bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Serial Mini‐Mental State Examinations to Diagnose and Monitor Delirium in Elderly Hospital Patients
Authors: O'Keeffe Shaun T. , Mulkerrin Eamon C. , Nayeem Kayser , Varughese Matthew , Pillay Isweri 
Published: May 2005

Objectives: To determine the responsiveness of serial Mini‐Mental State Examinations (MMSEs) for the diagnosis and monitoring of delirium in elderly hospital patients.Design: Prospective study.Setting: University teaching hospital.Participants: One hundred sixty‐five people admitted to an acute geriatric service.Measurements: Subjects were assessed using the MMSE and the Confusion Assessment Method on hospital Days 1 and 6. Changes in scores were compared between patients who remained free of delirium (n=124) and those who by Day 6 had developed delirium (n=14) or had resolution of delirium present on admission (n=22).Results: A number of measures of responsiveness confirmed that serial MMSE scores were responsive to resolution and to development of delirium. A fall of 2 or more points on the MMSE was the best determinant for detecting development of delirium (93% sensitivity, 90% specificity, positive likelihood ratio (LR)=8.9 (95% confidence interval (CI)=5.2–15.1) and negative LR=0.08 95% CI=0.01–0.53)). A rise of 3 or more points was the best determinant for detecting resolution of delirium (77% sensitivity, 75% specificity, positive LR=3.1 (95% CI=2.1–4.5) and negative LR=0.30 (95% CI=0.14–0.66)).Conclusion: The MMSE is responsive to short‐term changes in cognitive function in elderly patients. Serial MMSE tests should be helpful in monitoring the development and resolution of delirium in this population.
Perceived Barriers to Trying Self‐Management Approaches for Chronic Pain in Older Persons
Authors: Austrian Jonathan S. , Kerns Robert D. , Carrington Reid M. 
Published: May 2005

Objectives: To examine older persons' willingness to participate in exercise and relaxation programs for managing chronic pain, to identify characteristics associated with willingness to participate, and to ascertain their barriers to participation.Design: Cross‐sectional survey.Setting:A geriatric ambulatory care practice located in New York, New York, and the General Clinical Research Center of Weill Cornell Medical College.Participants: Sixty‐eight English‐speaking patients aged 70 and older with chronic pain.Measurements: Participants' level of willingness to participate in the programs was assessed using 5‐point Likert scales, and information regarding their demographic, clinical, psychological, and pain status was obtained. Qualitative methods were used to ascertain participants' perceived barriers to participation.Results: Participants had a mean age±standard deviation of 81.9±7.0 and were mostly white (85%) and female (68%). Although only 16% of participants reported current use of exercise as a pain‐management strategy, 73% reported a willingness to try the exercise program. Four percent reported current use of relaxation methods; 70% reported an interest in learning these techniques. Moderate correlations were found between increasing days of restricted activity due to pain and greater willingness to participate. Seventeen unique barriers were identified; the mean number of barriers reported per person was 2.9±1.8 for exercise and 2.2±1.4 for relaxation. Commonly reported barriers to participating in either program included time conflicts, transportation, treatment efficacy concerns, and fear of pain or injury.Conclusion: Older primary care patients with chronic pain are willing to try exercise and relaxation therapies to help manage pain but report a substantial number of barriers to participating in these programs. Addressing patient‐level barriers could improve engagement in and adherence to exercise and relaxation therapies for managing pain in older persons.
Simplifying Detection of Cognitive Impairment: Comparison of the Mini‐Cog and Mini‐Mental State Examination in a Multiethnic Sample
Authors: Borson Soo , Scanlan James M. , Watanabe Jill , Tu Shin‐Ping , Lessig Mary 
Published: May 2005

Objectives: To compare detection of cognitive impairment using the Mini‐Cog and Mini‐Mental State Examination (MMSE) and to identify sociodemographic variables that influence detection in an ethnoculturally diverse sample.Design: Cross‐sectional.Setting: A registry of the University of Washington Alzheimer's Disease Research Center Satellite.Participants: A heterogeneous community sample (n=371) of predominantly ethnic minority elderly assessed using a standardized research protocol, 231 of whom met criteria for dementia or mild cognitive impairment (MCI).Measurements: Demographic data, a standardized research protocol for cognitive assessment and dementia diagnosis, MMSE, and Mini‐Cog.Results: Both screens effectively detected cognitive impairment, the Mini‐Cog slightly better than the MMSE (P<.01). Overall accuracy of classification was 83% for the Mini‐Cog and 81% for the MMSE. The Mini‐Cog was superior in recognizing patients with Alzheimer‐type dementias (P=.05). Low education negatively affected detection using the MMSE (P<.001), whereas education did not affect the Mini‐Cog, and low literacy minimally affected it.Conclusion: The Mini‐Cog detects clinically significant cognitive impairment as well as or better than the MMSE in multiethnic elderly individuals, is easier to administer to non‐English speakers, and is less biased by low education and literacy.
ESAT-6/CFP-10 Fusion Protein and Peptides for Optimal Diagnosis of
Mycobacterium tuberculosis
Infection by Ex Vivo Enzyme-Linked Immunospot Assay in The Gambia
Authors: Hill Philip C. , Jackson-Sillah Dolly , Fox Annette , Franken Kees L. M. C. , Lugos Moses D. , Jeffries David J. , Donkor Simon A. , Hammond Abdulrahman S. , Adegbola Richard A. , Ottenhoff Tom H. M. , Klein Michel R. , Brookes Roger H. 
Published: May 2005

ABSTRACT

Overlapping peptides of
Mycobacterium tuberculosis
antigens ESAT-6 and CFP-10 offer increased specificity over the purified protein derivative skin test when they were used in an ex vivo enzyme-linked immunospot (ELISPOT) assay for gamma interferon detection for the diagnosis of
M. tuberculosis
infection from recent exposure. We assessed whether equivalent results could be obtained for a fusion protein of the two antigens and whether a combined readout would offer increased sensitivity in The Gambia. We studied the ELISPOT assay results for 488 household contacts of 88 sputum smear-positive tuberculosis (TB) cases. The proportions of subjects positive by each test and by the tests combined were assessed across an exposure gradient, defined according to sleeping proximity to a TB case. Eighty-eight (18%) subjects were positive for CFP-10 peptides, 148 (30%) were positive for ESAT-6 peptides, 161 (33%) were positive for both peptides, and 168 (34%) were positive for the fusion protein; 188 (39%) subjects had either a positive result for a peptide or a positive result for the fusion protein. There was reasonable agreement between the peptide and the protein results (kappa statistic = 0.78) and no significant discordance (
P
= 0.38). There was a strong correlation between the fusion protein and combined peptide spot counts (
r
= 0.9), and responses to the peptide and the proteins all increased significantly according to
M. tuberculosis
exposure. The proportion of subjects positive for either the pool of peptides or the fusion protein offered maximum sensitivity, being significantly higher than the proportion of subjects positive for ESAT-6 peptides alone (
P
= 0.007). A fusion protein of ESAT-6 and CFP-10 is equivalent to overlapping peptides for the diagnosis of latent
M. tuberculosis
infection. Use of a combination of peptides and fusion protein offers improved sensitivity.
Use of the Oxford Multilocus Sequence Typing Protocol and Sequencing of the Flagellin Short Variable Region To Characterize Isolates from a Large Outbreak of Waterborne
Campylobacter
sp. Strains in Walkerton, Ontario, Canada
Authors: Clark Clifford G. , Bryden Louis , Cuff Wilfred R. , Johnson Patricia L. , Jamieson Frances , Ciebin Bruce , Wang Gehua 
Published: May 2005

ABSTRACT

The Walkerton (Ontario, Canada) outbreak of waterborne
Escherichia coli
O157:H7 and
Campylobacter jejuni
was quite limited in both space and time, making it a good model for exploring the utility of different typing and subtyping methods for the characterization of relationships among isolates of these organisms. We have extended previous work with these organisms through analysis by the Oxford multilocus sequence typing (MLST) and the flagellin short variable region (fla-SVR) sequencing methods. Additional isolates not epidemiologically related to the Walkerton outbreak have also been included. Both sequencing methods identified and differentiated between Walkerton outbreak strains 1 and 2. When these strains were compared with isolates that were not part of the outbreak, the information produced by the fla-SVR method more often correlated with epidemiological findings than that produced by MLST, though both methods were required for optimal discrimination. The MLST data were more relevant in terms of the overall population structure of the organisms. Both mutation and recombination appeared to be responsible for generating diversity among the isolates tested.
Dissemination of Community-Acquired Methicillin-Resistant
Staphylococcus aureus
Clones in Northern Norway: Sequence Types 8 and 80 Predominate
Authors: Hanssen Anne-Merethe , Fossum Aina , Mikalsen Jarle , Halvorsen Dag S. , Bukholm Geir , Sollid Johanna U. Ericson 
Published: May 2005

ABSTRACT

Increasing frequencies of community-acquired methicillin-resistant
Staphylcoccus aureus
(MRSA) strain isolation have been reported from many countries. The overall prevalence of MRSA in Norway is still very low. MRSA isolates (
n
= 67) detected between 1995 and 2003 in northern Norway were analyzed by pulsed-field gel electrophoresis, multilocus sequence typing, and staphylococcal cassette chromosome
mec
(SCC
mec
) typing. Sixty-seven isolates were associated with 13 different sequence types. Two successful MRSA clones predominated. Sequence type 8 (ST8) (40%) and ST80 (19%) containing SCC
mec
type IV were detected in hospitals and communities in different geographic regions during a 7-year period. In general, there was a low level of antimicrobial resistance. Only 26% of the isolates were multiresistant. International epidemic clones were detected. The frequent findings of SCC
mec
type IV (91%) along with heterogeneous genetic backgrounds suggest a horizontal spread of SCC
mec
type IV among staphylococcal strains in parallel with the clonal spread of successful MRSA strains.
Evaluation of the COBAS Hepatitis C Virus (HCV) TaqMan Analyte-Specific Reagent Assay and Comparison to the COBAS Amplicor HCV Monitor V2.0 and Versant HCV bDNA 3.0 Assays
Authors: Konnick Eric Q. , Williams Sheri M. , Ashwood Edward R. , Hillyard David R. 
Published: May 2005

ABSTRACTPerformance characteristics of the COBAS hepatitis C virus (HCV) TaqMan analyte-specific reagent (TM-ASR) assay using the QIAGEN BioRobot 9604 for RNA extraction were evaluated and compared to the COBAS Amplicor HCV Monitor V2.0 (Amplicor) and Versant HCV bDNA 3.0 (Versant) assays using clinical samples. Calibration of TM-ASR using Armored RNA allowed determination of the distribution of HCV RNA in clinical samples, using 22,399 clinical samples. Limit of detection, linearity, and inter- and intraassay assay precision were determined for the TM-ASR assay using multiple clinical specimen panels across multiple determinations. Genotype specificity for the TM-ASR assay was determined using samples with different HCV RNA genotypes evaluated and compared against predetermined results. Contamination control of the TM-ASR assay was evaluated using pools of HCV RNA-positive and -negative samples tested in a checkerboard pattern over 12 runs of 96 samples. Correlation of the TM-ASR, Amplicor, and Versant assays was determined using 100 paired clinical samples and Deming regression analysis. The TM-ASR performed well with respect to linearity, precision, and contamination control. The correlation between TM-ASR and the Amplicor and Versant assays was poor, with large differences between assay results for individual samples. Calibration of the TM-ASR assay with Armored RNA allowed for a wide dynamic range and description of the distribution of HCV RNA in clinical samples.
Targeted Hybridization of IS
6110
Fingerprints Identifies the W-Beijing
Mycobacterium tuberculosis
Strains among Clinical Isolates
Authors: Kurepina Natalia , Likhoshvay Ekaterina , Shashkina Elena , Mathema Barun , Kremer Kristin , van Soolingen Dick , Bifani Pablo , Kreiswirth Barry N. 
Published: May 2005

ABSTRACT

Targeted IS
6110
-based RFLP genotyping can be applied to rapidly identify specific groups of biomedically/epidemiologically relevant
Mycobacterium tuberculosis
clinical isolates. One such group is the W-Beijing strain family (also known as Beijing/W), implicated in significant nosocomial and community outbreaks worldwide. Using previously defined criteria, we developed a simple and accurate method to identify members of the W-Beijing family, based on rehybridization of Southern blot membranes used previously in routine IS
6110
DNA fingerprint analysis. The hybridization probe constructed (“W-Beijing polyprobe”) contains the PCR-amplified fragments specific for three
M. tuberculosis
chromosomal loci used for the identification of W-Beijing strains. The targets include the
dnaA-dnaN
and NTF regions and the direct repeat locus. A total of 526 selected clinical isolates (representative of 253 different IS
6110
-defined strain types) were analyzed using the W-Beijing polyprobe. A total of 148 isolates from this collection were found to be members of the W-Beijing phylogenetic lineage, comprising 106 strains from the W-Beijing family (46 clusters) and 42 related isolates. Rehybridization results were confirmed by computer-assisted analysis. The sensitivity and specificity of this method were estimated at 98.7% and 99.7%, respectively. This study demonstrates that the W-Beijing polyprobe can accurately and reliably discriminate members of the W-Beijing phylogenetic lineage and the W-Beijing family of
M. tuberculosis
strains.
Global Trends in the Antifungal Susceptibility of
Cryptococcus neoformans
(1990 to 2004)
Authors: Pfaller M. A. , Messer S. A. , Boyken L. , Rice C. , Tendolkar S. , Hollis R. J. , Doern G. V. , Diekema D. J. 
Published: May 2005

ABSTRACT

The antifungal susceptibilities of 1,811 clinical isolates of
Cryptococcus neoformans
obtained from 100 laboratories in 5 geographic regions worldwide between 1990 and 2004 were determined. The MICs of amphotericin B, flucytosine, fluconazole, voriconazole, posaconazole, and ravuconazole were determined by the National Committee for Clinical Laboratory Standards broth microdilution method. Isolates were submitted to a central reference laboratory (University of Iowa) from study centers in Africa (5 centers, 395 isolates), Europe (14 centers, 102 isolates), Latin America (14 centers, 82 isolates), the Pacific region (7 centers, 50 isolates), and North America (60 centers, 1,182 isolates). Resistance to amphotericin B, flucytosine, and fluconazole was ≤1% overall. Susceptibility to flucytosine (MIC, ≤4 μg/ml) ranged from 35% in North America to 68% in Latin America. Similarly, only 75% of isolates from North America were susceptible to fluconazole (MIC, ≤8 μg/ml) compared to 94 to 100% in the other regions. Isolates remained highly susceptible to amphotericin B (99% susceptibility at a MIC of ≤1 μg/ml) over the entire 15-year period. Susceptibility to flucytosine (MIC, ≤4 μg/ml) increased from 34% in 1990 to 1994 to 66% in 2000 to 2004. Susceptibility to fluconazole (MIC, ≤8 μg/ml) increased from 72% in 1990 to 1994 to 96% in 2000 to 2004. Voriconazole, posaconazole, and ravuconazole all were very active (99% of isolates susceptible at MIC of ≤1 μg/ml) against this geographically diverse collection of isolates. We conclude that in vitro resistance to antifungal agents used in the treatment of cryptococcosis remains uncommon among isolates of
C. neoformans
from five broad geographic regions and has not increased over a 15-year period.
Significance of Transiently Positive Enzyme-Linked Immunosorbent Assay Results in Detection of
Helicobacter pylori
in Stool Samples from Children
Authors: Haggerty Thomas D. , Perry Sharon , Sanchez Luz , Perez-Perez Guillermo , Parsonnet Julie 
Published: May 2005

ABSTRACT

In young children, the significance of stool samples transiently positive for
Helicobacter pylori
antigen is unknown. As part of a larger prospective study on enteric infections, stool samples were obtained from 323 children at two time points 3 months apart and tested for
H. pylori
antigen using a commercially available enzyme-linked immunosorbent assay (ELISA) test. Seminested PCR for a
Helicobacter
-specific 16S rRNA gene was performed on all 26 pairs reverting from positive to negative (transient positives), all 4 persistent antigen-positive pairs, and 10 randomly selected persistent antigen-negative pairs.
Helicobacter
species were amplified from the first stool samples of 15/26 (58%) of the transient positives and 1 (25%) of 4 persistent positives. No
Helicobacter
species were amplified from the 10 persistent negatives. Among the 15 amplicons from transient-positive stool,
H. pylori
was sequenced and identified from 12 (80%; 95% confidence interval, 52% to 96%) and other
Helicobacter
spp. were identified from three (
Helicobacter canis
,
Helicobacter winghamensis
, and MIT 99-5504). Four of the 15 remained positive by PCR for the second (antigen-negative) stool sample, including all 3 initially identified as non-
H. pylori. Helicobacter bilis
was amplified from the second sample of a persistent positive. Two of eight transient positives from whom serum was available had accompanying transient elevations in anti-
H. pylori
antibodies. Transiently positive stool ELISAs for
H. pylori
are common and represent
H. pylori
in the majority of cases where sequences can be obtained. A not-insignificant percentage of antigen-positive stools, however, may represent other
Helicobacter
species.
Genotypic Analysis of the Earliest Known Prehistoric Case of Tuberculosis in Britain
Authors: Taylor G. Michael , Young Douglas B. , Mays Simon A. 
Published: May 2005

ABSTRACT

The earliest known case of human tuberculosis in Britain dates to the middle period of the Iron Age, approximately 2,200 years before present. Bone lesions on the spine of a male skeleton excavated at Tarrant Hinton in Dorset, United Kingdom, show evidence of Pott's disease and are supported by molecular evidence of
Mycobacterium tuberculosis
complex DNA amplified by IS
6110
PCR (19). In the present study, we used a further series of sensitive PCR methods to confirm the diagnosis of tuberculosis and to determine the genotype of the infecting strain. These tests demonstrated that this individual was infected with a strain of
M. tuberculosis
rather than
Mycobacterium bovis
. The strain had undergone the tuberculosis D1 deletion affecting the
mmpS6
and
mmpL6
genes and can therefore be identified as a member of the family of “modern”
M. tuberculosis
isolates. All evidence obtained was consistent with surviving mycobacterial DNA being highly fragmented in this case.
Identification of Non-
Helicobacter pylori
Spiral Organisms in Gastric Samples from Humans, Dogs, and Cats
Authors: Van den Bulck Kathleen , Decostere Annemie , Baele Margo , Driessen Ann , Debongnie Jean-Claude , Burette Alain , Stolte Manfred , Ducatelle Richard , Haesebrouck Freddy 
Published: May 2005

ABSTRACT

Tightly coiled bacteria are a rare cause of gastric pathology in humans and represent a mixture of species for which a zoonotic origin is suspected. Similar organisms are common inhabitants of the gastric mucosae of carnivores and pigs. It was the goal of the present study to determine the actual occurrence of each individual
Helicobacter
species in human, canine, and feline stomachs in order to better understand the possible zoonotic significance. Gastric biopsy samples from humans with histological evidence of non-
Helicobacter pylori
spiral bacteria (
n
= 123) and samples from the gastric antrum, corpus, and cardia from dogs (
n
= 110) and cats (
n
= 43) were subjected to a multiplex PCR, enabling the identification of
Helicobacter felis
,
Helicobacter bizzozeronii
,
Helicobacter salomonis
, and “
Candidatus
Helicobacter suis.” A PCR for detecting
H. pylori
was applied to all human samples. Single infections with “
Candidatus
Helicobacter suis,”
H. felis
,
H. bizzozeronii
,
H. salomonis
, a hitherto unknown genotype of a non-
H. pylori
spiral organism (
Helicobacter
-like organism 135 [HLO135]), and
H. pylori
were identified in 30.9%, 8.9%, 2.4%, 11.4%, 7.3%, and 8.9% of the human biopsy samples, respectively. Mixed infections (16.3%) with two or even three of these were also found. In the canine stomach,
H. bizzozeronii
(70.0%) was encountered as the main spiral organism, while
H. felis
(62.7%) and HLO135 (67.4%) were the predominant
Helicobacter
species found in the feline gastric mucosa. Although the majority of human non-
H. pylori
organisms are
Helicobacter
species naturally occurring in the stomachs of pigs, cats, and dogs, the frequent identification of
H. salomonis
in human gastric biopsy samples is in contrast to its rare identification in pet carnivore samples, urging us to suspect other sources of infection.
Genetic and Antigenic Variability of Human Respiratory Syncytial Virus (Groups A and B) Isolated over Seven Consecutive Seasons in Argentina (1995 to 2001)
Authors: Galiano Monica C. , Palomo Concepcion , Videla Cristina M. , Arbiza Juan , Melero José A. , Carballal Guadalupe 
Published: May 2005

ABSTRACT
The genetic and antigenic variability of human respiratory syncytial virus (HRSV) strains isolated in Buenos Aires from 1995 to 2001 was evaluated by partial nucleotide sequencing of the G gene and enzyme-linked immunosorbent assay analysis with anti-G monoclonal antibodies. Phylogenetic analyses showed that 37 group A strains clustered into five genotypes, whereas 20 group B strains clustered into three genotypes. Group A showed more genetic variability than group B. A close correlation between genotypes and antigenic patterns was observed. Changes detected in the G protein of viruses from both groups included (i) amino acid substitutions and(ii) differences in protein length due to either changes in stop codon usage or sequence duplications. Three B strains from 1999 exhibited a duplication of 20 amino acids, while one B strain from 2001 had 2 amino acids duplicated. The comparison among Argentinean HRSV strains and viruses isolated in other geographical areas during different epidemics is discussed.
Molecular Characterization of Vancomycin-Resistant
Enterococcus faecium
Isolates from Korea
Authors: Ko Kwan Soo , Baek Jin Yang , Lee Ji-Young , Oh Won Sup , Peck Kyong Ran , Lee NamYong , Lee Wee Gyo , Lee Kyungwon , Song Jae-Hoon 
Published: May 2005

ABSTRACT

A total of 98 vancomycin-resistant
Enterococcus faecium
(VREF) isolates from four tertiary-care hospitals in Korea during the period between 1998 and 2004 were analyzed for genotypic characteristics using the multiplex PCR, multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), and
esp
gene analysis. Ninety-two isolates of VREF with VanA phenotype and five of six isolates with VanB phenotype possessed the
vanA
gene. MLST analysis revealed 9 sequence types (STs), which belonged to a single clonal complex (CC78, clonal lineage C1). Five strains showing incongruence between phenotype and genotype (VanB-
vanA
) did not belong to the same genotypic clone. The
esp
gene was detected in all VREF strains, showing 12 different
esp
repeat profiles. Data suggest that an epidemic clonal group of VREF, CC78 with
esp
gene, is also present in Asia and has differentiated into multiple diverse genotypic clones during the evolutionary process.