bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Pilot Investigation of the Short‐Term Effects of an Interdisciplinary Intervention Program on Elderly Patients with Hip Fracture in Taiwan
Authors: Shyu Yea‐Ing Lotus , Liang Jersey , Wu Chi‐Chuan , Su Juin‐Yih , Cheng Huey‐Shinn , Chou Shih‐Wei , Yang Ching‐Tzu 
Published: May 2005

Objectives: To evaluate an interdisciplinary intervention program for older people with hip fracture in Taiwan.Design: Randomized experimental design.Setting: A 3,800‐bed medical center in northern Taiwan.Participants: Elderly patients with hip fracture (N=137) were randomly assigned to an experimental (n=68) or control (n=69) group.Intervention: An interdisciplinary program of geriatric consultation, continuous rehabilitation, and discharge planning.Measurements: Demographic and outcome variables were measured. Outcome variables included service utilization, clinical outcomes, self‐care abilities, health‐related quality‐of‐life (HRQOL) outcomes, and depressive symptoms.Results: Subjects in the experimental group improved significantly more than those in the control group in the following outcomes: ratio of hip flexion 1 month after discharge (P=.02), recovery of previous walking ability at 1 month (P=.04) and 3 months (P=.001) after discharge, and activities of daily living at 1 month (P=.01) and 2 months (P=.001) after discharge. Three months after discharge, the experimental group showed significant improvement in peak force of the fractured limb's quadriceps (P=.04) and the following health outcomes: bodily pain (P=.03), vitality (P<.001), mental health (P=.02), physical function (P< .001), and role physical (P=.006). They also had fewer depressive symptoms (P=.008) 3 months after discharge.Conclusion: This intervention program may benefit older people with hip fractures in Taiwan by improving their clinical outcomes, self‐care abilities, and HRQOL and by decreasing depressive symptoms within 3 months after discharge.
The Effect of Hospitalization with Medical Illnesses on the Suicide Risk in the Oldest Old: A Population‐Based Register Study
Authors: Erlangsen Annette , Vach Werner , Jeune Bernard 
Published: May 2005

Objectives: To compare the effect of hospitalization with medical illnesses on the suicide risk in the oldest old (≥80) with that in the old (65–79) and middle‐aged (52–64) using nationwide data.Design: Event‐history analysis using time‐varying covariates based on prospective individual‐level register data.Setting: Population‐based record linkage.Participants: All persons aged 52 and older living in Denmark during 1996 to 1998 (N=1,684,205).Measurements: The studied event is completed suicide. The following time‐varying variables are included in the analysis: current age, hospitalization with medical illnesses within previous 2 years, and number of different medical diagnoses given at hospitalizations within previous 2 years. Relative suicide risks were calculated using event‐history analysis. The proportional attributable risk was calculated to assess to which extent hospitalization can explain the increased suicide risk in the oldest old.Results: During the 3‐year study period, 1,184 persons committed suicide. Hospitalization with medical illnesses was associated with an increased suicide risk in the study population. The highest suicide rates were found in the oldest‐old men who had been hospitalized during the previous 2 years: 113 per 100,000 versus 80 per 100,000 in the general population of men aged 80 and older. Also, the oldest‐old women with a history of hospitalization had a higher suicide rate than their peer group. Nevertheless, the oldest old experienced a lower increase in risk after hospitalization than the middle‐aged. Experiencing three or more different diagnoses increased the risk further. Almost two‐thirds of the oldest old who committed suicide had experienced a medical hospitalization during a 2‐year period preceding the suicide. A substantial part of the greater suicide rate in the oldest old than in the middle‐aged can be attributed to the increased prevalence of medical hospitalization.Conclusion: The oldest old who have been hospitalized with medical illnesses have a significantly higher suicide risk than people in the same age range with no hospitalization, although they experience a lower increase in risk after hospitalization than the middle‐aged. The increased prevalence of medical illnesses explains a part of the greater suicide risk with age, especially for the oldest old women. Considering that hospitalization with medical illness often precedes suicide in the oldest old, hospitalization may play an important role in identification of suicidal ideation in older people.
Timing of Hospice Referral and Families' Perceptions of Services: Are Earlier Hospice Referrals Better?
Authors: Rickerson Elizabeth , Harrold Joan , Kapo Jennifer , Carroll Janet T. , Casarett David 
Published: May 2005

Objectives: To determine whether families of patients who enroll in hospice near the end of life believe that they receive less benefit from hospice services than families of patients who enroll earlier.Design: Semistructured interviews at the time of hospice enrollment and 1 month after the patient's death.Setting: This study was conducted at the Hospice of Lancaster County, Lancaster, PA, over a 12‐month period spanning 2003–2004.Participants: First‐time hospice admissions.Measurements: Interviews assessed the anticipated helpfulness of six hospice services (enrollment interviews) and the actual helpfulness of the same services (follow‐up interviews).Results: Length of stay in hospice was associated with families' reports of the number of services provided (Spearman rho=0.34, P<.001), and with the mean helpfulness ratings for the services that were provided (Spearman rho=0.34, P<.001), although even with short lengths of stay, most families reported that they received the services that they anticipated and that those services were helpful.Conclusion: These results indicate that families feel they receive greater benefits from longer lengths of stay in hospice. Future efforts to define an “optimal” length of stay in hospice should consider patients' and families' perceptions of the benefits that hospice offers.
Newly Reported Chronic Conditions and Onset of Functional Dependency
Authors: Wolff Jennifer L. , Boult Chad , Boyd Cynthia , Anderson Gerard 
Published: May 2005

Objectives: To examine the relationship between newly reported chronic conditions and subsequent functional dependency in older adults.Design: Three‐year cohort study.Setting: United States.Participants: A national sample of Americans age 65 and older (N=4,968) who participated in the Medicare Current Beneficiary Survey.Measurements: Self‐reports of new physician diagnoses between baseline and 12 months and functional dependency onset at 12‐, 24‐, and 36‐month follow‐up. Functional dependency is defined as needing help with or being unable to perform one or more activities of daily living or residence in a long‐term care facility.Results: After 12 months of follow‐up, 29.8% of participants reported one or more newly diagnosed conditions, increasing to 48.7% at 24 months and 61.3% at 36 months. Number of newly reported conditions was associated with greater probability of functional dependency; this association was strongest at 12 months. The odds of becoming functionally dependent were nearly twice as great in participants who reported one new chronic condition (odds ratio (OR)=1.9, 95% confidence interval (CI)=1.3–2.8), more than four times as great in those who reported two new chronic conditions (OR=4.3, 95%=CI 2.7–6.9), and 13 times as great in those who reported three or more new chronic conditions (OR=13.0, 95%=CI 6.5–26.3) as in those who reported no new chronic conditions. Newly reported dementia, stroke, psychological disorders, low body mass index, and obesity were significantly and consistently related to functional dependency throughout all 3 years of observation (OR=2.1–14.1).Conclusion: Findings from this study demonstrate the strong relationship between newly diagnosed chronic conditions and functional dependency and highlight the potential benefit of prevention in older adults.
Cost Analysis of Nursing Home Registered Nurse Staffing Times
Authors: Dorr David A. , Horn Susan D. , Smout Randall J. 
Published: May 2005

Objectives: To examine potential cost savings from decreased adverse resident outcomes versus additional wages of nurses when nursing homes have adequate staffing.Design: A retrospective cost study using differences in adverse outcome rates of pressure ulcers (PUs), urinary tract infections (UTIs), and hospitalizations per resident per day from low staffing and adequate staffing nursing homes. Cost savings from reductions in these events are calculated in dollars and compared with costs of increasing nurse staffing.Setting: Eighty‐two nursing homes throughout the United States.Participants: One thousand three hundred seventy‐six frail elderly long‐term care residents at risk of PU development.Measurements: Event rates are from the National Pressure Ulcer Long‐Term Care Study. Hospital costs are estimated from Medicare statistics and from charges in the Healthcare Cost and Utilization Project. UTI costs and PU costs are from cost‐identification studies. Time horizon is 1 year; perspectives are societal and institutional.Results: Analyses showed an annual net societal benefit of $3,191 per resident per year in a high‐risk, long‐stay nursing home unit that employs sufficient nurses to achieve 30 to 40 minutes of registered nurse direct care time per resident per day versus nursing homes that have nursing time of less than 10 minutes. Sensitivity analyses revealed a robust set of estimates, with no single or paired elements reaching the cost/benefit equality threshold.Conclusion: Increasing nurse staffing in nursing homes may create significant societal cost savings from reduction in adverse outcomes. Challenges in increasing nurse staffing are discussed.
Consensus Sequence-Based Scheme for Epidemiological Typing of Clinical and Environmental Isolates ofLegionella pneumophila
Authors: Gaia Valeria , Fry Norman K. , Afshar Baharak , Lück P. Christian , Meugnier Hélène , Etienne Jerome , Peduzzi Raffaele , Harrison Timothy G. 
Published: May 2005

ABSTRACTA previously described sequence-based epidemiological typing method for clinical and environmental isolates ofLegionella pneumophilaserogroup 1 was extended by the investigation of three additional gene targets and modification of one of the previous targets. Excellent typeability, reproducibility, and epidemiological concordance were determined for isolates belonging to both serogroup 1 and the other serogroups investigated. Gene fragments were amplified from genomic DNA, and PCR amplicons were sequenced by using forward and reverse primers. Consensus sequences are entered into an online database, which allows the assignment of individual allele numbers. The resulting sequence-based type or allelic profile comprises a string of the individual allele numbers separated by commas, e.g., 1,4,3,1,1,1, in a predetermined order, i.e.,flaA,pilE,asd,mip,mompS, andproA. The index of discrimination (D) obtained with these six loci was calculated following analysis of a panel of 79 unrelated clinical isolates. ADvalue of >0.94 was obtained, and this value appears to be sufficient for use in the epidemiological investigation of outbreaks caused byL. pneumophila. TheDvalue rose to 0.98 when the results of the analysis were combined with those of monoclonal antibody subgrouping. Sequence-based typing ofL. pneumophilais epidemiologically concordant and discriminatory, and the data are easily transportable. This consensus method will assist in the epidemiological investigation ofL. pneumophilainfections, especially travel-associated cases, by which it will allow a rapid comparison of isolates obtained in more than one country.
Antifungal Susceptibilities of
Candida
Species Causing Vulvovaginitis and Epidemiology of Recurrent Cases
Authors: Richter Sandra S. , Galask Rudolph P. , Messer Shawn A. , Hollis Richard J. , Diekema Daniel J. , Pfaller Michael A. 
Published: May 2005

ABSTRACT

There are limited data regarding the antifungal susceptibility of yeast causing vulvovaginal candidiasis, since cultures are rarely performed. Susceptibility testing was performed on vaginal yeast isolates collected from January 1998 to March 2001 from 429 patients with suspected vulvovaginal candidiasis. The charts of 84 patients with multiple positive cultures were reviewed. The 593 yeast isolates were
Candida albicans
(
n
= 420),
Candida glabrata
(
n
= 112),
Candida parapsilosis
(
n
= 30),
Candida krusei
(
n
= 12),
Saccharomyces cerevisiae
(
n
= 9),
Candida tropicalis
(
n
= 8),
Candida lusitaniae
(
n
= 1), and
Trichosporon
sp. (
n
= 1). Multiple species suggesting mixed infection were isolated from 27 cultures. Resistance to fluconazole and flucytosine was observed infrequently (3.7% and 3.0%); 16.2% of isolates were resistant to itraconazole (MIC ≥ 1 μg/ml). The four imidazoles (econazole, clotrimazole, miconazole, and ketoconazole) were active: 94.3 to 98.5% were susceptible at ≤1 μg/ml. Among different species, elevated fluconazole MICs (≥16 μg/ml) were only observed in
C. glabrata
(15.2% resistant [R], 51.8% susceptible-dose dependent [S-DD]),
C. parapsilosis
(3.3% S-DD),
S. cerevisiae
(11.1% S-DD), and
C. krusei
(50% S-DD, 41.7% R, considered intrinsically fluconazole resistant). Resistance to itraconazole was observed among
C. glabrata
(74.1%),
C. krusei
(58.3%),
S. cerevisiae
(55.6%), and
C. parapsilosis
(3.4%). Among 84 patients with recurrent episodes, non-albicans species were more common (42% versus 20%). A ≥4-fold rise in fluconazole MIC was observed in only one patient with
C. parapsilosis
. These results support the use of azoles for empirical therapy of uncomplicated candidal vulvovaginitis. Recurrent episodes are more often caused by non-albicans species, for which azole agents are less likely to be effective.
Comparison ofBorrelia burgdorferiSensu Lato Strains Isolated from Specimens Obtained Simultaneously from Two Different Sites of Infection in Individual Patients
Authors: Ružić-Sabljić Eva , Arnež Maja , Logar Mateja , Maraspin Vera , Lotrič-Furlan Stanka , Cimperman Jože , Strle Franc 
Published: May 2005

ABSTRACTThe aim of the present study was to analyze and compareBorreliastrains isolated from two different specimens obtained simultaneously from individual patients with Lyme borreliosis. Fifty such patients and 50 corresponding pairs ofBorreliaisolates (100 low-propagated strains) were subjected to genotypic and phenotypic analysis, including pulsed-field gel electrophoresis for species identification and plasmid profile determination and protein profile electrophoresis for the assessment of the presence and molecular masses of separated proteins. The strains were isolated from two distinct skin lesions (12 patients), skin and blood (28 patients), skin and cerebrospinal fluid (8 patients), and blood and cerebrospinal fluid (2 patients). Out of 100 isolates, 63 were typed asB. afzeliiand 37 asB. garinii. From each individual specimen only a singleBorreliaspecies was cultured. Comparison of 50Borreliastrain pairs isolated from two different specimens of an individual patient revealed that 12/50 (24%) patients were simultaneously infected with two differentBorreliastrains; in 3/50 (6%) patients strains differed at the species level, in 4 out of the remaining 47 (9%) patients a strain difference in plasmid profile was established, while 5 out of the remaining 43 (11%) patient strain pairs differed in regard to the protein profiles of the two concurrently isolated strains. The results of the present study indicate that human patients with Lyme borreliosis may simultaneously harbor differentB. burgdorferisensu lato strains.
Phylogeny and Identification of Enterococci by
atpA
Gene Sequence Analysis
Authors: Naser S. , Thompson F. L. , Hoste B. , Gevers D. , Vandemeulebroecke K. , Cleenwerck I. , Thompson C. C. , Vancanneyt M. , Swings J. 
Published: May 2005

ABSTRACT

The relatedness among 91
Enterococcus
strains representing all validly described species was investigated by comparing a 1,102-bp fragment of
atpA
, the gene encoding the alpha subunit of ATP synthase. The relationships observed were in agreement with the phylogeny inferred from 16S rRNA gene sequence analysis. However,
atpA
gene sequences were much more discriminatory than 16S rRNA for species differentiation. All species were differentiated on the basis of
atpA
sequences with, at a maximum, 92% similarity. Six members of the
Enterococcus faecium
species group (
E. faecium
,
E. hirae
,
E. durans
,
E. villorum
,
E. mundtii
, and
E. ratti
) showed >99% 16S rRNA gene sequence similarity, but the highest value of
atpA
gene sequence similarity was only 89.9%. The intraspecies
atpA
sequence similarities for all species except
E. faecium
strains varied from 98.6 to 100%; the
E. faecium
strains had a lower
atpA
sequence similarity of 96.3%. Our data clearly show that
atpA
provides an alternative tool for the phylogenetic study and identification of enterococci.
Evaluation of 12 Commercial Tests and the Complement Fixation Test for
Mycoplasma pneumoniae
-Specific Immunoglobulin G (IgG) and IgM Antibodies, with PCR Used as the “Gold Standard”
Authors: Beersma Matthias F. C. , Dirven Kristien , van Dam Alje P. , Templeton Kate E. , Claas Eric C. J. , Goossens Herman 
Published: May 2005

ABSTRACT

Serology and nucleic acid amplification are the main diagnostic tools for the diagnosis of
Mycoplasma pneumoniae
infection. Since no reference standard is generally accepted, serologic assays for
M. pneumoniae
have not been evaluated on a broad scale. In this study, 12 commercially available serologic assays (for immunoglobulin G [IgG] and IgM) and the complement fixation test (CFT) were evaluated by using
M. pneumoniae
DNA detection by real-time PCR as the “gold standard.” The assays tested were Platelia EIA (Bio-Rad), SeroMP EIA (Savyon), Serion classic EIA (Virion/Serion), Biotest EIA (Biotest), Ridascreen EIA (r-Biopharm), AniLabsystems EIA (Labsystems), Novum EIA (Novum Diagnostica), Diagnosys EIA (MP products), Genzyme/Virotech EIA, ImmunoWell EIA (Genbio), ImmunoCard EIA (Meridian), and SerodiaMycoII microparticle agglutination (Fujirebio). Serum samples (
n
= 46) from 27 PCR-positive patients with a known first day of disease and sera (
n
= 33) from PCR-negative controls were obtained from prospective studies of acute lower respiratory tract infections. Additionally, control sera (
n
= 63) from patients with acute viral or bacterial respiratory infections other than those caused by
M. pneumoniae
were tested. The results showed low specificities for both the Novum and the ImmunoCard IgM assays. The IgM assays with the best performances in terms of sensitivity and specificity were AniLabsystems (77% and 92%, respectively), SeroMP (71% and 88%, respectively), and CFT (65% and 97%, respectively). Good receiver operating characteristic areas under the curve were found for CFT (0.94), the Platelia assay (0.87), and the AniLabsystems assay (0.85). We conclude that there are few commercial serologic assays for the detection of
M. pneumoniae
infections with appropriate performances in terms of sensitivity and specificity and that PCR has become increasingly important for the diagnosis of
M. pneumoniae
infections in defined groups of patients.
Microarray-Based Detection of 90 Antibiotic Resistance Genes of Gram-Positive Bacteria
Authors: Perreten Vincent , Vorlet-Fawer Lorianne , Slickers Peter , Ehricht Ralf , Kuhnert Peter , Frey Joachim 
Published: May 2005

ABSTRACT

A disposable microarray was developed for detection of up to 90 antibiotic resistance genes in gram-positive bacteria by hybridization. Each antibiotic resistance gene is represented by two specific oligonucleotides chosen from consensus sequences of gene families, except for nine genes for which only one specific oligonucleotide could be developed. A total of 137 oligonucleotides (26 to 33 nucleotides in length with similar physicochemical parameters) were spotted onto the microarray. The microarrays (ArrayTubes) were hybridized with 36 strains carrying specific antibiotic resistance genes that allowed testing of the sensitivity and specificity of 125 oligonucleotides. Among these were well-characterized multidrug-resistant strains of
Enterococcus faecalis
,
Enterococcus faecium
, and
Lactococcus lactis
and an avirulent strain of
Bacillus anthracis
harboring the broad-host-range resistance plasmid pRE25. Analysis of two multidrug-resistant field strains allowed the detection of 12 different antibiotic resistance genes in a
Staphylococcus haemolyticus
strain isolated from mastitis milk and 6 resistance genes in a
Clostridium perfringens
strain isolated from a calf. In both cases, the microarray genotyping corresponded to the phenotype of the strains. The ArrayTube platform presents the advantage of rapidly screening bacteria for the presence of antibiotic resistance genes known in gram-positive bacteria. This technology has a large potential for applications in basic research, food safety, and surveillance programs for antimicrobial resistance.
Genetic Background Affects Stability of
mecA
in
Staphylococcus aureus
Authors: Katayama Yuki , Robinson D. Ashley , Enright Mark C. , Chambers Henry F. 
Published: May 2005

ABSTRACT

The staphylococcal methicillin resistance determinant,
mecA
, resides on a mobile genetic element, staphylococcus chromosomal cassette
mec
(SCC
mec
). The distribution of SCC
mec
in nature is limited to relatively few clonal complexes of related methicillin-resistant
Staphylococcus aureus
(MRSA). We have previously reported that some genetic backgrounds are restrictive of
mecA
and penicillin-binding protein 2a expression, which could account for the restricted clonal distribution of SCC
mec
in nature. In this study, we investigate the potential role of the host chromosome in the transformability and expression of
mecA
in 103 naturally occurring methicillin-susceptible
S. aureus
clinical isolates. The isolates, which had been genotyped previously by multilocus sequence typing, were classified into one of two mutually exclusive categories based on whether the isolates belonged to “major” MRSA lineages or to “other” lineages that are never or occasionally MRSA. We introduced
mecA
expressed on the low-copy-number plasmid pYK20 into each MSSA strain and assayed the phenotype of resistance to nafcillin by population analysis to assess the relationship between the stability of
mecA
expression and genetic background. Strains from the major MRSA lineages were more transformable with pYK20 and better able to maintain the plasmid and express resistance in comparison to strains from other lineages. These data support the hypothesis that the presence of
mecA
within relatively few clonal complexes is partly due to genetic factors that are permissive of
mecA
and its gene product.