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Find video protocols related to scientific articles indexed in Pubmed.
Assessing Statistical Competencies in Clinical and Translational Science Education: One Size Does Not Fit All.
Clin Transl Sci
PUBLISHED: 09-13-2014
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Statistics is an essential training component for a career in clinical and translational science (CTS). Given the increasing complexity of statistics, learners may have difficulty selecting appropriate courses. Our question was: what depth of statistical knowledge do different CTS learners require?
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Diagnostic outcome of muscle biopsy.
Muscle Nerve
PUBLISHED: 09-03-2014
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Introduction: We reviewed the diagnostic yield of muscle biopsy according to the presence or absence of muscle weakness, hyperCKemia, and electromyogaphic (EMG) abnormalities Methods: In a retrospective study, 698 muscle biopsy reports were analyzed. Logistic regression models for myopathy and specific myopathy were fit, and receiver-operating characteristic (ROC) curves were generated to assess prediction accuracy. The probability of finding specific myopathy was considered the main indication of a positive muscle biopsy. Results: Isolated hyperCKemia was poorly predictive of either myopathy or specific myopathy. Combined myopathic EMG, proximal weakness, and hyperCKemia was predictive. The predictability increased proportionally to the CK level in patients with proximal weakness and myopathic EMG. Cross validation showed accuracy around 70% for a probability threshold of 50% Discussion: The presence of hyperCKemia, proximal weakness, and myopathic EMG together were associated with highly positive diagnostic outcome of muscle biopsy. Isolated hyperCKemia had a poor diagnostic yield 2 © 2014 Wiley Periodicals, Inc.
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Blood manganese concentrations in Jamaican children with and without autism spectrum disorders.
Environ Health
PUBLISHED: 08-23-2014
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Manganese is an essential element for human health and development. Previous studies have shown neurotoxic effects in children exposed to higher levels of manganese. Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that impairs social interaction and communication. Several studies have hypothesized that ASD is caused through environmental exposures during crucial stages in brain development. We investigated the possible association between blood manganese concentrations (BMC) and ASD. We also identified factors associated with BMC in typically developing (TD) Jamaican children.
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Role of fruits, grains, and seafood consumption in blood cadmium concentrations of Jamaican children with and without Autism Spectrum Disorder.
Res Autism Spectr Disord
PUBLISHED: 08-05-2014
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Human exposure to cadmium has adverse effects on the nervous system. Utilizing data from 110 age- and sex-matched case-control pairs (220 children) ages 2-8 years in Kingston, Jamaica, we compared the 75(th) percentile of blood cadmium concentrations in children with and without Autism Spectrum Disorder (ASD). In both univariable and multivariable Quantile Regression Models that controlled for potential confounding factors, we did not find any significant differences between ASD cases and typically developing (TD) controls with respect to the 75(th) percentile of blood cadmium concentrations, (P > 0.22). However, we found a significantly higher 75(th) percentile of blood cadmium concentrations in TD Jamaican children who consumed shellfish (lobsters, crabs) (P <0.05), fried plantain (P <0.01), and boiled dumpling (P <0.01). We also observed that children living in Jamaica have an arithmetic mean blood cadmium concentration of 0.16?g/L which is similar to that of the children in developed countries and much lower than that of children in developing countries. Although our results do not support an association between blood cadmium concentrations and ASD, to our knowledge, this study is the first to report levels of blood cadmium in TD children as well as those with ASD in Jamaica.
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Neurofluctuation in patients with subcortical ischemic stroke.
Neurology
PUBLISHED: 06-25-2014
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The purpose of this study was to assess the incidence of deterioration, fluctuation, and associated risk of poor outcome in patients with subcortical stroke (SCS).
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Role of metabolic genes in blood arsenic concentrations of Jamaican children with and without autism spectrum disorder.
Int J Environ Res Public Health
PUBLISHED: 06-04-2014
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Arsenic is a toxic metalloid with known adverse effects on human health. Glutathione-S-transferase (GST) genes, including GSTT1, GSTP1, and GSTM1, play a major role in detoxification and metabolism of xenobiotics. We investigated the association between GST genotypes and whole blood arsenic concentrations (BASC) in Jamaican children with and without autism spectrum disorder (ASD). We used data from 100 ASD cases and their 1:1 age- and sex-matched typically developing (TD) controls (age 2-8 years) from Jamaica. Using log-transformed BASC as the dependent variable in a General Linear Model, we observed a significant interaction between GSTP1 and ASD case status while controlling for several confounding variables. However, for GSTT1 and GSTM1 we did not observe any significant associations with BASC. Our findings indicate that TD children who had the Ile/Ile or Ile/Val genotype for GSTP1 had a significantly higher geometric mean BASC than those with genotype Val/Val (3.67 µg/L vs. 2.69 µg/L, p < 0.01). Although, among the ASD cases, this difference was not statistically significant, the direction of the observed difference was consistent with that of the TD control children. These findings suggest a possible role of GSTP1 in the detoxification of arsenic.
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Bone Mineral Density across a Range of Physical Activity Volumes: NHANES 2007-2010.
Med Sci Sports Exerc
PUBLISHED: 05-30-2014
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The association between aerobic physical activity volume and bone mineral density (BMD) is not completely understood. The purpose of this study was to clarify the association between BMD and aerobic activity across a broad range of activity volumes, in particular volumes between those recommended in the 2008 Physical Activity Guidelines for Americans and those of trained endurance athletes.
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Real-Time Assay as A Tool for Detecting lytA Gene in Streptococcus pneumoniae Isolates.
Cell J
PUBLISHED: 05-25-2014
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In-time diagnosis of Streptococcus pneumoniae (S. pneumonia) can play a significant role in decreasing morbidity and mortality rate. Applying molecular methods has gained popularity due to the existing limits of routine diagnostic methods. Examining the expression of different genes of this bacterium through different molecular methods suggests that lytA gene has a higher sensitivity and specificity in diagnosis of Streptococcus pneumoniae. The aim of this study was to evalutate lytA gene expression in diagnosis of invasive S. pneumonia in culture positive specimens by real-time polymerase chain reaction (PCR).
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Cellular microparticle and thrombogram phenotypes in the Prospective Observational Multicenter Major Trauma Transfusion (PROMMTT) study: correlation with coagulopathy.
Thromb. Res.
PUBLISHED: 05-09-2014
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Trauma-induced coagulopathy following severe injury is associated with increased bleeding and mortality. Injury may result in alteration of cellular phenotypes and release of cell-derived microparticles (MP). Circulating MPs are procoagulant and support thrombin generation (TG) and clotting. We evaluated MP and TG phenotypes in severely injured patients at admission, in relation to coagulopathy and bleeding.
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New population-based reference values for spinal mobility measures based on the 2009-2010 National Health and Nutrition Examination Survey.
PUBLISHED: 04-25-2014
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To report population-based percentile reference values for selected spinal mobility measures in a nationally representative sample of 5,001 US adults ages 20-69 years who were examined in the 2009-2010 US National Health and Nutrition Examination Survey (NHANES).
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Thrombelastography detects possible coagulation disturbance in patients with intracerebral hemorrhage with hematoma enlargement.
Stroke
PUBLISHED: 01-14-2014
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Intracerebral hemorrhage (ICH) has high morbidity, and hematoma enlargement (HE) causes worse outcome. Thrombelastography (TEG) measures the dynamics of clot formation and dissolution, and might be useful for assessing bleeding risk. We used TEG to detect changes in clotting in patients with and without HE after ICH.
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Thrombelastography detects the anticoagulant effect of rivaroxaban in patients with stroke.
Stroke
PUBLISHED: 01-14-2014
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Factor Xa inhibitors are prescribed for stroke prevention in atrial fibrillation. Managing such patients is challenging especially if they are eligible for thrombolysis because there is no rapidly available test to detect the effect of such medications. Thrombelastography analyzes the dynamics of coagulation and can be rapidly performed. We sought to determine whether thrombelastography can detect the anticoagulation effect of factor Xa inhibitors in patients with stroke.
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Application of the American Heart Association/American College of Sports Medicine Adult Preparticipation Screening Checklist to a nationally representative sample of US adults aged >=40 years from the National Health and Nutrition Examination Survey 2001 to 2004.
Circulation
PUBLISHED: 01-13-2014
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Although the American Heart Association/American College of Sports Medicine's Preparticipation Questionnaire (AAPQ) is a recommended preexercise cardiovascular screening tool, it has never been systematically evaluated. The purpose of this research is to provide preliminary evidence of its effectiveness among adults aged ?40 years.
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Survival analysis, long-term outcomes, and percentage of recovery up to 8 years post-infection among the Houston West Nile virus cohort.
PLoS ONE
PUBLISHED: 01-01-2014
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In 2012, we witnessed a resurgence of West Nile virus (WNV) in the United States, with the largest outbreak of human cases reported since 2003. WNV is now endemic and will continue to produce epidemics over time, therefore defining the long-term consequences of WNV infection is critical. Over a period of eight years, we prospectively followed a cohort of 157 WNV-infected subjects in the Houston metropolitan area to observe recovery over time and define the long-term clinical outcomes. We used survival analysis techniques to determine percentage of recovery over time and the effects of demographic and co-morbid conditions on recovery. We found that 40% of study participants continued to experience symptoms related to their WNV infection up to 8 years later. Having a clinical presentation of encephalitis and being over age 50 were significantly associated with prolonged or poor recovery over time. Since the health and economic impact as a result of prolonged recovery, continued morbidity, and related disability is likely substantial in those infected with WNV, future research should be aimed at developing effective vaccines to prevent illness and novel therapeutics to minimize morbidity, mortality, and long-term complications from infection.
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Effect of intrinsic and extrinsic factors on global and regional cortical thickness.
PLoS ONE
PUBLISHED: 01-01-2014
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Global and regional cortical thicknesses based on T1-weighted magnetic resonance images acquired at 1.5 T and 3 T were measured on a relatively large cohort of 295 subjects using FreeSurfer software. Multivariate regression analysis was performed using Pillai's trace test to determine significant differences in cortical thicknesses measured at these two field strengths. Our results indicate that global cortical thickness is not affected by the field strength or gender. In contrast, the regional cortical thickness was observed to be field dependent. Specifically, the cortical thickness in regions such as parahippocampal, superior temporal, precentral and posterior cingulate is thicker at 3 T than at 1.5 T. In contrast regions such as cuneus and pericalcarine showed higher cortical thickness at 1.5 T than at 3 T. These differences appear to be age-dependent. The differences in regional cortical thickness between field strengths were similar in both genders. Further, male vs. female differences in regional cortical thickness were observed only at 1.5 T and not at 3 T. Our results indicate that magnetic field strength has a significant effect on the estimation of regional, but not global, cortical thickness. In addition, the pulse sequence, scanner type, and spatial resolution do not appear to have significant effect on the measured cortical thickness.
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Phagocytosis via complement or Fc-gamma receptors is compromised in monocytes from type 2 diabetes patients with chronic hyperglycemia.
PLoS ONE
PUBLISHED: 01-01-2014
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Type 2 diabetes patients (DM2) have a higher risk of tuberculosis (TB) that may be attributed to functional defects in their mononuclear phagocytes given the critical role of these cells in Mycobacterium tuberculosis containment. Our previous findings suggest that monocytes from DM2 have reduced association with serum-opsonized M. tuberculosis. To determine if this alteration is due to defects in phagocytosis via complement or Fc-gamma receptors (Fc?Rs), in this study we evaluated the uptake of sheep red blood cells coated with IgG or complement, respectively, by monocytes from individuals with and without DM2. We found that chronic hyperglycemia was significantly associated with reduced phagocytosis via either receptor by univariable and multivariable analyses. This defect was independent of host serum opsonins and flow cytometry data indicated this was not attributed to reduced expression of these phagocytic receptors on DM2 monocytes. The positive correlation between both pathways (R?=?0.64; p?=?0.003) indicate that monocytes from individuals with chronic hyperglycemia have a defect in the two predominant phagocytic pathways of these cells. Given that phagocytosis is linked to activation of effector mechanisms for bacterial killing, it is likely that this defect is one factor contributing to the higher susceptibility of DM2 patients to pathogens like M. tuberculosis.
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First report of Klebsiella pneumonia carbapenemase-producing Pseudomonas aeruginosa isolated from burn patients in Iran: phenotypic and genotypic methods.
GMS Hyg Infect Control
PUBLISHED: 01-01-2014
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Wound infection associated with carbapenem-resistant Pseudomonas aeruginosa in burn patients is a growing problem. One of the main mechanisms of resistance to carbapenem antibiotics is the ability of P. aeruginosa to produce carbapenemase enzymes. Klebsiella pneumonia carbapemenase (KPC) is an important type of carbapenemase which can hydrolyze carbapenem antibiotics. The Modified Hodge Test (MHT) and boronic acid as a KPC inhibitor are two phenotypic methods used for detection of carbapenemase. The sensitivity and specificity of these two phenotypic tests for the identification of KPC can be measured by PCR. In this study, 241 P. aeruginosa strains were isolated from wounds of hospitalized burn patients. Carbapenem-resistant P. aeruginosa isolates were determined by the disk diffusion method. KPC-producing carbapenem-resistant strains were examined using the Modified Hodge Test, followed by boronic acid. Further, strains with positive responses to MHT and boronic acid tests were analyzed with the PCR molecular method. One hundred eighty-six of 241 isolates were resistant to carbapenems and 75 were positive in the MHT. Three exhibited an at least 5-mm diameter difference when meropenem was combined with boronic acid vs meropenem alone in the boronic acid test. Two strains had a specific band with primer No.1 after gel electrophoresis. This study showed that MHT, despite excellent sensitivity, has variable specificity independent of bacterial species. Further, the use of KPC inhibitors such as boronic acid did not yield favorable sensitivity and specificity among the specimens from Iranian patients. Thus, it seems that sequencing after PCR should be considered the gold standard for the detection of KPC-producing P. aeruginosa.
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Iodinated Contrast Does Not Alter Clotting Dynamics in Acute Ischemic Stroke as Measured by Thromboelastography.
Stroke
PUBLISHED: 12-26-2013
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Iodinated contrast agents used for computed tomography angiography (CTA) may alter fibrin fiber characteristics and decrease fibrinolysis by tissue plasminogen activator (tPA). Thromboelastography (TEG) measures the dynamics of coagulation and correlates with thrombolysis in acute ischemic stroke patients. We hypothesized that receiving CTA before tPA will not impair thrombolysis as measured by TEG.
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Screening of congenital CMV infection in saliva of neonates by PCR: report of a pilot screening study in Iran.
Clin. Lab.
PUBLISHED: 11-27-2013
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Cytomegalovirus (CMV) is a leading cause of congenital infection in neonates. Most infants with congenital CMV infection are asymptomatic at birth and not diagnosed on routine clinical examination. To identify these at-risk infants early in life, polymerase chain reaction (PCR) assays are done to screen large populations of newborn infants.
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CLOTBUST-Hands Free: Pilot Safety Study of a Novel Operator-Independent Ultrasound Device in Patients With Acute Ischemic Stroke.
Stroke
PUBLISHED: 10-24-2013
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The Combined Lysis of Thrombus in Brain Ischemia With Transcranial Ultrasound and Systemic T-PA-Hands-Free (CLOTBUST-HF) study is a first-in-human, National Institutes of Health-sponsored, multicenter, open-label, pilot safety trial of tissue-type plasminogen activator (tPA) plus a novel operator-independent ultrasound device in patients with ischemic stroke caused by proximal intracranial occlusion.
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Cryoprecipitate Use in the Prospective Observational Multicenter Major Trauma Transfusion study (PROMMTT).
J Trauma Acute Care Surg
PUBLISHED: 08-13-2013
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There are few clinical data to guide the use of cryoprecipitate in severely injured trauma patients. Cryoprecipitate is a rich source of fibrinogen, and has been associated with improved survival in animal as well as limited human studies. Our objective was to identify patterns and predictors of cryoprecipitate use and determine whether transfusing cryoprecipitate was associated with improved survival.
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The impact of missing trauma data on predicting massive transfusion.
J Trauma Acute Care Surg
PUBLISHED: 08-13-2013
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Missing data are inherent in clinical research and may be especially problematic for trauma studies. This study describes a sensitivity analysis to evaluate the impact of missing data on clinical risk prediction algorithms. Three blood transfusion prediction models were evaluated utilizing an observational trauma dataset with valid missing data.
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Optimal allocation of sample sizes to multicenter clinical trials.
J Biopharm Stat
PUBLISHED: 06-22-2013
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In this article, we discuss an approach for optimal sample size allocation in designing multicenter clinical trials. The method we studied was adapted from a stratified sampling survey design. The sample size allocated to centers is a function of the centers treatment cost, the standard deviation of the endpoint, and the availability of patients. We illustrate our approach using two hypothetical scenarios derived from our experiences in designing and conducting multicenter clinical trials. Simulation results are also presented.
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Do-not-resuscitate orders in trauma patients may bias mortality-based effect estimates: an evaluation using the PROMMTT study.
J Trauma Acute Care Surg
PUBLISHED: 06-20-2013
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The impact of do-not-resuscitate (DNR) orders has not been systematically evaluated in acute trauma research. We determined the frequency, timing, and impact on mortality-based effect estimates for patients with DNR orders in the Prospective Observational Multicenter Major Trauma Transfusion (PROMMTT) study.
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A latent class model for defining severe hemorrhage: experience from the PROMMTT study.
J Trauma Acute Care Surg
PUBLISHED: 06-20-2013
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Several predictive models have been developed to identify trauma patients who have had severe hemorrhage (SH) and may need a massive transfusion (MT) protocol. However, almost all these models define SH as the transfusion of 10 or more units of red blood cells (RBCs) within 24 hours of emergency department admission (also known as MT). This definition excludes some patients with SH, especially those who die before a 10th unit of RBCs could be transfused, which calls the validity of these prediction models into question. We show how a latent class model could improve the accuracy of identifying the SH patients.
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Purposeful variable selection and stratification to impute missing Focused Assessment with Sonography for Trauma data in trauma research.
J Trauma Acute Care Surg
PUBLISHED: 06-20-2013
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The Focused Assessment with Sonography for Trauma (FAST) examination is an important variable in many retrospective trauma studies. The purpose of this study was to devise an imputation method to overcome missing data for the FAST examination. Owing to variability in patients injuries and trauma care, these data are unlikely to be missing completely at random, raising concern for validity when analyses exclude patients with missing values.
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The impact of missing trauma data on predicting massive transfusion.
J Trauma Acute Care Surg
PUBLISHED: 06-20-2013
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Missing data are inherent in clinical research and may be especially problematic for trauma studies. This study describes a sensitivity analysis to evaluate the impact of missing data on clinical risk prediction algorithms. Three blood transfusion prediction models were evaluated using an observational trauma data set with valid missing data.
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Application of the Berlin definition in PROMMTT patients: the impact of resuscitation on the incidence of hypoxemia.
J Trauma Acute Care Surg
PUBLISHED: 06-20-2013
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Acute lung injury following trauma resuscitation remains a concern despite recent advances. With the use of the PROMMTT study population, the risk of hypoxemia and potential modifiable risk factors are studied.
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Time-dependent prediction and evaluation of variable importance using superlearning in high-dimensional clinical data.
J Trauma Acute Care Surg
PUBLISHED: 06-20-2013
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Prediction of outcome after injury is fraught with uncertainty and statistically beset by misspecified models. Single-time point regression only gives prediction and inference at one time, of dubious value for continuous prediction of ongoing bleeding. New statistical machine learning techniques such as SuperLearner (SL) exist to make superior prediction at iterative time points while evaluating the changing relative importance of each measured variable on an outcome. This then can provide continuously changing prediction of outcome and evaluation of which clinical variables likely drive a particular outcome.
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Increasing time to operation is associated with decreased survival in patients with a positive FAST examination requiring emergent laparotomy.
J Trauma Acute Care Surg
PUBLISHED: 06-20-2013
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Focused assessment with sonography for trauma (FAST) is commonly used to facilitate the timely diagnosis of life-threatening hemorrhage in injured patients. Most patients with positive findings on FAST require laparotomy. Although it is assumed that an increasing time to operation (T-OR) leads to higher mortality, this relationship has not been quantified. This study sought to determine the impact of T-OR on survival in patients with a positive FAST who required emergent laparotomy.
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Clinical and mechanistic drivers of acute traumatic coagulopathy.
J Trauma Acute Care Surg
PUBLISHED: 06-20-2013
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Acute traumatic coagulopathy (ATC) occurs after severe injury and shock and is associated with increased bleeding, morbidity, and mortality. The effects of ATC and hemostatic resuscitation on outcome are not well-explored. The PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) study provided a unique opportunity to characterize coagulation and the effects of resuscitation on ATC after severe trauma.
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Cryoprecipitate use in the PROMMTT study.
J Trauma Acute Care Surg
PUBLISHED: 06-20-2013
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There are few clinical data to guide the use of cryoprecipitate in severely injured trauma patients. Cryoprecipitate is a rich source of fibrinogen and has been associated with improved survival in animal as well as limited human studies. Our objectives were to identify patterns and predictors of cryoprecipitate use and determine whether transfusing cryoprecipitate was associated with improved survival.
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Resuscitate early with plasma and platelets or balance blood products gradually: findings from the PROMMTT study.
J Trauma Acute Care Surg
PUBLISHED: 06-20-2013
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The trauma transfusion literature has yet to resolve which is more important for hemorrhaging patients, transfusing plasma and platelets along with red blood cells (RBCs) early in resuscitation or gradually balancing blood product ratios. In a previous report of PROMMTT results, we found (1) plasma and platelet:RBC ratios increased gradually during the 6 hours following admission, and (2) patients achieving ratios more than 1:2 (relative to ratios <1:2) had significantly decreased 6-hour to 24-hour mortality adjusting for baseline and time-varying covariates. To differentiate the association of in-hospital mortality with early plasma or platelet transfusion from that with delayed but gradually balanced ratios, we developed a separate analytic approach.
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Early resuscitation intensity as a surrogate for bleeding severity and early mortality in the PROMMTT study.
J Trauma Acute Care Surg
PUBLISHED: 06-20-2013
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The classic definition of massive transfusion, 10 or more units of red blood cells (RBCs) in 24 hours, has never been demonstrated as a valid surrogate for severe hemorrhage and can introduce survival bias. In addition, the definition fails to capture other products that the clinician may have immediately available, and may use, during the initial resuscitation. Assuming that units of resuscitative fluids reflect patient illness, our objective was to identify a rate of resuscitation intensity (RI) that could serve as an early surrogate of sickness for patients with substantial bleeding after injury.
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Prehospital intravenous fluid is associated with increased survival in trauma patients.
J Trauma Acute Care Surg
PUBLISHED: 06-20-2013
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Delivery of intravenous crystalloid fluids (IVF) remains a tradition-based priority during prehospital resuscitation of trauma patients. Hypotensive and targeted resuscitation algorithms have been shown to improve patient outcomes. We hypothesized that receiving any prehospital IVF is associated with increased survival in trauma patients compared with receiving no prehospital IVF.
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Waiver of consent in noninterventional, observational emergency research: the PROMMTT experience.
J Trauma Acute Care Surg
PUBLISHED: 06-20-2013
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In the PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) study, waiver of consent was used because previous literature reported low response rates and subsequent bias. The goal of this article was to examine the rationale and tradeoffs of using waiver of consent in PROMMTT.
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Seven deadly sins in trauma outcomes research: an epidemiologic post mortem for major causes of bias.
J Trauma Acute Care Surg
PUBLISHED: 06-20-2013
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Because randomized clinical trials in trauma outcomes research are expensive and complex, they have rarely been the basis for the clinical care of trauma patients. Most published findings are derived from retrospective and occasionally prospective observational studies that may be particularly susceptible to bias. The sources of bias include some common to other clinical domains, such as heterogeneous patient populations with competing and interdependent short- and long-term outcomes. Other sources of bias are unique to trauma, such as rapidly changing multisystem responses to injury that necessitate highly dynamic treatment regimens such as blood product transfusion. The standard research design and analysis strategies applied in published observational studies are often inadequate to address these biases.
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The University of Texas Houston Stroke Registry (UTHSR): implementation of enhanced data quality assurance procedures improves data quality.
BMC Neurol
PUBLISHED: 05-20-2013
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Limited information has been published regarding standard quality assurance (QA) procedures for stroke registries. We share our experience regarding the establishment of enhanced QA procedures for the University of Texas Houston Stroke Registry (UTHSR) and evaluate whether these QA procedures have improved data quality in UTHSR.
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Advancing clinical trial design in pulmonary hypertension.
Pulm Circ
PUBLISHED: 05-11-2013
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In pulmonary hypertension, as in many other diseases, there is a need for a smarter approach to evaluating new treatments. The traditional randomized controlled trial has served medical science well, but constrains the development of treatments for rare diseases. A workshop was established to consider alternative clinical trial designs in pulmonary hypertension and here discusses their merits, limitations and challenges to implementation of novel approaches.
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CLOTBUST-hands free: initial safety testing of a novel operator-independent ultrasound device in stroke-free volunteers.
Stroke
PUBLISHED: 04-18-2013
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We aimed to evaluate safety and tolerability of a novel operator-independent ultrasound device among stroke-free volunteers.
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Defining when to initiate massive transfusion: a validation study of individual massive transfusion triggers in PROMMTT patients.
J Trauma Acute Care Surg
PUBLISHED: 03-22-2013
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Early predictors of massive transfusion (MT) would prevent undertriage of patients likely to require MT. This study validates triggers using the Prospective Observational Multicenter Major Trauma Transfusion (PROMMTT) study.
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Genetic diversity of Shigella spp. and their integron content.
Foodborne Pathog. Dis.
PUBLISHED: 03-16-2013
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The aim of this study was to investigate the occurrence and resistance gene content of class 1 and 2 integrons among Shigella spp. and to study the genetic diversity of isolates using the pulsed-field gel electrophoresis (PFGE) method.
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Associations between dietary intake of choline and betaine and lung cancer risk.
PLoS ONE
PUBLISHED: 02-01-2013
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Evidence from human and animal research indicates that choline metabolic pathways may be activated during a variety of diseases, including cancer. We report results of a case-control study of 2821 lung cancer cases and 2923 controls that assessed associations of choline and betaine dietary intakes with lung cancer. Using multivariable logistic regression analyses, we report a significant association between higher betaine intake and lower lung cancer risk that varied by smoking status. Specifically, no significant association was observed between betaine intake and lung cancer among never-smokers. However, higher betaine intake was significantly associated with reduced lung cancer risk among smokers, and the protective effect was more evident among current than former smokers: for former and current smokers, the ORs (95% CI) of lung cancer for individuals with highest as compared to lowest quartiles of intake were 0.70(0.55-0.88) and 0.51(0.39-0.66) respectively. Significant linear trend of higher betaine intake and lower lung cancer risk was observed among both former (p(trend)?=?0.002) and current (p(trend)<0.0001) smokers. A similar protective effect was also observed with choline intake both in overall analysis as well as among current smokers, with p-values for chi-square tests being 0.001 and 0.004 respectively, but the effect was less evident, as no linear trend was observed. Our results suggest that choline and betaine intake, especially higher betaine intake, may be protective against lung cancer through mitigating the adverse effect of smoking.
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Social capital and disaster preparedness among low income Mexican Americans in a disaster prone area.
Soc Sci Med
PUBLISHED: 01-30-2013
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Examination of social capital and its relationship to disaster preparedness has grown in prominence partially due to world-wide need to effectively respond to terrorist attacks, viral epidemics, or natural disasters. Recent studies suggested that social capital may be related to a communitys ability to plan for and respond to such disasters. Few studies, however, have examined social capital constructs among low income populations living in disaster prone areas and accounted for the influence of social capital at the individual and community level. We examined social capital as measured by perceived fairness, perceived civic trust, perceived reciprocity and group membership. We undertook a multistage random cluster survey in three coastal counties in Texas (U.S.) noted for their high levels of poverty. Individuals from 3088 households provided data on social capital, socioeconomic and demographic characteristics, and self-reported level of preparedness for a hurricane. We used multivariable logistic regression to test potential associations between social capital measures and disaster preparedness. After adjusting for age, gender, marital status, ethnicity, education, employment, household income, acculturation, self-reported health, special needs persons in household, household size, and distance to the shore we found a higher prevalence of preparedness among individuals who reported the highest perception of fairness [AOR = 3.12, 95% CI: (1.86, 5.21)] compared to those individuals who reported lowest perceptions of fairness. We also found a higher prevalence of preparedness [AOR = 2.06; 95% CI: (1.17, 3.62)] among individuals who reported highest perceptions of trust compared to individuals who reported lowest perceptions of trust. Perceived reciprocity and group membership were not associated with preparedness. These results extend previous findings on social capital and disaster preparedness and further characterize social capitals presence among a low income population living in a hurricane prone area.
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The impact of tumor necrosis factor ? inhibitors on radiographic progression in ankylosing spondylitis.
Arthritis Rheum.
PUBLISHED: 01-27-2013
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To study the effect of tumor necrosis factor ? (TNF?) inhibitors on progressive spinal damage in patients with ankylosing spondylitis (AS).
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Pilot RCT results of stop my smoking USA: a text messaging-based smoking cessation program for young adults.
Nicotine Tob. Res.
PUBLISHED: 01-24-2013
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To address the lack of smoking cessation programs available to young adults, Stop My Smoking (SMS) USA, a text messaging-based smoking cessation program, was developed and pilot tested.
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Short report: Gender differences in tuberculosis notification in Pakistan.
Am. J. Trop. Med. Hyg.
PUBLISHED: 09-08-2011
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Worldwide, the male to female ratio of new smear-positive tuberculosis (TB) cases is approximately two to one. However, in Pakistan, this is not the case. Rates of notified TB cases are 20-30% higher in young females compared with males, and female rates remain high regardless of increasing age. This is in stark contrast to neighboring India, which is characterized by an excess of male TB cases. It is currently unknown why rates of notified TB are so high in females in Pakistan, but it is clear that this epidemiology is a public health issue of importance that impacts transmission dynamics and disease control initiatives.
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A cholera outbreak associated with drinking contaminated well water.
Arch Iran Med
PUBLISHED: 09-06-2011
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Cholera has been a significant public health challenge in many communities. An outbreak of acute diarrheal illness occurred among participants in a wedding ceremony in a village in Qazvin, Iran, in 2008. We conducted an epidemiological, environmental and microbiological investigation to determine the causative agent, source and extent of this outbreak.
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Coordination and management of multicenter clinical studies in trauma: Experience from the PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) Study.
Resuscitation
PUBLISHED: 08-15-2011
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Early death due to hemorrhage is a major consequence of traumatic injury. Transfusion practices differ among hospitals and it is unknown which transfusion practices improve survival. This report describes the experience of the PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) Study Data Coordination Center in designing and coordinating a study to examine transfusion practices at ten Level 1 trauma centers in the US.
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Association between Human Body Composition and Periodontal Disease.
ISRN Dent
PUBLISHED: 08-09-2011
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Obesity in humans might increase the risk of periodontitis. The aim of the present study was to examine the relationship between body composition of males and their periodontal status. AS total of 150 males (aged 30-60) were selected: 31 were periodontally healthy, 45 had gingivitis, 39 had initial periodontitis, and 35 suffered from established periodontitis. BMI (body mass index), WC (waist circumference), and body composition parameters (consisting of body water, body fat, and skeletal muscle and bone mass) were measured. After adjusting for age, history of diabetes, smoking, physical activity status, and socioeconomic status, statistically significant correlations were found between periodontitis and BMI, WC, and body composition. There was only a statistically significant difference between the periodontal health and established periodontitis; that is, periodontal disease in mild forms (gingivitis) and initial periodontitis do not influence these variables (BMI, WC, and body composition parameters) and only the severe form of the disease influences the variables. These data suggest that there is a considerable association between severe forms of periodontal disease in males and their body composition, but this preliminary finding needs to be confirmed in more extensive studies.
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In vitro and in vivo antibacterial activity of acorn herbal extract against some Gram-negative and Gram-positive bacteria.
Roum Arch Microbiol Immunol
PUBLISHED: 07-25-2011
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The search for safe and effective antimicrobial agents, which treat, therapeutically and prophylactically, a wide variety of bacterial infections still represents a top priority for the biomedical field. This study was undertaken to investigate the antimicrobial properties of herbal extract (acorn) against bacterial pathogens in intestinal tract infections in in vitro and in vivo conditions and to study the effect of herbal extracts against bacteria in comparison with current antibiotics.
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A potential in silico antibody-antigen based diagnostic test for precise identification of Acinetobacter baumannii.
J. Theor. Biol.
PUBLISHED: 07-06-2011
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Acinetobacter baumannii is a problematic nosocomial pathogen. The resistance to a wide range of antimicrobial agents, attributable to its biofilm phenotype, makes the treatment very difficult. Biofilm is a common feature of most pathogens. Biofilm associated proteins (Bap) are cellular surface components directly involved in biofilm formation process. The dearth of a fast precise diagnostic test and versatility of Bap sequences in A. baumannii were intuitions to design this study. In silico analysis is a reliable alternative to laborious experimental work in this connection. Databases were searched for an antigenic conserved region of Bap specific to A. baumannii. The region was selected based on alignments and propensity scales. Tertiary structure for this region was built and predicted B-cell epitopes were mapped on the surface of the built model. Our protein subunit was found to be a potential antigen, possessing several antigenic determinants, eliciting antibody. Hence this subunit could be used as a suitable agent for antibody-antigen based diagnostic test. This specific antigen can minimize laboratory errors in identification of A. baumannii and thus help clinicians to quick and precise diagnosis of the bacteria and initiatives to the treatment of the infection. Antigenicity of the region could also be explored for elicitation of antibody to protect the individuals exposed to A. baumannii.
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Protection against Acinetobacter baumannii infection via its functional deprivation of biofilm associated protein (Bap).
Microb. Pathog.
PUBLISHED: 06-21-2011
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Acinetobacter baumannii, a major nosocomial pathogen, has remarkable capacity to acquire antimicrobial resistance attributable to its biofilm formation ability. Biofilm associated protein (Bap), a specific cell surface protein, is directly involved in biofilm formation by A. baumannii and plays a major role in bacterial infectious processes. In the present study we cloned, expressed and purified a 371 amino acid subunit of Bap. Mice were immunized using recombinant Bap subunit. They were then challenged with A. baumannii to evaluate the immunogenicity and protectivity of Bap subunit. Humoral immune response to Bap was determined by ELISA. Injection of Bap subunit resulted in high antibody titers. Decrease in bacterial cell counts of the immunized mice was evident 18 h after challenge. Reaction of antibodies against Bap with several strains suggests that not only immunodominant regions of Bap in A. baumannii strains are conserved but also have the same epitope presenting pattern in different strains. Immunodominant region of Bap possesses target sites for a protective humoral immune response to A. baumannii. This seems to be a conserved region erecting efficacy of Bap as an appropriate vaccine candidate.
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An in silico DNA vaccine against Listeria monocytogenes.
Vaccine
PUBLISHED: 05-07-2011
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Listeria monocytogenes causes listeriosis with mortality rate >20%. Listeriolysin-O (LLO), a pore-forming hemolysin, belongs to the family of cholesterol-dependent toxins (CDTX) and plays roles in the pathogenicity. In this study bioinformatic analyses were carried out on LLO sequence as a major immunodominant listerial antigen toward designing a DNA vaccine stimulating cytotoxic T-lymphocytes (CTLs). Mouse and human constructs were designed based on predicted T cell epitopes and MHC class I binders, which were then tandemly fused together. LLO-derived construct codons and a variety of critical gene expression efficiency parameters were optimized. Post-translational modifications such as glycosylation, phosphorylation were analysed. The constructs corresponded to LLO sequences of L. monocytogenes in BLAST search. Neither human nor mouse construct was allergen. Secretory pathway was location of the human construct that enhances immune induction and contribute to the efficacy of the vaccine candidate. mRNAs from optimized DNA sequences of both human and mouse constructs are more stable than the native and are suitable for initiation of translation. The constructs contain several sites for phosphorylation that could improve its degradation and subsequent entry into the MHC class I pathway. Addition of GPI anchor, myristoylation and ubiquitin signals or proline (P), glutamic acid (E), serine (S), threonine (T) (PEST)-like motifs at the N-terminal of constructs increase efficacy of the DNA vaccine. Close physical contact between the favorable immunogen and the suitable CpG oligodeoxynucleotides (CpG ODN) promotes immune response. Vectors for checking the expression of constructs in mammalian cells and for harboring the foreign genes as DNA vaccine are suggested.
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qnr Prevalence in Extended Spectrum Beta-lactamases (ESBLs) and None-ESBLs Producing Escherichia coli Isolated from Urinary Tract Infections in Central of Iran.
Iran J Basic Med Sci
PUBLISHED: 04-20-2011
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Extensive use of quinolones has been associated with raising level of resistance. In the current, we focused on assessing the prevalence of Escherichia coli resistance to quinolones and frequency of qnrA, qnrB and qnrS in non ESBLs (extended spectrum beta-lactamases) and ESBLs producing E. coli with blaSHV and blaTEM.
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A meta-analysis of the relationship between endometrial thickness and outcome of in vitro fertilization cycles.
J Hum Reprod Sci
PUBLISHED: 03-22-2011
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The objective was to evaluate the relationship between endometrial thickness on the day of human chorionic gonadotropin administration and pregnancy outcome in in vitro fertilization cycles.
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Cross-sectional assessment reveals high diabetes prevalence among newly-diagnosed tuberculosis cases.
Bull. World Health Organ.
PUBLISHED: 03-22-2011
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To estimate the contribution of clinically-confirmed diabetes mellitus to tuberculosis (TB) rates in communities where both diseases are prevalent as a way to identify opportunities for TB prevention among diabetic patients.
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Detection of novel gyrA mutations in nalidixic acid-resistant isolates of Salmonella enterica from patients with diarrhoea.
Int. J. Antimicrob. Agents
PUBLISHED: 03-03-2011
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The aim of the current study was to detect mutations in the gyrA gene of quinolone-resistant Salmonella spp. isolates recovered in Tehran, Iran. Between April 2008 and September 2009, 174 Salmonella spp. were collected and assayed for quinolone resistance and detection of gyrA mutations. Isolates identified as Salmonella enterica were tested for susceptibility by the disk diffusion method. Polymerase chain reaction (PCR) amplification and sequencing of the gyrA gene segment encoding the quinolone resistance-determining region (QRDR) were performed for the nalidixic acid-resistant isolates. Amongst the 174 recovered Salmonella spp. isolates, 89 were resistant to nalidixic acid, of which 9 were resistant to enrofloxacin; 10 isolates had reduced susceptibility to nalidixic acid. None of the isolates were resistant to ciprofloxacin, but a single isolate showed reduced susceptibility. Twelve types of amino acid replacement were found in the QRDR region of GyrA, namely the previously described substitutions in positions 83 and 87 as well as five new substitutions Leu41-Pro, Arg47-Ser, Ser111-Thr, Ala118-Thr and Asp147-Gly. Double substitutions in both positions 83 and 87 were not identified. A Gly133-Glu substitution was identified in a single S. enterica serotype Typhi isolate.
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Coordination and management of multisite complementary and alternative medicine (CAM) therapies: experience from a multisite reflexology intervention trial.
Contemp Clin Trials
PUBLISHED: 02-15-2011
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Multisite randomized clinical trials allow for increased research collaboration among investigators and expedite data collection efforts. As a result, government funding agencies typically look favorably upon this approach. As the field of complementary and alternative medicine (CAM) continues to evolve, so do increased calls for the use of more rigorous study design and trial methodologies, which can present challenges for investigators.
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Biotyping, capsular typing, and antibiotic resistance pattern of Haemophilus influenzae strains in Iran.
Jpn. J. Infect. Dis.
PUBLISHED: 01-27-2011
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The aim of this study was to determine the capsular types of Haemophilus influenzae isolated from clinical specimens by slide agglutination serotyping (SAST) and PCR capsule typing methods. All the isolates were biotyped and their antibiotic resistance patterns also determined. Thirteen isolates of serotype b, 2 of serotype e, 4 of serotype f, and 19 nontypeable (NT) isolates were identified by SAST method in 38 H. influenzae culture-positive samples. Capsule typing by PCR increased the proportion of all invasive cases from 34.2% (by SAST) to 60.5%, and 6 culture-negative samples were identified as invasive H. influenzae (Hib) by this method. The discrepancy rate between SAST and PCR results were 41%. Biotypes I, II, and III were the prevalent biotypes whereas biotypes VI and VII were not found. The majority of capsule type b belonged to biotype II. The isolates were resistant to cotrimoxazole (47.1%) and ampicillin (43.6%). Multidrug resistance was observed in 7 of the isolates.
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Randomized controlled trial to improve childhood immunization adherence in rural Pakistan: redesigned immunization card and maternal education.
Trop. Med. Int. Health
PUBLISHED: 12-15-2010
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?A substantial dropout from the first dose of diphtheria-tetanus-pertussis (DTP1) to the 3rd dose of DTP (DTP3) immunization has been recorded in Pakistan. We conducted a randomized controlled trial to assess the effects of providing a substantially redesigned immunization card, centre-based education, or both interventions together on DTP3 completion at six rural expanded programme on immunization (EPI) centres in Pakistan.
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Prevalence of antibiotic-resistant Acinetobacter baumannii in a 1000-bed tertiary care hospital in Tehran, Iran.
Indian J Pathol Microbiol
PUBLISHED: 06-17-2010
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Acinetobacter baumannii is a ubiquitous pathogen that has emerged as a major cause of healthcare-associated infections. Acinetobacter baumannii usually causes respiratory tract, urinary tract, blood stream and surgical site infections. They are of increasing importance because of its ability to rapidly develop resistance to the major groups of antibiotics. There are few data available on the antimicrobial susceptibility of A. baumannii in Iran. During the period of study from July 2005 to November 2006, a total of 88 strains of A. baumannii were isolated from clinical specimens obtained from patients hospitalized in an Iranian 1000-bed tertiary care hospital. Conventional bacteriological methods were used for identification of A. baumannii. Susceptibility testing was performed by the method recommended by Clinical Laboratory and Standards Institute (CLSI). The majority of isolates were from respiratory tract specimens. The organism showed high rate of resistance to ceftriaxone (90.9%), piperacillin (90.9%), ceftazidime (84.1%), amikacin (85.2%) and ciprofloxacin (90.9%). Imipenem was the most effective antibiotic against A. baumannii and the rate of resistance for imipenem was 4.5%. The second most effective antibiotic was tobramycin, and 44.3% of A. baumannii isolates were resistant to this antibiotic. In conclusion, our study showed that the rate of resistance in A. baumannii to imipenem was low. There was a significant relationship between demographic features of patients such as age, undergoing mechanical ventilation, length of hospital stay and drug resistance.
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Intervention fidelity: aspects of complementary and alternative medicine research.
Cancer Nurs
PUBLISHED: 05-15-2010
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The Treatment Fidelity Workgroup (TFW) established by the National Institutes of Health provides a 5-point structure for intervention fidelity: dosing, interventionists consistency, intervention delivery, receipt, and enactment of the intervention. Using our reflexology trial, we apply the first 3 points.
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Socioeconomic status and prevalence of obesity and diabetes in a Mexican American community, Cameron County, Texas, 2004-2007.
Prev Chronic Dis
PUBLISHED: 05-15-2010
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Mexican Americans are at increased risk for obesity and diabetes. We established a cohort on the United States-Mexico border to determine the prevalence of obesity and diabetes in this Mexican American population and to see whether minor economic advantages had any effect on health.
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In silico analysis of antibody triggering biofilm associated protein in Acinetobacter baumannii.
J. Theor. Biol.
PUBLISHED: 05-08-2010
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Acinetobacter baumannii surface protein, commonly known as biofilm associated protein (Bap), is involved in biofilm formation. A high propensity among the clinical isolates to form biofilm and a significant association of biofilms with multiple drug resistance has been demonstrated. Production of antibodies can be used for inhibition of biofilm and control of the diseases caused by A. baumannii. Large molecular mass of Bap justifies an approach to identifying A. baumannii effective antigens. It has a core domain of seven repeat modules A-G. With the large number of available biofilm gene sequences, bioinformatic tools are needed to identify the genes encoding the antigens. Proteins containing these tandem repeats of Bap domains have high propensities to attach to each other to form biofilm. We hypothesized that conserved and functional domains of tandem repeat could be identified with a search and alignment of the repeats for evaluation of antigenic determinants. Here we demonstrate the results of bioinformatics screening and gene scan of the gene sequence database of homolog sequences to identify conserved domains. Higher scoring hits were found in repeat modules mostly D, B, C and A, respectively. Upon the analysis four regions of highly structural and functional conserved regions from Bap sequence of A. baumannii were selected. 3D structure, antigenicity and solubility predictions revealed that these regions were appropriate candidates for antibody production.
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Case-control study of disease determinants for non-typhoidal Salmonella infections among Michigan children.
BMC Res Notes
PUBLISHED: 04-16-2010
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Infections with Salmonella serotypes continue to be a significant global public health problem. In addition to contaminated foods, several other sources contribute to infections with Salmonella serotypes. We have assessed the role of socioeconomic factors, exposure to food, and environmental sources in the etiology of non-typhoidal Salmonella infections in Michigan children.
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High prevalence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a tertiary care hospital in Tehran, Iran.
J Infect Dev Ctries
PUBLISHED: 03-31-2010
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Extended-spectrum beta (beta)-lactamase (ESBL)-producing enterobacteria are major emerging pathogens in nosocomial infections.
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Enhancement of vancomycin activity by phenothiazines against vancomycin-resistant Enterococcus faecium in vitro.
Basic Clin. Pharmacol. Toxicol.
PUBLISHED: 03-28-2010
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The antimicrobial and resistance-reversal activities of seven phenothiazine derivatives were evaluated against vancomycin-sensitive Enterococcus faecalis ATCC 29212, vancomycin resistant E. faecalis ATCC 51299 and ten vancomycin-resistant E. faecium strains originating from human infections. Minimum inhibitory concentrations (MIC) of the compounds were determined by agar dilution method, and synergy between phenothiazines and vancomycin was investigated using Checkerboard (microbroth dilution) technique. We found that all enterococci strains, regardless of their susceptibility to vancomycin, were inhibited by phenothiazines at concentrations varying from 8 to 256 microg/ml, with thiethylperazine being the most potent inhibitory agent. Besides, all the phenothiazines showed partial synergy with vancomycin and could lessen MIC of vancomycin from 512 to 8 microg/ml at their sub-inhibitory concentrations. The highest reduction in MIC was observed with chlorpromazine (32 times); however, thiethylperazine and promethazine stood next (24 times). Although resistance modification was observed at concentrations higher than those that phenothiazines reach in vivo, the potential offered by non-antibiotics justify further animal experiments as well as clinical trials to establish their clinical relevance.
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