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101.
Background
Systemic embolism is a serious and sometime fatal complication of rheumatic MS.Objective
We assessed the predictive power of D-Dimer level to predict occurrence of left atrial (LA) thrombi in patients with rheumatic mitral stenosis (MS).Methods
D-dimer levels were analyzed for 24 patients with rheumatic MS with LA clot and 22 patients with rheumatic MS with no LA clot undergoing transeosophageal echocardiography. A level more than 4 µg/ml was taken as elevated to predict the presence of LA clot in the study groups.Results
For a cut-off value of 4 µg/ml, sensitivity was 66.67 % and specificity 100 % for prediction of LA clot and AUC 0.710. A cut-off value of less than 1 µg/ml, sensitivity was 91.67 % and 87. 5 % negative predictive value for ruling out presence of LA clot and AUC 0.721.Conclusion
A higher value of D-dimer can predict the possible presence of a LA clot and very low value can predict absence of clot in patients with rheumatic MS. 相似文献102.
Fasiha Kanwal Tuyen Hoang Timothy Chrusciel Jennifer R. Kramer Hashem B. El-Serag Janet Durfee Jason A. Dominitz Elizabeth M. Yano Steven M. Asch 《Digestive diseases and sciences》2014,59(2):273-281
Background
Available data suggest problems in the process of care provided to patients with chronic hepatitis C (HCV). However, the solutions to these problems are less obvious. Healthcare facility factors are potentially modifiable and may enhance process quality in HCV treatment.Methods
We evaluated the relationship between the process of HCV care and facility factors including number of weekly half-day HCV clinics per 1,000 HCV patients, HCV-specific quality-improvement initiatives, and administrative service of the HCV clinic (gastroenterology, infectious disease, primary care) for a cohort of 34,258 patients who sought care in 126 Veterans Affairs facilities during 2003–2006. We measured HCV care on the basis of 23 HCV-specific process measures capturing pretreatment (seven measures), preventive and/or comorbid (seven measures), and treatment and treatment monitoring care (nine measures).Results
Patients seen at a facility with >8 half-day clinics were 52 % more likely to receive overall indicated care (OR 1.52, 95 % CI 1.13–2.05). Patients seen at a facility with >3 HCV quality improvement initiatives were more likely to receive better preventive and/or comorbid care (OR 1.32, 95 % CI 1.00–1.74). Compared with patients in facilities with no dedicated HCV clinic, patients at facilities with gastroenterology-based clinics received better pretreatment care (OR 1.36, 95 % CI 1.01–1.85) and more antiviral treatment (OR 1.45, 95 % CI 1.06–1.97) whereas those at facilities with infectious disease-based or primary care-based clinics received better preventive and/or comorbid care (OR 1.59, 95 % CI 1.06–2.39 and 1.84, 95 % CI 1.21–2.79 respectively).Conclusion
Several facility factors affected the process of HCV care. These factors may serve as targets for quality-improvement efforts. 相似文献103.
The Intelence aNd pRezista Once A Day Study (INROADS): a multicentre,single‐arm,open‐label study of etravirine and darunavir/ritonavir as dual therapy in HIV‐1‐infected early treatment‐experienced subjects 下载免费PDF全文
PJ Ruane C Brinson M Ramgopal R Ryan B Coate M Cho TN Kakuda D Anderson 《HIV medicine》2015,16(5):288-296
104.
Shuhei Ueda Bui Thi Kim Ngan Bui Thi Mai Huong Itaru Hirai Le Danh Tuyen Yoshimasa Yamamoto 《Antimicrobial agents and chemotherapy》2015,59(6):3574-3577
We examined whether Escherichia coli isolates that produce CTX-M-9-type extended-spectrum β-lactamases (ESBL) are transferred between humans and chickens in a Vietnamese community. The phylogenetic group compositions, sequence types, antimicrobial resistance profiles, the prevalence of plasmid antibiotic resistance genes, and the plasmid replicon types generally differed between the human and chicken E. coli isolates. Our results suggest that transmission of the blaCTX-M-9-positive E. coli between humans and poultry was limited. 相似文献
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107.
Matthew Bidwell Goetz MD Tuyen Hoang PhD Herschel Knapp PhD MSSW Jane Burgess RN MS Michael D. Fletcher MHP BA Allen L. Gifford MD Steven M. Asch MD MPH 《Journal of general internal medicine》2013,28(10):1311-1317
BACKGROUND
Pilot data suggest that a multifaceted approach may increase HIV testing rates, but the scalability of this approach and the level of support needed for successful implementation remain unknown.OBJECTIVE
To evaluate the effectiveness of a scaled-up multi-component intervention in increasing the rate of risk-based and routine HIV diagnostic testing in primary care clinics and the impact of differing levels of program support.DESIGN
Three arm, quasi-experimental implementation research study.SETTING
Veterans Health Administration (VHA) facilities.PATIENTS
Persons receiving primary care between June 2009 and September 2011INTERVENTION
A multimodal program, including a real-time electronic clinical reminder to facilitate HIV testing, provider feedback reports and provider education, was implemented in Central and Local Arm Sites; sites in the Central Arm also received ongoing programmatic support. Control Arm sites had no interventionMAIN MEASURES
Frequency of performing HIV testing during the 6 months before and after implementation of a risk-based clinical reminder (phase I) or routine clinical reminder (phase II).KEY RESULTS
The adjusted rate of risk-based testing increased by 0.4 %, 5.6 % and 10.1 % in the Control, Local and Central Arms, respectively (all comparisons, p?<?0.01). During phase II, the adjusted rate of routine testing increased by 1.1 %, 6.3 % and 9.2 % in the Control, Local and Central Arms, respectively (all comparisons, p?<?0.01). At study end, 70–80 % of patients had been offered an HIV test.CONCLUSIONS
Use of clinical reminders, provider feedback, education and social marketing significantly increased the frequency at which HIV testing is offered and performed in VHA facilities. These findings support a multimodal approach toward achieving the goal of having every American know their HIV status as a matter of routine clinical practice. 相似文献108.
109.
Vu Thuy Duong Voong Vinh Phat Ha Thanh Tuyen Tran Thi Ngoc Dung Pham Duc Trung Pham Van Minh Le Thi Phuong Tu James I. Campbell Hoang Le Phuc Ton Thi Thanh Ha Nguyen Minh Ngoc Nguyen Thi Thanh Huong Pham Thi Thanh Tam Dang Thao Huong Nguyen Van Xang Nguyen Dong Le Thi Phuong Nguyen Van Hung Bui Duc Phu Tran My Phuc Guy E. Thwaites Lu Lan Vi Maia A. Rabaa Corinne N. Thompson Stephen Baker 《Journal of clinical microbiology》2016,54(4):1094-1100
Diarrheal disease is a complex syndrome that remains a leading cause of global childhood morbidity and mortality. The diagnosis of enteric pathogens in a timely and precise manner is important for making treatment decisions and informing public health policy, but accurate diagnosis is a major challenge in industrializing countries. Multiplex molecular diagnostic techniques may represent a significant improvement over classical approaches. We evaluated the Luminex xTAG gastrointestinal pathogen panel (GPP) assay for the detection of common enteric bacterial and viral pathogens in Vietnam. Microbiological culture and real-time PCR were used as gold standards. The tests were performed on 479 stool samples collected from people admitted to the hospital for diarrheal disease throughout Vietnam. Sensitivity and specificity were calculated for the xTAG GPP for the seven principal diarrheal etiologies. The sensitivity and specificity for the xTAG GPP were >88% for Shigella spp., Campylobacter spp., rotavirus, norovirus genotype 1/2 (GI/GII), and adenovirus compared to those of microbiological culture and/or real-time PCR. However, the specificity was low (∼60%) for Salmonella species. Additionally, a number of important pathogens that are not identified in routine hospital procedures in this setting, such as Cryptosporidium spp. and Clostridium difficile, were detected with the GPP. The use of the Luminex xTAG GPP for the detection of enteric pathogens in settings, like Vietnam, would dramatically improve the diagnostic accuracy and capacity of hospital laboratories, allowing for timely and appropriate therapy decisions and a wider understanding of the epidemiology of pathogens associated with severe diarrheal disease in low-resource settings. 相似文献
110.
Jennifer L.S. Willoughby Amy Chan Alfica Sehgal James S. Butler Jayaprakash K. Nair Tim Racie Svetlana Shulga-Morskaya Tuyen Nguyen Kun Qian Kristina Yucius Klaus Charisse Theo J.C. van Berkel Muthiah Manoharan Kallanthottathil G. Rajeev Martin A. Maier Vasant Jadhav Tracy S. Zimmermann 《Molecular therapy》2018,26(1):105-114