424 research outputs found
In Vitro Activity of Eravacycline against Gram-Negative Bacilli Isolated in Clinical Laboratories Worldwide from 2013 to 2017
No full textEravacycline is a novel, fully synthetic fluorocycline antibiotic developed for the treatment of serious infections, including those caused by multidrug-resistant (MDR) pathogens. Here, we evaluated the in vitro activities of eravacycline and comparator antimicrobial agents against a global collection of frequently encountered clinical isolates of Gram-negative bacilli. The CLSI broth microdilution method was used to determine MIC data for isolates of Enterobacterales (n = 13,983), Acinetobacter baumannii (n = 2,097), Pseudomonas aeruginosa (n = 1,647), and Stenotrophomonas maltophilia (n = 1,210) isolated primarily from respiratory, intra-abdominal, and urinary specimens by clinical laboratories in 36 countries from 2013 to 2017. Susceptibilities were interpreted using both CLSI and EUCAST breakpoints. Multidrug-resistant (MDR) isolates were defined by resistance to agents from ≥3 different antimicrobial classes. The MIC90s ranged from 0.25 to 1 μg/ml for Enterobacteriaceae and were 1 μg/ml for A. baumannii and 2 μg/ml for S. maltophilia, Proteus mirabilis, and Serratia marcescens Eravacycline's potency was up to 4-fold greater than that of tigecycline against genera/species of Enterobacterales, A. baumannii, and S. maltophilia The MIC90s for five of six individual genera/species of Enterobacterales and A. baumannii were within 2-fold of the MIC90s for their respective subsets of MDR isolates, while the MDR subpopulation of Klebsiella spp. demonstrated 4-fold higher MIC90s. Eravacycline demonstrated potent in vitro activity against the majority of clinical isolates of Gram-negative bacilli, including MDR isolates, collected over a 5-year period. This study further underscores the potential benefit of eravacycline in the treatment of infections caused by MDR Gram-negative pathogens
Potential role for telavancin in bacteremic infections due to gram-positive pathogens: Focus on staphylococcus aureus
No full textStaphylococcus aureus bacteremia (SAB) is one of the most common serious bacterial infections and the most frequent invasive infection due to methicillin-resistant S. aureus (MRSA). Treatment is challenging, particularly for MRSA, because of limited treatment options. Telavancin is a bactericidal lipoglycopeptide antibiotic that is active against a range of clinically relevant gram-positive pathogens including MRSA. In experimental animal models of sepsis telavancin was shown to be more effective than vancomycin. In clinically evaluable patients enrolled in a pilot study of uncomplicated SAB, cure rates were 88% for telavancin and 89% for standard therapy. Among patients with infection due to only gram-positive pathogens enrolled in the 2 phase 3 studies of telavancin for treatment of hospital-acquired pneumonia, cure rates for those with bacteremic S. aureus pneumonia were 41% (9/22, telavancin) and 40% (10/25, vancomycin) with identical mortality rates. These data support further evaluation of telavancin in larger, prospective studies of SAB
Adlerian Group Counseling
No full textBook Summary: With the guidance of world-renowned counseling author, teacher, and practitioner Gerald Corey, best-selling Theory AND PRACTICE OF GROUP COUNSELING, 8e equips readers with the knowledge and skills for effective group counseling and leadership. You\u27ll learn key theoretical approaches to group leadership and how to successfully apply each in practice. With Corey\u27s clear, straightforward writing style, you will have no difficulty understanding each theoretical concept and its relationship to group practice. And as you explore different approaches, your growing knowledge will enable you to integrate techniques from the various approaches you\u27ll study in this book to create a unique approach that works successfully for YOU
Geographic profiling in Nazi Berlin: fact and fiction
No full textGeographic profiling uses the locations of connected crime sites to make inferences about the probable location of the offender’s ‘anchor point’ (usually a home, but sometimes a workplace). We show how the basic ideas of the method were used in a Gestapo investigation that formed the basis of a classic German novel about domestic resistance to the Nazis during the Second World War. We use modern techniques to re-analyse this case, and show that these successfully locate the Berlin home address of Otto and Elise Hampel, who had distributed hundreds of anti-Nazi postcards, after analysing just 34 of the 214 incidents that took place before their arrest. Our study provides the first empirical evidence to support the suggestion that analysis of minor terrorism-related acts such as graffiti and theft could be used to help locate terrorist bases before more serious incidents occur
An overview of group work and implications for school counselors
No full textIncludes bibliographical references
Food and Drink: Eating Their Words
No full textA brief account of Deborah Joy Corey, a writer from Castine, and Blue Angel, the nonprofit she launched in 2019 to combat hunger in Hancock County. This work inspired Corey to collaborate with Debra Spark, author and Colby College professor, on a book called Breaking Bread: Essays from New England on Food, Hunger, and Family. The book features regional writers who run the gamut of notoriety and include Richard Russo, NPR\u27s Kathy Gunst, and Reza Jalali, executive director of the Portland Immigrant Welcome Center
Ceftaroline: A cephalosporin with expanded Gram-positive activity
No full textInfections caused by resistant Gram-positive pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) are now posing a major health risk for patients in hospital and community settings. There is a need to evaluate new antibiotics that would offer reliable clinical efficacy combined with a favorable safety profile for the treatment of such infections. Ceftaroline is a new member of the cephalosporin class of antibiotics with expanded activity against Gram-positive pathogens such as MRSA, vancomycin-intermediate S. aureus, vancomycin-resistant S. aureus and multidrug-resistant Streptococcus pneumoniae, while retaining good activity against common Gram-negative organisms. Phase II and III studies have shown ceftaroline to be an effective and well-tolerated treatment-tor complicated skin and skin-structure infections compared with standard therapy. Trials are ongoing in the treatment of community-acquired pneumonia. © 2009 Future Medicine.Andes D, 2006, ANTIMICROB AGENTS CH, V50, P1376, DOI 10.1128-AAC.50.4.1376-1383.2006; [Anonymous], 2006, M100S16 CLSI; BARRY PM, 2008, 48 ANN INT C ANT AG; Bo G, 2000, CLIN MICROBIOL INFEC, V6, P6; COREY GR, 2008, 48 ANN INT C ANT AG; Fenoll A, 2008, ANTIMICROB AGENTS CH, V52, P4209, DOI 10.1128-AAC.00712-08; Ge Y, 2006, 46 ANN INT C ANT AG; Ge Y, 2008, ANTIMICROB AGENTS CH, V52, P3398, DOI 10.1128-AAC.00149-08; Hinshaw RR, 2008, 48 ANN INT C ANT AG; Iizawa Yuji, 2004, Journal of Infection and Chemotherapy, V10, P146; Ishikawa T, 2003, BIOORGAN MED CHEM, V11, P2427, DOI 10.1016-S0968-0896(03)00126-3; JACQUELINE C, 2008, 48 ANN INT C ANT AG; JACQUELINE C, 2006, 46 ANN INT C ANT AG; Jacqueline C, 2007, ANTIMICROB AGENTS CH, V51, P3397, DOI 10.1128-AAC.01242-06; Kanafani ZA, 2006, ENFERM INFEC MICR CL, V24, P182, DOI 10.1157-13086552; Mariani PG, 2006, J ANTIMICROB CHEMOTH, V58, P481, DOI 10.1093-jac-dkl256; MOISE PA, 2000, ANTIMICROB AGENTS S1, V16, pS31; Mushtaq S, 2007, J ANTIMICROB CHEMOTH, V60, P300, DOI 10.1093-jac-dkm150; Riccobene T, 2008, 48 ANN INT C ANT AG; Sader HS, 2008, ANTIMICROB AGENTS CH, V52, P1153, DOI 10.1128-AAC.01351-07; Sader HS, 2005, ANTIMICROB AGENTS CH, V49, P3501, DOI 10.1128-AAC.49.8.3501-3512.2005; Sakoulas G, 2004, J CLIN MICROBIOL, V42, P2398, DOI 10.1128-JCM.42.6.2398-2402.2004; SARAVOLATZ LD, 2008, 48 ANN INT C ANT AG; SCHAADT RD, 2007, 47 ANN INT C ANT AG; Silverman JA, 2005, J INFECT DIS, V191, P2149, DOI 10.1086-430352; Talbot GH, 2007, ANTIMICROB AGENTS CH, V51, P3612, DOI 10.1128-AAC.00590-07; Tenover FC, 2007, CLIN INFECT DIS, V44, P1208, DOI 10.1086-513203; VIDAILLAC C, 2008, 48 ANN INT C ANT AG; Villegas-Estrada A, 2008, J AM CHEM SOC, V130, P9212, DOI 10.1021-ja8029448; Woods CW, 2004, CLIN INFECT DIS, V38, P1188, DOI 10.1086-383027; XIONG YQ, 2007, 47 ANN INT C ANT AG24181
Estudio de las complicaciones perianulares en la endocarditis infecciosa. Análisis de aspectos clínicos, microbiológicos, ecocardiográficos, terapéuticos y pronósticos en pacientes con abscesos perianulares y fístulas aorto-cavitarias en la endocarditis complicada.
No full text[spa] La endocarditis infecciosa (EI) es una enfermedad potencialmente muy grave, que puede llegar a ser mortal sin tratamiento, cuyo pronóstico ha experimentado una gran mejoría en las ultimas décadas. Este importante cambio en la historia natural de la enfermedad se ha reflejado en una progresiva disminución de la morbi-mortalidad, sobretodo gracias al uso de potentes antibióticos y al empleo de las técnicas quirúrgicas de reparación valvular. La EI es la infección del endotelio de las válvulas cardiacas por gérmenes patógenos. La elevada morbi-mortalidad de la EI se debe a la destrucción que se produce en las válvulas y los tejidos circundantes, debido a la particular anatomía valvular que impide la correcta difusión de los antibióticos al interior de las vegetaciones valvulares. La EI tenía en la era-preantibiótica una mortalidad del 100%. El gran descenso en la mortalidad se ha producido en las últimas tres décadas, con el desarrollo de la cirugía cardiaca y la posibilidad de efectuar recambios valvulares. Con la introducción de la ecocardiografía se han podido visualizar por primera vez mediante un método incruento las vegetaciones valvulares. El desarrollo de esta técnica de imagen ha sido fundamental y en la actualidad tiene un papel clave en el diagnóstico y manejo de esta entidad ya que permite estudiar con gran detalle la anatomía cardiaca. En la actualidad, la mortalidad por EI sobre válvula nativa en fase aguda oscila entre el 20% y el 30% y la supervivencia a los 10 años de seguimiento se sitúa entre el 70% y el 80%. El pronóstico de la EI depende de un gran número de variables. Las complicaciones perianulares en la endocarditis infecciosa representan la extensión de la infección más allá de las estructuras valvulares y representan una de las complicaciones más importantes en esta enfermedad. La formación de lesiones perianulares se asocia a un pronóstico desfavorable, con elevada mortalidad. La formación de fístulas aorto-cavitarias en la endocarditis sólo se ha descrito de forma ocasional en la endocarditis y, por ello, se desconocen sus características clínicas y sus factores pronósticos de mortalidad.La hipótesis del estudio es que la presencia de complicaciones graves en la EI (desarrollo de abscesos perianulares y fístulas aorto-cavitarias) detectadas por ecocardiografía se asocia a un incremento significativo de la morbi-mortalidad. El análisis de las características clínicas y pronósticas permitiría identificar los parámetros asociados a un curso desfavorable; de esta forma podrían redefinirse las líneas de actuación (fundamentalmente quirúrgicas) encaminadas a un abordaje más temprano en pacientes seleccionados, con más posibilidades de reconstrucción completa y erradicación de la infección. Identificar estas variables permitiría, en definitiva, aumentar la supervivencia a corto y medio plazo de los casos de EI complicada.Los objetivos de este estudio son: determinar las características clínicas y el pronóstico de los pacientes con abscesos perianulares íntegros y de pacientes con fistulización aorto-cavitaria en la endocarditis y determinar el impacto sobre el pronóstico de la aparición de fistulización aorto-cavitaria en la endocarditis complicada con lesiones perianulares.Se han publicado varios estudios multicéntricos con el objetivo de reclutar una gran serie de pacientes con complicaciones perianulares y poder estudiar con detalle las características clínicas de estas complicaciones y poder analizar sus factores pronósticos de mortalidad.ARTICULOS PUBLICADOSARTICULO 1:Anguera I, Quaglio G, Miró JM, Paré C, Azqueta M, Marco F, Mestres CA, Moreno A, Pomar JL, Mezzelani JL, Sanz G. Acquired aortocardiac fistulas complicating infective endocarditis. Am J Cardiol 2001;87:652-654. Impact factor (2005) : 3.14ARTICULO 2:Anguera I, Miro JM, Vilacosta I, Almirante B, Anguita M, Muñoz P, San Roman JA, de Alarcón A, Ripoll T, Navas E, Gonzalez-Juanatey C, Cabell CH, Sarriá C, Garcia-Bolao I, Fariñas MC, Leta R, Rufi G, Miralles F, Pare C, Evangelista A, Fowler Jr VG, Mestres CA, de Lazzari E, Guma JR. Aorto-cavitary fistulous tract formation in infective endocarditis. Clinical and echocardiographic features of 76 cases and risk factors for mortality. Eur Heart J 2005;26:288-297. Impact factor (2005) : 6.25ARTICULO 3: Anguera I, Miro JM, Evangelista A, Cabell CH, San Roman JA, Vilacosta, Almirante B, Ripoll T, Fariñas MC, Anguita M, Navas E, Gonzalez-Juanatey C, Garcia-Bolao I, Muñoz P, de Alarcón A, Sarriá C, Rufi G, Miralles F, Pare C, Fowler Jr VG, Mestres CA, de Lazzari E, Guma JR, Corey GR. Prognostic factors of mortality of Periannular complications in infective endocarditis. A multicenter cohort study of 351 patients with aorto-cavitary fistulae and non-ruptured periannular abscess (1992-2003). Am J Cardiol 2005 (en revisión editorial).ARTICULO 4: Anguera I, Miro JM, Cabell CH, Abrutyn E, Fowler VG, Hoen B, Olaison L, Stafford JA, Eykyn S, Habib G, Pare C, Wang A, Corey R and the ICE-MD Investigators. Characteristics of aortic periannular abscesses studied with transesophageal echocardiography. A report from the ICE-ME database. Am J Cardiol 2005;96:976-981. Impact factor (2005) : 3.14Como resultado de este estudio, puede concluirse que la fistulización aorto-cavitaria es una complicación infrecuente de la endocarditis infecciosa, que se asocia a una extensa destrucción tisular a nivel del anillo aórtico y a la presencia de abscesos perianulares. La ecocardiografía transesofágica es la técnica de elección para la detección y el estudio de las fístulas aorto-cavitarias. La aparición de insuficiencia cardiaca grave es frecuente en estos pacientes, y a pesar del tratamiento quirúrgico agresivo la mortalidad es elevada. La infección protésica, la cirugía urgente y el desarrollo de insuficiencia cardiaca son los factores pronósticos independientes de mortalidad en los pacientes con fístulas aorto-cavitarias en la endocarditis. La formación de fístulas aorto-cavitarias se asocia a un mayor grado de destrucción anular aórtica y con mayor frecuencia de desarrollo de insuficiencia cardiaca en comparación con los abscesos no fistulizados. Ambas complicaciones requieren con mucha frecuencia tratamiento quirúrgico y tienen una elevada mortalidad, pero la fistulización no constituye un factor pronóstico independiente de mortalidad, tanto a corto como a largo plazo. La formación de abscesos perianulares es frecuente en la endocarditis de localización aórtica, se asocia frecuentemente con infección estafilocócica, y tiene una elevada morbi-mortalidad. La infección estafilocócica es un factor de riesgo independiente de mortalidad en los pacientes que desarrollan abscesos perianulares a nivel aórtico.[eng] Title: "The study of periannular complications in infective endocarditis. Analysis of clinical, microbiological, echocardiographic, therapeutic and prognostic aspects of patients with non-ruptured periannular abscesses and with aorto-cavitary fistulous tract formation in IE"Infective endocarditis (IE) is a devastating disease associated with high death rates without appropriate treatment. The prognosis of IE has changed dramatically during the last three decades due to the use of potent antibiotics and the generalization of surgical therapies of valve repair. Infective endocarditis is characterized by the infection of the endothelium of cardiac valves caused by virulent organisms, and the elevated morbidity and mortality is produced by the destruction of valvular tissue and adjacent structures. In the modern era, one-year mortality of native valve IE is in the range of 20% - 30%, and 10-year survival is in the range of 70%-80%. Spread of infection in IE from valvular structures to the surrounding perivalvular tissue results in periannular complications. Periannular complications, including periannular abscess formation and aorto-cavitary fistulous (ACF) tract formation have not been adequately studied, and may place the patient at increased risk of adverse outcomes including heart failure (HF) and death. Aorto-cavitary fistulous tract formation has only been described occasionally.The main objectives of the present investigation were to investigate the clinical characteristics and the prognosis of patients with non-ruptured periannular abscesses and with aorto-cavitary fistulous tract formation in IE and to determine the prognostic impact of fistulization in patients with periannular lesions in the setting of IE.Several manuscripts including a large number of patients with periannular lesions have been published describing the clinical characteristics and prognostic factors of mortality of patients with periannular lesions in IE.Aorto-cavitary fistula is an uncommon complication of aortic IE associated with extensive aortic root destruction and presence of periannular abscesses. Transesophageal echocardiography is the diagnostic tool of choice for the detection of aorto-cavitary fistulae in both native and prosthetic valves. Despite aggressive surgical treatment, rates of heart failure and mortality are high. Prosthetic IE, urgent surgery and the development of heart failure were associated with an increased risk of death in patients with endocarditis complicated by fistulous tract formation. ACF formation in the course of IE is associated with higher rates of aortic annulus destruction and heart failure compared to non-ruptured abscess. Surgery and mortality rates for both complications were very high; however, despite the higher complications, ACF in the current era of high rates of surgical therapy was not an independent risk factor for mortality.Periannular abscess formation occurs frequently in aortic valve IE, is associated with staphylococcal etiology, and has a high morbidity and mortality. In the current era of TEE imaging and high use of surgical treatment periannular abscess formation in aortic valve IE is not an independent risk factor for mortality. Finally, S. aureus infection constitutes an independent prognostic factor for mortality in patients who develop an abscess
Am J Prev Med
No full textBackgroundTobacco marketing contributes to increased tobacco use susceptibility and sustained use. There are limited data on youth exposure to tobacco coupons, a type of pro-tobacco promotion.PurposeTo explore channels through which youth report exposure to coupons and characteristics associated with this exposure. This may help inform efforts aimed at decreasing youth exposure to advertising and promotion.MethodsData from the 2012 National Youth Tobacco Survey were analyzed in 2013 to estimate the self-reported prevalence of U.S. middle and high school student exposure to coupons through various channels. Associations among exposure to coupons and demographics, tobacco use, living with a tobacco user, and receptivity to tobacco marketing were examined using multivariate logistic regression models.ResultsApproximately 13% of students reported exposure to tobacco coupons in the past 30 days through mail, digital communications, or tobacco packages. Prevalence was greatest among current tobacco users (34.0%) and those receptive to tobacco marketing (23.4%) compared to non-tobacco users (9.3%) and those not receptive to tobacco marketing (8.2%), respectively. Coupon exposure varied by sex, grade, and race/ethnicity. In adjusted models, current tobacco use (AOR=3.4, 95% CI=3.0, 3.9); living with a tobacco user (AOR=2.1, 95% CI=1.9, 2.4); and receptivity to tobacco marketing (AOR=2.3, 95% CI=2.0, 2.7) were independently associated with coupon exposure.ConclusionsFindings from this study indicate that despite restrictions on marketing to youth, youth are still being exposed to tobacco promotions such as coupons. Efforts to limit youth exposure may be valuable in reducing curiosity, susceptibility, and initiation.CC999999/Intramural CDC HHSUnited States
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