bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment results of the Ewing sarcoma of bone and prognostic factors
Authors: Sarı Neriman , Toğral Giray , Çetindağ M. Faik , Güngör B. Şafak , İlhan İnci Ergürhan 
Published: September 2009

AbstractBackgroundThe purpose of this study is to assess the clinical outcome of patients with ESFT of the bone treated with the European Intergroup Cooperative Ewings Sarcoma Study (EICESS)‐92 treatment protocol at a single center, and to identify prognostic factors.MethodsNinety‐eight patients younger than 18 years of age, diagnosed with ESFT of the bone between 1992 and 2005, were analyzed retrospectively.ResultsEighty‐seven patients were treated with the EICESS‐92 protocol. The median follow‐up was 105 ± 38 months. The 5‐year event‐free survival (EFS) survival rate was 40%, the 5‐year overall survival (OS) rate was 47%. For non‐metastatic disease, the rates of 5‐year EFS and OS were 45% and 51%. These rates were 18% and 27%, for metastatic disease. The 5‐year EFS and OS rates were 17% and 30%, respectively for females. For males, theses rates were 45% and 48%. Of 87 patients, 52 were admitted with primary extremity lesions. Distant metastasis was detected in 48% of patients with a metaphyseal tumor. In patients with diaphyseal lesions, it was 17%. The 5‐year EFS and OS were 35% and 43%, respectively. In non‐metastatic disease, these measures were 43% and 50%, whereas in metastatic disease, they were 20% and 27%. In patients with a lesion originating from metaphysis, the 5‐year EFS was 17%, and the 5‐year OS was 29%, for patients with a diaphyseal lesion, these values were 50% and 54%.ConclusionThe presence of metastasis was closely related with metaphyseal tumors. The localization of tumor in the bone (i.e., diaphyseal or metaphyseal) and gender of patients seem to have prognostic importance. Pediatr Blood Cancer 2010; 54:19–24. © 2009 Wiley‐Liss, Inc.
End of life in children with cancer: Experience at the Pediatric Oncology Department of the Istituto Nazionale Tumori in Milan
Authors: Beretta Silvia , Polastri Daniela , Clerici Carlo Alfredo , Casanova Michela , Cefalo Graziella , Ferrari Andrea , Luksch Roberto , Massimino Maura , Meazza Cristina , Podda Marta Giorgia , Spreafico Filippo , Terenziani Monica , Bellani Franca Fossati 
Published: September 2009

AbstractBackgroundCoping with end‐stage pediatric cancer patients and the related bereavement is a challenge for all the caregivers involved.ProcedureForty‐seven cancer patients who died in 2006 were assessed as concerns the main place of care in the end stage of their disease, their symptoms, the palliative treatments received, and the site of death.ResultsThe end stage was managed at the Istituto Nazionale Tumori Pediatric Oncology Department in 61% of cases, at home in 26%, and in hospices or other hospital facilities in 11%. Pain was the most common symptom, followed by asthenia, anorexia, dyspnea, and nausea/vomiting. About half the patients died at home, 8.5% at our institute, 43% at other hospitals, and 8.5% in hospices.ConclusionsThe care of pediatric cancer patients during the end stage of their disease is the responsibility of the caregivers who have followed them up since their diagnosis. However, it would be useful to establish an exchange of information and expertise between pediatric oncologists and the other facilities involved (hospices, other hospitals) or people assisting patients at home (family, family pediatrician/general practitioner GP). Pediatr Blood Cancer 2010; 54:88–91. © 2009 Wiley‐Liss, Inc.
Electromagnetic interference and electrical conductivity characteristics of carbon/polycyanate composite with nanostrandsTM under tensile load
Authors: Mall S. , Harder B.T. , Petrosky J.C. , Hansen G. , Alexander M.D. , Hansen N.D. 
Published: September 2009

AbstractElectromagnetic interference (EMI) and electrostatic discharge (ESD) shielding effectiveness of M55/RS‐3 composite (i.e., carbon fiber in a toughened polycyanate resin matrix) combined with nickel nanostrandsTM was investigated when subjected to the monotonic tensile load. These were quantified in the terms of dB attenuation and sheet resistance, respectively. A baseline panel without nanostrandsTM and three lay‐ups with different locations of nickel nanostrandsTM layers were characterized. These locations were outside surfaces, dispersed throughout the laminate thickness or the mid‐plane. The nanostrandsTM are capable of providing EMI and ESD shielding protection without any detrimental effects on the mechanical behavior of the composite (i.e., damage mechanisms and ultimate tensile strength) under the tensile loading condition. The placement of nanostrandsTM on the exterior surfaces in the composite lay‐up provided better EMI and ESD shielding effectiveness. The EMI protection capability from nanostrandsTM at any location was practically constant with increasing tensile load up to the final fracture. However, sheet resistance did not change with increasing tensile load only when nanostrandsTM were placed at the outside surfaces. The nanostrandsTM layers were not damaged until the final composite fracture. POLYM. COMPOS., 31:1343–1351, 2010. © 2009 Society of Plastics Engineers
Fabrication of polycrystalline silver nanowires via reversed micelle with amphiphilic diblock copolymer and aluminum oxide template at controlled temperature
Authors: Liu Jui‐Hsiang , Hsieh Feng‐Ming 
Published: September 2009

AbstractAn amphiphilic diblock copolymer consisting of methyl methacrylate and methacrylic acid was synthesized using atom transfer radical polymerization via a hydrolysis process design. Silver nanoparticles were synthesized by a reverse micelle method using the synthesized diblock copolymer as a surfactant. Silver nanoparticle‐embedded fibers were then fabricated using an anodic aluminum oxide template. Silver nanoparticle‐embedded porous polymer fibers were fabricated by adding unreactive diphenyl sulfide in polymer matrix. They are expected to be applied to recyclable metal catalyst systems. After sintering of silver nanoparticle‐embedded polymer fibers at a relatively lower temperature, silver nanowires were fabricated. Moreover, the surfactant effect on both self assembly of nanoparticle clusters and silver nanowires surface smoothness were compared with the previously reported results. Silver nanoparticles coordinated amphiphilic copolymer was found to reveal higher thermal resistance. POLYM. COMPOS., 31:1352–1359, 2010. © 2009 Society of Plastics Engineers
The oligomerization of CynR in Escherichia coli
Authors: Knapp Gwendowlyn S. , Hu James C. 
Published: September 2009

AbstractDeletion analysis and alanine‐scanning based on a homology‐based interaction model were used to identify determinants of oligomerization in the transcriptional regulator CynR, a member of the LysR‐type transcriptional regulator (LTTR) family. Deletion analysis confirmed that the putative regulatory domain of CynR was essential for driving the oligomerization of λ repressor‐CynR fusion proteins. The interaction surface of a different LTTR and OxyR was mapped onto a multiple sequence alignment of the LTTR family. This mapping identified putative contacts in the CynR regulatory domain dimer interface, which were targeted for alanine‐scanning mutagenesis. Oligomerization was assayed by the ability of mutant λ repressor‐CynR fusions to assemble in E. coli revealing interesting similarities and differences between OxyR and CynR.
Staphylococcus aureus Bacteremia: Factors Predicting Hospital Mortality
Authors: Mylotte Joseph M. , Aeschlimann Jeffrey R. , Rotella Denise L. 
Published: September 2009

AbstractAmong 89 episodes of Staphylococcus aureus bacteremia, factors identified as independent predictors of hospital mortality were Acute Physiology and Chronic Health Evaluation III score >60 (odds ratio [OR], 3.2; 95% confidence inter val [CI95], 1.7 to 5.9) and Lifestyle score >1 (OR, 2.1; CI95, 1.2 to 3.6). Future studies of S aureus bacteremia should take into consideration acute severity of illness (as well as treatment and source of infection) when evaluating outcome.
Blood and Body Fluid Exposures Among Surgeons: A Survey of Attitudes and Perceptions Five Years Following Universal Precautions
Authors: Manian Farrin A. 
Published: September 2009

AbstractA mail survey of surgeons at our medical center 5 years following adoption of Universal Precautions revealed that 29% estimated having ≥1 potentially serious blood or body fluid exposures (BBEs) per month. Failure to report BBEs (usually needlesticks) to the employee health department was common, and the majority of surgeons in practice for ≥10 years never reported such exposures. The most commonly cited reason for not reporting BBEs was perceived low risk of acquiring bloodborne infections.
Bladder Management and Urinary Tract Infections in Danish Hospitals, Nursing Homes, and Home Care: A National Prevalence Study
Authors: Zimakoff Jette , Stickler David J. , Pontoppidan Birgitte , Larsen Severin O. 
Published: September 2009

AbstractObjective:To establish the prevalence of urinary tract infection in patients undergoing various forms of bladder management.Design:A nationwide descriptive point-prevalence survey with logistic regression analysis of the data relating infection to bladder management.Setting:Fifteen hospitals, 21 nursing homes, and 13 home care districts throughout Denmark.Patients:Information was collected on 3,665 patients. On the day of the study, 349 patients had indwelling catheters and 1,150 were using external urine drainage systems (condoms or diapers) for bladder management.Results:The prevalence of urinary tract infections in catheterized patients and those using external drainage systems was 13.2% and 8.1%, respectively. The prevalence of hospital-acquired urinary tract infection (4.2%) had not changed from that reported in 1978. The proportion of these infections related to the indwelling catheter, however, had reduced from 66% to 30%. Logistic regression analysis confirmed that, when corrected for the patient-related confounders (female gender, age >60 years, incontinence, immobility, and stay in hospital for longer than 15 days), condoms (odds ratio [OR], 5.94; 95% confidence interval [CI95], 2.8 to 12.5), indwelling catheters (OR, 3.3; CI95, 2.3 to 4.8), and diapers (OR, 1.5; CI95, 1.1 to 2.1) were significantly (P<.001, P<.001, and P=.008, respectively) related to infection.Conclusions:Prevalence surveys have revealed that over the period 1978 to 1991, during which efforts have been made to restrict the use of indwelling catheters and to encourage the care of catheterized patients according to guidelines recommended by the Danish National Centre for Hospital Hygiene, the percentage of hospital-acquired urinary tract infections associated with indwelling catheters has been halved. External urine drainage systems, however, have emerged as significant risk factors for urinary tract infection.
Multiply Antibiotic Resistant Gram-Negative Bacilli in a Long Term Care Facility A Case Control Study of Patient rick Factors and Prior Antibiotic Use
Authors: Muder Robert R , Brennen Carole , Drenning Stephanie D. , Stout Janet E. , Wagener Marilyn M. 
Published: September 2009

AbstractObjective:To determine the relation between prior exposure to specific antimicrobials and acquisition of gram-negative bacilli resistant to multiple ß-lactam and aminoglycoside antibiotics among long-term-care patients.Design:Case-control study. Cases were patients from whom multiply resistant Enterobacteriaceae or Pseudomonas aeruginosa were isolated; controls were patients from whom nonresistant bacteria of the same species were isolated. Prospectively defined risk factors included underlying illness, activity level, presence of decu-bitus ulcers, presence of indwelling devices, and prior exposure to specific antimicrobial agents. Resistant and control isolates of P aeruginosa were compared using pulsed-field gel electrophoresis (PFGE) of genomic DNA after digestion with XbaI.Setting:390-bed long-term Veterans' Affairs facility.Results:We identified 35 patients with multiply resistant Enterobacteriaceae and 24 patients with multiply resistant P aeruginosa. Of the resistant Enterobacteriaceae, 87% of isolates were resistant to piperacillin, 55% to ceftazidime, and 90% to gentamicin. Acquisition of multiply resistant Enterobacteriaceae was associated with presence of decubitus ulcers (odds ratio [OR], 12.2; 95% confidence interval [CI95], 3.3-44.2; P=.0002) and prior receipt of ampicillm (OR, 13.7; CI95, 2.2-84; P=.005). Of resistant isolates of P aeruginosa, 88% were resistant to piperacillin, 25% to ceftazidime, 42% to imipenem, and 67% to ciprofloxacin. Isolation of a multiply resistant P aeruginosa was associated with total days of antimicrobial exposure (OR, 1.07; CI95, 1.01-1.12; P=.011) and not with prior receipt of any individual agent. Eleven multiply resistant isolates shared a common PFGE pattern.Conclusions:In our long-term-care facility, acquisition of multiply resistant Enterobacteriaceae was associated with the presence of decubitus ulcers and prior exposure to ampicillin. Acquisition of resistant P aeruginosa was associated with total antibiotic exposure. Molecular typing of P aeruginosa isolates implicated patient-to-patient transmission of a limited number of resistant strains.
Nosocomial Neisseria meningitidis Molecular Analysis of a Clinical Problem
Authors: Louie Marie , Simor Andrew E. , Rachlis Anita , Louie Lisa 
Published: September 2009

AbstractOver a 1-week period, Neisseria meningitidis serogroup B was recovered from two patients in the intensive-care unit (ICU). A cross-infection was presumed when one patient developed invasive meningococcal disease and another patient was found to be colonized. Investigation by molecular typing showed that these cases were not related, demonstrating the value of molecular typing when investigating potential cross-infections in a closed environment such as the ICU.
Parvovirus B19-Antibody Serosurvey in 500 Developmentally Disabled Subjects
Authors: Lohiya Ghan-Shyam , Hogrefe Wayne , Tan-Figueroa Lilia , Caires Shirley 
Published: September 2009

AbstractSera of 500 residents were screened for parvovirus B19 immunoglobulin M (IgM) and immunoglobulin G (IgG) by enzyme-linked immunosorbent assay. Positive IgM and equivocal IgG or IgM results were confirmed by immunofluorescent antibody and Western blot. IgM was detected in 13 sera (2.6%), and IgG was detected in 285 (57%). Records of IgM-positive residents contained no evidence of erythema infectiosum or polyarthropathy.
Nosocomial Respiratory Syncytial Virus Infections Prevention and Control in Bone Marrow Transplant Patients
Authors: Garcia Ricardo , Raad Issam , Abi-Said Dima , Bodey Gerald , Champlin Richard , Tarrand Jeffrey , Hill Lou Anne , Umphrey Jan , Neumann Joyce , Englund Janet , Whimbey Estella 
Published: September 2009

AbstractObjective:To assess the effectiveness of a multi-faceted infection control strategy in limiting the nosocomial transmission of respiratory syncytial virus (RSV) infection to patients in a bone marrow transplant (BMT) unit.Design:Before/after trial.Setting:University-affiliated tertiary cancer center.Patients:Adult BMT recipients hospitalized during two consecutive wintertime community outbreaks of RSV infection.Interventions:An infection control strategy against nosocomial RSV infection was implemented in the BMT unit in February 1993. The strategy involved prompt identification, isolation, and cohorting of RSV-infected patients; prompt therapy with aerosolized ribavirin; use of masks and gloves by anyone entering an infected BMT patient's room; screening visitors for respiratory symptoms; restricting visitation by all children under 12 years of age and all family members and other visitors with RSV symptoms; and restricting symptomatic hospital staff from working in the BMT unit.Results:After implementation of the multifaceted infection-control strategy, there were four cases of nosocomial RSV infection in 3,870 patient days (incidence density, 1.0 case/1,000 patient days) compared with 14 cases of nosocomial RSV infection in 3,152 patient days (incidence density, 4.4 cases/1,000 patient days) during the 1992-1993 RSV season (rate ratio, 4.4; 95% confidence interval [CI95], 1.4-17.9; P<.01). This decrease in incidence occurred despite a comparable prevalence of community-acquired RSV cases between the two seasons (2.2% vs 3.2% in 1992-1993 and 1993-1994, respectively; prevalence ratio, 0.7; CI95, 0.2-2.1; P=0.5)Conclusion:Institution of a multifaceted infection control strategy significantly reduced the frequency of nosocomial RSV infection in a high-risk group of adult BMT recipients
Line-Associated Bloodstream Infections in Pediatric Intensive-Care–Unit Patients Associated With a Needleless Device and Intermittent Intravenous Therapy
Authors: McDonald L. Clifford , Banerjee Shailen N. , Jarvis William R. 
Published: September 2009

AbstractObjectives:To determine risk factors for an increase in line-associated bloodstream infections (BSIs) in three pediatric intensive-care units at one hospital that recently had changed brands of needleless access device.Design:Retrospective case-control studies; review of the units' infection control policies and procedures for accessing and replacing components of needleless access devices.Setting:A community tertiary-care hospital's three pediatric intensive-care units.Patients:Children in one of the three intensive-care units with a central venous catheter in place during January 1, 1995, through May 15, 1996, who developed laboratory-confirmed primary BSI. Children who had central venous catheters in place for >48 hours and who did not develop BSI were chosen randomly as controls.Results:Eight patients met the case definition; they had 11 episodes of BSI. Multivariate analysis identified duration of catheterization and exposure to the IVAC first-generation needleless device as independent risk factors for BSI. Compared with patients from another pediatric intensive-care unit in which the IVAC device also was used but in which an increased BSI rate did not occur, patients from the unit with an increased BSI rate were more likely to receive intermittent (vs continuous) intravenous therapy through one or more lumens. In both units, the IVAC device valve component was replaced every 6 days, and the endcap used to cover the valve (when connected to an unused lumen) was replaced every 24 hours or after each access. The BSI rate returned to baseline after institution of a policy to replace the entire IVAC device, valve, and endcap every 24 hours.Conclusions:An increased risk of BSI was associated with use of the IVAC first-generation needleless device when replaced every 6 days. This increased risk may have been more pronounced in one pediatric intensive-care unit, because patients were more likely to receive intermittent intravenous therapy. Intermittent intravenous therapy or central venous catheter flushing practices may be important determinants of BSI risk
Predictors of positive sputum cultures in exacerbations of chronic obstructive pulmonary disease
Authors: TSIMOGIANNI Angeliki M. , PAPIRIS Spyros A. , KANAVAKI Sofia , STATHOPOULOS Georgios T. , SOTIROPOULOU Christina , MANALI Effrosyni D. , MICHALOPOULOU Pinelopi , ROUSSOS Charis , KOTANIDOU Anastasia 
Published: September 2009

ABSTRACTBackground and objective:  Although sputum culture in patients with an acute exacerbation of COPD is of uncertain value, it is routinely done. The ability to clinically identify patients likely or unlikely to yield bacterial sputum isolates would potentially reduce unnecessary tests. The objective of this study was to identify the clinical predictors of positive sputum cultures in this patient population.Methods:  Consecutive patients with a COPD exacerbation requiring an emergency visit were prospectively enrolled. Quantitative sputum culture was performed on‐site. Data on current smoking, sputum purulence, FEV1, Medical Research Council chronic dyspnoea scale, BMI, severe exacerbations in the preceding year requiring hospitalization, PaO2, PaCO2, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and oral and inhaled steroid use were recorded.Results:  Of the 94 patients enrolled, sputum from 36 yielded bacterial pathogens. These patients were characterized by a higher frequency of purulent sputum, lower FEV1, BMI and PaO2, higher APACHE II score and more frequent use of inhaled steroids (P < 0.05). On multivariate regression, purulent sputum, FEV1 and BMI were independent determinants of a positive sputum culture. Using receiver‐operator‐optimized thresholds for these variables (purulent sputum, FEV1 < 35% predicted and BMI ≤ 22 kg/m2), we proposed a regression coefficient‐weighted prediction model that accurately determined the likelihood of sputum bacterial isolation.Conclusions:  A prediction model based on the variables of purulent sputum, FEV1 and BMI predicted sputum culture result with about 90% accuracy. Pending further validation, this model may save valuable healthcare resources.
Challenges in the surgical treatment of epilepsy patients with cortical dysplasia
Authors: Mathern Gary W. 
Published: September 2009

SummaryCortical dysplasia (CD) is the most common malformation of cortical development in epilepsy surgery patients. Patients with mild Palmini type I CD represent about 50% of the surgical cases, and these lesions tend to occur most often in the temporal lobe, often associated with hippocampal sclerosis. By comparison, patients with severe type II CD present at younger ages, often with multilobar extratemporal lesions, and more aggressive seizures. The presurgical evaluation in CD patients can be challenging, as no single test is 100% accurate. Based on retrospective cohort studies, the accuracy of investigations are: interictal scalp electroencephalography (EEG), 50%; ictal scalp EEG, 65%; magnetic resonance imaging (MRI), 66%; fluorodeoxyglucose–positron emission tomography (FDG‐PET), 81%; and ictal single photon emission computed tomography (SPECT), 57%. Intracranial electrodes are used in about 50% of patients with CD. Contemporary series report that 62% of patients with CD are seizure free after resective neurosurgery, with higher rates for complete (77%) compared with incomplete (20%) removal of the lesion. Morbidity (<3%) and mortality (0.2%) are low for patients with CD undergoing epilepsy neurosurgery. Future challenges include the noninvasive identification of patients with CD with 100% accuracy, evaluation of long‐term outcomes in surgical patients, and devising new treatments based on a better understanding of the neurobiology leading to seizures in CD tissue.