bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outbreak of Vancomycin-Resistant Enterococci in a Burn Unit
Authors: Falk Pamela S. , Winnike Janice , Woodmansee Carta , Desai M. , Mayhall C. Glen 
Published: February 2006

AbstractObjective:To investigate and control an outbreak of colonization and infection caused by vancomycin-resistant enterococci (VRE) in a burn intensive care unit (BICU).Design:Epidemiological investigation, including multiple point-prevalence culture surveys of patients and environment, cultures from hands of healthcare workers (HCWs), pulsed-field gel electrophoresis (PFGE) typing of patient and environmental isolates, case-control study, and institution and monitoring of control measures.Setting:BICU in an 800-bed university medical center in Galveston, Texas.Results:Between June 6, 1996, and July 14, 1997, 21 patients were colonized by VRE, and 4 of these patients developed bacteremia. Of 2,844 environmental cultures, 338 (11.9%) were positive, but all hand cultures from HCWs were negative. PFGE typing indicated that the outbreak was clonal, with VRE isolates from patients differing by ≤4 bands from the index case. Thirteen of 14 environmental isolates varied by ≤4 bands from the pattern of the index case. A case-control study analyzed by exact logistic regression identified diarrhea (odds ratio [OR], 43.9; 95% confidence interval [CI95], 5.5-infinity;P=.0001) and administration of an antacid (OR, 24.2; CI95,2.9-infinity;P=.002) as independent risk factors for acquisition of VRE. During a 5-week period in October and November 1996, all patient and 317 environmental cultures were negative for VRE. The outbreak recurred from a contaminated electrocardiogram lead that had not been identified during the prior 5 weeks. VRE were finally eradicated from the BICU in July 1997, using barrier isolation and a very aggressive environmental decontamination program.Conclusions:A VRE outbreak in a BICU over 13 months was caused by a single clone. After apparent eradication of VRE from a BICU, recrudescence of the outbreak occurred, evidently from a small inapparent source of environmental contamination. Changes in gastrointestinal (GI) tract function (motility) and administration of medications, other than antibiotics, that have an effect on the GI tract may increase the risk of GI tract colonization by VRE in burn patients. Application of barrier isolation and an aggressive environmental decontamination program can eradicate VRE from a burn population.
An Outbreak ofAcinetobacter baumannii:The Importance of Cross-Transmission
Authors: D'Agata Erika M.C. , Thayer Valerie , Schaffner William 
Published: February 2006

AbstractObjective:To investigate an outbreak of nosocomial infections due to multidrug-resistant (MDR)Acinetobacter baumanniiand to analyze the contribution of cross-transmission in the rise in infection rates.Design:Epidemiological investigation; molecular typing using pulsed-field gel electrophoresis (PFGE); matched case-control study to identify risk factors for infection.Setting:A 34-bed surgical intensive care unit at a tertiary-care hospital.Patients:Eighteen patients who developed MDRA baumanniinosocomial infection were matched to 36 patients who were admitted to the same surgical intensive care unit (SICU) room and did not develop an infection during the outbreak period.Results:Prior to the outbreak, the baseline attack rate of MDRA baumanniinosocomial infections was 3 per 100 patients per month. From February 1 through March 22, 1998, the attack rate rose to 16 per 100 patients per month, with a total of 18 infections. All isolates had indistinguishable PFGE patterns. Seventy environmental cultures were negative for MDRA baumannii. Following intense infection control education, the attack rate decreased to 4 per 100 patients per month. By conditional logistic regression, cases were exposed to a significantly higher number of patients with MDRA baumanniiinfections compared to controls (odds ratio, 1.1; 95% confidence interval, 1.01-1.2;P=.02), even after adjusting for length of SICU admission and exposure to antibiotics and invasive devices.Conclusion:Cross-transmission between patients contributed to the rise in rates of MDRA baumanniiinfections. A common environmental source was not detected.
Bloodborne Viral Infections in Patients Attending an Emergency Room in Mexico City: Estimate of Seroconversion Probability in Healthcare Workers After an Occupational Exposure
Authors: Kato-Maeda Midori , Ponce-de-León Samuel , Sifuentes-Osornio Jose , Rangel-Frausto M. Sigfrido , Calva-Mercado Juan , Infante-Suarez Lourdes , Villareal Fernando Morales , Ponce-de-León Sergio 
Published: February 2006

AbstractThe frequency of hepatitis C (HCV), hepatitis B (HBV), human immunodeficiency virus (HIV), and human T-cell lymphotropic virus (HTLV) I/II was determined in the emergency room of a teaching hospital. Of 909 patients, 19% had at least one infection; 7.8% had HCV, 6.9% HBV, 3.3% HIV, and 2.8% HTLV I/II. The probability that a healthcare worker would have an accident with an infected patient and seroconvert was 4.99 to 24.9 per 100,000 venipunctures for HBV, 5.6 to 8.4 for HCV, and 0.12-0.16 for HIV in our emergency room.
Long-Term Control ofLegionellaSpecies in Potable Water After a Nosocomial Legionellosis Outbreak in an Intensive Care Unit
Authors: Borau Joseph , Czap Ryan T. , Strellrecht Kathleen A. , Venezia Richard A. 
Published: February 2006

AbstractEnvironmental and patient-care control measures were initiated in response to an outbreak of legionellosis in an intensive care unit in 1992. The measures included maintaining elevated potable hot-water temperatures following superheating and using sterile water for administrations through nasogastric tubes.Legionellaspecies remained below detectable levels in the potable hot-water system upon reevaluation in 1999. Nosocomial cases of legionellosis have not been reported since the outbreak.
Prevalence of Nasal Colonization With Methicillin-Resistant Staphylococcus aureus in Selected Patient Populations
Authors: Price Margaret F. , Carlini Maria , Houston Susan , Gentry Layne O. 
Published: February 2006

AbstractMethicillin-resistant Staphylococcus aureus nasal colonization was investigated in patients arriving for elective cardiovascular surgery, renal patients admitted for arteriovenous graft surgery, and patients transferred to our hospital from other institutions. Renal patients were significantly more likely to be colonized and represent a potential source of MRSA to our institution.
Physician Preferences for Educational Media
Authors: Smith Theresa L. , Sinkowitz-Cochran Ronda L. , Jarvis William R. 
Published: February 2006

AbstractBackground:Although educational media have expanded in variety, information on physicians' preferences for types of educational media remains limited.Method:An assessment form was distributed to 14 medical societies evaluating their members' medical education media preferences and society antimicrobial-resistance educational offerings.Results:These 14 medical societies represent 349,685 physicians. All supported educational offerings, most frequently as professional meetings, followed by audiotapes, computer programs, Internet sites, or print-based self-study materials. Only 5 (36%) societies had measured how many members used their educational offerings. Eight (57%) societies had made antimicrobial resistance an educational priority for their medical societies. Antimicrobial treatment was the most commonly offered educational topic on antimicrobial resistance.Conclusions:These 14 medical societies help to educate over one half the practicing US physicians. However, less than one half of the societies knew how many of their members used the educational materials they offered, or how their members would prefer to obtain medical education. Understanding how physicians want to obtain medical information potentially could improve the delivery of medical knowledge to physicians.
Tuberculosis in Long-Term–Care Facilities
Authors: Smith Philip W. , Rajagopalan Shobita , Yoshikawa Thomas T. 
Published: February 2006

AbstractThe geriatric population represents the largest reservoir ofMycobacterium tuberculosisinfection in developed nations, including the United States. Tuberculosis (TB) case rates in the United States are highest for this age group compared with other age categories. The subtle clinical manifestations of TB in the elderly often can pose potential diagnostic dilemmas and therapeutic challenges, resulting in increased morbidity and mortality in this age group; this treatable infection unfortunately often is detected only at autopsy. Compared with their community-dwelling counterparts, the institutionalized elderly are at a greater risk both for reactivation of latent TB and for the acquisition of new TB infection. Prevention and control of TB in facilities providing long-term care to the elderly thus cannot be overemphasized.
The Microbial Genetics of Antibiotic Cycling
Authors: John Joseph F. , Rice Louis B. 
Published: February 2006

AbstractCycling of currently available antibiotics to reduce resistance is an attractive concept. For cycling strategies to be successful, their implementation must have a demonstrable impact on the prevalence of resistance determinants already dispersed throughout the hospital and associated healthcare facilities. While antibiotic use in hospitals clearly constitutes a stimulus for the emergence of resistance, it is by no means the only important factor. The incorporation of resistance determinants into potentially stable genetic structures, including bacteriophages, plasmids, transposons, and the more newly discovered movable elements termedintegronsandgene cassettes,forces some degree of skepticism about the potential for such strategies in institutions where resistance determinants are already prevalent. In particular, the expanding role of integrons may pose an ultimate threat to formulary manipulations such as cycling. Despite these concerns, the crisis posed by antimicrobial resistance warrants investigation of any strategy with the potential for reducing the prevalence of resistance. Over the next decade, new studies with carefully designed outcomes should determine the utility of antibiotic cycling as one control measure for nosocomial resistance.
Antibiotic Cycling and Marketing Into the 21st Century: A Perspective From the Pharmaceutical Industry
Authors: Lavin Bruce S. 
Published: February 2006

AbstractBefore the development of the first antimicrobial agents, bacteria already had demonstrated an ability to adapt to stress in the environment, resulting in the development of resistance that often makes the prevailing antibiotic treatment ineffective. The response to antimicrobial resistance in the medical community has been to use new or alternative antibiotics not previously used against the resistant bacteria. The pharmaceutical industry has responded to the resistance problem by producing newer antibiotics, either as modifications of currently existing compounds or as combinations of compounds that may inhibit or bypass the bacterial resistance mechanisms. The development of new antibiotics is a lengthy and costly process. To be successful, the pharmaceutical industry must anticipate the changing needs of the medical community, as well as the dynamic process of antimicrobial resistance. The marketing of new antimicrobial agents must be adaptable to the potential environmental pressures that induce bacterial resistance in order to ensure the longevity of the agents.
Strategies for Study of the Role of Cycling on Antimicrobial Use and Resistance
Authors: McGowan John E. 
Published: February 2006

AbstractResistant bacteria usually are seen first in the intensive care unit and other acute-care areas. Thus, strategies to control these organisms often are first tested in these healthcare settings. Frequent among these strategies are attempts to improve antimicrobial use. One proposed method to decrease resistance in special settings like the intensive care unit is the cycling or rotation of antimicrobials. This intervention must be evaluated in the context of other concomitant attempts to improve antimicrobial usage and must take into account other factors influencing resistance.Until such studies are done, the value of cycling and other efforts to limit prescribers' choices of drugs in endemic settings will be unclear. Studies to evaluate cycling will have to be of large scale to produce useful data. It is unlikely that many hospitals or healthcare systems will have sufficient resources on their own to develop studies of sufficient power to be applied widely. Thus, cooperative studies to provide data on this important issue should be an international priority.
Issue Saliency and Gender Stereotypes: Support for Women as Presidents in Times of War and Terrorism*
Authors: Falk Erika , Kenski Kate 
Published: February 2006

Objective.This article examines how issue saliency affects the public's perceptions of whether a man or a woman would make a better president when considering the most important problem facing the nation.Method.The study uses telephone survey data of adults in the United States collected by the Annenberg Public Policy Center in September 2003. Multinominial logistic regression models were conducted to parse out the effects of issue saliency on presidential gender preference while taking demographic characteristics and party identification into account.Results.People who said that terrorism, homeland security, and/or U.S. involvement in Iraq was the most important problem facing the nation were more likely to say that a man would do a better job handling the issue as president.Conclusion.This study finds that issue saliency affects presidential gender preference above and beyond demographic and party identification variables.
Socioeconomic Distinction, Cultural Tastes, and Cigarette Smoking*
Authors: Pampel Fred C. 
Published: February 2006

Objectives.The inverse relationship between socioeconomic status (SES) and smoking is typically seen in terms of the greater economic and social resources of advantaged groups, but it may also relate to cultural resources. This study aims to test theories of symbolic distinction by examining relationships between smoking and ostensibly unrelated cultural preferences.Methods.Using the 1993 General Social Survey, ordinal logistic regression models, and a three‐category dependent variable (never, former, and current smoker), the analysis estimates relationships of musical likes and dislikes with smoking while controlling for SES and social strain.Results.Preferences for classical music are associated with lower smoking, while preferences for bluegrass, jazz, and heavy metal music are associated with higher smoking.Conclusions.The results suggest that SES groups may use smoking, like other cultural tastes, to distinguish their lifestyles from those of others.
Ideological Extremism and Public Participation*
Authors: Whitford Andrew B. , Yates Jeff , Ochs Holona L. 
Published: February 2006

Objectives. Does aggregate ideological extremism reduce public participation? Does participation in governance processes fall when the social environment shifts to the extreme left or the extreme right of the political spectrum? Our main hypothesis is that the aggregate ideological orientation of the social environment constrains volunteerism in social regulatory programs.Methods. We test our hypothesis using a panel tobit analysis of data from the federal Long‐Term Care Ombudsman Program.Results. Our model of public participation (expressed as volunteerism) shows that participation expands when the ideological position of a state's citizens is at the extreme left or right of the political continuum. We show the differential effects of two types of aggregate ideological orientation: of citizens and their political leaders. We further find that participation is greatest in states with extremely liberal citizen ideological positions.Conclusions. These findings paint a more complex picture of the effect of extremism in the social environment on public participation measured as production volunteerism. In sum, public participation is greatest when the social environment is ideologically polarized, and social regulation is strongest when volunteerism is greatest.
Which Congregations Will Take Advantage of Charitable Choice? Explaining the Pursuit of Public Funding by Congregations*
Authors: Owens Michael Leo 
Published: February 2006

Objective.To determine the effects of clergy attitudes on the willingness of congregations to seek public funding to provide social welfare.Methods.Survey data are drawn from a probability sample of clergy leading congregations in metropolitan Atlanta, Georgia. A logistic regression model examines the effects of clergy attitudes on the potential pursuit of public funding by congregations.Results.Controlling for a set of congregation attributes, a positive attitude toward partnerships between congregations and secular groups and a fear of government entanglement with religion are the strongest attitudinal predictors of congregation willingness to pursue public funding. However, attributes, particularly the racial composition of members and denominational affiliation, also predict congregation willingness to seek public funding.Conclusions.Congregation willingness to pursue public funding is a function of clergy attitudes and congregation attributes, which has implications for politics and public policy.
Mexican Immigrant Self‐Employment Along the U.S.‐Mexico Border: An Analysis of 2000 Census Data*
Authors: Mora Marie T. , Dávila Alberto 
Published: February 2006

Objective. This study explores the entrepreneurial tendencies of Mexican immigrants in metropolitan statistical areas (MSAs) on the U.S. side of the Mexican border vis‐à‐vis the U.S. interior.Methods. Using 2000 Census data available in the 5% Integrated Public Use Microdata Series, we empirically analyze the self‐employment rates and earnings of Mexican immigrants residing in U.S. cities near Mexico versus those in nonborder MSAs.Results. Our findings indicate that Mexican immigrants in MSAs along the U.S.‐Mexico border have significantly higher self‐employment rates (but lower earnings) than their counterparts in the rest of the United States and non‐Hispanic whites in border cities. Explanations for these findings include the existence of trade opportunities in U.S. border cities as well as intense labor market competition that crowds a greater share of immigrants into self‐employment.Conclusion. Immigration reform that curtails the immigration flow from Mexico might hinder small business formation and economic development on the U.S. side of the Mexican border.
The Impact of Gentrification on Voter Turnout*
Authors: Gibbs Knotts H. , Haspel Moshe 
Published: February 2006

Objective. The goal of this article is to test between two competing theories (mobilization vs. destabilization) about the impact of gentrification on political participation.Methods. Using geographic information systems (GIS) software, Census data from 1990 and 2000, and a voter file for the City of Atlanta, we estimate a multilevel model of voter turnout.Results. Controlling for relevant individual and contextual factors, we find that gentrification decreases turnout among longstanding residents.Conclusions. Our findings provide support for the destabilization hypothesis and suggest that policymakers should develop strategies to soften the negative consequences of gentrification.
Globalization and the Digital Divide: The Roles of Structural Conduciveness and Global Connection in Internet Diffusion*
Authors: Crenshaw Edward M. , Robison Kristopher K. 
Published: February 2006

Objectives. The goal of this research is to examine the role of modernization (i.e., structural conduciveness) in the form of income, telephone price and structure, education, and political structures, and global contact in the form of world cities, trade, investment, activities of international nongovernmental organizations, and short‐term exchanges of population in driving the worldwide diffusion of the Internet.Methods. We use longitudinal regression analyses (1995–2000) of change in Internet hosts for approximately 80 developing countries.Results. The analyses suggest that foreign investment, major urban agglomerations, manufacturing exports, nongovernmental organization presence, and tourism as well as democratic openness, property rights, and income predict Internet diffusion during the time period under investigation.Conclusions. We conclude that indeed both conduciveness to Internet technology as well as globalization (contact) are important factors in the diffusion of the Internet.
Necrolytic migratory erythema
Authors: Kovács Réka K. , Korom Irma , Dobozy Attila , Farkas Gyula , Ormos Jenő , Kemény Lajos 
Published: February 2006

Background:  Necrolytic migratory erythema is considered to be a paraneoplastic dermatosis. The classical symptoms are associated with α‐cell pancreatic islet cell tumor or ‘glucagonoma’. Generally, extracutaneous hallmarks of this disease include weight loss, diabetes, anaemia and diarrhoea.Observation:  We report a case of a 39‐year‐old woman with a 3‐year history of recalcitrant psoriasiform eruption, who had no other associated symptoms on routine examination. Histologic examinations suggested necrolytic migratory erythema. Abdominal computer tomography was performed, which revealed a tumor in the tail of the pancreas. After distal resection of the pancreas her skin symptoms resolved in a few days time. Histology was consistent with glucagonoma. She is clinically well and symptomless and no signs of metastasis after 4 years.Conclusions:  It is infrequent to have only necrolytic migratory erythema, hyperglucagonaemia and islet‐cell tumor but no other extracutaneous symptoms in glucagonoma syndrome. To our knowledge, ours is the second such case reported in the literature. Skin symptoms are important, often they are the clue to the diagnosis of glucagonoma syndrome.
Subclinical chronic lymphocytic leukaemia associated with a 13q deletion presenting initially in the skin: apropos of a case
Authors: Khandelwal Abha , Seilstad Kay H. , Magro Cynthia M. 
Published: February 2006

Introduction:  B‐cell chronic lymphocytic leukaemia (B‐CLL) represents a low‐grade B‐cell lymphoproliferative disease that is the most common leukaemia in adults. The neoplastic cell is an autoreactive CD5 CD23 B lymphocyte. B‐CLL may involve the skin, typically in the context of known disease. We present a case of subclinical B‐CLL presenting initially in the skin.Case Report:  A 73‐year‐old male developed a lesion on his right cheek in April 2003 compatible with basal cell carcinoma. The re‐excision specimen contained a well‐differentiated atypical lymphocytic infiltrate consistent with B‐CLL along with residual carcinoma. Subsequent laboratory studies revealed peripheral blood lymphocytosis with smudge cells. A diagnosis was made of Rai stage 0 CLL. Chromosomal studies on peripheral blood showed a deletion at 13q14.3. Excision of a second primary skin carcinoma revealed a squamous cell carcinoma in association with B‐CLL that was identical to his previously diagnosed skin involvement.Conclusion:  This case identifies a cutaneous presentation of subclinical B‐CLL. There are two prior reports describing B‐CLL presenting initially in the skin. In one case, the infiltrates were incidental on a re‐excision specimen. The second report suggests 16% of B‐CLL patients have cutaneous manifestations as the first sign of disease.