Is ventilator-associated pneumonia related to frequency of breathing circuit changes? D. Murphy, BSN, CIC,* M. H. Kollef, MD, E. Trovillion, BSN, CIC, M. Jones, BSN, CIC, M. Illig, BSN, CIC, J. Dorris, BSN, V. Fraser, MD. Barnes-Jewish Hospital at Washington University Medical Center, St. Louis, MO

1995 ◽  
Vol 23 (2) ◽  
pp. 98
Keyword(s):  
Breathing Circuit ◽  
Medical Center ◽  
Ventilator Associated Pneumonia ◽  
Jewish Hospital ◽  
Washington University

scholarly journals Multiplatform assessment of saliva for SARS-CoV-2 molecular detection in symptomatic healthcare personnel and patients presenting to the emergency department

2021 ◽  
Author(s):  
Robert F Potter ◽  
Eric M Ransom ◽  
Meghan A Wallace ◽  
Caitlin Johnson ◽  
Jennie H Kwon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Molecular Detection ◽  
Clinical Symptoms ◽  
Medical Center ◽  
Relative Sensitivity ◽  
Healthcare Personnel ◽  
Percent Agreement ◽  
Jewish Hospital ◽  
Washington University ◽  
Alternative Specimen

Abstract Background Saliva has garnered great interest as an alternative specimen type for molecular detection of SARS-CoV-2. Data are limited on the relative performance of different molecular methods using saliva specimens and the relative sensitivity of saliva to NP swabs. Methods To address the gap in knowledge, we enrolled symptomatic healthcare personnel (n = 250) from Barnes-Jewish Hospital/Washington University Medical Center and patients presenting to the Emergency Department with clinical symptoms compatible with COVID-19 (n = 292). We collected paired saliva specimens and NP swabs. The Lyra SARS-CoV-2 assay (Quidel, San Diego, CA) was evaluated on paired saliva and NP samples. Subsequently we compared the Simplexa COVID-19 Direct Kit (Diasorin, Cypress, CA) and a modified SalivaDirect (Yale) assay on a subset of positive and negative saliva specimens. Results The positive percent agreement between saliva and NP samples using the Lyra SARS-CoV-2 assay was 63.2%. Saliva samples had higher SARS-CoV-2 cycle threshold values compared to NP swabs (p < 0.0001). We found a 76.47% (26/34) positive percent agreement for Simplexa COVID-19 Direct Kit on saliva and a 67.6% (23/34) positive percent agreement for SalivaDirect compared to NP swab results. Conclusion These data demonstrate molecular assays have variability in performance for detection of SARS-CoV-2 in saliva.

Completion Laryngectomy

1979 ◽  
Vol 88 (2) ◽  
pp. 172-177 ◽  
Author(s):  
Ernest M. Myers ◽  
Joseph H. Ogura
Keyword(s):  
Local Recurrence ◽  
Clinical Presentation ◽  
Medical Center ◽  
Partial Laryngectomy ◽  
Respiratory Obstruction ◽  
High Incidence ◽  
Conservation Surgery ◽  
Upper Respiratory ◽  
Washington University ◽  
Salvage Rate

From 1965 to 1975, 452 total laryngectomies were performed at the Washington University Medical Center, St. Louis, Missouri. Forty-two or 9.4% were completion laryngectomies. Completion laryngectomy is defined as the removal of the remaining larynx following an antecedent partial laryngectomy. These 42 cases are retrospectively analyzed in regards to original conservation surgery, clinical presentation, histopathology and salvage rate. The most common indications for completion laryngectomy were: 1) local recurrence, 2) local recurrence with associated severe upper respiratory obstruction, and 3) fistula control. The overall salvage rate following completion laryngectomy was 55% (23 patients). The highest rate was in patients with previous hemilaryngectomy (69%), followed by subtotal supraglottic laryngectomy (44%), and partial laryngopharyngectomy (14%). There is a high incidence of stomal occurrences (24% or 10 patients) associated with completion laryngectomy, particularly in patients with antecedent hemilaryngectomy. Most indications for completion laryngectomy present early, however, all patients must be carefully followed. Both the patient and the otolaryngologist must be ever vigilant following conservation surgery.

Relationship of Blood Pressure to Blood Lead Concentrations in Small Children

PEDIATRICS ◽  
1979 ◽  
Vol 63 (4) ◽  
pp. 674-676
Author(s):  
Ramesh C. Jhaveri ◽  
Lorenzo Lavorgna ◽  
Shiv K. Dube ◽  
Leonard Glass ◽  
Farida Khan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Symptoms ◽  
Medical Center ◽  
Blood Lead ◽  
Elevated Blood ◽  
Small Children ◽  
Lead Levels ◽  
Jewish Hospital ◽  
Relationship Of ◽  
Infants And Young Children

Elevated blood lead concentrations are associated with a variety of pathophysiologic changes in both children and adults, even in the absence of clinical symptoms. Although hypertension has been described in adults with elevated blood lead concentrations,1 there have been no systematic studies in infants and children in which lead levels were correlated with blood pressure measurements. In the present study, blood lead concentrations of greater than 40 µg/dl were associated with blood pressure elevations in infants and young children. SUBJECTS AND METHODS Thirty-four patients, age 1 to 3 years, who were referred to the Special Lead Clinic of the Jewish Hospital and Medical Center of Brooklyn because of blood lead levels of more than 40 µg/dl were subjects of the study.

scholarly journals Procurement of Human Tissues for Research Banking in the Surgical Pathology Laboratory: Prioritization Practices at Washington University Medical Center

2011 ◽  
Vol 9 (3) ◽  
pp. 245-251 ◽  
Author(s):  
Sandra A. McDonald ◽  
Rebecca D. Chernock ◽  
Tracey A. Leach ◽  
Ajaz A. Kahn ◽  
James H. Yip ◽  
...  
Keyword(s):  
Medical Center ◽  
Surgical Pathology ◽  
Human Tissues ◽  
Pathology Laboratory ◽  
Washington University

Sustained Reduction of Ventilator-Associated Pneumonia Rates Using Real-Time Course Correction With a Ventilator Bundle Compliance Dashboard

2015 ◽  
Vol 36 (11) ◽  
pp. 1261-1267 ◽  
Author(s):  
Thomas R. Talbot ◽  
Devin Carr ◽  
C. Lee Parmley ◽  
Barbara J. Martin ◽  
Barbara Gray ◽  
...  
Keyword(s):  
Real Time ◽  
Program Implementation ◽  
Time Course ◽  
Medical Center ◽  
Pearson Correlation ◽  
Academic Medical Center ◽  
Ventilator Associated Pneumonia ◽  
Interrupted Time Series Analysis ◽  
Adherence Assessment ◽  
Bundle Compliance

BACKGROUNDThe effectiveness of practice bundles on reducing ventilator-associated pneumonia (VAP) has been questioned.OBJECTIVETo implement a comprehensive program that included a real-time bundle compliance dashboard to improve compliance and reduce ventilator-associated complications.DESIGNBefore-and-after quasi-experimental study with interrupted time-series analysis.SETTINGAcademic medical center.METHODSIn 2007 a comprehensive institutional ventilator bundle program was developed. To assess bundle compliance and stimulate instant course correction of noncompliant parameters, a real-time computerized dashboard was developed. Program impact in 6 adult intensive care units (ICUs) was assessed. Bundle compliance was noted as an overall cumulative bundle adherence assessment, reflecting the percentage of time all elements were concurrently in compliance for all patients.RESULTSThe VAP rate in all ICUs combined decreased from 19.5 to 9.2 VAPs per 1,000 ventilator-days following program implementation (P<.001). Bundle compliance significantly increased (Z100 score of 23% in August 2007 to 83% in June 2011 [P<.001]). The implementation resulted in a significant monthly decrease in the overall ICU VAP rate of 3.28/1,000 ventilator-days (95% CI, 2.64–3.92/1,000 ventilator-days). Following the intervention, the VAP rate decreased significantly at a rate of 0.20/1,000 ventilator-days per month (95% CI, 0.14–0.30/1,000 ventilator-days per month). Among all adult ICUs combined, improved bundle compliance was moderately correlated with monthly VAP rate reductions (Pearson correlation coefficient, −0.32).CONCLUSIONA prevention program using a real-time bundle adherence dashboard was associated with significant sustained decreases in VAP rates and an increase in bundle compliance among adult ICU patients.Infect. Control Hosp. Epidemiol. 2015;36(11):1261–1267

NEWS AND ANNOUNCEMENTS

PEDIATRICS ◽  
1967 ◽  
Vol 40 (4) ◽  
pp. 697-701
Keyword(s):  
Heart Disease ◽  
American Academy ◽  
Pediatric Cardiology ◽  
Medical Center ◽  
New Haven ◽  
American Academy Of Pediatrics ◽  
Infancy And Childhood ◽  
Jewish Hospital

Heart Disease: District II of the American Academy of Pediatrics and the Department of Pediarics at the Jewish Hospital and Medical Center of Brooklyn are offering a postgraduate course in pediatric cardiology from November 2 to December 7, 1967. Entitled "Heart Disease in Infancy and Childhood," the course will be given at the Jewish Hospital and Medical Center of Brooklyn and co-directed by Dr. Regina Gluck and Dr. Irving Kroop. Lecturers include: Doctors Norman Talner, New Haven; Charlotte Ferencz, Buffalo; Daniel Downing, Philadelphia; William Mustard, Toronto; Alvin Bakst, Brooklyn; and Milton Markowitz, Baltimore.

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