bluuebunny/crossref_metadata_2025_split huggingface dataset:
Position statement: Testing physical condition in a population – how good are the methods?
Authors: Jørgensen Torben , Andersen Lars B. , Froberg Karsten , Maeder Urs , von Huth Smith Lisa , Aadahl Mette 
Published: September 2009

AbstractA poor physical condition – expressed as physical inactivity and poor physical fitness – is associated with the development of chronic diseases and premature death. Our aim was to evaluate the methods currently available for measuring physical activity and physical fitness in the general population.Physical activity is determined by duration, frequency, and intensity and derives from many different domains, making it difficult to assess over long periods and no feasible general criterion measure exists. Both objective and subjective methods are available. Of the objective methods, accelerometry is the most attractive technology, and is well enough developed for general use in large populations. The advantage of accelerometry is that it is not dependent on the memory of the individual, but its main disadvantage is that it grossly underestimates energy expenditure, due to the lack of registration of certain activities. This may be overcome to a certain extent by combining accelerometry with heart rate monitoring, although this still does not measure activity in different domains. Of the subjective methods, self‐report questionnaires are inexpensive and easy to administer. Many questionnaires have been developed, but we require (1) consensus on which measures to use for validation and (2) further development of internationally standardized questionnaires for use in different settings and to address different scientific questions. Many questionnaires correlate well with biological markers and development of chronic diseases, but subjective measurement will always entail a certain degree of misclassification. Furthermore, unstructured physical activity such as housework and gardening may be subject to recall bias. No method appears better to any other, and the choice of instrument will depend on the research question being asked. Future research should combine information from both objective and subjective methods.Physical fitness comprises several components, including cardiorespiratory endurance and muscle strength and endurance. Direct measurement of oxygen consumption is the criterion measure for cardiorespiratory endurance. As regards muscle strength and endurance, only test–retest reliability is available. Hand‐held dynamometers greatly facilitate field testing for maximal isometric muscle strength assessment, while force plate measurements can be used for the lower extremities. For endurance, simple tests such as push‐ups and sit‐ups are reliable.
Attitude of Healthcare Personnel Regarding Influenza Immunization
Authors: Watanakunakorn Chatrchai , Ellis George , Gemmel David 
Published: September 2009

AbstractObjectives:To survey the attitudes of healthcare personnel regarding influenza immunization.Design:A questionnaire was given to all hospital employees.Setting:A 650-bed community teaching hospital.Intervention:Employees were offered an in-service regarding influenza immunization in October 1991. Influenza immunization was given free of charge by Employee Health Services from October to December 1991. One thousand fifty-six employees (30.2%) received influenza vaccines. Survey forms were distributed with paychecks to all employees during the second half of January 1992. Completed survey forms were returned during the next 2 weeks.Results:One thousand two hundred three of the 3,501 (34.3%) questionnaires were returned. Some of the survey forms were not completely filled out. A total of 28.1% of male employees (202/717) and 35.4% of female employees (987/2783) (p<.01) responded. Mean years employed were 11.35 ± 7.57 for respondents and 9.30 ± 7.39 for all employees (p<.001). Four hundred sixty-one respondents (38.4%) received the influenza vaccine and 734 (6 1.4%) did not. Among the respondents, employees who were older or working full time were more likely to receive the vaccine. Proportionally, more respondents who received the vaccine attended the in-service, although only 8.7% of those immunized attributed their receiving influenza vaccine to the in-service. More physician respondents were vaccinated. Tbe respondents who received influenza vaccine were more likely to have received the vaccine during the past 2 years (p<.001). The major reasons given for not receiving the vaccine were “bad side effects” and “do not like shots.” The major side effect of influenza immunization was a “sore arm.” Multivariate analysis suggested that the in-service was not associated with obtaining the vaccine.Conclusions:The in-service regarding influenza immunization seemed to have a negligible influence. Most employees who received the vaccine had previous influenza immunization. There were no major side effects of influenza immunization. “Bad side effects” and “do not like shots” were major reasons given for not receiving influenza vaccine.
Inactivation of Clostridium Difficile Spores by Disinfectants
Authors: Rutala William A. , Gergen Maria F. , Weber David J. 
Published: September 2009

AbstractObjective:The current study was designed to evaluate the activity of glutaraldehyde-based disinfectants against Clostridium difficile using the Association of Official Analytical Chemists' (AOAC) sporicidal test. This study was undertaken because gastrointestinal endoscopes that may be contaminated with C difficile spores are most commonly disinfected between patients using glutaraldehyde-based disinfectants.Design:Using the AOAC test, the following disinfectants were tested: 2% alkaline glutaraldehyde, 2% acid glutaraldehyde, a 1: 16 dilution of a 2% glutaraldehyde-7.05% phenol- 1.20% sodium phenate, and a 1:20 dilution of a 10% glutaraldehyde-0.5% phenylphenol-0.1% amylphenol.Results:Test results of the four disinfectants against C difficile spores at exposure times of 10, 20, and 60 minutes were as follows (number of positive penicylinders per 30 replicates): 0, 0, and 0 for 2% alkaline glutaraldehyde; 6, 3, and 0 for 2% acid glutaraldehyde; 30, 29, and 30 for a 1:16 dilution of glutaraldehyde- 7.05% phenol-1.20% sodium phenate; and 30, 30, and 30 for a 1:20 dilution of glutaraldehyde- 0.5% phenylphenol-0.1% amylphenol.Conclusions:C difficile spores are more susceptible to inactivation by glutaraldehyde-based disinfectants than the spore-forming organisms recommended in the AOAC sporicidal test (i.e., Bacillus subtilis and Clostridium sporogenes). Diluting glutaraldehyde-based disinfectants below 2% led to the inability to inactivate spores of C difficle using exposure times commonly employed to disinfect semicritical items such as gastrointestinal endoscopes.
Nosocomial Invasive Aspergillosis in Lymphoma Patients Treated with Bone Marrow or Peripheral Stem Cell Transplants
Authors: Iwen Peter C. , Reed Elizabeth C. , Armitage James O. , Bierman Philip J. , Kessinger Anne , Vose Julie M. , Arneson Mark A. , Winfield Barbara A. , Woods Gail L. 
Published: September 2009

AbstractObjectives:To determine the prevalence of aspergillosis in lymphoma patients housed in a protective environment while undergoing a bone marrow transplant or peripheral stem cell transplant and its relation to lymphoma type, type of transplant, period of neutropenia, method of diagnosis, species of Aspergillus, and the use of empiric amphotericin B.Design:Clinical, autopsy, and microbiology records were reviewed retrospectively to determine the presence or absence of invasive aspergillosis. All positive specimens underwent further review to determine parameters outlined above.Setting:The review took place at the University of Nebraska Medical Center with lymphoma patients housed in the oncology/hematology special care unit, which consists of 30 single-patient rooms under positive pressure with high-efficiency particulate air filtration.Patients:4 17 lymphoma patients admitted to the oncology/hematology special care unit who underwent 427 courses of high-dose chemotherapy with or without total body irradiation followed by a stem cell rescue.Results:Twenty-two cases (5.2%) of nosocomial invasive aspergillosis (14 caused by Aspergillus flavus, 2 by Aspergillus terreus, 2 by Aspergillus fumigatus, and 4 by characteristic histology) were diagnosed. The prevalence of disease according to transplant was 8.7% for allogeneic bone marrow transplant (2/23 treatments), 5.6% for autologous peripheral stem cell transplant (9/161), and 4.5% for autologous bone marrow transplant (11/243). Fifteen patients were presumptively diagnosed prior to death (68.2%) most commonly by histologic examination of skin biopsies. All 22 patients received amphotericin B therapy, 17 prior to aspergillosis diagnosis, and 7 (31.8%) survived. No patient with disseminated disease survived.Conclusions:Even when housing lymphoma patients undergoing myeloablative therapy in a protective environment containing high-efficiency particulate air filtration, there was a risk of developing aspergillosis. These data also showed that antemortem diagnosis with aggressive amphotericin B therapy was most effective in the management of infected lymphoma patients when engraftment occurred and the disease did not become disseminated.
Physical and Chemical Composition of Hospital Waste
Authors: Li Chih-Shan , Jenq Fu-Tien 
Published: September 2009

AbstractFor selecting the most efficient treatment method of hospital waste, the composition analysis is generally considered to be the fundamental information. Currently, there are few studies regarding the characteristics of hospital waste. This study evaluated the physical and elemental composition of the hospital waste at the National Taiwan University Hospital (NTUH). The results should help us design an incinerator for the treatment of infectious waste, plastic syringes, pathological waste, and kitchen waste. During the study period, the estimated daily waste generation rate at NTUH was 4,600 kg/day, which consisted of 4,100 kg/day noninfectious refuse, 340 kg/day infectious waste, 70 kg/day kitchen waste, 50 kg/day pathological waste, and 40 kg/day plastic syringes. The NTUH waste consisted of 99.02% combustible wastes and 0.97% noncombustible wastes by mass. The combustibie wastes constituted paper (16.17%), textiles (9.77%), cardboard, wood, and leaves (1.12%), food waste (21.5 1%), and plastics (50.45%). The noncombustible waste included 0.40% metal and 0.57% glass. Furthermore, the analysis indicated that the wastes contained 38% moisture, 4% ashes, and 58% solid with an average heat value of 3,400 kcal/kg. From the elemental analysis, the dominant elements were found to be carbon (34%) and oxygen (15%).
Validation of Surgical Wound Classification in the Operating Room
Authors: Cardo Denise M. , Falk Pamela S. , Mayhall C. Glen 
Published: September 2009

AbstractObjective:To determine the accuracy with which circulating nurses (CNs) classify surgical procedures by risk of contamination in the operating room.Design:Classification of surgical procedures by CNs was compared with the classification of surgical procedures by a physician observer.Setting:University-affiliated, tertiary care hospital.Methods:Circulating nurses used the traditional wound classification system of clean, clean-contaminated, contaminated, and dirty-infected to classify surgical wounds in the operating room. A physician remained in the operating room throughout each of 100 surgical procedures and simultaneously classified surgical wounds without the knowledge of the CNs.Results:Classification of surgical wounds by CNs was compared with classification by the physician observer for 50 cases in general surgery and 50 cases in trauma surgery. Compared with the physician observer, the overall accuracy of classification by CNs was 88% (95% confidence interval [CI] of 81.6% to 94.4%; Kappa statistic, 0.83). Classification of surgical wounds was more difficult in trauma surgery (accuracy of 82%) than in general surgery (accuracy of 94%). Accuracy increased for both services when surgical wounds were classified into just two categories (clean or clean-contaminated versus contaminated or dirty-infected).Conclusions:Surgical wounds can be classified in the operating room with a high degree of accuracy by CNs. Classification was more difficult in trauma than in general surgery, but classification in trauma surgery improved with feedback to and additional education of CNs. The accuracy of classification by CNs was even higher when classifications were divided into just two categories.
Oxacillin- and Quinolone-Resistant Staphylococcus Aureus in Sao Paulo, Brazil: A Multicenter Molecular Epidemiology Study
Authors: Sader Helio S. , Pignatari Antonio C. , Hollis Richard J. , Leme Ivani , Jones Ronald N. 
Published: September 2009

AbstractObjective:To investigate the possibility of interhospital spread of multiresistant Staphylococcus aureus in Sao Paulo, Brazil.Design:We evaluated 13 nosocomial S aureus strains selected because of resistance to oxacillin and ciprofloxacin.Setting:The strains were collected between March 1991 and September 1991 from four hospitals in Sao Paulo. Two were teaching hospitals, and two were private hospitals.Patients:Each strain was isolated from a different patient. All patients were hospitalized when the strains were isolated.Interventions:The strains were typed by restriction endonuclease analyses of plasmid DNA (REAP) using EcoRI, HindIII, RsaI, and Alu1 and by extended antibiogram profile (34 drugs).Results:All strains had identical plasmid and antibiogram profile. They demonstrated the same plasmid pattern as previously described in one of the hospitals studied.Conclusions:Our results suggest the dissemination of a unique oxacillin- and quinolone-resistant strain of S aureus in several hospitals of Sao Paulo, Brazil.
A Cluster of Surgical Wound Infections due to Unrelated Strains of Group A Streptococci
Authors: Jamieson F.B. , Green K. , Low D.E. , Simor A.E. , Goldman C. , Ng J. , McGeer A. 
Published: September 2009

AbstractGroup A streptococci account for less than 1% of all surgical wound infections but are an important cause of nosocomial outbreaks. We report here a cluster of four group A streptococcal infections that occurred within an 11-day period on a single surgical service. The index case presented with toxic shock-like syndrome. Epidemiologic investigation did not identify any relationship between infections. Restriction endonuclease analysis and M and T typing found the four isolates to be unrelated. Restriction endonuclease analysis is a useful tool for determining relatedness of nosocomial isolates of group A streptococci.
Brucellosis Among Hospital Employees in Saudi Arabia
Authors: Kiel Frank W. , Khan M. Yousuf 
Published: September 2009

AbstractObjective:To report experience with brucellosis among expatriate hospital employees in an area of the world where brucellosis is endemic.Design:Review of cases from the viewpoints of direct supervisor and treating physician, including epidemiologic interviews and clinical follow-up.Setting:Tertiary care hospital center in a developing country that increased from 125 beds to 450 beds during the period studied.Patients:Employees with clinical findings suggesting brucellosis and in whom a positive blood culture or significantly elevated serologic test confirmed the diagnosis.Results:Nine hospital employees from nonendemic areas developed brucellosis. Five were from England and four from North America. Seven were bacteriology technologists, one was a nurse, and one was an obstetrician. Each had an acute febrile illness with malaise, arthralgia, or headache. Brucella titers were ≥ 1:1,280. Five were bacteremic with positive Brucella cultures. All responded to anti-Brucella therapy. Three patients had relapses, but there were no complications.Conclusions:Among Saudi patients, brucellosis is generally attributable to drinking infected milk or contacting infected animals. On the other hand, among expatriate hospital employees, the infection is likely due to processing Brucella cultures or dealing with infected body fluids. In 1988, the laboratory began stricter infection control measures. Since then, there has been only one case of brucellosis among the hospital employees.
Rhodococcus
Authors: Walsh Robert D. , Schochd Paul E. , Cunha Burke A. 
Published: September 2009

Infections due to Rhodococcus species are being reported with increasing frequency, especially among immunocompromised and HIV patients. R equi is the most commonly isolated species, usually from HIV patients with chronic cavitary pneumonia. Other species of Rhodococcus involved in human infections include R bronchialis, R terrae, R rhodochrous, and R aurantiacus.Organisms belonging to the genus Rhodococcus are widely distributed in nature, but are particularly abundant in soil. Trauma, steroids, immunosuppressive therapy, surgical procedures, HIV and immune-compromised status predispose patients to infection with Rhodococcus.
Use of Biological Indicators Designed for Stream or Ethylene Oxide to Monitor a Liquid Chemical Sterilization Process
Authors: Kralovic Raymond C. 
Published: September 2009

AbstractObjective:To determine the ability of a commercially available biological indicator (BI), used to monitor steam and ethylene oxide sterilization, to biologically monitor a liquid sterilization process consisting of a sterile processor, a proprietary peracetic acid sterilant, and a sterile rinse system.Design:Analysis of spore survival in BIs tested in STERIS SYSTEM 1™ liquid chemical sterilization processor and in vitro.Setting:STERIS Corp. research laboratory.Methods:In vitro tests were performed in the STERIS SYSTEM 1 Processor using 12-minute and 6-minute sterilant exposure cycles. D values (time to inactivate one log of spores), spore washoff and outgrowth time, and inhibitory effects of the sterilant were determined.Results:Sterilization of the spore-inoculated filter paper strips in the BIs was ascertained in both processor testing and in vitro tests using conditions identical to those in the processor. The extensive washing and dilution during the processor cycle resulted in only 0.2% and 1.8% removal of the spores from Bacillus stearother-mophilus and Bacillus subtilis inoculated spore strips, respectively.Carryover of the diluted sterilant to the culture medium did not inhibit the outgrowth of the spores, and D values could be obtained. B Stearothermophilus was two to three times more resistant to the sterilant than B subtilis. However, either spore meets the performance specifications applicable to BIs for monitoring sterilization processes.Conclusions:The data demonstrate that the commercial Bis evaluated are reproducible and verifiable indicators of the liquid chemical sterilization process. The same kind of performance specifications for producing BIs used to monitor steam or ethylene oxide systems also apply to the evaluated liquid chemical sterilization system.
Nosocomial Infections in Neutropenic Cancer Patients
Authors: Carlisle Penelope S. , Gucalp Rasim , Wiernik Peter H. 
Published: September 2009

AbstractObjective:Identification of overall and site-specific rates of nosocomial infection in neutropenic patients with cancer and associated pathogens.Design:Cumulative continuous prospective surveillance over a 42-month period. Criteria and definitions of infection in neutropenic patients (absolute neutrophil counts < 1,000/mm3) were developed, and surveillance was carried out by a certified infection control nurse and a senior oncology research fellow.Setting:A cancer research center with two designated oncology nursing units.Patients:Neutropenic patients with hematological and solid malignancies undergoing high-dose chemotherapy with and without autologous bone marrow transplantation. All patients admitted to both of the units during the study period were surveyed. Those who developed neutropenia are included in this report.Results:A total of 444 nosocomial infections were identified in 920 neutropenic patients during 9,582 days of neutropenia for an overall rate of 48.3 per 100 neutropenic patients, or 46.3 per 1,000 days at risk. The rate of bloodstream infection per 100 neutropenic patients was 13.5 (gram-positive, 9.2; gram-negative, 4.8; and Candida 1.2). Other site-specific rates were: urinary tract, 5.7; respiratory tract, 5.5; thrush, 6.6; skin, 3.4; and gastrointestinal tract, 3.4. Among 392 pathogens identified, there were 137 (35%) gram-positive cocci, 105 (27%) gram-negative rods, 70 (18%) Candida, 37 (9%) gram-positive rods, 22 (6%) viruses, and 15 (4%) Aspergillus.Conclusions:The rate of both overall and site-specific nosocomial infections in neutropenic patients is high. Neutropenia is a significant intrinsic risk factor that should be addressed in surveillance programs. Infection control and infectious diseases practitioners may need to modify techniques for surveillance, control, and management of infection in this population.
An Outbreak of Mupirocin-Resistant Staphylococcus aureus on a Dermatology Ward Associated with an Environmental Reservoir
Authors: Layton Marcelle C. , Perez Maritza , Heald Peter , Patterson Jan Evans 
Published: September 2009

AbstractObjective:To investigate a cluster of mupirocin-resistant Staphylococcus aureus on a dermatology ward.Design:An outbreak of mupirocin-resistant S aureus was noted on the dermatology ward during a prospective epidemiologic study of methicillin-resistant S aureus (MRSA) and borderline methicillin-susceptible S aureus (BMSSA). Pulsed-field gel electrophoresis (PFGE) of whole-cell DNA digested with Sma I was used as a marker of strain identity.Setting and Patients:An 850-bed university hospital with a 12-bed inpatient dermatology ward. Most patients have severe, exfoliating dermatologic disorders.Results:MRSA or BMSSA were isolated from 13 patients on the dermatology ward over a 14-month period. Eleven of these isolates (84.6%) were mupirocin-resistant. Nine isolates were present on admission (81.8%); 8 of these patients had been hospitalized on the same ward within the last two months. Nasal and hand cultures from 36 personnel were negative for mupirocin-resistant MRSA or BMSSA. Extensive environmental culturing revealed that a blood pressure cuff and the patients' communal shower were positive for mupirocin-resistant BMSSA. PFGE of all mupirocin-resistant isolates demonstrated that the nine patients and both environmental sources had identical DNA typing patterns.Interventions:Changing of blood pressure cuffs between patients and more stringent cleaning of communal areas was initiated. Repeat environmental cultures were negative.Conclusions:S aureus is not usually associated with an environmental reservoir; however, these patients all had severe desquamation, which may have prolonged environmental contamination.