bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening of Physicians for Tuberculosis
Authors: Fraser Victoria J. , Kilo Charles M. , Bailey Thomas C. , Medoff Gerald , Dunagan W. Claiborne 
Published: September 2009

AbstractObjective:To determine the prevalence of tuberculous infection among a sample of physicians at Barnes Hospital and to determine the frequency of tuberculin skin testing and the adequacy of follow-up for physicians with positive tuberculin skin tests.Design:Convenience sample.Setting1,000-bed, university-affiliated tertiary care hospital.SubjectsPhysicians attending departmental conferences were screened for tuberculosis. Prior history of tuberculosis, antituberculous therapy, BCG vaccination, and previous tuberculin skin test results were obtained with a standardized questionnaire. Tuberculin skin tests were performed on those who were previously skintest negative.Outcome Measure:Tuberculosis infection, prophylactic therapy.Results:Eighty-six (24.5%) of 351 physicians in the study were skin test positive by history or currently performed skin test. Of 61 who reported a previously reactive skin test, 40 (66%) had been eligible for isoniazid prophylaxis, but only 15 (37.5%) of 40 had completed at least six months of therapy. Of 290 physicians reporting a previously negative skin test, 25 conversions (8.6%) were identified. Previously undiagnosed, asymptomatic pulmonary tuberculosis was identified in one physician.ConclusionsInfection with Mycobacterium tuberculosis is common among physicians. Physicians were screened irregularly for tuberculosis, and the use of prophylactic therapy was inconsistent. Aggressive tuberculosis screening programs for healthcare workers should be instituted.
Foodhandler-Associated Salmonella Outbreak in a University Hospital Despite Routine Surveillance Cultures of Kitchen Employees
Authors: Khuri-Bulos Najwa A. , Khalaf Mahmoud Abu , Shehabi Asem , Shami Khaled 
Published: September 2009

AbstractObjective:To describe an outbreak of salmonella food poisoning that probably was due to contamination of mashed potatoes by a foodhandler, which occurred despite a policy for routine surveillance stool cultures of kitchen employees.Design:A case control study of 223 individuals who ate the lunch meal on September 23, 1989, at the Jordan University Hospital (JUH) cafeteria.Setting:Tertiary care university hospital in Amman, the capital of Jordan.Patients:Individuals who developed loose stool or vomiting 6 to 72 hours after eating the lunch meal of September 23, 1989, at the JUH cafeteria.Results:Of 619 individuals, 183 fit the case definition (attack rate, 19.6%); 150 were employees, 26 were inpatients, and seven were visitors. Twelve other employees became sick 4 to 6 days later and probably were infected secondarily. The incubation period ranged from 16 to 72 hours in 183 instances. Symptoms included diarrhea (88%), fever (71%), abdominal pain (74%), dehydration (34%), and bloody stool (5%). Eighty-four were hospitalized. Cultures of eight food items were negative, but stool culture on 90 of 180 patients and 11 of 61 kitchen employees yielded Salmonella enteritidis group D.A cohort study of 223 individuals revealed a food-specific attack rate of 72% for the steak and potato meal and 18% for the rice and meat meal (RR, 4; CI95, 2.62 to 6.24; P<0.01). Stratified analysis of the steak and potato meal revealed that the potatoes were implicated most strongly (RR, 1.93; CI95, 1.42 to 2.64; p<0.01). Cultures were obtained from all kitchen employees, and 11 of 61 grew Salmonella enteritidis group D. One asymptomatic, culture-positive employee prepared the mashed potatoes on September 23. All of these employees had negative stool cultures 3 months earlier.Conclusion:This outbreak probably was caused by massive contamination of mashed potatoes by the contaminated hands of the foodhandler. Routine stool culture of foodhandlers is not cost-effective and should not be used as a substitute for health education and proper hygienic practices.
Quantitative Skin Cultures at Potential Catheter Sites in Neonates
Authors: Bertone Susan A. , Fisher Margaret C. , Mortensen Joel E. 
Published: September 2009

AbstractObjective:To identify and quantify the bacterial and fungal flora present at body sites used for vascular catheterization of infants in a neonatal intensive care unit.Design:Quantitative skin cultures were obtained from a group of neonatal patients to determine the bacterial flora found on the skin at four sites. Quantitative cultures of the jugular, subclavian, umbilical, and femoral sites were obtained on 50 infants, ranging in age from 2 days to 3 months old.Setting:The neonatal intensive care unit of St. Christopher's Hospital for Children, a university-affiliated tertiary care children's hospital.Results:Colony counts ranged from 0 to 106 colony-forming units/ 10 cm2. Types of organisms found were consistent with other published studies and included coagulase-negative staphylococci, Staphylococcus aureus, yeast, aerobic gram-negative rods, Enterococcus species, Corynebacterium species, and alpha-hemolytic streptococci. There was a significantly higher mean colony count at the combined jugular/femoral sites versus the subclavian site (P<0.01) and umbilical site (P<0.05). Mean colony counts did not differ significantly between the jugular and femoral site, or between the subclavian and umbilical site. The umbilical site was more likely to be colonized with aerobic gram-negative rods, Enterococcus species, and yeast, while the subclavian had coagulase-negative staphylococci as the predominant organism. The jugular and femoral sites demonstrated a higher colony count of aerobic gram-negative rods, Enterococcus species and yeast than the other sites.If central venous catheters need to be in place for extended periods of time, placement at a site with lower bacterial densities on the skin may help minimize catheter-associated infections. This study supports the subclavian as the preferred site.
Prevalence of Tuberculin Reactivity Among Healthcare Workers from a Mexican Hospital
Authors: Molina-Gamboa Julio , Fivera-Morales Irma , Ponce-de-Leon-Rosales Samuel 
Published: September 2009

Abstract:The prevalence of tuberculosis (TB) infection in healthcare workers (HCWs) is completely unknown in Mexico. To evaluate the frequency of TB infection in our hospital, we performed a prevalence study of tuberculin reactivity among a random sample of asymptomatic HCWs. Our results showed an extremely high prevalence of PPD reactivity (70%) among 175 HCWs, probably related to the high incidence of active TB in the general population and to the absence of preventive programs.
Evaluation of Interhospital Spread of Methicillin-Resistant Staphylococcus aureus in Sao Paulo, Brazil, Using Pulsed-Field Gel Electrophoresis of Chromosomal DNA
Authors: Sader Helio S. , Pignatari Antonio C. , Hollis Richard J. , Jones Ronald N. 
Published: September 2009

Abstract:The widespread dissemination of a single clone of methicillin-resistant Staphylococcus aureus (MRSA) in several hospitals in Sao Paulo could make the intrahospital epidemiologic evaluation of MRSA outbreaks very difficult. The high index of PPD reactivity among our healthcare workers (HCWs) obligates us to develop programs suitable to the prevailing conditions of Latin American hospitals to control TB inside healthcare facilities.
Special Organism Isolation: Attempting to Bridge the Gap
Authors: Patterson Jan Evans , Sanchez Rebecca O. , Hernandez Jose , Grota Patti , Ross Kathryn A. 
Published: September 2009

There have been many changes in infection control in the 10 years since the last publication of isolation guidelines for hospitals by the Centers for Disease Control and Prevention (CDC). Hospitals since have used the 1988 CDC Update on Universal Precautions as a minimum because it is required by the Occupational Safety and Health Administration. Even before these changes, Lynch and Jackson described the concept of body substance isolation, which is intended primarily to decrease cross-transmission between patients. Many hospitals' universal precautions policies also incorporate the concept of body substance isolation to prevent the transmission of non-bloodborne as well as bloodborne pathogens. The 1988 CDC update states that the use of universal precautions does not eliminate the need for other category- or disease-specific isolation, or an institution's own system of isolation precautions.West Haven Veterans Affairs Medical Center in Connecticut and the University Health System and Audie L. Murphy Memorial Veterans Hospital in San Antonio, Texas, have adopted a universal precautions/body substance isolation (UP/BSI) policy as a standard for all patients in an attempt to lessen the confusion. All three hospitals are large, university-affiliated, tertiary care teaching institutions. Blood and all body fluids or tissue from all patients are considered potentially infectious and barrier precautions are used accordingly. Body substance isolation has been shown to decrease the transmission of some non-blood-borne pathogens.
Vancomycin-Resistant Enterococcus faecium in Hospitalized Children
Authors: Rubin Lorry G. , Tucci Victor , Cercenado Emilia , Eliopoulos George , Isenberg Henry D. 
Published: September 2009

AbstractObjectve:Determine the epidemiology and risk factors for colonization with vancomycin-resistant Enterococcus faecium.Design:Survey; case-control study.Setting:Children's hospital.Patients:Pediatric oncology patients.Intervention:Contact isolation, restriction of vancomycin prescribing.Results:There was a high prevalence of colonization with vancomycin-resistant enterococci among pediatric oncology patients. The length of hospitalization and the administration of vancomycin and other intravenous antibiotics was associated with colonization. Prevention of colonization was associated with restriction of vancomycin use and contact isolation.Conclusions:Vancomycin use may predispose to colonization with vancomycin-resistant E faecium. Vancomycin-resistant E faecium may be nosocomially spread. Contact isolation and restriction of vancomycin use may prevent spread of vancomycin-resistant E faecium.
Methicillin-Resistant Staphylococcus aureus in Hospitals and Long-Term Care Facilities: Microbiology, Epidemiology, and Preventive Measures
Authors: Boyce John M. 
Published: September 2009

Strains of methicillin-resistant Staphylococcus aureus (MRSA) have become increasingly common in the United States and in many other countries since 1975. Although MRSA was recovered primarily in university and federal hospitals in this country during the late 1970s, these organisms are being encountered with increasing frequency in all types of hospitals, especially in the eastern half of the United States. Although there is a paucity of information available on the prevalence of MRSA in long-term care facilities, a few reports suggest that MRSA is also seen frequently in these settings. Because colonized patients are frequently transferred between hospitals and long-term care facilities, a continuing circuit of MRSA transmission occurs in areas where these organisms are prevalent.MRSA prevalence rates vary widely by locale and by type and size of hospital. In some geographic areas, the prevalence remains low, whereas in other areas, from 10% to 50% of all S aureus isolates recovered from patients in large medical centers are MRSA. Even within a given city, MRSA prevalence rates may vary widely among acute care hospitals.
Group A Streptococcal Outbreaks in Nursing Homes
Authors: Schwartz Benjamin , Ussery Xilla T. 
Published: September 2009

Group A streptococci (Streptococcus pyogenes) are the most common bacterial cause of pharyngitis and a frequent cause of cutaneous infections including impetigo and cellulitis. More rarely, group A streptococci are implicated as the etiologic agent in patients with pneumonia, bacteremia, and a newly described toxic shock-like syndrome.' While invasive group A streptococcal infections occur in persons of all ages, the incidence of these infections is greatest in the elderly, as is the case/fatality ratio. Factors that may contribute to the increased risk of invasive group A streptococcal infections in the elderly include a higher prevalence of underlying illnesses and, possibly, decreased levels of antibodies directed against the group A streptococcal M-protein, a major determinant of virulence.From the advent of the antibiotic era until the mid-1980s, the occurrence of severe group A streptococcal infections declined. However, since 1985, rheumatic fever outbreaks in civilian and military populations, a syndrome designated the streptococcal toxic shock-like syndrome, and an increased incidence of group A streptococcal bacteremia have been reported. These changes in the epidemiology of group A streptococcal infections have been associated with changes in the serotype distribution, with an increasing proportion of invasive infections caused by M-1 and M-3 strains, and an increase in the proportion of organisms producing pyrogenic exotoxin A, which has been linked to the toxic shock-like syndrome.
Using Force Field Analysis to Promote Use of Personal Protective Equipment
Authors: White Caroline McCoy , Berger Marie C. 
Published: September 2009

Force field analysis, a technique promulgated by Lewin 50 years ago, is an aid to infection control practice in situations where it is necessary for individuals to substitute new routines for previously accepted practice, as in the required used of personal protective equipment as part of Universal Precautions. By providing a way to link the multiple factors that may be determinants of an individual's behavior, force field analysis offers a way to uncover salient issues and to identify potentially fruitful avenues for intervention to promote the desired behavior change.Force field analysis directs attention to the goal(s) to be achieved through the behavior and to the forces that drive or restrain the individual in the performance of the behavior being examined. Viewed in relation to use of personal protective equipment as part of infection control procedures, using force field analysis involves becoming clear about the purpose(s) of using personal protective equipment, factors that motivate and make easy the use of personal protective equipment, and factors that act as barriers or deterrents to using personal protective equipment. Recent commentaries in this journal have addressed these issues separately: Jackson and Lynch described the differing purposes of systems of infection control commonly referred to as Universal Precautions and their consequently differing procedures, pointing out potentials for confusion owing to goal; Campbell, 3 reviewing theories of motivation and power, suggested that infection control practitioners attend to these in addition to the technical aspects of practice. Force field analysis brings together these and others of the myriad elements that influence behavior, allowing the practitioner to think creatively about why and why not particular behavior occurs and then to think about what might help make the behavior more likely to occur.
Stalked barnacle (Pollicipes pollicipes) harvesting in the Berlengas Nature Reserve, Portugal: temporal variation and validation of logbook data
Authors: Jacinto David , Cruz Teresa , Silva Teresa , Castro João J. 
Published: September 2009

Abstract
Jacinto, D., Cruz, T., Silva, T., and Castro, J. J. 2010. Stalked barnacle (Pollicipes pollicipes) harvesting in the Berlengas Nature Reserve, Portugal: temporal variation and validation of logbook data. – ICES Journal of Marine Science, 67: 19–25. Stalked barnacle (Pollicipes pollicipes) exploitation at the Berlengas Nature Reserve, Portugal, by professional harvesters has been subject to specific regulation since 2000. The only available information on barnacle exploitation there comes from catch reports (logbooks) provided by the harvesters. We evaluated the quality of the logbook information, described the temporal patterns of P. pollicipes fishing effort from 2000 to 2006 based on the logbook data, and modelled the daily fishing effort in relation to variability in oceanographic conditions. Results suggest different levels of reliability for the information contained in the logbooks: (i) information on the date of harvest seems to be reliable because 83% of the observed harvest dates were also declared; (ii) information on the quantity harvested shows a large discrepancy (mean = 31.8%) between declared and observed amounts, but we believe it can be used to analyse temporal patterns of exploitation, because there was no systematic bias (under- and overreporting was to the same extent). The total quantity of barnacles harvested between 2000 and 2006 (∼16 t year−1) was closely related to the effort applied. Daily harvesting effort was considered a function of two predictive variables (significant wave height and tidal range) and of their interaction. Neither the harvesting activity nor the resource itself seems to be at risk of collapse if such levels of pressure are maintained, but efforts should be made to increase surveillance and monitoring within the marine protected area.
Altered Standards of Care During an Influenza Pandemic: Identifying Ethical, Legal, and Practical Principles to Guide Decision Making
Authors: Levin Donna , Cadigan Rebecca Orfaly , Biddinger Paul D. , Condon Suzanne , Koh Howard K. ,   Joint Massachusetts Department of Public Health-Harvard Altered Standards of Care Working Group
Published: September 2009

ABSTRACTAlthough widespread support favors prospective planning for altered standards of care during mass casualty events, the literature includes few, if any, accounts of groups that have formally addressed the overarching policy considerations at the state level. We describe the planning process undertaken by public health officials in the Commonwealth of Massachusetts, along with community and academic partners, to explore the issues surrounding altered standards of care in the event of pandemic influenza. Throughout 2006, the Massachusetts Department of Public Health and the Harvard School of Public Health Center for Public Health Preparedness jointly convened a working group comprising ethicists, lawyers, clinicians, and local and state public health officials to consider issues such as allocation of antiviral medications, prioritization of critical care, and state seizure of private assets. Community stakeholders were also engaged in the process through facilitated discussion of case scenarios focused on these and other issues. The objective of this initiative was to establish a framework and some fundamental principles that would subsequently guide the process of establishing specific altered standards of care protocols. The group collectively identified 4 goals and 7 principles to guide the equitable allocation of limited resources and establishment of altered standards of care protocols. Reviewing and analyzing this process to date may serve as a resource for other states. (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S132–S140)
Associated cancers in parents and offspring of polycythaemia vera and myelofibrosis patients
Authors: Hemminki Kari , Sundquist Jan , Bermejo Justo L. 
Published: September 2009

SummaryPolycythaemia vera (PV) and primary myelofibrosis (MF) show concordant familial clustering but limited population level data are available on the aggregation of other discordant neoplasms in these families. We used the Swedish Family‐Cancer Database to assess risks for VP and MF in families of cancer patients. A total of 3530 first PV and 1606 MF patients were identified, with high concordant familial risks. Several discordant familial associations were found for PV (acute myeloid leukaemia, Hodgkin disease, prostate and bladder cancers) or for MF (chronic lymphatic leukaemia, colorectal, kidney and cervical cancers) or for both (nervous system, eye and endocrine tumours).
Reduced helminth burden increases allergen skin sensitization but not clinical allergy: a randomized, double‐blind, placebo‐controlled trial in Vietnam
Authors: Flohr C. , Tuyen L. N. , Quinnell R. J. , Lewis S. , Minh T. T. , Campbell J. , Simmons C. , Telford G. , Brown A. , Hien T. T. , Farrar J. , Williams H. , Pritchard D. I. , Britton J. 
Published: September 2009

SummaryBackground: Observational evidence suggests that infection with helminths protects against allergic disease and allergen skin sensitization. It is postulated that such effects are mediated by helminth‐induced cytokine responses, in particular IL‐10.Objective: We tested this hypothesis in a rural area of central Vietnam where hookworm infection is endemic.Methods: One thousand five hundred and sixty‐six schoolchildren aged 6–17 were randomly allocated to receive either anti‐helminthic therapy or a placebo at 0, 3, 6, and 9 months. We compared changes in the prevalence of exercise‐induced bronchoconstriction, allergen skin sensitization, flexural eczema on skin examination, questionnaire‐reported allergic disease (wheeze and rhinitis symptoms), and immunological parameters (hookworm‐induced IFN‐γ, IL‐5, IL‐10) between 0 and 12 months.Results: One thousand four hundred and eighty‐seven children (95% of these randomized) completed the study. The most common helminth infections were hookworm (65%) and Ascaris lumbricoides (7%). There was no effect of the therapy on the primary outcome, exercise‐induced bronchoconstriction (within‐participant mean percent fall in peak flow from baseline after anti‐helminthic treatment 2.25 (SD 7.3) vs. placebo 2.19 (SD 7.8, P=0.9), or on the prevalence of questionnaire‐reported wheeze [adjusted odds ratio (OR)=1.16, 95% confidence interval (CI) 0.35–3.82, P=0.8] and rhinitis (adjusted OR=1.39, 0.89–2.15, P=0.1), or flexural dermatitis on skin examination (adjusted OR=1.15, 0.39–3.45, P=0.8). However, anti‐helminthic therapy was associated with a significantly higher allergen skin sensitization risk (adjusted OR=1.31, 1.02–1.67, P=0.03). This effect was particularly strong for children infected with A. lumbricoides at baseline (adjusted OR=4.90, 1.48–16.19, P=0.009). Allergen skin sensitization was inversely related to hookworm‐specific IL‐10 at baseline (adjusted OR=0.76, 0.59–0.99, P=0.04). No cytokine tested, including IL‐10, changed significantly after the anti‐helminthic therapy compared with the placebo.Conclusion: A significant reduction in worm burden over a 12‐month period in helminth‐infected children increases the risk of allergen skin sensitization but not of clinical allergic disease. The effect on skin sensitization could not be fully explained by any of the immunological parameters tested. Cite this as: C. Flohr, L. N. Tuyen, R. J. Quinnell, S. Lewis, T. T. Minh, J. Campbell, C. Simmons, G. Telford, A. Brown, T. T. Hien, J. Farrar, H. Williams, D. I. Pritchard and J. Britton, Clinical & Experimental Allergy, 2010 (40) 131–152.