bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methicillin Resistance and Risk Factors for Embolism inStaphylococcus aureusInfective Endocarditis
Authors: Hsu Ron-Bin , Lin Fang-Yue 
Published: June 2007

Objective.Infective endocarditis caused byStaphylococcus aureusis an ominous prognosis associated with a high prevalence of embolic episodes and neurological involvement. Whether methicillin resistance decreases the risk of embolism in infective endocarditis is unclear. We sought to assess the association between methicillin resistance and risk factors for embolism in S.aureusinfective endocarditis.Design.Retrospective chart review. Data from patients with infective endocarditis due to methicillin-resistantS. aureus werecompared with data from patients with endocarditis due to methicillin-susceptibleS. aureus.Logistic regression was used to identify independent risk factors for embolism.Setting.A 2,000-bed, university-affiliated tertiary care hospital.Patients.Between 1995 and 2005, 123 patients withS. aureusinfective endocarditis were included in the study. There were 74 male patients and 49 female patients, with a median age of 54 years (range, 0-89 years).Results.Of 123 infections, 30 (24%) were nosocomial infections, and 14 (11%) were prosthetic valve infections. Of 123S. aureusisolates, 48 (39%) were methicillin resistant. In total, embolism occurred in 45 (37%) of these patients: pulmonary embolism in 22 (18%), cerebral embolism in 21 (17%), and peripheral embolism in 6 (5%). The independent risk factors for an embolism were injection drug use, presence of a cardiac vegetation with a size of 10 mm or greater, and absence of nosocomial infection. For 83 patients with aortic or mitral infective endocarditis, independent risk factors for an embolism were the presence of a cardiac vegetation with a size of 10 mm or greater and endocarditis due to methicillin-susceptibleS. aureus.Overall, in-hospital death occurred for 32 (26%) of 123 Patients. Methicillin-resistant infection was not an independent risk factor for death.Conclusions.Methicillin-resistant S.aureusinfection was associated with decreased risk of embolism in left-side endocarditis, but was not associated with in-hospital death.
Costs of Management of Occupational Exposures to Blood and Body Fluids
Authors: O'Malley Emily M. , Scott R. Douglas , Gayle Julie , Dekutoski John , Foltzer Michael , Lundstrom Tammy S. , Welbel Sharon , Chiarello Linda A. , Panlilio Adelisa L. 
Published: June 2007

Objective.To determine the cost of management of occupational exposures to blood and body fluids.Design.A convenience sample of 4 healthcare facilities provided information on the cost of management of occupational exposures that varied in type, severity, and exposure source infection status. Detailed information was collected on time spent reporting, managing, and following up the exposures; salaries (including benefits) for representative staff who sustained and who managed exposures; and costs (not charges) for laboratory testing of exposure sources and exposed healthcare personnel, as well as any postexposure prophylaxis taken by the exposed personnel. Resources used were stratified by the phase of exposure management: exposure reporting, initial management, and follow-up. Data for 31 exposure scenarios were analyzed. Costs were given in 2003 US dollars.Setting.The 4 facilities providing data were a 600-bed public hospital, a 244-bed Veterans Affairs medical center, a 437-bed rural tertiary care hospital, and a 3,500-bed healthcare system.Results.The overall range of costs to manage reported exposures was $71-$4,838. Mean total costs varied greatly by the infection status of the source patient. The overall mean cost for exposures to human immunodeficiency virus (HIV)-infected source patients (n = 19, including those coinfected with hepatitis B or C virus) was $2,456 (range, $907-$4,838), whereas the overall mean cost for exposures to source patients with unknown or negative infection status (n = 8) was $376 (range, $71-$860). Lastly, the overall mean cost of management of reported exposures for source patients infected with hepatitis C virus (n = 4) was $650 (range, $186-$856).Conclusions.Management of occupational exposures to blood and body fluids is costly, the best way to avoid these costs is by prevention of exposures.
Controlling for Severity of Illness in Assessment of the Association Between Antimicrobial-Resistant Infection and Mortality: Impact of Calculation of Acute Physiology and Chronic Health Evaluation (APACHE) II Scores at Different Time Points
Authors: Hamilton Keith W. , Bilker Warren B. , Lautenbach Ebbing 
Published: June 2007

Background.In studies of the association between antibiotic-resistant infection and mortality, the importance of controlling for the underlying severity of illness is well recognized. However, it is unclear when the severity of illness should be assessed. Controlling for severity of illness on the day the culture specimen is obtained may underestimate the true association between resistance and mortality.Objective.TO assess the impact of calculating the Acute Physiology and Chronic Health Evaluation (APACHE) II score at different time points on the association between antimicrobial resistance and mortality.Methods.We used an existing data set from a study that investigated the association between fluoroquinolone resistance and mortality. The APACHE II score was calculated at 3 time points: the day the culture specimen was obtained, 1 day before the culture specimen was obtained, and 2 days before the culture specimen was obtained. Separate multivariable models were constructed using the 3 different APACHE II scores. These models were compared qualitatively.Results.Of 91 total subjects, 51 were infected with a fluoroquinolone-resistant strain and 40 with a fluoroquinolone-susceptible strain. The median APACHE II score for all subjects was 13 (95% confidence interval [CI], 11-15) when calculated on the day the culture specimen was obtained, 12 (95% CI, 11-13) when calculated 1 day before, and 11 (95% CI, 10-13) when calculated 2 days before the culture specimen was obtained. Of 91 subjects, 12 (13.2%) died. The 3 multivariable models (each with the APACHE II score calculated on a different day) were not substantively different; the adjusted odds ratio for the association between fluoroquinolone-resistant infection and mortality varied only from 1.38 to 1.65 in the 3 models.Conclusions.APACHE II scores calculated at different time points relative to obtainment of the culture specimen did not differ substantively. Furthermore, when the adjusted association between fluoroquinolone resistance and mortality was assessed, there were no substantive differences across multivariable models that incorporated APACHE II scores calculated at different time points.
Reduction in Hospitalwide Incidence of Infection or Colonization with Methicillin-ResistantStaphylococcus aureusWith Use of Antimicrobial Hand-Hygiene Gel and Statistical Process Control Charts
Authors: Harrington Glenys , Watson Kerrie , Bailey Michael , Land Gillian , Borrell Susan , Houston Leanne , Kehoe Rosaleen , Bass Pauline , Cockroft Emma , Marshall Caroline , Mijch Anne , Spelman Denis 
Published: June 2007

Objective.To evaluate the impact of serial interventions on the incidence of methicillin-resistantStaphylococcus aureus(MRSA).Design.Longitudinal observational study before and after interventions.Setting.The Alfred Hospital is a 350-bed tertiary referral hospital with a 35-bed intensive care unit (ICU).Interventions.A series of interventions including the introduction of an antimicrobial hand-hygiene gel to the intensive care unit and a hospitalwide MRSA surveillance feedback program that used statistical process control charts but not active surveillance cultures.Methods.Serial interventions were introduced between January 2003 and May 2006. The incidence and rates of new patients colonized or infected with MRSA and episodes of MRSA bacteremia in the intensive care unit and hospitalwide were compared between the preintervention and intervention periods. Segmented regression analysis was used to calculate the percentage reduction in new patients with MRSA and in episodes of MRSA bacteremia hospitalwide in the intervention period.Results.The rate of new patients with MRSA in the ICU was 6.7 cases per 100 patient admissions in the intervention period, compared with 9.3 cases per 100 patient admissions in the preintervention period (P= .047). The hospitalwide rate of new patients with MRSA was 1.7 cases per 100 patient admissions in the intervention period, compared with 3.0 cases per 100 patient admissions in the preintervention period (P< .001). By use of segmented regression analysis, the maximum and conservative estimates for percentage reduction in the rate of new patients with MRSA were 79.5% and 42.0%, respectively, and the maximum and conservative estimates for percentage reduction in the rate of episodes of MRSA bacteremia were 87.4% and 39.0%, respectively.Conclusion.A sustained reduction in the number of new patients with MRSA colonization or infection has been demonstrated using minimal resources and a limited number of interventions.
Mutations inArabidopsis Multidrug Resistance-LikeABC Transporters Separate the Roles of Acropetal and Basipetal Auxin Transport in Lateral Root Development
Authors: Wu Guosheng , Lewis Daniel R. , Spalding Edgar P. 
Published: June 2007

AbstractAuxin affects the shape of root systems by influencing elongation and branching. Because multidrug resistance (MDR)-like ABC transporters participate in auxin transport, they may be expected to contribute to root system development. This reverse genetic study of Arabidopsis thaliana roots shows that MDR4-mediated basipetal auxin transport did not affect root elongation or branching. However, impaired acropetal auxin transport due to mutation of the MDR1 gene caused 21% of nascent lateral roots to arrest their growth and the remainder to elongate 50% more slowly than the wild type. Reporter gene analyses indicated a severe auxin deficit in the apex of mdr1 but not mdr4 lateral roots. The mdr1 deficit was explained by 40% less acropetal auxin transport within the mdr1 lateral roots. The slow elongation of mdr1 lateral roots was rescued by auxin and phenocopied in the wild type by an inhibitor of polar auxin transport. Confocal microscopy analysis of a functional green fluorescent protein–MDR1 translational fusion showed the protein to be auxin inducible and present in the tissues responsible for acropetal transport in the primary root. The protein also accumulated in lateral root primordia and later in the tissues responsible for acropetal transport within the lateral root, fully supporting the conclusion that auxin levels established by MDR1-dependent acropetal transport control lateral root growth rate to influence root system architecture.
Neuromuscular complications of thyrotoxicosis
Authors: Kung Annie W. C. 
Published: June 2007

SummaryThyroid hormones exert multiple effects on the neuromuscular system and the brain, with the most important being their role in stimulating the development and differentiation of the neuromuscular system and brain in foetal and neonatal life. In the presence of hyperthyroidism, muscular and neurological symptoms may be the presenting clinical features of the disease. The frequency and severity of neuromuscular complications vary considerably and are probably related to the degree of hyperthyroidism, although in some patients the neuromuscular dysfunction is caused by associated disorders rather than by hyperthyroidism per se. This update focuses on the most common neurological and muscular disorders that occur in patients with thyrotoxicosis. It is beyond the scope of this paper to discuss thyroid eye disease and cardiac complications, in themselves separate complications of specific myocytes.
Preoperative undetectable serum thyroglobulin in differentiated thyroid carcinoma: incidence, causes and management strategy
Authors: Giovanella Luca , Ceriani Luca , Ghelfo Antonella , Maffioli Marco , Keller Franco 
Published: June 2007

SummaryBackground  In recent years serum thyroglobulin (Tg) measurement during thyroxine (T4) treatment and/or after stimulation by endogenous TSH or recombinant human TSH (rhTSH) has eclipsed other diagnostic procedures in managing patients with differentiated thyroid cancer (DTC). However, preoperative undetectable Tg was reported in up to 12% of patients affected by DTC and recurrences of DTC with no increase in serum Tg have also been described. Clearly, a negative Tg measurement may falsely reassure both the patient and the clinician in these cases.Aim  We retrospectively evaluated the incidence of undetectable or reduced preoperative serum Tg in a group of 436 patients affected by DTC. Additionally, we evaluated the role of Tg retesting by two different immunoassays in patients with low Tg at first measurement.Methods  We retrospectively selected 17 patients with undetectable (i.e. less than functional sensitivity of assay method) or reduced Tg (i.e. between functional sensitivity and minimum normal value) among 436 patients with histologically proved DTC. The remaining 419 patients were used as control cases. Frozen sera from all patients were retested by two different Tg immunoassays.Results  Globally, 17 out of 436 (3·8%) patients showed undetectable (n = 5, 1·1%) or reduced (n = 12, 2·7%) preoperative Tg. The Tg level was above the minimum normal value in 3 and 4 out of 5, and 8 and 9 out of 12 of these patients, respectively, when two different immunoassays were employed. On the other hand, undetectable or reduced Tg levels were found in 3·0%–5·1% of control cases when different immunoassays were used.Conclusions  Regardless of the method employed, 3·0–5·1% of patients with DTC showed undetectable or reduced preoperative Tg. This fact must be recognized, as Tg cannot be used as a benchmark for DTC follow‐up in these cases. However, Tg retesting with different immunoassays seems to be useful in ruling out these pitfalls in a large majority of patients, and also indicates the most effective assay to be employed in these cases.
Enhanced exoenzyme activities in sediments in the presence of deposit‐feeding Chironomus riparius larvae
Authors: STIEF PETER 
Published: June 2007

Summary1. The combined effects of deposit‐feeding, bioturbation and bioirrigation by benthic macrofauna on the enzymatic hydrolysis of organic matter were studied in microcosms. Chironomus riparius larvae (Insecta, Diptera) served as model macrofauna and stinging nettle leaves (Urtica dioica) were used as a detrital food source.2. In the upper 10 mm of the sediment (the habitat of C. riparius larvae), the activities of several exoenzymes, the contents of several fractions of particulate organic matter (POM), and the concentrations of dissolved oxidants (O2, NO) were measured on a small scale. Fluorescent particles (luminophores) were used to quantify the vertical redistribution of particles within the same layer.3. In control sediment, the addition of detrital food enhanced exoenzyme activities in the 0–2 mm layer only. In the presence of C. riparius larvae, exoenzyme activities increased to 10 mm depth. Further, the content of POM in the 0–2 mm layer was lower in the presence than in the absence of larvae, suggesting ingestion and subduction of the added detritus. After prolonged incubation without further food addition, exoenzyme activities returned close to background values in both treatments, whereas the vertical distribution of POM remained unchanged.4. The overall penetration depth of O2 and NO into the sediment was greater in the presence than the absence of C. riparius, the differences being more pronounced after prolonged incubation. Locally high O2 and NO concentrations due to bioirrigation by C. riparius were measured deep in the sediment. Net downward transport of particles was observed only in the presence of C. riparius larvae and only at the beginning of the incubation.5. I conclude that deposit‐feeding and bioturbation by macrofauna can quickly remove freshly deposited POM from the sediment surface and transfer it to less oxygenated sites (i.e. animal guts and deep sediment layers). Bioirrigation also increases the availability of oxidants deep in the sediment. The oscillation of oxidant supply to POM particles by ingestion–egestion, burial and re‐burial, and the intermittent bioirrigation of subsurface sediment, is probably the cause of the increased rate of organic matter hydrolysis, the rate‐limiting step in mineralization.
Repeated matings and sperm depletion in the freshwater crayfish Austropotamobius italicus
Authors: RUBOLINI DIEGO , GALEOTTI PAOLO , PUPIN FABIO , SACCHI ROBERTO , NARDI PIETRO A. , FASOLA MAURO 
Published: June 2007

Summary1. In sexually reproducing organisms, the energetic costs of spermatogenesis can be considerable, and can limit the reproductive potential of the males. In species where males mate more than once during the reproductive season, the costs of sperm production are generally predicted to result in a decrease of ejaculate size and quality with successive fertilizations.2. In this study we examined the variation in ejaculate size among successive fertilizations in a long‐lived freshwater crayfish species, Austropotamobius italicus.3. Sexually active adult males of various sizes were allowed to mate repeatedly with different females on consecutive days. Trials for a given male ended when he copulated but did not release any sperm or refused to mate.4. Males fertilized between 0 and 4 females, and most (42.5%) fertilized a single female. The overall number of females fertilized by a given male decreased with increasing male body size. Ejaculate size decreased markedly with consecutive fertilizations in a similar fashion among both large and small males, while simultaneously increasing with female body size. The total ejaculate size over successive fertilizations decreased with increasing male size.5. Our study indicates that either sperm production or release involves non‐trivial costs in freshwater crayfish, and suggests that large/old males may face greater difficulties in gamete release than small/young ones, as shown by the lower number of females fertilized by large compared with small males, which may reflect the ongoing senescence of their reproductive performance.
The diffuse transition between the Zagros continental collision and the Makran oceanic subduction (Iran): microearthquake seismicity and crustal structure
Authors: Yamini-Fard F. , Hatzfeld D. , Farahbod A. M. , Paul A. , Mokhtari M. 
Published: June 2007

SummaryThe nature of the transition between the Zagros intra-continental collision and the Makran oceanic subduction is a matter of debate: either a major fault cutting the whole lithosphere or a more progressive transition associated with a shallow gently dipping fault restricted to the crust. Microearthquake seismicity located around the transition between the transition zone is restricted to the west of the Jaz-Murian depression and the Jiroft fault. No shallow micro-earthquakes seem to be related to the NNW-SSE trending Zendan-Minab-Palami active fault system. Most of the shallow seismicity is related either to the Zagros mountain belt, located in the west, or to the NS trending Sabzevaran-Jiroft fault system, located in the north. The depth of microearthquakes increases northeastwards to an unusually deep value (for the Zagros) of 40 km. Two dominant types of focal mechanisms are observed in this region: low-angle thrust faulting, mostly restricted to the lower crust, and strike-slip at shallow depths, both consistent with NS shortening. The 3-D inversion of P traveltimes suggests a high-velocity body dipping northeastwards to a depth of 25 km. This high-velocity body, probably related to the lower crust, is associated with the deepest earthquakes showing reverse faulting. We propose that the transition between the Zagros collision and the Makran subduction is not a sharp lithospheric-scale transform fault associated with the Zendan-Minab-Palami fault system. Instead it is a progressive transition located in the lower crust. The oblique collision results in partial partitioning between strike-slip and shortening components within the shallow brittle crust because of the weakness of the pre-existing Zendan-Minab-Palami faults.
Three‐dimensional photo‐elastic stress analysis of maxillary and mandibular complete dentures
Authors: KORAN A. , CRAIG R. G. 
Published: June 2007

SummaryThree‐dimensional photo‐elasticity was used to study the stress distribution in complete dentures in functional positions. A new loading device was developed utilizing a linear motion bearing as its main component and mandibular dentures were evaluated for the first time. The stress concentrations were highest (2.5 fringes) on the working side of the mandibular denture. This was also demonstrated in the maxillary denture; however, the magnitude was less (1.8 fringes). The results indicate that this method could be used to quantitatively evaluate the effect of various occlusal schemes upon the denture bases.
Functional analysis of fixed bridges on abutment teeth with reduced periodontal support
Authors: LUNDGREN DAN , NYMAN STURE , HEIJL LARS , CARLSSON GUNNAR E. 
Published: June 2007

SummaryThe present study examines (he function of fixed bridges on abutment teeth with reduced but non‐inflamed periodontal tissues. Eighteen patients with advanced periodontal breakdown and indication for oral rehabilitation received periodontal treatment and their dentitions were restored with fixed bridgework. The analysis of function performed 2‐5 years after insertion of the reconstructions was made by (1) evaluation of the patients' opinion on chewing ability and function of the masticatory system; (2) clinical examination of the border movements of the mandible, the status of the temporomandivular joints and the chewing muscles, and (3) measurements of the bite force in different areas of the dentition.The results of the study show that the functional capacity of the type of extensive bridgework discussed is good and that the patients–in spite of severe loss of periodontal tissue–achieve bite force values that are almost comparable to those in individuals with natural teeth. Comparison of the function of fixed bridges and that of removable dentures is also discussed.
Elastic tissue in the temporomandibular disc of miniature swine
Authors: CHRISTENSEN LARS VESTERGAARD 
Published: June 2007

SummarySix intraarticular discs from the temporomandibular joints of three miniature swine were examined for the distribution and orientation of elastic fibres. Elastic tissue was abundant in the posterior portion of the disc, less tissue was seen anteriorly and marginally and the least amount in the central portion.
The reproducibility of electromyographic recordings of the masseter muscle in humans
Authors: NOURI A. , ROTHWELL P. S. , DUXBURY A. J. 
Published: June 2007

SummaryAn investigation was undertaken into the reproducibility of electromyograms of masseter muscles in five human subjects. Under standardized conditions, integrated electromyographic recordings were taken during three sessions on each of 5 days. Analysis of variance showed that at the 0.05 probability level the results were reproducible for each subject not only during the same day but also between days.
Prosthetic treatment of dentinogemsis imperfecta
Authors: EERIKÄINEN ESKO 
Published: June 2007

SummaryProsthetic reconstruction was made on dentition affected by dentinogenesis imperfecta. The bite was first raised with fixed bite plates, and then with temporary acrylic bridges; finally full gold and veneer crowns were made in the posterior teeth. The crowns were retained on the severely attrited teeth with self‐threading parapulpal screws (TMS®, Whaledent International, New York, U.S.A.) and amalgam and composite resin (Consise®, 3M Company, St Paul, U.S.A.) posts. The teeth seem to have enough strength to withstand the occlusal forces, and the dentine appears hard enough to retain parapulpal screws. The prosthetic construction is still functioning well today, 5 years after starting treatment.