bluuebunny/crossref_metadata_2025_split huggingface dataset:
Staphylococcus aureus Nasal Colonization in Patients with Cirrhosis: Prospective Assessment of Association with Infection
Authors: Chang Feng Yee , Singh Nina , Gayowski Timothy , Wagener Marilyn M. , Marino Ignazio R. 
Published: September 2009

ABSTRACTOBJECTIVE: To determine if Staphylococcus aureus colonization of the anterior nares was a risk factor for S aureus infection in patients with cirrhosis and to determine the predictors of S aureus infection in colonized patients.DESIGN: Prospective cohort study.PATIENTS: 84 consecutive patients with cirrhosis admitted to the liver transplant unit of a university-affiliated Veterans' Affairs Medical Center.RESULTS: Overall, 39 (46%) of the 84 patients were nasal carriers of S aureus, of which 24 (29%) were methicillin-resistant Staphylococcus aureus (MRSA) and 15 (18%) were methicillin-sensitive Staphylococcus aureus (MSSA). Only MRSA, but never MSSA, carriage was acquired in the hospital; all 15 of the MSSA versus 14 (58%) of the 24 MRSA carriers were nasal carriers on first (admission) culture (P=.001). Of the 10 (42%) of 24 MRSA carriers who were not colonized on admission, 3 became MRSA carriers within 1 month, and 7 acquired MRSA carriage more than a month later. Higher Child-Pugh score was independently associated with MRSA carriage (odds ratio [OR], 1.54; 95% confidence interval [CI95], 1.1-2.3). S aureus nasal carriers (9 [23%] of 39) were significantly more likely to develop S aureus infections than noncarriers (2 [4%] of 45; P=.02). Central venous catheter use was associated independently with S aureus infections in the carriers (OR, 4.1; CI95, 2.8-6.1). Mortality was significantly higher in carriers who developed S aureus infections as compared to those who did not (57% vs 13%; P=.022); S aureus infection was an independent predictor of mortality in the carriers (OR, 8.7; CI95, 1.2-63.8).CONCLUSIONS: Colonization of the anterior nares was a significant predictor of S aureus infection in patients with cirrhosis
Report of the Council on Scientific Affairs American Medical Association: Immunization of Healthcare Workers With Varicella Vaccine
Authors: Lyznicki James M. , Bezman Rebecca J. , Genel Myron ,   Council on Scientific Affairs, American Medical Association
Published: September 2009

ABSTRACTOBJECTIVE: In June 1996, a resolution was introduced to the House of Delegates of the American Medical Association (AMA) asking the AMA to advocate that healthcare workers be given the informed option of receiving the varicella vaccine. The AMA Council on Scientific Affairs studied this issue and presented this report to the House of Delegates in June 1997.METHODS: Information for the report was derived from published literature and from personal communications with medical and public health experts and the vaccine manufacturer.FINDINGS: Nosocomial outbreaks of varicella-zoster virus (VZV) can result in serious morbidity and mortality. Sero-logical testing of healthcare workers and immunization of nonimmune individuals is recommended by infection control and infectious disease experts to prevent nosocomial transmission of VZV. While current data indicate that the vaccine is safe and poses minimal risks to both adults and children, ongoing research should address various concerns about the long-term safety, efficacy, and epidemiological impact of more widespread use of the vaccine.CONCLUSION: Unless contraindicated, all susceptible healthcare workers should receive the varicella vaccine. Whereas individuals with a definite history of VZV infection can be considered immune, those with a negative or uncertain history should undergo serological testing and, if seronegative, should be immunized
Postexposure Prophylaxis for Human Immunodeficiency Virus: Frequency of Initiation and Completion of Newly Recommended Regimen
Authors: Sepkowitz Kent A. , Rivera Pedro , Louther Joyce , Lim Suzanne , Pryor Betty 
Published: September 2009

AbstractRecent evidence demonstrating the efficacy of zidovudine, as well as experience with protease inhibitors, led to revision of recommendations for occupational exposures to human immunodeficiency virus-infected blood. At our hospital, this resulted in significant increases in rates of reported exposures and prophylaxis initiation. Among 10 healthcare workers given three-drug, protease-inhibitor-containing regimens, five completed 4 weeks, two completed 4 weeks of two drugs, and three stopped due to intolerance. Three workers missed work due to side effects
Identification and Voluntary Reduction of Vancomycin Use for Perioperative Antibiotic Prophylaxis During Coronary Artery Bypass Graft Surgery
Authors: Pear Suzanne M. , Goldsmith Deborah L. , Williamson Theresa H. , Mandel David , Sethi Gulshan K. , Arzouman David A. , Ampel Neil M. 
Published: September 2009

AbstractVancomycin prophylaxis for coronary artery bypass graft surgery without prosthetic valve implantation voluntarily decreased from 94% to 18% in one medical center. Median hospital stay (10 vs 9 days, P=.30) and number of postoperative infections (17.0% vs 14.3%, P=.60) did not differ among patients who received vancomycin and those who did not.
Nosocomial Transmission of a Drug-Sensitive W-Variant Mycobacterium tuberculosis Strain Among Patients With Acquired Immunodeficiency Syndrome in Tennessee
Authors: Haas David W. , Milton Scott , Kreiswirth Barry N. , Brinsko Vicki L. , Bifani Pablo J. , Schaffner William 
Published: September 2009

AbstractObjective:To use DNA fingerprinting to characterize nosocomial spread of Mycobacterium tuberculosis following hospitalization of a patient with acquired immunodeficiency syndrome and active pulmonary tuberculosis, for whom respiratory isolation was not initiated promptly.Design:Epidemiological investigation.Setting:A tertiary-care medical center in Tennessee.Participants:Patients and healthcare workers potentially exposed to the infectious patient in 1992.Results:Of 172 healthcare workers exposed, 35 (20%) were judged to have acquired tuberculous infection. Risk of acquisition was greatest for nurses and medical receptionists. Active tuberculosis later developed in one healthcare worker and one hospitalized patient. Nosocomial transmission was supported by epidemiological evidence and DNA fingerprinting. The outbreak strain of Mycobacterium tuberculosis differed from other isolates at this hospital, but its DNA hybridization pattern was highly similar to that of the multidrug-resistant outbreak strain W that has been prevalent in New York City, suggesting a common strain ancestry. However, the Tennessee isolates were susceptible to all first-line antituberculous agents.Conclusions:This report suggests the possibility that a molecular characteristic(s) shared by these successful outbreak strains is associated with increased transmissibility or pathogenicity and emphasizes the need for continued vigilance for tuberculosis in the nosocomial setting.
Klebsiella Pneumoniae Bloodstream Infections in Neonates in a Hospital in the Kingdom of Saudi Arabia
Authors: Al-Rabea Ayman Abdulaziz , Burwen Dale R. , Eldeen Mariam A. Fath , Fontaine Robert E. , Tenover Fred , Jarvis William R. 
Published: September 2009

AbstractObjective:To identify risk factors for Klebsiella pneumoniae bloodstream infections (BSI) in neonates in a hospital in the Kingdom of Saudi Arabia (KSA).Design:Two case-control studies among hospitalized neonates during February 15-May 14, 1991, and a procedural and microbiological investigation.Setting:Hospital A, a maternity and children's hospital in KSA.Patients:Case patients had a blood culture positive for K pneumoniae after >2 days of hospitalization and had no evidence of a nonblood primary site of infection.Results:When the 20 case patients were compared with controls, hospitalization in a critical-care unit (odds ratio [OR], 5.5; 95% confidence interval [CI95], 1.20-51.1; P=.03) was identified as a risk factor. When the case patients were compared with a second set of controls matched by critical-care status, receipt of a particular intravenous fluid (D10%/0.2NS; OR, 11.0; CI95, 1.42-85.2; P=.009) or a blood product (OR undefined; P=.04) were identified as risk factors. Infusates were administered via umbilical catheters for most case and control patients (19/20 vs 15/20, P>.05); catheters were manipulated more frequently in patients in criticalcare units. Umbilical catheter tip, skin, or mucus membrane K pneumoniae colonization occurred in 47% and 53% of evaluated case and control patients, respectively. Available K pneumoniae isolates from blood cultures and colonization sites had identical antimicrobial susceptibility patterns. Emphasis on handwashing, careful preparation and administration of infusates, and aseptic technique for catheter insertion, maintenance, and manipulation was temporally associated with resolution of the epidemic.Conclusions:This outbreak was probably due to infusion therapy practices that led to BSI in nursery patients colonized with K pneumoniae. Both catheter-related infections and extrinsic contamination of infusates may have occurred. Hospital personnel should be aware of their potential to spread nosocomial pathogens from person to person and should implement Centers for Disease Control and Prevention recommendations to decrease nosocomial BSIs.
A Genome-Scale Metabolic Model of Arabidopsis and Some of Its Properties
Authors: Poolman Mark G. , Miguet Laurent , Sweetlove Lee J. , Fell David A. 
Published: September 2009

AbstractWe describe the construction and analysis of a genome-scale metabolic model of Arabidopsis (Arabidopsis thaliana) primarily derived from the annotations in the Aracyc database. We used techniques based on linear programming to demonstrate the following: (1) that the model is capable of producing biomass components (amino acids, nucleotides, lipid, starch, and cellulose) in the proportions observed experimentally in a heterotrophic suspension culture; (2) that approximately only 15% of the available reactions are needed for this purpose and that the size of this network is comparable to estimates of minimal network size for other organisms; (3) that reactions may be grouped according to the changes in flux resulting from a hypothetical stimulus (in this case demand for ATP) and that this allows the identification of potential metabolic modules; and (4) that total ATP demand for growth and maintenance can be inferred and that this is consistent with previous estimates in prokaryotes and yeast.
Analysis of Metabolic Flux Phenotypes for Two Arabidopsis Mutants with Severe Impairment in Seed Storage Lipid Synthesis
Authors: Lonien Joachim , Schwender Jörg 
Published: September 2009

AbstractMajor storage reserves of Arabidopsis (Arabidopsis thaliana) seeds are triacylglycerols (seed oils) and proteins. Seed oil content is severely reduced for the regulatory mutant wrinkled1 (wri1-1; At3g54320) and for a double mutant in two isoforms of plastidic pyruvate kinase (pkpβ1pkpα; At5g52920 and At3g22960). Both already biochemically well-characterized mutants were now studied by 13C metabolic flux analysis of cultured developing embryos based on comparison with their respective genetic wild-type backgrounds. For both mutations, in seeds as well as in cultured embryos, the oil fraction was strongly reduced while the fractions of proteins and free metabolites increased. Flux analysis in cultured embryos revealed changes in nutrient uptakes and fluxes into biomass as well as an increase in tricarboxylic acid cycle activity for both mutations. While in both wild types plastidic pyruvate kinase (PKp) provides most of the pyruvate for plastidic fatty acid synthesis, the flux through PKp is reduced in pkpβ1pkpα by 43% of the wild-type value. In wri1-1, PKp flux is even more reduced (by 82%), although the genes PKpβ1 and PKpα are still expressed. Along a common paradigm of metabolic control theory, it is hypothesized that a large reduction in PKp enzyme activity in pkpβ1pkpα has less effect on PKp flux than multiple smaller reductions in glycolytic enzymes in wri1-1. In addition, only in the wri1-1 mutant is the large reduction in PKp flux compensated in part by an increased import of cytosolic pyruvate and by plastidic malic enzyme. No such limited compensatory bypass could be observed in pkpβ1pkpα.
Environmental Aid: Driven by Recipient Need or Donor Interests?*
Authors: Lewis Tammy L. 
Published: September 2009

Objective This study investigates the trends in the distribution of environmental aid from the U.S. Agency for International Development (USAID), U.S. foundations, and a multilateral donor, the Global Environmental Fund (GEF), to determine whether aid is driven by donor interests or recipient need.Methods Data from USAID, the Foundation Center, GEF, and other secondary sources are analyzed using logistic and OLS regressions.Results Traditional donor interests (politics, economics, and security) and donors' environmental interests (those favoring “global” environmental concerns over local ones) explain which nations receive environmental aid and which do not and how much nations receive. In general, the allocation of environmental aid differs from that of official development assistance. The United States does not demonstrate a middle‐income bias; multilateral aid is not more “humanitarian” than bilateral aid. Foundations' allocation patterns favor traditional donors interests.Conclusions Environmental aid does not target the nations that are most in need of abating local pollution. Instead, environmental aid donors favor nations with whom they have had prior relations (economic and security), nations that are democratic, and nations with unexploited natural resources. In short, donor interests outweigh recipient need.
Empowering surgical nurses improves compliance rates for antibiotic prophylaxis after caesarean birth
Authors: Shimoni Zvi , Kama Naama , Mamet Yaakov , Glick Joseph , Dusseldorp Natan , Froom Paul 
Published: September 2009

AbstractTitle.  Empowering surgical nurses improves compliance rates for antibiotic prophylaxis after caesarean birth. Aim.  This paper is a report of a study of the effect of empowering surgical nurses to ensure that patients receive antibiotic prophylaxis after caesarean birth.Background.  Despite the consensus that single dose antibiotic prophylaxis is beneficial for women have either elective or non‐elective caesarean delivery, hospitals need methods to increase compliance rates.Method.  In a study in Israel in 2007 surgical nurses were empowered to ensure that a single dose of cefazolin was given to the mother after cord clamping. A computerized system was used to identify women having caesarean births, cultures sent and culture results. Compliance was determined by chart review. Rates of compliance, suspected wound infections, and confirmed wound infections in 2007 were compared to rates in 2006 before the policy change. Relative risks were calculated dividing 2007 rates by those in 2006, and 95% confidence intervals were calculated using Taylor’s series that does not assume a normal distribution. Statistical significance was assessed using the chi‐square test.Findings.  The compliance rate was increased from 25% in 2006 to 100% in 2007 (chi‐square test, P < 0·001). Suspected wound infection rates decreased from 16·8% (186/1104) to 12·6% (137/1089) after the intervention (relative risk 0·75, 95% confidence interval, 0·61–0·92).Conclusion.  Surgical nurses can ensure universal compliance for antibiotic prophylaxis in women after caesarean birth, leading to a reduction in wound infections.
Practical guidelines for applying statistical process control to blood component production
Authors: Beckman N. , Nightingale M. J. , Pamphilon D. 
Published: September 2009

summary.Legislation, guidelines and recommendations for blood components related to statistical process control (SPC) and the selection of a quality monitoring (QM) sampling regimen are subject to misinterpretation and lack practical guidance on implementation. The aim of this article is: to review and interpret applicable European legislation and guidelines and to develop an SPC strategy that meets these requirements; and to provide practical guidance on the selection and application of appropriate techniques and the interpretation of resultant blood component QM data. A methodology is presented which utilizes: an algorithm to select an appropriate quality‐monitoring strategy for the blood component parameter under consideration; a range of straightforward, validated SPC techniques for variable data and an assessment of process capability (Cpk) and blood component parameter ‘criticality’ to determine the sampling regimen. The methodology was applied to routine National Health Service Blood and Transplant (NHSBT) blood component data for 2005–2006. Cpk values ranged from 0.22 to >3 and their predicted non‐conformance rates were close to those observed (23 to <0.001%). Required sample size ranged from 0.01 to 10%. Chosen techniques identified significant deviation from ‘as validated’ performance within an appropriate time‐scale. Thus the methodology was straightforward to apply and prompted the choice of a clinically and operationally appropriate sampling regimen and analysis for each blood component parameter. This evidence‐based, targeted use of SPC for blood component monitoring provides an essential focus on processes with a low capability in achieving their specifications.
Plasma levels of retinoids, carotenoids and tocopherols in patients with mild obstructive sleep apnoea
Authors: DAY Regina M. , MATUS Ismael A. , SUZUKI Yuichiro J. , YEUM Kyung‐Jin , QIN Jian , PARK Ah‐Mee , JAIN Vivek , KURU Tunay , TANG Guangwen 
Published: September 2009

ABSTRACTBackground and objective:  OSA is associated with increased incidence of cardiovascular diseases. Pathogenic mechanisms of vascular diseases include thickened vascular walls due to the increased number of smooth muscle cells (SMC). Retinoic acid (RA) suppresses the growth of SMC, and reduced retinoid levels are associated with vascular diseases. Oxidant signalling promotes SMC growth, thus antioxidant levels may also influence the development of cardiovascular diseases. The present study tested the hypothesis that plasmas from OSA patients contain altered levels of retinoids, carotenoids and tocopherols.Methods:  Plasma samples were taken before and after sleep from patients with OSA (mostly mild) without known cardiovascular diseases and from control subjects. Levels of retinoids, carotenoids and tocopherols were measured using sensitive gas chromatograph‐mass spectrometry and high pressure liquid chromatography methods and total antioxidant capacity was assessed fluorometrically.Results:  Results showed that plasmas from patients with OSA had significantly lower retinyl palmitate and 9‐cis RA compared with control subjects, while levels of retinol, all‐trans RA and 13‐cis RA were indifferent. All‐transβ‐carotene and 9‐cisβ‐carotene were also lower in OSA patients. Levels of all‐trans RA and 13‐cis RA in OSA patients were reduced after sleep compared with before sleep. OSA patients showed significantly higher δ‐tocopherol compared with controls. Treatment of cultured human vascular SMC with post‐sleep OSA patient plasmas promoted cell growth, but not in controls.Conclusions:  Mild OSA exhibits altered levels of specific retinoids, carotenoids and tocopherols, which may be markers and/or mediators for the increased susceptibility of patients to vascular diseases.
Serum indoxyl sulfate as an early marker for detecting chronic cyclosporine nephrotoxicity
Authors: Umino Daisuke , Ohtomo Yoshiyuki , Hara Satoshi , Someya Tomonosuke , Fujinaga Shuichiro , Shimizu Toshiaki 
Published: September 2009

AbstractBackground: Cyclosporine A (CsA) is an effective agent for frequently relapsing steroid‐dependent nephrotic syndrome (FR‐SDNS), but its use can also be complicated by renal toxicity. Because no biochemical markers from urine or blood samples have yet been established for detecting CsA‐induced renal injury to date, repeated renal biopsies are therefore required for all patients with long‐term CsA treatment. The purpose of the present study was therefore to detect early change of CsA nephropathy (CsAN) using blood samples.Methods: Several biochemical markers were analyzed in an attempt to examine the renal function in 24 patients with FR‐SDNS who had been treated with CsA. Those included serum cystatin C and indoxyl sulfate, as well as creatinine and β2‐microglobulin.Results: Renal biopsy findings indicated chronic CsAN in 13 of the 24 patients. Among those markers, only serum indoxyl sulfate was significantly elevated in patients with CsAN.Conclusions: It may be possible for measurement of serum indoxyl sulfate level to replace repeated renal biopsies in evaluation of chronic CsAN in pediatric patients with FR‐SDNS.
Early use of probiotics is important therapy in infants with severe congenital anomaly
Authors: Kanamori Yutaka , Iwanaka Tadashi , Sugiyama Masahiko , Komura Makoto , Takahashi Takuya , Yuki Norikatsu , Morotomi Masami , Tanaka Ryuichiro 
Published: September 2009

AbstractBackground:  Infants with severe congenital anomaly often need to undergo operation followed by antibiotic therapy. As a result they inevitably acquire abnormal intestinal microbiota, which cause severe infections such as necrotizing enterocolitis. Also, intestinal function deteriorates and their nutritional state is very poor. In order to prevent these situations probiotic therapy is proposed as an effective supporting treatment. Probiotic therapy were therefore applied to infants with severe congenital anomaly as early as possible to ascertain its efficacy.Methods:  As probiotics, two bacteria were used: Bifidobacterium breve Yakult and Lactobacillus casei Shirota. Probiotic therapy was used in four infants with severe congenital anomaly as early as possible after surgery. Their intestinal microbiota and physical growth were followed through the treatment course.Results:  Two patients suffered from meconium peritonitis with ileal atresia. One patient was born with complex anomalies (omphalocele, bladder exstrophy, myelomeningocele). The fourth patient suffered from complete urorectal septum malformation. The intestinal microbiota of these four patients was first induced to be probiotic dominant and finally changed to commensal anaerobe dominant that was similar to normal intestinal microbiota. Pathogenic bacteria were seldom detected. The patients' physical growth was excellent despite short bowel and pulmonary hypoplasia.Conclusion:  Probiotic therapy was effective in inducing probiotic dominant intestinal microbiota and normal intestinal microbiota in infants with severe congenital anomalies. As a result their intestinal absorptive functions were activated and severe infections were completely prevented. All of the infants grew well despite their physical disadvantages.