scholarly journals Associations of Early COVID-19 Cases in San Francisco With Domestic and International Travel

2020 ◽  
Vol 71 (11) ◽  
pp. 2976-2980 ◽  
Author(s):  
Wei Gu ◽  
Xianding Deng ◽  
Kevin Reyes ◽  
Elaine Hsu ◽  
Candace Wang ◽  
...  
Keyword(s):  
New York ◽  
San Francisco ◽  
Odds Ratio ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
International Travel ◽  
Care Hospital ◽  
Viral Genomes

Abstract In early-to-mid March 2020, 20 of 46 (43%) COVID-19 cases at a tertiary care hospital in San Francisco, California were travel related. Cases were significantly associated with travel to either Europe (odds ratio, 6.1) or New York (odds ratio, 32.9). Viral genomes recovered from 9 of 12 (75%) cases co-clustered with lineages circulating in Europe.

scholarly journals Risk Factors of Poorly Controlled Childhood Epilepsy - A Study in A Tertiary Care Hospital

2012 ◽  
Vol 34 (2) ◽  
pp. 44-50 ◽  
Author(s):  
AKM Moinuddin ◽  
Md Mizanur Rahman ◽  
Shaheen Akhter ◽  
Syeda Tabassum Alam ◽  
CA Kawser
Keyword(s):  
Risk Factors ◽  
Early Onset ◽  
Odds Ratio ◽  
Tertiary Care Hospital ◽  
Focal Epilepsy ◽  
Tertiary Care ◽  
Idiopathic Epilepsy ◽  
Care Hospital ◽  
Hospital Design ◽  
One Year

Objective: Identifying the risk factors of poor seizure control in children in a setting of tertiary care hospital. Design: Retrospective study. Setting: Child Development and Neurology Unit in the department of Paediatrics of Bangabandhu Sheikh Mujib Medical University (BSMMU). Study period: January 2004 through December 2005. Subjects: One hundred and twenty epileptic children were studied. They were grouped into controlled group (seizure free for more than six months) and poorly controlled group (having one or more seizure per month over a period of six months or more and who had experienced trials of at least two different antiepileptic drugs at optimum doses alone or in combination with adequate compliance) at the end of intervention and compared. Results: In this study 76 (63.3%) children were male and 44 (36.7%) children were female. Out of 120 cases 79 (65.8%) were in controlled group and 41 (34.2%) cases had poorly controlled epilepsy. Mean age of the controlled group and poorly controlled group of children were 79 months and 40.3 months respectively. Focal epilepsy was found in 30 (68%) cases in controlled and in 14 (31.8%) cases of poorly controlled group and generalized epilepsy was found in 42 (72%) cases in controlled and in 19 (28.8%) cases in poorly controlled group. Idiopathic epilepsy was more common which was 37 (46%) in controlled group against 14 (34%) in poorly controlled group. But symptomatic and cryptogenic cases were more prevalent with poorly controlled group 57.5% than controlled group 53%. In poorly controlled group 48.8% had cerebral palsy in comparison to 22.8% of controlled group. Early onset of seizure before one year was 25.3% in controlled and 78% in poorly controlled group (odds ratio=.2322, p =.0082) and one or more seizure per week 43% in controlled and 92.7% in poorly controlled group (odds ratio=.1218, p=.0032) were found as risk factors of poorly controlled epilepsy. Conclusion: Early onset of seizure before one year, symptomatic epilepsy and one or more seizure per week at diagnosis were found as risk factors of poorly controlled epilepsy in children attending a tertiary care hospital. DOI: http://dx.doi.org/10.3329/bjch.v34i2.10216 BJCH2010; 34(2): 44-50

scholarly journals Appropriateness of Gram-Negative Agent Use at a Tertiary Care Hospital in the Setting of Significant Antimicrobial Resistance

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
Neil M. Vora ◽  
Christine J. Kubin ◽  
E. Yoko Furuya
Keyword(s):  
New York ◽  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Categorical Variables ◽  
Care Hospital ◽  
Antimicrobial Stewardship Program ◽  
Gram Negative ◽  
Stewardship Program

Abstract Background.  Practicing antimicrobial stewardship in the setting of widespread antimicrobial resistance among gram-negative bacilli, particularly in urban areas, is challenging. Methods.  We conducted a retrospective cross-sectional study at a tertiary care hospital with an established antimicrobial stewardship program in New York, New York to determine appropriateness of use of gram-negative antimicrobials and to identify factors associated with suboptimal antimicrobial use. Adult inpatients who received gram-negative agents on 2 dates, 1 June 2010 or 1 December 2010, were identified through pharmacy records. Clinical data were collected for each patient. Use of gram-negative agents was deemed optimal or suboptimal through chart review and according to hospital guidelines. Data were compared using χ2 or Fischer's exact test for categorical variables and Student t test or Mann–Whitney U test for continuous variables. Results.  A total of 356 patients were included who received 422 gram-negative agents. Administration was deemed suboptimal in 26% of instances, with the most common reason being spectrum of activity too broad. In multivariable analysis, being in an intensive care unit (adjusted odds ratio [aOR], .49; 95% confidence interval [CI], .29–.84), having an infectious diseases consultation within the previous 7 days (aOR, .52; 95% CI, .28–.98), and having a history of multidrug-resistant gram-negative bacilli within the past year (aOR, .24; 95% CI, .09–.65) were associated with optimal gram-negative agent use. Beta-lactam/beta-lactamase inhibitor combination drug use (aOR, 2.6; 95% CI, 1.35–5.16) was associated with suboptimal use. Conclusions.  Gram-negative agents were used too broadly despite numerous antimicrobial stewardship program activities.

scholarly journals Population Structure of Klebsiella pneumoniae Causing Bloodstream Infections at a New York City Tertiary Care Hospital: Diversification of Multidrug-Resistant Isolates

2015 ◽  
Vol 53 (7) ◽  
pp. 2060-2067 ◽  
Author(s):  
Angela Gomez-Simmonds ◽  
Michelle Greenman ◽  
Sean B. Sullivan ◽  
Joshua P. Tanner ◽  
Madeleine G. Sowash ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Klebsiella Pneumoniae ◽  
York City ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Mortality Rates ◽  
Care Hospital ◽  
Content Type

Despite the growing importance of carbapenem-resistantKlebsiella pneumoniae(CRKP), the clonal relationships between CRKP and antibiotic-susceptible isolates remain unclear. We compared the genetic diversity and clinical features of CRKP, third-generation and/or fourth-generation cephalosporin-resistant (Ceph-R)K. pneumoniae, and susceptibleK. pneumoniaeisolates causing bloodstream infections at a tertiary care hospital in New York City between January 2012 and July 2013. Drug susceptibilities were determined with the Vitek 2 system. Isolates underwent multilocus sequence typing and PCR sequencing of thewziandblaKPCgenes. Clinical and microbiological data were extracted from patient records and correlated with molecular data. Among 223 patients, we identified 272 isolates. Of these, 194 were susceptible, 30 Ceph-R, and 48 CRKP, belonging to 144 sequence types (STs). Susceptible (127 STs) and Ceph-R (20 STs) isolates were highly diverse. ST258 dominated CRKP strains (12 STs, with 63% ST258). There was minimal overlap in STs between resistance groups. TheblaKPC-3gene (30%) was restricted to ST258/wzi154, whereasblaKPC-2(70%) was observed for severalwziallele types. CRKP infections occurred more frequently among solid organ transplant (31%) and dialysis (17%) patients. Mortality rates were high overall (28%) and highest among CRKP-infected patients (59%). In multivariable analyses, advanced age, comorbidities, and disease severity were significant predictors of 30-day mortality rates, whereas theK. pneumoniaesusceptibility phenotype was not. Among CRKP infections, we observed a borderline significant association of increased mortality rates with ST258 and thewzi154 allele. Although the clonal spread of ST258 continues to contribute substantially to the dissemination of CRKP, non-ST258 strains appear to be evolving. Further investigations into the mechanisms promoting CRKP diversification and the effects of clonal backgrounds on outcomes are warranted.

scholarly journals Experience from a COVID-19 screening centre of a tertiary care institution: A retrospective hospital-based study

2020 ◽  
Author(s):  
Somen Kumar Pradhan ◽  
Dinesh Prasad Sahu ◽  
Durgesh Prasad Sahoo ◽  
Arvind Kumar Singh ◽  
Binod Kumar Patro ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Specific Treatment ◽  
International Travel ◽  
Health Concern ◽  
Care Hospital ◽  
Patient Profile ◽  
Patient Reported ◽  
Epidemiological Characteristics

AbstractIntroductionThe COVID-19 pandemic continuing to be a significant public health concern across the whole world, including India. In the absence of any specific treatment or vaccine against COVID-19., the role of efficient testing and reporting has been uncontested so far as the number of cases is rising daily. In order to strengthen the screening activities and to prevent nosocomial infection, facility-based screening centres have been designed and operated at various level of healthcare, including tertiary care institutions.MethodsThe present study has been planned with an objective to understand the patient profile and evaluate the functioning of COVID-19 screening OPD(CS-OPD) at a tertiary care hospital. In this hospital-based retrospective study, data from individuals visiting the COVID-19 screening OPD during the period from 17th March 2020 to 31st July 2020 were collected. We documented and analysed relevant demographic, epidemiological and clinical characteristics of the patients.ResultsA total of 10,735 patients visited the COVID-19 screening OPD during the defined study period out of which 3652 individuals were tested. Majority of the patients, i.e. 65.67% (7050) were male and in 15-59 years age group (84.68%). Most common symptoms among patients visiting CS-OPD was Cough (9.86%). Out of the total, 17.17% (1843) of patient reported to the CS-OPD with contact history of COVID-19 positive patient. On the other hand, 13.49% (1448) of patients were with either domestic or international travel history. The overall testing rate and positivity rate for CS-OPD during this period were found to be 34.02% and 7.94% respectively.ConclusionThe clinical, demographic and epidemiological characteristics of patients visiting CS-OPD varied across the study period depending upon the containment and testing strategy. The CS-OPD played a crucial role in preventing nosocomial infection and maintaining non-COVID care at the tertiary care hospital.

scholarly journals High prevalence of t895 and t9364 spa types of methicillin-resistant Staphylococcus aureus in a tertiary-care hospital in México: Different lineages of Clonal Complex 5

2020 ◽  
Author(s):  
C Negrete-González ◽  
E Turrubiartes-Martínez ◽  
OG Galicia-Cruz ◽  
DE Noyola ◽  
G Martínez-Aguilar ◽  
...  
Keyword(s):  
New York ◽  
Staphylococcus Aureus ◽  
Clonal Complex ◽  
Tertiary Care Hospital ◽  
Sccmec Type ◽  
Tertiary Care ◽  
Molecular Characteristics ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Spa Types

Abstract BACKGROUND Staphylococcus aureus is a leading cause of broad-spectrum infections both, in the community and within the healthcare settings. The methicillin-resistant Staphylococcus aureus (MRSA) variant has became a global issue of public health. The aim of this study was to examine the clinical and molecular characteristics of Staphylococcus aureus isolates and to define the population structure and distribution of major MRSA clones present in a tertiary-care hospital in Mexico. RESULTS From April 2017 to April 2018, 191 isolates of Staphylococcus aureus were collected. The frequency of MRSA was 26.7%, these strains exhibited resistance to clindamycin (85.3%), erythromycin (86.2%), levofloxacin (80.3%), and ciprofloxacin (86.3%). The majority of MRSA strains harbored the SCCmec type II (39/51); the t895 (29/51) and t9364 (6/51) were the most common spa types in both, hospital-associated MRSA and community associated MRSA isolates. The clones ST5-MRSA-II-t895 (New York /Japan clone) and ST1011-MRSA-II-t9364 (New York /Japan-Mexican Variant clone) were the most frequent. Finally, different lineages of Clonal Complex 5 (90.6%) and Clonal Complex 8 (9.1%) were identified in this study. CONCLUSION Our study provides valuable information about the epidemiology of MRSA in a city of the central region of Mexico, and this is the first report on the association between the t895 and t9364 spa types and the ST5 and ST1011 lineages, respectively.

scholarly journals Reflections of an Earliest Established Screening and Testing Facility for COVID-19 in the Largest Metropolis, Pakistan

2021 ◽  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
International Travel ◽  
Care Hospital ◽  
Screening Criteria ◽  
Travel History ◽  
Clinical Exposure ◽  
Testing Facility ◽  
The World ◽  
Public Exposure

As the world struggles to deal with the COVID-19 pandemic, this article talks about the experience and findings of the first COVID-19 screening facility in a tertiary care hospital in Karachi, Pakistan. Department of Family Medicine at Aga Khan University (AKU) took initiative where COVID-19 screening of stable patients first began in a dedicated area. Since testing kits were limited and community spread had not started, nurses would screen every walk-in patient based on the presence of fever, cough, travel history and exposure to COVID-19 positive patient in the last 14 days, and advise swab testing if indicated. Out of 742-screened patients, approximately 66% were males and 34% were females. 38% of patients reported fever and 54% of patients reported cough. 8% (65) patients checked all three screening criteria of cough, fever and international travel exposure whereas 35% were asymptomatic. The majority had clinical exposure (38.3%) followed by public exposure (33.4%) and international travel exposure (19.8%).

Microorganism contamination of mezuzahs in a tertiary care hospital in Brooklyn, New York City

2013 ◽  
Vol 41 (11) ◽  
pp. 1139-1140
Author(s):  
Ceres T. Tiu ◽  
Alejandro Villegas ◽  
Khawar Khurshid ◽  
Catalina Salinas ◽  
Lauren Bertelle ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital

scholarly journals Assessment between hypoparathyroidism and the number of parathyroid glands preserved during thyroidectomy: a record based study

2019 ◽  
Vol 6 (11) ◽  
pp. 3963
Author(s):  
Srujan Kumar Bellapu
Keyword(s):  
Odds Ratio ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Major Complication ◽  
Parathyroid Glands ◽  
Care Hospital ◽  
Permanent Hypoparathyroidism ◽  
Papillary Thyroid ◽  
Minimum Number ◽  
Transient Hypoparathyroidism

Background: Hypoparathyroidism is a major complication of thyroidectomy. The association between the number of parathyroid glands preserved and hypoparathyroidism is not well understood. The objectives of the study were to evaluate the clinical characteristics and the frequency of hypoparathyroidism during thyroidectomy, and to determine the minimum number of parathyroid glands that need to be preserved to prevent hypoparathyroidism.Methods: A retrospective study was conducted in Department of Surgery in Tertiary care hospital from January 2016 to December 2017. Around 250 patients who underwent total thyroidectomy for papillary thyroid carcinoma were analysed. We evaluated the frequency of hypoparathyroidism according to the number of parathyroid glands preserved.Results: Incidental parathyroidectomy occurred in 20% of the patients; one parathyroid gland in 16%, two in 1.5%, and three in 0.9%. Transient hypoparathyroidism was increased when incidental parathyroidectomy occurred (odds ratio 1.63, 95% confidence interval 1.07 to 3.13, p=0.03). There was no significant relationship between the number of parathyroid glands preserved and permanent hypoparathyroidism (p=0.16).Conclusions: Conservation of all parathyroid glands decreases transient hypoparathyroidism equated with when three or fewer glands are preserved but does not affect permanent hypoparathyroidism.

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