bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sedation and Analgesia Usage in Severe Pandemic H1N1 (2009) Infection: A Comparison to Respiratory Failure Secondary to Other Infectious Pneumonias
Authors: Olafson Kendiss , Ramsey Clare D , Ariano Robert E , Stasiuk Allison , Siddiqui Faisal , Wong Davie , Guinn Aaron , Braun Joel , Kumar Anand , Zarychanski Ryan 
Published: December 2011

BACKGROUND: During the 2009 H1N1 pandemic (pH1N1), patients requiring mechanical ventilation for respiratory failure received high doses of sedation and analgesia. OBJECTIVE: To examine sedation and analgesia use among patients with respiratory failure due to severe pH1N1 infection compared to other infectious pneumonias. METHODS: In this observational cohort study of intensive care unit (ICU) patients with respiratory failure, we compared doses of sedatives and analgesics administered to patients with pH1N1, non-pH1N1 viral pneumonia, and adult respiratory distress syndrome (ARDS) secondary to bacterial pneumonia, on days 1, 3, 7, 14, and 28 of ICU admission. Cumulative drug use, daily drug use, and weight-adjusted medication doses were examined. RESULTS: The study population consisted of 37 patients with pH1N1 infection, 22 patients with non-pH1N1 viral pneumonia, and 46 patients with ARDS secondary to bacterial pneumonia. To achieve similar levels of sedation using the Richmond Agitation Sedation Scale, patients with pH1N1 were administered the highest cumulative median doses of fentanyl (11, 230 μg; interquartile range [IQR] 3240-21, 000), compared to 2400 μg (IQR 130-7130) in viral pneumonia and 2880 μg (IQR 600-6950) in ARDS (p < 0.001). Patients with pH1N1 were also administered the highest cumulative median doses of midazolam at 820 mg (IQR 330-1160), compared to 160 mg (IQR 20-390) in viral pneumonia and 160 mg (IQR 20-480 mg) in ARDS (p < 0.001). The pH1N1 group received the highest median daily fentanyl and midazolam doses on all study days. The pH1N1 group did not differ significantly in cumulative propofol dose compared with the other 2 study groups. CONCLUSIONS: Sedative and analgesic use may be uniquely higher in critically ill patients with pH1N1 infection compared to patients with other infectious pneumonias. This finding may be important for resource planning in future pandemics. Further study is required to explore the underlying mechanisms for potentially higher sedative and analgesic requirements in this patient population.
Post-receptor IGF1 insensitivity restricted to the MAPK pathway in a Silver–Russell syndrome patient with hypomethylation at the imprinting control region on chromosome 11
Authors: Montenegro Luciana R , Leal Andrea C , Coutinho Debora C , Valassi Helena P L , Nishi Mirian Y , Arnhold Ivo J P , Mendonca Berenice B , Jorge Alexander A L 
Published: December 2011

BackgroundHypomethylation of the paternal imprinting center region 1 (ICR1) is the most frequent molecular cause of Silver–Russell syndrome (SRS). Clinical evidence suggests that patients with this epimutation have mild IGF1 insensitivity.ObjectiveTo assess in vitro IGF1 action in fibroblast culture from a patient with SRS and IGF1 insensitivity.MethodsFibroblast cultures from one patient with SRS due to ICR1 demethylation and controls were established. The SRS patient has severe growth failure, elevated IGF1 level, and poor growth rate during human recombinant GH treatment. IGF1 action was assessed by cell proliferation, AKT, and p42/44-MAPK phosphorylation. Gene expression was determined by real-time PCR.ResultsDespite normal IGF1R sequence and expression, fibroblast proliferation induced by IGF1 was 50% lower in SRS fibroblasts in comparison with controls. IGF1 and insulin promoted a p42/44-MAPK activation in SRS fibroblasts 40 and 36%, respectively, lower than that in control fibroblasts. On the other hand, p42/44-MAPK activation induced by EGF stimulation was only slightly reduced (75% in SRS fibroblasts in comparison with control), suggesting a general impairment in MAPK pathway with a greater impairment of the stimulation induced by insulin and IGF1 than by EGF. A PCR array analysis disclosed a defect in MAPK pathway characterized by an increase in DUSP4 and MEF2C gene expressions in patient fibroblasts.ConclusionA post-receptor IGF1 insensitivity was characterized in one patient with SRS and ICR1 hypomethylation. Although based on one unique severely affected patient, these results raise an intriguing mechanism to explain the postnatal growth impairment observed in SRS patients that needs confirmation in larger cohorts.
Target of Rapamycin (TOR) in Nutrient Signaling and Growth Control
Authors: Loewith Robbie , Hall Michael N 
Published: December 2011

Abstract
TOR (Target Of Rapamycin) is a highly conserved protein kinase that is important in both fundamental and clinical biology. In fundamental biology, TOR is a nutrient-sensitive, central controller of cell growth and aging. In clinical biology, TOR is implicated in many diseases and is the target of the drug rapamycin used in three different therapeutic areas. The yeast Saccharomyces cerevisiae has played a prominent role in both the discovery of TOR and the elucidation of its function. Here we review the TOR signaling network in S. cerevisiae.
Treatment of diffuse coronary artery disease with long lengths (≥30 mm) of intracoronary stents
Authors: Jeong Hong , Luu Jane T. , Minisi Anthony J. 
Published: December 2011

AbstractThe interventional treatment of diffuse coronary artery disease often requires the placement of long lengths of intracoronary stents. We have anecdotally observed that target vessel failure rates seem high in these patients. Therefore, we examined long-term angiographic and clinical outcomes in patients treated with long lengths of intracoronary stent. A total of 312 consecutive patients who received ≥30 mm of stent(s) in a single coronary vessel were identified. Bare metal stents (BMS) were placed in 118 of these patients and drug eluting stents (DES) were used in 175 patients. Nineteen patients who received both BMS and DES were excluded from comparative analysis. The mean number of stents placed was 2.4±0.92 and the mean stent length was 45.7±18.2 mm. For the entire cohort, the restenosis rate was 20.8%. Restenosis rates were significantly higher in the BMS group compared to the DES group (34.7% vs. 11.4%;p<0.0001). The rates of major adverse cardiac events were significantly lower in the DES group compared to the BMS group. In conclusion, the treatment of diffuse coronary artery disease by placement of long lengths of intracoronary stent is a durable therapeutic option when DES are utilized.
The use of intravascular ultrasound (IVUS) for direct portosystemic shunt (DIPS) evaluation
Authors: Krokidis Miltiadis , Hatzidakis Adam 
Published: December 2011

AbstractA 32-year-old male with Budd-Chiari syndrome secondary to paroxysmal nocturnal haemoglobinuria (PNH) underwent direct portosystemic shunt (DIPS). The procedure was difficult, and after initial attempts without success via the internal jugular vein, a stent was placed with ultrasound (US) guidance via femoral approach. Unfortunately, following these two prolonged DIPS procedures, two weeks apart, the patient developed contrast-induced nephropathy, precluding further use of conventional contrast media and necessitating an alternative imaging modality to assess stent function. Transabdominal US was unable to clearly visualize the stent, so intravascular ultrasound (IVUS) was utilized. Good quality images were obtained and the stent's patency was accurately evaluated, identifying the presence of thrombus and leading to balloon angioplasty and improved flows. IVUS may be useful for DIPS stent evaluation.
A pancreatopleuralis fistula sikeres konzervatív kezelése
Authors: Sahin-Tóth Gábor , Farkas Gyula , Takács Tamás , Leindler László , Lázár György 
Published: December 2011

Absztrakt
A szerzők konzervatív módon sikeresen kezelt esetük kapcsán a pancreatopleuralis fistula (PPF) terápiás stratégiájának lehetőségeit foglalják össze. A PPF ritka szövődménye a krónikus pancreatitisnek. Többnyire alkoholos etiológiára visszavezethető, relapsusban levő pancreatitis talaján jön létre, és dominálóan dyspnoés tüneteket produkál. Diagnózishoz fizikális vizsgálat mellett a mellkasi folyadék laboratóriumi vizsgálatával, illetve képalkotó eljárások segítségével juthatunk. Az ERCP a legfontosabb lépés a PPF diagnózisának felállításában. Gyógyítása során a somatostatin analóg gyógyszeres, az endoscopos kezelés során végzett EST, illetve a ductus Wirsungianus stentelése és a folyamatos enteralis (jejunalis) táplálás együttes hatása vezethet eredményre. E komplex terápia melletti sikertelenség esetén a PPF műtéti megoldása javasolt.
Adult Health Behaviors Over the Life Course by Sexual Orientation
Authors: Boehmer Ulrike , Miao Xiaopeng , Linkletter Crystal , Clark Melissa A. 
Published: December 2011

Objectives. We estimated differences in health behaviors among adults by sexual orientation. Methods. We pooled 4 years of data (2001, 2003, 2005, and 2007) from the California Health Interview Survey. We estimated the frequency of smoking, alcohol use, healthy dietary behaviors, physical activity, and health care utilization, and we used logistic regression modeling to determine the odds of each behavior with increasing age and for 2 age groups: younger than 50 years and 50 years old or older. Results. At any adult age, lesbians had greater odds of smoking and binge drinking than did heterosexual women, and gay and bisexual men had greater health care utilization than did heterosexual men. Other risk behaviors differed with age. Conclusions. Some behavioral change interventions should target lesbians, gays, and bisexuals at all ages, whereas other interventions should specifically target individuals at younger ages.
Policy Instruments Used by States Seeking to Improve School Food Environments
Authors: Shroff Monal R. , Jones Sonya J. , Frongillo Edward A. , Howlett Michael 
Published: December 2011

US legislatures and program administrators have sought to control the sale of foods offered outside of federally funded meal programs in schools, but little is known about which policies, if any, will prevent obesity in children. We used a theoretical policy science typology to understand the types of policy instruments used by US state governments from 2001 to 2006. We coded 126 enacted bills and observed several types of instruments prescribed by state legislatures to influence the foods sold in schools and improve the school food environment. Our study helps to better understand the various instruments used by policymakers and sets the stage to examine the effectiveness of the policy instruments used to prevent obesity.
Outcomes of a Latino Community-Based Intervention for the Prevention of Diabetes: The Lawrence Latino Diabetes Prevention Project
Authors: Ockene Ira S. , Tellez Trinidad L. , Rosal Milagros C. , Reed George W. , Mordes John , Merriam Philip A. , Olendzki Barbara C. , Handelman Garry , Nicolosi Robert , Ma Yunsheng 
Published: December 2011

Objectives. We tested the effectiveness of a community-based, literacy-sensitive, and culturally tailored lifestyle intervention on weight loss and diabetes risk reduction among low-income, Spanish-speaking Latinos at increased diabetes risk. Methods. Three hundred twelve participants from Lawrence, Massachusetts, were randomly assigned to lifestyle intervention care (IC) or usual care (UC) between 2004 and 2007. The intervention was implemented by trained Spanish-speaking individuals from the community. Each participant was followed for 1 year. Results. The participants’ mean age was 52 years; 59% had less than a high school education. The 1-year retention rate was 94%. Compared with the UC group, the IC group had a modest but significant weight reduction (−2.5 vs 0.63 lb; P = .04) and a clinically meaningful reduction in hemoglobin A1c (−0.10% vs −0.04%; P = .009). Likewise, insulin resistance improved significantly in the IC compared with the UC group. The IC group also had greater reductions in percentage of calories from total and saturated fat. Conclusions. We developed an inexpensive, culturally sensitive diabetes prevention program that resulted in weight loss, improved HbA1c, and improved insulin resistance in a high-risk Latino population.
Public Health Department Accreditation Implementation: Transforming Public Health Department Performance
Authors: Riley William J. , Bender Kaye , Lownik Elizabeth 
Published: December 2011

In response to a call for improved quality and consistency in public health departments, the Public Health Accreditation Board (PHAB) is leading a voluntary public health accreditation initiative in the United States. The public health department accreditation system will implement a comprehensive set of standards that set uniform performance expectations for health departments to provide the services necessary to keep communities healthy. Continuous quality improvement is a major component of PHAB accreditation, demonstrating a commitment to empower and encourage public health departments to continuously improve their performance. The accreditation process was tested in 30 health departments around the country in 2009 and 2010, and was launched on a national level in September 2011 at the National Press Club in Washington, DC.
Appealing to Vanity: Could Potential Appearance Improvement Motivate Fruit and Vegetable Consumption?
Authors: Whitehead Ross D. , Ozakinci Gozde , Stephen Ian D. , Perrett David I. 
Published: December 2011

Fruit and vegetable consumption is inadequate among adults in the United States; this contributes to preventable morbidity and mortality. More effective dietary intervention strategies are needed. Recently, interventions that advertise the consequences of behavior for appearance have been successful in modifying sun-exposure habits and tobacco use. Such an approach might also facilitate dietary improvement. Consumption of carotenoid-rich fruit and vegetables positively affects skin color, which influences perceptions of health and attractiveness, and promoting such an effect may motivate target audiences to increase consumption of this important food group. This approach represents a novel direction for the field and is potentially suitable for cost-effective, population-level dissemination through the visual media.
A Curriculum for the New Dental Practitioner: Preparing Dentists for a Prospective Oral Health Care Environment
Authors: Polverini Peter J. 
Published: December 2011

The emerging concept of prospective health care would shift the focus of health care from disease management to disease prevention and health management.Dentistry has a unique opportunity to embrace this model of prospective and collaborative care and focus on the management of oral health.Academic dentistry must better prepare future dentists to succeed in this new health care environment by providing them with the scientific and technical knowledge required to understand and assess risk and practice disease prevention. Dental schools must consider creating career pathways for enabling future graduates to assume important leadership roles that will advance a prospective oral health care system.
Evaluation of an educational campaign to increase hand hygiene at a small animal veterinary teaching hospital
Authors: Shea Annie , Shaw Scott 
Published: December 2011

Abstract
Objective—To establish baseline data on rates of hand hygiene behavior, evaluate the effectiveness of an educational intervention aimed at improving hand hygiene, and determine whether methods similar to those applied in human hospitals to improve hand hygiene can be successfully applied in a small animal veterinary hospital.
Design—Prospective observational study.
Sample—568 and 187 observations of interactions between small animal patients and veterinary health-care providers before and after, respectively, educational intervention.
Procedures—Proper hand hygiene practices were defined as use of antibacterial foam or hand washing before or after physical interactions between health-care providers (veterinary medical faculty members, residents, interns, students, and technicians) and patients or proper use of gloves. Data were collected by anonymous direct observation. After an initial observation period, a multimodal educational campaign promoted proper hand hygiene with specific attention to increasing use of antibacterial foam. Two months later, data on proper hand hygiene practices after intervention were collected.
Results—At baseline, 117 of 568 (20.6%) interactions met criteria for proper hand hygiene practices; after intervention, a significantly greater proportion (78/187 [41.7%]) of interactions met criteria for proper hand hygiene practices. Use of antibacterial foam significantly increased from 34 of 568 (6.0%) to 67 of 187 (35.8%) interactions. Health-care providers were 4.1 times as likely to wash their hands with soap and water or to use antibacterial foam on their hands after the intervention than before the intervention.
Conclusions and Clinical Relevance—Initial low rates of proper hand hygiene practices at baseline were improved substantially 2 months after implementing a low-cost multimodal educational campaign.
The Prevalence of Darunavir-Associated Mutations in HIV-1-Infected Children in the Uk
Authors: Donegan Katherine L , Walker A Sarah , Dunn David , Judd Ali , Pillay Deenan , Menson Esse , Lyall Hermione , Tudor-Williams Gareth , Gibb Diana M 
Published: December 2011

Background We examined the prevalence of ritonavir-boosted darunavir (DRV) resistance-associated mutations (RAMs) in HIV-infected children in the UK to determine the drug's potential clinical utility as a first-line or second- line protease inhibitor (PI). Methods The prevalence of DRV RAMs, identified from IAS 2010 and Stanford, and the Stanford susceptibility score, were estimated in PI-naive and PI-experienced children in the Collaborative HIV Paediatric Study and the UK HIV Drug Resistance Database 1998–2008. Associations between type/duration of PI exposure and area under the viraemia curve on PI with the number of RAMs were investigated using multivariate Poisson regression. Results A total of 17/417 (4%) children with a resistance test when PI-naive had one IAS DRV RAM, and 1 had a Stanford mutation; none had multiple DRV RAMs. A total of 177 PI-experienced children had a test after a median 2.7 years (IQR 1.1–5.2) on PIs; 19 (11%) had one IAS DRV RAM, 7 (4%) had two RAMs, 1 (0.6%) had three RAMs and 1 (0.6%) had four RAMs. DRV RAMs were independently associated with increased years on a PI, a larger area under the viraemia curve since starting PIs, and any exposure to PIs other than lopinavir (all P≤0.05). Only 6 (3%) PI-experienced children had intermediate-level DRV/ritonavir resistance; none had high-level resistance. Conclusions DRV resistance was negligible in PI-naive children and those with lopinavir PI exposure alone. However resistance increased with increasing time, and with higher levels of viraemia, on PIs. Once-daily DRV/ritonavir would be valuable as a second PI or an alternative first PI, particularly if coformulated with a booster in an appropriate formulation for children.
Emergence of extended-spectrum beta-lactamases-producing Escherichia coli in community-acquired urinary infections in Casablanca, Morocco
Authors: Bourjilat Fatna , Bouchrif Brahim , Dersi Noureddine , Gros Claude Jean David Perrier , Amarouch Hamid , Timinouni Mohammed 
Published: December 2011

Introduction: Extended-spectrum beta-lactamase- (ESBL)-producing Escherichia coli are an increasingly significant cause of community-acquired infection worldwide. The aim of this study was to assess the prevalence of ESBL-producing E. coli in a community, to analyze the relationship between strains studied, and to characterize the ESBL genes involved in this resistance. Methodology: ESBL production was detected by the double disk synergy test. Genes encoding ESBLs (blaTEM, blaCTM, blaSHV) were identified by PCR and DNA sequencing. Conjugation experiments were performed to check the transferability of antibiotic resistance genes. Strain inter-relationships were studied by pulsed field gel electrophoresis. Results: Seven ESBL-producing E. coli were identified among the 535 E. coli isolates. Most of them expressed a CTX-M enzyme (6/7) with a predominance of CTX-M-15 (6/6). Two strains possessed TEM in combination with CTX-M-15 or SHV-5. Plasmid content and gene transfer analysis showed that resistance genes were carried by high molecular weight conjugative plasmids. PFGE analysis showed that the strains were not clonal. Conclusions: ESBL-producing E. coli from urinary tract infections in Casablanca belong to different clones and carry mobile beta-lactamase genes. It is therefore essential to monitor the epidemiology of ESBLs in E. coli and related organisms locally to effectively combat resistance.
An outbreak of Elizabethkingia meningoseptica neonatal meningitis in Mauritius
Authors: Issack Mohammad I , Neetoo Yaseen 
Published: December 2011

Introduction: Elizabethkingia meningoseptica is a rare but well-recognised cause of neonatal meningitis. Reported outbreaks have involved very few cases. We describe the management and outcome of a relatively large outbreak of E.meningoseptica neonatal meningitis Methodology: From August 2002 to December 2003, eight cases of meningitis caused by E. meningoseptica occurred among babies admitted to the neonatal ward of Jawarhlal Nehru hospital, Mauritius. In all cases, the organism was isolated from the cerebrospinal fluid. Infection control measures were re-emphasized after each case and environmental swabs were cultured on several occasions. Results: The affected babies were aged 6 to 20 days (mean age of 10 days). Seven of the babies weighed < 2,500 g. All CSF isolates had the same antibiotic susceptibility pattern. Apart from one baby who died shortly after admission, all cases responded to treatment with intravenous piperacillin and oral rifampicin for three weeks. Hydrocephalus developed in two babies and was subsequently fatal in one case. At follow-up of the other cases, one baby had severe neurological sequelae but a full recovery was observed in the other four cases. The source of the outbreak could not be established conclusively. Conclusions: The outcome was better than what has been reported in the medical literature. Prompt identification of the causative organism and initiation of appropriate antimicrobial therapy is essential. The combination of piperacillin and rifampicin should be considered an option for the treatment of E. meningoseptica neonatal meningitis if supported by properly performed antibiotic susceptibility test results.