bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Assessment of Body Fluid Disturbances in Patients with Obstructive Jaundice
Authors: Padillo Francisco J. , Rodriguez María , Gallardo Jose M. , Andicoberry Beatriz , Naranjo Antonio , Martín‐Malo Alejandro , Miño Gonzalo , Sitges‐Serra Antonio , Pera‐Madrazo Carlos 
Published: February 2006

Abstract.Postoperative renal dysfunction in obstructive jaundice (OJ) patients has been associated with hypovolemia and depletion of the extracellular water compartment (ECW). The aim of the study was to evaluate the preoperative status of body compartments in OJ patients measured by two methods. In a prospective study 39 OJ patients (11 benign and 28 malignant obstructions) were investigated, with 15 healthy subjects used as a control group (CG). Bioelectrical impedance analysis (BIA) determinations and values derived from anthropometric measurements were used to assess body compartment status. The coefficient of variation of BIA was below 4% in both OJ and CG subjects. No differences were found in intracellular water. However total body water (TBW) and ECW were reduced in OJ patients (50.5 ± 4.6 vs. 56 ± 8% body weight, p= 0.05; and 21 ± 4.5 vs. 23.8 ± 2.5% body weight, p < 0.05, respectively). There were no differences between benign and malignant obstructions. Seventy four percent of OJ patients had an ECW volume below the mean ± 2 SD in the CG subjects. Anthropometric and BIA determinations correlated closely for TBW measurements in both CG (r= 0.92, p < 0.001) and OJ patients (r= 0.91, p < 0.001). Bland‐Altman analysis also showed that for TBW the BIA was in agreement with anthropometry. In the present study, BIA offered a good correlation with anthropometric determinations and was a reliable method for body fluid disturbances assessment in jaundiced patients.
Value of Intravenous Cholangiography prior to Laparoscopic Cholecystectomy
Authors: Jansen Marc , Truong Son , Treutner Karl‐Heinz , Neuerburg Jörg , Schraven Christoph , Schumpelick Volker 
Published: February 2006

Abstract.We performed a retrospective study on 163 patients for evaluation of the benefit of intravenous cholangiography prior to laparoscopic cholecystectomy. Radiographic evaluation of the various areas of the biliary system was classified regarding resolution of anatomic structures: well detailed (excellent), impaired image but reliable interpretation possible (good), insufficient contrast with limited assessment (poor), no reliable judgment possible (insufficient). The common bile duct could be described as “good” in 96.3%, whereas the cystic duct could be described as “good” in only 54.6%. Concrements of the gallbladder were recognized in 72.4%, and common bile duct stones were diagnosed in only two of three patients. A distal junction of the cystic duct was found in nine cases, but there was no influence on the following operative procedure. Only one of two patients with a short cystic duct was identified. We found no improvement after routine use of intravenous cholangiography concerning the evidence of common bile duct stones or the avoidance of lesions of the common bile duct. Hence routine use of intravenous cholangiography prior to laparoscopic cholecystectomy is not justified.
Thoracic Epidural Anesthesia for Pain Relief and Postoperation Recovery with Modified Radical Mastectomy
Authors: Yeh Chun‐Chang , Yu Jyh‐Cherng , Wu Ching‐Tang , Ho Shung‐Tai , Chang Tzu‐Ming , Wong Chih‐Shung 
Published: February 2006

p < 0.001) and decreased pethidine consumption (17.2 ± 7.0 vs. 76.3 ± 17.4 mg) (p < 0.001) were observed in the TEA group than in the GA group, respectively. A worse visual analog scale (VAS) pain score was observed in the GA group (5.7 ± 0.6) than in TEA patients (4.3 ± 0.4) (p < 0.01). The average bed rest time was significantly shorter in the TEA group (16.9 ± 0.9 hours) (p < 0.01) than in the GA group (27.1 ± 4.1 hours). Overall satisfaction scores were significantly higher in the TEA group (4.4 ± 0.1) (p < 0.01) than in the GA group (3.5 ± 0.2). Side effects were observed at a higher frequency in the GA group (16/32) (p < 0.0001) than in the TEA group (3/32). The frequency of pethidine injection for pain relief was significantly lower in the TEA group (8/32) (p < 0.0001) than in the GA group (24/32). The total hospital cost (NT 64,392 ± 3,523 vs. NT 53,806 ± 2,817) (p= 0.0342) and anesthesia cost (NT 7,968 ± 246 vs. NT 5,268 ± 262) (p < 0.0001) are also significantly lower in the TEA group than the GA group. In conclusion, TEA provided better postoperative pain relief and recovery and lower cost than GA for MRM surgery.
Comparative Study of Carbohydrate Antigen 195 and Carcinoembryonic Antigen for the Diagnosis of Pancreatic Carcinoma
Authors: Andicoechea Alejandro , Vizoso Francisco , Alexandre Enrique , Martínez Aránzazu , Díez María Cruz , Riera Luis , Martinez Enrique , Ruibal Alvaro 
Published: February 2006

p < 0.001). Sensitivity was increased to 92.5% with the simultaneous use of the two antigens, but the difference was statistically significant only with CEA (p < 0.001). The specificity of CA195 calculated from all patients with benign diseases was lower than that of CEA (73.1% vs. 89.8%). However, using a cutoff value of 100 U/ml for CA195, the specificity of this antigen (82%) was higher than that of CEA. These results demonstrate that marked elevations of tumor antigen CA195 are relatively specific for pancreatic carcinoma, and that this antigen is superior to CEA for diagnosing pancreatic cancer by virtue of its higher sensitivity.
Preliminary results on correlation between neural response imaging and ‘most comfortable levels' in cochlear implantation
Authors: Akin I , Kuran G , Saka C , Vural M 
Published: February 2006

During cochlear implantation, precise placement of the cochlear electrodes against the cochlear nerve is one of the most important steps, necessary to enable the patient to be aware of the stimulus from the implanted device. Neural response imaging (NRI) is a new tool which measures the evoked compound action potential generated as a result of electrical stimulation of the cochlea by properly placed electrodes during surgery.The aim of this study was to examine the correlation between intra-operative NRI recordings and ‘most comfortable levels’ (M levels) measured during standard fitting with the SoundWave fitting software, in cochlear implantation patients. Seven adult subjects were included in the study. The average duration of profound bilateral deafness was seven years (range = 19 years) and the mean age at implantation was 24 years (range = 17–34 years). All subjects underwent implantation and reached the one-month fitting session; one patient reached the two-month fitting session. The intra-operative NRI threshold (tNRI) was observed to be much higher than the first fitting M levels. The tNRI was 203 per cent of the sequential M value and 246 per cent of the paired M value. All but one intra-operative tNRI values were greater than 150 clinical units (CU), and all first fitting M levels were on average below 100 CU. No obvious correlation was found between individual intra-operative tNRI and first fitting M levels. The M levels at one month were much higher than the first fitting M levels, with much more dispersion.
Rossby-wave driven zonal flows in the ionospheric E-layer
Authors: KALADZE T. D. , WU D. J. , POKHOTELOV O. A. , SAGDEEV R. Z. , STENFLO L. , SHUKLA P. K. 
Published: February 2006

Abstract.A novel mechanism for the generation of large-scale zonal flows by small-scale Rossby waves in the Earth's ionospheric E-layer is considered. The generation mechanism is based on the parametric excitation of convective cells by finite amplitude magnetized Rossby waves. To describe this process a generalized Charney equation containing both vector and scalar (Korteweg–de Vries type) nonlinearities is used. The magnetized Rossby waves are supposed to have arbitrary wavelengths (as compared with the Rossby radius). A set of coupled equations describing the nonlinear interaction of magnetized Rossby waves and zonal flows is obtained. The generation of zonal flows is due to the Reynolds stresses produced by finite amplitude magnetized Rossby waves. It is found that the wave vector of the fastest growing mode is perpendicular to that of the magnetized Rossby pump wave. Explicit expression for the maximum growth rate as well as for the optimal spatial dimensions of the zonal flows are obtained. A comparison with existing results is carried out. The present theory can be used for the interpretation of the observations of Rossby-type waves in the Earth's ionosphere.
Conclusiveness of the Cochrane Neonatal Reviews: A systematic analysis
Authors: Mandel Dror , Littner Yoav , Mimouni Francis B. , Lubetzky Ronit 
Published: February 2006

Abstracts Aim: To assess the conclusiveness of the Cochrane Neonatal Reviews (CNRs). We tested the hypotheses that: 1) the majority of the reviews is inconclusive; 2) the majority of reviews recognizes the need for further studies; 3) the ability to reach a conclusion is dependent upon both the number of studies and the number of patients. We also aimed to determine whether the conclusiveness of the CNRs was affected by time.Methods: We selected CNRs available in the Cochrane Library in June 2004. The number of randomized clinical trials (RCTs) found, number of RCTs included for analysis, number of patients enrolled, the stated need for further studies, and the conclusiveness of CNRs were recorded.Results: Out of 170 CNRs, 67.7% were conclusive. The average number of articles was similar, but the total number of patients enrolled was three times higher in the conclusive CNRs. The percentage of articles included in conclusive studies was significantly higher than in inconclusive ones. The vast majority of CNRs recognized the need for further studies. The number of studies included correlated significantly with the total number of patients included. The percentage of conclusive CNRs correlated negatively with year of publication.Conclusion: The majority of CNRs is conclusive, but emphasizes the need for further studies. The ability of a CNR to reach a conclusion is affected by the cumulative sample size and by the number of studies performed. The probability of a newer review to be conclusive is lower than that of an older review.
Management of Occupational Exposures to Hepatitis C Virus Current Practice and Controversies
Authors: Alvarado-Ramy Francisco , Alter Miriam J. , Bower William , Henderson David K. , Sohn Annette H. , Sinkowitz-Cochran Ronda L. , Jarvis William R. 
Published: February 2006

AbstractUnlike hepatitis B virus and human immunodeficiency virus, there currently are no immunization or chemoprophylactic interventions available to prevent infection after an occupational exposure to hepatitis C virus (HCV). A “Reality Check” session was held at the 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections to gather information on current practices related to management of occupational exposures to HCV, generate discussion on controversial issues, and identify areas for future research. Infection control professionals in attendance were knowledgeable in most issues addressed regarding the management of occupational exposures to HCV. Areas of controversy included the use of antiviral therapy early in the course of HCV infection and the appropriate administrative management of an HCV-infected healthcare worker.
Clostridium difficile- Associated Diarrhea in a VA Medical Center Clustering of Cases, Association With Antibiotic Usage, and Impact on HIV-infected Patients
Authors: Mody Lona R. , Smith Sharon M. , Dever Lisa L. 
Published: February 2006

AbstractA case-control study of patients with stools assayed forClostridium difficiletoxin over a 24-month period at a Veterans Affairs hospital found that the majority of cases (70.6%) occurred in temporal clusters. Clustering was particularly evident on a designated human immunodeficiency virus (RW) unit. Thirty-four (75.5%) of 45 HIV-infected patients withC difficile-associated diarrhea (CDAD) died during their hospitalization. Third-generation cephalosporins were the antibiotics most strongly associated with CDAD.
Invasive Aspergillosis Outbreak on a Hematology-Oncology Ward
Authors: Burwen Dale R. , Lasker Brent A. , Rao Nalini , Durry Elias , Padhye Arvind A. , Jarvis William R. 
Published: February 2006

AbstractAn outbreak of invasive aspergillosis occurred in a community hospital in temporal association with construction activity. Epidemiological investigation showed that patients who are at highest risk comprise a small group and are readily identifiable. Clinicians should strive to protect these patients, following guide-lines published by the Centers for Disease Control and Prevention.
Tap Water Colonization With Psmdomonas aeruginosa in a Surgical Intensive Care Unit (ICU) and Relation to Psmdomonas Infections of ICU Patients
Authors: Trautmann Matthias , Michalsky Thomas , Wiedeck Heidemarie , Radosavljevic Vladan , Ruhnke Markus 
Published: February 2006

AbstractWater faucets on a surgical intensive care ward were examined prospectively as a source of Pseudomonas aeruginosa infections. All water outlets harbored distinct genotypes of P aeruginosa over prolonged time periods. Over a period of 7 months, 5 (29%) of 17 patients were infected with P aeruginosa genotypes also detectable in tap water.
Application of the IDSA Guidelines for the Use of Antimicrobial Agents in Neutropenic Patients: Impact on Reducing the Use of Glycopeptides
Authors: Nucci Marcio , Landau Marianne , Silveira Fernanda , Spector Nelson , Pulcheri Wolmar 
Published: February 2006

AbstractWe evaluated the impact of applying the Infectious Diseases Society of America guidelines for febrile neutropenic patients in reducing the use of glycopeptides. Forty-five prior episodes of febrile neutropenia were compared to 97 episodes seen after application of the guidelines. Glycopeptide use was reduced from 73% to 43% of episodes (P=.0008), without changes in outcome.
Bacterial Contamination of Fabric Stethoscope Covers: The Velveteen Rabbit of Health Care?
Authors: Milam Michael W. , Hall Melanie , Pringle Teri , Buchanan Kay 
Published: February 2006

AbstractTo determine if fabric stethoscope covers pose an infection control problem, we studied how they are cared for by our healthcare workers and performed microbiological investigations on 22 covers collected over a 3-week period. Our study suggests that fabric stethoscope covers represent a potential infection control problem because they are used for prolonged periods, are infrequently laundered, and are contaminated with bacteria.
Surveillance and Control of Methicillin-ResistantStaphylococcus aureusInfections in French Hospitals
Authors: Lepelletier Didier , Richet Hervé 
Published: February 2006

AbstractObjective:To assess the way French hospitals conduct surveillance for, and control infections caused by, methicillin-resis-tantStaphylococcus aureus(MRSA), and to evaluate the incidence of these infections.Design:Retrospective analysis of sample surveillance data.Setting:Representative sample of French hospitals.Participants:Representative sample of 38 French public hospitals.Methods:Hospitals were selected randomly in 1996, taking into account their location and number of beds. Administrative data, surveillance denominators used, antimicrobial resistance rates, and infection control practices were analyzed for the period 1990 to 1995. The same 38 centers were contacted 3 years later, in 1998, to reassess their surveillance and control activities.Results:French hospitals were slow to implement MRSA surveillance programs; only 5% had such programs in 1990, when the median incidence per admission (0.37%) and per patient-days (0.04%) of MRSA infections was already high. Despite the implementation of surveillance programs in 66% of French hospitals in 1995 and 87% in 1998, the MRSA infection rates remained stable from 1990 to 1995 and increased from 1995 to 1998. The proportion of French hospitals having a policy for the transfer of MRSA-infected patients to other hospitals increased from 47% in 1995 to 61% in 1998, whereas screening for MRSA colonization (42%-53%) and isolation for colonized or infected patients (87%-89%) remained stable.Conclusions:This first national survey showed that French hospitals probably were not optimally prepared to control and prevent MRSA infections, since they were slow to respond to the growing problem.
Neonatal Bacteremia: Patterns of Antibiotic Resistance
Authors: Bromiker Ruben , Arad Ilan , Peleg Ofra , Preminger Aviya , Engelhard Dan 
Published: February 2006

AbstractObjective:To determine the incidence and evaluate the antimicrobial-susceptibility patterns of bacterial infections in our neonatal units.Design:Retrospective surveillance study.Setting:The neonatal units of the Hadassah University Hospitals, Jerusalem, Israel.Patients:All newborns admitted from January 1994 through February 1999.Methods:The records of all patients with positive blood and cerebrospinal fluid cultures were reviewed. Bacteremia was considered early-onset (vertical) when occurring within the first 72 hours of life and late-onset (nosocomial) when occurring later. The prevalence and antibiotic-resistance patterns of vertically transmitted and nosocomially acquired strains were compared and studied over time.Results:219 of 35,691 newborn infants had at least one episode of bacteremia (6.13/1,000 live births). There were 305 identified organisms, of which 21% (1.29/1,000 live births) were considered vertically transmitted and 79% nosocomially acquired. The most common organism causing early-onset disease (29.2%) was group B streptococcus (0.38/1,000 live births), whereas coagulase-negative staphylococci (51%) were the most prevalent in late-onset disease. All gram-positive bacteria were susceptible to vancomycin. Most gram-positive organisms other than staphylococci were susceptible to ampicillin. Gram-negative organisms represented 31% of all isolates. Generally, there was a trend of increasing resistance to commonly used antibiotics among nosocomially acquired gram-negative organisms, compared to those vertically transmitted, with statistically significant differences for ampicillin and mezlocillin (P<.05 andP<.01, respectively). Over the years, a trend toward an increasing resistance to antibiotics was observed among gram-negative organisms.Conclusions:The trend of increasing bacterial resistance to commonly used antibiotics necessitates the implementation of a rational empirical treatment strategy, based on local susceptibility data, reserving certain agents for emerging resistant pathogens.
Epidemiology of Biological-Exposure Incidents Among Spanish Healthcare Workers
Authors: Monge Vicente , Mato Gloria , Mariano Alberto , Fernández Cristina , Fereres José ,   GERABTAS Working Group
Published: February 2006

AbstractObjective:To determine the frequency and the epidemiological characteristics of biological-exposure incidents occurring among healthcare personnel.Design:Prospective surveillance study.Setting:Participating Spanish primary-care and specialty centers from January 1994 to December 1997.Participants:70 centers in 1994, 87 in 1995, 97 in 1996, and 104 in 1997.Methods:Absolute and relative frequencies were calculated for several variables (position held, area of care, type of injuring object, activity, etc) and for the different categories of each variable.Results:There were 20,235 registered incidents. Annual incidence rates were as follows: 1994, 51 per 1,000; 1995, 58 per 1,000; 1996, 54 per 1,000; and 1997, 59 per 1,000. Mean age of accident victims was as follows: 1994, 35.68 (standard deviation [SD], 16.26); 1995, 33.6 (SD, 11.9); 1996, 38.2 (SD, 17.27); and 1997, 36.7 (SD, 16.33) years. Of the 20,235 incidents, 15,860 (80.7%) occurred to women; 50% (9,833) accidents were among nursing staff. The type of incident most frequently reported was percutaneous injury (81.1%). The highest frequency of accidents was seen in medical and surgical areas (28% and 25.6%, respectively). Blood and blood products were the most commonly involved material (87.6%). Administration of intramuscular or intravenous medication was the activity associated with the highest accident rate (20.3%). The most frequent immediate action in response was rinsing and disinfecting (65.6%).Conclusions:The incident registry was highly stable in terms of incidence rates over the observation period and served to highlight the large number of incidents recorded each year. The potential implications of die results are the need to explore reasons for increased exposures in certain areas, with the aim of focusing prevention efforts, and, similarly, to establish the factors associated with diminished incidence rates to model successful measures.
Hospital Bloodborne Pathogens Programs: Program Characteristics and Blood and Body Fluid Exposure Rates
Authors: Beekmann Susan E. , Vaughn Thomas E. , McCoy Kimberly D. , Ferguson Kristi J. , Torner James C. , Woolson Robert F. , Doebbeling Bradley N. 
Published: February 2006

AbstractObjective:To describe hospital practices and policies relating to bloodborne pathogens and current rates of occupational exposure among healthcare workers.Participants and Methods:Hospitals in Iowa and Virginia were surveyed in 1996 and 1997 about Standard Precautions training programs and compliance. The primary outcome measures were rates of percutaneous injuries and mucocutaneous exposures.Results:153 (64%) of 240 hospitals responded. New employee training was offered no more than twice per year by nearly one third. Most (79%-80%) facilities monitored compliance of nurses, housekeepers, and laboratory technicians; physicians rarely were trained or monitored. Implementation of needlestick prevention devices was the most common action taken to decrease sharps injuries. Over one half of hospitals used needleless intravenous systems; larger hospitals used these significantly more often. Protected devices for phlebotomy or intravenous placement were purchased by only one third. Most (89% of large and 80% of small) hospitals met the recommended infection control personnel-to-bed ratio of 1:250. Eleven percent did not have access to postexposure care during all working hours. Percutaneous injury surveillance relied on incident reports (99% of facilities) and employee health records (61%). The annual reported percutaneous injury incidence rate from 106 hospitals was 5.3 injuries per 100 personnel. Compared to single tertiary-referral institution rates determined more than 5 years previously, current injury rates remain elevated in community hospitals.Conclusions:Healthcare institutions need to commit sufficient resources to Standard Precautions training and monitoring and to infection control programs to meet the needs of all workers, including physicians. Healthcare workers clearly remain at risk for injury. Further effective interventions are needed for employee training, improving adherence, and providing needlestick prevention devices.