scholarly journals The first case of Mycobacterium vaccae sepsis in a non-Hodgkin lymphoma patient: biological understandings and clinical consequencies

2020 ◽  
Vol 2 (10) ◽  
Author(s):  
Pierluigi Congedo ◽  
Angelo Gardellini ◽  
Lucia Corich ◽  
Angela Papa ◽  
Mauro Turrini
Keyword(s):  
Clinical Decision Making ◽  
Clinical Decision ◽  
Ionization Time ◽  
Content Type ◽  
Mycobacterium Vaccae ◽  
Link Type ◽  
Hodgkin Lymphoma Patient ◽  
Non Hodgkin Lymphoma ◽  
First Case ◽  
Disseminated Disease

Mycobacterium vaccae is a rapidly growing nonpathogenic species of the Mycobacteriaceae family of bacteria that can cause pulmonary and disseminated disease in particular in immunocompromised individuals. Here we describe a first case of matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass-spectrometry (MS) identification of this pathogen in a patient with non-Hodgkin’s lymphoma during chemoimmunotherapy salvage treatment, and its impact on clinical decision making.

Combined data mining techniques based patient data outlier detection for healthcare safety

2016 ◽  
Vol 9 (1) ◽  
pp. 42-68 ◽  
Author(s):  
Gebeyehu Belay Gebremeskel ◽  
Chai Yi ◽  
Zhongshi He ◽  
Dawit Haile
Keyword(s):  
Data Mining ◽  
Decision Making ◽  
Patient Safety ◽  
Outlier Detection ◽  
Clinical Data ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Healthcare Services ◽  
Content Type ◽  
Outliers Detection

Purpose – Among the growing number of data mining (DM) techniques, outlier detection has gained importance in many applications and also attracted much attention in recent times. In the past, outlier detection researched papers appeared in a safety care that can view as searching for the needles in the haystack. However, outliers are not always erroneous. Therefore, the purpose of this paper is to investigate the role of outliers in healthcare services in general and patient safety care, in particular. Design/methodology/approach – It is a combined DM (clustering and the nearest neighbor) technique for outliers’ detection, which provides a clear understanding and meaningful insights to visualize the data behaviors for healthcare safety. The outcomes or the knowledge implicit is vitally essential to a proper clinical decision-making process. The method is important to the semantic, and the novel tactic of patients’ events and situations prove that play a significant role in the process of patient care safety and medications. Findings – The outcomes of the paper is discussing a novel and integrated methodology, which can be inferring for different biological data analysis. It is discussed as integrated DM techniques to optimize its performance in the field of health and medical science. It is an integrated method of outliers detection that can be extending for searching valuable information and knowledge implicit based on selected patient factors. Based on these facts, outliers are detected as clusters and point events, and novel ideas proposed to empower clinical services in consideration of customers’ satisfactions. It is also essential to be a baseline for further healthcare strategic development and research works. Research limitations/implications – This paper mainly focussed on outliers detections. Outlier isolation that are essential to investigate the reason how it happened and communications how to mitigate it did not touch. Therefore, the research can be extended more about the hierarchy of patient problems. Originality/value – DM is a dynamic and successful gateway for discovering useful knowledge for enhancing healthcare performances and patient safety. Clinical data based outlier detection is a basic task to achieve healthcare strategy. Therefore, in this paper, the authors focussed on combined DM techniques for a deep analysis of clinical data, which provide an optimal level of clinical decision-making processes. Proper clinical decisions can obtain in terms of attributes selections that important to know the influential factors or parameters of healthcare services. Therefore, using integrated clustering and nearest neighbors techniques give more acceptable searched such complex data outliers, which could be fundamental to further analysis of healthcare and patient safety situational analysis.

scholarly journals Toward data-based clinical decision making for adults with challenging behavior using the Behavior Problems Inventory-Short Form (BPI-S)

2018 ◽  
Vol 23 (2) ◽  
pp. 103-110 ◽  
Author(s):  
Darren L. Bowring ◽  
Vasiliki Totsika ◽  
Richard P. Hastings ◽  
Sandy Toogood
Keyword(s):  
Behavior Problems ◽  
Behavior Change ◽  
Challenging Behavior ◽  
Clinical Decision Making ◽  
Short Form ◽  
Challenging Behaviors ◽  
Clinical Decision ◽  
Service Evaluation ◽  
Content Type ◽  
Clinically Significant

Purpose The Behavior Problems Inventory-Short Form (BPI-S) is a shorter version of the Behavior Problems Inventory-01. In this paper, BPI-S population norms are reported from a total administrative population of adults with intellectual disability (ID). To facilitate the use of the BPI-S in clinical services to assess behavior change, the purpose of this paper is to describe how to use BPI-S clinically significant and reliable change (RC) scores. Design/methodology/approach Data were gathered on 265 adults with ID known to services. Proxy informants completed the BPI-S on challenging behaviors over the previous six months. Clinically significant cut-off values and RC scores were calculated using the Jacobson and Truax’s (1991) method. Findings BPI-S clinical reference data are presented to provide benchmarks for individual and group comparisons regarding challenging behavior. Examples demonstrate how to use clinical norms to determine change. Practical implications Behavior change is a major goal of researchers and practitioners. Data from the present study can make the BPI-S a valuable tool for determining change in challenging behavior following service input or intervention. Originality/value Whilst well used in research, the BPI-S may be less extensively used in practice. This present study provides data to enable researchers and practitioners to use the BPI-S more widely in assessing clinical outcomes, such as intervention research and service evaluation.

Evaluation of offending behaviour programme selection: the PNA

2019 ◽  
Vol 21 (4) ◽  
pp. 264-277
Author(s):  
Laura Ramsay ◽  
Jamie S. Walton ◽  
Gavin Frost ◽  
Chloe Rewaj ◽  
Gemma Westley ◽  
...  
Keyword(s):  
Decision Making ◽  
High Intensity ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Policy Makers ◽  
Content Type ◽  
Maximum Security ◽  
Research Findings ◽  
Probation Service ◽  
Offending Behaviour

Purpose The purpose of this paper is to outline the qualitative research findings of the effectiveness of Her Majesty’s Prison and Probation Service Programme Needs Assessment (PNA) in supporting decision making regarding selection onto high-intensity offending behaviour programmes. Design/methodology/approach Qualitative data analysis was used through the application of thematic analysis. Results were pooled using principles from meta-synthesis in order to draw conclusions as to whether the PNA was operating as designed. Findings Four overarching themes were identified, which have meaning in guiding decision making into, or out of high-intensity programmes. These were risk, need and responsivity, the importance of attitudes, motivation and formulation and planning. Research limitations/implications The majority of data were collected from category C prisons. Generalisability of findings to high-intensity programmes delivered in maximum security prisons and prisons for younger people aged 18–21 years is limited. The research team had prior knowledge of the PNA, whether through design or application. Procedures were put in place to minimise researcher biases. Practical implications Findings suggest that the PNA is effective in guiding clinical decision making. Practitioners and policy makers can be assured that the processes in place to select into high-intensity programmes are effective, and aligned with the What Works in reducing re-offending. Originality/value This is the first evaluation into the effectiveness of the PNA designed to support clinical decision making regarding participant selection onto accredited offending behaviour programmes. Implications for practice have been discussed.

Understanding critical care nurses’ autonomy in Jordan

2017 ◽  
Vol 30 (4) ◽  
pp. 432-442 ◽  
Author(s):  
Mahmoud Maharmeh
Keyword(s):  
Decision Making ◽  
Critical Care ◽  
Clinical Practice ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Critical Care Nurses ◽  
Cross Sectional Survey ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Content Type

Purpose The aim of this study was to describe Jordanian critical care nurses’ experiences of autonomy in their clinical practice. Design/methodology/approach A descriptive correlational design was applied using a self-reported cross-sectional survey. A total of 110 registered nurses who met the eligibility criteria participated in this study. The data were collected by a structured questionnaire. Findings A majority of critical care nurses were autonomous in their decision-making and participation in decisions to take action in their clinical settings. Also, they were independent to develop their own knowledge. The study identified that their autonomy in action and acquired knowledge were influenced by a number of factors such as gender and area of practice. Practical implications Nurse’s autonomy could be increased if nurses are made aware of the current level of autonomy and explore new ways to increase empowerment. This could be offered through classroom lectures that concentrate on the concept of autonomy and its implication in practice. Nurses should demonstrate autonomous nursing care at the same time in the clinical practice. This could be done through collaboration between educators and clinical practice to help merge theory to practice. Originality/value Critical care nurses were more autonomous in action and knowledge base. This may negatively affect the quality of patient care and nurses’ job satisfaction. Therefore, improving nurses’ clinical decision-making autonomy could be done by the support of both hospital administrators and nurses themselves.

scholarly journals Sneathia amnii bacteraemia and chorioamnionitis leading to second trimester abortion: a case report

2021 ◽  
Vol 3 (12) ◽  
Author(s):  
Lien Gruwier ◽  
Aaron Sprenkels ◽  
Sofie Hulsbosch ◽  
Anne Vankeerberghen ◽  
Reinoud Cartuyvels
Keyword(s):  
Type Species ◽  
Culture Broth ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Content Type ◽  
Link Type ◽  
First Case ◽  
Gene Sequence Analysis ◽  
The Usa ◽  
Septic Abortion

Background. Sneathia amnii (formerly designated as Leptotrichia amnionii ) was first described in 2002 in the USA. Members of the genus Sneathia can be part of the normal flora of the genitourinary tract, but have been implicated in invasive (mostly gynaecological) infections. Case presentation. To the best of our knowledge, here we present the first case of S. amnii infection in Belgium, in a young woman presenting with fever leading to second trimester septic abortion. Conclusions. Despite its pathogenicity, S. amnii remains an underrated cause of infections due to inherent difficulties with conventional laboratory methods. By extracting the bacterial DNA directly from the blood culture broth and performing a 16S ribosomal RNA gene sequence analysis we succeeded in identifying S. amnii as the most probable cause of the septic abortion in our patient.

scholarly journals Molecular characterization of a novel bla CTX-M-3-carrying Tn6741 transposon in Morganella morganii isolated from swine

2020 ◽  
Vol 69 (8) ◽  
pp. 1089-1094
Author(s):  
Xingwei Luo ◽  
Yajun Zhai ◽  
Dandan He ◽  
Xiaodie Cui ◽  
Yingying Yang ◽  
...  
Keyword(s):  
Type Species ◽  
Susceptibility Testing ◽  
Morganella Morganii ◽  
Ionization Time ◽  
Content Type ◽  
Genetic Environment ◽  
Link Type ◽  
Flight Mass Spectrometry ◽  
First Time

Introduction. The bla CTX-M-3 gene has rarely been reported in Morganella morganii strains and its genetic environment has not yet been investigated. Aim. To identify the bla CTX-M-3 gene in M. morganii isolated from swine and characterize its genetic environment. Methodology. A M. morganii isolate (named MM1L5) from a deceased swine was identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and subjected to antimicrobial susceptibility testing. The bla genes were detected and then the genetic location and environment of bla CTX-M-3 were investigated by Southern blot and PCR mapping, respectively. The M. morganii bla CTX-M-3 gene was cloned and expressed in Escherichia coli . Results. Isolate MM1L5 harboured the bla CTX-M-3 and bla TEM-1 genes. The bla CTX-M-3 gene, located on the chromosome, was co-carried with an IS26 and bla TEM-1 gene by a novel 6361 bp IS26-flanked composite transposon, designated Tn6741. This transposon consisted of a novel bla CTX-M-3-containing module, IS26-ΔISEcp1-bla CTX-M-3-Δorf477-IS26 (named Tn6710), and a bla TEM-1-containing module, IS26-Δorf477-bla TEM-1-tnpR-IS26, differing from previous reports. Phylogenetic analysis showed a significant variation based on the sequence of Tn6741, as compared to those of other related transposons. Interestingly, although the cloned bla CTX-M-3 gene could confer resistance to ceftiofur, cefquinome, ceftriaxone and cefotaxime, one amino acid substitution (Ile-142-Thr) resulted in a significant reduction of resistance to these antimicrobials. Conclusion. This is the first time that bla CTX-M-3 has been identified on a chromosome from a M. morganii isolate. Furthermore, the bla CTX-M-3 gene was located with an IS26 element and bla TEM-1 gene on a novel IS26-flanked composite transposon, Tn6741, suggesting that Tn6741 might act as a reservoir for the bla CTX-M-3 and bla TEM-1 genes and may become an important vehicle for their dissemination among M. morganii .

scholarly journals Translating the Science of Patient Reported Outcomes into Practice: Meaningfulness of HM-PRO Scores in Patients with Hematological Malignancies

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4860-4860 ◽  
Author(s):  
Pushpendra Goswami ◽  
Esther Natalie Oliva ◽  
Tatyana Ionova ◽  
Sam Salek
Keyword(s):  
Hodgkin Lymphoma ◽  
Myeloid Leukemia ◽  
Clinical Decision Making ◽  
Signs And Symptoms ◽  
Clinical Decision ◽  
Cross Sectional ◽  
Non Hodgkin Lymphoma ◽  
Patient Reported ◽  
The Mean ◽  
The Impact

Abstract Introduction: Patient-reported outcome (PRO) measures not only have been widely used in clinical research but also increasingly employed in daily clinical practice to understand the health outcomes of medical interventions. A novel hematological malignancy (HM) specific PRO tool, HM-PRO, has been recently developed for use in daily clinical practice. The HM-PRO is a composite measure consisting of two scales: Part A - measuring the 'impact on patients' quality of life (QoL); and Part B-measuring the effect of 'signs and symptoms' experienced by the patients. Both scales have linear scoring system ranging from 0 to 100, with higher scores representing greater impact on QoL and symptom burden. The assessment of the "meaningfulness" of HM-PRO scores is essential if clinicians are to be able to use the instrument to understand patient health outcomes to aid their clinical decision-making and encourage better patient engagement. One way of enhancing the clinical utility of scores on multi-item questionnaires is by investigating the importance (to patients and clinicians) of cross-sectional differences by anchoring those differences and changes to clinically familiar events that are related to patient well-being. The aims of the present study were to determine the relationship between the HM-PRO scores and a Global Question (GQ) measuring the impact on a patient's life from patients' perspective and to identify bands of HM-PRO scores equivalent to each GQ descriptor, reflecting patients' global rating of PROs. Methods: In this multicenter cross-sectional study, 905 patients: male 486; mean age 64.3 (±12.4, years; mean time since diagnosis 4.6 (±5.2) years; with different HM's ( acute lymphoblastic leukemia n=29, acute myeloid leukemia n=67, aggressive non Hodgkin lymphoma n=54, chronic lymphocytic leukemia n=64, chronic myeloid leukemia n=45, Hodgkin lymphoma n=37, indolent non Hodgkin lymphoma n=41, myelodysplastic syndrome n=158, multiple myeloma n=296, and myeloproliferative neoplasm n=114); in different disease states (stable-399, remission-277, and progressing - 229) were recruited from seven secondary hospitals and five patient organizations in the UK. All patients were asked to complete the HM-PRO and answer the global question as an anchor. Anchor-based differences were determined cross-sectionally (differences between clinically-defined groups at one time point) to determine clinically important differences in scores. The data analysis was carried out using IBM SPSS 23, a statistical software. Results: The mean HM-PRO score for Part A was 31.7 (±21.6) with median of 28.3 (IQR 13.6-46.6), for Part B was 20.9 (±14.2) with median of 17.6 (IQR 8.8 - 29.4), and the mean GQ score was 3.2 (±1.19) with range 1-5. The mean, mode, and median of the GQ scores for each HM-PRO score for both scales of HM-PRO were used to devise the bands (Figure 1) and intra-class correlation coefficient (ICC) was calculated for level of agreement. The set of scores proposed for adoption included: for Part A HM-PRO scores 0-7 = 'no impact' on patients' QoL (GQ=1, n=64), scores 8-25 = 'a small impact' on patients' QoL (GQ=2, n=133), scores 26-41 = 'moderate impact' on patients' QoL (GQ=3, n=97), scores 42-74 = 'very large impact' on patients' QoL (GQ=4, n=111), and scores 75-100 = 'extremely large impact' on patients' QoL (GQ=5, n=18), with ICC =0.80 (95% CI-0.77 - 0.83); for Part B HM-PRO scores 0-3 = 'no effect' of signs and symptoms on patient's life (GQ=1, n=56), scores 4-16 = 'a small effect' of signs and symptoms on patient's life (GQ=2, n=133), scores 17-29 = 'a moderate effect' of signs and symptoms on patient's life (GQ=3, n=122), scores 30-65 = 'very large effect' of signs and symptoms on patient's life (GQ=4, n=104), and scores 66-100 = 'extremely large effect' of signs and symptoms on patient's life (GQ=5, n=3), with ICC =0.75 (95% CI- 0.71-0.78), respectively (Table 1). Conclusion: This study employed the anchor-based approach for devising a set of score banding for both Part A and Part B of HM-PRO. The proposed bands (Part A=0-7, 8-25, 26-41, 42-74, 75-100; Part B=0-3, 4-16, 17-29, 30-65, 66-100) had the highest agreement and number of patients in the individual bands. The proposed bands could be applied independent of gender and different age groups. The findings of this study will help the clinician and the care team to interpret the HM-PRO scores to aid their clinical decision-making process in daily routine practice. Disclosures Oliva: Sanofi: Consultancy, Speakers Bureau; Celgene: Consultancy, Other: Royalties, Speakers Bureau; La Jolla: Consultancy; Amgen: Consultancy, Speakers Bureau; Novartis: Consultancy, Speakers Bureau; Janssen: Consultancy, Speakers Bureau. Ionova:Takeda: Research Funding; BMS: Research Funding.

scholarly journals First case report of post-operative infection due to Francisella tularensis after cardiac surgery

2019 ◽  
Vol 1 (8) ◽  
Author(s):  
Arif Maqsood Ali ◽  
Muhammad Noor ul Amin ◽  
Shazia Arif
Keyword(s):  
Cardiac Surgery ◽  
Case Report ◽  
Francisella Tularensis ◽  
Type Species ◽  
Detection Methods ◽  
Culture Bottle ◽  
Content Type ◽  
Chest Infection ◽  
Link Type ◽  
First Case

Background. Francisella tularensis is a rare zoonotic bacterium that spreads sporadically by various routes, including infected arthropod bites, ingestion of contaminated water and inhalation of contaminated dust. However, its occurrence in postoperative chest infection has never been reported. Pathogen isolation, serology and molecular detection methods are commonly used for the diagnosis of tularaemia. Case presentation. We present the first case report of the isolation of F. tularensis from a patient with a chest infection (a boy in his teens) following cardiac surgery for closure of a ventral septal defect. It was isolated on blood and chocolate agar on the third day after the subculture of drain fluid collected in a blood culture bottle incubated in Bact T/Alert 3-D (bioMerieux, France). The organism was identified as F. tularensis by Vitek GN ID Cards (Vitek 2 Compact, bioMerieux, France). The patient made a smooth recovery with antibiotic therapy. Conclusion. F. tularensis can cause post-operative infection, especially in patients with a rural background.

scholarly journals Burkholderia humptydooensis sp. nov., a New Species Related to Burkholderia thailandensis and the Fifth Member of the Burkholderia pseudomallei Complex

2016 ◽  
Vol 83 (5) ◽  
Author(s):  
Apichai Tuanyok ◽  
Mark Mayo ◽  
Holger Scholz ◽  
Carina M. Hall ◽  
Christopher J. Allender ◽  
...  
Keyword(s):  
Burkholderia Pseudomallei ◽  
Acid Methyl Ester ◽  
Culture Collection ◽  
Closely Related Species ◽  
Ionization Time ◽  
Molecular Analyses ◽  
Content Type ◽  
Link Type ◽  
Water Wells ◽  
A New Species

ABSTRACT During routine screening for Burkholderia pseudomallei from water wells in northern Australia in areas where it is endemic, Gram-negative bacteria (strains MSMB43T, MSMB121, and MSMB122) with a similar morphology and biochemical pattern to B. pseudomallei and B. thailandensis were coisolated with B. pseudomallei on Ashdown's selective agar. To determine the exact taxonomic position of these strains and to distinguish them from B. pseudomallei and B. thailandensis, they were subjected to a series of phenotypic and molecular analyses. Biochemical and fatty acid methyl ester analysis was unable to distinguish B. humptydooensis sp. nov. from closely related species. With matrix-assisted laser desorption ionization–time of flight analysis, all isolates grouped together in a cluster separate from other Burkholderia spp. 16S rRNA and recA sequence analyses demonstrated phylogenetic placement for B. humptydooensis sp. nov. in a novel clade within the B. pseudomallei group. Multilocus sequence typing (MLST) analysis of the three isolates in comparison with MLST data from 3,340 B. pseudomallei strains and related taxa revealed a new sequence type (ST318). Genome-to-genome distance calculations and the average nucleotide identity of all isolates to both B. thailandensis and B. pseudomallei, based on whole-genome sequences, also confirmed B. humptydooensis sp. nov. as a novel Burkholderia species within the B. pseudomallei complex. Molecular analyses clearly demonstrated that strains MSMB43T, MSMB121, and MSMB122 belong to a novel Burkholderia species for which the name Burkholderia humptydooensis sp. nov. is proposed, with the type strain MSMB43T (American Type Culture Collection BAA-2767; Belgian Co-ordinated Collections of Microorganisms LMG 29471; DDBJ accession numbers CP013380 to CP013382 ). IMPORTANCE Burkholderia pseudomallei is a soil-dwelling bacterium and the causative agent of melioidosis. The genus Burkholderia consists of a diverse group of species, with the closest relatives of B. pseudomallei referred to as the B. pseudomallei complex. A proposed novel species, B. humptydooensis sp. nov., was isolated from a bore water sample from the Northern Territory in Australia. B. humptydooensis sp. nov. is phylogenetically distinct from B. pseudomallei and other members of the B. pseudomallei complex, making it the fifth member of this important group of bacteria.

Pediococcus lolii DSM 19927T and JCM 15055T are strains of Pediococcus acidilactici

2012 ◽  
Vol 62 (Pt_12) ◽  
pp. 3105-3108 ◽  
Author(s):  
Anneleen Wieme ◽  
Ilse Cleenwerck ◽  
Anita Van Landschoot ◽  
Peter Vandamme
Keyword(s):  
Dna Hybridization ◽  
Type Species ◽  
Rrna Gene ◽  
Pediococcus Acidilactici ◽  
Culture Collections ◽  
Ionization Time ◽  
Content Type ◽  
Link Type ◽  
Flight Mass Spectrometry ◽  
Gene Sequence Analysis

Strain NGRI 0510QT, isolated from ryegrass silage, was recently classified as a representative of a novel Pediococcus species, Pediococcus lolii Doi et al. 2009. It was deposited in the DSMZ and JCM culture collections as DSM 19927T and JCM 15055T, respectively. A polyphasic taxonomic study, including matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, pheS and 16S rRNA gene sequence analysis, fluorescent amplified fragment length polymorphism and DNA–DNA hybridization, was used to prove that both subcultures of the type, and only, strain of this species are strains of Pediococcus acidilactici .

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