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41.
Gregory C Gray Troy McCarthy Mark G Lebeck David P Schnurr Kevin L Russell Adriana E Kajon Marie L Landry Diane S Leland Gregory A Storch Christine C Ginocchio Christine C Robinson Gail J Demmler Michael A Saubolle Sue C Kehl Rangaraj Selvarangan Melissa B Miller James D Chappell Danielle M Zerr Deanna L Kiska Diane C Halstead Ana W Capuano Sharon F Setterquist Margaret L Chorazy Jeffrey D Dawson Dean D Erdman 《Clinical infectious diseases》2007,45(9):1120-1131
BACKGROUND: Recently, epidemiological and clinical data have revealed important changes with regard to clinical adenovirus infection, including alterations in antigenic presentation, geographical distribution, and virulence of the virus. METHODS: In an effort to better understand the epidemiology of clinical adenovirus infection in the United States, we adopted a new molecular adenovirus typing technique to study clinical adenovirus isolates collected from 22 medical facilities over a 25-month period during 2004-2006. A hexon gene sequence typing method was used to characterize 2237 clinical adenovirus-positive specimens, comparing their sequences with those of the 51 currently recognized prototype human adenovirus strains. In a blinded comparison, this method performed well and was much faster than the classic serologic typing method. RESULTS: Among civilians, the most prevalent adenovirus types were types 3 (prevalence, 34.6%), 2 (24.3%), 1 (17.7%), and 5 (5.3%). Among military trainees, the most prevalent types were types 4 (prevalence, 92.8%), 3 (2.6%), and 21 (2.4%). CONCLUSIONS: For both populations, we observed a statistically significant increasing trend of adenovirus type 21 detection over time. Among adenovirus isolates recovered from specimens from civilians, 50% were associated with hospitalization, 19.6% with a chronic disease condition, 11% with a bone marrow or solid organ transplantation, 7.4% with intensive care unit stay, and 4.2% with a cancer diagnosis. Multivariable risk factor modeling for adenovirus disease severity found that age <7 years (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.4-7.4), chronic disease (OR, 3.6; 95% CI, 2.6-5.1), recent transplantation (OR, 2.7; 95% CI, 1.3-5.2), and adenovirus type 5 (OR, 2.7; 95% CI, 1.5-4.7) or type 21 infection (OR, 7.6; 95% CI, 2.6-22.3) increased the risk of severe disease. 相似文献
42.
Sylvie Di Filippo Bertrand Semiond Ricardo Roriz Francois Sassolas Marie José Raboisson André Bozio 《The Journal of heart and lung transplantation》2003,22(8):876-882
BACKGROUND: Coronary vasculopathy is the main cause of cardiac graft failure. Because yearly coronary angiography is invasive in children, a non-invasive method for detecting graft vasculopathy is needed. The aim of this study was to test dobutamine-stress echocardiography in a pediatric population to determine its feasibility, safety and reliability in the detection of graft coronary artery disease. METHODS: Eighteen patients, aged 2 days to 16.8 years at transplantation (mean 8.4 years), underwent 44 dobutamine-stress echocardiography (DSE) exams, at a follow-up of 1.1 to 11.8 years (mean 5.1 years). Selective coronary angiography was performed for comparison. Echocardiographic recordings were obtained in 4 standard views of the left ventricle and measurements carried out within the frames of a 16-segment model. Segmental scores of contractility were obtained for each segment and a total segmental contractility index was calculated at each stage. RESULTS: All patients reached the maximum dose stage. Maximum heart rate was 57% to 90% of predicted maximum. Maximum systolic blood pressure reached 190 mmHg. Segmental scores were normal in 37 and abnormal in 7 cases. Echographic results were concordant with angiography in 82% and discordant in 18% of the cases (4 negative DSEs with minor angiographic lesions, 2 positive DSEs with normal angiography), but there was no significant angiographic lesion with normal DSE. CONCLUSIONS: DSE is a safe and highly feasible non-invasive technique in transplanted children. A normal DSE study successfully predicts the absence of significant coronary artery disease in the post-transplant population. 相似文献
43.
Donna Marie Wing R.N. Ed.D. Timmy Thompson 《Public health nursing (Boston, Mass.)》1995,12(6):417-423
Abstract Traditional Native American people are experiencing serious health, economic, and social problems resulting from alcoholism. Native Americans maintain a worldview of health and illness that conflicts with the dominant culture's approach to treatment. The purposes of this study were to describe the health beliefs of traditional Muscogee (Creek) Indians concerning the causes of illness and learn how these beliefs relate to alcoholism. The researchers conducted in-depth interviews of 55 traditional Muscogee (Creek) participants to learn traditional beliefs about illness and alcoholism. Data were analyzed using content analysis. Results indicate that both illness and alcoholism are perceived as having natural and unnatural (supernatural) causes. A challenge facing nurses is how to provide culturally sensitive care when clients' and nurses' beliefs about the cause of alcoholism may be in conflict. The authors discuss preservation, accommodation, and repatterning of health care beliefs as a basis for planning culturally sensitive nursing care. 相似文献
44.
Marie Thérèse Labro 《Clinical microbiology and infection》1996,1(S1):S24-S30
A brief overview is provided of the bioactivity of macrolides against a range of bacterial species. Topics considered include the cellular pharmacokinetics of uptake and efflux of these drugs and the importance of intra- or extracellular and cytoplasmic or granular location on their activity. Emphasis is placed on the importance of synergy between macrolides and host defenses, with drug accumulation producing modification of cellular function, such as enhancement of phagocytosis, and exocytosis of polymorphonuclear neutrophils. Such interaction may explain the activity of such agents against organisms which normally inhibit fusion of phagolysosomes. 相似文献
45.
Marianne R. Freeman Wiley Mittenberg Marie Dicowden Maya Bat-Ami 《Brain injury : [BI]》1992,6(1):65-70
A controlled treatment outcome study was conducted comparing the efficacy of memory remediation treatment with no treatment on traumatic brain-injury patients. The memory remediation treatment consisted of both compensatory and executive training skills and was delivered 6 hours weekly over a 2 1/2-week period. Six subjects in the treatment group and 6 subjects in the control group were matched on WAIS-R FSIQ scores, pre-test memory scores and age. Pre-and post-test measures were obtained for both groups on a paragraph memory task. A significant difference was demonstrated between the treatment and control post-test memory scores. The experimental group significantly improved memory scores beyond that of the control group, suggesting that memory remediation is effective for head-injury patients with memory deficits. Discussion of findings and suggestions for further investigation are presented. 相似文献
46.
Danuta Wasserman Christer HellstrÖm Jerzy Wasserman Olof Beck Eva Andersson Marie Åsberg 《Archives of Suicide Research》1997,3(3):153-169
The aim of this study was to investigate markers of serotonin and immune function in suicidal patients. Cytotoxic activity of natural killer cells (NK) and CD16 lymphocytes were studied in 28 suicide attempters and 26 healthy controls, and related in patients to 5-hydroxyindoleacetic acid (5-HIAA) in cerebrospinal fluid (CSF). Patients with CSF 5-HIAA below the median had significantly lower NK cell activity than other patients. CD16 cell frequency was significantly lower in patients than in controls, and patients also tended to have lower NK cell cytotoxicity than healthy controls. There were no statistically significant correlations between 4-hydroxy-3methoxyphenyl glycol (HMPG), homovanillic acid (HVA), CSF cortisol and NK cell activity. The results support the hypothesis of compromised immune function in suicidal patients with evidence of disordered serotonin function. 相似文献
47.
Marie Biancuzzo 《分娩》1994,21(2):96-100
ABSTRACT: This case report describes a primipara who successfully breastfed 35-week-gestation twins for over six months. Positive interactions, research-based management strategies, and innovative problem solving helped her avoid the individual, interpersonal, and system factors that can injuence lactation failure. (BIRTH 21:2, June 1994) 相似文献
48.
Louise Rose MN Adult Ed Cert BN ICU Cert Dip Nurs Marie F. Gerdtz RN BN AE Cert GDAET PhD 《Australasian emergency nursing journal : AENJ》2007,10(1):26-29
The use of mechanical ventilation in the Emergency Department requires adequate resources in order to maintain patient safety and avoid potential risks. Moreover, developments in technology require increased knowledge of mechanical ventilation techniques to address the complexity of decision-making involved. Organisational issues and system factors have the potential to negatively impact on the ability of the emergency service to provide optimum care to patients receiving mechanical ventilation. These issues include staffing and skill-mix, demand on emergency services, role-delineation, scope of practice, and current mechanisms for monitoring of quality and safety. Furthermore, in response to advances in ventilator technology, current education programs for both nursing and medical staff require review to ensure that they provide comprehensive information about the types of ventilation techniques now available and the relative risks and benefits associated with their application.This article is the second in a two-part series and explores the educational and organisational factors that impact upon safety and quality of care delivered to patients receiving mechanical ventilation in the emergency department. Recommendations for future policy development, curriculum review and reporting mechanisms to support further research in the application of mechanical ventilation in the emergency department are made. 相似文献
49.
50.
C. Noonan M. Farrell J. Mullaney H. Cassidy M. A. Asghar B. J. Young Marie Hickey-Dwyer A. Patterson W. Power M. Hillery A. Benedict-Smith L. M. T. Collum S. Fitzsimon E. O’Donoghue R. Hitchings G. B. Arden A. O’Mahony A. Murray A. Whyte M. Shehata Hugh O’Donoghue Rosemary Robinson J. Toland P. Eustace 《Irish journal of medical science》1991,160(10):322-324