bluuebunny/crossref_metadata_2025_split huggingface dataset:
General practice encounters with older Australians
Authors: O'Halloran Julie , Britt Helena 
Published: May 2004

Objectives: To describe the content of general practitioners’ (GP) encounters with patients aged 65 years or more, and to determine any differences in the way problems are managed between the 65–74 and 75 years and over age groups. Method: A secondary analysis of data collected through the Bettering the Evaluation and Care of Health (BEACH) program was carried out. Results: Encounters with older patients accounted for 25.0% of a GP's total workload. Circulatory conditions, in particular hypertension, were the most frequently managed, with cardiovascular medications the most frequently prescribed. Numerous differences exist in the characteristics and management of older patients when divided into those aged 65–74 and 75 years and over, with patients aged 75 years or more receiving investigations and non‐pharmacological treatments significantly less often. Conclusion: The present study provides a baseline measure of the management of older patients in general practice.
Vitamin D deficiency and secondary hyperparathyroidism in older people with low trauma fractures
Authors: Hii Susanna , Scherer Sam 
Published: May 2004

Objectives: To determine the prevalence of vitamin D deficiency and hyperparathyroidism in older patients with low trauma fractures, and to develop a statistical model to predict the serum level of 25‐hydroxyvitamin D required to prevent secondary hyperparathyroidism. Method: Descriptive cohort study conducted in an aged care centre in Melbourne, Australia. Participants comprised 107 patients aged over 65 years with low trauma fractures. Serum 25‐hydroxyvitamin D (25OHD), parathyroid hormone (PTH) and plasma creatinine levels were measured. Anthropometric data, Barthel index, Mini‐Mental State Examination and use of diuretics were also assessed. Results: Fifty‐one per cent of patients had 25OHD <30 nmol/L and 86% had 25OHD <50 nmol/L. Thirty‐two per cent had secondary hyperparathyroidism which was significantly associated with vitamin D deficiency and use of frusemide. Statistical models demonstrated higher PTH at serum 25OHD below 60 nmol/L. Conclusions: Vitamin D deficiency is common among older people. Serum 25OHD may need to be greater than 60 nmol/L to prevent secondary hyperparathyroidism.
Risk factors for and prediction of falls in an acute aged care psychiatry unit
Authors: Draper Brian , Busetto Giselle , Cullen Breda 
Published: May 2004

Objectives: To evaluate the predictive value of the Aged Care Psychiatry Unit (ACPU) Falls Screen and to describe the outcomes associated with falls in an acute aged care psychiatry unit. Methods: The development of the ACPU Falls Screen for use in an acute aged care psychiatry unit is described. Consecutive admissions to an acute aged care psychiatry unit were assessed prospectively with the ACPU Falls Screen, Health of the Nation Outcomes Scale for older persons (HoNOS 65+) and the Resource Utilisation Groups Activities of Daily Living (RUG ADL) Scale. Details of all falls and their consequences were documented on a falls incident form. Other information, extracted from medical records, included psychiatric and medical diagnoses, psychotropic medication prescription, electroconvulsive therapy (ECT), length of stay and demographic data. Multiple logistic regression was used to examine putative predictors of falls. Results: Ninety‐five admissions were included in the sample, of which 28 (29%) had falls. Multiple falls occurred in 16% of admissions. No serious injuries were recorded. Falls were associated with significantly higher scores on the ACPU Falls Screen, behavioural overactivity and recent receipt of ECT. However, falls were not associated with significant differences in psychiatric outcome, although multiple falls were associated with an increased length of stay. Receiver operating characteristic (ROC) curves for the ACPU Falls Screen indicated it had poor predictive value for falls. Conclusions: Falls are common in acute aged care psychiatry units. The ACPU Falls Screen was not a good predictor of falls. Universal precautions should be taken to prevent falls, particularly after ECT and in admissions with behavioural overactivity.
Distribution of Insertion Sequences Associated with Tn
1546
-Like Elements among
Enterococcus faecium
Isolates from Patients in Korea
Authors: Huh Ji Young , Lee Wee Gyo , Lee Kyungwon , Shin Wan Shik , Yoo Jin Hong 
Published: May 2004

ABSTRACT

The
vanA
gene cluster is carried as a part of Tn
1546
-like elements. The genetic diversity in Tn
1546
-like elements has been documented previously. The differences described thus far have included the integration of insertion sequence (IS) elements IS
1216V
, IS
1251
, IS
1476
, and IS
1542
. Among these, IS
1216V
has been reported to be widespread in VanA enterococci of diverse geographic areas, whereas IS
1542
and IS
1476
have been reported only in the United Kingdom and Canada, respectively. We investigated the distribution of ISs among 20
vanA
-containing
Enterococcus faecium
isolates from human patients in nine different university hospitals in Korea. Pulsed-field gel electrophoresis (PFGE) was performed to identify the clonality of the isolates. Moreover, PCR amplification of the internal regions of Tn
1546
was performed for structural analysis of the
van
gene, and both DNA strands of the PCR amplicons were directly sequenced by the dideoxy termination method. The PFGE patterns revealed a high degree of clonal diversity. Structural analyses of the
van
gene detected IS
1542
and IS
1216V
in the genomes of all 20 isolates, whereas it did not detect IS
1476
or IS
1251
in the genomes of any of the isolates. In addition, IS
19
was detected in the
vanS
-
vanH
intergenic region of one isolate. These data indicate that identification of the IS within a
vanA
gene cluster could be a useful tool in epidemiological investigations. In addition, the distribution of ISs associated with Tn
1546
-like elements among the Korean isolates is therefore similar to that among European vancomycin-resistant enterococci.
Rapid Screening Method for Detection of Bacteria in Platelet Concentrates
Authors: Ribault S. , Harper K. , Grave L. , Lafontaine C. , Nannini P. , Raimondo A. , Besson Faure I. 
Published: May 2004

ABSTRACTPublic awareness has long focused on the risks of the transmission of viral agents through blood product transfusion. This risk, however, pales in comparison to the less publicized danger associated with the transfusion of blood products contaminated with bacteria, in particular, platelet concentrates. Up to 1,000 cases of clinical sepsis after the transfusion of platelet concentrates are reported annually in the United States. The condition is characterized by acute reaction symptoms and the rapid onset of septicemia and carries a 20 to 40% mortality rate. The urgent need for a method for the routine screening of platelet concentrates to improve patient safety has long been recognized. We describe the development of a rapid and highly sensitive method for screening for bacteria in platelet concentrates for transfusion. No culture period is required; and the entire procedure, from the time of sampling to the time that the final result is obtained, takes less than 90 min. The method involves three basic stages: the selective removal of platelets by filtration following activation with a monoclonal antibody, DNA-specific fluorescent labeling of bacteria, and concentration of the bacteria on a membrane surface for enumeration by solid-phase cytometry. The method offers a universal means of detection of live, nondividing, or dead gram-negative and gram-positive bacteria in complex cellular blood products. The sensitivity is higher than those of the culture-based methods available at present, with a detection limit of 10 to 102CFU/ml, depending upon the bacterial strain.
Comparison of a Duplex Quantitative Real-Time PCR Assay and the COBAS Amplicor CMV Monitor Test for Detection of Cytomegalovirus
Authors: Herrmann Björn , Cavaglia Larsson Viviana , Rubin Carl-Johan , Sund Fredrik , Eriksson Britt-Marie , Arvidson Johan , Yun Zhibing , Bondeson Kåre , Blomberg Jonas 
Published: May 2004

ABSTRACT

A duplex quantitative real-time PCR (qPCR) assay was designed to detect both the polymerase gene (
pol
) and the glycoprotein gene (
gB
) of cytomegalovirus (CMV). The detection limit of the qPCR was determined to be 1 to 3 copies/reaction and the linear measure interval was 10
3
to 10
8
copies/ml. The qPCR system was compared to the COBAS Amplicor CMV Monitor test (COBAS) by an analysis of 138 plasma samples. Both systems detected CMV in 71 cases and had negative results for 33 samples. In addition, 34 samples were positive by qPCR and negative by the COBAS assay, but in no case was the COBAS result positive and the qPCR result negative. Thus, qPCR detected 48% more positive cases than the COBAS method. For samples with ≥10
5
copies/ml by qPCR, a saturation effect was seen in the COBAS assay and quantification required dilution. Copy numbers for
pol
and
gB
by qPCR generally agreed. However, the reproducibility of qPCR assays and the need for an international standard are discussed. Discrepant copy numbers for
pol
and
gB
by qPCR were found for samples from two patients, and sequence analysis revealed that the corresponding CMV strains were mismatched at four nucleotide positions compared with the
gB
fragment primer sequences. In conclusion, a duplex qPCR assay in a real-time format facilitates quantitative measurements and minimizes the risk of false-negative results.
Clinically Feasible Biofilm Susceptibility Assay for Isolates of
Pseudomonas aeruginosa
from Patients with Cystic Fibrosis
Authors: Moskowitz Samuel M. , Foster Jessica M. , Emerson Julia , Burns Jane L. 
Published: May 2004

ABSTRACT

Pseudomonas aeruginosa
is the predominant cause of chronic airway infection in cystic fibrosis (CF). CF airway isolates are often tested for antibiotic susceptibility but are rarely eradicated by the antibiotics identified as potentially effective. The growth state of
P. aeruginosa
in CF airways is probably different from that exhibited under conventional susceptibility testing conditions and may represent a bacterial biofilm. Biofilm susceptibility testing methods were adapted to create an assay for implementation in a clinical microbiology laboratory. This assay gave reproducible results when examined in 300 paired determinations with 12 antimicrobial agents, with a serious error rate of 5.7%. The biofilm assay was used retrospectively to test these 12 agents against 94 isolates from 41 CF patients. The biofilm inhibitory concentrations (BICs) were much higher than the corresponding conventionally determined MICs for the β-lactam antibiotics (median values: aztreonam, >128 μg/ml versus 4 μg/ml; ceftazidime, 128 μg/ml versus 2 μg/ml; piperacillin-tazobactam, 256 μg/ml versus 4 μg/ml; and ticarcillin-clavulanate, 512 μg/ml versus 16 μg/ml, respectively) and doxycycline (>64 μg/ml versus 16 μg/ml); and similar for meropenem (4 μg/ml versus ≤ 1 μg/ml), ciprofloxacin (0.5 μg/ml versus 1 μg/ml), and the aminoglycosides amikacin (32 μg/ml versus 16 μg/ml), gentamicin (16 μg/ml versus 8 μg/ml), and tobramycin (4 μg/ml versus 2 μg/ml). The median BIC for azithromycin was 2 μg/ml, whereas isolates were uniformly resistant when tested by standard methods. This demonstrates the feasibility of adapting biofilm susceptibility methods to the clinical microbiology laboratory and opens the way to examining whether biofilm testing might be used to select more effective antibiotic combinations for CF airway infections than methods in current use.
Performance Assessment of DNA Fragment Sizing by High-Sensitivity Flow Cytometry and Pulsed-Field Gel Electrophoresis
Authors: Ferris Matthew M. , Yan Xiaomei , Habbersett Robbert C. , Shou Yulin , Lemanski Cheryl L. , Jett James H. , Yoshida Thomas M. , Marrone Babetta L. 
Published: May 2004

ABSTRACT

The sizing of restriction fragments is the chief analytical technique utilized in the production of DNA fingerprints. Few techniques have been able to compete with pulsed-field gel electrophoresis (PFGE), which is capable of discriminating among bacteria at species and strain levels by resolving restriction fragments. However, an ultrasensitive flow cytometer (FCM) developed in our lab has also demonstrated the ability to discriminate bacteria at species and strain levels. The abilities of FCM warrant a quantitative parallel comparison with PFGE to assess and evaluate the accuracy and precision of DNA fragment sizing by both techniques. Replicate samples of
Staphylococcus aureus
Mu50 were analyzed along with two clinical
S. aureus
isolates. The absolute fragment sizing accuracy was determined for PFGE (5% ± 2%) and FCM (4% ± 4%), with sequence-predicted Mu50 SmaI fragment sizes used as a reference. Precision was determined by simple arithmetic methods (relative standard deviation for PFGE [RSD
PFGE
] = 3% ± 2% and RSD
FCM
= 1.2% ± 0.8%) as well as by the use of dendrograms derived from Dice coefficient-unweighted pair group method with arithmetic averages (UPGMA) and Pearson-UPGMA analyses. All quantitative measures of PFGE and FCM precision were equivalent, within error. The precision of both methods was not limited by any single sample preparation or analysis step that was tracked in this study. Additionally, we determined that the curve-based clustering of fingerprint data provided a more informative and useful assessment than did traditional band-based methods.
High Seroprevalence of Human T-Cell Lymphotropic Virus Type 1 in Blood Donors in Guyana and Molecular and Phylogenetic Analysis of New Strains in the Guyana Shelf (Guyana, Suriname, and French Guiana)
Authors: Pouliquen Jean-François , Hardy Lynette , Lavergne Anne , Kafiludine Eric , Kazanji Mirdad 
Published: May 2004

ABSTRACT

The prevalence of human T-cell lymphotropic virus type 1 (HTLV-1) and HTLV-2 in blood donors in Guyana has never been estimated. We evaluated the prevalence of these viruses in blood donors by enzyme-linked immunosorbent assay and Western blotting and showed a prevalence of HTLV-1 of 1.3%; no HTLV-2 was detected. Female donors had a much higher HTLV-1 seroprevalence (3.6%) than male donors (0.7%). HTLV-1-seropositive donors tended to be slightly older than the average age for the total pool of donors. We also investigated the phylogenetic and molecular characteristics of HTLV-1 strains in Guyana and compared them with those identified in Suriname and French Guiana. Analysis of portions of the
env
and long terminal repeat nucleotide sequences showed that all the strains in Guyana and Suriname, like those in French Guiana, belonged to the transcontinental group of cosmopolitan subtype A. The similarities were greater between strains from Suriname and Guyana than between strains from Suriname and Guyana and those from French Guiana. Nevertheless, our results confirm that the HTLV-1 strains in all three countries have a common African origin.
Detection of
Shigella
by a PCR Assay Targeting the
ipaH
Gene Suggests Increased Prevalence of Shigellosis in Nha Trang, Vietnam
Authors: Thiem Vu Dinh , Sethabutr Orntipa , von Seidlein Lorenz , Van Tung Tran , Canh Do Gia , Chien Bui Trong , Tho Le Huu , Lee Hyejon , Houng Huo-Shu , Hale Thomas L. , Clemens John D. , Mason Carl , Trach Dang Duc 
Published: May 2004

ABSTRACT

Shigella
spp. are exquisitely fastidious gram-negative organisms which frequently escape detection by traditional culture methods. To get a more complete understanding of the disease burden caused by
Shigella
in Nha Trang, Vietnam, real-time PCR was used to detect
Shigella
DNA. Randomly selected rectal swab specimens from 60
Shigella
culture-positive patients and 500
Shigella
culture-negative patients detected by population-based surveillance of patients seeking care for diarrhea were processed by real-time PCR. The target of the primer pair is the invasion plasmid antigen H gene sequence (
ipaH
), carried by all four
Shigella
species and enteroinvasive
Escherichia coli. Shigella
spp. could be isolated from the rectal swabs of 547 of 19,206 (3%) patients with diarrhea.
IpaH
was detected in 55 of 60 (93%)
Shigella
culture-positive specimens, whereas it was detected in 87 of 245 (36%) culture-negative patients free of dysentery (
P
< 0.001). The number of PCR cycles required to detect a PCR product was highest for culture-negative, nonbloody diarrheal specimens (mean number of cycles to detection, 36.6) and was lowest for children with culture-positive, bloody diarrheal specimens (mean number of cycles, 25.3) (
P
< 0.001). The data from real-time PCR amplification indicate that the culture-proven prevalence of
Shigella
among patients with diarrhea may underestimate the prevalence of
Shigella
infections. The clinical presentation of shigellosis may be directly related to the bacterial load.
Clonal Diversity and Stability of Subgingival
Eikenella corrodens
Authors: Fujise O. , Chen W. , Rich S. , Chen C. 
Published: May 2004

ABSTRACT

Eikenella corrodens
is a commensal subgingival bacterium commonly found in both periodontally nondiseased and diseased subjects. The present study examined the clonal diversity and stability of subgingival
E. corrodens
over time. Ninety-five subjects were enrolled at the baseline examination, including 44 periodontally nondiseased subjects and 51 subjects with aggressive periodontitis. Twenty-two nondiseased subjects and 11 subjects with aggressive periodontitis were subsequently reexamined after an average interval of 14 months. Two subgingival plaque samples were obtained from each subject to determine the total cultivable bacteria. In addition, multiple
E. corrodens
isolates from each sample were recovered for clonal analysis by arbitrarily primed PCR. The mean numbers of distinct
E. corrodens
clones harbored by nondiseased subjects and subjects with aggressive periodontitis were 1.3 and 3.0, respectively. Thirty-nine percent of the nondiseased subjects and 63% of the subjects with aggressive periodontitis harbored multiple clones of
E. corrodens
. The numbers of distinct
E. corrodens
clones increased significantly (Mann-Whitney ranking test,
P
< 0.05) in sites from patients with aggressive periodontitis, in sites with pocket depths of 4 mm or greater, in sites with a clinical attachment loss of 2 mm or greater, and in sites coinfected with
Porphyromonas gingivalis
. Comparison of
E. corrodens
clones recovered at the baseline and those recovered at the follow-up examination showed that
E. corrodens
colonization was not stable. Thirty-eight of the 66 follow-up samples (58%) showed a complete change (including de novo colonization of the sites or complete elimination of the organism from the sites) of the subgingival
E. corrodens
clonal types between the baseline and the follow-up examinations. Our results suggest a complexity of subgingival microbiota not seen previously.
PCR-Based Assay for Differentiation of
Pseudomonas aeruginosa
from Other
Pseudomonas
Species Recovered from Cystic Fibrosis Patients
Authors: Spilker Theodore , Coenye Tom , Vandamme Peter , LiPuma John J. 
Published: May 2004

ABSTRACT

Pseudomonas aeruginosa
is the major opportunistic bacterial pathogen in persons with cystic fibrosis (CF); pulmonary infection occurs in approximately 80% of adult CF patients. Much of CF patient management depends on accurate identification of
P. aeruginosa
from sputum culture. However, identification of this species may be problematic due to the marked phenotypic variability demonstrated by CF sputum isolates and the presence of other closely related species. To facilitate species identification, we used 16S ribosomal DNA (rDNA) sequence data to design PCR assays intended to provide genus- or species-level identification. Both assays yielded DNA fragments of the predicted size. We tested 42 culture collection strains (including 14
P. aeruginosa
strains and 28 strains representing 16 other closely related
Pseudomonas
species) and 43 strains that had been previously identified as belonging to 28 nonpseudomonal species also recovered from CF patient sputum. Based on these 85 strains, the specificity and sensitivity of both assays were 100%. To further assess the utility of the PCR assays, we tested 66 recent CF sputum isolates. The results indicated that preliminary phenotypic testing had misidentified several isolates. The 16S rDNA sequence was determined for 38 isolates, and in all cases it confirmed the results of the PCR assays. Thus, we have designed two PCR assays: one is specific for the genus
Pseudomonas
, while the other is specific for
P. aeruginosa
. Both assays show 100% sensitivity and specificity.
Development of a Bacteriophage Phage Replication Assay for Diagnosis of Pulmonary Tuberculosis
Authors: McNerney Ruth , Kambashi Bupe S. , Kinkese Juliana , Tembwe Ruth , Godfrey-Faussett Peter 
Published: May 2004

ABSTRACT

Successful infection and replication of bacteriophages is indicative of the presence of viable bacteria. We describe here the development of a bacteriophage replication assay for the detection of
Mycobacterium tuberculosis
by using mycobacteriophage D29. Optimization of phage inoculate and incubation times allowed highly sensitive detection of
M. bovis
BCG. Fewer than 10 CFU (100 CFU/ml) were detected. No false-positive results were observed in negative samples. Application of the assay to 496 sputum specimens in the National Reference Laboratory of Zambia produced sensitivity, specificity, and positive and negative predictive values of 44.1, 92.6, 82.2, and 67.5%, respectively, compared to culture on Lowenstein-Jensen medium. The equivalent corresponding results for direct fluorescent smear microscopy were 42.3, 96.8, 91.2, and 67.6%. The small increase in sensitivity over that of direct microscopy does not justify the introduction of this technique for routine diagnosis of pulmonary tuberculosis at this time.
Incidence of Group C Human Rotavirus in Central Australia and Sequence Variation of the VP7 and VP4 Genes
Authors: Schnagl Roger D. , Boniface Karen , Cardwell Pauline , McCarthy Damien , Ondracek Caroline , Coulson Barbara , Erlich John , Morey Fran 
Published: May 2004

ABSTRACT
Human group C rotavirus was identified in central Australia in each of eight years over a 16-year period between 1982 and 1997. Cases occurred either sporadically but over a relatively short period of time or as clustered outbreaks. These are the only reports of human group C rotavirus in Australia other than that of a single case reported approximately 1,800 km away in 1982. The electrophoretic genome profiles of isolates were identical for all those identified within the same year but different between those identified in different years. The VP7 genes of four isolates identified in four different years over a 7-year period between 1987 and 1993, and the VP4 genes of two of these isolates showed relatively little variation in genome and deduced amino acid sequence upon comparison of the equivalent genes between isolates. The sequences were also very similar to those from the corresponding genes from most of the human group C rotavirus isolates from other countries. This continues the observation of a high degree of gene sequence conservation among human group C rotaviruses worldwide.