 1.3; 95% CI 0.8-2.1), with similar findings after 1 year and by visual analogue scale. In conclusion, community-acquired bacteraemia is associated with increased risk for subsequent deterioration in functional status compared with blood-culture-negative controls, and with a high risk for deterioration in quality of life. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  4. A Prognostic Model for One-year Mortality in Patients Requiring Prolonged Mechanical Ventilation

    PubMed Central

    Carson, Shannon S.; Garrett, Joanne; Hanson, Laura C.; Lanier, Joyce; Govert, Joe; Brake, Mary C.; Landucci, Dante L.; Cox, Christopher E.; Carey, Timothy S.

    2009-01-01

    Objective A measure that identifies patients who are at high risk of mortality after prolonged ventilation will help physicians communicate prognosis to patients or surrogate decision-makers. Our objective was to develop and validate a prognostic model for 1-year mortality in patients ventilated for 21 days or more. Design Prospective cohort study. Setting University-based tertiary care hospital Patients 300 consecutive medical, surgical, and trauma patients requiring mechanical ventilation for at least 21 days were prospectively enrolled. Measurements and Main Results Predictive variables were measured on day 21 of ventilation for the first 200 patients and entered into logistic regression models with 1-year and 3-month mortality as outcomes. Final models were validated using data from 100 subsequent patients. One-year mortality was 51% in the development set and 58% in the validation set. Independent predictors of mortality included requirement for vasopressors, hemodialysis, platelet count ≤150 ×109/L, and age ≥50. Areas under the ROC curve for the development model and validation model were 0.82 (se 0.03) and 0.82 (se 0.05) respectively. The model had sensitivity of 0.42 (se 0.12) and specificity of 0.99 (se 0.01) for identifying patients who had ≥90% risk of death at 1 year. Observed mortality was highly consistent with both 3- and 12-month predicted mortality. These four predictive variables can be used in a simple prognostic score that clearly identifies low risk patients (no risk factors, 15% mortality) and high risk patients (3 or 4 risk factors, 97% mortality). Conclusions Simple clinical variables measured on day 21 of mechanical ventilation can identify patients at highest and lowest risk of death from prolonged ventilation. PMID:18552692

  5. Is comorbid status the best predictor of one-year mortality in patients with severe sepsis and sepsis with shock?

    PubMed

    Huddle, N; Arendts, G; Macdonald, S P J; Fatovich, D M; Brown, S G A

    2013-07-01

    Understanding longer term outcomes in critically ill patients will assist treatment decisions, allocation of scarce resources and clinical research in that population. The aim of this study was to compare a well-validated means of determining comorbidity, the Charlson Comorbidity Score, to other verified risk stratification models in predicting one-year mortality and other outcomes in emergency department patients with severe sepsis and sepsis with shock. We conducted a planned subgroup analysis of a prospective observational study, the Critical Illness and Shock Study, in adult patients with sepsis meeting study criteria for critical illness. From emergency department arrival, patients were prospectively enrolled with data collected for a minimum of one year post-enrolment. Scoring systems were derived from this data and compared using receiver-operating characteristic curves. One hundred and four patients were enrolled. The 28-day mortality was 18% and one-year mortality 40%. For predicting one-year mortality, the area under the receiver-operating characteristic curve for age-weighted Charlson Comorbidity Score (0.71, 95% confidence interval 0.61 to 0.81) was at least as good or superior to other scoring systems analysed. The intensive care unit admission rate was 45% and the median hospital length-of-stay was eight days. We conclude that in patients who present to the emergency department with severe sepsis or sepsis with shock, age-weighted Charlson Comorbidity Score is a predictor of one-year mortality that is simple to calculate and at least as accurate as other validated scoring systems.

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

    PubMed Central

    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

  7. Non-O1, non-O139 Vibrio cholerae bacteraemia in an Australian population.

    PubMed

    Trubiano, J A; Lee, J Y H; Valcanis, M; Gregory, J; Sutton, B A; Holmes, N E

    2014-05-01

    This retrospective case series identifies the largest cohort of non-O1, non-O139 Vibrio cholerae bacteraemia in an Australian population from 2000 to 2013. We examine the risk factors, epidemiology, clinical presentations and mortality of non-O1, non-O139 V. cholerae bacteraemia in Victoria and compare them with published cases in the literature. This case series highlights the pathogenic potential of non-O1, non-O139 V. cholerae and identifies possible associations with host (underlying chronic liver disease and malignancy) and environmental factors (contaminated water supply and raw seafood). Clinicians should be aware of the morbidity and mortality associated with invasive non-O1, non-O139 V. cholerae infections, particularly in immunocompromised patients. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

  8. Vancomycin minimum inhibitory concentration, host comorbidities and mortality in Staphylococcus aureus bacteraemia.

    PubMed

    Holmes, N E; Turnidge, J D; Munckhof, W J; Robinson, J O; Korman, T M; O'Sullivan, M V N; Anderson, T L; Roberts, S A; Warren, S J C; Gao, W; Johnson, P D R; Howden, B P

    2013-12-01

    We reported an association between elevated vancomycin MIC and 30-day mortality in patients with Staphylococcus aureus bacteraemia (SAB), including patients with methicillin-susceptible S. aureus (MSSA) treated with flucloxacillin. A detailed analysis of comorbidities and disease severity scores in the same cohort of patients was performed to ascertain if unknown clinical parameters may have influenced these results. The association between elevated vancomycin MIC and 30-day mortality in SAB remained significant (p 0.001) on multivariable logistic regression analysis even when accounting for clinical factors. In addition, the association persisted when restricting analysis to patients with MSSA bacteraemia treated with flucloxacillin. This suggests that elevated vancomycin MIC is associated with but not causally linked to an organism factor that is responsible for increased mortality.

  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... 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 § 4...

  10. 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 § 4...

  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... 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 § 4...

  12. 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... 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 § 4...

  13. The Difference That One Year of Schooling Makes for Russian Schoolchildren. Based on PISA 2009: Reading

    ERIC Educational Resources Information Center

    Tiumeneva, Yu. A.; Kuzmina, Ju. V.

    2015-01-01

    The PISA 2009 data (in reading) investigated the effectiveness of one year of schooling in seven countries: Russia, Czech Republic, Hungary, Slovakia, Germany, Canada, and Brazil. We used an instrumental variable, which allowed us to estimate the effect of one year of schooling through the fuzzy method of regression discontinuity. The analysis was…

  14. 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…

  15. 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…

  16. 28 CFR 58.29 - Renewal for an additional one year period.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Renewal for an additional one year period. 58.29 Section 58.29 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) REGULATIONS RELATING TO THE BANKRUPTCY REFORM ACTS OF 1978 AND 1994 § 58.29 Renewal for an additional one year period. If an...

  17. 28 CFR 58.16 - Renewal for an additional one year period.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Renewal for an additional one year period. 58.16 Section 58.16 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) REGULATIONS RELATING TO THE BANKRUPTCY REFORM ACTS OF 1978 AND 1994 § 58.16 Renewal for an additional one year period. If an...

  18. Improved quality of life over one year is associated with improved adherence in patients with schizophrenia.

    PubMed

    Hayhurst, K P; Drake, R J; Massie, J A; Dunn, G; Barnes, T R E; Jones, P B; Lewis, S W

    2014-03-01

    Quality of life (QoL) is increasingly considered an important outcome in health research. We wished to explore the determinants of change in QoL in patients with schizophrenia over the course of a one-year RCT. Predictors of change in observer-rated QoL (Quality of Life Scale: QLS) were assessed in 363 patients with schizophrenia during the CUtLASS clinical trial. Change in QLS score over the course of a year correlated with change in psychotic and depressive symptoms and treatment adherence. Linear regression showed that improvement in QoL was predicted by reduction in negative and depressive symptoms and improvement in adherence rating. These three change scores together explained 38% of the variance in QLS change. Exploration of the direction of any possible causal effect, using TETRAD, indicated that improved adherence leads to improved QoL, and that change in depression also leads to QoL change. The relationship between QoL and negative symptoms suggests that greater social activity (reflected as better QoL scores) improves negative symptoms. Such a direct relationship between treatment adherence and QoL has not been reported before. Improving adherence to medication would appear to be a key approach to improving measured quality of life in people with schizophrenia. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  19. One-year evaluation of cognitive-behavioral intervention in osteoarthritis.

    PubMed

    Calfas, K J; Kaplan, R M; Ingram, R E

    1992-12-01

    We compared a cognitive-behavior modification and a traditional education intervention for adults with osteoarthritis (OA). Forty OA patients were randomly assigned to one of two groups: cognitive-behavior modification or didactic lectures. During ten weekly sessions, the cognitive-behavior group learned methods for coping with pain and the disabilities associated with OA. The traditional education group experienced a series of lectures from health care professionals. Prior to the interventions and following 2, 6, and 12 months, patients in both groups were evaluated with a general Quality of Well-being (QWB) scale, the Arthritis Impact Measurement Scales (AIMS), the Beck Depression Inventory (BDI), and other measures. Although there were some differences between the two groups at 2-month follow-up, by the end of 1 year, physical and psychological functioning did not differ significantly between the two groups. In comparison to baseline, both groups demonstrated initial changes on QWB, depression, and the pain component of the AIMS. Improvements in depression remained through the 1-year follow-up. Multiple regression analysis demonstrated that the mobility and physical activity aspects of the AIMS were significant long-term predictors of outcome (1 year) for general quality-of-life measures. One-year outcomes for depression were significantly predicted from scores on social support and mobility measures from the AIMS. We conclude that cognitive-behavior modification and education produce similar effects on long-term physical and psychological functioning in OA patients.

  20. Prognostic factors and impact of antibiotherapy in 117 cases of anaerobic bacteraemia.

    PubMed

    Robert, R; Deraignac, A; Le Moal, G; Ragot, S; Grollier, G

    2008-08-01

    Bacteraemia due to anaerobic bacteria occurs infrequently, making the systematic use of an anaerobic blood sample bottle in patients with sepsis controversial. We retrospectively reviewed the clinical and microbiological data from all cases of anaerobic bacteraemia in a teaching hospital over 2 years and determined the prognostic factors and antibiotic management. With the goal of evaluating the morbidity and mortality of bacteraemia due to anaerobic bacteria, a case-control study was also performed. One hundred eighty-four blood cultures from 125 patients grew at least one anaerobic bacterium, representing 0.5% of all and 7.0% of the positive blood cultures. One hundred seventeen patients were studied. In 24 cases, anaerobic blood cultures were associated with concomitant aerobic bacteria isolation. The most frequently isolated anaerobic species were Bacteroides sp. (n = 62), Clostridium sp. (n = 25), and Fusobacterium sp. (n = 12). The most frequent site of origin was the digestive tract (n = 61). In 51 cases, patients did not receive adequate empirical antianaerobic therapy. The mortality rate was 27%. Age [odds ratio (OR) 1.059; 95% confidence interval (CI) 1.021-1.100], cancer history (OR 3.21, 95% CI 1.126-9.156), and ineffective definitive antibiotherapy (OR 19.292, 95% CI 5.330-69.832) were independently associated with increased hospital mortality. The 72 patients that could be matched with patients without anaerobic bacteria according to their primary diagnosis had a longer hospitalisation and a trend toward increased mortality (P = 0.08). Anaerobic bacteraemia contributed significantly to the morbidity of the patients, and adequate empirical antibiotherapy may play an important role in the clinical outcomes.

  1. Streptococcus bovis bacteraemia revisited: clinical and microbiological correlates in a contemporary series of 59 patients.

    PubMed

    Fernández-Ruiz, Mario; Villar-Silva, Julia; Llenas-García, Jara; Caurcel-Díaz, Luis; Vila-Santos, Juan; Sanz-Sanz, Francisca; Chaves, Fernando; Guerra-Vales, Juan Manuel

    2010-10-01

    To characterise the clinical features, associations and outcome in a contemporary series of patients with Streptococcus bovis bacteraemia (SBB). Retrospective analysis of all episodes of SBB at the University Hospital 12 de Octubre (Madrid, Spain) between January 1997 and November 2008 was performed. Patient data were reviewed, focusing on clinical and microbiological associations with the different biotypes of S. bovis. Fifty-nine episodes of SBB were documented in 59 adult patients (30 males; mean age: 70.9 ± 15.0 years). Chronic liver disease was identified in 20 patients (33.9%). Sixteen patients (27.1%) presented infective endocarditis (IE) and 14 (23.7%) had a biliary source of bacteraemia. Thirty-three patients (55.9%) underwent colonic evaluation, adenomatous polyps being the most common finding (21 patients). Malignancy was diagnosed following SBB in 9 cases, including 6 patients with colorectal carcinoma (18.2% of those who underwent colonic evaluation). Of 22 isolates biotyped, 12 were S. bovis biotype I and 10 were S. bovis biotype II. IE was more frequent among patients with S. bovis biotype I (P =0.010), whereas bacteraemia due to biotype II species was more likely to be of biliary origin (P=0.078). S. bovis biotyping identifies some clinically relevant associations. Copyright © 2010 The British Infection Society. Published by Elsevier Ltd. All rights reserved.

  2. Variability of treatment duration for bacteraemia in the critically ill: a multinational survey.

    PubMed

    Corona, Alberto; Bertolini, Guido; Ricotta, Anna Maria; Wilson, A Peter R; Singer, Mervyn; Wilson, A J Peter

    2003-11-01

    No definitive evidence is available to inform 'best' antibiotic practice for treating bacteraemia in the critically ill patient, either in terms of duration of therapy, or the use of mono- versus combination therapy. We therefore undertook a large-scale international survey to assess the variability of current practice. A questionnaire was sent to membership lists of national and international intensive care societies. Responses from 254 intensive care units in 34 countries revealed a wide variation in antibiotic strategy for all types of bacteraemia, ranging from short course (or=10 days) use of broad-spectrum combinations. Two factors were significantly associated with antibiotic prescribing practice, namely the country of origin (in those with >or=10 responders) and the level of microbiologist and/or infectious diseases specialist input. The greater the specialist input, the shorter the duration of therapy (P < 0.0001). The wide variability in antibiotic prescribing patterns suggests an urgent need to produce high-quality evidence to identify optimal antibiotic prescribing policies for bacteraemia in the critically ill patient.

  3. Non-typhoidal salmonella bacteraemia--an under-recognized feature of AIDS in African adults.

    PubMed

    Kankwatira, Anstead M; Mwafulirwa, Gershom A K; Gordon, Melita A

    2004-10-01

    Non-typhoidal salmonella (NTS) infections are severe, invasive and recurrent in the HIV-infected adult, and NTS are the commonest cause of hospital admission with bacteraemia in sub-Saharan Africa. NTS bacteraemia typically presents in patients with HIV/AIDS once the CD4 count falls below 200 cells/microL. In-patient mortality is 35%-60%, and is highest in patients with confusion or severe anaemia. Among survivors, 25%-45% may have single or multiple recurrences of NTS bacteraemia 1-6 months after the first illness, requiring retreatment. Diagnosis relies on blood culture, so in many areas this disease cannot be definitively diagnosed, and must be empirically treated. Treatment is guided by local antibiotic sensitivities; fluoroquinolones are particularly useful for initial treatment if there is multidrug reistance to other agents, and may result in lower recurrence rates than other agents. Where possible, long-term secondary chemoprophylaxis to prevent recurrence is advisable. Successful ARV treatment also prevents recurrence. There is inadequate knowledge about the epidemiology of carriage and transmission among at-risk populations.

  4. The association between malaria and non-typhoid Salmonella bacteraemia in children in sub-Saharan Africa: a literature review.

    PubMed

    Takem, Ebako Ndip; Roca, Anna; Cunnington, Aubrey

    2014-10-13

    Plasmodium falciparum malaria and non-typhoid Salmonella (NTS) bacteraemia are both major causes of morbidity and mortality in children in sub-Saharan Africa. Co-infections are expected to occur because of their overlapping geographical distribution, but accumulating evidence indicates that malaria is a risk factor for NTS bacteraemia. A literature review was undertaken to provide an overview of the evidence available for this association, the epidemiology of malaria-NTS co-infection (including the highest risk groups), the underlying mechanisms, and the clinical consequences of this association, in children in sub-Saharan Africa. The burden of malaria-NTS co-infection is highest in young children (especially those less than three years old). Malaria is one of the risk factors for NTS bacteraemia in children, and the risk is higher with severe malaria, especially severe malarial anaemia. There is insufficient evidence to determine whether asymptomatic parasitaemia is a risk factor for NTS bacteraemia. Many mechanisms have been proposed to explain how malaria causes susceptibility to NTS, ranging from macrophage dysfunction to increased gut permeability, but the most consistent evidence is that malarial haemolysis creates conditions which favour bacterial growth, by increasing iron availability and by impairing neutrophil function. Few discriminatory clinical features have been described for those with malaria and NTS co-infection, except for a higher risk of anaemia compared to those with either infection alone. Children with malaria and NTS bacteraemia co-infection have higher case fatality rates compared to those with malaria alone, and similar to those with bacteraemia alone. Antimicrobial resistance is becoming widespread in invasive NTS serotypes, making empirical treatment problematic, and increasing the need for prevention measures. Observational studies indicate that interventions to reduce malaria transmission might also have a substantial impact on

  5. Streptococcus pneumoniae bacteraemia due to parotitis in a patient with systemic sclerosis and secondary Sjögren's syndrome.

    PubMed

    Yii, Irene Yuen Lin; Tan, Jamie Bee Xian; Fong, Warren Weng Seng

    2016-10-01

    Invasive pneumococcal disease is an uncommon and notifiable disease in Singapore. It is often associated with significant morbidity and mortality. We report a rare case of invasive pneumococcal bacteraemia due to parotitis in a patient with systemic sclerosis and secondary Sjögren's syndrome. We also present a retrospective review of Streptococcus pneumoniae bacteraemia cases in Singapore General Hospital from January 2011 to April 2016. A 59-year-old Malay lady with a history of systemic sclerosis with secondary Sjögren's syndrome presented with fever and left parotid gland swelling. Clinical examination revealed poor salivary pooling and left parotid swelling without fluctuance. Ultrasound of the left parotid gland confirmed acute parotitis without evidence of abscess or sialolithiasis. Blood cultures were positive for S. pneumoniae. She was diagnosed to have invasive pneumococcal bacteraemia secondary to acute parotitis, and treated with intravenous benzylpenicillin with clearance of bacteraemia after 3 days. Upon discharge, her antibiotics were changed to intravenous ceftriaxone to facilitate outpatient parenteral antibiotic therapy for another 2 weeks. She responded favourably to antibiotics at follow-up, with no complications from the bacteraemia. A review of the microbiological records of the Singapore General Hospital revealed 116 cases of pneumococcal bacteraemia, most (80.3 %) of which were due to pneumonia. None were due to parotitis. S. pneumoniae parotitis and subsequent bacteraemia is rare. Prompt recognition of the disease and appropriate use of antibiotics are important. This case highlights that close communication between healthcare workers (microbiologist, rheumatologist and infectious disease specialist) is essential in ensuring good clinical outcomes in patients with a potentially fatal disease.

  6. Streptococcus pneumoniae bacteraemia due to parotitis in a patient with systemic sclerosis and secondary Sjögren’s syndrome

    PubMed Central

    Tan, Jamie Bee Xian; Fong, Warren Weng Seng

    2016-01-01

    Introduction: Invasive pneumococcal disease is an uncommon and notifiable disease in Singapore. It is often associated with significant morbidity and mortality. We report a rare case of invasive pneumococcal bacteraemia due to parotitis in a patient with systemic sclerosis and secondary Sjögren’s syndrome. We also present a retrospective review of Streptococcus pneumoniae bacteraemia cases in Singapore General Hospital from January 2011 to April 2016. Case presentation: A 59-year-old Malay lady with a history of systemic sclerosis with secondary Sjögren’s syndrome presented with fever and left parotid gland swelling. Clinical examination revealed poor salivary pooling and left parotid swelling without fluctuance. Ultrasound of the left parotid gland confirmed acute parotitis without evidence of abscess or sialolithiasis. Blood cultures were positive for S. pneumoniae. She was diagnosed to have invasive pneumococcal bacteraemia secondary to acute parotitis, and treated with intravenous benzylpenicillin with clearance of bacteraemia after 3 days. Upon discharge, her antibiotics were changed to intravenous ceftriaxone to facilitate outpatient parenteral antibiotic therapy for another 2 weeks. She responded favourably to antibiotics at follow-up, with no complications from the bacteraemia. A review of the microbiological records of the Singapore General Hospital revealed 116 cases of pneumococcal bacteraemia, most (80.3 %) of which were due to pneumonia. None were due to parotitis. Conclusion: S. pneumoniae parotitis and subsequent bacteraemia is rare. Prompt recognition of the disease and appropriate use of antibiotics are important. This case highlights that close communication between healthcare workers (microbiologist, rheumatologist and infectious disease specialist) is essential in ensuring good clinical outcomes in patients with a potentially fatal disease. PMID:28348790

  7. Glomerular diseases outcome at one year in a tertiary care centre

    PubMed Central

    Mahmud, Huma Mamun; Kumar, Darshan; Irum, Humera; Farman Ali, Syed

    2015-01-01

    Objectives: To determine outcome in primary and secondary glomerular diseases at one year follow up. Methods: Study design is observational cohort, done in out-patient department, Dow Iinternational Medical College, DUHS. All information gathered on a proforma. All patients with dipstick positive proteinuria and clinical glomerular disease were included in study. Patients with no proteinuria were excluded so were patients with stage 5 CKD. Patients were followed for proteinuria and renal insufficiency at completion of one year follow up. Statistical analysis was done on SPSS version 16. Result: Total number of patients who completed one year follow up was 173. Mean age of patients was 51.67+ 10.16 (range 15 to 75 years). Ninety two (53.2%), were males and 81(46.8%) were females, ratio being 1.1: 1.0. Mean weight of our patients was 67.43+ 14.13 Kg, (35 to 107 kg). Commonest cause of glomerular disease in our patient was diabetic nephropathy which was seen in 94.2% patients. Commonest associated problem with glomerular disease was hypertension seen in 66.5% of patients. Four out of 173 patients had stage 5 CKD at end of follow up at one year while quantitativ proteinuria remained same at one year follow up. Conclusion: One year follow up is critical for patients with glomerular disease associated with stage 4 CKD as progression to end stage renal failure may be seen within one year in these patients. PMID:26101512

  8. 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

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

    PubMed Central

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

    2016-01-01

    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

  10. 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.

  11. 10 to 1: Bugs Win in NASA Study, One-Year Mission Video Miniseries Highlights Microbes

    NASA Image and Video Library

    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...

  12. Completion of One Year Bioventing Test, Jet Fuel Storage Tank #20, Randolph AFB, TX

    DTIC Science & Technology

    2007-11-02

    the contractor from collecting the soil samples after the bioventing system had been operating one year. Soil gas sampling results showed a three order of magnitude reduction in TVH at MPA-6 and MPC-6.

  13. Association between Hypoalbuminaemia and Mortality in Patients with Community-Acquired Bacteraemia Is Primarily Related to Acute Disorders

    PubMed Central

    Magnussen, Bjarne; Oren Gradel, Kim; Gorm Jensen, Thøger; Kolmos, Hans Jørn; Pedersen, Court; Just Vinholt, Pernille; Touborg Lassen, Annmarie

    2016-01-01

    We sought to investigate whether hypoalbuminaemia was mainly caused by acute or chronic factors in patients with community-acquired bacteraemia. In this population-based study, we considered 1844 adult cases of community-acquired bacteraemia that occurred in Funen, Denmark between 2000 and 2008. We used a stepwise prognostic predisposition-insult-response-organ dysfunction (PIRO) logistic regression model by initially including age and comorbidity, then added bacterial species, and finally sepsis severity. The models were furthermore analysed using receiver operating characteristic (ROC) curves. Outcomes comprised mortality incidence on days 0–30 and 31–365 after the bacteraemia episode. Each step was performed with and without baseline albumin level measured on the date of bacteraemia. In 422 patients, their latest albumin measurement taken 8–30 days before the date of bacteraemia was also used in the analysis together with the baseline albumin level. For each decrease of 1g/L in plasma albumin level, the odds ratios (95% confidence intervals) of mortality in the period of 0–30 days after bacteraemia were 0.86 (0.84–0.88) in both predisposition (P) and predisposition-insult (PI) models and 0.87 (0.85–0.89) in the full PIRO-model. The AUC values were 0.78 and 0.66 for mortality in the period of 0–30 days in the model comprising only predisposition factors with and without albumin levels added as a factor, respectively. The AUC values in the full PIRO-model were 0.81 and 0.73 with and without consideration of albumin levels, respectively. A higher proportion of patients died within 30 days if there was a decrease in the albumin level between days 8 and 30 before bacteraemia and the actual bacteraemia date. A single plasma albumin measurement on the bacteraemia date was a better prognostic predictor of short-term mortality than the sepsis severity score. PMID:27611431

  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. 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.

  16. The social origins of sustained attention in one-year-old human infants

    PubMed Central

    Yu, Chen; Smith, Linda B.

    2016-01-01

    Summary 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 word 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

  17. One-Year Course and Effects of Insomnia in Rural Chinese Adolescents

    PubMed Central

    Luo, Chunliu; Zhang, Jihui; Pan, Jiyang

    2013-01-01

    ; Zhang J; Pan J. One-year course and effects of insomnia in rural Chinese adolescents. SLEEP 2013;36(3):377-384. PMID:23450433

  18. 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.

  19. Clostridium perfringens bacteraemia, an analysis of 28 cases over 10 years in a university hospital of Madrid.

    PubMed

    Lopez-Fabal, M ª Fátima; Sanz, Nuria; Ruiz-Bastian, Mario; Barros, Carlos; Gomez-Garces, Jose-Luis

    2017-03-31

    Bacteraemia caused by anaerobic bacteria is rare in the hospital setting. The Clostridium genus is the second most common cause of these infections, particularly Clostridium perfringens, which has a high mortality rate. However, reviews in the literature of these infections are scarce. The aim of this study was to retrospectively document the incidence, clinical characteristics and risk factors involved in the acquisition of bacteraemia caused by C. perfringens among patients treated at our hospital over a 10-year period. Twenty-eight patients with C. perfringens bacteraemia were included in the study. We evaluated pre-existing comorbidities, the source of bacteraemia, clinical features, the antimicrobial treatment administered and patient outcome. C. perfringens bacteraemia occurs rarely in our setting, but with a very high mortality rate. This rate is associated with old age and pre-existing, largely gastrointestinal malignancies. It presents with few specific symptoms but requires rapid and appropriate diagnosis and treatment to reduce the high mortality of this infection. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  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. Impact of the MIC of piperacillin/tazobactam on the outcome for patients with bacteraemia due to Enterobacteriaceae: the Bacteraemia-MIC project.

    PubMed

    Delgado-Valverde, Mercedes; Torres, Eva; Valiente-Mendez, Adoración; Almirante, Benito; Gómez-Zorrilla, Silvia; Borrell, Núria; Corzo, Juan E; Gurgui, Mercedes; Almela, Manuel; García-Álvarez, Lara; Fontecoba-Sánchez, María Cruz; Martínez-Martínez, Luis; Cantón, Rafael; Praena, Julia; Causse, Manuel; Gutiérrez-Gutiérrez, Belén; Roberts, Jason A; Farkas, Andras; Pascual, Álvaro; Rodríguez-Baño, Jesús

    2016-02-01

    Our objective was to evaluate the impact of low versus borderline MIC of piperacillin/tazobactam on the clinical outcomes of patients with bacteraemia caused by Enterobacteriaceae who were treated with that antimicrobial. A prospective observational multicentre cohort study was conducted in 13 Spanish university hospitals. Patients >17 years old with bacteraemia due to Enterobacteriaceae who received empirical piperacillin/tazobactam treatment for at least 48 h were included. Outcome variables were clinical response at day 21, clinical response at end of treatment with piperacillin/tazobactam and all-cause 30 day mortality. Univariate and multivariate logistic regression analyses were performed. Overall, 275 patients were included in the analysis; 248 (90.2%) in the low MIC group (≤ 4 mg/L) and 27 (9.8%) in the borderline MIC group (8-16 mg/L). The biliary tract was the most common source of infection (48.4%) and Escherichia coli was the most frequent pathogen (63.3%). Crude 30 day mortality rates were 10.5% and 11.1% for the low MIC group and the borderline MIC group, respectively (relative risk = 1.06, 95% CI = 0.34-3.27, P = 1). Multivariate analysis of failure at day 21 and at end of treatment with piperacillin/tazobactam and 30 day mortality showed no trend towards increased clinical failure or mortality with borderline MICs (OR = 0.96, 95% CI = 0.18-4.88, P = 0.96; OR = 0.47, 95% CI = 0.10-2.26, P = 0.35; OR = 1.48, 95% CI = 0.33-6.68, P = 0.6). We did not find that higher piperacillin/tazobactam MIC within the susceptible or intermediate susceptibility range had a significant influence on the outcome for patients with bacteraemia due to Enterobacteriaceae. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. The Impact of Sleep Complaints on Physical Health and Immune Outcomes in Rescue Workers: A One-Year Prospective Study

    PubMed Central

    Irish, Leah A.; Dougall, Angela L.; Delahanty, Douglas L.; Hall, Martica

    2014-01-01

    Objectives The present study examined the extent to which sleep assessed soon after a trauma predicted subsequent physical health and immune functioning in rescue workers. Methods Participants included 159 men and women who performed rescue and clean-up operations at the site of a major airplane crash. One hundred twenty-eight participants were retained for a one-year follow-up. Self-report measures of sleep quality and psychological distress were obtained within 2 months of the crash, and a physical health questionnaire was completed at one-year follow-up. Natural killer (NK) cell number and cytotoxicity were assessed using blood samples collected from a subset of participants (n=51) at the one-year follow-up. Results After adjusting for gender, age, BMI, and initial distress, initial sleep quality complaints were associated with more physical symptoms (β=.32, p<.001), poorer perceived health (β= −.27, p=.009), and increased health care utilization (β=.31, p=.003) at follow-up. In contrast, initial sleep quality was not associated with NK cell number (r=.10, p=.55) or activity (r=.02, p=.90). Change in sleep quality over the year following the crash was not a significant predictor of health or immune outcomes. Conclusions These data suggest that poor sleep quality in the aftermath of trauma signals increased risk for future adverse physical health outcomes, and underscore the importance of addressing sleep complaints soon after trauma to mitigate the negative impact on physical health. PMID:23324875

  3. 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

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

    PubMed

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

    2016-01-01

    To determine whether the initial characteristics of individual patterns of peripheral refraction relate to subsequent changes in refraction over a one-year period. 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. 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. No evidence was found to support the hypothesis that the pattern of RPRE is predictive of subsequent refractive change in this age group. Copyright © 2015 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  5. Lesson of the month 1: Spontaneous septic thrombophlebitis presenting with bacteraemia diagnosed by PET-CT scan.

    PubMed

    Harnett, Patrick; Jain, Shaifali

    2017-10-01

    Spontaneous septic thrombophlebitis is a rare complication of Staphylococcus aureus bacteraemia. Its true incidence is unknown as septic thrombus is not often considered as a source in the typical 'screen' of tests used to find the source of a bacteraemia.Positron emission tomography computerised tomography (PET-CT) is becoming increasingly available to physicians, is highly sensitive and yields specific anatomical information regarding abnormal metabolically active sites in infection, inflammation and neoplasia.In this case, PET-CT enabled the identification of the source of a septic thrombus and enabled focused management. PET-CT should be considered as part of the raft of tests used to identify an obscure source of fever/bacteraemia. © Royal College of Physicians 2017. All rights reserved.

  6. [Pityriasis versicolor in infants under one year of age. A report of 92 cases].

    PubMed

    Isa-Isa, R; Cruz, A C; Arenas, R; Duarte, Y; Linares, C M; Bogaert, H

    2001-09-01

    Pityriasis versicolor is a common world wide mycosis caused by Malassezia spp. and by Malassezia furfur sensu lato. It is uncommon in children and almost always with atypical clinical manifestations. It has been reported as exceptional in children under one year of age. To determine the clinical and epidemiological data of pityriasis versicolor in infants under one year of age. This is a restrospective and transversal study of pityriasis versicolor in the pediatric population studied during one year at the Instituto Dermatologico y Cirugia de Piel in Dominican Republic. Everyone with a Malassezia spp. positive scotch tape test with methylene blue were included. Among 5160 cases of pityriasis versicolor where 797 were children, we found 92 (11%) cases under one year of age. The clinical manifestations were atypical and the most commonly affected zone was the face (81%) and thorax (16%). Less frequently the neck (8.6%) and upper and lower limbs (5%) were affected. Pityriasis versicolor in children under one year of age is not exceptional in humid and hot climates. The hypochromic lesions are the main clinical manifestation and the most affected site is the face. Diagnosis is easy and cheap with a positive Malassezia spp. scotch tape test with methylene blue.

  7. Cognitive impairments in former patients with work-related stress complaints - one year later.

    PubMed

    Eskildsen, Anita; Andersen, Lars Peter; Pedersen, Anders Degn; Andersen, Johan Hviid

    2016-11-01

    Patients on sick leave due to work-related stress often present with cognitive impairments. The aim of this prospective cohort study was to examine the long-term consequences of prolonged work-related stress in terms of cognitive functioning one year after initial professional care seeking. We tested a group of patients with work-related stress with a comprehensive neuropsychological test battery at two occasions, one year apart. At both time points, we compared the performance of patients with healthy controls matched pairwise on sex, age and length of education. This paper presents the results from the one-year follow-up. When adjusting for practice effects, patients improved on measures of prospective memory and processing speed. However, patients continued to perform worse than controls on all tests, though only half of the comparisons reached statistical significance. The effect sizes of the differences between the two groups at one-year follow-up were small to medium. In conclusion, former patients with prolonged work-related stress improved, but they continued to perform worse than controls after one year. In the acute phase, the largest impairments were related to executive function and mental speed but at follow-up memory impairments also became apparent.

  8. Changes in Inmates’ Substance Use and Dependence From Pre-Incarceration to One Year Post-Release

    PubMed Central

    Tangney, June P.; Folk, Johanna B.; Graham, David M.; Stuewig, Jeffrey B.; Blalock, Daniel V.; Salatino, Andrew; Blasko, Brandy B.; Moore, Kelly E.

    2016-01-01

    Purpose To assess changes in inmates’ misuse of substances from pre- to post-incarceration. Methods In Study 1, professionals (n = 162) and laypersons (n = 50) predicted how jail inmates’ substance misuse would change from pre-incarceration to post-release. In Study 2, a longitudinal study of 305 jail inmates, we examined actual changes in substance use and dependence from pre-incarceration to the first year post-incarceration, as well as whether changes varied as a function of demographic, criminal justice, treatment, and personality factors. Results Professionals and laypersons predicted little change in substance misuse whereas, in fact, inmates’ frequency of substance use and dependence decreased substantially from pre-incarceration to post-release. Sharper decreases were observed for inmates who were female, younger, more educated, serving longer sentences, enrolled in substance abuse treatment, high in shame-proneness, and low in criminogenic thinking. Race, first time incarceration, transfer to other correctional facilities, mandated community supervision (probation), and guilt-proneness did not predict changes in substance use or dependence. Conclusions Although substance misuse decreased, this remains a population high in need of substance abuse treatment both upon arrest and at one year post-incarceration; 60% of former inmates met at least one DSM-IV criterion for substance dependence at one year post-release. PMID:27458324

  9. Bacteraemia due to Streptococcus gallolyticus subspecies pasteurianus is associated with digestive tract malignancies and resistance to macrolides and clindamycin.

    PubMed

    Sheng, Wang-Huei; Chuang, Yu-Chung; Teng, Lee-Jene; Hsueh, Po-Ren

    2014-08-01

    This study was intended to delineate the association between digestive tract malignancies and bacteraemia due to Streptococcus gallolyticus subspecies pasteurianus. We reviewed the medical records and microbiological results of patients with bacteraemia due to Streptococcus bovis during the period 2000-2012. Species and subspecies identification of isolates originally classified as S. bovis was confirmed by 16S rRNA sequencing and PCR restriction fragment length polymorphism (PCR-RFLP) assays. Minimum inhibitory concentrations of antimicrobial agents were determined by the broth microdilution method. Of the 172 S. bovis complex isolates obtained from 172 patients (age range, <1-94 years, median age, 66) with bacteraemia, 31 isolates were identified to be S. gallolyticus subspecies gallolyticus, 126 were S. gallolyticus subspecies pasteurianus, and 15 were shown to be Streptococcus infantarius. The majority (n = 104, 60%) of patients were male and had underlying malignancies (n = 87, 51%). Bacteraemia due to S. gallolyticus subspecies gallolyticus was significantly associated with endocarditis while S. gallolyticus subspecies pasteurianus was more likely to be associated with malignancies of the digestive tract, including gastric, pancreatic, hepatobiliary and colorectal cancers. Septic shock at presentation was the only factor associated with mortality among patients with bacteraemia due to either subspecies of S. bovis. Isolates of S. gallolyticus subspecies pasteurianus had higher rates of resistance to macrolides and clindamycin than isolates of S. gallolyticus subspecies gallolyticus. Extensive diagnostic work-up for digestive tract malignancies and trans-esophageal echocardiogram should be investigated in patients with bacteraemia caused by S. gallolyticus. Copyright © 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  10. Molecular epidemiology of vancomycin-resistant enterococcal bacteraemia: results from the Canadian Nosocomial Infection Surveillance Program, 1999-2009.

    PubMed

    McCracken, M; Wong, A; Mitchell, R; Gravel, D; Conly, J; Embil, J; Johnston, L; Matlow, A; Ormiston, D; Simor, A E; Smith, S; Du, T; Hizon, R; Mulvey, M R

    2013-07-01

    Vancomycin-resistant enterococci (VRE) can be associated with serious bacteraemia. The focus of this study was to characterize the molecular epidemiology of VRE from bacteraemia cases that were isolated from 1999 to 2009 as part of Canadian Nosocomial Infection Surveillance Program (CNISP) surveillance activities. From 1999 to 2009, enterococci were collected from across Canada in accordance with the CNISP VRE surveillance protocol. MICs were determined using broth microdilution. PCR was used to identify vanA, B, C, D, E, G and L genes. Genetic relatedness was examined using multilocus sequence typing (MLST). A total of 128 cases of bacteraemia were reported to CNISP from 1999 to 2009. In 2007, a significant increase in bacteraemia rates was observed in western and central Canada. Eighty-one of the 128 bacteraemia isolates were received for further characterization and were identified as Enterococcus faecium. The majority of isolates were from western Canada (60.5%), followed by central (37.0%) and eastern (2.5%) Canada. Susceptibilities were as follows: daptomycin, linezolid, tigecycline and chloramphenicol, 100%; quinupristin/dalfopristin, 96.3%; high-level gentamicin, 71.6%; tetracycline, 50.6%; high-level streptomycin, 44.4%; rifampicin, 21.0%; nitrofurantoin, 11.1%; clindamycin, 8.6%; ciprofloxacin, levofloxacin and moxifloxacin, 1.2%; and ampicillin, 0.0%. vanA contributed to vancomycin resistance in 90.1% of isolates and vanB in 9.9%. A total of 17 sequence types (STs) were observed. Beginning in 2006 there was a shift in ST from ST16, ST17, ST154 and ST80 to ST18, ST412, ST203 and ST584. The increase in bacteraemia observed since 2007 in western and central Canada appears to coincide with the shift of MLST STs. All VRE isolates remained susceptible to daptomycin, linezolid, chloramphenicol and tigecycline.

  11. 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. Copyright © 2016 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  12. Sustaining practice change one year after completion of the national depression management leadership initiative.

    PubMed

    Chung, Henry; Duffy, Farifteh Firoozmand; Katzelnick, David J; Williams, Mark D; Trivedi, Madhukar H; Rae, Donald S; Regier, Darrel A

    2013-07-01

    This report describes the sustainability of quality improvement interventions for depression care in psychiatric practice one year after the completion of the National Depression Management Leadership Initiative (NDMLI) in 2006. The main intervention involved continued use of the nine-item depression scale of the Patient Health Questionnaire (PHQ-9) for routine care of patients with depressive disorders. One year after project completion, lead psychiatrists from the 17 participating practices were surveyed about the sustainability of key practice interventions and dissemination of the interventions. All 14 practices that provided baseline and follow-up data reported sustained use of the PHQ-9 for screening, diagnosis, or monitoring purposes. Moreover, practices reported dissemination of this approach to clinicians within and outside their practices. Psychiatrists reported sustainability and dissemination of PHQ-9 use one year after the conclusion of the NDMLI. The model has potential as a depression care improvement strategy and is worthy of additional study.

  13. Statistical learning leads to persistent memory: Evidence for one-year consolidation.

    PubMed

    Kóbor, Andrea; Janacsek, Karolina; Takács, Ádám; Nemeth, Dezso

    2017-04-10

    Statistical learning is a robust mechanism of the brain that enables the extraction of environmental patterns, which is crucial in perceptual and cognitive domains. However, the dynamical change of processes underlying long-term statistical memory formation has not been tested in an appropriately controlled design. Here we show that a memory trace acquired by statistical learning is resistant to inference as well as to forgetting after one year. Participants performed a statistical learning task and were retested one year later without further practice. The acquired statistical knowledge was resistant to interference, since after one year, participants showed similar memory performance on the previously practiced statistical structure after being tested with a new statistical structure. These results could be key to understand the stability of long-term statistical knowledge.

  14. Evaluation of the effect of appropriate antimicrobial therapy on mortality associated with Acinetobacter nosocomialis bacteraemia.

    PubMed

    Kuo, Shu-Chen; Lee, Yi-Tzu; Yang, Su-Pen; Chiang, Mei-Chun; Lin, Yi-Tsung; Tseng, Fan-Chen; Chen, Te-Li; Fung, Chang-Phone

    2013-07-01

    Appropriate antimicrobial therapy is effective for severe infections caused by Acinetobacter baumannii, but efficacy for other Acinetobacter species remains to be established. The current study was designed to determine whether appropriate antimicrobial therapy reduces the mortality of patients with Acinetobacter nosocomialis bacteraemia. A 9-year retrospective study of 266 patients with monomicrobial A. nosocomialis bacteraemia was conducted at a large teaching hospital in Taiwan. Multivariable analysis was performed to evaluate the impact on 14-day mortality according to clinical characteristics, severity of disease and use of appropriate antimicrobial therapy. The influence of APACHE II score on the impact of appropriate antimicrobial therapy was analysed by including an interaction term. The overall 14-day mortality was 9.4%. Multivariable analysis revealed that APACHE II score was the only factor significantly associated with mortality (odds ratio, 1.18; 95% confidence interval, 1.11-1.25; p <0.001). Appropriate antimicrobial therapy was not associated with reduced mortality regardless of disease severity. In the subgroup analyses in patients with different clinical conditions, APACHE II score was consistently an independent factor for 14-day mortality, and appropriate antimicrobial therapy did not affect the mortality in any group. In conclusion, severity of disease, based on the APACHE II score, was the independent risk factor for 14-day mortality for patients with monomicrobial A. nosocomialis bacteraemia, even in different clinical conditions. In contrast, appropriate antimicrobial therapy did not reduce the 14-day mortality. The result highlighted a different effect of appropriate antimicrobial therapy on infections caused by two phenotypically undifferentiated Acinetobacter.

  15. Escherichia coli bacteriocins: antimicrobial efficacy and prevalence among isolates from patients with bacteraemia.

    PubMed

    Budič, Maruška; Rijavec, Matija; Petkovšek, Ziva; Zgur-Bertok, Darja

    2011-01-01

    Bacteriocins are antimicrobial peptides generally active against bacteria closely related to the producer. Escherichia coli produces two types of bacteriocins, colicins and microcins. The in vitro efficacy of isolated colicins E1, E6, E7, K and M, was assessed against Escherichia coli strains from patients with bacteraemia of urinary tract origin. Colicin E7 was most effective, as only 13% of the tested strains were resistant. On the other hand, 32%, 33%, 43% and 53% of the tested strains exhibited resistance to colicins E6, K, M and E1. Moreover, the inhibitory activity of individual colicins E1, E6, E7, K and M and combinations of colicins K, M, E7 and E1, E6, E7, K, M were followed in liquid broth for 24 hours. Resistance against individual colicins developed after 9 hours of treatment. On the contrary, resistance development against the combined action of 5 colicins was not observed. One hundred and five E. coli strains from patients with bacteraemia were screened by PCR for the presence of 5 colicins and 7 microcins. Sixty-six percent of the strains encoded at least one bacteriocin, 43% one or more colicins, and 54% one or more microcins. Microcins were found to co-occur with toxins, siderophores, adhesins and with the Toll/Interleukin-1 receptor domain-containing protein involved in suppression of innate immunity, and were significantly more prevalent among strains from non-immunocompromised patients. In addition, microcins were highly prevalent among non-multidrug-resistant strains compared to multidrug-resistant strains. Our results indicate that microcins contribute to virulence of E. coli instigating bacteraemia of urinary tract origin.

  16. A prospective observational study of bacteraemia in adults admitted to an urban Mozambican hospital

    PubMed Central

    Preziosi, M; Zimba, T F; Lee, K; Tomas, M; Kinlin, S; Nhatave-Paiva, C; Bene, R; Paunde, T; Lopes, H; Kalkhoff, S; Prathap, V; Akrami, K; Noormahomed, E V; Schooley, R T; Aronoff-Spencer, E

    2017-01-01

    Background Bacteraemia is a common cause of fever among patients presenting to hospitals in sub-Saharan Africa. The worldwide rise of antibiotic resistance makes empirical therapy increasingly difficult, especially in resource-limited settings. Objectives To describe the incidence of bacteraemia in febrile adults presenting to Maputo Central Hospital (MCH), an urban referral hospital in the capital of Mozambique, and characterise the causative organisms and antibiotic susceptibilities. We aimed to describe the antibiotic prescribing habits of local doctors, to identify areas for quality improvement. Methods Inclusion criteria were: (i) ≥18 years of age; (ii) axillary temperature ≥38°C or ≤35°C; (iii) admission to MCH medical wards in the past 24 hours; and (iv) no receipt of antibiotics as an inpatient. Blood cultures were drawn from enrolled patients and incubated using the BacT/Alert automated system (bioMérieux, France). Antibiotic susceptibilities were tested using the Kirby-Bauer disc diffusion method. Results Of the 841 patients enrolled, 63 (7.5%) had a bloodstream infection. The most common isolates were Staphylococcus aureus, Escherichia coli, and non-typhoidal Salmonella. Antibiotic resistance was common, with 20/59 (33.9%) of all bacterial isolates showing resistance to ceftriaxone, the broadest-spectrum antibiotic commonly available at MCH. Receipt of insufficiently broad empirical antibiotics was associated with poor in-hospital outcomes (odds ratio 8.05; 95% confidence interval 1.62 – 39.91; p=0.04). Conclusion This study highlights several opportunities for quality improvement, including educating doctors to have a higher index of suspicion for bacteraemia, improving local antibiotic guidelines, improving communication between laboratory and doctors, and increasing the supply of some key antibiotics. PMID:26242671

  17. 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).

  18. Citrobacter koseri bacteraemia complicated by paraspinal abscess and spondylodiscitis--a case report.

    PubMed

    Hayati, Shaharuddin Nor; Leong, Chee Loon; Kumar, Chidambaram Suresh; Lee, Christopher

    2012-06-01

    Paraspinal abscess and spondylodiscitis due to Citrobacter koseri is a very rare condition. We report a remarkable case of Citrobacter koseri bacteraemia complicated by paraspinal abscess and spondylodiscitis in a patient who has successfully been treated in our hospital. Our patient demonstrates one of the common challenges in the practice of infectious disease medicine, wherein an innocuous presentation may and often underlie a serious infection. This case report elucidates to us that the diagnosis of a paraspinal abscess and spondylodiscitis requires a high index of suspicion in at risk patient presenting with compatible signs and symptoms.

  19. Outcome of bacteraemia in patients admitted to the adult medical wards of the UKM hospital.

    PubMed

    Petrick, P; Kong, N C T; Nordiah, A J; Cheong, I K S; Tamil, M A

    2007-10-01

    The clinical outcome of bacteraemic patients is influenced by many factors. It is vital to know one's own local hospital epidemiological data so as to provide optimal care to the affected patients. This was a prospective, observational study carried out in the said patient population over a period of four months in the year 2005. One hundred and ninety one patients presented with bacteraemia over the study period. Fifty-two (27%) of the patients died. Mechanical ventilation, inappropriate empirical antibiotic usage, Chinese ethnicity and low serum albumin levels independently affected prognosis. These factors should alert physicians to those patients who require more intensive monitoring and care.

  20. Kingella kingae infections in paediatric patients: 5 cases of septic arthritis, osteomyelitis and bacteraemia.

    PubMed

    Birgisson, H; Steingrimsson, O; Gudnason, T

    1997-01-01

    Kingella kingae is a Gram-negative rod most often recognized as 1 of the organisms causing septic arthritis and osteomyelitis in children. Infection caused by K. kingae had not been diagnosed in Iceland until 5 cases were diagnosed at the Paediatric Department at the University Hospital of Iceland over a 1 year period. In this report we describe these 5 children with invasive infection caused by K. kingae (2 with septic arthritis, 1 with osteomyelitis, 1 with septic arthritis and osteomyelitis, and 1 with bacteraemia) and review the literature. All bacterial isolates were identified by the Bactec culture system.

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

    PubMed

    Matha, S M; Rahiman, S N; Gelbart, B G; Duke, T D

    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.

  2. Cognitive functioning one month and one year following febrile status epilepticus.

    PubMed

    Weiss, Erica F; Masur, David; Shinnar, Shlomo; Hesdorffer, Dale C; Hinton, Veronica J; Bonner, Melanie; Rinaldi, Julie; Van de Water, Virginia; Culbert, James; Shinnar, Ruth C; Seinfeld, Syndi; Gallentine, William; Nordli, Douglas R; Frank, L Mathew; Epstein, Leon; Moshé, Solomon L; Sun, Shumei

    2016-11-01

    The objective of this study was to determine early developmental and cognitive outcomes of children with febrile status epilepticus (FSE) one month and one year after FSE. One hundred ninety four children with FSE were evaluated on measures of cognition, receptive language, and memory as part of the FEBSTAT study and compared with 100 controls with simple febrile seizures (FSs). Children with FSE did not differ dramatically on tasks compared with FS controls at one month after FSE but demonstrated slightly weaker motor development (p=0.035) and receptive language (p=0.034) at one year after FSE. Performances were generally within the low average to average range. Within the FSE cohort, non-White children performed weaker on many of the tasks compared with Caucasian children. At the one-year visit, acute hippocampal T2 findings on MRI were associated with weaker receptive language skills (p=0.0009), and human herpes virus 6 or 7 (HHV6/7) viremia was associated with better memory performances (p=0.047). Febrile status epilepticus does not appear to be associated with significant cognitive impairment on early developmental measures, although there is a trend for possible receptive language and motor delay one year after FSE. Further follow-up, which is in progress, is necessary to track long-term cognitive functioning. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. 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…

  4. Black-tailed prairie dog populations one year after treatment with rodenticides

    Treesearch

    Anthony D. Apa; Daniel W. Uresk; Raymond L. Linder

    1990-01-01

    Three rodenticide treatments, zinc phosphide with prebait, strychnine with prebait, and strychnine without prebait, were applied to black-tailed prairie dog (Cynomys ludovicianus) colonies in west central South Dakota. Results were compared immediately posttreatment and for one year after application. Zinc phosphide was the most effective for...

  5. 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…

  6. 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…

  7. One-Year Prevalence Rates of Major Depressive Disorder in First-Year University Students

    ERIC Educational Resources Information Center

    Price, E. Lisa; McLeod, Peter J.; Gleich, Stephen S.; Hand, Denise

    2006-01-01

    First-year university students may be more at risk for experiencing Major Depressive Disorder (MDD) than the general population given associated risk factors of this age range. A two-phase procedure was used to estimate the one-year prevalence rate of MDD and comorbid Major Anxiety Disorders among first-year university students at a small Canadian…

  8. How a One-Year Overseas Teacher Education Programme Improved a Teacher's Motivation Strategies

    ERIC Educational Resources Information Center

    Wong, Ruth

    2016-01-01

    This longitudinal study investigates how in-service study abroad can improve the professional skills of teachers in regard to the strategies and attitudes they use to better motivate their students to learn English. The subject of this study is an in-service English as a Foreign Language (EFL) teacher from China who undertook a one-year teacher…

  9. The effect of admission creatinine levels on one-year mortality in acute myocardial infarction.

    PubMed

    Cakar, Mehmet Akif; Gunduz, Huseyin; Vatan, Mehmet Bulent; Kocayigit, Ibrahim; Akdemir, Ramazan

    2012-01-01

    We have known that patients with renal insufficiency (creatinine level) have increased mortality for coronary artery disease. In this study, the relationship between admission creatinine level and one year mortality are evaluated in patients with acute myocardial infarction (AMI). 160 AMI patients (127 men and 33 women with a mean age of 59 ± 13) were enrolled in the study. Serum creatinine levels were measured within 12 hours of AMI. The patients were divided into two groups according to admission serum creatinine level. (1) elevated group (serum creatinine > 1.3 mg/dL) and (2) normal group (≤1.3 mg/dL). One year mortality rates were evaluated. Elevated serum creatinine is observed in the 27 patients (16.9%). The mean creatinine level is 1.78 ± 7 mg/dL in the elevated group and 0.9 ± 0.18 mg/dL in the normal group (P < 0.0001). The mortality rate of the elevated group (n = 7, 25.9%) is higher than that of the normal group (n = 9, 6.8%). A significant increase in one year mortality is also observed (P=002) 60. The mildly elevated admission serum creatinine levels are markedly increased to one year mortality in patients with AMI.

  10. 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...

  11. One-year clinical evaluation of composite restorations in posterior teeth: effect of adhesive systems.

    PubMed

    Sundfeld, R H; Scatolin, R S; Oliveira, F G; Machado, L S; Alexandre, R S; Sundefeld, M L M M

    2012-01-01

    This clinical study assessed the performance of posterior composite resins applied with the Adper™ Single Bond Plus (SB) and Adper™ Scotchbond SE (SE) adhesive systems and Filtek™ Supreme Plus composite resin, using modified US Public Health Service criteria. A total of 97 restorations were placed in posterior teeth by two calibrated operators. Application of the materials followed manufacturers' instructions. The restorations were evaluated by two examiners at baseline and after one year. Statistical analyses were conducted using the proportion test at a significance level of 5% (p<0.05). All the restorations evaluated (ie, 100%) received an alpha rating for the criteria of marginal discoloration and marginal integrity at baseline. At one year, for marginal discoloration, 64.6% of SB and 61.2% of SE received an alpha rating. For marginal integrity, 72.9% of SB and 77.6% of SE received an alpha rating. The other restorations received bravo ratings for both criteria. None of the teeth that received the restorative systems presented caries lesions around the restorations. A total of eight teeth presented postoperative sensitivity one week after baseline, five with SB and three with SE; the symptom had disappeared one year later. One year later, composite resin restorations using either adhesive system showed satisfactory clinical performance.

  12. 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.

  13. Student Views of Hybrid Learning: A One-Year Exploratory Study

    ERIC Educational Resources Information Center

    Lin, Qiuyun

    2009-01-01

    This one-year case study examined hybrid learning in two elementary teacher education courses, which incorporated the Blackboard Learning Management System (LMS) into the online portion of the coursework. Fifty-one elementary teacher candidates who were enrolled in two hybrid courses participated in the study. Both quantitative and qualitative…

  14. 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…

  15. Acquiring Academic English in One Year: An Unlikely Proposition for English Language Learners

    ERIC Educational Resources Information Center

    Guerrero, Michael D.

    2004-01-01

    This article examines the primary assumption underlying the recent passage of propositions aimed at meeting the need of English language learners (ELLs). The assumption is that English language learners normally need only one year of intensive structured English immersion to learn English well enough to be academically successful in an all-English…

  16. [Perinatal encephalopathy sequelae identified by a neurobehavioral scale in one year old infants].

    PubMed

    Chávez-Torres, Raquel; Sánchez-Pérez, Carmen; Pérez-Tejada, Haroldo Elorza; Flores-Huerta, Samuel; Klünder Klünder, Miguel; Ruiz-Chávez, Jaime; Luna-Sánchez, Yolanda; Campos-Campos, Laura; Gómez-Barrera, Raúl; Villanueva-Padrón, Laura; Maldonado-Jiménez, Georgina

    2012-01-01

    to identify neurodevelopmental sequelae in one year old infants with perinatal encephalopathy utilizing the neurobehavioral scale named Vanedela. a cohort of 75 newborns with perinatal encephalopathy was assessed with a neurobehavioral follow-up scale at age of 1, 4, 8 and 12 months. A distinction was made between functional, structural and combined encephalopathy. Two groups of neurodevelopmental outcome at one year were identified: with or without sequelae. Nonparametric statistics was used. infants with functional encephalopathy had the best scores, followed by those with structural encephalopathy, while infants with a combined encephalopathy had the lowest scores. At one year of age, the group with neurobehavioral sequelae exhibited the lowest scores and retarded growth. At the same age, the group with functional encephalopathy exhibited no neurobehavioral sequelae, and reached better scores and growth. the neurobehavioral follow-up scale is able to identify the neurodevelopmental sequelae at the age of one year in infants with perinatal encephalopathy. The application of Vanedela in the clinical field requires of little time, its results are trustworthy and very useful for the neurobehavioral follow-up assessment.

  17. 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…

  18. 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…

  19. 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,"…

  20. Completion of One-Year Bioventing Test, Fire Training Area, FT-03

    DTIC Science & Technology

    2007-11-02

    The Air Force Center for Environmental Excellence (AFCEE) one-year bioventing test and evaluation project at the Fire Training Area, FT-03 has been...results from your site and 109 other sites currently under operation, bioventing is cost-effectively remediating fuel contamination in a reasonable time frame.

  1. 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…

  2. Evaluation of the DC Opportunity Scholarship Program: Impacts after One Year. NCEE 2017-4022

    ERIC Educational Resources Information Center

    Dynarski, Mark; Rui, Ning; Webber, Ann; Gutmann, Babette

    2017-01-01

    The District of Columbia Opportunity Scholarship Program (OSP) was created by Congress to provide tuition vouchers to low-income parents who want their child to attend a private school. The Scholarships for Opportunity and Results (SOAR) Act of 2011 also mandated an evaluation of the OSP program. This report examines impacts one year after…

  3. Genetic variation in rootability of cuttings from one-year-old western hemlock seedlings.

    Treesearch

    Frank C. Sorensen; Robert K. Campbell

    1980-01-01

    One-year-old western hemlock (Tsuga heterophylla (Raf.) Sarg.) seedlings from three open-pollination families from eight locations in the Washington and Oregon Coast Ranges were cultured under accelerated growth conditions in a glasshouse. Forty cuttings from each of five seedlings (open-pollination siblings) per family were then placed in a...

  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. [Predictive ability of clinical parameters of bacteremia in hemodialysed patients].

    PubMed

    Egea, Ana L; Vilaró, Mario; De la Fuente, Jorge; Cuestas, Eduardo; Bongiovanni, María E

    2012-01-01

    No clinical events to differentiate bacteteremia from other pathologies in hemodialysis patients therefore the physicians makes diagnosis and treatment decisions based on clinical evidence an local epidemiology. the aim of this work was to study the frequency of microorganism isolated from blood culture of hemodialysis patients with suspected bacteraemia and evaluate Sensitivity (S) and Specificity (E) of medical diagnostic orientation in this cases of suspected Materials and methods: we performed an observational and prospective study for one year in hemodialysis patient with suspected bacteremia. We evaluated blood pressure, temperature (Tº), altered conscious state (AEC), respiratory frequency (FR), chills (ESC),diarrhea (DIARR), blood culture results and microbiological identification. We work with the mean ± standar desviation for continuous variables and frequencies for categorical variables We analyzed S, E, negative predictive value (VPN), positive predictive value (VPP) RESULTADOS: a total of 87 events with suspected bacteremia 34 (39%) were confirmed with positive blood culture the most common microorganisms were cocci Gram positive (CGP) 65%, Most relevant clinical variables were PCP ≥ 2 (VPN 81%), Tº ≥ 38 (VPN 76%) and AEC (E 98% y VPP 80%). CGP were the most prevalent microorganisms None of the clinical variables shows high S and E indicating low usefulness as a predictive tool of bacteremia Excepting AEC with E98% and VPP 80% but it would be necessary to evaluate this variable with a more number patient. Results justify to routine HC use like diagnostic tool.

  6. Change of residence and functional status within three months and one year following hip fracture surgery.

    PubMed

    Ariza-Vega, Patrocinio; Jiménez-Moleón, José Juan; Kristensen, Morten Tange

    2014-01-01

    To study the recovery of patients in terms of 18 activities of daily living and change of residence within the year following a hip fracture. This prospective cohort study was carried out in a trauma service of an acute hospital in southern Spain including 159 patients with a hip fracture, 65 years or older and allowed weight-bearing after surgery. Patients or their relatives were interviewed about their residential status and functional level at pre-fracture, three months and one year after surgery, using the Functional Independence Measure. Losses of function for the main activities affected were, at the first month, third month and one year relative to the pre-fracture status, 50%, 25% and 12%, respectively, for locomotion, 40%, 25% and 20%, respectively, for mobility and 27%, 17% and 15%, respectively, for self care (p < 0.001). Residential status changed mostly for patients who lived in their own home (73% before fracture to 58% at one year). The loss of independence in the first year after a hip fracture is substantial for specific activities. Recovery mainly takes place during the first three months after surgery. Change of residence mostly involved those patients who lived alone in their own home at pre-fracture. Implications for Rehabilitation One year after fracture, patients did not recover their previous function, and the activities most affected at the one-year follow-up were: dressing lower body, bathing/showering, transfer bathtub/shower and walking up/down stairs. After a hip fracture, most recovery of the function happens within the first three months, though some functional activities continue recovering over the first year. Rehabilitation programs cannot be based only on mobility activities, the recovery of other daily living activities should also be included.

  7. Rates and Predictors of Renewed Quitting After Relapse During a One-Year Follow-Up Among Primary Care Patients

    PubMed Central

    Bold, Krysten W.; Rasheed, Abdullah S.; McCarthy, Danielle E.; Jackson, Thomas C.; Fiore, Michael C.; Baker, Timothy B.

    2014-01-01

    Background Most people who quit smoking relapse within a year of quitting. Little is known about what prompts renewed quitting after relapse or how often this results in abstinence. Purpose To identify rates, efficacy, and predictors of renewed quit attempts after relapse during a one-year follow-up. Methods Primary care patients in a comparative effectiveness trial of smoking cessation pharmacotherapies reported daily smoking every 6–12 weeks for 12 months to determine relapse, renewed quitting, and 12-month abstinence rates. Results Of 894 known relapsers, 291 (33%) renewed quitting for at least 24 hours and 99 (34%) of these were abstinent at follow-up. The average latency to renewed quitting was 106 days and longer latencies predicted greater success. Renewed quitting was more likely for older, male, less dependent smokers, and later abstinence was predicted by fewer depressive symptoms and longer past abstinence. Conclusions Renewed quitting is common and produces meaningful levels of cessation. PMID:24796541

  8. Financial consequences of hospital-acquired bacteraemia in three Belgian hospitals in 2003 and 2004.

    PubMed

    Pirson, M; Leclercq, P; Jackson, T; Leclercq, M; Garrino, M; Sion, C

    2008-01-01

    The financial and human costs of hospital-acquired infections are increasingly recognised in many healthcare systems. This study seeks to quantify excess expenditures on hospital-acquired bacteraemia (HAB) in three Belgian general hospitals in 2003 and 2004. Patients with HAB were compared with patients in the same All Patient Refined Diagnosis Related Groups (APR-DRGs) without HAB. Patient level costs were estimated using a hospital costing system developed by the 'Université Libre de Bruxelles', and compared with DRG-based funding for the three hospitals. HAB incidence was consistent with the national rate for two of the three hospitals, but considerably higher for the third. Both severity of illness and mortality were higher in the HAB group. Nosocomial bacteraemia was associated with an increased length of stay of 30 days and of 6.1 days in intensive care units. When compared with uninfected patients in the same DRG, treatment of HAB patients cost an additional euro 16,709. At current funding rates, hospitals made a mean profit of euro 446 for uninfected patients, but a mean loss of euro 2,431 for patients with HAB. Our findings suggest that hospitals have a financial interest in reducing the rate of HAB, even in a system which funds such complications through severity adjustments in the APR-DRG system. Growing international interest in pay for performance and other funding schemes will only strengthen these financial incentives.

  9. 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

  10. 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.

  11. An unusual dual infection with Salmonella bredeney, including bacteraemia, and enterohaemorrhagic Escherichia coli O157 that posed a therapeutic dilemma.

    PubMed

    Grynik, Alina; Shaukat, Syed; Htut, Ei Ei Phyu; Karas, Johannis Andreas

    2012-10-01

    In this case report, we describe an unusual case of a patient who had a dual infection with Salmonella bredeney including bacteraemia and enterohaemorrhagic Escherichia coli O157 following travel to Cyprus. This posed a therapeutic dilemma. We delayed treatment of the Salmonella infection until signs of colitis had resolved.

  12. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study.

    PubMed

    Magaziner, J; Simonsick, E M; Kashner, T M; Hebel, J R; Kenzora, J E

    1990-05-01

    This study evaluates predictors of recovery in walking ability, PADLs, and IADLs one year following hospital discharge for hip fracture. The sample consisted of 536 hip fracture patients aged 65 and older admitted from the community to one of seven Baltimore area hospitals between 1984 and 1986 and surviving one year post-hospital discharge. A large proportion of hip fracture patients do not regain pre-fracture PADL and IADL levels; most recovery in walking ability and ability to perform PADL and IADLs occurs by 6 months. Those who are older, have longer hospital stays, and are rehospitalized, exhibit poorer recovery, as do those displaying chronic or acute cognitive deficits and depressive symptomatology while hospitalized. Also, contact with one's social network following hospital discharge is associated with greater recovery. Findings point to the importance of psychosocial factors for recovery and suggest areas where hospital-based interventions and discharge planning efforts should focus.

  13. One Year After ART Initiation: Psychosocial Factors Associated with Stigma Among HIV-Positive Mozambicans

    PubMed Central

    Pearson, C. R.; Micek, M. A.; Pfeiffer, J.; Montoya, P.; Matediane, E.; Jonasse, T.; Cunguara, A.; Rao, D.; Gloyd, S. S.

    2010-01-01

    The pathways through which stigma is associated with psychological distress remains understudied in Africa. This study evaluates stigma among 277 Mozambicans who were on an antiretroviral therapy (ART) regimens for a full year. Using bivariate and multiple regression analyses, we examine psychosocial factors (disclosure decisions, perceived social support, and depression) associated with stigma, at ART initiation and one year later. We found one year after initiating ART, participants reported no change in stigma, a decreased in perceived social support, and an increase in depressive symptomology. Disclosing HIV status to friends (vs. family or partner) was associated with lower levels of stigma. These findings suggest that HIV care in comparable settings should include counselling, support groups, and peer support, that includes stigma and disclosure concerns prior to and during the first year following diagnosis. Most importantly, assessment and treatment of depression should be incorporated into ongoing HIV care. PMID:19639405

  14. Lungs exposed to nuclear catastrophe: one-year therapeutic programme in Chernobyl liquidators group.

    PubMed

    Chuchalin, A G; Maracheva, A V; Grobova, O M; Cherniaev, A L; Antonov, N S; Kalmanova, E N; Dmitrov, E V; Voisin, C

    1997-02-01

    The high prevalence of chronic respiratory problems in cleaning technicians (so-called "liquidators") of the destroyed reactor at Chernobyl and prolonged persistence of inhaled radioactive particles in their lungs suggested a substantial link between radioactive exposure and the diseases observed. Taking into account the importance of the problem, we started this study with the aim of establishing an effective and useful therapeutic program and assessing its efficacy during a one-year period of treatment. Chernobyl liquidators (n = 20) were screened by clinical history, physical examination, lung function test, chest radiograph, electrocardiogram, complete blood cell counts, serum chemistry, immunological blood tests, and complete BAL fluid investigation. One group of the patients (n = 10) underwent a special one-year treatment including polyvitamins, N-acetylcysteine, and therapeutic BAL every 3 months. The technique of therapeutic BAL has proven to be a promising and effective tool in the treatment of lung diseases induced by inhalation of radioactive particles.

  15. 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

  16. Early Adverse Events as Predictors of One-Year Mortality during Mechanical Circulatory Support

    PubMed Central

    Genovese, Elizabeth A.; Dew, Mary Amanda; Teuteberg, Jeffrey J.; Simon, Marc A.; Bhama, Jay K.; Bermudez, Christian A.; Lockard, Kathleen L; Winowich, Steve; Kormos, Robert L.

    2010-01-01

    Background Ventricular assist devices (VADs) provide effective treatment for end-stage heart failure, however most patients experience ≥1 major adverse event (AE) while on VAD support. Although early, non-fatal AEs may increase the risk of later mortality during VAD support, this relationship has not been established. Therefore, we sought to determine the impact of AEs occurring during the first 60 days of VAD support on one-year mortality. Methods A retrospective analysis was performed using prospectively collected data from a single-site database for patients aged ≥18 years receiving left- or biventricular support during 1996-2008, who survived >60 days on VAD support. Fourteen major classes of AEs occurring during this 60-day period were examined. One-year survival rates of patients with and without each major AE were compared. Results There were 163 patients included; the mean age was 49.5 years, 80% were male, 87% were European American, 72% had left ventricular support, and 83% were bridge to transplant. The occurrence of renal failure, respiratory failure, bleeding events, and reoperations during the first 60 days after implantation significantly increased the risk of one-year mortality. Controlling for gender, age, VAD type, and intention to treat, renal failure was the only major AE significantly associated with later mortality (hazard ratio=2.96, p=0.023). Conclusions Specific AEs (renal, respiratory and bleeding events, and reoperations) significantly decrease longer-term survival, with renal failure conferring a 3-fold increased risk of one-year mortality. Peri-operative management should focus on strategies to mitigate risk for renal failure in order to maximize later outcomes. PMID:20580265

  17. Relative Condition Factors of Fish as Bioindicators One Year after the Deepwater Horizon Oil Spill

    DTIC Science & Technology

    2012-02-01

    Research Report 3. DATES COVERED (From - To) 07-01-2010 to 30-1-2012 4. TITLE AND SUBTITLE Relative Condition Factors of Fish as Bioindicators One...Condition index, relative condition factor, bioindicator , oil spill 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF...Condition Factors of Fish as Bioindicators One Year after the Deepwater Horizon Oil Spill Joshua Courtney,1 Taylor Klinkmann,2 Amy Courtney,1 Joseph

  18. [One year persistence of atorvastatin and amlodipine fixed dose combination versus atorvastatin therapy].

    PubMed

    Simonyi, Gábor; Ferenci, Tamás

    2016-03-13

    Hypertension and dyslipidemia are modifiable cardiovascular risk factors. In Hungary hypertension and dyslipidemia are quite frequent conditions. The patients' adherence is very important factor to reach the targets. The aim of the authors was to investigate the one-year persistence of the atorvastatin therapy and atorvastatin and amlodipine fixed dose combination. National Health Insurance Found prescriptions database of Hungary on pharmacy claims between October 1, 2012 and September 30, 2013 was analyzed. The authors identified patients who filled prescriptions for atorvastatin and amlodipine fixed dose combination and atorvastatin prescribed for the first time. Patients did not receive similar drugs for one year before the study. To model the persistence, the apparatus of survival analysis was used, where "survival" was the time to abandon the medication. As it was available to month precision, discrete time survival analysis was applied: a generalized linear model was estimated with complementary log-log link function with the kind of drug being the only explanatory variable. During the trial period, atorvastatin and atorvastatin plus amlodipine fixed dose combination was started in 192,579 and 24,433 patients, respectively. One year persistence rate in patients with atorvastatin and amlodipine fixed dose combination was 43%, and 21% in patients with atorvastatin therapy. The 360-days-restricted study period, the mean duration of persistence was 221.4 (SE: 0.894) days in patients on atorvastatin and amlodipine fixed dose combination and 153.0 days (SE: 0.297) in those on atorvastatin regimen. The hazard of discontinuation was almost twofold higher during treatment with atorvastatin therapy compared with the use of the atorvastatin and amlodipine fixed dose combination (hazard ratio = 1.85, p<0.0001). There is a significant difference between the one-year persistence of atorvastatin therapy and atorvastatin plus amlodipine fixed dose combination. The result

  19. [One year persistence of metformin monotherapy versus metformin/sitagliptin fixed dose combination].

    PubMed

    Simonyi, Gábor; Ferenci, Tamás

    2016-04-17

    In treatment of type 2 diabetes mellitus it is important to reach glycaemic targets. The elements of this are the adequate diet and the patient's adherence to medication. The aim of the authors was to investigate the one year persistence of the metformin monotherapy and sitagliptin/metformin fixed dose combination in type 2 diabetic patients. National Health Insurance Found prescriptions database of Hungary on pharmacy-claims between October 1, 2012 and September 30, 2013 was analyzed. The authors identified patients who filled prescriptions for metformin monotherapy and fixed dose combinations of sitagliptin/metformin prescribed for the first time. Patients have not received similar drugs one year previous to study. To model the persistence, the apparatus of survival analysis was used, where "survival" was the time to abandon the medication. As it was available to month precision, discrete time survival analysis was applied: a generalized linear model was estimated with complementary log-log link function with the kind of drug being the only explanatory variable. During the trial period, metformin monotherapy or sitagliptin/metformin fixed dose combination was started in 63,386 and 10,039 patients, respectively. One year persistence rate in patients with metformin monotherapy was 30%, and 58% in patients with sitagliptin/metformin fixed dose combination. Considering only the 360-day study period, the mean duration of persistence was 173.4 days in patients on metformin monotherapy and 261.9 days on sitagliptin/metformin fixed dose combination. The hazard of discontinuation was more than twofold higher during treatment with metformin monotherapy compared with the use of the sitagliptin/metformin fixed dose combination (hazard ratio = 2.267, p<0.001). There is a significant difference between the one year persistence of metformin monotherapy and sitagliptin/metformin fixed dose combination in type 2 diabetic patients. The result demonstrated sitagliptin

  20. Thyrotoxicosis Developing Within One Year Following Migration to the United States

    PubMed Central

    Peter, Sebastian A.

    1985-01-01

    Two members of a family from Guyana, South America, developed thyrotoxicosis within one year of migration to the United States. Both patients had pre-existing multinodular goiters. Their clinical manifestation was consistent with that of iodide-induced thyrotoxicosis. This syndrome may be more common than previously reported in the United States. Physicians practicing in inner-city areas with a significant immigrant population should be more aware of this entity. PMID:4078917

  1. Successful Ziprasidone Monotherapy in a Case of Delusional Parasitosis: A One-Year Followup

    PubMed Central

    Serroni, Nicola; Marini, Stefano; Rapini, Gabriella; Valchera, Alessandro; Fornaro, Michele; Mazza, Monica; Martinotti, Giovanni; Di Giannantonio, Massimo

    2013-01-01

    Delusional parasitosis is characterized by the false idea that own body is infested by invisible mites, insects, or other parasites. This case report describes a 24-year-old woman with delusional parasitosis who was treated with ziprasidone monotherapy (120 mg/day) with a complete remission of delusion and followed for one year without symptom recurrences. These findings, although preliminary, indicate that further investigation of ziprasidone monotherapy for the treatment of delusional parasitosis is warranted in further trials. PMID:23762722

  2. Completion of One Year Bioventing Tests: Area H; Area K; and Waikakalaua Fuel Storage Annex

    DTIC Science & Technology

    2007-11-02

    The Air Force Center for Environmental Excellence (AFCEE) one-year bioventing test and evaluation projects at the above sites have been completed... bioventing is cost-effectively remediating fuel contamination in a reasonable time frame. We recommend its application in areas within the above sites where...for a Field Treatability Test for Bioventing , May 1992, including Addendum One, February 1994. These are found in the "Tool Box" recently sent to your base.

  3. Completion of One-Year Bioventing Test, POL Storage Area C

    DTIC Science & Technology

    2007-11-02

    The Air Force Center for Environmental Excellence (AFCEE) one-year bioventing test and evaluation project at the POL Storage Area has been completed...reduction of contaminant levels as the bioventing continued. Table 2 provides a summary of initial and final soil and soil gas sampling results for total...currently under operation, bioventing is cost-effectively remediating fuel contamination in a reasonable time frame. We recommend its application

  4. Completion of One-Year Bioventing Test, Vandenberg AFB BX Service Station and Facility 6454

    DTIC Science & Technology

    2007-11-02

    The Air Force Center for Environmental Excellence (AECEE) one-year bioventing test and evaluation projects at the BX Service Station and Facility... bioventing is cost-effectively remediating fuel contamination in a reasonable time-frame. We recommend its application throughout the Air Force and at other...sites on your installation using the criteria in the AFCEE Test Plan and Technical Protocol for a Field Treatability Test for Bioventing , May 1992

  5. OCLC book interlibrary loan in a basic-unit hospital library: one year's experience.

    PubMed

    Landwirth, T K

    1983-04-01

    Methodist Medical Center of Illinois Medical Library, a "basic-unit" medical library (i.e., not a resource library) in the Regional Medical Library Program recently completed one year of borrowing and lending books using OCLC. Of the books successfully borrowed through OCLC, 79% were obtained from nonmedical libraries. Forming cost-sharing OCLC clusters among basic units makes OCLC an affordable alternative to borrowing books from overburdened medical resource libraries.

  6. Geriatric conditions in acutely hospitalized older patients: prevalence and one-year survival and functional decline.

    PubMed

    Buurman, Bianca M; Hoogerduijn, Jita G; de Haan, Rob J; Abu-Hanna, Ameen; Lagaay, A Margot; Verhaar, Harald J; Schuurmans, Marieke J; Levi, Marcel; de Rooij, Sophia E

    2011-01-01

    To study the prevalence of eighteen geriatric conditions in older patients at admission, their reporting rate in discharge summaries and the impact of these conditions on mortality and functional decline one year after admission. A prospective multicenter cohort study conducted between 2006 and 2008 in two tertiary university teaching hospitals and one regional teaching hospital in the Netherlands. Patients of 65 years and older, acutely admitted and hospitalized for at least 48 hours, were invited to participate. Eighteen geriatric conditions were assessed at hospital admission, and outcomes (mortality, functional decline) were assessed one year after admission. 639 patients were included, with a mean age of 78 years. IADL impairment (83%), polypharmacy (61%), mobility difficulty (59%), high levels of primary caregiver burden (53%), and malnutrition (52%) were most prevalent. Except for polypharmacy and cognitive impairment, the reporting rate of the geriatric conditions in discharge summaries was less than 50%. One year after admission, 35% had died and 33% suffered from functional decline. A high Charlson comorbidity index score, presence of malnutrition, high fall risk, presence of delirium and premorbid IADL impairment were associated with mortality and overall poor outcome (mortality or functional decline). Obesity lowered the risk for mortality. Geriatric conditions were highly prevalent and associated with poor health outcomes after admission. Early recognition of these conditions in acutely hospitalized older patients and improving the handover to the general practitioner could lead to better health outcomes and reduce the burden of hospital admission for older patients.

  7. One Year Follow-up Evaluation of Project Towards No Drug Abuse (TND-4)

    PubMed Central

    Sun, Ping; Sussman, Steve; Dent, Clyde W.; Ann Rohrbach, Louise

    2008-01-01

    Objectives This paper describes the one-year outcomes of the fourth experimental trial of Project Towards No Drug Abuse. Two theoretical content components of the program were examined to increase our understanding of the relative contribution of each to the effectiveness of the program. Methods High schools in Southern California (n=18) were randomly assigned to one of three conditions: cognitive perception information curriculum, cognitive perception information + behavioral skills curriculum, or standard care (control). The curricula were delivered to high school students (n=2734) by project health educators and regular classroom teachers. Program effectiveness was assessed with both dichotomous and continuous measures of 30-day substance use at baseline and one-year follow-up. Results Across all program schools, the two different curricula failed to significantly reduce dichotomous measures of substance use (cigarette, alcohol, marijuana, and hard drugs) at one-year follow-up. Both curricula exerted an effect only on the continuous measure of hard drug use, indicating a 42% (p=0.02) reduction in the number of times hard drugs were used in the last 30 days in the program groups relative to the control. Conclusions The lack of main effects of the program on dichotomous outcomes was contrary to previous studies. The effect on hard drug use among both intervention conditions replicates previous work and suggests that this program effect may have been due to changes in cognitive misperception of drug use rather than behavioral skill. PMID:18675294

  8. INCRAFT® Stent-Graft System: one-year outcome of the INNOVATION Trial.

    PubMed

    Coppi, G; Njila, M; Coppi, G; Saitta, G; Silingardi, R; Pratesi, C; Chiesa, R; Scheinert, D; Brunkwall, J S; Torsello, G

    2014-02-01

    Endovascular repair has surpassed open surgical treatment as the most common procedure in patients with abdominal aortic aneurysms (AAA), yet its applicability remains limited to those with aortoiliac anatomy suitable for the introduction and deployment of the devices. The current study was performed to assess the safety and efficacy of INCRAFT® (Cordis Corporation, Bridgewater, NJ), an ultra-low-profile device for the treatment of AAA. The INNOVATION study is a first in human prospective, multicenter trial involving 6 centers in Europe. From March 2010 to June 2011 60 patients with asymptomatic AAA were treated with the INCRAFT® bifurcated Stent-Graft System. The main inclusion criteria were a proximal aortic neck of 15 mm or more in length and up to 27 mm in diameter; iliac landing zones greater than 10 mm in length and between 9 and 18 mm in diameter; an access vessel large enough to accept the 14F outer diameter of the delivery system; and an aortic bifurcation >18 mm in diameter. The primary endpoint was technical success at one-month; one-year safety endpoints included the absence of device- or procedure-related major adverse events; absence of type I or III endoleaks; and maintenance of device integrity through one year of follow-up. Among 60 patients treated at six centers, the primary endpoint was met in 56 of 58 patients (97%; 95% CI, 88-100%) who came back for one month follow-up, two patients did not come back for their one month follow-up assessments but remained enrolled in the study. Fifty-six had one-year follow-up data showing 100% freedom from aneurysm enlargement with absence of type I and III endoleaks in all patients. There were two patients (3.6%) with a type Ia endoleak which was successfully treated with secondary endovascular intervention in both occasions. Core laboratory evaluation of the postoperative imaging studies documented absence of endograft migration, stent fracture, or limb occlusion. A single patient (1.8%) died within one

  9. Nutritional status assessment during Alzheimer's disease: results after one year (the REAL French Study Group).

    PubMed

    Guerin, O; Soto, M E; Brocker, P; Robert, P H; Benoit, M; Vellas, B

    2005-01-01

    Weight loss and malnutrition are frequent and serious complications of Alzheimer's disease. The aim of the present article was to describe the cognitive and behavioural characteristics of the test population within the frame of the PHRC REAL.FR cohort (for Réseau sur la Maladie d'Alzheimer Français), depending on their nutritional state, and to consider their evolution one year after the original inclusion. The study population' stratification was done in three groups according to their Mini Nutritional Assessment (MNA) score: malnutrition group (MNA < 17.5), at risk of malnutrition group (MNA 17.5-23.5), and normal nutritional status group (MNA > or = 23.5). 561 patients were evaluated at inclusion time, 393 at one year. The evaluation included the following scales: Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE), Activities Daily Living (ADL), Instrumental Activities Daily Living (IADL), Neuro Psychiatric Inventory (NPI) and Zarit scale (ZARIT). Comparison and descriptive analysis for each MNA group at baseline and at one year has been performed. at baseline, the well-nourished and the malnutrition risk groups are significantly different concerning age, IADL and NPI; the well-nourished and undernutrition groups are different concerning MMSE, NPI and Zarit; the malnutrition risk and undernutrition groups are only different concerning NPI. At one year, the well-nourished and the malnutrition risk and undernutrition groups are different concerning one lonely variable, the NPI, in a significant way. The comparison of the three groups between baseline and one-year evaluation demonstrate for the well-nourished group an aggravation of MMSE, ADL, IADL, NPI, for the malnutrition risk group of MMSE and IADL, and for the undernutrition group of MMSE, IADL and NPI. Among the patients suffering from Alzheimer's disease, the most malnutritioned worsen highly on cognitive and functional capacities. Furthermore, the nutritional aggravation seems

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

    USDA-ARS?s Scientific Manuscript database

    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...

  11. One-Year Follow-Up of Patients Undergoing Transvenous Extraction of Pacemaker and Defibrillator Leads

    PubMed Central

    Kempa, Maciej; Budrejko, Szymon; Piepiorka-Broniecka, Marta; Rogowski, Jan; Kozlowski, Dariusz; Raczak, Grzegorz

    2015-01-01

    Introduction The number of pacemaker and ICD implantations has increased substantially in the recent years. Therefore, complications are also observed in a greater number. In many cases, transvenous extraction of the previously implanted device (pacemaker or ICD) is the only solution. One may find in the literature information about the efficacy and safety of that procedure, but data concerning the results of long-term follow up are still limited. Aim The aim of the study was to assess the one-year mortality in the cohort of patients undergoing transvenous lead extraction procedures in our centre. Methods Records of the patients undergoing transvenous lead removal in the Department of Cardiology and Electrotherapy of the Medical University of Gdańsk were analyzed. We collected detailed information about 192 patients that had undergone the procedure from January 2003 until June 2012. Data were collected from medical and surgical records. We analyzed concomitant diseases, indications, and possible complications. Long-term follow-up data were gathered in the follow-up ambulatory records and over-the-phone interviews with patients or families. In several cases, we consulted the database of the Polish National Health Fund. Results During the early post-operative period 5 patients died, although none of those deaths was associated with the procedure itself. No other major complications were observed. During one-year follow-up other 5 patients died, which gave the overall one-year survival rate of 92.7%. Heart failure, renal failure and an infective indication showed significant association with increased mortality. Conclusion Results of transvenous lead extraction, a relatively safe procedure, should be assessed over time extending beyond the sole perioperative period. Some complications may be delayed in their nature, and may be observed only during the long-term follow up. PMID:26694032

  12. Direct resin composite restorations versus indirect composite inlays: one-year results.

    PubMed

    Mendonça, Juliano Sartori; Neto, Ranulfo Gianordoli; Santiago, Sérgio Lima; Lauris, José Roberto Pereira; Navarro, Maria Fidela de Lima; de Carvalho, Ricardo Marins

    2010-05-01

    The aim of this study was to evaluate the clinical performance of direct resin composite restorations (Tetric Ceram-TC) and indirect composite inlays (Targis-TG) after 12 months. Seventy-six Class I and II restorations (44 direct and 32 indirect) were inserted in premolars and molars with carious lesions or deficient restorations in 30 healthy patients according to the manufacturer's instructions. Each restoration was evaluated at baseline and after 12 months according to the modified USPHS criteria for color match (CM), marginal discoloration (MD), secondary caries (SC), anatomic form (AF), surface texture (ST), marginal integrity (MI), and pulp sensitivity (PS). Data were analyzed by Fisher and McNemar Chi-square tests. No secondary caries and no pulpal sensitivity were observed after 12 months. However, significant changes in marginal discoloration (MD) criteria could be detected between baseline and one-year results for both materials (p<0.05). For marginal integrity (MI) criteria, the differences between baseline and one-year recall were statistically significant (p<0.05). For marginal integrity (MI) criteria, Tetric Ceram (TC) showed results statistically superior to Targis (TG) in both observation periods (p<0.05). No statistically significant changes in color match (CM), anatomic form (AF), or surface texture (ST) appeared during the observation periods (p>0.05). BDirect resin composite restorations performed better than indirect composite inlays for marginal integrity, but all restorations were judged to be clinically acceptable. Tetric Ceram direct restorations and Targis indirect inlays in posterior teeth provide satisfactory clinical performance and the comparison between them showed little difference after one year.

  13. [One year persistence of free and fixed dose combinations of perindopril/amlodipine].

    PubMed

    Simonyi, Gábor; Ferenci, Tamás; Medvegy, Mihály; Gasparics, Roland; Finta, Ervin

    2017-09-01

    In management of hypertension patient adherence is one of the most important factors. In hypertension the cardiovascular risk reduction can be reached only by prolonged and effective pharmacotherapy. To evaluate the persistence of one-year treatment of free and fixed-dose combination of perindopril/amlodipine in hypertension. Information from the National Health Insurance of Hungary prescriptions database on pharmacy claims between October 1, 2012 and September 30, 2013 was analysed. Authors identified patients who filled prescriptions for free and fixed-dose combination of perindopril/amlodipine, prescribed for the first time for hypertension. Patients have not received antihypertensive therapy with similar active substances during the one year before. Apparatus of survival analysis was used, where "survival" was the time to abandon the medication. As it was available to month precision, discrete time survival analysis was applied. 109,248 patients met the inclusion criteria. Combination antihypertensive therapy with perindopril/amlodipine was started with a free or a fixed-dose combination of these agents in 19,365 and 89,883 patients, respectively. One year persistence rate in patients taking perindopril/amlodipine as a free combination was 27.15%, whereas it was 46.89% in those on the fixed-dose combination. Mean duration of persistence was 177.6 days in patients on the perindopril/amlodipine free, whereas 245.7 days on fixed-dose combination. Actual rate of discontinuation was approximately twice higher with the treatment of free, compared with the use of the fixed-dose combination (hazard ratio =1.94 [95% CI: 1.91-1.98], p<0.001). Orv Hetil. 2017; 158(36): 1421-1425.

  14. Predictors of Mortality Up to One Year After Emergent Major Abdominal Surgery in Older Adults

    PubMed Central

    Cooper, Zara; Mitchell, Susan L.; Gorges, Rebecca J.; Rosenthal, Ronnie A.; Lipsitz, Stuart R.; Kelley, Amy S.

    2015-01-01

    Background The number of older patients who undergo emergent major abdominal procedures is expected to increase yet little is known about mortality beyond 30 days after surgery. Objective Identify factors associated with mortality among older patients at 30, 180 and 365 days after emergency major abdominal surgery. Design A retrospective study of the Health and Retirement Study (HRS) linked to Medicare Claims from 2000-2010. Setting N/A Participants Medicare beneficiaries > 65.5 years enrolled in the Health and Retirement Study (HRS) from 2000-2010, with at least one urgent/emergent major abdominal surgery and a core interview from the HRS within 3 years prior to surgery. Main Outcomes and Measures Survival analysis was used to describe all-cause mortality at 30, 180 and 365 days after surgery. Complementary log-log regression was used to identify patient characteristics and postoperative events associated with worse survival. Results 400 patients had one of the urgent/emergent surgeries of interest. Of these 24% were > 85 years; 50% had coronary artery disease, 48% had cancer, and 33% had congestive heart failure; and 37% experienced a postoperative complication. Postoperative mortality was 20%, 31% and 34% at 30, 180 days and 365 days. Among those > 85 years, 50% were dead one year after surgery. After multivariate adjustment including postoperative complications, dementia (Hazard ratio (HR) 2.02, 95%CI 1.24-3.31), hospitalization within 6 months before surgery (HR 1.63, 95% CI 1.12-2.28) and complications (HR 3.45, 95%CI (2.32-5.13) were independently associated with worse one-year survival. Conclusion Overall mortality is high up to one year after surgery in many older patients undergoing emergency major abdominal surgery. The occurrence of a complication is the clinical factor most strongly associated with worse survival. PMID:26661929

  15. Reduction in depressive symptoms in primary prevention ICD scheduled patients - One year prospective study.

    PubMed

    Amiaz, Revital; Asher, Elad; Rozen, Guy; Czerniak, Efrat; Levi, Linda; Weiser, Mark; Glikson, Michael

    2017-09-01

    Implantable Cardioverter Defibrillators (ICDs), have previously been associated with the onset of depression and anxiety. The aim of this one-year prospective study was to evaluate the rate of new onset psychopathological symptoms after elective ICD implantation. A total of 158 consecutive outpatients who were scheduled for an elective ICD implantation were diagnosed and screened based on the Mini International Neuropsychiatric Interview (MINI). Depression and anxiety were evaluated using the Hamilton Rating Scales for Depression (HAM-D) and Anxiety (HAM-A). Patient's attitude toward the ICD device was evaluated using a Visual Analog Scale (VAS). Patients' mean age was 64±12.4years; 134 (85%) were men, with the majority of patients performing the procedure for reasons of 'primary prevention'. According to the MINI diagnosis at baseline, three (2%) patients suffered from major depressive disorder and ten (6%) from dysthymia. Significant improvement in HAM-D mean scores was found between baseline, three months and one year after implantation (6.50±6.4; 4.10±5.3 and 2.7±4.6, respectively F(2100)=16.42; p<0.001). There was a significantly more positive attitude toward the device over time based on the VAS score [F(2122)=53.31, p<0.001]. ICD implantation significantly contributes to the reduction of depressive symptoms, while the overall mindset toward the ICD device was positive and improved during the one-year follow-up. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. A One-Year Evaluation of a Free Fissure Sealant Program.

    PubMed

    M, Bakhtiar; N, Azadi; A, Golkari

    2016-12-01

    Pit and fissure sealant therapy has been approved as an effective measure in the prevention of occlusal dental caries. Resin based materials are the most common materials used worldwide. A variety of resin based fissure sealants are produced and used. Most of them have been presented with ideal results in research environment. However, their effectiveness in the real life, especially in a mass application program such as Iran's oral health reform plan is not clear. To evaluate the longevity of different fissure sealant applied in Iran's oral health reform plan in Fars Province (south of Iran) after one year. Seven counties were selected. One hundred 6- to 8-year-old school children who had undergone fissure sealant therapy in spring 2015 were randomly selected from each county. Their first molars were examined to evaluate the status of the fissure sealants which were applied one year ago. Data on the type/brand of fissure sealant materials, type and experience of clinicians who applied them, existence of a chair-side assistant, and whether the children were caries-free at the time of fissure sealant application were collected from the existing reports. Data of 1974 teeth from 598 children were used for the final analysis. The effects of type/brand of the material was significant on the final results and remained significant (p < 0.001) after adjustments for the level of fluoride, urban/rural area, upper/lower jaw, type of clinician who applied the sealant, existence of a chair-side assistant, and child's gender, age, and being caries-free. Many factors affect the success rate of a fissure sealant therapy program. The type/brand of the material remained significantly related to the success rate of the fissure sealant even after adjustments for other influencing factors. In this study, ClinproTM Sealant (3M/ESPE, USA) showed better longevity after one year of application.

  17. Declining financial capacity in patients with mild Alzheimer disease: a one-year longitudinal study.

    PubMed

    Martin, Roy; Griffith, H Randall; Belue, Katherine; Harrell, Lindy; Zamrini, Edward; Anderson, Britt; Bartolucci, Alfred; Marson, Daniel

    2008-03-01

    The objective of this study was to investigate change over time in financial abilities in patients with mild Alzheimer disease (AD). The authors conducted a prospective 1-year longitudinal study at a large southern U.S. metropolitan-area medical school university. Participants included healthy older adults (N=63) and patients with mild AD (N=55). The authors conducted a standardized performance measure of financial capacity. Performance was assessed on 18 financial tasks, nine domains of financial activity, and overall financial capacity. Capacity outcomes classifications (capable, marginally capable, or incapable) for domains and overall performance were made using cut scores referenced to comparison group performance. At baseline, patients with mild AD performed significantly below healthy older adults on 16 of 18 tasks, on all nine domains, and on overall financial capacity. At one-year follow up, comparison group performance was stable on all variables. In contrast, patients with mild AD showed substantial declines in overall financial capacity, on eight of nine domains, and on 12 of 18 tasks. Similarly, the proportion of the mild AD group classified as marginally capable and incapable increased substantially over one year for the two overall scores and for five financial domains. Financial capacity is already substantially impaired in patients with mild AD at baseline and undergoes rapid additional decline over one year. Relative to the comparison group, overall financial capacity performance in the AD group declined 10%, from approximately 80% of the comparison group performance at baseline to 70% at follow up. Financial skills showed differential rates of decline on both simple and complex tasks. Of clinical and public policy interest was the declining judgment of patients with mild AD regarding simple fraud schemes. The study supports the importance of prompt financial supervision and planning for patients newly diagnosed with AD.

  18. Postpartum behaviour as predictor of weight change from before pregnancy to one year postpartum

    PubMed Central

    2011-01-01

    Background Postpartum weight retention affects many women and increases the risk of becoming overweight. The research objective was to study modifiable factors contributing to weight change at one year postpartum. Methods In this prospective cohort, postpartum behavior, such as physical activity, sedentary behavior, sleep, and intake of total energy, total fat and saturated fatty acids of 118 Dutch women were assessed in 2003/2004 by self-report at 6 weeks, 6 and 12 months postpartum. Mean postpartum scores were computed for the behavioral measures. In linear regression models it was determined which factors were associated with average weight change from before pregnancy to one year postpartum. Furthermore, factors associated with substantial postpartum weight retention (≥ 5 kg) were also studied in logistic regression models. Results At one year postpartum, the average weight of participants had increased by 0.9 kg (SD 4.4). Moreover, 20% of the women retained ≥ 5 kg. Women who perceived themselves more physically active than others were almost ten times less likely to retain ≥ 5 kg than women who perceived themselves equally active (OR = 0.11, 95%CI: 0.02 - 0.66). Exceeding the guideline for saturated fatty acid intake (OR = 3.40, 95%CI: 1.04 - 11.11), total gestational weight gain (OR = 1.14/kg, 95%CI: 1.01 - 1.27), and not having completed post high school education (OR = 5.13, 95%CI: 1.66 - 15.90) increased the odds of retaining ≥ 5 kg. Conclusions Since one in five women had substantial weight retention postpartum, effective interventions for the prevention of weight retention are much needed. Future studies should evaluate whether interventions focusing on the identified modifiable postpartum factors are successful in reducing weight retention after childbirth. PMID:21410953

  19. One-year, simultaneous combined exposure of CDMA and WCDMA radiofrequency electromagnetic fields to rats.

    PubMed

    Jin, Yeung-Bae; Lee, Hae-June; Seon Lee, Jae; Pack, Jeong-Ki; Kim, Nam; Lee, Yun-Sil

    2011-04-01

    We investigated whether one-year, long-term, simultaneous exposure to code division multiple access (CDMA; 849 MHz) and wideband code division multiple access (WCDMA; 1.95 GHz) radiofrequencies (RF) would induce chronic illness in Sprague-Dawley (SD) rats. Two groups of 40 SD rats (50% males and females in sham and exposed groups) were exposed to CDMA and WCDMA RF simultaneously at 2.0 W/kg for 45 min/day (total 4.0 W/kg), 5 days per week for a total of one year. Body and organ weight measurements, urinalysis, haematological and blood biochemical analysis, and histopathological evaluations were performed. The mortality patterns in male and female rats exposed to RF were compared with those found in gender-matched sham control animals. No significant alteration in body weight was observed with the simultaneous combined RF exposure. Most RF-exposed rats showed no significant alteration, based on urinalysis, haematology, blood biochemistry, or histopathology. However, some altered parameters of the complete blood count and serum chemistry were seen in RF-exposed rats. The total tumour incidence was not different between sham-exposed and RF-exposed animals. Our results suggest that one-year chronic exposure to CDMA (849 MHz) and WCDMA (1.95 GHz) RF simultaneously at 2.0 W/kg for 45-min RF exposure periods (total, 4 W/kg) did not increase chronic illness in rats, although there were some altered parameters in the complete blood count and serum chemistry.

  20. [Acceleration of Embryonic Development of Pinus sibirica Trees with a One-Year Reproductive Cycle].

    PubMed

    Tret'yakova, I N; Lukina, N V

    2016-01-01

    The study of the formation of embryonic structures in Pinus sibirica forms with a one-year reproductive cycle showed that the acceleration of the embryonic process manifested itself as a reduction of the coenocytic stage of the female gametophyte development (1.5 months instead of 1 year). The egg was not fertilized because of the asynchronous maturation of male and female gametophytes. Seeds without embryos were formed. We assumed that the acceleration of the reproductive process in Pinus sibirica was caused by a mutation in the female generative organs.

  1. Evaluation of one-year mortality after geriatric ankle fractures in patients admitted to nursing homes.

    PubMed

    Kadakia, Rishin J; Hsu, Raymond Y; Hayda, Roman; Lee, Yoojin; Bariteau, Jason T

    2015-10-01

    The incidence of geriatric ankle fractures will undoubtedly increase as the population continues to grow. Many geriatric patients struggle to function independently after such injury and often require placement into nursing homes. The morbidity and mortality associated with nursing homes is well documented within the field of orthopaedic surgery. However, there is currently no study examining the mortality associated with nursing home placement following hospitalization for an ankle fracture. Therefore, the purpose of this study was to determine if geriatric patients admitted to nursing homes following an ankle fracture experience elevated mortality rates. Patients were identified using diagnosis codes for ankle fractures from all 2008 part A Medicare claims, and those admitted to nursing homes were identified using a Minimum Data Set (MDS). The Medicare database was also analyzed for specific variables including over-all one year mortality, length of stay, age distribution, certain demographical characteristics, incidence of medical and surgical complications within 90 days, and the presence of comorbidities. Multivariate logistic regression analysis was used to determine if patients admitted to nursing homes had elevated mortality rates. 19,648 patients with ankle fractures were identified, and 11,625 (59.0%) of these patients went to a nursing home after hospitalization. Patients who went to a nursing home had higher Elixhauser and Deyo-Charlson comorbidity scores (p<0.0001). Nursing home patients also had significantly increased rates of postoperative medical and surgical complications. One year mortality was 6.9% for patients who did not go to a nursing home and 15.4% for patients who were admitted to a nursing home (p<0.0001). However, multivariate logistic regression analysis demonstrated no significant difference in one year mortality between patients admitted to nursing homes and those who were not (OR=1.1; 95% CI 0.99-1.24, p>0.05). Although admission to

  2. [Changes in relevant attitudes of nurses after one year of working with Balint groups].

    PubMed

    Kraljević, R; Gregurek, R; Kulenović, M; Vuletin, J; Magerle, A; Kajević, M; Pavicić, S; Mandić, K; Klain, E

    1995-01-01

    The present study was carried out in the Popovaca Psychiatric Hospital and the examinees were nurses (N = 44) allocated to educative work in Balint groups. Authors discuss if any change may occur in the attitude towards some relevant notions during the one-year educative work in Balint groups. A graphic form of semantic differential was used as the measuring instrument. The findings of this study suggest that during the educational process the attitude towards notions "education", "doctor" and "myself" becomes more negative. The attitude towards the notion "patient" remains unchanged.

  3. Granuloma-forming interstitial pneumonia occurring one year after the start of everolimus therapy.

    PubMed

    Saito, Yoshinobu; Kunugi, Shinobu; Suzuki, Yasutomo; Narita, Kousuke; Miura, Yukiko; Minegishi, Yuji; Kimura, Go; Kondo, Yukihiro; Azuma, Arata; Fukuda, Yuh; Gemma, Akihiko

    2013-01-01

    We experienced a case of interstitial lung disease (ILD) that occurred one year after the start of everolimus therapy for renal cell carcinoma. The pathological features included interstitial pneumonia with granuloma formation. Everolimus is known to cause ILD; however, its pathology is unclear. Granuloma-forming interstitial pneumonia associated with everolimus is uncommon, although it may be one of the pathological patterns associated with everolimus-induced ILD. This is a slow-onset case of everolimus-induced ILD in a patient with renal cell carcinoma. Physicians should thus be aware of the potential for the development of ILD at any time during the administration of everolimus therapy.

  4. 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.

  5. Why do subjective vertigo and dizziness persist over one year after a vestibular vertigo syndrome?

    PubMed

    Best, Christoph; Eckhardt-Henn, Annegret; Tschan, Regine; Dieterich, Marianne

    2009-05-01

    The overlap and interlinkage of dizzy symptoms in patients with psychiatric and vestibular vertigo/dizziness disorders is the subject of an ongoing debate. In a one-year follow up in 68 patients with vestibular vertigo syndromes, the persistency of vertigo and dizziness symptoms was examined and correlated with vestibular parameters and results from a psychiatric evaluation. Patients with vestibular migraine showed poorest improvement of vertigo and dizziness symptoms over time. In addition, patients who developed anxiety or depressive disorder after the onset of the vestibular disorder showed poor improvement and high persistency of symptoms.

  6. 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.

  7. One-year follow-up study of first suicide attempts in first episode psychosis: Personality traits and temporal pattern.

    PubMed

    Canal-Rivero, Manuel; Barrigón, Maria Luisa; Perona-Garcelán, Salvador; Rodriguez-Testal, Juan F; Giner, Lucas; Obiols-Llandrich, Jordi E; Ruiz-Veguilla, Miguel

    2016-11-01

    The highest suicide rates occur after psychiatric hospitalization or soon after discharge. In addition to other factors, personality traits have been suggested as predictors of suicide attempts (SA) after first episode psychosis (FEP). In this study we examined their temporal pattern and the influence of personality traits on first suicide attempts (fSA) during one year after FEP. One-year follow-up of 65 FEP patients. Bivariate and multivariable analyses were performed to explore the relationship between personality traits and fSA. This analysis was also adjusted for a set of sociodemographic, clinical and psychopathological variables. fSAs in the six months following FEP were predicted by higher scores in passive-dependent personality traits (OR = 2.42, 95% CI = 1.15-5.09) and severity of symptoms at onset (OR = 2.00, 95% CI = 1.07-3.76). Severity of symptoms at onset (OR = 2.71, CI = 1.15-6.39) was the most significant predictor of fSA from six to twelve months after FEP. Seventy percent of fSA occurred during the first six months after FEP, decreasing considerably afterwards. Our study suggests that personality traits play a role in fSA after FEP. Specifically, passive-dependent personality traits emerged as a predictor of fSA in the six months following FEP. Severity of symptoms at onset predicted early and late first suicide attempts. We also found that risk of fSA is highest during the six months following FEP. These results can contribute to the implementation of prevention program. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Estimating the incidence and 30-day all-cause mortality rate of Escherichia coli bacteraemia in England by 2020/21.

    PubMed

    Bhattacharya, Alex; Nsonwu, Olisaeloka; Johnson, Alan P; Hope, Russell; England, Public Health; Infections, Healthcare Associated; Resistance, Antimicrobial

    2017-09-30

    Escherichia coli bacteraemia rates have been increasing in England. Using the national mandatory surveillance data for E. coli bacteraemia from 2012/13 to 2016/17, we aimed to estimate the incidence of E.coli bacteraemia and 30-day all-cause case fatality rate (CFR) by 2020/21 in the absence of new interventions to reduce infection rates. After controlling for age, sex, and hospital versus community-onset of infection, it is estimated that the incidence of E. coli bacteraemia will be 90.5 (95% PI: 89.8-91.3) per 100 000 population (n=50 663), with an associated CFR of 11.5 (95% PI: 11.2-11.8) per 100 000 population (n=6554) by 2020/21. Copyright © 2017. Published by Elsevier Ltd.

  9. THE CLINICAL UTILITY OF FUNCTIONAL PERFORMANCE TESTS WITHIN ONE-YEAR POST-ACL RECONSTRUCTION: A SYSTEMATIC REVIEW

    PubMed Central

    Narducci, Elizabeth; Waltz, Amanda; Gorski, Katheryn; Leppla, Lucas

    2011-01-01

    Introduction: A tear of the anterior cruciate ligament (ACL) represents a significant injury for an athlete that requires substantial time away from sport, and significant rehabilitation after reconstruction. The physical therapist is responsible to determine when a patient is capable of tolerating the physical demands of daily activities and to attempt to prevent re-injury. Physical or functional performance tests (FPTs) are one mechanism used to evaluate the athlete's physical skills and capabilities prior to returning to sports participation. The purpose of this systematic review is to critically examine the clinical utility of functional performance tests used with patients less than or equal to one year post ACL reconstruction. Methods: A systematic review of the relevant literature was performed using PRISMA guidelines. A total of twelve studies were included for analysis. Results: Two independent blinded reviewers then analyzed and rated the final included articles (n=12) utilizing the Newcastle-Ottawa Scale (NOS). Percent overall agreement between raters for the NOS was 88% with a fixed-marginal kappa (κ) of 0.80. Of the 12 included articles, the FPTs were utilized as an outcome measure within the study design (41.7%) or studied as a measure of function (58.3%). Among those studies that used FPTs as a “measure of function” 71.4% studied a battery of FPTs, while 28.6% studied a single test. None of the studies utilized FPTs as a measure to determine readiness to return to sport. Discussion: FPTs are being utilized with patients, less than or equal to one year post ACL reconstruction, either as an assessment of functional performance or as an outcome measure. No studies identified a FPT or test battery that has construct or predictive validity for “return to sport” in athletic population one-year post-ACL reconstruction. The identification of the critical elements within the return to sport construct may allow lower extremity performance tests to be

  10. Change in borderline symptoms one year after therapeutic community treatment for severe personality disorder.

    PubMed

    Dolan, B; Warren, F; Norton, K

    1997-09-01

    The view that severe personality disorder (SPD) is untreatable derives from poor-quality studies of treatment outcome which use indirect measures of SPD pathology. This study evaluates the impact of psychotherapeutic in-patient treatment on core personality disorder symptoms. 137 SPD patients completed the Borderline Syndrome Index (BSI) on referral and one year post-treatment ('admitted', n = 70) or one year post-referral ('non-admitted', n = 67); 22 of the non-admitted group were refused extra-contractual referral funding for their treatment. There was a significantly greater reduction in BSI scores in the treated than in the non-admitted group. Changes in BSI scores were significantly positively correlated with length of treatment. Assessment of the reliability and clinical significance of changes in individual subjects showed that the magnitude of this change was reliable and clinically significant in 42.9% of the admitted sample, compared with only 17.9% of the non-admitted sample (18.2% of the unfunded group). Specialist in-patient treatment is effective in reducing core SPD psychopathology.

  11. 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

  12. 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.

  13. Experiences of chronic stress one year after the Gulf oil spill.

    PubMed

    Werner, Danilea; Locke, Chris

    2012-01-01

    One of the largest oil spills in world history happened off the Alabama Gulf coast in April of 2010. One year later the Gulf Coast community was still trying to recover and reestablish itself as a major source for the shipping, tourism, fishing and energy industries. Although this disaster did not physically destroy communities and families, it did take an economic and psychological toll. Researchers conducted focus groups with mental health professionals employed by Project Rebound, a state sponsored response to disasters in Alabama to explore the mental health effects of the Gulf Oil Spill on two gulf coast communities one year after the spill. Project Rebound clinicians were the front line of the mental health response to the spill and collaborated with community service agencies to provide support to adults, children, and families in the Gulf Coast community. The semi-structured focus groups allowed staff to discuss the extent of mental health treatment utilization as well as provide valuable input as to what can be done to better prepare communities and agencies for future disasters.

  14. 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.

  15. 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.

  16. Auranofin versus penicillamine in rheumatoid arthritis. One-year results from a prospective clinical investigation.

    PubMed

    Manthorpe, R; Hørbov, S; Sylvest, J; Vinterberg, H

    1986-01-01

    Forty patients with definite or classical active rheumatoid arthritis were stratified by the minimization procedure to auranofin (6 mg/day) or penicillamine (go slow and low regime). This investigation is a prospective planned 3 year patient and 'doctor-open' as well as 'doctor-blind' clinical trial. This article describes the results after 12 months. Both drugs decreased disease activity and improved the functional capacity in a similar way. Two patients in the auranofin group and 5 in the penicillamine group stopped treatment due to major side effects. Four other patients in the auranofin group left treatment: 2 due to death from unrelated cause and 2 according to the Helsinki II Declaration. After one year a further patient in the auranofin group and 2 in the penicillamine group stopped treatment due to lack of clinical effect. Side effects due to auranofin were statistically more frequent distal in the gastrointestinal tract (loose stools/diarrhoea) than with penicillamine. In contrast, penicillamine produced significantly more side effects in the oral cavity (mainly taste disturbances) than auranofin. Other side effects were about equal in the two groups, but 2 cases of severe proteinuria and one with obstructive lung disease were observed in the penicillamine group. Only 3 patients did not complain of any untoward effect during the 12-month period. We conclude that on the basis of this one year investigation it is an open question whether one should select auranofin or penicillamine for the treatment of clinical active rheumatoid arthritis.

  17. One year orthopaedic trauma experience using an advanced interdisciplinary hybrid operating room.

    PubMed

    Richter, Peter H; Yarboro, Seth; Kraus, Michael; Gebhard, Florian

    2015-10-01

    Hybrid operating rooms have been used successfully in several surgical specialties, but no data have been published for orthopaedic trauma. We present our one-year orthopaedic trauma experience using a hybrid operating room, which incorporates 3D fluoroscopic imaging as well as navigation capabilities. Data were compiled for a series of 92 cases performed in an advanced hybrid operating room at the level one trauma center in Ulm, Germany. All patients who had surgery performed using this operating room during the first year were included. Setup time and surgical complications using hybrid operating room were recorded and analysed. The hybrid operating room resulted in no higher rate of complication than expected from the same cases in a conventional operating room. The hybrid room did however allow the surgeon to confidently place implants for orthopaedic trauma cases, and was most advantageous for spine and pelvis cases, both minimally invasive and conventional. Further, appropriate reduction and implant position was confirmed with 3D imaging prior to leaving the operating room and obviated the need for postoperative CT scan. Based on our one-year experience, the hybrid operating room is a useful and safe tool for orthopaedic trauma surgery.

  18. 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.

  19. 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

  20. The One-Year Mission: By the Numbers on This Week @NASA – February 26, 2016

    NASA Image and Video Library

    2016-02-26

    The International Space Station’s historic one-year expedition has been a mission of numbers – one that could add up to huge benefits for future space exploration – including the Journey to Mars, as well as for life on Earth. In March 2015, 2 space explorers, NASA’s Mark Kelly and Russia’s Mikhail Kornienko, set out on an unprecedented odyssey to the 1-and-only laboratory in microgravity, to conduct a multitude of biomedical and psychological studies on how the human body reacts to long-duration spaceflight. Based on a scheduled March 1 return to Earth – the one-year crew’s 340 days in space will have seen -- almost 400 experiments conducted aboard the station, 5,440 orbits of the Earth, and Kelly and Kornienko will have traveled a total of about 143, 846, 525 miles – roughly the distance of a trip from Earth to Mars. Also, Next space station crew trains, Tipping point technologies, CST-100 Starliner water testing, and NASA’s journey to diversity!

  1. Epidemiology of cancer in children under one year of age in Mexico City.

    PubMed

    Rendón-Macías, M E; Mejía-Aranguré, J M; Juárez-Ocaña, S; Fajardo-Gutiérrez, A

    2005-04-01

    In this work, the epidemiology of cancer in children under one year of age in Mexico City is described. A survey (observational, descriptive and prolective study) from 1 January 1996 to 31 December 1999 was conducted at two paediatric hospitals of the Instituto Mexicano de Seguro Social in Mexico City (IMSS-MC). To calculate both the general and the by sex incidence (rates are given per 10) all new cases recorded for children under one year of age (numerator) and Mexico City population served by the IMSS (denominator) were used. When the total of 34 cases that fulfilled the requirements was analysed, an incidence of 194.5 was obtained. Leukaemia occupied first place with a rate of 68.6 and hepatic and germinal cells tumours occupied second place with an incidence of 28.6, whereas peripheral nervous system tumours (neuroblastoma) showed a very low rate (11.4). Overall, the male/female ratio for tumours was 1.4:1, with the ratio varying with different types of tumours. Cancer incidence in this population was shown to be close to that in developed countries, but differed in the distribution of the type of tumour: leukaemia had a very high incidence and that for neuroblastoma was very low.

  2. One-year reciprocal relationship between community participation and mental wellbeing in Australia: a panel analysis.

    PubMed

    Ding, Ning; Berry, Helen L; O'Brien, Léan V

    2015-03-01

    The links between social capital and mental wellbeing are established but the direction of the social capital-wellbeing relationship is rarely systematically examined. This omission undermines the validity of social capital as a basis for health interventions. The aim of this paper was to explore the short-term (one-year) reciprocal relationship between community participation - an important component of social capital - and mental wellbeing. We used nationally representative Household, Income and Labour Dynamics in Australia (HILDA) Survey data, 2005-11. The HILDA Survey is an annual cohort study from which was extracted a sub-sample of panel data (the same people participating across multiple waves) enabling us to use fixed effects regression methods to model the longitudinal association of mental health and participation controlling for individual heterogeneity. The results showed that better mental wellbeing in one year was generally related to more community participation the next year, while greater past community participation was linked to better mental wellbeing the next year independent of (i) initial mental wellbeing, (ii) multiple potentially confounding factors and (iii) unobserved and time-constant heterogeneity. Political participation was marginally related to worse mental health in both directions. The results also showed that the association between community participation and mental wellbeing the next year is weaker for those with poor initial wellbeing than for initially healthier respondents. Our findings may inform the trial and scientific evaluation of programs aimed at increasing informal social connectedness and civic engagement to promote mental wellbeing.

  3. [One-year effect of health counseling on life style and risk factors of heart disease].

    PubMed

    Andersen, Lars Bo; Klausen, Klaus; Nisbeth, Ole

    2002-03-25

    We examined the need for counselling and the effect on willingness and ability to change life-style, and subsequent changes in risk factors for CHD. All 152 male employees in a computer company, 25-45 years of age, were invited to participate in a controlled intervention study over one year. The subjects were randomised to an intervention group (I group) and a control group. The I group was divided into subgroups based on baseline behaviour and risk factor status. Changes were evaluated after one year. After an initial health examination, participants in the I group were counselled at baseline and at 5 months. Eighty-five (56%) men participated. Twenty-nine were assigned to a control group and 56 to an intervention group (I group) (dropouts = 8). An exercise group (E group) was advised to take up aerobics exercise three times/week, a diet group to reduce the intake of saturated fat and increase fish products, and smokers to stop smoking. Forty were recommended one or more behavioural changes and eight had no need. Thirty-four were willing to make behavioural changes. Compared to the control group, the fitness level increased (p < 0.01) and body weight decreased in the I group (p < 0.05). Individual counselling promotes regular exercise with subsequent improvements in CHD risk factors. The diet and smoking counselling models were less successful in terms of compliance.

  4. One year follow-up of the Chicago televised smoking cessation program.

    PubMed Central

    Flay, B R; Gruder, C L; Warnecke, R B; Jason, L A; Peterson, P

    1989-01-01

    We compared the relative effectiveness of four different conditions of self-help and social support provided to people attempting to quit smoking in conjunction with a televised cessation program: Smokers ready to quit were able to request written manuals from hardware stores to accompany a televised program. At worksites we provided the written manual to all workers. At a random half of the worksites, we also provided training to discussion leaders who subsequently led discussions among smokers attempting to quit with the program. At health maintenance organization sites we invited smokers who had requested program materials to participate in similar group discussions at health centers. In this paper we report one year follow-up results for the above four groups and compare them with previously reported results of a self-help manual alone. Results for the television plus manual condition were better than those of past studies (25 percent nonsmoking prevalence and 10 percent continuous cessation one year after the program) and considerably better than the manual alone. None of the other conditions designed to supplement the manual plus television produced better long-term outcomes; we explore the reasons for this. The program did encourage and help over 50,000 Chicago smokers to attempt quitting with the American Lung Association manual, 100 times as many as would have done so without the televised program. At least 15 other similar programs implemented since 1984 multiply this effect. PMID:2782506

  5. Results of the prospective evaluation of radial keratotomy (PERK) study one year after surgery.

    PubMed

    Waring, G O; Lynn, M J; Gelender, H; Laibson, P R; Lindstrom, R L; Myers, W D; Obstbaum, S A; Rowsey, J J; McDonald, M B; Schanzlin, D J

    1985-02-01

    The Prospective Evaluation of Radial Keratotomy (PERK) study is a nine-center, self-controlled clinical trial of a standardized technique of radial keratotomy in 435 patients who had physiologic myopia with a preoperative refraction between -2.00 and -8.00 diopters. The surgical technique consisted of eight incisions using a diamond micrometer knife with blade length determined by intraoperative ultrasonic pachymetry and the diameter of central clear zone determined by preoperative refraction. At one year after surgery, myopia was reduced in all eyes; 60% were within +/- 1.00 diopter of emmetropia; 30% were undercorrected and 10% were overcorrected by more than 1.00 diopter (range of refraction, -4.25 to +3.38 D). Uncorrected visual acuity was 20/40 or better in 78% of eyes. The operation was most effective in eyes with a refraction between -2.00 and -4.25 diopters. Thirteen percent of patients lost one or two Snellen lines of best corrected visual acuity. However, all but three eyes could be corrected to 20/20. Ten percent of patients increased astigmatism more than 1.00 diopter. Disabling glare was not detected with a clinical glare tester, but three patients reduced their driving at night because of glare. Between six months and one year, the refraction changed by greater than 0.50 diopters in 19% of eyes.

  6. [Distortion product otoacoustic emissions before and after one year exposure to impulse noise].

    PubMed

    Konopka, Wiesław; Olszewski, Jurek; Pietkiewicz, Piotr; Mielczarek, Marzena

    2006-01-01

    Firearms are a common source of impulse noise that may be very harmful to the auditory organ. Impulse noise from weapons and explosions continually produces hearing damage among military personnel. The discovery of otoacoustic emission (OAE) has given a new possibility of early diagnosis of noise induced hearing loss. The transiently evoked otoacoustic emission (TEOAE) and distortion product otoacoustic emission (DPOAE) are non-invasive, objective and frequency specific audiometric tests for evaluating outer hair cell function. The aim of the study was to asses the effects of exposure to impulse noise on DPOAE after one year of the obligatory military service. The study comprised 92 (184 ears) soldiers, subjected to impulse noise during military service. The examine group was divided according total noise exposure. The control group consisted of secondary school students not exposed to noise. DPOAE was recorded before and after one year of military service. After military service significant deterioration of DPOAE level was observed at frequencies of 1, 3, and 4 kHz on the right ear and 2, 5 and 6 kHz left one. 1. Reduction of DPOAE amplitude connected all frequencies. 2. We did not notice significant differences between groups connected total noise exposure.

  7. Analysis of the new code stroke protocol in Asturias after one year. Experience at one hospital.

    PubMed

    García-Cabo, C; Benavente, L; Martínez-Ramos, J; Pérez-Álvarez, Á; Trigo, A; Calleja, S

    2016-07-25

    Prehospital code stroke (CS) systems have been proved effective for improving access to specialised medical care in acute stroke cases. They also improve the prognosis of this disease, which is one of the leading causes of death and disability in our setting. The aim of this study is to analyse results one year after implementation of the new code stroke protocol at one hospital in Asturias. We prospectively included patients who were admitted to our tertiary care centre as per the code stroke protocol for the period of one year. We analysed 363 patients. Mean age was 69 years and 54% of the cases were men. During the same period in the previous year, there were 236 non-hospital CS activations. One hundred forty-seven recanalisation treatments were performed (66 fibrinolysis and 81 mechanical thrombectomies or combined treatments), representing a 25% increase with regard to the previous year. Recent advances in the management of acute stroke call for coordinated code stroke protocols that are adapted to the needs of each specific region. This may result in an increased number of patients receiving early care, as well as revascularisation treatments. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Predominance of healthcare-associated cases among episodes of community-onset bacteraemia due to extended-spectrum β-lactamase-producing Enterobacteriaceae.

    PubMed

    Zahar, Jean-Ralph; Lesprit, Philippe; Ruckly, Stephane; Eden, Aurelia; Hikombo, Hitoto; Bernard, Louis; Harbarth, Stephan; Timsit, Jean-François; Brun-Buisson, Christian

    2017-01-01

    Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) are endemic pathogens worldwide. Infection with ESBL-PE may be associated with inadequate antibiotic therapy and a poor outcome. However, risk factors for ESBL-PE community-acquired infections are ill-defined. An observational multicentre study was performed in 50 hospitals to identify the prevalence of and risk factors for community-acquired ESBL-PE bacteraemia. All patients presenting with community-onset Enterobacteriaceae bacteraemia were recorded over a 2-month period (between June and November 2013). Risk factors and 14-day outcomes of patients were investigated. Among 682 Enterobacteriaceae bacteraemia episodes recorded, 58 (8.5%) were caused by ESBL-PE. The most frequent species isolated were Escherichia coli (537; 76.7%) and Klebsiella spp. (68; 9.7%), of which 49 (9.1%) and 8 (11.8%), respectively, were ESBL-producers. Most ESBL-PE episodes were healthcare-associated, and only 22 (38%) were apparently community-acquired. The main risk factor for community-acquired ESBL-PE bacteraemia was a prior hospital stay of ≥5 days within the past year. The overall 14-day survival was 90%; only 4 (6.9%) of 58 patients with ESBL-PE bacteraemia died. Inadequate initial antibiotic therapy was administered to 55% of patients with ESBL-PE bacteraemia but was not associated with increased 14-day mortality. Although many patients had community-onset ESBL-PE bacteraemia, almost two-thirds of the episodes were actually healthcare-associated, and true community-acquired ESBL-PE bacteraemia remains rare. In our essentially non-severely ill population, inappropriate initial therapy was not associated with a higher risk of mortality.

  9. Clostridium hastiforme bacteraemia secondary to pyometra in a 64-year-old woman.

    PubMed

    Ørum, Matilde; Fuglsang-Damgaard, David; Nielsen, Hans Linde

    2017-01-18

    The Gram-negative, rod-shaped, anaerobe bacteria Tissierella praeacuta was first described in 1908 by Tissier. However, during the past decade, Clostridium hastiforme has been recognised as a later synonym of T. praeacuta. C. hastiforme/T. praeacuta has only rarely been described in previous literature as a cause of human infection. We present here a case report of C. hastiforme/T. praeacuta bacteraemia secondary to pyometra in a 64-year-old woman with a history of multiple sclerosis and an intrauterine device inserted three decades earlier. C. hastiforme/T. praeacuta was isolated from blood as well as pus from the site of infection. The patient was cured with a combination of drainage and antibiotic therapy.

  10. Haemolytic–uraemic syndrome with bacteraemia caused by a new hybrid Escherichia coli pathotype

    PubMed Central

    Mariani-Kurkdjian, P; Lemaître, C; Bidet, P; Perez, D; Boggini, L; Kwon, T; Bonacorsi, S

    2014-01-01

    We describe a new atypical Shiga-toxin-producing Escherichia coli (STEC) responsible for a severe episode of haemolytic–uraemic syndrome in an adult with a relapse associated with bacteraemia. This STECs train of serotype O80:H2 harboured stx2c and stx2d gene subtypes, the rare eae ξ variant and a ColV plasmid with a conserved virulence plasmidic region involved in virulence of human and avian extraintestinal pathogenic E. coli. This atypical hybrid pathotype, which represents a new threat, is a further demonstration that STEC may be a recipient for extraintestinal virulence factors and raises again the question of antibiotic therapy during STEC infection. PMID:25356358

  11. 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.

  12. Naturally occurring bacteraemia in American lobsters, Homarus americanus Milne-Edwards, in Long Island Sound.

    PubMed

    Bartlett, S L; Wooster, G A; Sokolowski, M S; Dove, A D M; Bowser, P R

    2008-01-01

    The health status of the American lobster, Homarus americanus Milne-Edwards, in Long Island Sound (LIS) has been in decline, with seasonal mortality events occurring since 1998. In order to assess the potential effects of environmental conditions on lobster health via haemolymph analysis, lobsters collected from various sites in LIS were examined and sampled while concurrent environmental data (water temperature, salinity and dissolved oxygen) were recorded. The pH of the haemolymph of each lobster was tested, followed by a collection of haemolymph for serum biochemistry analysis and bacterial culture. This report focuses on the results of the bacterial sampling. The majority of bacteria cultured were opportunistic pathogens commonly found in the environment, including some that are associated with sewage and pollution. The prevalence of bacteraemia was correlated with the site of collection, the month in which the lobsters were sampled, and water temperature.

  13. Vibrio cholerae non-O1, non-O139 bacteraemia associated with pneumonia, Italy 2016.

    PubMed

    Marinello, Serena; Marini, Giulia; Parisi, Giancarlo; Gottardello, Lorena; Rossi, Lucia; Besutti, Valeria; Cattelan, Anna Maria

    2017-04-01

    This paper describes an elderly male patient, living in the Veneto Region, Italy, who developed Vibrio cholerae bacteraemia and pneumonia. Some days previously, while on holiday in the Lagoon of Venice, he had been collecting clams in seawater, during which he suffered small abrasions of the skin. On admission to hospital, he was confused, had fever and a cough, but neither diarrhoea nor signs of gastroenteritis were found. Both blood and stool cultures grew V. cholerae of non-O1 non-O-139 type, and the patient recovered after prompt administration of intravenous ceftriaxone for 2 weeks. This clinical case emphasises the role of global warming and climate changes in causing increasing numbers of water-borne infections.

  14. 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.

  15. Antibiotic treatment and mortality in patients with Listeria monocytogenes meningitis or bacteraemia.

    PubMed

    Thønnings, S; Knudsen, J D; Schønheyder, H C; Søgaard, M; Arpi, M; Gradel, K O; Østergaard, C

    2016-08-01

    Invasive Listeria monocytogenes infections carry a high mortality despite antibiotic treatment. The rareness of the infection makes it difficult to improve antibiotic treatment through randomized clinical trials. This observational study investigated clinical features and outcome of invasive L. monocytogenes infections including the efficacy of empiric and definitive antibiotic therapies. Demographic, clinical and biochemical findings, antibiotic treatment and 30-day mortality for all episodes of L. monocytogenes bacteraemia and/or meningitis were collected by retrospective medical record review in the North Denmark Region and the Capital Region of Denmark (17 hospitals) from 1997 to 2012. Risk factors for 30-day all-cause mortality were assessed by logistic regression. The study comprised 229 patients (median age: 71 years), 172 patients had bacteraemia, 24 patients had meningitis and 33 patients had both. Significant risk factors for 30-day mortality were septic shock (OR 3.0, 95% CI 1.4-6.4), altered mental state (OR 3.6, 95% CI 1.7-7.6) and inadequate empiric antibiotic therapy (OR 3.8, 95% CI 1.8-8.1). Cephalosporins accounted for 90% of inadequately treated cases. Adequate definitive antibiotic treatment was administered to 195 patients who survived the early period (benzylpenicillin 72, aminopenicillin 84, meropenem 28, sulfamethoxazole/trimethoprim 6, and piperacillin/tazobactam 5). Definitive antibiotic treatment with benzylpenicillin or aminopenicillin resulted in a lower 30-day mortality in an adjusted analysis compared with meropenem (OR 0.3; 95% CI 0.1-0.8). In conclusion, inadequate empiric antibiotic therapy and definitive therapy with meropenem were both associated with significantly higher 30-day mortality.

  16. [Economic impact of nosocomial bacteraemia. A comparison of three calculation methods].

    PubMed

    Riu, Marta; Chiarello, Pietro; Terradas, Roser; Sala, Maria; Castells, Xavier; Knobel, Hernando; Cots, Francesc

    2016-12-01

    The excess cost associated with nosocomial bacteraemia (NB) is used as a measurement of the impact of these infections. However, some authors have suggested that traditional methods overestimate the incremental cost due to the presence of various types of bias. The aim of this study was to compare three assessment methods of NB incremental cost to correct biases in previous analyses. Patients who experienced an episode of NB between 2005 and 2007 were compared with patients grouped within the same All Patient Refined-Diagnosis-Related Group (APR-DRG) without NB. The causative organisms were grouped according to the Gram stain, and whether bacteraemia was caused by a single or multiple microorganisms, or by a fungus. Three assessment methods are compared: stratification by disease; econometric multivariate adjustment using a generalised linear model (GLM); and propensity score matching (PSM) was performed to control for biases in the econometric model. The analysis included 640 admissions with NB and 28,459 without NB. The observed mean cost was €24,515 for admissions with NB and €4,851.6 for controls (without NB). Mean incremental cost was estimated at €14,735 in stratified analysis. Gram positive microorganism had the lowest mean incremental cost, €10,051. In the GLM, mean incremental cost was estimated as €20,922, and adjusting with PSM, the mean incremental cost was €11,916. The three estimates showed important differences between groups of microorganisms. Using enhanced methodologies improves the adjustment in this type of study and increases the value of the results. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  17. Staphylococcus aureus bacteraemia in a UK tertiary referral centre: a 'transoesophageal echocardiogram for all' policy.

    PubMed

    Holden, Elisabeth; Bashir, Ahmed; Das, Ira; Morton, Hugh; Steadman, Christopher D; Nightingale, Peter; Steeds, Richard P; David, Miruna D

    2014-07-01

    Infective endocarditis (IE) is a feared complication in up to 38% of cases of Staphylococcus aureus bacteraemia (SAB). BSAC guidelines recommend echocardiography in all cases of SAB. The aim of this study was to determine the incidence of IE in SAB using transoesophageal echocardiography (TOE) as the first step in diagnostic imaging. This study also sought to identify clinical predictors that could improve stratification of those with and without IE. A guideline was implemented that any SAB resulted in the microbiology department (i) recommending that the patient be referred for TOE and (ii) notifying the echocardiography department, resulting in streamlined listing of the patient for TOE. All cases of SAB were then assessed prospectively at University Hospitals Birmingham NHS Foundation Trust between September 2011 and October 2012. Previously identified risk factors for complicated S. aureus bacteraemia were recorded. There were 98 SAB episodes in total. TOE was performed in 58 (59%) with a further 22 episodes imaged by transthoracic echocardiography alone. IE was diagnosed overall in 13 (16%) cases investigated with echocardiography. No risk factor for IE other than presence of a cardiac device was detected in this group (P = 0.013). The rate of IE found in SAB is high when TOE is performed first line. There are no clear risk factors to improve yield or the type of echocardiography to be performed. Echocardiography should be performed in all cases and TOE should be considered where it is expected to influence management, as long as local resources allow. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  18. Bacteraemia in neonatal foals: clinicopathological differences between Gram-positive and Gram-negative infections, and single organism and mixed infections.

    PubMed

    Corley, K T T; Pearce, G; Magdesian, K G; Wilson, W D

    2007-01-01

    Treatment for bacteraemia in foals must be started before the identity of the causative organism is known. Information aiding selection of effective antimicrobials should improve outcome. To describe differences in clinical and clinicopathological data and outcome in foals with bacteraemia due to different classes of bacteria. Records of foals with a positive blood culture, age < 10 days and presenting to a university hospital 1995-2004, were reviewed. Bacterial culture results, subject details, historical information, physical examination findings at admission and clinicopathological data generated during the first 48 h of hospitalisation were analysed. Results from foals with Gram-positive or Gram-negative organisms, single or mixed organism bacteraemias, and with bacteraemia due to 3 commonly isolated organisms were compared. Eighty-five foals met the inclusion criteria. Gram-negative organisms (n = 59) Gram-positive organisms (n = 13) or multiple organisms (n = 19) were cultured from individual foals. Foals with Gram-negative bacteraemia had lower total white blood cell and lymphocyte counts at admission than did those from which only Gram-positive bacteria were cultured. Mixed organism bacteraemia was associated with tachycardia, increased serum concentrations of sodium, chloride and urea nitrogen, acidosis, respiratory distress, recumbency on admission and nonsurvival. Actinobacillus spp. infections were associated with leucopenia, neutropenia, lymphopenia and depression on hospital admission. Recognising particular patterns of clinical and clinicopathological findings associated with infection with specific groups of bacteria may, in the future, aid antimicrobial selection and influence prognosis in bacteraemic foals.

  19. Serratia marcescens bacteraemia outbreak in haemodialysis patients with tunnelled catheters due to colonisation of antiseptic solution. Experience at 4 hospitals.

    PubMed

    Merino, José L; Bouarich, Hanane; Pita, Mª José; Martínez, Patricia; Bueno, Blanca; Caldés, Silvia; Corchete, Elena; Jaldo, Mª Teresa; Espejo, Beatriz; Paraíso, Vicente

    The application of antiseptic solution for handling tunnelled catheters is recommended in patients undergoing haemodialysis. These routine antiseptic procedures in handling catheters are crucial to avoid complications. We report an outbreak of Serratia marcescens (S. marcescens) bacteraemia in numerous haemodialysis units of the Community of Madrid. The first cases of bacteraemia due to S. marcescens were isolated in December 2014. The Preventive Medicine Services were informed of the detection of an atypical pathogen in several patients, suspecting a probable nosocomial outbreak. Information from 4 centres with similar S. marcescens bacteraemia was analysed. Twenty-one cases of bacteraemia related to S. marcescens were identified. The mean age of affected patients was 72±10 years. The mean time on haemodialysis of affected patients was 33±13 months (range: 3-83 months), the median time of tunnelled catheter was 22±13 months. In 11 cases the clinical picture was similar, with hypotension and general malaise during the haemodialysis session. Fever was present in a further 7 cases. In 3 cases the presentation was asymptomatic and was detected by blood cultures. All patients had tunnelled catheters (12 patients with catheter in the right jugular vein, 5 in the left jugular, 2 in the right femoral artery and 2 in the left subclavian artery). Gentamicin intravenous doses (1mg/kg) with catheter lock solution with ciprofloxacin post-dialysis were administered for 3 weeks in 6 patients. In 12 patients the treatment was ceftazidime (2g IV) plus catheter lock solution with the same antibiotic, for 2 weeks. Four patients received oral ciprofloxacin for 2 weeks, in one case together with IV vancomycin. The patients were asymptomatic and without new episodes 48hours after the treatment. No major complications were observed. The teams informed the health authorities of the situation, which then reported the presence of batches of antiseptic (chlorhexidine 0.05 and 2

  20. Hypervirulent Klebsiella pneumoniae clones causing bacteraemia in adults in a teaching hospital in Barcelona, Spain (2007-2013).

    PubMed

    Cubero, M; Grau, I; Tubau, F; Pallarés, R; Dominguez, M A; Liñares, J; Ardanuy, C

    2016-02-01

    Virulent hypermucoviscous Klebsiella pneumoniae strains associated with the magA and rmpA genes have mainly emerged in Asia. We analysed the frequency and the clinical and molecular epidemiology of K. pneumoniae bacteraemia isolates obtained over a 7-year period (2007-2013). Fifty-three of 878 K. pneumoniae invasive isolates (5.4%) showed a hypermucoviscous phenotype (by the string test). Of these, 16 (30.2%) were magA(+)/rmpA(+), 12 (22.6%) were magA(-)/rmpA(+), and the remaining 25 (47.2%) were magA(-)/rmpA(-). After multilocus sequence typing and wzi sequencing, all magA(+)/rmpA(+) isolates were serotype K1 and sequence type (ST)23. Of the 12 magA(-)/rmpA(+) isolates, nine were K2 (ST380, ST86, ST65, ST25 and ST493), and three magA(-)/rmpA(+) isolates had the new wzi allele 122, an unknown serotype, and the new ST1013. The remaining isolates, which were magA(-)/rmpA(-), showed different serotypes and STs. Patients with magA(+)/rmpA(+) or magA(-)/rmpA(+)K. pneumoniae bacteraemia more frequently had pyogenic liver abscesses (PLAs) and pneumonia than patients with magA(-)/rmpA(-)K. pneumoniae bacteraemia (respectively: 21.4% vs. 8%, p 0.26; and 17.9% vs. 0%, p 0.05). In fact, magA(-)/rmpA(-) isolates were similar to the those termed 'classic' K. pneumoniae isolates causing bacteraemia, the urinary and biliary tracts being the main foci of infection. In conclusion, hypervirulent clones (CC23K1, CC86K2, CC65K2, and CC380K2) were infrequent among K. pneumoniae isolates causing bacteraemia in our geographical area. A hypermucoviscous phenotype as determined with the string test is not enough to recognize these clones; additional molecular studies are needed. Patients with magA(+) and/or rmpA(+)K. pneumoniae bacteraemia more frequently had PLAs and pneumonia than patients without hypermucoviscosity genes. Copyright © 2015. Published by Elsevier Ltd.

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

    PubMed

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

    2016-01-01

    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. 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. Primary care in Finland. A total of 46 research course participants who had finished the research courses between 2007 and 2012. 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. 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. Clinical 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 research course. A doctoral research course encouraged networking, and

  2. 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

  3. A One-Year Evaluation of a Free Fissure Sealant Program

    PubMed Central

    M, Bakhtiar; N, Azadi; A, Golkari

    2016-01-01

    Statement of Problem: Pit and fissure sealant therapy has been approved as an effective measure in the prevention of occlusal dental caries. Resin based materials are the most common materials used worldwide. A variety of resin based fissure sealants are produced and used. Most of them have been presented with ideal results in research environment. However, their effectiveness in the real life, especially in a mass application program such as Iran’s oral health reform plan is not clear. Objectives: To evaluate the longevity of different fissure sealant applied in Iran’s oral health reform plan in Fars Province (south of Iran) after one year. Materials and Methods: Seven counties were selected. One hundred 6- to 8-year-old school children who had undergone fissure sealant therapy in spring 2015 were randomly selected from each county. Their first molars were examined to evaluate the status of the fissure sealants which were applied one year ago. Data on the type/brand of fissure sealant materials, type and experience of clinicians who applied them, existence of a chair-side assistant, and whether the children were caries-free at the time of fissure sealant application were collected from the existing reports. Results: Data of 1974 teeth from 598 children were used for the final analysis. The effects of type/brand of the material was significant on the final results and remained significant (p < 0.001) after adjustments for the level of fluoride, urban/rural area, upper/lower jaw, type of clinician who applied the sealant, existence of a chair-side assistant, and child’s gender, age, and being caries-free. Conclusions: Many factors affect the success rate of a fissure sealant therapy program. The type/brand of the material remained significantly related to the success rate of the fissure sealant even after adjustments for other influencing factors. In this study, ClinproTM Sealant (3M/ESPE, USA) showed better longevity after one year of application. PMID

  4. FUNCTIONAL TESTING TO DETERMINE READINESS TO DISCONTINUE BRACE USE, ONE YEAR AFTER ACL RECONSTRUCTION

    PubMed Central

    Hunter‐Giordano, Airelle; Axe, Michael J.; Snyder‐Mackler, Lynn

    2013-01-01

    Background: While the use of functional knee braces for return to sports or high level physical activity after ACL reconstruction (ACLR) is controversial, brace use is still prevalent.1,2,3,4,5 All active patients in the practice are braced after ACLR and must pass a battery of sports tests before they return to play in their brace. Criteria include a 90% score on 4 one‐legged hop tests9 burst superimposition strength test,10 Knee Outcome Survey Activities of Daily Living Scale,8 and a global rating of knee function. Purpose: The purpose of this study was to describe the use of criterion‐based guidelines to determine if athletes who had undergone an ACLR function better with or without their functional brace, one year after surgery. Study Design: Cross‐Sectional Study Methods: Sixty‐four patients post ACLR performed 4 one‐legged hop tests,9 burst superimposition strength test,10 and completed the Knee Outcome Survey Activities of Daily Living Scale,8 and a global rating of knee function one year after surgery with and without their brace. Results: Participants included 35 men and 29 women with a mean age of 25 years. The Mean Knee Outcome Survey Activities of Daily Living score was 98%, and the global rating was 97%. Of the subjects, one patient failed hop testing by at least one criterion with and without the brace. Three additional patients failed the test while braced but passed un‐braced, and one patient passed with the brace, but failed without the brace. Subjects performed significantly better un‐braced than braced in all hop tests: single leg hop braced = 101%; un‐braced = 107% (p<0.001); cross‐over hop braced = 100%; un‐braced = 105% (p<0.001); triple hop braced = 99%; un‐braced = 101% (p=0.003); timed hop braced = 98%; un‐braced = 103% (p = 0.004). Conclusions: Sixty‐two of 64 patients continued to score above return to play criteria one year after ACLR. All but two subjects in the cohort performed better un‐braced than braced

  5. Embryonated duck ("balut") eggshell aspiration in a one-year-old boy.

    PubMed

    Lapeña, J F

    2009-05-01

    A one-year-old boy with two months' chronic cough and dysphonia, unresponsive to therapy for pneumonia, had a radiopaque, wedge-shaped tracheal foreign body noted on anteroposterior, but not lateral radiographs, and he eventually became aphonic. Laryngoscopy yielded a subglottic embryonated duck eggshell. Foreign body aspiration should be considered in the presence of chronic cough. Radiopaque airway foreign bodies may be metallic or calcific. The patient was fond of sucking soup from a partially-shelled embryonated duck egg. The last occasion occurred immediately before the onset of cough. The hard egg white of the same delicacy is a commonly-ingested oesophageal foreign body in the Philippines, but the preceding slurping of the amniotic fluid predisposes one to unusual eggshell aspiration. With the continuing global migration of overseas workers and their families, healthcare providers with Asian and Southeast Asian clients should consider such cultural practices in assessing symptoms suggestive of aerodigestive foreign bodies.

  6. One-year follow-up of toric intraocular lens implantation in forme fruste keratoconus.

    PubMed

    Navas, Alejandro; Suárez, Raúl

    2009-11-01

    We present 2 cases of toric intraocular lens implantation for keratoconus: A 55-year-old man with forme fruste keratoconus with a preoperative uncorrected distance visual acuity (UDVA) of 20/800 and a refraction of -6.50-3.00x135 and a 46-year-old man with a claw-shaped topographic pattern, a family history of keratoconus, and a UDVA of 20/800 with a refraction of -5.00-3.00x85. The refraction had been stable for at least 5 years in both patients. Phacoemulsification and implantation of an acrylic toric IOL were uneventful. One year postoperatively, the UDVA was 20/25 in both cases, with a refraction of -0.25-0.50x140 and 0.25-0.50x60, respectively. No progression and no IOL rotation were observed. Toric IOLs may provide excellent outcomes in patients with stable and nonprogressive corneal ectasia.

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. IMA GFATM RNTCP PPM project: milestones in sight one year after.

    PubMed

    Chugh, Satish

    2008-07-01

    The IMA GFATM RNTCP PPM has completed its one year journey on 31-03-2008 and gaining the momentum. The IMA's three-tier administrative structure looks after the Project Implementation Plan (PIP) at all levels. At the end of first year, the PIP has come up to the satisfaction of all. The indicators of success have been tabulated and reproduced in this article. The objectives, targets of 'stop tuberculosis' strategy by 2050 has been mentioned to inform that less than 1 case per million population per year will no longer be a public health problem. What is public-private mix and how it enhances the quality of diagnosis and takes treatment convenient for patients is also being elaborated. Scientific bases of intermittent regimen of DOTS are also effective and this forms the rationale of the usage of the thrice-weekly regimens recommended in the RNTCP.

  12. Improved cognitive function in schizophrenia after one year of cognitive training and vocational services.

    PubMed

    Greig, Tamasine C; Zito, Wayne; Wexler, Bruce E; Fiszdon, Joanna; Bell, Morris D

    2007-11-01

    A year-long program of Neurocognitive Enhancement Therapy (NET) was used to remediate cognitive deficits in people with schizophrenia who were participating in a vocational program. Seventy-two stable outpatients with schizophrenia or schizoaffective disorder, recruited from an urban community mental health center were randomly assigned to a twelve-month vocational program (VOC) or NET+VOC. The vocational program had characteristics of individual placement and support (IPS) programs but also included transitional funding. NET included computer-based cognitive training exercises, a social information processing group and a work feedback group. Sixty-two participants completed a neuropsychological test battery before and after treatment. After one year of treatment, participants receiving NET+VOC had significantly greater improvements on measures of executive function and working memory than did participants in the VOC only condition. Augmenting vocational services with a multifaceted cognitive remediation program may improve cognition in participants with schizophrenia or schizoaffective disorder.

  13. Clinical outcomes at one year following keratoconus treatment with accelerated transepithelial cross-linking

    PubMed Central

    Artola, Alberto; Piñero, David P.; Ruiz-Fortes, Pedro; Soto-Negro, Roberto; Pérez-Cambrodí, Rafael J

    2017-01-01

    This study evaluated the clinical outcomes in keratoconus corneas following accelerated transepithelial corneal collagen cross-linking (CXL) (Avedro KXL® system, Waltham, MA, USA) over one year of follow-up. The mean depth of the demarcation line measured by optical coherence tomography (OCT) was 205.19 µm. One month after surgery, a non-statistically significant change was noted in sphere (P=0.18) and in spherical equivalent (P=0.17), whereas a significant improvement was observed in corrected distance visual acuity (P=0.04). A significant change was observed in topographic astigmatism (P=0.03) and posterior corneal a sphericity (P=0.04). Accelerated transepithelial CXL may be a useful technique for the management of progressive keratoconus. PMID:28503442

  14. [Vitamin B12 deficiency in a one-year-old, exclusively breast fed child].

    PubMed

    Borkowska, Anna; Plata-Nazar, Katarzyna; Łuczak, Grazyna; Matheisel, Agnieszka

    2007-01-01

    Vitamin B12 deficiency is a rare condition in children. The most frequent cause is vegetarian diet. In infants it can happen in breast fed children whose mother is on this diet. The clinical feature of the disease presents with megaloblastic anemia and symptoms such as: weakness, refusing to eat, hypotonia, paraesthesia, delayed or regressed development. We present a case report of vitamin B12 deficiency in a one-year-old, exclusively breast fed child. The mother's diet during pregnancy and breast-feeding were normal. The quality of the mother's diet and her haematological status during pregnancy and breast-feeding should be carefully monitored. It is necessary to introduce a variety of foods to expand the infant's diet at the proper time. The diagnosis of anaemia in the mother and/or in the child requires a careful investigation.

  15. The new FUor star HBC 722 - one year after the outburst

    NASA Astrophysics Data System (ADS)

    Semkov, Evgeni; Peneva, Stoyanka

    The first results from studies of the new FU Orionis star found in the field of NGC 7000 are presented in the paper. During one year since the registration of outburst fourteen papers containing data from observations of this object have been published in the astronomical journals. These publications present photometric and spectral observations of HBC 722 ranging from the far infrared to X-ray wavelength region. HBC 722 is the first FU Orionis object, whose outburst was observed from its very beginning in all spectral ranges. We expect that the interest in this object will increase in the coming years and the results will help to explore the nature of young stars.

  16. 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

  17. [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.

  18. One-year outcomes after successful chronic total occlusion percutaneous coronary intervention.

    PubMed

    Wilson, W M; Walsh, S J; Bagnall, A; Yan, A T; Hanratty, C G; Egred, M; Smith, E; Oldroyd, K G; McEntegart, M; Irving, J; Douglas, H; Strange, J; Spratt, J C

    2017-03-15

    We aimed to determine clinical outcomes 1 year after successful chronic total occlusion (CTO) PCI and, in particular, whether use of dissection and re-entry strategies affects clinical outcomes. Hybrid approaches have increased the procedural success of CTO percutaneous coronary intervention (PCI) but longer-term outcomes are unknown, particularly in relation to dissection and re-entry techniques. Data were collected for consecutive CTO PCIs performed by hybrid-trained operators from 7 United Kingdom (UK) centres between 2012 and 2014. The primary endpoint (death, myocardial infarction, unplanned target vessel revascularization) was measured at 12 months along with angina status. One-year follow up data were available for 96% of successful cases (n = 805). In total, 85% of patients had a CCS angina class of 2-4 prior to CTO PCI. Final successful procedural strategy was antegrade wire escalation 48%; antegrade dissection and re-entry (ADR) 21%; retrograde wire escalation 5%; retrograde dissection and re-entry (RDR) 26%. Overall, 47% of CTOs were recanalized using dissection and re-entry strategies. During a mean follow up of 11.5 ± 3.8 months, the primary endpoint occurred in 8.6% (n = 69) of patients (10.3% (n = 39/375) in DART group and 7.0% (n = 30/430) in wire-based cases). The majority of patients (88%) had no or minimal angina (CCS class 0 or 1). ADR and RDR were used more frequently in more complex cases with greater disease burden, however, the only independent predictor of the primary endpoint was lesion length. CTO PCI in complex lesions using the hybrid approach is safe, effective and has a low one-year adverse event rate. The method used to recanalize arteries was not associated with adverse outcomes. © 2017 Wiley Periodicals, Inc.

  19. [Epidemiology and risk factors in injuries due to fall in infants under one year-old].

    PubMed

    Jiménez de Domingo, Ana; Rubio García, Elena; Marañon Pardillo, Rafael; Arias Constanti, Vanessa; Frontado Haiek, Luis Alberto; Soriano Arola, Marta; Ripoll Oliveras, Francesc; Remón García, Cristina; Estopiña Ferrer, Gloria; Lorente Romero, Jorge

    2017-06-01

    To describe the epidemiological characteristics of unintentional injuries due to falls in children under one year and to analyse the risk factors associated with severe injuries. This multicentre, observational and cross-sectional study included all children less than one year treated for unintentional fall in the Emergency Departments of 8 Spanish Hospitals, belonging to the «Unintentional Paediatric Injury Workshop» of the Spanish Paediatric Emergency Society, between March 1st, 2014 and February 28th, 2015. Out of 289,887 emergency department cases, 1,022 were due to unintentional falls. The median age was 8 months and 52.5% were males. Fall injuries were more frequent among children aged 9-12 months (37.6%), and 83.5% occurred at home. The most common mechanism was fall from nursery equipment (69.4%), and 47.8% occurred from a height under 50cm. More than two-thirds (68%) of falls were witnessed, but in half of the cases (329) the caregiver was not in area. Serious injuries were seen in 12% of cases. In this study, a fall height greater than 50cm, falls in the street, from the arms of the carer, and from the stairs were identified as independent risk factors for worse outcomes. The most serious injuries occur in children <3 months and from a height of >50cm, though not related to unwitnessed falls. Because the most common serious injury mechanism is the fall from the arms of the carer, from stairs, and falls in the street, these facts should be highlighted in order to avoid morbidity. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Grief reactions of couples to perinatal loss: a one-year prospective follow-up.

    PubMed

    Tseng, Ying-Fen; Cheng, Hsiu-Rong; Chen, Yu-Ping; Yang, Shu-Fei; Cheng, Pi-Tzu

    2017-09-07

    Perinatal losses are traumatic events in the lives of families and can have serious long-term consequences for the psychological health of parents and any subsequent children. A prospective follow-up study. We recruited, at a teaching hospital in southern Taiwan, a convenience sample of 30 couples whose babies either miscarried or were stillborn. At one month (T1), three months (T2), six months (T3), and one year (T4) after the pregnancy loss, all participants completed four questionnaires. To analyze the changing status of their grief and its related factors, we used a Generalized Estimating Equation (GEE) to account for correlations between repeated observations. Post-bereavement grief levels fell over the four time-points. Mothers reported feeling more grief than did the fathers. Couples with a history of infertility, no religious beliefs, or no living children before the loss felt more grief from a perinatal miscarriage or stillbirth. Furthermore, couples reported more grief if their marital satisfaction level was low, if their socioemotional support from their in-laws was low, or if they had never participated in a ritual for their deceased baby. Three months post-loss is the crucial period for bereaved parents after a perinatal loss. Being a parent, having no previous living children, and low-level socioemotional support from the mother's parents-in-law are significant high-risk factors for a high level of grief one year after perinatal death. We recommend that health professionals increase their ability to identify the factors that psychologically affect post-loss grief. Active post-loss follow-up programs should focus on these factors to offer specific support and counselling. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  1. Jaundice increases the rate of complications and one-year mortality in patients with hypoxic hepatitis.

    PubMed

    Jäger, Bernhard; Drolz, Andreas; Michl, Barbara; Schellongowski, Peter; Bojic, Andja; Nikfardjam, Miriam; Zauner, Christian; Heinz, Gottfried; Trauner, Michael; Fuhrmann, Valentin

    2012-12-01

    Hypoxic hepatitis (HH) is the most frequent cause of acute liver injury in critically ill patients. No clinical data exist about new onset of jaundice in patients with HH. This study aimed to evaluate the incidence and clinical effect of jaundice in critically ill patients with HH. Two hundred and six consecutive patients with HH were screened for the development of jaundice during the course of HH. Individuals with preexisting jaundice or liver cirrhosis at the time of admission (n = 31) were excluded from analysis. Jaundice was diagnosed in patients with plasma total bilirubin levels >3 mg/dL. One-year-survival, infections, and cardiopulmonary, gastrointestinal (GI), renal, and hepatic complications were prospectively documented. New onset of jaundice occurred in 63 of 175 patients with HH (36%). In patients who survived the acute event of HH, median duration of jaundice was 6 days (interquartile range, 3-8). Patients who developed jaundice (group 1) needed vasopressor treatment (P < 0.05), renal replacement therapy (P < 0.05), and mechanical ventilation (P < 0.05) more often and had a higher maximal administered dose of norepinephrine (P < 0.05), compared to patients without jaundice (group 2). One-year survival rate was significantly lower in group 1, compared to group 2 (8% versus 25%, respectively; P < 0.05). Occurrence of jaundice was associated with an increased frequency of complications during follow-up (54% in group 1 versus 35% in group 2; P < 0.05). In particular, infections as well as renal and GI complications occurred more frequently in group 1 during follow-up. Jaundice is a common finding during the course of HH. It leads to an increased rate of complications and worse outcome in patients with HH. Copyright © 2012 American Association for the Study of Liver Diseases.

  2. Integrated disease management improves one-year quality of life in primary care COPD patients: a controlled clinical trial.

    PubMed

    Chavannes, Niels H; Grijsen, Marlous; van den Akker, Marjan; Schepers, Huub; Nijdam, Maddy; Tiep, Brian; Muris, Jean

    2009-09-01

    AIMD: To assess the long-term effectiveness of an integrated disease management (IDM) program (consisting of optimal medication, reactivation, education, and exacerbation management) in primary care patients with chronic obstructive pulmonary disease (COPD). Controlled trial comparing the effects of IDM on quality of life--assessed by the St. George's Respiratory Questionnaire (SGRQ)--in primary care COPD patients. The minimal clinically important change on the SGRQ was accepted as being -4 points. Baseline and one year differences were compared using paired sample T-tests. The differential effects of an FEV1/FVC ratio <0.7 and dyspnoea as assessed by the Medical Research Council (MRC) Dyspnoea scale were investigated. The average age of subjects was 63 years, with an average post-bronchodilator FEV1 of 67% predicted, average FEV1/FVC ratio of 0.65, a mean of 35 pack-years smoking, and 63% were male. No significant differences existed between groups at baseline. After one year of IDM, SGRQ had improved by -4.6 points (95% CI, -7.2 to -2.0; p=0.001) in the intervention group, versus -0.7 points (95% CI, - 3.0 to 1.6; p=0.6) in the usual care group. In patients with an FEV1/FVC ratio <0.7, SGRQ improved by -5.9 points (95% CI, -9.6 to -2.2; p=0.002) in the IDM group, while in the usual care group SGRQ improved by -0.8 points (95% CI, -4.1 to 2.4; p=0.6). In patients with an MRC Dyspnoea score >2 and FEV1/FVC <0.7, SGRQ improved by -13.4 points (95% CI, -20.8 to -6.1; p=0.002) in the IDM group, versus -0.3 points (95% CI, -5.5 to 4.9; p=0.9) in the usual care group. In this study, IDM improved one-year quality of life in primary care COPD patients, compared to usual care. The improvement in SGRQ was both clinically relevant and statistically significant, and was greatest in patients with FEV1/FVC <0.7 and MRC Dyspnoea score >2.

  3. Nursing students' intentions to use research as a predictor of use one year post graduation: a prospective study.

    PubMed

    Forsman, Henrietta; Wallin, Lars; Gustavsson, Petter; Rudman, Ann

    2012-09-01

    Graduating nursing students are expected to have acquired the necessary skills to provide research-based care to patients. However, recent studies have shown that new graduate nurses report their extent of research use as relatively low. Because behavior intention is a well-known predictor of subsequent behavior, this gives reasons to further investigate graduating nursing students' intentions to use research in clinical practice after undergraduate study. To investigate graduating nursing students' intentions to use research in clinical practice and, furthermore, to investigate whether intention in itself and as a mediating variable can predict subsequent research use behavior in clinical practice one year post graduation. A follow-up study was performed of graduating nursing students in their final semester of undergraduate study (2006) and at one year post graduation (2008). Data were collected within the larger national survey LANE (Longitudinal Analysis of Nursing Education). A sample of 1319 respondents was prospectively followed. Graduating nursing students' intentions to use research instrumentally were studied as a predictor of their subsequent instrumental research use one year post graduation. A statistical full mediation model was tested to evaluate the effects of intention and factors from undergraduate study on subsequent research use in daily care. Thirty-four percent of the nursing students intended to use research on more than half or almost every working shift in their future clinical practice. Intention showed a direct effect on research use behavior. In addition, significant indirect effects on research use were shown for capability beliefs (regarding practicing the principles of evidence-based practice) and perceived support for research use (from campus and clinical education), where intention acted as a mediating factor for those effects. Students rated a modest level of intention to use research evidence. Intentions close to graduation acted

  4. Tubular maximum phosphate reabsorption capacity in living kidney donors is independently associated with one year recipient GFR.

    PubMed

    van Londen, Marco; Aarts, Brigitte M; Sanders, Jan-Stephan F; Hillebrands, Jan-Luuk; Bakker, Stephan J L; Navis, Gerjan; de Borst, Martin H

    2017-10-04

    The donor glomerular filtration rate (GFR) measured before kidney donation is a strong determinant of recipient graft outcome. No tubular function markers have been identified that can similarly be used in donors to predict recipient outcomes. In the current study we investigated whether the predonation tubular maximum reabsorption capacity of phosphate (TmP-GFR), which may be considered as a functional tubular marker in healthy kidney donors, is associated with recipient GFR at one year after transplantation, a key determinant of long-term outcome. We calculated the predonation TmP-GFR from serum and 24h-urine phosphate and creatinine levels in 165 kidney donors, and recipient 125I-iothalamate GFR and eGFR (CKD-EPI) at 12 months after transplantation. Kidney donors were 51±10 years old, 47% were men, and mean GFR was 118±26 mL/min. The donor TmP-GFR was associated with recipient GFR 12 months after transplantation (GFR 6.0 mL/min lower per 1 mg/dL decrement of TmP-GFR), which persisted after multivariable adjustment for donor age, sex, predonation GFR and blood pressure and other potential confounders. Results were highly similar when eGFR at 12 months was taken as the outcome. Tubular damage markers KIM-1 and NGAL were low and not associated with recipient GFR. A lower donor TmP-GFR before donation, which may be considered to represent a functional measure of tubular phosphate reabsorption capacity, is independently associated with a lower recipient GFR one year after transplantation. These data are the first to link donor tubular phosphate reabsorption with recipient GFR post-transplantation. Copyright © 2017, American Journal of Physiology-Renal Physiology.

  5. Psychological distress after physical injury: a one-year follow-up study of conscious hospitalised patients.

    PubMed

    Skogstad, Laila; Tøien, Kirsti; Hem, Erlend; Ranhoff, Anette Hylen; Sandvik, Leiv; Ekeberg, Øivind

    2014-01-01

    Acute physical injury may lead to psychological distress. The relationship between peritraumatic responses, injury severity, the personality trait of optimism/pessimism and psychological distress is not fully understood. In addition, the development of post-traumatic stress symptoms may differ in subgroups. One hundred and eighty-one patients (18-65 years) completed questionnaires 1 (baseline), 3 and 12 months after first admission for acute physical injury. All patients were conscious on arrival. Scores on the Casualty Chain Inventory (CCI) for peritraumatic responses, the Impact of Event Scale (IES), the Hospital Anxiety and Depression Scale (HADS), the Life Orientation Test-Revised (LOT-R), trauma-related variables (ISS, Abbreviated Injury Scale [AIS], Glasgow Coma Scale [GCS]), and background variables were assessed. Mean IES scores were 21.5 (95% CI: 19.0-24.0) at baseline and 15.8 (13.5-18.1) at 12 months (p<0.001). One subgroup (delayed onset, 12.2%) had an increase of at least 10 points in the IES score and another subgroup (chronic, 13.3%) had high and persistent post-traumatic stress symptoms during the follow-up period. At baseline, 45.3% had an IES score ≥ 20, indicating possible clinical case levels, compared with 33.1% at 12 months. Accordingly, 14% had anxiety symptoms and 10.8% had depression symptoms at a case level (HADS ≥ 8) at one-year follow-up. Mutually independent predictors of post-traumatic stress symptoms at 12 months were dissociation (OR 1.3, 95% CI: 1.1-1.6) and perception (OR 1.1, 95% CI: 1.0-1.3) measured by the CCI. Being in work before injury (OR 0.1, 95% CI: 0.02-0.4) and higher educational level (OR 0.3, 95% CI: 0.1-0.7) were associated with fewer IES symptoms. Dissociation and having a pessimistic trait predicted anxiety and depression at 12 months. Previous psychiatric problems predicted anxiety symptoms, and high educational level predicted less depression symptoms. One-third of conscious physical injured patients had post

  6. Leclercia adecarboxylata and catheter-related bacteraemia: review of the literature and outcome with regard to catheters and patients.

    PubMed

    De Mauri, Andreana; Chiarinotti, Doriana; Andreoni, Stefano; Molinari, Gian Lorenzo; Conti, Novella; De Leo, Martino

    2013-10-01

    Infection is a common complication in patients carrying a central venous catheter (CVC) and is associated with increased morbidity and mortality. Leclercia adecarboxylata is an unusual but emerging pathogen in healthy and immunocompromised patients. We report a case of L. adecarboxylata bacteraemia in a patient with a haemodialysis tunnelled CVC. In accordance with the susceptibility to the tested antimicrobials, a long-course treatment with intravenous gentamicin plus amoxicillin-clavulanic acid and gentamicin-lock therapy was adopted. The patient had a full recovery and the catheter was not removed. We also performed a systematic PubMed/Medline and Scopus review of peer-reviewed English papers on L. adecarboxylata infections, focusing on bacteraemia in patients with different types of CVCs. Moreover, we suggest a treatment algorithm to preserve the patient and maintain the CVC.

  7. 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…

  8. Absence of low back pain in patients followed weekly over one year with automated text messages

    PubMed Central

    2012-01-01

    Background In order to define the onset of a new episode of low back pain (LBP), the definition of a "non-episode" must be clear. De Vet et al reviewed the scientific literature but found no evidence-based definitions of episodes or non-episodes of LBP. However, they suggested that pain-based episodes should be preceded and followed by a period of at least one month without LBP. As LBP is an episodic disease, it is not clear whether a sufficient number of patients with LBP will be LBP-free for at least one month ("non-episode") to justify the use of this duration in the definition of pain free episode. Objectives Two clinical populations were followed weekly over one year making it possible 1) to determine the maximum numbers in a row of weeks without LBP, 2) to determine the prevalence of non-episodes throughout a one-year period, and 3) to find the prevalence of patients who reported to be in a non-episode of LBP at the end of the study. Methods Secondary data were used from two recent clinical studies, in which weekly automated text messages (SMSes) had been collected on the number of days with LBP in the preceding week for one year. Weeks with 0 days of LBP were defined as "zero-weeks" and four zero-weeks in a row were defined as a period without LBP (a"non-episode") according to de Vet et al's suggestion. The study participants, all from the secondary care sector, consisted of: study 1) patients with LBP and Magnetic Resonance Imaging-identified Modic changes and study 2) patients without obvious acute disc problems, Modic changes or other pathologies, who therefore were assumed to have non-specific LBP. Both studies were two-armed intervention studies without a significant difference in outcome between intervention groups. The number of zero-weeks was identified in each participant. Thereafter the numbers of participants who reported at least one non-episode during the study period were identified. Finally, the numbers of participants who had a non-episode at

  9. Comparative effectiveness of cefazolin versus cloxacillin as definitive antibiotic therapy for MSSA bacteraemia: results from a large multicentre cohort study.

    PubMed

    Bai, Anthony D; Showler, Adrienne; Burry, Lisa; Steinberg, Marilyn; Ricciuto, Daniel R; Fernandes, Tania; Chiu, Anna; Raybardhan, Sumit; Science, Michelle; Fernando, Eshan; Tomlinson, George; Bell, Chaim M; Morris, Andrew M

    2015-05-01

    We compared the effectiveness of cefazolin versus cloxacillin in the treatment of MSSA bacteraemia in terms of mortality and relapse. A retrospective cohort study examined consecutive patients with Staphylococcus aureus bacteraemia from six academic and community hospitals between 2007 and 2010. Patients with MSSA bacteraemia who received cefazolin or cloxacillin as the predominant definitive antibiotic therapy were included in the study. Ninety-day mortality was compared between the two groups matched by propensity scores. Of 354 patients included in the study, 105 (30%) received cefazolin and 249 (70%) received cloxacillin as the definitive antibiotic therapy. In 90 days, 96 (27%) patients died: 21/105 (20%) in the cefazolin group and 75/249 (30%) in the cloxacillin group. Within 90 days, 10 patients (3%) had a relapse of S. aureus infection: 6/105 (6%) in the cefazolin group and 4/249 (2%) in the cloxacillin group. All relapses in the cefazolin group were related to a deep-seated infection. Based on the estimated propensity score, 90 patients in the cefazolin group were matched with 90 patients in the cloxacillin group. In the propensity score-matched groups, cefazolin had an HR of 0.58 (95% CI 0.31-1.08, P = 0.0846) for 90 day mortality. There was no significant clinical difference between cefazolin and cloxacillin in the treatment of MSSA bacteraemia with respect to mortality. Cefazolin was associated with non-significantly more relapses compared with cloxacillin, especially in deep-seated S. aureus infections. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  10. 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.

  11. 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

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

    PubMed

    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

    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. 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. 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). 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.

  13. The Functional Task Test: Results from the One-Year Mission

    NASA Technical Reports Server (NTRS)

    Bloomberg, J. J; Batson, C. D.; Buxton, R. E.; Feiveson, A. H.; Kofman, I. S.; Laurie, S.; Lee, S. M. C.; Miller, C. A.; Mulavara, A. P.; Peters, B. T.; May-Phillips, T.; Ploutz-Snyder, L. L.; Reschke, M. F.; Ryder, J. W.; Stenger, M. B.; Taylor, L. C.; Wood, S. J.

    2017-01-01

    landing. The FTT one-year results will be presented at the meeting, and a comparison will be made with data previously obtained using the same protocol on astronauts tested before and after 6 months in space. Future work will focus on collecting data from additional subjects from one-year flights to gain a better assessment of extreme long-duration exposure to spaceflight on both functional measure of performance and physiological metrics.

  14. Impact of personality disorders on health-related quality of life one year after burn injury.

    PubMed

    Ekeblad, Frida; Gerdin, Bengt; Öster, Caisa

    2015-01-01

    Personality disorders (PDs) are associated with significant distress, disability, and cause great difficulties in life. PDs have been suggested to influence adaptation after major burns, but the potential relationship has not been fully elucidated. This study aimed to describe the prevalence of PDs in 107 patients with major burn injury, and to identify the impact of PDs on perceived patient outcome assessed as health-related quality of life (HRQoL) one year after burn. One burn-specific instrument (Burn Specific Health Scale-Brief (BSHS-B)) and two generic instruments (EuroQol Five Dimensions and Short Form 36 Health Survey) were used, and Psychiatric Axis I and II disorders were assessed one year post burn. This study identified an above normal prevalence of PDs among individuals afflicted by burn, and participants with PD had a significantly larger lifetime burden of Axis I disorders compared to participants without PD. Participants with PDs scored significantly lower than those without PD in the BSHS-B domain Skin involvement, and the effect of having a PD was related to the subscale Treatment regimens. There was no relationship between the presence of PD and generic HRQoL. An implication of these observations is that special rehabilitation efforts including more tailored interventions must be offered to these patients to ensure that the obstacles they perceive to caring for themselves in this respect are eliminated. This study identified an above normal prevalence of PDs among individuals afflicted by burn and these individuals reported poor burn-specific health-related quality of life. The identification of difficulties with compliance and endurance regarding daily skin care may cause negative consequences for optimal rehabilitation and underscore the importance of offering more tailored interventions in rehabilitation. Inflexible behavioral patterns related to the PD diagnosis imply the need for communication strategies by the rehabilitation team, which

  15. [The nutritional status of reproductive women at one year after the disaster of Earthquake in Wenchuan].

    PubMed

    Yin, Shi-an; Zhao, Xian-feng; Zhao, Li-yun; Fu, Ping; Zhang, Jian; Ma, Guan-sheng

    2010-08-01

    To evaluate the effects of Wenchuan Earthquake on the nutritional status and the prevalence of nutritional anemia, vitamin A deficiency (VAD) and vitamin D deficiency among reproductive women (15 - 44 years old) in the disaster areas one year after the Earthquake. A nutritional survey was conducted in 3 counties in April 2009, one year after the Earthquake. Two towns from each county were selected as study sites, and this survey recruited 58 pregnant, 66 lactating and 242 non-pregnant-non-lactating women. A comparison was made to the results of 2002 Chinese Nutrition and Health Survey. The cereals and roots intakes of the pregnant, lactating and non-pregnant-non-lactating women living in the disaster area were (426.8 ± 271.8), (568.0 ± 306.1), and (483.0 ± 277.7) g/d respectively, which were almost the same results (486.8, 509.3 and 495.1 g/d, respectively) from 2002 National Nutrition and Health Survey. The fat and oil intakes were (41.9 ± 51.6), (55.5 ± 69.2), and (66.9 ± 125.7) g/d, respectively, which were also the same ad the results (45.2, 43.9 and 41.4 g/d, respectively) from 2002 National Nutrition and Health Survey. The intakes of meats and poultries were only (58.1 ± 67.7), (76.3 ± 218.7), and (23.9 ± 29.6) g/d respectively, which were much lower than the recommended food intakes from the Branch of Maternal and Child Nutrition of Chinese Nutrition Society. The vitamin A deficiency and marginal deficiency prevalence were 6.9% (24/347) and 18.2% (63/347), respectively. The deficiency and insufficiency of vitamin D was sum to 93.9% (323/344). The prevalence of anemia was 32.6% (112/344). 51.0% (171/335) reproductive women were iron deficient, and 61.6% (210/347) women were suffering zinc deficiency. The study findings indicated that the dietary structure was seriously effected by the Earthquake. The sources from animal and legume products were relatively low. The micronutrients nutritional status was poor. The vitamin A, vitamin D, and iron, zinc

  16. Psychiatric disorders in children at one year after the tsunami disaster in Thailand.

    PubMed

    Piyasil, Vinadda; Ketumarn, Panom; Prubrukarn, Ratanotai; Pacharakaew, Siripapa; Dumrongphol, Hattaya; Rungsri, Sarinee; Sitdhiraksa, Nantawat; Pitthayaratsathien, Nattorn; Prasertvit, Jiraporn; Sudto, Korapin; Theerawongseree, Siriporn; Aowjinda, Sumitra; Thaeramanophab, Somchit; Jotipanu, Vajiraporn; Chatchavalitsakul, Wilairatana

    2008-10-01

    The tsunami that struck Thailand on 26th December 2004 was the greatest natural disaster in the country's history. It left in its wake unprecedented damage and destruction. Children suffered the loss of parents or guardians, and survivors were left to cope with psychological trauma of the disaster To assess the psychiatric disorders in tsunami victim children at one year after the event. A cross sectional study was done. One thousand three hundred and sixty-four students from 2 schools were enrolled. Three tests were used according to the students' grades, pediatric symptoms checklist, Childhood Depressive Inventory and the Revised Child Impact of Events scale (CRIES). Psychiatric disorders were diagnosed by child and adolescent psychiatrists, using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM IV). Analysis data by using SPSS version 10.0 and Chi-square test. The results were presented as percentage and p-value. Psychiatric disorders were found in 142 students or 10.4 percents of all students at one year after the tsunami disaster. Not all the students who had psychiatric disorders developed them as the result of the tsunami disaster However, ninety students or 6.3 percent of all the students did have psychiatric disorders resulting from the tsunami disaster The most common psychiatric problem was post traumatic stress disorder Ten percent of grade 4-6 students and 11 percent of grade 7-9 students had psychiatric disorders. The prevalence was lower in kindergarten and grade 1-3 students of which the percentage was 2.3 and 3.8 respectively. The prevalence of psychiatric disorders at 1 year after the tsunami disaster was 10.4 percent of all the students or 33.1 percent of victims. The prevalence of psychiatric disorders in grade 4-6 and 7-9 students was higher than in kindergarten and grade 1-3 students. The most common psychiatric problem is post traumatic stress disorder.

  17. 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

  18. Adolescent inpatient psychiatric admission rates and subsequent one-year mortality in England: 1998-2004.

    PubMed

    James, Anthony; Clacey, Joe; Seagroatt, Valerie; Goldacre, Michael

    2010-12-01

    Adolescence is a time of very rapid change not only in physical but also psychological development. During the teenage years there is a reported rise in the prevalence of psychiatric disorders. The aim of this study was to investigate age- and sex-specific National Health Service (NHS) hospital inpatient admission rates for psychiatric conditions in adolescents in England, and to examine their mortality within one year of discharge. Using a record-linked NHS Hospital Episode Statistics (HES) dataset for England, and linked death certificates, age- and sex-specific admission rates and subsequent mortality rates were analysed by single year of age for people aged 10-19 years. There were similar numbers of admissions for males and females: 29,595 and 28,188 respectively. Admission rates increased substantially with increasing age, from .2 per 1000 population per year aged 10 years to 2.2 per 1000 aged 19 years. There was no appreciable difference in death rates for males and females in the year following discharge--males .23% (based on 68 deaths), females .18% (52 deaths). However, these death rates were significantly higher than those found in the general population of equivalent age: expressed as standardised mortality ratios (SMRs), setting the SMRs for males and females in the general population each as 100, the SMR in the psychiatric population were 518 (95% CI 402-657) for males and 937 (692-1225) for females. The diagnostic groups with the highest mortality were development disorders (SMR 3017, 95% CI 1757-4831), eating disorders (SMR 1103, 443-2272), and affective disorders (SMR 940, 589-1423). Adolescent psychiatric disorders represent a serious public health issue, with a steep rise in hospital admissions during the teenage years, and a six-fold increased death rate within one year of discharge compared to the general population of the same age. © 2010 The Authors. Journal of Child Psychology and Psychiatry. © 2010 Association for Child and Adolescent

  19. One year B and D vitamins supplementation improves metabolic bone markers.

    PubMed

    Herrmann, Wolfgang; Kirsch, Susanne H; Kruse, Vera; Eckert, Rudolf; Gräber, Stefan; Geisel, Jürgen; Obeid, Rima

    2013-03-01

    Vitamin D and vitamin B deficiency are common in elderly subjects and are important risk factors for osteoporosis and age-related diseases. Supplementation with these vitamins is a promising preventative strategy. The objective of this study was to evaluate the effects of vitamins D3 and B supplementation on bone turnover and metabolism in elderly people. Healthy subjects (n=93; >54 years) were randomly assigned to receive either daily vitamin D3 (1200 IU), folic acid (0.5 mg), vitamin B12 (0.5 mg), vitamin B6 (50 mg), and calcium carbonate (456 mg) (group A) or only vitamin D3 plus calcium carbonate (group B) in a double blind trial. We measured at baseline and after 6 and 12 months of supplementation vitamins, metabolites, and bone turnover markers. At baseline mean plasma 25-hydroxy vitamin D [25(OH)D] was low (40 or 30 nmol/L) and parathormone was high (63.7 or 77.9 pg/mL). 25(OH)D and parathormone correlated inversely. S-Adenosyl homocysteine and S-adenosyl methionine correlated with bone alkaline phosphatase, sclerostin, and parathormone. One year vitamin D3 or D3 and B supplementation increased plasma 25(OH)D by median 87.6% (group A) and 133.3% (group B). Parathormone was lowered by median 28.3% (A) and 41.2% (B), bone alkaline phosphatase decreased by 2.8% (A) and 16.2% (B), osteocalin by 37.5% (A) and 49.4% (B), and tartrate-resistant-acid-phosphatase 5b by 6.1% (A) and 36.0% (B). Median total homocysteine (tHcy) was high at baseline (group A: 12.6, group B: 12.3 µmol/L) and decreased by B vitamins (group A) to 8.9 µmol/L (29.4%). tHcy lowering had no additional effect on bone turnover. One year vitamin D3 supplementation with or without B vitamins decreased the bone turnover significantly. Vitamin D3 lowered parathormone. The additional application of B vitamins did not further improve bone turnover. The marked tHcy lowering by B vitamins may modulate the osteoporotic risk.

  20. Species-level assessment of the molecular basis of fluoroquinolone resistance among viridans group streptococci causing bacteraemia in cancer patients.

    PubMed

    Sahasrabhojane, Pranoti; Galloway-Peña, Jessica; Velazquez, Luis; Saldaña, Miguel; Horstmann, Nicola; Tarrand, Jeffrey; Shelburne, Samuel A

    2014-06-01

    Viridans group streptococci (VGS) are a major cause of bacteraemia in neutropenic cancer patients, particularly those receiving fluoroquinolone prophylaxis. In this study, we sought to understand the molecular basis for fluoroquinolone resistance in VGS causing bacteraemia in cancer patients by assigning 115 VGS bloodstream isolates to specific species using multilocus sequence analysis (MLSA), by sequencing the quinolone resistance-determining regions (QRDRs) of gyrA, gyrB, parC and parE, and by testing strain susceptibility to various fluoroquinolones. Non-susceptibility to one or more fluoroquinolones was observed for 78% of isolates, however only 68.7% of patients were receiving fluoroquinolone prophylaxis. All but one of the determinative QRDR polymorphisms occurred in GyrA or ParC, yet the pattern of determinative QRDR polymorphisms was significantly associated with the fluoroquinolone prophylaxis received. By combining MLSA and QRDR data, multiple patients infected with genetically indistinguishable fluoroquinolone-resistant Streptococcus mitis or Streptococcus oralis strains were discovered. Together these data delineate the molecular mechanisms of fluoroquinolone resistance in VGS isolates causing bacteraemia and suggest possible transmission of fluoroquinolone-resistant S. mitis and S. oralis isolates among cancer patients. Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  1. [AIRBAg study: preliminary results after one year of screening for COPD in dairy farmers].

    PubMed

    Jouneau, S; Pinault, M; Gouyet, T; Brinchault, G; Guillot, S; Viel, J-F; Presle, J-C; Desrues, B

    2015-03-01

    The AIRBAg study screens for bronchial obstruction in dairy farmers. We present the preliminary results after one year. A prospective screening study based on questionnaires and electronic mini-spirometry (Néo-6(®)) that includes a representative sample of dairy farmers from the departments of Morbihan and Île-et-Vilaine in Brittany. The dairy farmers had an occupational medicine appointment and, if they demonstrated at least one marker of possible bronchial obstruction (chronic cough, chronic bronchitis, dyspnoea, wheezing, FEV1/FEV6<0.8), they were referred to a pulmonologist. The data we present here were extracted from the occupational medicine appointments because the pulmonologists' appointments are still running. Among the 277 dairy farmers included, 125 (45%) demonstrated "possible bronchial obstruction". The total score of the CAT questionnaire was higher in these farmers (9.1±6.2 versus 5.8±4.0; P<0.0001). In multivariate analysis markers of "possible bronchial obstruction" were eczema, manual foddering and duration of mechanical straw litter spreading. Occupational medicine appointments identified markers of "possible bronchial obstruction". We will have the complete results from AIRBAg study in 2015. Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  2. Complete denture services: clinical technique, lab costs, manpower, and reimbursement. One-year review.

    PubMed

    Ewoldsen, Nels

    2011-01-01

    Complete denture services at comprehensive care public health clinics are not common in part because of clinician concerns regarding outcomes. Educational debt forgiveness has attracted recent dental graduates to public health dentistry; however, not all recent graduates receive denture education experiences necessary to attain proficiency. While fundamental patient assessment and denture construction are taught, psychological assessment and communication with denture patients requires experience. A thorough understanding of occlusion, phonetics, esthetics and laboratory steps is also necessary. Expecting recent dental graduates to become proficient providing complete dentures at minimal reimbursement levels, with no mentorship or on-site laboratory support, is unrealistic. Public health dental clinics operate at full capacity performing emergency, preventive and restorative procedures. Complete dentures come with a laboratory fee approximately one-half the total reimbursement, meaning a remake drops clinic revenue to zero while doubling expenses. It is understandable that full schedules, marginal reimbursement, unpredictability and the risk of an occasional failure block clinician interest in providing denture services. This one-year report of services describes a three-appointment complete denture technique offering improved patient and laboratory communication, reduced chair time and controlled cost, resulting in high-quality complete dentures.

  3. [Screening digital mammography: one year result for the Alpes-Maritimes region].

    PubMed

    Balu-Maestro, C; Bailly, L; Granon, C; Namer, M

    2010-05-01

    After one year of experience with screening digital mammography, the results of this technique (n=9640) are compared to screen-film mammography (n=240 376) with double reading. Evaluation for each technique of the rate of call-back, positive results before and after work-up by the first reader and distribution based on the BI-RADS classification by the ACR, rate of complementary US, detected abnormalities (microcalcifications) and detected cancers. The rate of positive mammograms was significantly higher for the digital technique (17.3% versus 15.1%) because of the first reader (16.3% versus 13.9%) whereas it was significantly lower after complementary work-up (3% versus 3.7%). The rate of BI-RADS 0 was significantly higher with digital imaging irrespective of patient age. The rate of US was higher for type 1 and 2 breasts at digital imaging (46% versus 36%, p<0.0001) while the reverse was true for denser breasts (49% versus 54%; p:0.0005). More microcalcifications were detected on digital imaging (24.4% versus 21.8%) without impact on the rate of DCIS and invasive carcinomas. The rate of cancers detected with both technique were identical. The increased number of positive results at first reading and increased number of US for digital mammography may relate to a learning curve and difficulties in comparing with prior examinations. These results should continuously be monitored and compared to national averages.

  4. 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

  5. [Clinical Psychology in Primary Care: A Descriptive Study of One Year of Operation].

    PubMed

    Sánchez-Reales, S; Tornero-Gómez, M J; Martín-Oviedo, P; Redondo-Jiménez, M; del-Arco-Jódar, R

    2015-01-01

    Our aim is to present the first year of operation of a Clinical Psychology service in a Primary Care setting. A descriptive study was performed by analysing the requests and the care intervention of the Psychology Service, in collaboration with 36 general practitioners (33% of the staff), belonging to 6 health centres. Within the one year period, 171 outpatients from 15 years and older were referred with mild psychological disorders (> 61 in the global assessment functioning scale, APA, 2002). A total of 111 outpatients received psychological care. The main diagnoses were adaptation disorder, affective disorder, and anxiety. More than half (54.82%) of them achieved a full recovery. After a year follow up, a drop of 25.19% was observed in medicines use. The Primary Care Psychology team is a halfway unit between Primary Care practitioners and specialised units in order to deal with mild mental symptomatology which otherwise could be undertreated. It represents an important support for practitioners. Secondly, the early intervention can prevent mental problems becoming chronic, as shown by the drop in medication use. In spite of the not very high agreement between the practitioner's diagnoses and those made by the Psychology unit, it has set up an important means of communication and with direct and immediate interdisciplinary action. This should eventually lead to savings in economic resources and human suffering. Copyright © 2014. Publicado por Elsevier España, S.L.U.

  6. 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. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  7. Client experiences in work rehabilitation in Sweden: a one-year follow-up study.

    PubMed

    Wallstedt-Paulsson, Eva; Erlandsson, Lena-Karin; Eklund, Mona

    2007-01-01

    This study, carried out in a work rehabilitation unit in Sweden, investigated how clients perceived their work experiences after a one-year follow up. A semi-structured interview was administered to 14 former clients and a content analysis was applied. Seven categories were derived from the results: 'Expectations of the rehabilitation process'; 'Social relationships'; 'Client influences on the rehabilitation process'; 'Occupations engaged in during the rehabilitation programme'; 'Perceived outcome'; 'Current occupations'; and 'Future aspirations'. The dominating expectations were to find a job, with an overall desire for change. The social relationships with the staff and other clients were of great importance. The positive outcome of the rehabilitation was described as feeling better or having new skills. The perceived negative outcome was that the rehabilitation programme had not turned out as the client expected. The clients reported varying daily occupations after the rehabilitation experience and a majority were contented and optimistic about their future. The main conclusions of the study are that when planning a work rehabilitation programme, efforts have to be made to examine clients' interests and skills, and to develop a dialogue between clients and staff. Further research is needed to evaluate the work rehabilitation experience from the clients' perspective.

  8. Characterization of a Spurious One-year Signal in HARPS Data

    NASA Astrophysics Data System (ADS)

    Dumusque, Xavier; Pepe, Francesco; Lovis, Christophe; Latham, David W.

    2015-08-01

    The HARPS spectrograph is showing an extreme stability, close to the m s-1 level, over more than 10 years of data. However, the radial velocities of some stars are contaminated by a spurious one-year signal with an amplitude that can be as high as a few m s-1. This signal is in opposition of phase with the revolution of Earth around the Sun and can be explained by the deformation of spectral lines crossing block stitchings of the CCD when the spectrum of an observed star is alternatively blueshifted and redshifted due to the motion of Earth around the Sun. This annual perturbation can be suppressed by either removing those affected spectral lines from the correlation mask used by the cross-correlation technique to derive precise radial velocities, or by simply fitting a yearly sinusoid to the radial velocity data. This is mandatory if we want to detect long-period low-amplitude signals in the HARPS radial velocities of quiet solar-type stars. Based on observations made with the HARPS instrument on the ESO 3.6 m telescope at the La Silla Observatory (Chile).

  9. [Adverse cutaneous reactions to drugs among hospitalized patients: a one year surveillance].

    PubMed

    Danza, Alvaro; López, Maynés; Vola, Magdalena; Alvarez-Rocha, Alfredo

    2010-11-01

    Adverse cutaneous reactions to Drugs (CDRs) are of particular interest among all adverse Drug reactions (ADR) due to their frequency, potential severity and because of the importance of an early diagnosis. Antimicrobial agents, anticonvulsants and non-steroidal anti-inflammatory Drugs are the Drugs associated to the highest risk of CDRs. To assess CDRs in hospitalized patients and identify the Drugs involved. All patients hospitalized in the Hospital de Clínicas in Montevideo, Uruguay, with suspected CDRs, detected during one year, were included in this prospective study. The imputability was established using the Karch and Lasagna algorithm modified by Naranjo. We analyzed age, gender, Drugs involved, causal disease, severity, latency and evolution. Seventeen patients, aged 17 to 85 years (15 females) with CDRs were identifed. Twelve had morbilliform exanthemas, four had reactions with eosinophilia and systemic symptoms and one had a Stevens Johnson syndrome. The Drugs involved were antimicrobials in nine cases, hypouricemic agents in four cases, anticonvulsants in three cases and aspartic insulin in one. Twelve patients had a life threatening reaction and one required admission to the intensive care unit. No deaths occurred. CDRs were more common in women and most of them were caused by antimicrobial agents.

  10. One-Year stable perovskite solar cells by 2D/3D interface engineering.

    PubMed

    Grancini, G; Roldán-Carmona, C; Zimmermann, I; Mosconi, E; Lee, X; Martineau, D; Narbey, S; Oswald, F; De Angelis, F; Graetzel, M; Nazeeruddin, Mohammad Khaja

    2017-06-01

    Despite the impressive photovoltaic performances with power conversion efficiency beyond 22%, perovskite solar cells are poorly stable under operation, failing by far the market requirements. Various technological approaches have been proposed to overcome the instability problem, which, while delivering appreciable incremental improvements, are still far from a market-proof solution. Here we show one-year stable perovskite devices by engineering an ultra-stable 2D/3D (HOOC(CH2)4NH3)2PbI4/CH3NH3PbI3 perovskite junction. The 2D/3D forms an exceptional gradually-organized multi-dimensional interface that yields up to 12.9% efficiency in a carbon-based architecture, and 14.6% in standard mesoporous solar cells. To demonstrate the up-scale potential of our technology, we fabricate 10 × 10 cm(2) solar modules by a fully printable industrial-scale process, delivering 11.2% efficiency stable for >10,000 h with zero loss in performances measured under controlled standard conditions. This innovative stable and low-cost architecture will enable the timely commercialization of perovskite solar cells.

  11. Changing body structure components and motor skills in Military High School students within one year.

    PubMed

    Glavač, Boris; Dopsaj, Milivoj; Djordjević, Marina; Maksimović, Miloš; Marinković, Marjan; Nedeljković, Jasmina

    2015-08-01

    BACKGROUND/AIM. Proper growth and development ofadolescents in the morphological, functional and psychosocial aspects is the imperative of the educational process. The aim of this study was to determine the status and changes in the indicators of morphological characteristics, motor skills and lifestyle habits among the students of the Military High School in Belgrade. The study included 217 students aged 15 to 18 years (from the first to the fourth grade). The two measurements performed at the intervals of one year were used to determine: the body structure by means of 10 variables and motor skills by 4 variables, while life habits were determined by 25 variables. The differences in the indicators of morphological characteristics were recorded in all the groups, being the highest in the first year of schooling. During the period of growing up, a reduction of fatty component in percentage values was found, as well as an increase of muscle mass. The progressive growth of motor skills in the first, second and the third grade was recorded in the manifestation of power, and endurance improved only in the first year. In terms of dietary habits, there was no difference among the groups. The obtained results indicate proper morphological and motor development and the formation of lifestyle habits. The data obtained will serve as a basis for health and functional prevention and upgrading in terms of improvement of the process of military education.

  12. Efficacy of a multidisciplinary treatment program on one-year outcomes of individuals with Parkinson's disease.

    PubMed

    Carne, William; Cifu, David; Marcinko, Paul; Pickett, Treven; Baron, Mark; Qutubbudin, Abu; Calabrese, Vincent; Roberge, Peggy; Holloway, Kathryn; Mutchler, Brian

    2005-01-01

    The efficacy of the multidisciplinary treatment approach to the management of Parkinson's disease (PD) was examined at a regional Veteran's Administration Parkinson's Disease Research, Education and Clinical Center (PADRECC). The records of 43 consecutive individuals with PD were examined. The Unified Parkinson's Disease Rating Scale (UPDRS) was employed to assess disease progression. Changes between initial and one-year follow-up UPDRS motor functioning (Part III) scores were compared to expected disease progression from prior research. In this cohort, thirty patients (69.8%) had improved, 2 were unchanged (4.7%) and 11 patients (25.6%) had worsened at the mean 12.2-month follow-up period. The range of multidisciplinary interventions included neurology (100%), physiatrist (93%), and psychology (41.9%) visits, medication changes (60.5%), rehabilitation therapy (62.8%), functional diagnostic testing (16.3%), support group (9.3%), home exercise programs (86%), and disease and wellness education (83.7%). Statistical analyses of the individual components of the program did not demonstrate significant differences between improvers and non-improvers. Clinical implications and study limitations are discussed.

  13. 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

  14. CHARACTERIZATION OF A SPURIOUS ONE-YEAR SIGNAL IN HARPS DATA

    SciTech Connect

    Dumusque, Xavier; Latham, David W.; Pepe, Francesco; Lovis, Christophe

    2015-08-01

    The HARPS spectrograph is showing an extreme stability, close to the m s{sup −1} level, over more than 10 years of data. However, the radial velocities of some stars are contaminated by a spurious one-year signal with an amplitude that can be as high as a few m s{sup −1}. This signal is in opposition of phase with the revolution of Earth around the Sun and can be explained by the deformation of spectral lines crossing block stitchings of the CCD when the spectrum of an observed star is alternatively blueshifted and redshifted due to the motion of Earth around the Sun. This annual perturbation can be suppressed by either removing those affected spectral lines from the correlation mask used by the cross-correlation technique to derive precise radial velocities, or by simply fitting a yearly sinusoid to the radial velocity data. This is mandatory if we want to detect long-period low-amplitude signals in the HARPS radial velocities of quiet solar-type stars.

  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. 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.

  17. Posterior arthroscopic subtalar arthrodesis: ten cases at one-year follow-up.

    PubMed

    Albert, A; Deleu, P-A; Leemrijse, T; Maldague, P; Devos Bevernage, B

    2011-06-01

    Isolated subtalar arthrodesis is the treatment of choice for several conditions -mostly subtalar arthritis, tarsal coalition and posterior tibial tendon dysfunction- unresponsive to conservative treatment. Arthroscopic procedures are an interesting recent alternative, less invasive than conventional open techniques. Posterior arthroscopy, in prone position, could be more advantageous than the conventional lateral and/or anterior approach. Ten cases, from 20 to 59-years-old, were prospectively followed up for minimum of one-year (range 12 to 31 months). Arthritis and tarsal coalition were the most common indications. Fusion was observed in all cases at a maximum of nine weeks. Mean average AOFAS score improved from 47 to 78. No complications were noted related to the technique. Only two patients, operated for a symptomatic subtalar coalition, complained of some residual pain due to a lateral submalleolar impingement. Interest of preservation of vascular talar supply and bone grafting are discussed. The good results using this innovative technique are encouraging. Long-term randomized studies remain necessary to confirm the reliability of the procedure in these different indications, and the type of bone graft to favour, if really needed. Level IV therapeutic study. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  18. One-Year stable perovskite solar cells by 2D/3D interface engineering

    NASA Astrophysics Data System (ADS)

    Grancini, G.; Roldán-Carmona, C.; Zimmermann, I.; Mosconi, E.; Lee, X.; Martineau, D.; Narbey, S.; Oswald, F.; de Angelis, F.; Graetzel, M.; Nazeeruddin, Mohammad Khaja

    2017-06-01

    Despite the impressive photovoltaic performances with power conversion efficiency beyond 22%, perovskite solar cells are poorly stable under operation, failing by far the market requirements. Various technological approaches have been proposed to overcome the instability problem, which, while delivering appreciable incremental improvements, are still far from a market-proof solution. Here we show one-year stable perovskite devices by engineering an ultra-stable 2D/3D (HOOC(CH2)4NH3)2PbI4/CH3NH3PbI3 perovskite junction. The 2D/3D forms an exceptional gradually-organized multi-dimensional interface that yields up to 12.9% efficiency in a carbon-based architecture, and 14.6% in standard mesoporous solar cells. To demonstrate the up-scale potential of our technology, we fabricate 10 × 10 cm2 solar modules by a fully printable industrial-scale process, delivering 11.2% efficiency stable for >10,000 h with zero loss in performances measured under controlled standard conditions. This innovative stable and low-cost architecture will enable the timely commercialization of perovskite solar cells.

  19. 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.

  20. Twenty-one years of child advocacy: an editorial retrospective of the Teuscher years.

    PubMed

    Kohn, D W

    1990-01-01

    On the eleventh anniversary of his Editorship of JDC, Dr. George Teuscher took stock of the state of the Journal, noting progress made and challenges ahead, writing that, "A good journal cannot ride on its reputation... Constant effort to improve, resourcefulness, and prolific reading and study are required of the editor of a prestigious journal." He has written extensively on the importance of writing and effective communication in the face of an information explosion, stating that, "The journal is still the best means of presenting new information to the professions." Writing a note of encouragement to the editor of a new dental journal, he observed, "Of course the dental and medical literature can boast of some great editors, who earned their reputations because they were able to apply intelligence, writing ability, knowledge of the scientific method, and imagination to a new undertaking." After twenty-one years, it is safe to say that Dr. Teuscher is such an Editor; he has filled our minds with knowledge and our hearts with wisdom; he has reminded us of the best that is in us; he has helped us to feel the anguish of the afflicted and oppressed; he has brought knowledge and skill to help the infirm: and he has taught us to stand in awe before the mystery of being.

  1. Post-abortion contraception choices of women in Ghana: a one-year review.

    PubMed

    Rominski, Sarah D; Morhe, Emmanuel S K; Lori, Jody

    2015-01-01

    Low rates of contraception in much of sub-Saharan Africa result in unplanned pregnancies, which in young, unmarried women often result in unsafe abortion. Increasing the use of highly effective forms of contraception has the potential to reduce the abortion-related mortality and morbidity. In this cross-sectional study, information collected by the post-abortion family planning counsellor was analysed. De-identified data from one year (June 2012-May 2013) were extracted from the logbook. Multivariate linear and logistic regression was performed. A total of 612 women received care for post-abortion complications from June 2012 to May 2013. Young, unmarried women, and those who were being treated for complications arising from an induced versus spontaneous abortion were more likely to report they would use 'abstinence' as their method of contraception following their treatment. This vulnerable group could benefit from an increased uptake of long-acting reversible contraceptive methods to avoid repeated unplanned pregnancies and the potential of future unsafe abortions.

  2. Prenatal drug exposure and teratological risk: one-year experience of an Italian Teratology Information Service.

    PubMed

    De Santis, Marco; Cesari, Elena; Ligato, Maria Serena; Nobili, Elena; Straface, Gianluca; Cavaliere, Annafranca; Caruso, Alessandro

    2008-02-01

    Concern about exposure to drugs, radiation, or infection during pregnancy occur often because pregnancy is not always planned. A teratology information service offers rapid scientific counseling to all those worried about prenatal exposure. The aim of this study is to present data on the most common pharmaceutical products responsible for teratogenic risk in the one-year experience of a teratology information service in Italy. The survey was conducted among 8664 callers who contacted our Teratology Information Service in Rome between January and December 2006. Data on maternal age, gravidity, parity, maternal health status, and details of exposure (dose and timing) were collected and stored in a specific data base. Scientific counseling on prenatal exposure was given to the caller by a specialized service operator, specifying the type of risk and suggesting appropriate tests for prenatal diagnosis. Most of the people called regarding drug exposure; increased risk was present in only 5% of the pregnant women calling during pregnancy. Selective serotonin reuptake inhibitors (SSRIs) are the first category that are actually considered of increased risk to the fetus. The second category is represented by antiepileptic drugs. This experience confirms previous data that there is a high teratological risk perception among both women and physicians. The drugs estimated to present increased risk are medications used for chronic neurological diseases, mainly mood disorders and epilepsy. Preconceptional counseling for these women could be an effective strategy to prevent such exposure and to improve maternal and fetal outcome.

  3. 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.

  4. One year of free school fruit in Norway--7 years of follow-up.

    PubMed

    Bere, Elling; te Velde, Saskia J; Småstuen, Milada Cvancarova; Twisk, Jos; Klepp, Knut-Inge

    2015-11-10

    It is important that health-promoting efforts result in sustained behavioural changes, preferably throughout life. However, only a very few intervention studies evaluate long term follow up. The aim of the present study is to evaluate the overall and up to seven years effect of providing daily one piece of fruit or vegetable (FV) for free for one school year. A total of 38 randomly drawn elementary schools from two counties in Norway participated in the Fruit and Vegetables Make the Marks project. Baseline (2001) and follow-up surveys were conducted in May 2002, 2005 and 2009 (n = 320 with complete data) to assess FV and unhealthy snack intake. Mixed models were used to analyze the data. Statistically significant adjusted overall effects of the intervention were revealed for FV intake (1.52 times/day) but this weakened over time. A significant adjusted overall effect (-1.54 consumptions/week) and a significant seven-year-follow-up effect (-2.02 consumptions/week) was found for consumption of unhealthy snacks for pupils of parents without higher education. One year of free school fruit resulted in higher FV intake and lower unhealthy snack intake, however this weakened over time for FV intake and became stronger for snack intake. More follow-up studies with larger samples and lower attrition rates are needed in order to further evaluate the long-term effect.

  5. One-Year stable perovskite solar cells by 2D/3D interface engineering

    PubMed Central

    Grancini, G.; Roldán-Carmona, C.; Zimmermann, I.; Mosconi, E.; Lee, X.; Martineau, D.; Narbey, S.; Oswald, F.; De Angelis, F.; Graetzel, M.; Nazeeruddin, Mohammad Khaja

    2017-01-01

    Despite the impressive photovoltaic performances with power conversion efficiency beyond 22%, perovskite solar cells are poorly stable under operation, failing by far the market requirements. Various technological approaches have been proposed to overcome the instability problem, which, while delivering appreciable incremental improvements, are still far from a market-proof solution. Here we show one-year stable perovskite devices by engineering an ultra-stable 2D/3D (HOOC(CH2)4NH3)2PbI4/CH3NH3PbI3 perovskite junction. The 2D/3D forms an exceptional gradually-organized multi-dimensional interface that yields up to 12.9% efficiency in a carbon-based architecture, and 14.6% in standard mesoporous solar cells. To demonstrate the up-scale potential of our technology, we fabricate 10 × 10 cm2 solar modules by a fully printable industrial-scale process, delivering 11.2% efficiency stable for >10,000 h with zero loss in performances measured under controlled standard conditions. This innovative stable and low-cost architecture will enable the timely commercialization of perovskite solar cells. PMID:28569749

  6. Macrobenthic community structure in the deep Gulf of Mexico one year after the Deepwater Horizon blowout

    NASA Astrophysics Data System (ADS)

    Washburn, Travis W.; Reuscher, Michael G.; Montagna, Paul A.; Cooksey, Cynthia; Hyland, Jeffrey L.

    2017-09-01

    The impacts of the 2010 Deepwater Horizon (DWH) disaster on deep-sea Gulf of Mexico benthic communities were analyzed one year after the blowout. Richness, diversity, and evenness were severely impaired within a radius of approximately 1 km around the DWH wellhead. However, lower diversity than background was observed in several stations up to 29 km to the southwest of the wellhead. Compared to samples from 2010, abundance near the DWH wellhead increased in 2011 with some of the highest values found at stations within the 1 km radius. The increase was mostly caused by the high abundance of opportunistic polychaetes of the family Dorvilleidae, genus Ophryotrocha. At contaminated stations near the DWH wellhead, diversity did not change with increased sampling area, whereas a steep increase of diversity with increasing sampling area was observed at stations farther from the wellhead. The spatial extent of DWH impacts appeared to decrease from 2010 to 2011. Impacts on diversity near the wellhead were still observed; however, the large increase in abundance may indicate the initial stages of recovery, year-to-year variability, or an early stage of succession following a disturbance; and this can be resolved only with additional temporal sampling.

  7. 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.

  8. 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

  9. Predictors of one-year attrition in female Marine Corps recruits.

    PubMed

    Pollack, Lance M; Boyer, Cherrie B; Betsinger, Kelli; Shafer, Mary-Ann

    2009-04-01

    The study seeks to identify demographic and health-related predictors of attrition among female Marine Corps recruits. Data are from a longitudinal study of female recruits entering the Marine Corps between June 1999 and June 2000 (N = 2,157). Measures come from tracking data and a self-administered paper-and-pencil questionnaire. During recruit training (RT) 11.2% of recruits were discharged. Among RT graduates 6.6% were discharged during the following year. The cumulative attrition rate was 17.1%. No prior history of regular exercise was the only consistent predictor of discharge. Multivariate analysis also identified unsafe sex, age, race/ethnicity, and recruiting status (for active duty vs. reserve) as significant predictors of cumulative attrition. One-year attrition among female Marines may be reduced by more extensively screening applicants who report risk-taking behavior. Such screening can exclude applicants who are unlikely to succeed and identify others who may need additional support to complete their tour of duty.

  10. Medical assistance at the Brazilian juniors tennis circuit--a one-year prospective study.

    PubMed

    Silva, R T; Takahashi, R; Berra, B; Cohen, M; Matsumoto, M H

    2003-03-01

    A prospective study was conducted during one year to evaluate injuries in Brazilian Junior tennis players during the national circuit, in 2001. Male and female athletes in the age categories under 12, under 14, under 16 and under 18 years, all members of The Brazilian Tennis Confederation, participated in the study. Two physiotherapists and/or one physician evaluated the athletes. A total of 280 medical examinations were performed in 151 tennis players who needed medical treatment during the tournaments. The 151 athletes had 1-6 medical treatments during the tournaments and the mean was 1.8 treatment per athlete. The overall incidence was 6.9 medical treatments for every 1,000 games played. Medical assistance tothe athletes was performed on court in 83 (29.6%) occasions, 185 (66.1%) at the medical department and in both in 12 (4.3%) occasions. Retirement of the match was reported in 9 (3.2%) lesions. The most frequent injuries were: muscle contractures (76 - 27.14%), muscle pain/fatigue (36-12.85%), muscle strain (35-12.52%), tendinopathies (20 - 7.14%), cramps (16 -5.71%), ankle sprain (12 -4.28%) and low back pain (10-3.57%). Muscle pathology was the major source of injuries causing the athlete to seek medical assistance. Preventative measures are important to reduce the number of injuries, which may include muscle stretching programs and adequate nutrition and hydration.

  11. Leaching of metals from sewage sludge during one year and their relationship to particle size.

    PubMed

    Ahlberg, G; Gustafsson, O; Wedel, P

    2006-11-01

    Leaching of metals from sewage sludge can lead to their accumulation in topsoil and can also contaminate groundwater. Our objectives were to document the metal leachates and the size distribution of leached particles from sewage sludge and to identify possible correlations with physical factors. Results from monthly lysimeter sampling showed an initial release followed by decline for most metals. Cadmium, Ca, Sr, Li, Mn, Ni and Zn showed a "cyclic" behaviour. Filtration revealed that this "cyclicity" had no correlation to the size of released particles, but Al, Cr, Fe, Cu, Ag and Pb were clearly related to release of coarser particles most of the year. Total metal amounts leached during one year, relative to original sludge content, had the order Na>Ca=Mg>Mn>Sr>Zn>K>Li=Ni>Cd>Co>Rb>Ag>Cr>Ba=Cu>Ga>Al=Pb=Fe. There were no simple correlations between monthly measured leachate concentrations and precipitation, temperature or pH of precipitation. Occasional leachate sampling might give misleading values for metals with "cyclic" behaviour.

  12. Anemia in a cohort of HIV-infected Hispanics: prevalence, associated factors and impact on one-year mortality

    PubMed Central

    2014-01-01

    Background Anemia occurs frequently in HIV-infected patients and has been associated with an increased risk of death in this population. For Hispanic subjects, information describing this blood disorder during HIV is scarce. Therefore, the present study examined data from a cohort of HIV-positive Hispanics to determine the prevalence of anemia, identify its associated factors, and evaluate its relationship with one-year mortality. Methods This study included 1,486 patients who enrolled between January, 2000 and December, 2010 in an HIV-cohort in Bayamón, Puerto Rico. Data were collected through personal interviews and medical record abstractions. To determine the factors independently associated with anemia, a multivariable logistic regression model was used. Kaplan-Meier and Cox proportional hazards models were also performed to estimate survival time and to predict death risk. Results The prevalence of anemia at enrollment was 41.5%. Factors independently associated with increased odds of anemia were: unemployment (OR = 2.02; 95% CI 1.45-2.79), CD4 count <200 cells/μL (OR = 2.66; 95% CI 1.94-3.66), HIV viral load ≥100,000 copies/mL (OR = 1.94; 95% CI 1.36-2.78), white blood cell count <4,000 cells/μL (OR = 2.42; 95% CI 1.78-3.28) and having clinical AIDS (OR = 2.39; 95% CI 1.39-4.09). Overweight (OR = 0.43; 95% CI 0.32-0.59) and obese (OR = 0.44; 95% CI 0.29-0.67) BMI’s were independently associated with reduced odds of anemia. Survival differed significantly by anemia status (log-rank test: p < 0.001). One-year mortality estimates were: 30.8%, 23.3%, 8.4% and 2.5%, for patients with severe, moderate, mild and no anemia, respectively. Having anemia at baseline was independently associated with an increased one-year mortality risk (severe anemia: HR = 9.06; 95% CI: 4.16-19.72; moderate anemia: HR = 6.51; 95% CI: 3.25-13.06; mild anemia: HR = 2.53; 95% CI: 1.35-4.74). Conclusions A high prevalence of anemia at

  13. Molecular and clinical characterization of plasmid-mediated AmpC β-lactamase-producing Escherichia coli bacteraemia: a comparison with extended-spectrum β-lactamase-producing and non-resistant E. coli bacteraemia.

    PubMed

    Matsumura, Y; Nagao, M; Iguchi, M; Yagi, T; Komori, T; Fujita, N; Yamamoto, M; Matsushima, A; Takakura, S; Ichiyama, S

    2013-02-01

    Plasmid-mediated AmpC β-lactamase-producing Escherichia coli (AmpC-E) bacteraemia was characterized by comparison with bacteraemia caused by extended-spectrum β-lactamase (ESBL)-producing E. coli (ESBL-E) and non-resistant E. coli (NR-E) in the era of the worldwide spread of the CTX-M-15-producing O25b-ST131-B2 clone. Of 706 bloodstream E. coli isolates collected between 2005 and 2010 in three Japanese university hospitals, 111 ESBL screening-positive isolates were analysed for AmpC and ESBL genes by PCR. A case-control study was performed in which the cases consisted of all of the patients with AmpC-E bacteraemia. Phylogenetic groups, sequence types and O25b serotype were determined. Twenty-seven AmpC-E isolates (26 of which were of the CMY-2 type) were identified, and 54 ESBL-E and 54 NR-E isolates were selected for the controls. Nineteen AmpC-E isolates were also positive for ESBL. CTX-M-14 was the most prevalent ESBL type among both the AmpC-E and ESBL-E isolates. The O25b-ST131-B2 clone was the most prevalent among the ESBL-E isolates (26%) and the second most prevalent among the NR-E isolates (13%), but only one O25b-ST131-B2 clone was found among the AmpC-E isolates. Twenty-three different sequence types were identified among the AmpC-E isolates. When compared with bacteraemia with ESBL-E, previous isolation of multidrug-resistant bacteria and intravascular catheterization were independently associated with a lower risk for AmpC-E. When compared with NR-E bacteraemia, prior use of antibiotics was the only significant risk factor for AmpC-E. Unlike the spread of the O25b-ST131-B2 clone between ESBL-E and NR-E, the AmpC-E isolates were not dominated by any specific clone. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.

  14. Physical activity levels after treatment for breast cancer: one-year follow-up.

    PubMed

    Devoogdt, Nele; Van Kampen, Marijke; Geraerts, Inge; Coremans, Tina; Fieuws, Steffen; Lefevre, Johan; Philippaerts, Renaat; Truijen, Steven; Neven, Patrick; Christiaens, Marie-Rose

    2010-09-01

    Among patients with breast cancer, few studies have examined the pattern of change of physical activity levels over time or the predictive factors for this change. Particularly sparse are studies comparing pre-surgical physical activity levels with those 12 months post-surgery. Patients with a primary operable breast cancer (N = 267) filled in the Physical Activity Computerised Questionnaire before breast surgery and 1, 3, 6 and 12 months post-operatively. Patient-, disease- and treatment-related factors were prospectively collected. Total physical activity level and occupational, sport and household activity levels were significantly decreased the first month post-operatively and did not recover during the first year after surgery. 'Being employed' was a predictive factor for a larger decrease of the total activity level, comparing the pre-operative and 12 months post-surgery stages. Having a spouse, a pN2-3 lesion and over 20 lymph nodes dissected predicted a decrease in occupational activity. Advanced age and smoking behaviour predicted a decrease in sport activities, and not having a spouse predicted a decrease in household activities. This study showed that 1 year after breast cancer surgery, pre-operative physical activity levels were not recovered. Breast cancer patients, and in particular those at risk for a decreased physical activity level, should be identified, encouraged and guided to increase their activities.

  15. 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.

  16. A one-year prospective study of refractory status epilepticus in Modena, Italy.

    PubMed

    Giovannini, Giada; Monti, Giulia; Polisi, Michela M; Mirandola, Laura; Marudi, Andrea; Pinelli, Giovanni; Valzania, Franco; Girardis, Massimo; Nichelli, Paolo F; Meletti, Stefano

    2015-08-01

    Refractory status epilepticus (RSE) is a particular critical condition characterized by seizures that continue despite the use of first- and second-line therapies and by high mortality. To date, only one prospective study investigated clinical features and prognostic factors in RSE. In this study, we performed a one-year prospective survey to identify clinical features, outcomes, and variables associated with the development of RSE in the adolescent and adult population of Modena, northern Italy. We observed 83 episodes of SE in 83 patients. In 31% of the cases, third-line therapy (anesthetic drug) was needed. Among this group, 14% resolved and were classified as RSE, while, in 17%, seizures recurred at withdrawal of anesthetics and were classified as super-RSE. The development of RSE/super-RSE was associated with a stuporous/comatose state at presentation and with the absence of a previous history of epilepsy. Refractory status epilepticus/super-refractory status epilepticus showed a worse outcome compared with responsive SE: 54% versus 21% for 30-day mortality; 19% versus 56% for a return to baseline condition. This prospective study confirms stupor/coma at onset as a relevant clinical factor associated with SE refractoriness. We observed a rate of RSE comparable with previous reports, with high mortality and morbidity. Mortality in the observed RSE was higher than in previous studies; this result is probably related to the low rate of a previous epilepsy history in our population that reflects a high incidence of acute symptomatic etiologies, especially the inclusion of patients with postanoxic SE who have a bad prognosis per se. This article is part of a Special Issue entitled "Status Epilepticus". Copyright © 2015 Elsevier Inc. All rights reserved.

  17. [Therapy of acute ankle sprain: one-year results of primary conservative treatment].

    PubMed

    Suhr, A; Mückley, T; Hofmann, G O; Spahn, G

    2012-03-01

    Ankle sprains (supination-eversion injury) have a high incidence. Conservative treatment is generally the method of choice. This study is intended to evaluate the 1-year results of a standardised treatment protocol. A total of 416 patients who had suffered an ankle sprain were included into this study. All of them had undergone primary conservative treatment. A total of 66 of them (15.9 %) had undergone operative treatment within one year after injury. The indications for operation were persistent pain, swelling or persistent instability. In 33 patients an arthroscopy for evaluation of the joint and debridement was used. In the case of a persistent instability 22 ligament augmentations (Kuner periostal flap) and 11 peroneus tenodesis (Watson-Jones) were performed. The evaluation was done by using the AOFAS score ("Ankle Hindfoot Scale" of the American Orthopedic Foot and Ankle Society). A 1-year follow-up was possible in 96.4 % of the patients. The mean AOFAS score was 77.1 ± 10.5 points after conservative treatment. Those patients who needed an arthroscopic debridement had a slightly better outcome (AOFAS score 79.5 ± 10.2 points). Patients who had undergone stabilisation operations tended to have the best outcome (p = 0.093). The AOFAS score was 79.6 ± 15.4 points in patients after periostal flap augmentation, respectively, 83.0 ± 7.4 points after peroneus tenodesis. The results confirm the benefit of conservative treatment in acute ankle sprain. Even so about 15 - 20 % of the patients still suffer from persistent pain, swelling or instability. The indication for operative intervention should be made relatively broadly. Most of these patients profit from the operation. Above all, after ankle sprain patients need a continuous re-evaluation by a specialised centre during the first post-injury year. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Ergonomic stressors and upper extremity musculoskeletal disorders in automobile manufacturing: a one year follow up study.

    PubMed

    Punnett, L; Gold, J; Katz, J N; Gore, R; Wegman, D H

    2004-08-01

    To estimate the one year cumulative incidence and persistence of upper extremity (UE) soft tissue disorders, in a fixed cohort of automotive manufacturing workers, and to quantify their associations with ergonomic exposures. At baseline and at follow up, cases of UE musculoskeletal disorders were determined by interviewer administered questionnaire and standardised physical examination of the upper extremities. The interview obtained new data on psychosocial strain and updated the medical and work histories. An index of exposure to ergonomic stressors, obtained at baseline interview, was the primary independent variable. Cumulative incidence and persistence of UE disorders (defined both by symptoms and by physical examination plus symptoms) were analysed in relation to baseline ergonomic exposures, adjusting for other covariates. The incidence of new disorders was modelled using multivariate proportional hazards regression among workers who were not cases in the first year and the prevalence on both occasions was modelled by repeated measures analysis. A total of 820 workers (69% of eligible cohort members) was examined. Follow up varied slightly by department group but not by baseline exposure level or other characteristics. Among the non-cases at baseline, the cumulative incidence of UE disorders was 14% by symptoms and 12% by symptoms plus examination findings. These rates increased with index of physical exposures primarily among subjects who had the same jobs at follow up as at baseline. Increased exposure during follow up increased risk of incidence. The persistence of UE disorders from baseline to follow up examination was nearly 60% and somewhat associated with baseline exposure score. These longitudinal results confirm the previous cross sectional associations of UE musculoskeletal disorders with exposure to combined ergonomic stressors. The exposure-response relation was similar for incident cases defined by symptoms alone and those confirmed by physical

  19. 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.

  20. Asymptomatic pseudotumours after metal-on-metal hip resurfacing show little change within one year.

    PubMed

    van der Weegen, W; Brakel, K; Horn, R J; Hoekstra, H J; Sijbesma, T; Pilot, P; Nelissen, R G H H

    2013-12-01

    The aim of this study was to establish the natural course of unrevised asymptomatic pseudotumours after metal-on-metal (MoM) hip resurfacing during a six- to 12-month follow-up period. We used repeated metal artefact reduction sequence (MARS)-magnetic resonance imaging (MRI), serum metal ion analysis and clinical examination to study 14 unrevised hips (mean patient age 52.7 years, 46 to 68, 5 female, 7 male) with a pseudotumour and 23 hips (mean patient age 52.8 years, 38 to 69, 7 female, 16 male) without a pseudotumour. The mean post-operative time to the first MARS-MRI scan was 4.3 years (2.2 to 8.3), and mean time between the first and second MARS-MRI scan was eight months (6 to 12). At the second MRI scan, the grade of severity of the pseudotumour had not changed in 35 hips. One new pseudotumour (Anderson C2 score, moderate) was observed, and one pseudotumour was downgraded from C2 (moderate) to C1 (mild). In general, the characteristics of the pseudotumours hardly changed. Repeated MARS-MRI scans within one year in patients with asymptomatic pseudotumours after MoM hip resurfacing showed little or no variation. In 23 patients without pseudotumour, one new asymptomatic pseudotumour was detected. This is the first longitudinal study on the natural history of pseudotumours using MARS-MRI scans in hip resurfacing, and mirrors recent results for 28 mm diameter MoM total hip replacement.

  1. Cooling unit for the AmpaCity project - One year successful operation

    NASA Astrophysics Data System (ADS)

    Herzog, Friedhelm; Kutz, Thomas; Stemmle, Mark; Kugel, Torsten

    2016-12-01

    High temperature super conductors (HTS) can efficiently be cooled with liquid nitrogen down to a temperature of 64 K (-209 °C). Lower temperatures are not practical, because at 63 K (-210 °C) nitrogen becomes solid. To achieve this temperature level the coolant has to be vaporized below atmospheric pressure. Messer has developed a cooling unit with an adequate vacuum subcooler, a liquid nitrogen circulation system, and a storage vessel for cooling an HTS-power cable. Liquid nitrogen is circulated through the superconducting cable to take out the heat, and afterward it is pumped through the subcooler to be recooled. In the circulation system liquid nitrogen is used as a dielectric fluid and as a heat transfer medium. It stays always liquid (subcooled) and does not vaporize. On the secondary side of the subcooler liquid nitrogen from the storage vessel is used as refrigerant. It is vaporized under a pressure of 150 mbar to achieve the desired low temperatures. The cooling unit was delivered in 2013 for the German AmpaCity project of RWE Deutschland AG, Nexans and Karlsruhe Institute of Technology. Within this project RWE and Nexans installed the worldwide longest superconducting power cable in the city of Essen, Germany. The cooling unit cools a 10 kV concentric HTS cable (40 MV A) with a length of 1000 m. The cable is in operation since March 10th, 2014. After more than one year of practical operation many important figures from cable and cooling unit are available. These figures are discussed and a total energy balance is shown to compare liquid nitrogen cooling with alternative mechanical cooling systems.

  2. Motor recovery of stroke patients after rehabilitation: one-year follow-up study.

    PubMed

    Kuptniratsaikul, Vilai; Kovindha, Apichana; Suethanapornkul, Sumalee; Massakulpan, Pornpimon; Permsirivanich, Wutichai; Kuptniratsaikul, Patcharawimol Srisa-An

    2017-01-01

    Purpose To investigate motor recovery of stroke patients 1 year after rehabilitation. Materials and Methods A cross-sectional study of 192 stroke patients discharged from rehabilitation wards in nine tertiary hospitals was conducted. Motor recovery was assessed using the Brunnstrom motor recovery stages (BMRS), at 6 and 12 months after discharge. Factors related to the BMRS of the hand, arm and leg were analyzed. Results The mean age of patients was 62.2 years (57.3% male). Significantly more patients presented improvement of at least one BMRS of the hand, arm and leg compared with those with decreasing BMRS (p < 0.001). The percentage of patients with BMRS III- VI at 6 months was greater than that at discharge, but the recovery at 12 months was slightly higher than that at 6 months. It seems that motor recovery from stroke was near maximal at six months. Regarding the factors related to motor recovery, only lengths of stay (LOS) <30 d during the first admission and Barthel index at discharge ≥10 were related to the improvement of BMRS of the hand, arm and leg on multivariate analysis. Additionally, no complication at discharge was associated with the improvement of BMRS of the leg. Conclusions Approximately half of our stroke patients had motor improvement of at least one stage of BMRS at one year. Motor recovery after stroke at the end of the first year was associated with shorter LOS during the first admission, higher discharge Barthel index score and absence of complications at discharge.

  3. One year sediment trap fluxes from a mooring in the western tropical North Atlantic

    NASA Astrophysics Data System (ADS)

    Korte, L.; Van der Does, M.; Munday, C. I.; Schouten, S.; Brummer, G. J. A.; Stuut, J. B. W.

    2015-12-01

    Particle fluxes in the oceans are determined by environmental circumstances and differ from site to site. In the western tropical North Atlantic the particle flux is considered to be rather low since there is low nutrient input and low productivity. It is, however, influenced by atmospheric dust deposition, Amazon River discharge, and nitrogen fixation. This brings both refractory lithogenic material and new nutrients into the system, affecting primary production and particle export. Particle export in particular has attracted attention since it is potentially partially responsible for atmospheric CO2 sequestration. Here we present one year (October 2012 until November 2013) flux data collected by two sediment traps at 1200 m and 3500 m depth in the western tropical North Atlantic (12⁰N, 49⁰W), combined with satellite data, giving information about environmental circumstances and particle export fluxes from the surface to the deep ocean. Average total mass fluxes vary between 40 - 270 mg/m2/d and 30 - 170 mg /m2/d at the upper and lower depths, respectively. Peak fluxes during the second half of April and by the end of October/start of November 2013 are notable since they differ in nature; carbonaceous material dominates fluxes in spring and biogenic opal in fall. While the fall peak seems related to Amazon River dispersal, the spring peak appears to arise due to changing environmental conditions; rising SST possibly combined with dry dust deposition, causing a spring bloom. Both peak fluxes go along with elevated organic matter and lithogenic fluxes in the upper trap at 1200 m. At this depth, additional individual elevated lithogenic fluxes are also accompanied by raised organic matter. The lithogenic and opal fractions are considered to be the main ballast components for organic carbon aggregates, or vice versa. See: www.nioz.nl/dust

  4. Sacroiliac Joint Fusion: One Year Clinical and Radiographic Results Following Minimally Invasive Sacroiliac Joint Fusion Surgery

    PubMed Central

    Kube, Richard A.; Muir, Jeffrey M.

    2016-01-01

    Background: Recalcitrant sacroiliac joint pain responds well to minimally-invasive surgical (MIS) techniques, although long-term radiographic and fusion data are limited. Objective: To evaluate the one-year clinical results from a cohort of patients with chronic sacroiliac (SI) joint pain unresponsive to conservative therapies who have undergone minimally invasive SI joint fusion. Methods: SI joint fusion was performed between May 2011 and January 2014. Outcomes included radiographic assessment of fusion status, leg and back pain severity via visual analog scale (VAS), disability via Oswestry Disability Index (ODI) and complication rate. Outcomes were measured at baseline and at follow-up appointments 6 months and 12 months post-procedure. Results: Twenty minimally invasive SI joint fusion procedures were performed on 18 patients (mean age: 47.2 (14.2), mean BMI: 29.4 (5.3), 56% female). At 12 months, the overall fusion rate was 88%. Back and leg pain improved from 81.7 to 44.1 points (p<0.001) and from 63.6 to 27.7 points (p=0.001), respectively. Disability scores improved from 61.0 to 40.5 (p=0.009). Despite a cohort containing patients with multiple comorbidities and work-related injuries, eight patients (50%) achieved the minimal clinically important difference (MCID) in back pain at 12 months, with 9 (69%) patients realizing this improvement in leg pain and 8 (57%) realizing the MCID in ODI scores at 12 months. No major complications were reported. Conclusion: Minimally invasive SI joint surgery is a safe and effective procedure, with a high fusion rate, a satisfactory safety profile and significant improvements in pain severity and disability reported through 12 months post-procedure. PMID:28144378

  5. Caries increment in children and urinary catecholamines: findings at one-year.

    PubMed

    Vanderas, A P; Manetas, K; Papagiannoulis, L

    2000-01-01

    This one-year follow-up study investigates the relationship between urinary catecholamine levels and dental caries increment in 314 children, boys and girls, ages six to eight years. Dental caries was recorded clinically and radiographically and oral hygiene was evaluated by recording the dental plaque. A 24-hour urine sample was collected for each subject, in a year interval, and a representative sample was analyzed by the HPLC technique to assay the catecholamine content. Socioeconomic factors such as parental age, education, and profession were recorded by a questionnaire distributed to the parents. Of the examined children, forty-four (16 boys and 28 girls) did not develop new dental caries and constituted the Caries-Free group. Two New Caries groups, A and B, of forty-four children each (16 boys and 28 girls) were matched by age and sex. Differences were tested in the quantitative and qualitative data by the paired t-test and the chi 2 test, respectively, while a regression analysis was applied to measure the effects of norepinephrine and dopamine on epinephrine. The logistic multiple-regression analysis was used to test, in the entire population, the impact of catecholamines and other related factors on the probability of a subject's developing new dental caries. The 95 percent probability was used. The results showed statistically significant differences in epinephrine and norepinephrine values between Caries-Free and New Caries group A in both examinations. Also, significant differences were found between Caries-Free and New Caries group B in epinephrine and norepinephrine at the first examination, while at the second examination the difference was significant only in epinephrine. The data provide evidence, therefore, that an emotionally stressful state can be an etiologic factor of dental caries.

  6. Ergonomic stressors and upper extremity musculoskeletal disorders in automobile manufacturing: a one year follow up study

    PubMed Central

    Punnett, L; Gold, J; Katz, J; Gore, R; Wegman, D

    2004-01-01

    Aims: To estimate the one year cumulative incidence and persistence of upper extremity (UE) soft tissue disorders, in a fixed cohort of automotive manufacturing workers, and to quantify their associations with ergonomic exposures. Methods: At baseline and at follow up, cases of UE musculoskeletal disorders were determined by interviewer administered questionnaire and standardised physical examination of the upper extremities. The interview obtained new data on psychosocial strain and updated the medical and work histories. An index of exposure to ergonomic stressors, obtained at baseline interview, was the primary independent variable. Cumulative incidence and persistence of UE disorders (defined both by symptoms and by physical examination plus symptoms) were analysed in relation to baseline ergonomic exposures, adjusting for other covariates. The incidence of new disorders was modelled using multivariate proportional hazards regression among workers who were not cases in the first year and the prevalence on both occasions was modelled by repeated measures analysis. Results: A total of 820 workers (69% of eligible cohort members) was examined. Follow up varied slightly by department group but not by baseline exposure level or other characteristics. Among the non-cases at baseline, the cumulative incidence of UE disorders was 14% by symptoms and 12% by symptoms plus examination findings. These rates increased with index of physical exposures primarily among subjects who had the same jobs at follow up as at baseline. Increased exposure during follow up increased risk of incidence. The persistence of UE disorders from baseline to follow up examination was nearly 60% and somewhat associated with baseline exposure score. Conclusions: These longitudinal results confirm the previous cross sectional associations of UE musculoskeletal disorders with exposure to combined ergonomic stressors. The exposure-response relation was similar for incident cases defined by symptoms

  7. Towards a "crime pollen calendar" - pollen analysis on corpses throughout one year.

    PubMed

    Montali, Elisa; Mercuri, Anna Maria; Trevisan Grandi, Giuliana; Accorsi, Carla Alberta

    2006-11-22

    A palynological study was carried out on 28 corpses brought in one year (June 2003-May 2004) to the morgue of the Institute of Legal Medicine of Parma (Northern Italy). This preliminary research focuses on the date of death, which was known for all corpses examined. Pollen sampling and analyses were made with the first aim of comparing the pollen grains found on corpses with those diffused in the atmosphere in the region in the same season as the known date of death. Eyebrows, hair-line near the forehead, facial skin and nasal cavities were sampled. Most of the corpses had trapped pollen grains, with the exception of two December corpses. All pollen grains were found with cytoplasm and in a good state of preservation. In this way, a series of reference data was collected for the area where the deaths occurred, and we examined whether pollen grains on corpses could be an index of the season of death. To verify this hypothesis, the pollen analyses were compared with data reported in the airborne pollen calendars of Parma and the region around. Pollen calendars record pollen types and their concentrations in the air, month by month. The quantity of pollen recorded on corpses did not prove to be directly related to the quantity of pollen in the air. But qualitatively, many pollen types which are seasonal markers were found on corpses. Main corpse/air discrepancies were also observed due to the great influence that the local environmental conditions of the death scene have in determining the pollen trapped by a corpse. Qualitative plus quantitative pollen data from corpses appeared helpful in indicating the season of death. A preliminary sketch of a "crime pollen calendar" in a synthetic graphic form was made by grouping the corpse pollen records into three main seasons: A, winter/spring; B, spring/summer; C, summer/autumn. Trends match the general seasonal trend of pollen types in the air.

  8. An examination of emerging in-space propulsion concepts for one-year crewed mars missions

    NASA Astrophysics Data System (ADS)

    Pelaccio, Dennis G.; Rauwolf, Gerald A.; Maggio, Gaspare; Patel, Saroj; Sorensen, Kirk

    2002-01-01

    A study was completed that provides a meaningful, even-handed, comparison assessment of promising candidate, in-space, exploration propulsion concepts to support emerging ``near-term'' crewed Mars mission applications. In particular, the study examined the mission performance feasibility and risk of a number of near-, mid-, and far-term in-space propulsion concepts to support crewed Mars missions starting in 2018 that can have the crewed portion of the mission performed in one year or less. This study used exploration propulsion system team technology specialist advocates to identify seven meaningful, representative mission architecture scenarios to ``best'' demonstrate the capability of such in-space propulsion technology options to support the near-term crewed Mars mission requirement. Additionally, a common set of top-level mission/system requirements was established for the study, which was incorporated in the assessment of all the mission options considered. Mission performance for abundant chemical (Ab-Chem), bimodal nuclear thermal rocket (BNTR), high power nuclear electric propulsion (HP-NEP), momentum tether/chemical, solar electric propulsion (SEP), solar electric propulsion/chemical (SEP-Chem) and Variable Specific Impulse Magnetoplasma Rocket (VASIMR) based missions were estimated for this quick trip, 2018 crewed Mars flight opportunity. Each of these mission options are characterized in terms of their overall mission performance capability, crewed mission duration, Initial Mass to Low Earth Orbit (IMLEO), which including dry and propellant weight required, overall mission time, number of flight elements (propulsion units/tank sets), and number of Earth-to-Orbit (ETO) vehicle launches. Potential top-level development, implementation, and operational issues/risks for each mission scenario considered are also identified. .

  9. Flexibility of the elderly after one-year practice of yoga and calisthenics.

    PubMed

    Farinatti, Paulo T V; Rubini, Ercole C; Silva, Elirez B; Vanfraechem, Jacques H

    2014-01-01

    Flexibility training responses to distinct stretching techniques are not well defined, especially in the elderly. This study compared the flexibility of elderly individuals before and after having practiced hatha yoga and calisthenics for 1 year (52 weeks), at least 3 times/week. Sixty-six subjects (12 men) measured and assigned to 3 groups: control (n = 24, age = 67.7±6.9 years), hatha yoga (n = 22, age = 61.2±4.8 years), and calisthenics (n = 20, age = 69.0±5.8 years). The maximal range of passive motion of 13 movements in 7 joints was assessed by the Flexitest, comparing the range obtained with standard charts representing each arc of movement on a discontinuous and non-dimensional scale from 0 to 4. Results of individual movements were summed to define 4 indexes (ankle+knee, hip+trunk, wrist+elbow, and shoulder) and total flexibility (Flexindex). Results showed significant increases of total flexibility in the hatha yoga group (by 22.5 points) and the calisthenics group (by 5.8 points) (p < 0.01 for each) and a decrease in the control group (by 2.1 points) (p < 0.01) after one year of intervention. Between-group comparison showed that increases in the hatha yoga group were greater than in the calisthenics group for most flexibility indexes, particularly the overall flexibility (p <0.05). In conclusion, the practice of hatha yoga (i.e., slow/passive movements) was more effective in improving flexibility compared to calisthenics (i.e., fast/dynamic movements), but calisthenics was able to prevent flexibility losses observed in sedentary elderly subjects.

  10. One-year Clinical Evaluation of Resin Composite Restorations of Noncarious Cervical Lesions in Smokers.

    PubMed

    de Carvalho, Luana Dutra; Gondo, Renata; Lopes, Guilherme Carpena

    2015-08-01

    To evaluate the one-year clinical performance of composite restorations in noncarious cervical lesions placed in smoking and non-smokers using a multimode adhesive system with two adhesive strategies. Among the selected cervical lesions, four experimental groups were formed based on the patients' smoking habit and bonding strategies with a multimode adhesive system (n = 38): G1: etchand- rinse in non-smokers; G2: selective enamel etching in non-smokers; G3: etch-and-rinse in smokers; G4: selective enamel etching in smokers. The restorations were paired, ie, each patient received at least two restorations. A nanofilled resin composite was applied and light cured incrementally in all groups by one operator. Two calibrated examiners evaluated the restorations at baseline, 6 and 12 months after placement. The modified USPHS criteria were used for evaluation. Data were analyzed using the chi-square (for associations between groups) and McNemar tests. No statistically significant difference was found between groups for the criteria of retention, marginal discoloration, color match, marginal integrity, or sensitivity after 6 and 12 months. The assessments over time showed a statistically significant difference only for marginal discoloration at 12 months for groups 1, 3, and 4 when compared to baseline (p = 0.031). There were no statistical differences for any criteria evaluated among smokers and non-smokers, except for color match, where a difference was found after the baseline evaluation. Regarding the adhesive strategy, etch-and-rinse resulted in a clinical performance similar to that of selective enamel etching over 12 months. Neither cigarette smoking habit nor adhesive strategy influenced the clinical performance of resin composite cervical restorations over the first year.

  11. Treatment of cellulite using a 1440-nm pulsed laser with one-year follow-up.

    PubMed

    DiBernardo, Barry E

    2011-03-01

    Cellulite is characterized by a thickened hypodermal fat layer, along with hypodermal fat lobules that extend upward into the dermis, expanding and stretching the fibrous septae that separate the fat lobules. Eventually, the septae sclerose, contract, and harden, holding the skin at an inflexible length while the surrounding tissue continues to expand. The author evaluates the efficacy, safety, and duration of clinical benefit associated with a pulsed laser that delivers 1440-nm energy to the dermal-hypodermal interface for the treatment of cellulite. The changes in the dermal structure that affect the appearance of cellulite are also examined. Ten healthy women with cellulite on their thighs enrolled in a prospective Institutional Review Board-approved study conducted in the author's private plastic surgery clinic. Patients received a single treatment with a 1440-nm pulsed laser. Energy was delivered to the subdermal tissue through a fiber that was designed for side firing and enclosed in a cannula. Treatment addressed the thickened hypodermal fat layer, hypodermal fat lobules that extended upward into the dermis, and fibrous septae by thermal subcision. The mean age of the patients was 47 years ± 5.4 years. Mean skin thickness (as shown by ultrasound) and skin elasticity were shown by objective measurements to increase significantly at one, three, six, and 12 months. Subjective physician and subject evaluations indicated improvement, high subject satisfaction, and minimal adverse effects. In this study, a single treatment with the 1440-nm pulsed laser improved the appearance of cellulite, an improvement that persisted through at least one year of follow-up with minimal adverse effects.

  12. One-year survey of paediatric anaphylaxis in an allergy department.

    PubMed

    Gaspar, Â; Santos, N; Piedade, S; Santa-Marta, C; Pires, G; Sampaio, G; Arêde, C; Borrego, L M; Morais-Almeida, M

    2015-11-01

    To determine the frequency of anaphylaxis in an allergy outpatient department, allowing a better understanding regarding aetiology, clinical manifestations and management, in children and adolescents. From among 3646 patients up to 18 years old observed during one-year period, we included those with history of anaphylaxis reported by allergists. Sixty-four children had history of anaphylaxis (prevalence of 1.8%), with mean age 8.1±5.5 years, 61% being male. Median age of the first anaphylactic episode was 3 years (1 month-17 years). The majority of patients had food-induced anaphylaxis (84%): milk 22, egg 7, peanut 6, tree nuts 6, fresh fruits 6, crustaceans 4, fish 4 and wheat 2. Food-associated exercise-induced anaphylaxis was reported in 2 adolescents. Drug-induced anaphylaxis occurred in 8%: 4 non-steroidal anti-inflammatory drugs and 1 amoxicillin. Three children had cold-induced anaphylaxis, one adolescent had anaphylaxis to latex and one child had anaphylaxis to insect sting. The majority (73%) had no previous diagnosis of the etiologic factor. Symptoms reported were mainly mucocutaneous (94%) and respiratory (84%), followed by gastrointestinal (42%) and cardiovascular (25%). Fifty-one patients were admitted to the emergency department, although only 33% were treated with epinephrine. Recurrence of anaphylaxis occurred in 26 patients (3 or more episodes in 14). In our paediatric population, the main triggering agent of anaphylaxis was IgE-mediated food allergy. Epinephrine is underused, as reported by others. Often, children have several episodes before being assessed by an allergist. We stress the importance of systematic notification and improvement of educational programmes in order to achieve a better preventive and therapeutic management of this life-threatening entity.

  13. Residual angle closure one year after laser peripheral iridotomy in primary angle closure suspects.

    PubMed

    Baskaran, Mani; Yang, Elizabeth; Trikha, Sameer; Kumar, Rajesh S; Wong, Hon Tym; He, Mingguang; Chew, Paul Tk; Foster, Paul J; Friedman, David; Aung, Tin

    2017-09-05

    To determine the incidence and baseline clinical and anterior segment optical coherence tomography (AS-OCT) predictors associated with residual angle closure as assessed by gonioscopy 1 year after laser peripheral iridotomy (LPI) in primary angle closure suspects (PACS). Sub-analysis of randomized controlled trial data METHODS: AS-OCT images (Visante, Carl Zeiss Meditec, Dublin, CA) from 181 PACS subjects ≥ 50 years of age, were analyzed using customized software, prior to, and 1 year after LPI. Other parameters assessed were intraocular pressure (IOP) and axial length (Axl). Residual angle closure was defined as the inability to see the posterior trabecular meshwork for at least 2 quadrants on gonioscopy after LPI. Multivariate regression analysis determined the baseline predictors of residual angle closure 1 year after LPI. The mean age of participants was 62.4 (SD 9.9) years. The majority were female (137, 75.7%) and Chinese 174, 96.1%). At 1 year post LPI, 148 (81.8%) subjects had gonioscopic residual angle closure. Univariate analysis showed that baseline Axl, anterior chamber area, anterior chamber volume, angle opening distance at 750 microns from the scleral spur and angle recess area were smaller while baseline lens vault and iris curvature were larger in residual angle closure subjects (all p<0.05). Multivariate analysis revealed that baseline iris volume (B=-0.08, P=0.035) and baseline IOP (B=0.23, p=0.032) were predictors for residual angle closure. One year after LPI, >80% of PACS had gonioscopic residual angle closure. Greater baseline iris volume and higher IOP at baseline are independent risk factors for residual gonioscopic angle closure. Copyright © 2017. Published by Elsevier Inc.

  14. Groundwater monitoring at three Oak Ridge National Laboratory inactive waste impoundments: results after one year

    SciTech Connect

    Francis, C. W.; Stansfield, R. G.

    1986-10-01

    To determine if the migration of potential contaminants from three inactive waste impoundments at Oak Ridge National Laboratory poses a threat to groundwater quality, at least one upgradient groundwater monitoring well and threee downgradient monitoring wells were installed at each impoundment in early 1985. These three unlined impoundments, formerly used to collect and, in some instances, treat wastewater are: the 3513 impoundment; the Old Hydrofracture Facility (OHF) impoundment; and the Homogeneous Reactor Experimnt No. 2 impoundment. Groundwater samples were collected quarterly for one year. Analyses were conducted for the groundwater protection parameters promulgated by the Resource Conservation and Recovery Act. The groundwater samples were also analyzed for polychlorinated biphenyls, copper, nickel, zinc, /sup 90/Sr, /sup 137/Cs, and tritium. The contaminants found most often to affect groundwater quality at all three waste impoundments were radionuclides. For example, mean concentrations of gross beta and gross alpha activity exceeded drinking water limits at all three sites. The gross beta limit was exceeded at the 3513 and OHF impoundments by either /sup 90/Sr or tritium levels. At the 3513 impoundment, there was substantial evidence that the downgradient groundwater has been contaminated by chromium and lead and possibly by halogenated organic compounds. At the OHF impoundment, the mean level of tritium measured in the upgradient well (about 91,000 Bq/L as compared with 80,000 Bq/L in the downgradient wells) indicated that the groundwater quality has been affected by the radioactive wastes buried in the low-level radioactive waste burial ground solid waste storage area-5 upgradient of the impoundment. Testing for groundwater contamination, disclosed statistically significant contamination at all three sites.

  15. 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

  16. 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),…

  17. 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…

  18. 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…

  19. 77 FR 3745 - Establishment of a One-Year Retention Period for Patent-Related Papers That Have Been Scanned...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... Papers That Have Been Scanned Into the Image File Wrapper System or the Supplemental Complex Repository... comments on a proposal to establish a retention period of one year for patent-related papers that have been... the paper would have otherwise occurred. The one-year retention period for papers scanned into IFW...

  20. A new one year interuniversity Master Programme in Water Resources Management in the French speaking community of Belgium

    NASA Astrophysics Data System (ADS)

    Dassargues, A.; Vanclooster, M.; Xanthoulis, D.; Descy, J. P.

    2009-04-01

    A new one year interuniversity Master Programme in Water Resources Management, organised within the French speaking Community of Belgium is presented. This new programme was launched in September 08. The programme is jointly organised by the « Académie Wallonie-Europe » and the « Académie Louvain ». The programme aims advanced training in the domain of water resources management, targeted to a French speaking audience of undergraduate and graduate students, as well as professionals working in the water sector area. During the training, emphasis is put on the understanding of the processes that determine the fluxes in terrestrial hydrosystems (quantitative and qualitative fluxes). Emphasis is also put on the assessment of different components of the hydrosystem (monitoring and data analysis) and the predictive modelling of the hydrosystem supporting optimal water management. The programme includes both advanced training in basic disciplines related to hydrological sciences (hydrology, climatology, hydrogeology, unsaturated zone hydrology, hydrobiology) and inter-disciplinary training in water resources management. The interdisciplinary teaching team includes hydrogeologists, agronomists, hydrologists, climatologists, hydraulic engineers, hydrobiologists and hydrogeophysicists from the four participating universities. Practical exercises and field work are included in the teaching modules and the master thesis work is oriented towards practical water management problems. The programme is accessible to undergraduate students holding an initial master degree in sciences, applied sciences and engineering. Particular attention is devoted to recruit students from French speaking developing countries.

  1. Soil biodiversity in artificial black pine stands one year after selective silvicultural treatments

    NASA Astrophysics Data System (ADS)

    Mocali, Stefano; Fabiani, Arturo; Landi, Silvia; Bianchetto, Elisa; Montini, Piergiuseppe; Samaden, Stefano; Cantiani, Paolo

    2017-04-01

    differences were observed for mesofauna and nematode community diversity which displayed a higher diversity after thinning in both Amiata and Pratomagno. Nevertheless, Coleoptera showed higher richness values in Pratomagno, where the wood degrader Nebria tibialis subcontracta specie dominated, compared to Amiata. In conclusion, a general increase of soil biodiversity occurred in the plots after thinning compared to untreated control within the two areas, but such results are still heterogeneous and poorly statistically significant. As expected, one year is not enough time to appreciate significant enhance of the overall biodiversity after such silvicultural treatments. Thus, more evident and significant results are expected on the next two years.

  2. One-year follow-up of patients with long-lasting post-herpetic neuralgia.

    PubMed

    Pica, Francesca; Gatti, Antonio; Divizia, Marco; Lazzari, Marzia; Ciotti, Marco; Sabato, Alessandro Fabrizio; Volpi, Antonio

    2014-11-01

    Recent information on epidemiology and management of post-herpetic neuralgia (PHN), a painful complication of zoster, is scarce. This study was conducted at the Pain Clinic of the Policlinico Tor Vergata, Rome, Italy, on eighty-five immunocompetent patients with a clinical diagnosis of PHN. At enrollment (time 0, T0), the patients were interviewed by physicians to obtain demographic data and information about their zoster clinical history and underwent a blood test for VZV-DNA research. DN4 and SF-12 questionnaires were used to assess the neuropathic nature of pain and the overall health status, respectively. A one-year follow-up was planned for enrolled cases, who were visited at regular intervals of at least 3 months. At T0 all the patients were at least 6 months from the episode of acute zoster and still presented with intense pain (mean VAS =6.7; mean DN4 = 5.7). Using antivirals within 72 hours from the rash onset was associated to a significant reduction of pain at T0 (p = 0.006 vs untreated patients). Only 2.6% of patients treated with antivirals during acute zoster but 18.6% of the untreated ones presented with neuropathic pain at T12 (p =0.007), even though the two groups were similar at T0. VZV-DNA was found in 5 out of the 50 available blood samples. At the last follow-up visit, PCS and MCS scores of the PHN patients were found to be recovered over those of the historical age-matched healthy controls. Undesirable side effects of analgesic therapies were observed in 15.3 to 28.8% of the patients. Patients who six months after acute zoster still have significant neuropathic pain, have a high probability of suffering from chronic pain in the subsequent months/years. The initial antiviral treatment has a significant impact on the pain. Current strategies of analgesic therapy are effective to achieve relief of pain in PHN patients, but they are burdened with heavy and undesirable side effects.

  3. Influence of lansoprazole and rabeprazole on mycophenolic acid pharmacokinetics one year after renal transplantation.

    PubMed

    Miura, Masatomo; Satoh, Shigeru; Inoue, Kazuyuki; Kagaya, Hideaki; Saito, Mitsuru; Suzuki, Toshio; Habuchi, Tomonori

    2008-02-01

    Peptic ulcer disease is a common complication after organ transplantation, and long-term administration of antiulcer agents is needed in many renal transplant recipients. Although several drug interactions with mycophenolic acid (MPA), the active metabolite of the prodrug mycophenolate mofetil (MMF), have been reported, little is known about the interaction between MPA and proton pump inhibitors (PPIs). The present study investigated the drug interaction between MMF and lansoprazole or rabeprazole and the impact of cytochrome (CYP) 2C19, and multidrug resistance (MDR)1 C3435T polymorphisms on these drug interactions at 1 year after renal transplantation. Retrospectively, 61 recipients were divided into 3 groups: MMF and tacrolimus as combination immunosuppressive therapy, together with either 30 mg lansoprazole (n = 22) or 10 mg rabeprazole (n = 17), or without PPI (n = 22). One year after transplantation, plasma concentrations of MPA were measured by high-performance liquid chromatography. The mean dose-unadjusted and -adjusted Cmax of MPA with 30 mg lansoprazole were significantly lower than those without PPI (11.8 vs. 17.8 microg/mL, P = 0.0197, and 22.6 vs. 33.1 ng/mL/mg MMF, P = 0.0222, respectively). In recipients having the CYP2C19 *1/*2+*1/*3 or MDR1 C3435T CC genotype, the mean dose-adjusted AUC0-12 of MPA with 30 mg lansoprazole was significantly smaller than that with 10 mg rabeprazole or without PPI. The plasma concentration of MPA was influenced by 30 mg lansoprazole but not 10 mg rabeprazole. Because of the greater gastric acid secretion-inhibitory effect of 30 mg lansoprazole in recipients having the CYP2C19 *1/*2+*1/*3 (intermediate metabolizer) or MDR1 C3435T CC genotype, the elution and hydrolysis of MMF might be decreased. Although the clinical relevance might be minor, the fact that administration of 30 mg lansoprazole in patients having the CYP2C19 *2 or *3 allele or the MDR1 C3435T CC genotype diminishes the absorption of MPA in the

  4. 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

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

    PubMed

    Molina, Gustavo F; Faulks, Denise; Mazzola, Ignacio; Mulder, Jan; Frencken, Jo E

    2014-05-07

    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. 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. 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). These short-term results indicate that ART appears to be an effective treatment protocol for treating

  6. 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

  7. 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

  8. One-year mortality among Danish intensive care patients with acute kidney injury: a cohort study

    PubMed Central

    2012-01-01

    Introduction There are few studies on long-term mortality among intensive care unit (ICU) patients with acute kidney injury (AKI). We assessed the prevalence of AKI at ICU admission, its impact on mortality during one year of follow-up, and whether the influence of AKI varied in subgroups of ICU patients. Methods We identified all adults admitted to any ICU in Northern Denmark (approximately 1.15 million inhabitants) from 2005 through 2010 using population-based medical registries. AKI was defined at ICU admission based on the risk, injury, failure, loss of kidney function, and end-stage kidney disease (RIFLE) classification, using plasma creatinine changes. We included four severity levels: AKI-risk, AKI-injury, AKI-failure, and without AKI. We estimated cumulative mortality by the Kaplan-Meier method and hazard ratios (HRs) using a Cox model adjusted for potential confounders. We computed estimates for all ICU patients and for subgroups with different comorbidity levels, chronic kidney disease status, surgical status, primary hospital diagnosis, and treatment with mechanical ventilation or with inotropes/vasopressors. Results We identified 30,762 ICU patients, of which 4,793 (15.6%) had AKI at ICU admission. Thirty-day mortality was 35.5% for the AKI-risk group, 44.2% for the AKI-injury group, and 41.0% for the AKI-failure group, compared with 12.8% for patients without AKI. The corresponding adjusted HRs were 1.96 (95% confidence interval (CI) 1.80-2.13), 2.60 (95% CI 2.38 to 2.85) and 2.41 (95% CI 2.21 to 2.64), compared to patients without AKI. Among patients surviving 30 days (n = 25,539), 31- to 365 day mortality was 20.5% for the AKI-risk group, 23.8% for the AKI-injury group, and 23.2% for the AKI-failure group, compared with 10.7% for patients without AKI, corresponding to adjusted HRs of 1.33 (95% CI 1.17 to 1.51), 1.60 (95% CI 1.37 to1.87), and 1.64 (95% CI 1.42 to 1.90), respectively. The association between AKI and 30-day mortality was evident in

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

    PubMed

    Nakahara, Satomi; Tachibana, Masayuki; Watanabe, Yoichi

    2016-05-08

    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

  10. 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

  11. [Functional changes in one-year and related factors among community-dwelling frail elderly].

    PubMed

    Kono, A; Kanagawa, K

    2000-06-01

    The purpose of this study was to investigate physical and psychosocial characteristics together with life activities related to functional changes among frail elderly, including J-rank individuals able to walk outdoors and take a bus as well as people of A-rank capable of moving around inside the house but incapable of going outside. The study design was of longitudinal type. Participants were community-dwelling frail elderly, 61 J-rank and 90 A-rank individuals aged over 65-years and caregivers. Nurses conducted home interviews as Wajima City, Ishikawa Prefecture in Japan, in 1998 at the baseline and 1999 at follow-up, and evaluated the degree of independence of the frail elderly. With the baseline survey, physical function, psychosocial characteristics, and life activities were assessed. At the follow-up survey, 3.3% people of J-rank elderly had died and 83.6% were at home. Among the A-rank elderly, 11.1% had died and 80.6% were at home. Functional change in one-year was as follows: 31.4% people of J-rank had declined and 68.6% remained the same. 19.4% people of A-rank improved, 65.3% unchanged, and 15.3% declined. Among J-rank elderly, functional decline was significantly related to low ADL level and less verbal contact with their caregivers. Life activities such as getting out to the garden or around the house, worshipping at a temple, doing house chores, shopping, and gardening, related to maintained function. Among A-rank elderly with the low ADL, function similarity declined. Life activities such as visiting friends, gardening, and performing self-care chores were significantly linked to improvement. The results suggest that the degree of independence of frail elderly may easily change. ADL is related to functional change among frail elderly of both A and J rank. It is recommended that facilitating activities like house chores or getting out the house for J-rank individuals and self-care for A-rank elderly is important to prevent functional decline

  12. Can innovative ambulance transport avert pregnancy-related deaths? One-year operational assessment in Ethiopia.

    PubMed

    Godefay, Hagos; Kinsman, John; Admasu, Kesetebirhan; Byass, Peter

    2016-06-01

    To maximise the potential benefits of maternity care services, pregnant women need to be able to physically get to health facilities in a timely manner. In most of sub-Saharan Africa, transport represents a major practical barrier. Here we evaluate the extent to which an innovative national ambulance service in Ethiopia, together with mobile phones, may have been successful in averting pregnancy-related deaths. An operational assessment of pregnancy-related deaths in relation to utilisation of the new national ambulance service was undertaken in six randomly selected Districts in northern Ethiopia. All 183 286 households in the six randomly selected Districts were visited to identify live-births and deaths among women of reproductive age that occurred over a one-year period. The uptake of the new ambulance transport service for women's deliveries in the same six randomly selected Districts over the same period was determined retrospectively from ambulance log books. Pregnancy-related deaths as determined by the World Health Organization (WHO 2012) verbal autopsy tool [13] and the InterVA-4 model [14] were analysed against ambulance utilisation by District, month, local area, distance from health facility and mobile network coverage. A total of 51 pregnancy-related deaths and 19 179 live-births were documented. Pregnancy-related mortality for Districts with above average ambulance utilisation was 149 per 100 000 live-births (95% confidence interval CI 77-260), compared with 350 per 100 000 (95% CI 249-479) for below average utilisation (P = 0.01). Distance to a health facility, mobile network availability and ambulance utilisation were all significantly associated with pregnancy-related mortality on a bivariable basis. On a multivariable basis, ambulance non-utilisation uniquely persisted as a significant determinant of mortality (mortality rate ratio 1.97, 95% CI 1.05-3.69; P = 0.03). The uptake of freely available transport in connection with women

  13. One year experience with computer-assisted propofol sedation for colonoscopy.

    PubMed

    Lin, Otto S; La Selva, Danielle; Kozarek, Richard A; Tombs, Deborah; Weigel, Wade; Beecher, Ryan; Koch, Johannes; McCormick, Susan; Chiorean, Michael; Drennan, Fred; Gluck, Michael; Venu, Nanda; Larsen, Michael; Ross, Andrew

    2017-04-28

    To report our one-year experience with computer assisted propofol sedation (CAPS) for colonoscopy as the first United States Medical Center to adopt CAPS technology for routine clinical use. Between September 2014 and August 2015, 2677 patients underwent elective outpatient colonoscopy with CAPS at our center. All colonoscopies were performed by 1 of 17 gastroenterologists certified in the use of the CAPS system, with the assistance of a specially trained nurse. Procedural success rates, polyp detection rates, procedure times and recovery times were recorded and compared against corresponding historical measures from 2286 colonoscopies done with midazolam and fentanyl from September 2013 to August 2014. Adverse events in the CAPS group were recorded. The mean age of the CAPS cohort was 59.9 years (48.7% male); 31.3% were ASA I, 67.3% ASA II and 1.4% ASA III. 45.1% of the colonoscopies were for screening, 31.5% for surveillance, and 23.4% for symptoms. The mean propofol dose administered was 250.7 mg (range 16-1470 mg), with a mean fentanyl dose of 34.1 mcg (0-100 mcg). The colonoscopy completion and polyp detection rates were similar to that of historical measures. Recovery times were markedly shorter (31 min vs 45.6 min, P < 0.001). In CAPS patients, there were 20 (0.7%) cases of mild desaturation (< 90%) treated with a chin lift and