bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increasing Pneumococcal Vaccination Rates Among Hospitalized Patients
Authors: Nowalk Mary Patricia , Middleton Donald B. , Zimmerman Richard K. , Hess Mary M. , Skledar Susan J. , Jacobs Marjorie A. 
Published: March 2006

AbstractObjective:To increase the proportion of inpatients vaccinated against pneumococcal infection.Design:Pre- and post-intervention study.Setting:University medical center–affiliated, suburban community teaching hospital.Patients:Unvaccinated inpatients 65 years and older and those 2 to 64 years old who had chronic medical conditions predisposing them to invasive pneumococcal infection.Intervention:The nursing staff screened newly admitted patients for eligibility based on age, diagnosis, or medications from a computer-generated admissions list and placed a pre-printed order form for the pneumococcal polysaccharide vaccine (PPV) on the charts of eligible patients. Following the physician's order, the nursing staff administered the PPV and recorded it. Ongoing quality improvements including admission vaccination screening and computer-based record keeping were initiated to identify unvaccinated eligible patients and track vaccination status.Results:Efforts resulted in rates of in-hospital vaccination ranging from 3.1% to 7.9% (mean, 5.2% ± 1.7% [standard deviation]) and significant improvements in the assessment of previous vaccination status, reaching 54% of eligible patients after 1 year. Ascertainment of a previous vaccination increased significantly following the initiation of the use of admission forms that specifically assessed vaccination status and a system to permanently record vaccination status in an electronic medical record (P < .05).Conclusion:Concerted efforts using electronic medical records significantly improved the assessment and documentation of inpatient vaccination status. Greater improvement of the rates of in-hospital vaccination will require healthcare system–wide efforts such as a standing order policy for vaccinating all eligible patients. Standing orders for inpatient immunization supported by effective assessment and tracking systems have the potential to raise vaccination rates to the goals of Healthy People 2010 (Infect Control Hosp Epidemiol 2003;24:526-531)
Evaluation of the Antimicrobial Efficacy of Urinary Catheters Impregnated With Antiseptics in an In Vitro Urinary Tract Model
Authors: Gaonkar Trupti A. , Sampath Lester A. , Modak Shanta M. 
Published: March 2006

AbstractObjectives:To evaluate the long-term efficacy of urinary Foley catheters (latex and silicone) impregnated with (1) chlorhexidine and silver sulfadiazine (CXS) and (2) chlorhexidine, silver sulfadiazine, and triclosan (CXST) in inhibiting extra-luminal bacterial adherence and to compare their efficacy with that of silver hydrogel latex (SH) and nitrofurazone-treated silicone (NF) catheters.Design:The antimicrobial spectrum of these catheters was evaluated using a zone of inhibition assay. A novel in vitro urinary tract model was developed to study the potential in vivo efficacy of antimicrobial catheters in preventing extraluminal bacterial colonization. The “meatus” was inoculated daily withStaphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa,andCandida albicans. The “bladder” portion of the model was cultured daily to determine bacterial growth.Results:Both CXS and CXST catheters had a broader antimicrobial spectrum than SH and NF catheters. In the in vitro model, CXST latex and silicone catheters exhibited significantly better efficacy (3 to 25 days) against uropathogens, compared with CXS (1 to 14 days) and control (0 to 5 days) catheters (P= .01). CXST latex catheters exhibited significantly longer protection againstStaphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, andPseudomonas aeruginosa, compared with SH catheters (P= .01). CXST silicone catheters resisted colonization withStaphylococcus aureusandStaphylococcus epidermidisfor a significantly longer period (23 to 24 days) than did NF catheters (9 to 11 days) (P= .01).Conclusion:Catheters impregnated with synergistic combinations of chlorhexidine, silver sulfadiazine, and triclosan exhibited broad-spectrum, long-term resistance against microbial colonization on their outer surfaces (Infect Control Hosp Epidemiol2003;24:506-513)
Efficacy of Environmental Measures in Reducing Potentially Infectious Bioaerosols During Sputum Induction
Authors: Menzies Dick , Adhikari Neill , Arietta Marie , Loo Vivian 
Published: March 2006

AbstractObjective:To evaluate the airborne viable bacterial concentrations generated during sputum induction and their reduction with exhaust ventilation, ultraviolet germicidal irradiation (UVGI), or both.Methods:Exhaust ventilation, upper air UVGI lights, and a portable UVGI unit were operated independently or in combination while and after sputum induction was performed for 58 patients suspected of having active tuberculosis. Viable airborne bacteria were sampled with volumetric air samplers, grown on blood agar, and identified with standard techniques.Results:During and immediately after sputum induction, concentrations of airborne bacteria, particularly respiratory tract or oropharyngeal organisms, increased rapidly, regardless of environmental conditions. The subsequent rate of reduction of airborne bacteria was most rapid with the portable UVGI unit, followed by upper air UVGI with air mixing. Exhaust ventilation achieved high air changes per hour, but efficacy in reducing airborne bacterial concentrations was low. However, the continuous entrainment of bacteria-laden air from the hallway outside may have resulted in underestimation. The efficacy of a wall-mounted upper air UVGI fixture was significantly less if there was no air mixing. The irradiation from this fixture was of adequate germicidal intensity only in a narrow horizontal plane 2.5 m above the floor.Conclusion:Sputum induction was associated with a rapid and substantial increase in airborne bacteria despite the use of exhaust ventilation providing more than 30 air changes per hour, and the adjunct use of UVGI. This emphasizes that health-care workers involved in similar cough-inducing procedures performed for patients with suspected tuberculosis must wear appropriate personal respirators (Infect Control Hosp Epidemiol2003;24:483-489)
Analysis of Three Outbreaks Due toKlebsiellaSpecies in a Neonatal Intensive Care Unit
Authors: Ayan Melek , Kuzucu Cigdem , Durmaz Riza , Aktas Elif , Cizmeci Zeynep 
Published: March 2006

AbstractObjective:To investigate the clinical, microbiological, and epidemiologic features of three outbreaks caused byKlebsielladuring 3 years.Setting:Neonatal intensive care unit of a university hospital.Patients:Thirty affected neonates.Methods:Data were collected through chart reviews and conversations with physicians. Screening samples were obtained from the staff, the neonates, and the environment. Antibiogram typing and arbitrarily primed polymerase chain reaction-based fingerprinting were used to type the strains.Results:The first outbreak had 13K. pneumoniaestrains isolated. The second outbreak had 10K. oxytocastrains isolated. The third outbreak had 20K. pneumoniaestrains isolated. More than half of the patients had low birth weights, were premature, and underwent mechanical ventilation and intravenous catheterization. Approximately three-fourths of the patients died. The isolates tested were completely susceptible to meropenem, cefoxitin, and ciprofloxacin and were resistant to cephalothin. More than half of these strains were resistant to many beta-lactam antibiotics, amikacin, and trimethoprim/sul-famethoxazole. Typing procedures yielded 3 antibiotypes and 3 genotypes among the isolates of the first outbreak, 3 antibiotypes with 1 subtype and 2 genotypes with 1 subtype in the second outbreak, and 2 antibiotypes and 2 genotypes in the third outbreak.Conclusions:Klebsiellaoutbreaks mainly affected premature neonates with intravenous catheters, mechanical ventilation, or both. The high mortality rate (76.7%) was notable. Resistance to multiple antibiotics, but mainly to broad-spectrum beta-lactam antibiotics, was observed, particularly inK. pneumoniaeisolates. Molecular typing indicated that the three outbreaks were not related to one other (Infect Control Hosp Epidemiol2003;24:495-500).
Take Two Orthogonals and Call Me in the Morning
Authors: Birnbaum David 
Published: March 2006

AbstractAnalysis of variance (ANOVA) is used to prevent inflated type I error when hypothesis testing involves comparing more than two groups. If an ANOVA result indicates a statistically significant difference exists somewhere within, the next task is to discover exactly which combination or combinations of those groups account for the significant difference. Among many methods available for that exploration, orthogonal contrasts and relatively simple graphs are noteworthy (Infect Control Hosp Epidemiol 2003;24:544-547).
An Outbreak of Epidemic Keratoconjunctivitis in a Pediatric Unit Due to Adenovirus Type 8
Authors: Chaberny Iris F. , Schnitzler Paul , Geiss Heinrich Konrad , Wendt Constanze 
Published: March 2006

AbstractObjectives:To investigate and control an outbreak of epidemic keratoconjunctivitis (EKC) occurring in a neonatal intensive care unit (NICU) and to determine signs specific for EKC in newborns.Design:Outbreak investigation and case–control study.Setting:NICU of a 1,600-bed university hospital in Heidelberg, Germany.Patients:Case-patients were defined as individuals who had adenoviral antigen detected by ELISA or by PCR from conjunctival swabs or who had clinical signs of conjunctivitis. Twelve newborns from the NICU who had EKC between October and November 1998 were compared with 11 who had bacterial conjunctivitis.Intervention:Control measures included cohorting patients in contact isolation, using gloves and gowns for patient care, and using a hand rub and disinfectants with virucidal activity.Results:Thirteen patients, 6 healthcare workers, and 11 relatives of the patients had EKC, according to our case definition. Case-patients were more likely than control-patients to develop lacrimal swelling (P< .001), eye redness (P= .004), and lacrimation (P= .037) involving both eyes (P= .002). Prior examination by an ophthalmologist was a significant risk factor for EKC (P= .004). For diagnosis or treatment of retinopathy, premature newborns were seen by an ophthalmologist from a nearby eye care center where an EKC outbreak was ongoing. No new cases were diagnosed more than 10 days after the implementation of control measures.Conclusion:In newborns, lacrimal swelling, eye redness, and lacrimation in both eyes should evoke suspicion of EKC. Ophthalmologists who have had contact with known EKC cases should use antiseptics and disinfectants with virucidal activity before contact with newborns or abstain from examining newborns (Infect Control Hosp Epidemiol2003;24:514-519)
Respiratory Syncytial Virus Pneumonia in an Adult Renal Transplant Patient: An Unexpected Nosocomial Infection
Authors: Morales Rodrigo , Kirkpatrick Michael , Browne Barry , Emovon Osemwegie 
Published: March 2006

AbstractThis article describes a case of respiratory syncytial virus pneumonia believed to have been acquired nosocomially in an adult renal transplant recipient. The mode of transmission, diagnosis, and prevention of infection due to this virus in the immunocompromised patient are discussed (Infect Control Hosp Epidemiol2003;24:548-550.
Molecular Epidemiology of Systemic Infection Caused byEnterobacter cloacaein a High-Risk Neonatal Intensive Care Unit
Authors: Kuboyama Rogerio Hakio , Oliveira Helenice Bosco de , Moretti-Branchini Maria Luiza 
Published: March 2006

AbstractObjective:To investigate the molecular epidemiology of systemic nosocomial infections caused byEnterobacter cloacae.Setting:Neonatal intensive care unit (NICU) of a tertiary-care university hospital.Patients:Forty-two high-risk neonates with systemic infections caused byE. cloacae.Methods:From 1995 to 1997, the variables associated with death in these patients were evaluated. The molecular epidemiology of the strains responsible for the systemic infections, and 14 unrelated strains, was studied using plasmid analysis and pulsed-field gel electrophoresis (PFGE).Results:The overall mortality rate for infection caused byE. cloacaewas 34%, whereas the crude mortality rate during the study period was 8.12% (P< .001). Gestational age (preterm neonates) and birth weight (small for gestational age) were not associated with a higher risk of death. Insertion of a venous catheter by dissection of a peripheral vein was the only invasive procedure related to death (P= .016) in this study. A molecular analysis showed that three outbreaks, each occurring in a different year, were caused by strains with distinctive DNA profiles. Only one outbreak was identified by the infection control service, in the NICU. Plasmid analysis and PFGE showed similar ability to discriminate control strains from theE. cloacaestrains isolated from the neonates.Conclusions:Systemic infections caused byE. cloacaein our NICU were associated with a high mortality rate and occurred as small, unrecognized outbreaks. These results may not be generalizable because the data were from a single center (Infect Control Hosp Epidemiol2003;24:490-494).
Invasive Pulmonary Aspergillosis Soon After Therapy With Infliximab, a Tumor Necrosis Factor-Alpha–Neutralizing Antibody: A Possible Healthcare-Associated Case?
Authors: Rosa Francesco G. De , Shaz David , Campagna Anthony C. , Dellaripa Paul F. , Khettry Urmila , Craven Donald E. 
Published: March 2006

AbstractBackground:Infliximab is a chimeric monoclonal antibody against tumor necrosis factor (TNF)-alpha, used for the treatment of Crohn's disease and rheumatoid arthritis. Recently, an increased risk of infection due toMycobacterium tuberculosisand rare cases of invasive fungal disease have been reported following infliximab therapy.Case Report:A 73-year-old woman with chronic rheumatoid arthritis who had been treated with methotrexate, leflunomide, and prednisone was given the first of three doses of infliximab in June 2001. In July 2001, she presented with cough, and in August, she had a right upper lobe infiltrate that was treated with levofloxacin without improvement. In October, the patient had right upper and middle lobe infiltrates on a chest x-ray and computed tomography scan. At bronchoscopy, an endobronchial mass was biopsied, which demonstratedAspergillus fumigatus. Our patient had frequently accompanied her daughter on visits to another medical center following a stem cell transplant, where her daughter was instructed to wear a mask during all visits because of extensive building construction. We postulate that our patient may have acquired pulmonary aspergillosis during this period. Literature reviews on granulomatous diseases following infliximab therapy and hospital-acquired aspergillosis are presented.Conclusion:The temporal relationship between the administration of infliximab andA. fumigatusinfection in this patient suggests a causal relationship and possible healthcare-associated acquisition. These data underscore the importance of both patient and family education on prevention strategies when potent immune-modulating medications such as infliximab have been prescribed (Infect Control Hosp Epidemiol2003;24:477-482)
Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force
Authors: Boyce John M. , Pittet Didier 
Published: March 2006

SummaryThe Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis in health-care settings. In addition, it provides specific recommendations to promote improved hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and personnel in health-care settings. This report reviews studies published since the 1985 CDC guideline (Garner JS, Favero MS. CDC guideline for handwashing and hospital environmental control, 1985.Infect Control1986;7:231-43) and the 1995 APIC guideline (Larson EL, APIC Guidelines Committee. APIC guideline for handwashing and hand antisepsis in health care settings.Am J Infect Control1995;23:251-69) were issued and provides an in-depth review of hand-hygiene practices of HCWs, levels of adherence of personnel to recommended handwashing practices, and factors adversely affecting adherence. New studies of the in vivo efficacy of alcohol-based hand rubs and the low incidence of dermatitis associated with their use are reviewed. Recent studies demonstrating the value of multidisciplinary hand-hygiene promotion programs and the potential role of alcohol-based hand rubs in improving hand-hygiene practices are summarized. Recommendations concerning related issues (e.g., the use of surgical hand antiseptics, hand lotions or creams, and wearing of artificial fingernails) are also included.
West Nile Virus Induced Vocal Fold Paralysis
Authors: Steele Natalie P. , Myssiorek David 
Published: March 2006

AbstractObjective: West Nile virus has recently become a public health concern in the United States, after an outbreak in New York City in 1999. It is a mosquito‐borne virus that causes a spectrum of disease from flu‐like symptoms to encephalopathy, muscle weakness, and, in some cases, death.Study Design: Case Report.Methods: A patient infected with West Nile virus presented with progressive muscle weakness, and later developed bilateral vocal fold paresis. His clinical presentation, physical and laboratory examination findings, and course of illness will be discussed.Results: After a prolonged hospital stay, and presumptive treatment for Guillain‐Barré, repeat CSF analysis revealed infection with the West Nile virus. The patient developed bilateral vocal fold paralysis during his hospital course. At long‐term follow‐up, the patient's left vocal fold paralysis persisted, while the right vocal fold paralysis had resolved.Conclusions: Although several viruses have been associated with recurrent laryngeal nerve injury, this is the first report of West Nile virus induced vocal fold paralysis.
Comparison of Biomechanical Properties of Alloderm and Enduragen as Static Facial Sling Biomaterials
Authors: Vural Emre , McLaughlin Nathan , Hogue William R. , Suva Larry J. 
Published: March 2006

AbstractBackground: Static slings are one of the most commonly used surgical rehabilitation methods in the management of chronic facial paralysis. Acellular human cadaveric dermis (Alloderm; Life Cell Corp., Branchburg, NJ) is used for this purpose; however, it has variable stretching properties that may necessitate additional “tuning‐up” procedure(s). Acellular porcine dermis (Enduragen; Tissue Sciences Laboratories, plc., Aldershot, U.K.) was recently introduced as a biologic implant and it is compositionally similar to Alloderm. However, no data currently exist regarding its biomechanical properties and potential use as an alternative implant to Alloderm in static facial sling procedures.Objective: The objective of this study was to compare the biomechanical properties of Alloderm and Enduragen for static facial sling procedures in the management of the paralytic face.Study Design: This study consisted of an in vitro prospective study in an academic medical research setting.Methods: Same size and thickness Alloderm and Enduragen samples were tested with MTS 858 Bionix materials test system for load‐to‐failure, displacement under increasing and constant stress, and stiffness.Results: Enduragen showed significantly less elongation under increasing stress and at the beginning of constant stress. Load‐to‐failure and stiffness were significantly higher in Alloderm; however, both biomaterials have adequate stiffness and load‐to‐failure for a static facial sling procedure.Conclusions: Enduragen may serve as another potential static facial sling material, because it stretches significantly less than Alloderm under stress. Clinical experience is needed with Enduragen to determine its potential use as a static facial sling material.
EGFR Regulates the Side Population in Head and Neck Squamous Cell Carcinoma
Authors: Chen Jocelyn S. , Pardo Francisco S. , Wang‐Rodriguez Jessica , Chu Theresa S. , Lopez Jay Patrick , Aguilera Joseph , Altuna Xabier , Weisman Robert A. , Ongkeko Weg M. 
Published: March 2006

AbstractObjective: To identify the presence of side population (SP) cells in established head and neck squamous carcinoma cell (HNSCC) lines and to determine the role of EGFR in the regulation of the side population of these cells.Methods: SP cells were identified using flow cytometry analysis by the ability of these cells to extrude the Hoechst 33342 dye via the drug transporter BCRP1/ABCG2. Effect of EGFR on the side population was determined also by difference in Hoechst extrusion and by immunofluorescence. Immunohistochemical staining was performed to show the presence of the BCRP1/ABCG2 transporter and the phosphorylated form of EGFR in HNSCC tissue.Results: SP cells are present in HNSCC cell lines. With the Hoechst 33342 extrusion assay, SP cells were found to comprise an average of 0.69% of the UMSCC10B cells and 0.91% of HN12 cells. Addition of the EGF ligand increased the SP population while inactivation of the EGFR kinase by Iressa significantly decreased SP.Conclusion: In established head and neck squamous cell carcinoma cell lines, SP cells were found using methods that determine expression and function of the drug transporter BCRP1/ABCG2. Activation of EGFR, a gene implicated in tumorigenesis in HNSCC leads to increased SP, and conversely, inhibition of EGFR leads to decrease in SP. This finding could help explain the role of EGFR in regulating cancer stem cells and thus tumorigenesis in HNSCC.
Microvessel Density in Head and Neck Squamous Cell Carcinoma Primary Tumors and Its Correlation with Clinical Staging Parameters
Authors: Lentsch Eric J. , Goudy Steven , Sosnowski Jeffrey , Major Scott , Bumpous Jeffrey M. 
Published: March 2006

AbstractObjective: Our objective was to assess angiogenesis in head and neck squamous cell primary tumors and measure its correlation with tumor site and clinical and pathologic staging parameters.Study Design: Patients from the tumor registries of the University of Louisville and affiliated hospitals who had biopsy‐proven head and neck squamous cell carcinoma were retrospectively assessed over a 5‐year period (1995–2000).Methods: Patient records were reviewed for tumor site, TNM staging, surgical treatment, and tumor pathologic staging data. Cell blocks were obtained for each of the study patients, and CD31 staining was used to measure microvessel density (MVD) in areas of primary tumor hot spots.Results: Twenty‐eight consecutive patients met inclusion criteria and had adequate cell blocks for evaluation. MVD for T3 staged (41.2 MVD, mean) and T4 staged (36.4 MVD, mean) tumors were higher than earlier staged T1 staged (31.3 MVD, mean) and T2 staged (24.9 MVD, mean) tumors. Laryngeal T3 and T4 tumors had MVDs as high as 43.4 MVD (mean) and 40.4 MVD (mean), respectively, compared with a 23.9 MVD for T2 tumors. This difference was statistically significant (P < .01). Our report indicates a trend toward increasing MVD with N‐stage.Conclusion: Our series demonstrates that there is a strong correlation between MVD in primary tumor hot spots and tumor T‐stage, which implies that tumor angiogenesis may be a factor in tumor progression.