scholarly journals 708. Evaluation of Fungal Culture versus Bacterial Culture for the Identification of Various Mold Species

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S453-S454
Author(s):  
Erin Su ◽  
Rosemary She
Keyword(s):  
Los Angeles ◽  
Bacterial Culture ◽  
Medical Center ◽  
Fungal Culture ◽  
Dimorphic Fungi ◽  
Bacterial Cultures ◽  
Invasive Mold Infections ◽  
Respiratory Specimens ◽  
Specimen Sampling ◽  
Wound Tissue

Abstract Background Invasive mold infections are challenging to diagnose and in part relies on fungal cultures. A large proportion of mold isolates are recovered on routine bacterial cultures in our medical center, thus we sought to define the utility of bacterial versus fungal cultures for isolation of mold from clinical specimens. Methods Routine bacterial and fungal culture results from wound, tissue, body fluid, and respiratory specimens from Jan 2019-Dec 2020 from Keck Medical Center of USC (Los Angeles, CA) were retrospectively reviewed. Cases were excluded if specimens were collected specifically for dermatophyte recovery or for blood culture. Cultures in which mold, including dimorphic fungi, were isolated were included in the evaluation. Results Mold was isolated from 612 specimens from 408 patients, with recovery from 329 bacterial and 450 fungal cultures. Among the 329 bacterial cultures, fungal cultures were not requested in 119 (36.2%) while the remaining 210 had concurrent fungal cultures which recovered mold in 167 cases (79.5%). Of 450 fungal cultures recovering mold, a corresponding bacterial culture was performed in 445, isolating mold in 181 (38.8%) of these cases. Two or more molds were found in 28 fungal cultures and in 5 bacterial cultures. Of positive specimens with both fungal and bacterial cultures performed (n=488), mold was isolated in fungal cultures in 446 (91.4%) and in bacterial cultures in 209 (42.9%) (Table). Yield of molds in 488 specimens with concomitant bacterial and fungal cultures Conclusion Although a significant number of molds are recovered in routine bacterial cultures, over half would be missed without concomitant fungal cultures. Conversely, recovery of clinically relevant mold species was optimal when both bacterial and fungal cultures were requested on a specimen. This may be related to increased specimen sampling and incubation conditions allowing for broader organism recovery. Disclosures All Authors: No reported disclosures

scholarly journals 739. A Two-Center Assessment of Histopathologic Diagnostic Performance for Fungal Organism Identification

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S419-S419
Author(s):  
Cristina R Costales ◽  
Susan Butler-Wu ◽  
Rosemary She
Keyword(s):  
Los Angeles ◽  
Diagnostic Performance ◽  
Medical Center ◽  
False Negative ◽  
Surgical Pathology ◽  
Fungal Culture ◽  
Medical Centers ◽  
Significant Difference ◽  
Tissue Specimens ◽  
Fungal Tissue

Abstract Background Accurate detection and identification of invasive fungal pathogens relies on concordance of several complementary laboratory techniques, including fungal culture, serology, and histopathologic identification. Histopathologic stains such as the Gomori methenamine silver stain (GMS) are used to highlight fungal cell wall in tissue specimens. We sought to determine the diagnostic performance of histopathology fungal stains as compared to fungal culture for diagnosis of invasive fungal tissue infection at tertiary medical centers with dissimilar patient populations. Methods We performed a retrospective review of all surgical pathology specimens with reported GMS results and concurrent fungal culture at Keck Medical Center (Keck) and Los Angeles County + USC Medical Center (LAC). Ratios of GMS diagnostic performance were compared using chi-squared analyses, with fungal culture as the gold standard for detection. Results Of 1347 LAC surgical pathology specimens stained with GMS to evaluate for fungal infection, 229 (17.0%) had concurrent tissue specimens submitted for fungal culture. Of 1546 Keck GMS-stained surgical pathology specimens, 358 (23.2%) had concurrent tissue for fungal culture. GMS stain performance at LAC showed a sensitivity of 53.7% (95% CI: 37.4-69.3%) and specificity of 90.4% (95% CI: 85.2-94.2%). At Keck, GMS showed a sensitivity of 64.1% (95% CI: 52.4-74.7%), specificity of 88.9% (95% CI: 84.7-92.4%), without significant difference in performance between sites, (p=0.27) and (p=0.62), respectively. Among filamentous fungi, GMS false negative frequency at LAC was 5.3% (10/190) and 4.0% (11/277) at Keck, without significant difference (p=0.51). A subset of pathology reports suggested the fungus genus based on histologic morphology. Of 10 LAC pathology specimens with fungal genus specified, 2 (20.0%) reports gave the incorrect genus and 8/18 (44.4%) reports at Keck gave incorrect genus as per concurrent culture isolate result. Table 1. Diagnostic performance of GMS histopathology stain on surgical pathology specimens compared to tissue fungal culture at LAC and Keck Medical Centers from July 2015 through December 2018. Conclusion GMS stain had low-to-moderate sensitivity when compared to fungal tissue culture. Increased submission of concurrent tissue for fungal culture is likely to improve detection. When genus level identification was attempted, fungal forms were incorrectly identified in about one-third of histopathology specimens. Disclosures All Authors: No reported disclosures

scholarly journals Impact of COVID-19 infection among cancer patients treated at the Los Angeles County Medical Center

2021 ◽  
Vol 26 ◽  
pp. 100273
Author(s):  
Lauren Antrim ◽  
Stephen Capone ◽  
Stephen Dong ◽  
David Chung ◽  
Sonia Lin ◽  
...  
Keyword(s):  
Los Angeles ◽  
Cancer Patients ◽  
Los Angeles County ◽  
Medical Center

scholarly journals Association of CYP3A7*1C and Serum Dehydroepiandrosterone Sulfate Levels in Women with Polycystic Ovary Syndrome

2008 ◽  
Vol 93 (7) ◽  
pp. 2909-2912 ◽  
Author(s):  
Mark O. Goodarzi ◽  
Ning Xu ◽  
Ricardo Azziz
Keyword(s):  
Los Angeles ◽  
Polycystic Ovary Syndrome ◽  
White Women ◽  
Polycystic Ovary ◽  
Medical Center ◽  
Free Testosterone ◽  
Total Testosterone ◽  
Adrenal Androgen ◽  
Androgen Excess ◽  
Ovary Syndrome

Abstract Context: Adrenal androgen excess is common in polycystic ovary syndrome (PCOS) and appears to be heritable. CYP3A7 metabolizes dehydroepiandrosterone and its sulfate (DHEAS). A promoter variant, CYP3A7*1C, which results in persistent expression in adults, was associated with reduced DHEAS levels in a previous study, which led us to consider CYP3A7*1C as a modulator of adrenal androgen excess in patients with PCOS. Objective: The objective was to replicate the association between CYP3A7*1C and reduced DHEAS levels in PCOS patients and assess its possible role in modulating testosterone levels. Design: Women with and without PCOS were genotyped for CYP3A7*1C, and this variant was tested for association with DHEAS and total and free testosterone. Setting: Subjects were recruited from the reproductive endocrinology clinic at the University of Alabama at Birmingham; controls were recruited from the surrounding community. Genotyping took place at Cedars-Sinai Medical Center (Los Angeles, CA). Participants: A total of 287 white women with PCOS and 187 controls were studied. Main Measurements: CYP3A7*1C genotype, PCOS risk, and androgen levels were measured. Results: PCOS subjects who carried the CYP3A7*1C variant had lower levels of serum DHEAS and total testosterone (P = 0.0006 and 0.046, respectively). The variant was not associated with PCOS risk. Conclusion: This study replicated prior work of the association of CYP3A7*1C and decreased DHEAS in a different population of young PCOS women, providing further genetic evidence that CYP3A7 plays a potential role in modulation of DHEAS levels. Adult expression of CYP3A7 may modify the PCOS phenotype by ameliorating adrenal androgen excess.

Development of neurosurgery in Southern California and the Los Angeles County/University of Southern California Medical Center

1993 ◽  
Vol 79 (1) ◽  
pp. 145-148
Author(s):  
John H. Schneider ◽  
Martin H. Weiss ◽  
William T. Couldwell
Keyword(s):  
Los Angeles ◽  
Los Angeles County ◽  
Southern California ◽  
Medical Center ◽  
University Of Southern California ◽  
Content Type ◽  
School Of Medicine ◽  
Integral Role ◽  
Southern California School ◽  
The University

✓ The Los Angeles County General Hospital has played an integral role in the development of medicine and neurosurgery in Southern California. From its fledgling beginnings, the University of Southern California School of Medicine has been closely affiliated with the hospital, providing the predominant source of clinicians to care for and to utilize as a teaching resource the immense and varied patient population it serves.

NEWS AND ANNOUNCEMENTS

PEDIATRICS ◽  
1969 ◽  
Vol 44 (6) ◽  
pp. 1041-1043
Keyword(s):  
Los Angeles ◽  
Medical Center ◽  
University Of California ◽  
Fort Lauderdale ◽  
Pediatric Service ◽  
The University

The Variety Children Hospital Annual Pediatric Postgraduate Course, "Current Pediatric Therapy," will be held at Miami Beach, January 25-29, 1970. A faculty of more than 20 speakers will be under the Chairmanship of Donald H. Altman, M.D. For application write Dr. Altman at Variety Children Hospital, Miami, Florida 33155. Symposium on Immunologic Incompetence: The Departments of Pediatrics of Cedars-Sinai Medical Center and the University of California at Los Angeles, and the Johnson and Johnson Institute for Pediatric Service are sponsoring a symposium on Immunologic Incompetence in Fort Lauderdale, Florida, March 1-4, 1970.

Abstract 13804: Clinical Profile and Outcomes of Myocardial Infarction With Non-obstructive Coronary Arteries in Older Adults

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ara H Rostomian ◽  
Derek Q Phan ◽  
Mingsum Lee ◽  
Ray X Zadegan
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Los Angeles ◽  
Coronary Arteries ◽  
Medical Center ◽  
Invasive Coronary Angiography ◽  
Obstructive Coronary Artery Disease ◽  
Kaiser Permanente ◽  
Artery Disease

Introduction: Myocardial Infarction with non-obstructive coronary artery disease (MINOCA) is found in 5%-6% of patients with acute myocardial infarction (AMI). As such, the diagnosis and management of AMI patients with non-obstructive coronary artery disease (NOCAD) poses a challenge as compared to patients with MI with coronary artery disease (MICAD). Hypothesis: To evaluate the characteristics and outcomes of MINOCA in older patients as compared with MICAD patients, with and without revascularization. Methods: This was a retrospective observational study of patients ≥80 years old who underwent invasive coronary angiography (ICA) for AMI between 2009-2019 at Kaiser Permanente Los Angeles Medical Center. MINOCA was defied as <50% stenosis of coronary arteries on angiography with a troponin level ≥0.05 ng/ml. Patients with MINOCA vs MICAD were compared. Multivariate logistic regression was used to identify independent predictors of MINOCA and Kaplan-Meier survival analysis was used to analyze all-cause mortality between cohorts. Results: A total of 259 patients with MINOCA (mean ± SD age 83.8±2.7 years, 68% female) and 687 patients with MICAD (84.7±3.4 years, 40% female) were analyzed. Younger age (odds ratio [OR]=1.11; 95% confidence interval [CI]=1.05-1.18), female sex (OR=3.14; CI=2.20-4.48), black race (OR=2.53; CI=1.61-3.98), no history of prior stroke (OR=1.56; CI=1.06-2.33), atrial fibrillation or flutter (OR=2.04; CI:1.38-3.02), lower troponin levels (OR=1.08; CI:1.03-1.11), and lower triglyceride levels per 10 mg/dl increments (OR=1.06; CI:1.03-1.11) increased the odds of having MINCOA as compared to MICAD. At median follow-up of 2.4 years, MINOCA was associated with a lower rate of death (44.8% vs 55.2%, p<0.01) compared to un-revascularized MICAD, but no difference (31.3% vs 40.4%, p=0.68) when compared to re-vascularized MICAD. Conclusions: Patients age ≥80 years with MINOCA have fewer traditional risk factors compared to their counterparts with MICAD and fewer deaths compared to un-revascularized MICAD, but similar mortality compared to revascularized MICAD

A Prospective 12-Month Study of Prescriptions in Long-Term Care Nursing Facility Residents

2019 ◽  
Vol 34 (3) ◽  
pp. 206-214
Author(s):  
Edward L. Schneider ◽  
Jung Ki Kim ◽  
Diana Hyun ◽  
Anjali Lobana ◽  
Rick Smith ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Los Angeles ◽  
Long Term Care ◽  
Medical Center ◽  
Full Time ◽  
Nursing Facilities ◽  
Geriatric Population ◽  
Nursing Facility ◽  
Term Care

AIM: The most frequent use of medications in the geriatric population occurs in skilled nursing facilities. This quality assurance study prospectively examines the high number of prescriptions ordered for long-term nursing facility residents throughout their first year after admission. METHODS: The investigators prospectively followed 101 consecutive long-term-stay older adult residents at the Joyce Eisenberg Keefer Medical Center, a nursing facility of Los Angeles Jewish Home for the Aging (LAJH) over a 12-month period. Preadmission prescriptions were obtained for 91 residents, as well as prescriptions at 1 week, 1 month, 3 months, 6 months, and 1 year after admission. The number of prescriptions by staff physicians and outside physicians was examined. RESULTS: Over the 12 months following admission, the mean number of scheduled prescriptions increased significantly from 11.1 prior to admission to 13.0 by 6 months and to 13.3 by 12 months (P-value < 0.05). The residents who were hospitalized during the 12 months of observation received significantly more scheduled, as needed, and total prescriptions than those not hospitalized. Physicians employed full time by LAJH ordered significantly fewer additional prescriptions than physicians with outside practices. The patients of the staff physicians also had fewer hospitalizations than those of the outside physicians. CONCLUSION: This quality assurance study reveals a statistically significant increase in the number of prescriptions made in a long-term care setting over a 12-month prospective study. Patients of staff physicians received fewer prescriptions and were hospitalized less frequently than patients of physicians who practiced outside LAJH.

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