tbuckley/cabot-search huggingface dataset:
Electronic Thermometers and Nosocomial Infections
Authors: E. I. Abter
Journal: Annals of Internal Medicine (1993)

Letters15 January 1993Electronic Thermometers and Nosocomial InfectionsE. I. Abter, MD, E. K. Chapnick, MD, and A. Stahl, MDE. I. Abter, MDSearch for more papers by this author, E. K. Chapnick, MDSearch for more papers by this author, and A. Stahl, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-2-199301150-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The study by Livornese and colleagues [1] is not the first to suggest an electronic thermometer as a vehicle for transmission of nosocomial infection. In a previously reported study, the rate of transmission of Clostridium difficile was significantly reduced after removal of electronic thermometers [2].Management of bacteremia due to vancomycin-resistant enterococci is problematic. Recent studies have suggested the possibility of in vitro inhibition of vancomycin-resistant enterococci using various antibiotic combinations such as vancomycin, penicillin, and gentamicin [3]. However, Livornese and colleagues [1] were the first to report a combination that was effective in vivo.References1. Livornese L, Dias S, Samel C, Romanowski B, Taylor S, May P, et al. Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers. Ann Intern Med. 1992; 117:112-6. Google Scholar2. Brooks S, Veal R, Kramer M, Dore L, Schupf N, Adachi M. Reduction in the incidence of Clostridium difficile-associated diarrhea in an acute care hospital and a skilled nursing facility following replacement of electronic thermometers with single-use disposables. Infect Control Hosp Epidemiol. 1992; 13:98-103. Google Scholar3. Caron F, Carbon C, Gutmann L. Triple-combination penicillin-vancomycin-gentamicin for experimental endocarditis caused by a moderately penicillin- and high glycopeptide-resistant isolate of Enterococcus faecium. J Infect Dis. 1991; 164:888-93. Google Scholar Author, Article, and Disclosure InformationAuthors: E. I. Abter, MD; E. K. Chapnick, MD; A. Stahl, MD PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 January 1993Volume 118, Issue 2Page: 156-157KeywordsBacteremiaClostridium difficileNosocomial infectionsPenicillinThermometersVancomycin ePublished: 15 August 2000 Issue Published: 15 January 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Incidence and outcome of symptomatic urinary tract infection in children.
Authors: J A Dickinson
Journal: BMJ (1979)

The incidence of symptomatic urinary tract infection in 2879 children aged under 15 years was studied over 18 months in a single general practice. Infection was diagnosed if bacterial counts in three consecutive samples exceeded 100,000/ml. The incidence of urinary tract infection was 1.7 per 1000 boys at risk per year and 3.1 per 1000 girls. These values are lower than those of comparable studies, possibly because of the stricter diagnostic criterion used in the study. Urinary pus cell counts were also carried out and sometimes found to be misleading. Of the 14 children found to have an infection, three had a radiological abnormality. Five of the children had a recurrence of infection within the first two years, and one an asymptomatic bacteriuria seven years after diagnosis. Only six out of 34 children presenting with dysuria had infected urine, and an association was discovered between abacterial dysuria (or the urethral syndrome) in the remainder and a concurrent upper respiratory tract infection. All children should undergo radiological investigation after their first confirmed infection. Diagnosis and management could be improved by providing all general practitioners with a semiquantitative method of urine culture such as the dip slide.
Effects of Hemorrhagic Shock on Vascular Permeability to Red Blood Cells
Authors: Isaac Djerassi, Albert Roy
Journal: Circulation Research (1962)

The lymph collected from the left thoracic lymph duct of dogs in severe shock due to blood loss becomes grossly hemorrhagic. Reversible hemorrhagic shock is not accompanied by changes in lymph appearance or content of red blood cells. The increased levels of red cells in the lymph was observed prior to the appearance of the characteristic gross intestinal and peritoneal hemorrhages.
Chloramphenicol versus ampicillin plus gentamicin for community acquired very severe pneumonia among children aged 2-59 months in low resource settings: multicentre randomised controlled trial (SPEAR study)
Authors: Rai Asghar, Salem Banajeh, Josefina Egas, Patricia Hibberd, Imran Iqbal, Mary Katep-Bwalya, Zafarullah Kundi, Paul Law, William MacLeod, Irene Maulen-Radovan, Greta Mino, Samir Saha, Fernando Sempertegui, Jonathon Simon, Mathuram Santosham, Sunit Singhi, Donald M Thea, Shamim Qazi
Journal: BMJ (2008)

<b>Objective</b> To evaluate whether five days' treatment with injectable ampicillin plus gentamicin compared with chloramphenicol reduces treatment failure in children aged 2-59 months with community acquired very severe pneumonia in low resource settings. <b>Design</b> Open label randomised controlled trial. <b>Setting</b> Inpatient wards within tertiary care hospitals in Bangladesh, Ecuador, India, Mexico, Pakistan, Yemen, and Zambia. <b>Participants</b> Children aged 2-59 months with WHO defined very severe pneumonia. <b>Intervention</b> Chloramphenicol versus a combination of ampicillin plus gentamicin. <b>Main outcome measures</b> Primary outcome measure was treatment failure at five days. Secondary outcomes were treatment failure defined similarly among all participants evaluated at 48 hours and at 10 and 21 days. <b>Results</b> More children failed treatment with chloramphenicol at day 5 (16% <i>v</i> 11%; relative risk 1.43, 95% confidence interval 1.03 to 1.97) and also by days 10 and 21. Overall, 112 bacterial isolates were obtained from blood and lung aspirates in 110 children (11.5%), with the most common organisms being <i>Staphylococcus aureus</i> (n=47) and <i>Streptococcus pneumoniae</i> (n=22). In subgroup analysis, bacteraemia with any organism increased the risk of treatment failure at 21 days in the chloramphenicol group (2.09, 1.41 to 3.10) but not in the ampicillin plus gentamicin group (1.12, 0.59 to 2.13). Similarly, isolation of <i>S pneumoniae</i> increased the risk of treatment failure at day 21 (4.06, 2.73 to 6.03) and death (5.80, 2.62 to 12.85) in the chloramphenicol group but not in the ampicillin plus gentamicin group. No difference was found in treatment failure for children with <i>S aureus</i> bacteraemia in the two groups, but the power to detect a difference in this subgroup analysis was low. Independent predictors of treatment failure by multivariate analysis were hypoxaemia (oxygen saturation &lt;90%), receiving chloramphenicol, being female, and poor immunisation status. <b>Conclusion</b> Injectable ampicillin plus gentamicin is superior to injectable chloramphenicol for the treatment of community acquired very severe pneumonia in children aged 2-59 months in low resource settings. <b>Trial registration</b> Current Controlled Trials ISRCTN39543942.
The effects of alpha-adrenergic agonists on hyperpnea-induced airway obstruction in dogs.
Authors: C Omori, W Mitzner, A N Freed
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Two alpha-adrenergic agonists that inhibit hyperpnea-induced airway obstruction (HIAO) in asthmatic subjects were used to examine the role of bronchial blood flow in the development of HIAO in canine periphery airways. A bronchoscope was used to record peripheral airway resistance (Rp) in anesthetized dogs before and after hyperpnea with dry air. Hyperpnea increased Rp 64 +/- 8% (mean +/- SE) above baseline. Treatment with norepinephrine (NOR) either before or at various times after hyperpnea inhibited HIAO (p < 0.01). We also found that NOR inhibited acetylcholine-induced bronchoconstriction. However, beta-adrenergic blockade with propranolol completely eliminated these effects. Thus, NOR inhibited HIAO in canine peripheral airways via the stimulation of beta-adrenergic receptors and the attenuation of airway smooth muscle contractility. In contrast, pretreatment with methoxamine (MX) decreased HIAO by approximately 25% when compared with the vehicle control, and this effect was completely eliminated by alpha-adrenergic blockade with phentolamine. Relative to NOR, MX provides weak protection against HIAO via the direct stimulation of alpha-adrenergic receptors and their subsequent effect on either mucus secretion or bronchovascular tone. We conclude that bronchial blood flow plays at best a minor role in the development of HIAO.
Imaging of Bilateral Striopallidodentate Calcinosis
Authors: SHIGEYUKI OGI, NOBUYOSHI FUKUMITSU, DAISUKE TSUCHIDA, MAYUKI UCHIYAMA, YUTAKA MORI, KAZUTAKA MATSUI
Journal: Clinical Nuclear Medicine (2002)

Bilateral symmetric striopallidodentate calcinosis, also known as Fahr’s disease, is characterized by bilateral calcifications of the basal ganglia, thalami, dentate nuclei of the cerebellum, and the white matter of the cerebral hemisphere. Intracranial calcifications are easily visible as high-density areas on computed tomographic images. On magnetic resonance images, the calcifications exhibit different signal intensities. The differences in signal intensity are thought to be related to the stage of the disease, differences in calcium metabolism, and the volume of the calcium deposit. The moderate reduction of cerebral blood flow in bilateral thalami was also identified using brain SPECT.
Effect of a barrier at Bloor Street Viaduct on suicide rates in Toronto: natural experiment
Authors: M. Sinyor, A. J. Levitt
Journal: BMJ (2010)

<b>Objective</b> To determine whether rates of suicide changed in Toronto after a barrier was erected at Bloor Street Viaduct, the bridge with the world's second highest annual rate of suicide by jumping after Golden Gate Bridge in San Francisco. <b>Design</b> Natural experiment. <b>Setting</b> City of Toronto and province of Ontario, Canada; records at the chief coroner's office of Ontario 1993-2001 (nine years before the barrier) and July 2003-June 2007 (four years after the barrier). <b>Participants</b> 14 789 people who completed suicide in the city of Toronto and in Ontario. <b>Main outcome measure</b> Changes in yearly rates of suicide by jumping at Bloor Street Viaduct, other bridges, and buildings, and by other means. <b>Results</b> Yearly rates of suicide by jumping in Toronto remained unchanged between the periods before and after the construction of a barrier at Bloor Street Viaduct (56.4 <i>v</i> 56.6, P=0.95). A mean of 9.3 suicides occurred annually at Bloor Street Viaduct before the barrier and none after the barrier (P&lt;0.01). Yearly rates of suicide by jumping from other bridges and buildings were higher in the period after the barrier although only significant for other bridges (other bridges: 8.7 <i>v</i> 14.2, P=0.01; buildings: 38.5 <i>v</i> 42.7, P=0.32). <b>Conclusions</b> Although the barrier prevented suicides at Bloor Street Viaduct, the rate of suicide by jumping in Toronto remained unchanged. This lack of change might have been due to a reciprocal increase in suicides from other bridges and buildings. This finding suggests that Bloor Street Viaduct may not have been a uniquely attractive location for suicide and that barriers on bridges may not alter absolute rates of suicide by jumping when comparable bridges are nearby.
Doppler Echocardiography for Assessing Left Ventricular Diastolic Function
Authors: Paolo Spirito
Journal: Annals of Internal Medicine (1988)

During the last 2 years, the use of pulsed Doppler echocardiography for assessing left ventricular diastolic function has received increased attention. This method is based on measurements derived from a waveform that reflects the velocity of blood flow through the mitral valve during ventricular filling. The technique is particularly attractive because it is noninvasive and relatively simple. Technically satisfactory recordings can be obtained in most patients. In a relatively short period, numerous studies using the Doppler technique to assess diastolic function in children and adults with cardiac disease have been published. This review appraises the current status of applications of Doppler echocardiography and critically examines the strengths, limitations, and ultimate potentials of this new method.
Increased Levels of Serum Angiotensin-Converting Enzyme Activity in Hyperthyroidism
Authors: HlDEKI YOTSUMOTO
Journal: Annals of Internal Medicine (1982)

Serum angiotensin-converting enzyme activity was significantly elevated in 21 patients with hyperthyroidism (65 ± 18 U/mL) as compared with levels in healthy control subjects (30 ± 9 U/mL). In eight patients treated with thionamide drugs, the enzyme activities decreased to a normal range as thyroid hormone concentrations returned to euthyroid levels. When two patients became hyperthyroid due to an insufficient maintenance dose of antithyroid drugs, the increase in the serum thyroid hormone concentration was followed by the re-elevation of serum angiotensin-converting enzyme levels with a time lag of about 2 weeks. Levels of this enzyme are increased reflecting the elevated serum thyroid hormone levels in hyperthyroidism. The hyperthyroid state should be considered when serum angiotensin-converting enzyme levels are high.
Hysterectomy and sexual wellbeing: More questions are yet to be answered
Authors: A. Bradford
Journal: BMJ (2004)

EDITOR—Roovers et al take subjective distress into account in their examination of sexual outcomes after hysterectomy.1 This is a much needed aspect of the research on this topic. I am disappointed that, as so often in this type of research, the method does not include the use of a well validated interview or …
"Catabolic" loss of body protein after human liver transplantation.
Authors: S J O'Keefe, R Williams, R Y Calne
Journal: BMJ (1980)

no known unique quality.Historically a major commitment to the cotton industry has been a feature of the high prevalence area, yet other towns also associated with the cotton industryfor example, Rochdale-have low prevalences.We are most grateful to the radiologists, radiographers, and x-ray records staff in the towns surveyed.Their kindness and help made the survey possible.The study was
CRC Handbook of Hospital Acquired Infections
Authors: Robert W. Haley
Journal: JAMA (1982)

In the first half of the 1970s, a revolution occurred in the management of nosocomial infections in US hospitals. In 1970, fewer than 5% of hospitals had organized infection surveillance and control programs, but by 1977 the great majority had fullor part-time infection-control nurses maintaining surveillance over infectious complications of hospitalization and assisting infection-control committees in formulating and applying methods of controlling and preventing them. This dramatic emergence of a new discipline stimulated an outpouring of scientific articles, training courses and manuals, and guidelines. By the late 1970s, this information explosion whetted appetites for general textbooks and other means of collecting and organizing information on the new surveillance and control technologies. Through the 1970s, the only widely read volume covering a broad range of subjects on infection control was the practical handbook<i>Infection Control in the Hospital</i>, published by the American Hospital Association. Finally, in 1979, the textbook<i>Hospital Infections</i>
Clinical electrophysiologic effects of tocainide.
Authors: J L Anderson, J W Mason, R A Winkle, P J Meffin, R E Fowles, L Peters, D C Harrison
Journal: Circulation (1978)

The electrophysiologic properties of tocainide were evaluated by electrophysiologic studies in 11 patients before, during and after a constant intravenous infusion of the drug for 15 minutes. Peak plasma tocainide concentrations averaged 11.0 +/- 1.7 microgram/ml (SEM), range 3.7 to 22.7. AH, HV, QRS, QTc and RR intervals were measured every 5 minutes during sinus and atrial-paced rhythms and showed small changes which were not statistically significant for HV and QRS. Mild shortening of RR was significant (P less than 0.05) at 15 minutes only. AH tended to increase slightly for spontaneous (but not paced) rhythm, becoming significant at 15 minutes only (P less than 0.05). QTc decreased slightly, a change which was significant (P less than 0.05) for paced but not spontaneous rhythm. A progressive rise in mean arterial pressure occurred during infusion and persisted through 30 minutes (P less than 0.001). Comparison of electrophysiologic studies at 0 and 30 minutes showed decreased in mean effective refractory periods of atrium, A-V node, and right ventricle by 17, 22, and 23 msec, respectively (P less than 0.05, 0.01, 0.01). Functional refractory period of the A-V node showed an average decrease which was not significant. Sinus node recovery time and Wenckebach cycle length were unchanged. The drug was well tolerated in all 11 patients. Hypotension in a twelfth patient may or may not have been drug related. These results obtained at therapeutic plasma concentrations suggest qualitative similarities between the conduction system effects of tocainide and those published for lidocaine.
Late Surgical Fenestration for Complications After the Fontan Operation
Authors: Jack Rychik, Jonathan J. Rome, Marshall L. Jacobs
Journal: Circulation (1997)

Background Significant morbidity after Fontan operation results in either takedown, heart transplantation, or death. Initial creation of a fenestration results in less morbidity and mortality; however, the role of late creation of a fenestration in aiding patients manifesting morbidity after an initial nonfenestrated Fontan operation is unclear. Methods and Results We reviewed our experience with late creation of a surgical fenestration in 9 patients (5.2±3.1 years old) exhibiting chronic effusions (n=4) or protein-losing enteropathy (PLE) (n=5) after lateral tunnel-type Fontan operation. Patients with effusions had creation via coronary punch of two or three 3-mm defects; patients with PLE had creation of a large, 5-mm defect. One child with effusions and multisystem organ failure before fenestration died 7 weeks after surgery secondary to low cardiac output; the other 3 had resolution of effusions within 4 to 6 weeks. Of the 5 with PLE, 3 had normalization of serum proteins and resolution of symptoms at 2 to 6 weeks. The 2 failures had arterial saturations &gt;89% after surgery. Follow-up was from 25 to 30 months. Spontaneous closure of defects occurred in all 3 with effusions. No return of symptoms was noted in 2; however, the third reaccumulated effusions and has undergone refenestration with a large defect. All 3 patients with PLE have remained asymptomatic with patency of the fenestration (4 to 5 mm on echocardiography) and arterial saturation ≤85% for &gt;2 years. Conclusions Late surgical creation of fenestration results in resolution of morbidity after Fontan operation. Improvement is related to the degree of right-to-left shunt created.
Pericardiectomy in Uremia
Authors: Satwant Singh
Journal: JAMA (1974)

Pericardial effusion with cardiac tamponade in chronic renal failure is treated conventionally by aggressive dialysis, repeated pericardicentesis, and less often, by surgery (pericardial window or partial pericardiectomy). Although serious complications have followed pericardial aspiration in several reported cases, it continues to be the most widely practiced therapeutic maneuver. Pericardicentesis was performed in four patients on our longterm dialysis program during a one-year period. Serious complications occurred in all, and proved fatal in three. Surgical intervention in one of the three who died, and in two other patients, resulted in immediate relief of cardiac embarrassment without surgical complications or subsequent recurrence of tamponade. We recommend elective partial pericardiectomy in all patients with uremic cardiac tamponade. Pericardicentesis should be reserved for dire emergencies only. (<i>JAMA</i>228:1132-1135, 1974)
Identification of Candidate Transcription Factor Binding Sites in the Cattle Genome
Authors: Derek M. Bickhart, George E. Liu
Journal: Genomics Proteomics & Bioinformatics (2013)

A resource that provides candidate transcription factor binding sites (TFBSs) does not currently exist for cattle. Such data is necessary, as predicted sites may serve as excellent starting locations for future omics studies to develop transcriptional regulation hypotheses. In order to generate this resource, we employed a phylogenetic footprinting approach-using sequence conservation across cattle, human and dog-and position-specific scoring matrices to identify 379,333 putative TFBSs upstream of nearly 8000 Mammalian Gene Collection (MGC) annotated genes within the cattle genome. Comparisons of our predictions to known binding site loci within the PCK1, ACTA1 and G6PC promoter regions revealed 75% sensitivity for our method of discovery. Additionally, we intersected our predictions with known cattle SNP variants in dbSNP and on the Illumina BovineHD 770k and Bos 1 SNP chips, finding 7534, 444 and 346 overlaps, respectively. Due to our stringent filtering criteria, these results represent high quality predictions of putative TFBSs within the cattle genome. All binding site predictions are freely available at http://bfgl.anri.barc.usda.gov/BovineTFBS/ or http://199.133.54.77/BovineTFBS.
Autologous antitumor activity by NK cells expanded from myeloma patients using GMP-compliant components
Authors: Evren Alici, Tolga Sutlu, Bo Björkstrand, Mari Gilljam, Birgitta Stellan, Hareth Nahi, Hernan Concha Quezada, Gösta Gahrton, Hans-Gustaf Ljunggren, M. Sirac Dilber
Journal: Blood (2008)
Physicians’ Reasons for Not Entering Eligible Patients in a Randomized Clinical Trial of Surgery for Breast Cancer
Authors: Kathryn M. Taylor, Richard G. Margolese, Colin L. Soskolne
Journal: New England Journal of Medicine (1984)

We studied the reasons surgical principal investigators chose not to enter patients in a large, multicenter trial sponsored by a cooperative group. In 1976 the National Surgical Adjuvant Project for Breast and Bowel Cancers (NSABP) initiated a clinical trial to compare segmental mastectomy and postoperative radiation, or segmental mastectomy alone, with total mastectomy. Because the low rates of accrual were threatening to close the trial prematurely, we mailed a questionnaire to the 94 NSABP principal investigators, asking why they were not entering eligible patients in the trial. A response rate of 97 per cent was achieved. Physicians who did not enter all eligible patients offered the following explanations: (1) concern that the doctor-patient relationship would be affected by a randomized clinical trial (73 per cent), (2) difficulty with informed consent (38 per cent), (3) dislike of open discussions involving uncertainty (22 per cent), (4) perceived conflict between the roles of scientist and clinician (18 per cent), (5) practical difficulties in following procedures (9 per cent), and (6) feelings of personal responsibility if the treatments were found to be unequal (8 per cent). Further investigation into the behavioral aspects of the investigator-patient relationship is particularly pressing, since fear of change in this relationship was the most common reason given for not entering eligible patients in the trial.