bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histopathologic and Cytopathologic Diagnostic Discrepancies in Head and Neck Region: Pitfalls, Causes, and Preventive Strategies
Authors: Fathallah Lamia , Tulunay Ozlem E. , Feng Jining , Husain Mujtaba , Jacobs John R. , Al‐Abbadi Mousa A. 
Published: February 2006

BACKGROUNDClinicians commonly utilize fine needle aspiration biopsy (FNAB) for the primary investigation of head and neck masses. Correlation of these results with the surgical resection diagnosis is an essential part of quality control and assurance programs in all cytology laboratories.METHODSOf 610 cases, 20 (3.3%) had corresponding surgical resections performed within 3 months of the FNAB, with a discrepant diagnosis identified through a search that involved all FNABs performed on the head and neck region, excluding the thyroid gland, at Wayne State University between 1999 and 2004. Sites of discrepant samples included the parotid or submandibular gland (n = 5), lymph nodes (n = 8), and paratracheal/paraesophageal neck masses (n = 7).RESULTSThe reasons of false‐negative FNABs included sampling errors (n = 3), insufficient material for an adequate interpretation (n = 5), lack of triage necessary for ancillary studies (n = 4), and interpretation errors (n = 6). There were 2 false‐positive FNABs, both reported as mucoepidermoid carcinoma and showed chronic sialadenitis in one and lymphoepithelial cyst in the other.CONCLUSIONSFNAB is an effective tool for the diagnosis and triage of patients with head and neck masses that can be further improved with an onsite immediate adequacy evaluation and triage performed by a pathologist.
Correlation between Middle Turbinate and Ipsilateral Ethmoid Histopathology in Chronic Rhinosinusitis
Authors: Busaba Nicolas Y. , Shin Hyei Jung , Faquin William C. 
Published: February 2006

OBJECTIVEStudy the concept of “rhinosinusitis” in patients with inflammatory paranasal sinus disease (IPSD).STUDY DESIGN AND SETTINGProspective case control series in a tertiary care facility. Twenty‐two consecutive patients with IPSD without polyposis were enrolled. A partial middle turbinectomy and ethmoidectomy were performed and the histopathologic findings of the surgical specimens from the 2 sites was studied. The general degree of inflammation, epithelial thickening, and inflammatory cell count were measured.RESULTSThe degree of middle turbinate inflammation correlated with that of the ipsilateral ethmoid sinus (Spearman's rho coefficient = 0.450; P < 0.05). Epithelial thickness was more prominent in the ethmoid sinus. The total inflammatory cell count was comparable. There was a statistically significant correlation among total inflammatory cell count, plasma cell count, and eosinophil count between the 2 sites.CONCLUSIONThe ethmoid sinus inflammation in IPSD is accompanied by a commensurate ipsilateral middle turbinate inflammation.SIGNIFICANCEThe data support the use of the term “rhino‐sinusitis.”
Perioperative Complications with the Bone‐Anchored Hearing Aid
Authors: Shirazi Mobeen A. , Marzo Sam J. , Leonetti John P. 
Published: February 2006

OBJECTIVETo discuss perioperative complications associated with the bone‐anchored hearing aid (BAHA) and their management.STUDY DESIGN AND SETTINGA retrospective review of 58 patients who underwent implantation of BAHA for unilateral conductive, mixed, or sensorineural hearing losses was performed at a tertiary referral center.RESULTSBetween September 2003 and June 2005, 58 patients underwent implantation of a BAHA. There were 30 female and 28 male patients, with a mean age of 48 years (range 8–80 years). Complications occurred in 19% (11/58) of patients. Most adverse events were seen early in the series. The most common complication, partial or complete loss of the skin graft, occurred in 10% (6/58) of patients. These were managed successfully with local wound care. Five percent (3/58) of patients had skin growth over the abutment. Two of these cases were managed with office debridement, whereas 1 patient required revision under general anesthesia. There was implant extrusion in 3% (2/58) of patients, and both of these patients later underwent successful reimplantation. All patients had their implant activated 3 months after surgery. There were no perioperative or postoperative deaths.CONCLUSIONComplications related to BAHA implantation are relatively minor and usually involve partial or complete loss of the skin graft. Most complications were successfully managed in the office.
Patient Selection and Efficacy of Pillar Implant Technique for Treatment of Snoring and Obstructive Sleep Apnea/Hypopnea Syndrome
Authors: Friedman Michael , Vidyasagar Ramakrishnan , Bliznikas Darius , Joseph Ninos J. 
Published: February 2006

OBJECTIVEPillar implant (PIT) is a simple, office‐based procedure with minimal morbidity that was introduced in 2003 to treat snoring and mild/moderate obstructive sleep apnea/hypopnea syndrome (OSAHS). We studied the: (1) success rate using subjective symptoms and objective polysomnographic improvement; (2) success rate based on BMI, OSAHS severity and Friedman tongue position (FTP); and (3) its value as an adjunctive or revision procedure.STUDY DESIGN AND SETTINGRetrospective review of 125 patients who underwent the PIT for snoring and OSAHS. Patients were grouped: Group I had PIT only (n = 29); Group II received adjunctive nasal procedures (n = 37), Group III received adjunctive oropharyngeal procedures (n = 55); and Group IV had failed previous UPPP (n = 4).RESULTSOverall subjective and objective “cure” rates were 88.0% and 34.4%, respectively. Group IIb had the best objective cure rate of 46.7%. Neither AHI nor BMI correlated with outcome measures, whereas FTP did correlate. (FTP I and II had improved success vs FTP III and IV). Ten patients had partial extrusion of the PIT. These were removed and new PIT were carried out at a later date.CONCLUSIONSBased on a short‐term study, the Pillar implant is an effective treatment for snoring and OSAHS in selected patients and can be combined with adjunctive procedures to treat OSAHS.
Purinoceptors as therapeutic targets for lower urinary tract dysfunction
Authors: Ford Anthony P D W. , Gever Joel R. , Nunn Philip A. , Zhong Yu , Cefalu Joseph S. , Dillon Michael P. , Cockayne Debra A. 
Published: February 2006

Lower urinary tract symptoms (LUTS) are present in many common urological syndromes. However, their current suboptimal management by muscarinic and α1‐adrenoceptor antagonists leaves a significant opportunity for the discovery and development of superior medicines. As potential targets for such therapeutics, purinoceptors have emerged over the last two decades from investigations that have established a prominent role for ATP in the regulation of urinary bladder function under normal and pathophysiological conditions. In particular, evidence suggests that ATP signaling via P2X1 receptors participates in the efferent control of detrusor smooth muscle excitability, and that this function may be heightened in disease and aging. ATP also appears to be involved in bladder sensation, via activation of P2X3 and P2X2/3 receptors on sensory afferent neurons, both within the bladder itself and possibly at central synapses. Such findings are based on results from classical pharmacological and localization studies in non‐human and human tissues, knockout mice, and studies using recently identified pharmacological antagonists – some of which possess attributes that offer the potential for optimization into candidate drug molecules. Based on recent advances in this field, it is clearly possible that the development of selective antagonists for these receptors will occur that could lead to therapies offering better relief of sensory and motor symptoms for patients, while minimizing the systemic side effects that limit current medicines.British Journal of Pharmacology (2006) 147, S132–S143. doi:10.1038/sj.bjp.0706637
Clinical and Laboratory Features of Community-Associated Methicillin-ResistantStaphylococcus aureus:Is It Really New?
Authors: Johnson Leonard B. , Saeed Sajjad , Pawlak Joan , Manzor Odette , Saravolatz Louis D. 
Published: February 2006

Objective.To review the epidemiologic and molecular characteristics of community-associated methicillin-resistantStaphylococcus aureus(CA-MRSA) in Detroit, Michigan, to assess the risk factors for infection and the response to therapy.Design.Prospective clinical and laboratory study of 2003-2004 CA-MRSA isolates. Molecular features were compared with CA-MRSA isolates from 1980.Setting.A 600-bed urban academic medical center.Patients.Twenty-three patients with CA-MRSA infections from 2003-2004 were evaluated. In addition, laboratory analysis was performed on 13 CA-MRSA isolates from 1980.Main Outcome Measures.Laboratory analysis of isolates included antimicrobial susceptibility testing, pulsed-field genotyping, testing for Panton-Valentine leukocidin (PVL) genes, and staphylococcal cassette chromosomemectyping.Results.Patients were predominantly young African American males and presented with skin and soft-tissue infections. All isolates were resistant to erythromycin and highly susceptible to other agents. Patients were generally treated successfully with combination incision and drainage and systemic antibiotics. Among the 23 isolates, 20 (87%) were the same strain. This strain carried the staphylococcal cassette chromosomemectype IV and PVL genes and is genetically identical to USA 300. Thirteen isolates of patients from our community who presented with CA-MRSA infections in 1980 represented a single clone that is unique compared with the 2003-2004 isolates. This strain carried staphylococcal cassette chromosomemectype IVA but did not carry the PVL genes.Conclusions.In our community, CA-MRSA is largely due to a single clone with a type IVmecgene and PVL gene. The type IV staphylococcal cassette chromosomemectype can be demonstrated in CA-MRSA isolates from a remote period, suggesting that earlier outbreaks were not related to healthcare exposure.
The Role of Institutional Epidemiologic Weight in Guiding Infection Surveillance and Control in Community and Hospital Populations
Authors: Hartley David M. , Furuno Jon P. , Wright Marc O. , Smith David L. , Perencevich Eli N. 
Published: February 2006

Background.Institutions such as hospitals, prisons, and long-term care facilities have been identified as focal points for the transmission of emerging infections. Cost-effective control of these infections in large populations requires the identification of optimal subpopulations for targeted infection control interventions. Our objective was to quantify and compare the relative impact that individual institutions or subpopulations have on wider population-level outbreaks of emerging pathogens.Design.We describe a simple mathematical model to compute the epidemiologic weight (EW) of an institution or subpopulation. The EW represents the rate at which newly infectious individuals exit the institution under consideration.Setting.A hypothetical academic tertiary-care hospital (700 beds, 5-day length of stay [LOS]) and prison (3098 inmates, 27-day LOS).Patients.Individuals entering a hospital in-patient prison ward and nonprisoners entering both medical and surgical intensive-care units and those admitted to the general medical and surgical wards.Results.The recent example of the community-acquired methicillin-resistantStaphylococcus aureusepidemic is used to illustrate the EW calculation. Hospitals and prisons, which often have vastly dissimilar populations sizes and LOSs and might have differing transmission rates, can have comparable EWs and thus contribute equally to an epidemic in the community.Conclusions.This method highlights the importance of measuring entrance and exit colonization prevalences for the optimal targeting of prevention measures. The EW not only identified superspreader institutions but also ranks them, enabling public health workers to optimize the allocation of resources to places where they are likely to be of most benefit.
The Influence of the Composition of the Nursing Staff on Primary Bloodstream Infection Rates in a Surgical Intensive Care Unit
Authors: Robert Jérôme , Fridkin Scott K. , Blumberg Henry M. , Anderson Betsy , White Nancy , Ray Susan M. , Chan Jinlene , Jarvis William R. 
Published: February 2006

AbstractObjectives:To determine the risk factors for acquisition of nosocomial primary bloodstream infections (BSIs), including the effect of nursing-staff levels, in surgical intensive care unit (SICU) patients.Design:A nested case-control study.Setting:A 20-bed SICU in a 1,000-bed inner-city public hospital.Patients:28 patients with BSI (case-patients) were compared to 99 randomly selected patients (controls) hospitalized ≥3 days in the same unit.Results:Case- and control-patients were similar in age, severity of illness, and type of central venous catheter (CVC) used. Case-patients were significantly more likely than controls to be hospitalized during a 5-month period that had lower regular-nurse-to-patient and higher pool-nurse-to-patient ratios than during an 8-month reference period; to be in the SICU for a longer period of time; to be mechanically ventilated longer; to receive more antimicrobials and total parenteral nutrition; to have more CVC days; or to die. Case-patients had significantly lower regular-nurse-to-patient and higher pool-nurse-to-patient ratios for the 3 days before BSI than controls. In multivariate analyses, admission during a period of higher pool-nurse-to-patient ratio (odds ratio [OR]=3.8), total parenteral nutrition (OR=1.3), and CVC days (OR=1.1) remained independent BSI risk factors.Conclusions:Our data suggest that, in addition to other factors, nurse staffing composition (ie, pool-nurse-to-patient ratio) may be related to primary BSI risk. Patterns in intensive care unit nurse staffing should be monitored to assess their impact on nosocomial infection rates. This may be particularly important in an era of cost containment and healthcare reform.
Evaluation of Two Retrospective Active Surveillance Methods for the Detection of Nosocomial Infection in Surgical Patients
Authors: Belío-Blasco Cristina , Torres-Fernández-Gil M. Antonia , Echeverría-Echarri J. Lorenzo , Gómez-López Luis I. 
Published: February 2006

AbstractObjective:To compare the sensitivity and specificity of two retrospective active surveillance methods based on review of the medical record and review of the discharge form in identifying nosocomial infection, taking the prospective surveillance method as the reference standard.Design:Blind comparison of three active nosocomial infection surveillance methods.Setting:Department of General Surgery of a tertiary-care hospital with a referral population of 266,000 people.Methods:All operated patients admitted to the Department of Surgery for more than 24 hours and discharged from January 1, 1994, to December 31, 1994, were included. Prospective surveillance consisted of daily review of the patient's record during hospitalization. Retrospective surveillance consisted of review of the medical record and the discharge form. Sensitivity and specificity of both retrospective methods were calculated.Results:Of the 1,514 patients included in the study, 1,476 (97.5%) were reviewed by means of the retrospective surveillance system. A total of 20, 8, and 4 hours per week was needed for the active prospective system, review of the medical record, and review of the hospital discharge form, respectively. The documented cumulative incidence of nosocomial infection was 21.8% for the prospective system, 19.6% for review of the medical record, and 12.6% for review of the discharge form. The overall sensitivity of review of the medical record was 88% and of the discharge form 56%, with a specificity of 99%. For review of the medical record, the highest sensitivity was 93%, for urinary tract infections; for review of the discharge form, the highest was 57%, for surgical-wound infection.Conclusions:The retrospective method of review of the medical record was the most efficient active surveillance strategy in detecting nosocomial infection in surgical patients
Tuberculosis Isolation Comparison of Written Procedures and Actual Practices in Three California Hospitals
Authors: Sutton Patrice M. , Nicas Mark , Harrison Robert J. 
Published: February 2006

AbstractObjective:To evaluate implementation of healthcare worker exposure control measures for tuberculosis (TB)-patient isolation, as specified by Centers for Disease Control and Prevention (CDC) guidelines and the hospital's TB-control policy.Design:Prospective multihospital study comparing CDC guidelines and hospital policy for TB-patient isolation to once-weekly observations of TB-patient isolation practices over 14 consecutive weeks at each hospital.Setting:Three urban hospitals (two county, one private community) in counties in California with a high incidence rate of TB.Measurements:Work practices for TB-patient isolation were observed and ventilation performance of isolation rooms was assessed while patient rooms were in use for TB isolation.Results:Of 170 TB-patient rooms observed, 119 (70%) involved a patient in a designated TB isolation room, the room was under negative pressure, the door was closed, and a “respiratory precautions” sign was on the door; 32 patient-room units (19%) were not under negative pressure or not designated as negative-pressure rooms. Of 151 patient-room units mechanically capable of negative pressure at a prior point in time, 16 (11%) were not under negative pressure at the time of use. Of 67 patient-room units equipped with continuous monitoring devices, 8 (12%) involved devices that did not accurately reflect the direction of airflow. Of the 62 healthcare workers observed using a respirator for TB, 40 (65%) did not don the respirator properly.Conclusions:Implementing CDC guidelines for TB-patient isolation was feasible but imperfect in the three hospitals. Day-to-day work practices deviated from hospital policy. Prospectively quantifying the implementation of a hospital TB isolation policy while the room is in use may lead to improved estimates of risk and may help to identify and thereby prevent avoidable healthcare worker exposures toMycobacterium tuberculosisaerosol. Auditing practices and verifying equipment performance is likely to identify unexpected problems in implementation of the TB control program.
Prevalence of Positive Tuberculin Skin Reactions in a Two-Step Testing Program at a Tertiary-Care Center in Eastern North Carolina
Authors: Swinker Marian 
Published: February 2006

AbstractThe results of performing two-step tuberculin skin testing of healthcare workers at a hospital in eastern North Carolina in 1997 and 1998 were reviewed. Of 1,248 new employees, approximately 500 required two-step testing, which identified only 5 new employees who might have been falsely labeled as converters during the subsequent year's surveillance testing.
Practical Guidelines for Vancomycin Usage, With Prospective Drug-Utilization Evaluation
Authors: Drori-Zeides Tayl , Raveh David , Schlesinger Yechiel , Yinnon Amos M. 
Published: February 2006

AbstractTo strengthen guidelines for vancomycin use, practical guidelines were developed. A prospective survey was conducted of all patients receiving vancomycin during two 1-month periods, 1 year apart, during which significant improvements were noted. Practical guidelines may contribute to appropriateness of vancomycin use, serve as educational tools, and facilitate improved surveillance.
Vancomycin Use in Pediatric Hematology-Oncology Patients
Authors: Hopkins Heidi A. , Sinkowitz-Cochran Ronda L. , Rudin Benjamin A. , Keyserling Harry L. , Jarvis William R. 
Published: February 2006

AbstractA cross-sectional study was performed of pediatric hematology-oncology patients who received vancomycin; use was compared to the Centers for Disease Control and Prevention (CDC) recommendations for vancomycin use. Thirty-seven patients received 308 doses of vancomycin. All patients initially received vancomycin as empirical therapy; 100% of this use was not consistent with the CDC recommendations.
Nosocomial Pseudo-outbreak ofFusarium verticillioidesAssociated With Sterile Plastic Containers
Authors: Grigis Annalisa , Farina Claudio , Symoens Françoise , Nolard Nicole , Goglio Antonio 
Published: February 2006

AbstractTwenty-six patients were implicated in a nosocomial pseudo-outbreak ofFusarium verticillioides. Examination of clinical records and handling procedures revealed a fungal contamination of supposedly sterile containers used for biological materials. An accurate system of monitoring permitted us to determine the origin of the infection and the means of its spread.
What's the Score?
Authors: Birnbaum David 
Published: February 2006

AbstractIf you have calculated a confidence interval for an infection rate and found the interval extending into meaningless negative numbers, chances are the error is due to use of approximation formulae. Many of us unknowingly were taught to use the Wald approximation, which does not always approximate the exact binomial distribution accurately. Poor approximation can occur in infection surveillance at both small and large sample sizes.
Control of Influenza in the Long-Term–Care Facility: A Review of Established Approaches and Newer Options
Authors: Arden Nancy H. 
Published: February 2006

AbstractInfluenza infections pose a serious threat to residents of nursing homes and other long-term–care facilities. Annual vaccination of residents and staff with the currently licensed inactivated influenza vaccine continues to be the mainstay of prevention. Live attenuated influenza vaccine, which is expected to be licensed in the United States in the near future, may offer added protection for elderly persons when administered in conjunction with inactivated vaccine. Antiviral agents also can be useful as an adjunct to vaccination, especially for control of institutional outbreaks. Two new antiviral agents that appear to be less toxic than amantadine and rimantadine have recently been approved.
Epidemiological Differences Between Sepsis Syndrome With Bacteremia and Culture-Negative Sepsis
Authors: Fariñas-Álvarez Concepción , Fariñas M. Carmen , Fernández-Mazarrasa Carlos , Llorca Javier , Delgado-Rodríguez Miguel 
Published: February 2006

AbstractObjective:To explore the association of putative disease markers and potential risk factors with the nosocomial sepsis syndrome.Design:Prospective case-control study matched for gender, age, and length of preinfection hospital stay.Setting:1,200-bed tertiary-care center in Spain.Patients:Cases were selected using the sepsis syndrome criteria of the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference and were divided into three groups: sepsis with bacteremia (109 cases), sepsis with positive culture other than blood (122 cases), and sepsis with negative culture (115 cases without documented infection but with sepsis syndrome, clinically suspected infection, and empirical antibiotic treatment). Controls were randomly selected from the daily list of inpatients. Data were collected prospectively. Crude and multiple-risk-factor-adjusted odds ratios and their 95% confidence intervals were computed using conditional logistic regression analysis.Results:Presence of coma in the 48 hours before sepsis, intensive care unit (ICU) stay, and decreased serum albumin levels at admission were common epidemiological markers identified for the three groups of cases. Having a central venous catheter was the main healthcare-related risk factor for bacteremia. ICU stay and nasogastric tube were the main risk factors for sepsis with positive culture other than blood. Coma within 48 hours before sepsis and the need of intensive care were the only two markers identified for culture-negative sepsis.Conclusion:Culture-negative sepsis does not behave like culture-positive sepsis, and this may imply that implementation of preventive measures to decrease the risk of bacteremia may not decrease the risk of sepsis syndrome.