scholarly journals 1407. Potential Impact of the Biofire® Film Array Meningitis and Encephalitis (ME) Panel in Reducing Repeat Lumbar Punctures in Patients with Meningitis and Encephalitis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S512-S512
Author(s):  
Elizabeth A Aguilera ◽  
Shelby Simar ◽  
Susan H Wootton ◽  
Rodrigo Hasbun
Keyword(s):  
Pediatric Patients ◽  
Diagnostic Yield ◽  
Unknown Etiology ◽  
Blood Cell Count ◽  
Additional Testing ◽  
The Mean ◽  
Polymerase Chain ◽  
Potential Impact ◽  
Acyclovir Therapy ◽  
The Impact

Abstract Background The Biofire® FilmArray Meningitis Encephalitis (FAME) is a multiplex polymerase chain reaction (PCR) test can rapidly detect up to 14 pathogens that cause meningitis and encephalitis. The impact on preventing repeat lumbar punctures to obtain more diagnostic studies is currently unknown. Methods Patients admitted to Memorial Hermann Hospital (MHH) between July 2018-February 2019 with community-acquired symptoms of meningitis or encephalitis, CSF with white blood cell count >5 cells/mm3, and with leftover CSF at the MHH microbiology laboratory were eligible for the study. Testing FAME was performed after discharge for specimens that had not been centrifuged, had a volume of ≥200 μL, were appropriately stored, and were collected by lumbar puncture (LP) for evaluation of suspected meningitis/encephalitis. Results Of 1,382 CSF specimens screened, 70 (5.0%) met the criteria and were tested with FAME. The majority was adults (72.8%), non-Caucasian (68.6%), male (60%), immunocompetent (75.7%) and had a meningitis presentation (75.7%). Mean age was 36.9 years (1 mo-89 years). The mean duration between CSF collection and any PCR result done in the hospital was 60 hours. Fifteen patients (21.4%) required 25 repeat LPs [13 (86.6%) for additional testing (7 (53.8%) pediatric patients) and 2 (13.3%) for cryptococcal meningitis assessment]. The FAME could have prevented repeat LPs in 86.6% of patients. Five of the 13 repeat LP (38.4%) FA ME showed a pathogen [VZV (2), HSV 1 (1), HHSV-6 (1), Neisseria meningitidis (1)]. Of 46 tests with negative FA ME, acyclovir therapy was started in 22 (47.8%) with a mean of 6 doses dispensed. 38 (26.6%) patients were discharged with an unknown etiology of whom FA ME was positive in 8 (21%) [HSV2 (37.5%), VZV (25%), Enterovirus (25%) and HSV1 (12.5%)]. PCR was ordered in the hospital for only 4 (50%) of these patients. Conclusion The FAME identified an etiology in 21% of patients with meningitis and encephalitis symptoms discharged with an unknown etiology. A total of 18.5% of patients required a repeat LP for additional testing. FAME testing offers an avenue for reducing the burden of repeat LPs and duration of unnecessary anti-infective therapy while increasing diagnostic yield. Disclosures All authors: No reported disclosures.

ASSOCIATION BETWEEN QUALITY OF SLEEPAND OTHER PARAMETERS IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE.

2021 ◽  
pp. 25-27
Author(s):  
Umesh kr. Mishra ◽  
Sunita Tiwari ◽  
Sumit Rungta ◽  
Pooja Mishra ◽  
Gulam Akhtar
Keyword(s):  
Sleep Disorders ◽  
Quality Of Sleep ◽  
Night Time ◽  
Rem Latency ◽  
The Mean ◽  
Potential Impact ◽  
Nocturnal Polysomnography ◽  
The Impact ◽  
Gerd Symptoms

Background: Night time reux has been shown to be associated with fragmented sleep. However, few studies have assessed the quality of sleep on gastroesophageal reux and the impact of gastroesophageal reux on reported quality of sleep and quality of sleep on gastroesophageal reux. The aims of this study were to evaluate the quality of sleep and other parameters in patients with gastroesophageal reux disease.50 Subjects with typical GERD symptoms ≥3 times a week and All subjects were administered 3 questionnaires: PSQI , ESS, GERD-HRQL . All the subjects underwent nocturnal polysomnography and completed a all 3 questionnaire before NPSG. Results: Overall ,the mean percentage of N1 was 9.10±9.74 ,N2 was 83.97±13.81 , N3 was 3.44±4.16 , N4 was 0.60±2.04 , REM was 2.14±3.79 , PSQI was 12.48±1.23 , ESS was 11.80±0.76 , TST (hr) was 5.19±0.74 , SPT(hr) was 6.58±0.77 , sleep efciency(%) was 52.50±27.16 , Latency (mint) was 22.79±30.85 , REM Latency (mints) was 96.99±151.86 ,and Microarousal index was 36.05±25.93 . To assess the potential impact of sleep quality via nocturnal polysomnography on severity of gastroesophageal reux , we performed correlations between the GERD questionnaire and nocturnal polysomnography reports . We observed that PSQI(r= -0.285, p<0.045) , ESS(r=0.206, p=0.05) , N1(r=0.202 , p>0.160) , N2(r=- 0.045 ,p>0.758) , N3(r=-0.079, p>0.583) , N4(r-0.209 ,p>0.145),REM(r=0.045 ,p>0.756) , TST(r=0.036 ,p>0.803), SPT(r=0.015,p>0.917) , Sleep Efciency (r=-0.113,p>0.435) , Sleep Latency (r=-0.045 ,p>0.756), REM Latency (r=0.165, p >0.253), Microarousal index (r=0.058 , p>0.683). Conclusions: Gastroesophageal reux disease and sleep disorders are extremely prevalent conditions, and it seems intuitive that there must be some overlap between the two. Sleep disorders may in fact be one of the most prevalent of the extraesophageal complications of GERD and often goes unrecognized.

scholarly journals UNIDADES PARANÁ SEGURO E SEGURANÇA PÚBLICA NO MUNICÍPIO DE CURITIBA: uma avaliação quantitativa local da implementação das unidades

2015 ◽  
Vol 18 (2) ◽  
pp. 497
Author(s):  
Andréa Benetti Carvalho de Oliveira ◽  
Thomaz Teodorovicz ◽  
Luiz Alberto Esteves ◽  
Marlon Alves Cardoso
Keyword(s):  
State Government ◽  
Impact Evaluation ◽  
Study Groups ◽  
Public Security ◽  
Statistical Methodology ◽  
Security Community ◽  
The Mean ◽  
Potential Impact ◽  
The Impact ◽  
The City

O governo estadual do Paraná começou, em 2012, a implantação de um novo modelo de policiamento, pautado no conceitode “policiamento comunitário”, voltado à redução de homicídios e combate a crimes relativos às drogas: as “Unidades Paraná Seguro”. O objetivo do trabalho é mensurar o impacto dessas unidades na criminalidade em Curitiba. A base de dados analisada continha informações trimestrais de ocorrências criminais para o período entre janeiro de 2011 e setembro de 2013. Essas informações foram agrupadas em três categorias: crimes contra pessoas; relativos a drogas; e contra o patrimônio. Para tanto, aplica a metodologia estatística de diferenças-em-diferenças em uma base de dados em painel para estimar o efeito tratamento médio, tanto nos bairros inseridos, como vizinhos às zonas de influência das unidades. Os resultados indicam que, embora o impacto sobre os crimes relativosàs drogas não tenha sido significativo, houve redução nos homicídios e significativo decréscimo dos crimes contra o patrimônio.Palavras-chave: Segurança pública, polícia comunitária, Unidades Paraná Seguro, avaliação de impacto, política pública.UNITS PARANÁ INSURANCE AND PUBLIC SAFETY IN THE CITY OF CURITIBA: a quantitative local evaluation of units’ implementationAbstract: In 2012 Paraná’s state government has begun the implementation of a new policing model: the “Unidade Paraná Seguro”(UPS). Based on the “community policy” concept, UPS’ main goal is to reduce both the rate of homicides and drug-related crimes.This paper aims to measure the results of such policy regarding its potential impact over Curitiba’s criminality rates. Quarterly crimerecords at a district-level from January/2011 until September/2013 were allocated in three different study-groups: crime againstindividuals; drug-related crimes; and property crimes. Differences-in-differences statistical methodology was applied to estimate the mean treatment effect on districts with an UPS and on its border districts. The results indicate that, although the impact over drug-related crimes was not statistically significant, there was reduction in homicides and significant reduction in property crimes.Key words: Public security, community police, Units Paraná Insurance, impact evaluation, public policy

scholarly journals The Impact of a Nanocellulose-Based Wound Dressing in the Management of Thermal Injuries in Children: Results of a Retrospective Evaluation

Life ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 212
Author(s):  
Julia Cattelaens ◽  
Laura Turco ◽  
Luc M. Berclaz ◽  
Birgit Huelsse ◽  
Wolfgang Hitzl ◽  
...  
Keyword(s):  
Wound Dressing ◽  
Pediatric Patients ◽  
Wound Dressings ◽  
Retrospective Evaluation ◽  
Thermal Injuries ◽  
Hospital Stays ◽  
The Mean ◽  
The Impact ◽  
First Time

The aim of this retrospective study is to evaluate for the first time the impact of a nanocellulose-based wound dressing in the treatment of pediatric patients with both partial- and deep-thickness burns. Usability and effectiveness were defined based on parameters such as frequency of dressing changes under narcosis, duration of hospital stay, onset of complications, need for additional treatments, and follow up scar formation assessment. Fifty-six children who sustained burns in the year 2018 and were treated with a nanocellulose-based wound dressing were included in the trial. The mean stay in hospital was 6.7 days. Patients underwent dressing changes under narcosis 2.4 times on average, and none had wound-associated infection. In all, 82% of the patients were treated only with nanocellulose-based wound dressings, and reepithelialization occurred after ten days. The majority of patients had scars with normal pigmentation (98%), vascularization (91%), height (92%), and pliability (92%). In conclusion, using a nanocellulose-based wound dressing for the treatment of both superficial, partial-thickness and deep, full-thickness burns has several advantages. Compared with the results published in literature on other wound dressings, it requires a moderate number of dressing changes under narcosis and results in short hospital stays. Additionally, it has a low associated infection rate and promotes wound healing.

scholarly journals Healthcare Workers Hospitalized with COVID-19: Outcomes from the Burden of COVID-19 study at the University of Louisville Center of Excellence for Research in Infectious Diseases [CERID]

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Ruth Carrico ◽  
Keyword(s):  
Healthcare Workers ◽  
Small Population ◽  
Long Term Effects ◽  
University Of Louisville ◽  
The Mean ◽  
Polymerase Chain ◽  
The University ◽  
Epidemiological Characteristics ◽  
The Impact

Introduction: On March 6, 2020, the current ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) also known as COVID-19 reached the commonwealth of Kentucky. Within days the first cases of infection and hospitalization were identified among healthcare workers (HCW) in Kentucky, other states in the U.S., and around the world. There is little information available regarding the impact of COVID-19 on the HCW population within this area. The objective of this study is to describe the baseline characteristics of hospitalized HCWs infected with COVID-19. Methods: Data collection was performed as part of a retrospective study of patients hospitalized with COVID-19 in any of nine acute care hospitals in Louisville. COVID-19 infection was confirmed using Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR). Descriptive statistics were performed on clinical and epidemiological characteristics of hospitalized patients with COVID-19 who had indicated healthcare as their occupation. Results: Of the 700 adults hospitalized with COVID-19 from March 7 through July 1, 2020, 23 were HCWs. The mean age was 51 years and 78% were female. The majority of hospitalized HCWs had comorbidities including obesity (70%), hypertension (57%), hyperlipidemia (35%) and diabetes (26%). Common symptoms reported were fever (70%), dyspnea (78%), cough (78%) and fatigue (57%). Nine HCWs (39%) were admitted to the intensive care unit (ICU) and 6 (26%) developed acute respiratory distress syndrome (ARDS). Two (9%) patients developed a new, serious arrhythmia, two sustained cardiac arrest (9%), and two (9%) died in-hospital. Conclusions: Older adult HCWs with underlying health conditions such as obesity and hypertension were more likely to be hospitalized and have severe in-hospital complications. One HCW death due to COVID-19 was identified in this small population. These findings can help to identify and strengthen approaches to protect HCWs from SARS-CoV-2 infection and from long term effects of COVID-19.

scholarly journals Determination of Colistin in Contents Derived from Gastrointestinal Tract of Feeding Treated Piglet and Broiler

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 422
Author(s):  
Chun Peng ◽  
Sanling Zuo ◽  
Yinsheng Qiu ◽  
Shulin Fu ◽  
Lijuan Peng
Keyword(s):  
Bacterial Infections ◽  
Ecological Environment ◽  
Resistant Bacteria ◽  
Quantitative Mass Spectrometry ◽  
Limit Values ◽  
Quantitation Limit ◽  
The Mean ◽  
Potential Impact ◽  
The Impact

Colistin is considered as the last-resort treatment for multiantibiotic-resistant Gram-negative bacterial infections in humans. However, the oral administration of colistin to livestock and poultry results in the introduction of large amounts of colistin to the surrounding environment via urine and feces, potentially inducing the prevalence of colistin-resistant bacteria and the impact on the ecological environment. We established a quantitative mass spectrometry (MS) based method to measure colistin in contents recovered from the gastrointestinal segments of piglets and broilers, as well as colistin in feces from the animals. The mean recoveries of colistin from different matrices were between 73.2% and 103.9%. The quantitation limit values for different matrices ranged from 0.37 to 1.85 ng/g. In colistin-treated swine samples, the highest concentration of colistin was detected in feces samples at a level of 1248.3 ng/g. However, the highest concentration of colistin in broiler samples was around 4882.9 ng/g, which was found in the contents derived from broilers’ ceca. The employment of the proposed method to assess colistin in animals’ gastrointestinal tracts might help to understand the colistin absorption in animals’ guts and the potential impact of colistin on the emergence of resistant bacteria in animals’ gut flora and the ecological environment.

scholarly journals Evaluation of Vancomycin Dosing in Pediatric Cystic Fibrosis Patients

2016 ◽  
Vol 21 (2) ◽  
pp. 155-161 ◽  
Author(s):  
Erin J. McDade ◽  
Jennifer L. Hewlett ◽  
Siby P. Moonnumakal ◽  
Carol J. Baker
Keyword(s):  
Cystic Fibrosis ◽  
Pulmonary Function ◽  
Pediatric Patients ◽  
Primary Objective ◽  
Vancomycin Trough ◽  
Vancomycin Dosage ◽  
Trough Concentrations ◽  
The Mean ◽  
The Impact ◽  
Vancomycin Treatment

OBJECTIVES: The presence of methicillin-resistant Staphylococcus aureus (MRSA) in cystic fibrosis (CF) patients' sputa is associated with a decline in pulmonary function and increased mortality. Vancomycin is the preferred treatment for MRSA pneumonia in children. No published studies have evaluated the vancomycin dose needed to achieve goal vancomycin trough concentrations (VTCs; 15–20 mg/L) in pediatric patients with CF. The primary objective is to determine whether a vancomycin dosage of 60 mg/kg/day achieves a goal VTC in pediatric CF patients. Secondary objectives include determining the average dosage required to reach a goal VTC and the impact of achieving a goal VTC on estimated glomerular filtration rate (eGFR) and pulmonary function. METHODS: A retrospective review of pediatric patients with CF who received vancomycin was conducted. RESULTS: A total of 90 vancomycin treatment courses were analyzed. Standard vancomycin dosing (60 mg/kg/day) achieved goal VTC in 11 courses (12.2%). The mean dosage required to achieve a goal VTC for all courses was 70.6 ± 16.7 mg/kg/day. Patients who achieved goal VTCs were more often older, weighed more, and had higher serum creatinine concentrations at therapy initiation. On average, a dosage of 70.6 mg/kg/day was required to achieve a goal VTC. Despite dosages up to 120 mg/kg/day, no significant changes in renal function occurred. Achieving a goal VTC had no significant impact on eGFR or pulmonary function during therapy. CONCLUSIONS: Vancomycin dosing of 60 mg/kg/day does not reliably achieve a VTC of 15 to 20 mg/L in pediatric CF patients. Younger CF patients may require higher vancomycin doses.

OVIPOSITION, TEMPORAL DISTRIBUTION, AND POTENTIAL IMPACT OF STROBILOMYIA LARICIS MICHELSEN AND S. VIARIA (HUCKETT) (DIPTERA: ANTHOMYIIDAE) ON EASTERN LARCH, LARIX LARICINA (DU ROI) K. KOCH

1996 ◽  
Vol 128 (1) ◽  
pp. 67-78 ◽  
Author(s):  
Martha McClure ◽  
Dan T. Quiring ◽  
Jean J. Turgeon
Keyword(s):  
Field Study ◽  
Temporal Distribution ◽  
Larix Laricina ◽  
Patterned Surface ◽  
Seed Crop ◽  
The Mean ◽  
Potential Impact ◽  
The Impact ◽  
Eggs And Larvae

AbstractA 2-year field study was carried out to locate and identify eggs, determine the temporal distributions of eggs and larvae, and assess the impact of Strobilomyia laricis and S. viaria on Larix laricina. Eggs of S. laricis were beige with a patterned surface and usually laid one per cone in the bud scales at the base of the cone. Eggs of S. viaria were white and smooth and usually laid one per cone between the ovuliferous scales of the cone. Strobilomyia laricis oviposited from mid- to late May and S. viaria from late May to mid-June, each species initiating oviposition at a different stage of cone phenology. Peak egg densities of S. laricis were 25 and 65% higher than those of S. viaria in 1990 and 1991, respectively. Larvae of both species completed development at the same time, from mid-June to early July. The mean number of scales eaten per cone did not differ between species; one larva damaged a mean of 8.4 scales per cone in 1990 and 10.7 scales per cone in 1991. As the number of scales per cone increased, the mean number of scales eaten increased and the mean percentage of scales eaten decreased. Cone crops were light in both years. In 1990, the only year we were able to differentiate cone maggot larvae, 44% of cones were damaged by S. laricis and only 16% by S. viaria. Together, S. laricis and S. viaria damaged 60 and 67% of the cones and destroyed 38 and 50% of the potential seed crop in 1990 and 1991, respectively.

The Impact of Systemic Inflammatory Response Syndrome (SIRS) and Sepsis Training on Pediatric Nurses

2021 ◽  
Vol 18 (2) ◽  
pp. 68-71
Author(s):  
Smriti Mathema ◽  
Pawana Kayastha ◽  
Pushpa Raj Sharma
Keyword(s):  
Nursing Staff ◽  
Pediatric Patients ◽  
Early Recognition ◽  
Knowledge Score ◽  
Pediatric Nurses ◽  
The Mean ◽  
Significant Change ◽  
The One ◽  
Pediatric Sepsis ◽  
The Impact

Introduction: Research demonstrates the importance of key interventions in reducing mortality rates of pediatric patients with sepsis. Of health care practitioners, nurses typically spend the most time with patients, and they must be knowledgeable in recognizing the SIRS and sepsis while also being aware of the importance of prompt intervention. Aims: The purpose of this study is to assess the knowledge of pediatric nurses of SIRS and reassess their knowledge after a sepsis training program. Methods: This time-series design study from February 2017 to February 2019 included 24 nursing staff involved in taking care of pediatric patients. The nurses were divided into two groups and they underwent a one-day training on sepsis. They were the evaluated periodically on their knowledge on pediatric sepsis at four different time points. The retention of knowledge was calculated based on the change in scores, as per mean numeric scores, immediately after the training compared to 12 and 24 months after the training.  Results: In the thematic area ‘Early recognition of signs/symptoms of SIRS’ and ‘Assessment of application of knowledge’, there was a significant change (<0.001) from baseline in the mean scores once the nurses underwent training. The KAP assessment revealed a low total score of 14.5 out of 25 prior to the SIRS/Sepsis training There was a significant change (<0.001) in the mean knowledge score after the one-day training, 14.5 compared to 22.3, and the knowledge was retained 12 months after the training 19.2, whereas after 24 months post-training was 15.9. Conclusion: There is an urgent need to train and constantly re-train our nursing staff to ensure their ability of to accurately and efficiently recognize sepsis and hence help prevent pediatric morbidity and mortality.

Asteroid and Comet Impact Speeds upon Mars: Significance for Panspermia and the Supply of Organics

1997 ◽  
Vol 161 ◽  
pp. 197-201 ◽  
Author(s):  
Duncan Steel
Keyword(s):  
Probability Distributions ◽  
Regions Of Interest ◽  
Significant Fraction ◽  
Organic Chemicals ◽  
Impact Speed ◽  
The Mean ◽  
The Impact

AbstractWhilst lithopanspermia depends upon massive impacts occurring at a speed above some limit, the intact delivery of organic chemicals or other volatiles to a planet requires the impact speed to be below some other limit such that a significant fraction of that material escapes destruction. Thus the two opposite ends of the impact speed distributions are the regions of interest in the bioastronomical context, whereas much modelling work on impacts delivers, or makes use of, only the mean speed. Here the probability distributions of impact speeds upon Mars are calculated for (i) the orbital distribution of known asteroids; and (ii) the expected distribution of near-parabolic cometary orbits. It is found that cometary impacts are far more likely to eject rocks from Mars (over 99 percent of the cometary impacts are at speeds above 20 km/sec, but at most 5 percent of the asteroidal impacts); paradoxically, the objects impacting at speeds low enough to make organic/volatile survival possible (the asteroids) are those which are depleted in such species.

Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

2020 ◽  
pp. 1-16
Author(s):  
Julie L. Wambaugh ◽  
Lydia Kallhoff ◽  
Christina Nessler
Keyword(s):  
Retrospective Analysis ◽  
Sound Production ◽  
Apraxia Of Speech ◽  
Practice Schedule ◽  
Practice Schedules ◽  
Baseline Performance ◽  
The Mean ◽  
Number Of Treatment ◽  
The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

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