550 research outputs found
Mood disorders in familial epilepsy: A test of shared etiology
No full textObjective: Mood disorders are the most common comorbid conditions in epilepsy but the cause remains unclear. One possible explanation is a shared genetic susceptibility to epilepsy and mood disorders. We tested this hypothesis by evaluating lifetime prevalence of mood disorders in relatives with and without epilepsy in families containing multiple individuals with epilepsy, and comparing the findings with rates from a general population sample.
Methods: The Composite International Diagnostic Interview was administered to 192 individuals from 60 families, including 110 participants with epilepsy of unknown cause (50 focal epilepsy [FE], 42 generalized epilepsy [GE], 6 FE and GE, 12 unclassifiable) and 82 relatives without epilepsy (RWOE). Odds ratios (ORs) for lifetime prevalence of mood disorders in participants with versus without epilepsy were computed through logistic regression, using generalized estimation equations to account for familial clustering. Standardized prevalence ratios (SPRs) were used to compare prevalence in family members with general population rates.
Results: Compared with RWOE, ORs for mood disorders were significantly increased in participants with FE (OR = 2.4, 95% confidence interval [CI] = 1.1 - 5.2) but not in those with GE (OR = 1.0, 95% CI = 0.4 - 2.2). In addition, prevalence of mood disorders was increased in individuals with epilepsy who had ≥1 relative with FE. Compared with general population rates, mood disorders were significantly increased in individuals with FE but not in those with GE. Rates were also increased in RWOE, but not significantly so (SPR = 1.4, P = 0.14).
Significance: These findings are consistent with the hypothesis of shared genetic susceptibility to epilepsy and mood disorders, but suggest (1) the effect may be restricted to FE, and (2) the shared genetic effect on risk of mood disorders and epilepsy may be restricted to individuals with epilepsy, that is, to those in whom the genetic risk for epilepsy is “penetrant.”Peer reviewedThis is the accepted version of the following article: Insel BJ, Ottman R, Heiman GA. Mood disorders in familial epilepsy: A test of shared etiology. Epilepsia. 2018;00:1–9. https://doi.org/10.1111/epi.13985, which has been published in the Early View form at http://onlinelibrary.wiley.com/doi/10.1111/epi.13985/full. This article may be used for non-commercial purposes in accordance with the Wiley Self-Archiving Policy [https://authorservices.wiley.com/author-resources/Journal-Authors/licensing-open-access/open-access/self-archiving.html]
Industry Education: The Merger Continues
No full textIn the discussion - Industry Education: The Merger Continues - by Rob Heiman Assistant Professor Hospitality Food Service Management at Kent State University, the author originally declares, “Integrating the process of an on-going catering and banquet function with that of selected behavioral academic objectives leads to an effective, practical course of instruction in catering and banquet management. Through an illustrated model, this article highlights such a merger while addressing a variety of related problems and concerns to the discipline of hospitality food service management education.”
The article stresses the importance of blending the theoretical; curriculum based learning process with that of a hands-on approach, in essence combining an in-reality working program, with academics, to develop a well rounded hospitality student.
“How many programs are enjoying the luxury of excessive demand for students from industry [?],” the author asks in proxy for, and to highlight the immense need for qualified personnel in the hospitality industry.
As the author describes it, “An ideal education program concerns itself with the integration of theory and simulation with hands-on experience to teach the cognitive as well as the technical skills required to achieve the pre-determined hospitality education objectives.”
In food service one way to achieve this integrated learning curve is to have the students prepare foods and then consume them. Heiman suggests this will quickly illustrate to students the rights and wrongs of food preparation. Another way is to have students integrating the academic program with feeding the university population. Your author offers more illustrations on similar principles.
Heiman takes special care in characterizing the banquet and catering portions of the food service industry, and he offers empirical data to support the descriptions. It is in these areas, banquet and catering, that Heiman says special attention is needed to produce qualified students to those fields. This is the real focus of the discussion, and it is in this venue that the remainder of the article is devoted.
“Based on the perception that quality education is aided by implementing project assignments through the course of study in food service education, a model description can be implemented for a course in Catering and Banquet Management and Operations. This project model first considers the prioritized objectives of education and industry and then illustrates the successful merging of resources for mutual benefits,” Heiman sketches.
The model referred to above is also the one aforementioned in the thesis statement at the beginning of the article. This model is divided into six major components; Heiman lists and details them. “The model has been tested through two semesters involving 29 students,” says Heiman. “Reaction by all participants has been extremely positive. Recent graduates of this type of program have received a sound theoretical framework and demonstrated their creative interpretation of this theory in practical application,” Heiman says in summation
Furious rabies after an atypical exposure.
No full textCitation: Wertheim, H. F. L. et al. (2009) 'Furious rabies after an atypical exposure', PLoS Medicine, 6(3): e1000044. [Available at http://medicine.plosjournals.org]. © 2009 Wertheim et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Staphylococcus aureus infections; Lead by the nose
No full textAn overview and the latest insights regarding S. aureus nasal carriage, associated risks of developing infections and possible preventive measures, will be given in Chapter 2. Since mupirocin efficacy studies in preventing nosocomial infections have only been performed in surgical and dialysis patients, we decided to design and perform a mupirocin efficacy study in non-surgical patients. These patients are also responsible for a great burden in S. aureus hospital infections. This randomized, placebo-controlled trial is described in Chapter 3.
This trial lead to four new research questions:
1. What is the risk of nosocomial S. aureus bacteremia for S. aureus carriers versus noncarriers?
2. Is there a difference in risk of mortality for carriers versus non-carriers once bacteremic with S. aureus?
3. What is the efficacy of mupirocin on reducing S. aureus carriage at extra-nasal sites?
4. Can invasive S. aureus strains be identified by genotyping?
The first two research questions are addressed in Chapter 4. Chapter 5 describes a study in which the effect of mupirocin on nasal, pharyngeal and perineal carriage of S. aureus is investigated (question 3). Chapter 6 describes a nested-case control study where genotyping data of invasive S. aureus strains are compared to non-invasive strains (question 4). Development of prophylactic strategies are always based on the understanding of the pathogenesis of the specific disease. The mechanisms underlying S. aureus nasal carriage and how nasal carriage results in disease are still incompletely understood. We decided to study whether nose picking is a determinant of S. aureus nasal carriage. Nose picking behaviour seems to be an obvious determinant, but was never studied before. In collaboration with the department of otolaryngology, we performed a study on nose picking behaviour and S. aureus nasal carriage, which we describe in Chapter 7.
When we study S. aureus, we can extrapolate these findings to methicillin resistant S. aureus (MRSA). This is essentially the same micro-organism, the only difference is that the latter is more difficult to treat with antibiotics. The Netherlands are well known for their low prevalence rate of MRSA in the hospitals. In the U.S.A. more than 40% of the S. aureus strains cultured from hospitalized patients are methicillin-resistant, as compared to less than 1% in the Netherlands. In the Netherlands, MRSA could usually be related to a hospital admission in a foreign country, indicating that most MRSA strains were imported into the country. But in the last few years there were reports that many MRSA strains could not be related to sources abroad. Therefore, we wanted to know the prevalence of MRSA carriage in patients admitted to the hospital with no relation to a foreign admission. We performed such a prevalence study with an improved detection technique, as described in Chapter 8 and Chapter 9.
All studies included in this thesis are based on the assumption that the anterior nares are the main reservoir for S. aureus in humans. All studies, their results and conclusions are, therefore, "lead by the nose"
Editorial: Antimicrobial Stewardship in Low- and Middle-Income Countries
No full textGyssens, IC (corresponding author), Dept Internal Med, Nijmegen, Netherlands.
Radboud Ctr Infect Dis, Nijmegen, Netherlands.
Hasselt Univ, Fac Med & Hlth Sci, Hasselt, Belgium.
[email protected]
What is the evidence base of used aggregated antibiotic resistance percentages to change empiric antibiotic treatment? A scoping review
No full textBackground: Antibiotic resistance requires continuous monitoring by experts to decide whether empiric antibiotic therapies (EAT) should be replaced by alternative antibiotics. The exact moment and criteria for this change is unclear and generally based on consensus between experts. Objectives: This scoping review aims to identify from the literature the resistance thresholds used for a change in EAT and the criteria that they are based upon. Methods: Scoping review for which a comprehensive structured literature search was conducted. Rayyan, software for systematic reviews, was used for the screening of abstracts and titles. Data sources: Pubmed and hand-searching of reference lists and grey literature. Eligibility: Papers concerning any type of bacterial infectious disease and mentioning or defining antibiotic resistance thresholds for decision making purposes for EAT were included. The inclusion and analysis of articles was done by two researchers, any conflicts were resolved through discussion or by consulting a third reviewer. Results: We identified 3146 unique papers. Following title-abstract screening, 125 papers were comprehensively read, 16 papers included. The included papers gave thresholds for urinary tract infections, respiratory tract infections, meningitis, skin and soft tissue infections, gonorrhoea and bone and joint infections. Six criteria were found that were commonly used to base the thresholds on. These were: disease severity, efficacy of treatment, adverse drug events, risk of C. difficile infection, costs and increased resistance. The number of criteria used to define each threshold varied from 1 up to 6 criteria between papers. Conclusions: The thresholds used for EATs are few, commonly based on expert opinion estimates and therefore can have broad ranges. Used criteria underlying reported thresholds are heterogenous and require standardization. Considering the rising trend in resistance there is a clear need for rigid tools to determine thresholds in order to support guideline development with the best and timely evidence
The diagnostic accuracy of the GeneXpert ESBL-ampC prototype assay for rapid PCR-based detection of Extended-Spectrum Beta-Lactamase genes directly from urine
No full textContains data beloning to our research. Routine urine samples were collected between February and July 2021 in two Dutch clinical medical microbiology laboratories according to a predefined list containing certain culture characteristics. All urine samples were screened for the presence of ESBL genes (blaCTX-M2, blaCTX-M14, blaCTX-M15) with random-access qPCR using the Cepheid GeneXpert® ESBL-ampC prototype assay. The qPCR and microbiological culture results were compared. After calculation of the sensitivity and specificity, discrepancies were investigated by whole-genome sequencin
Health and economic burden of human Streptococcus suis infection in Viet Nam and the contribution of undercooked pig product consumption practices: implications for prevention and control
No full textStreptococcus suis is a zoonotic bacterium capable of causing severe systemic infection in humans, including central nervous system infection (meningitis) which can lead to long-term sequelae including deafness and vestibular dysfunction. Despite a growing body of literature on the epidemiology, microbiology and molecular aspects of the disease, there has been little progress on the prevention and control of this disease in Asia. This thesis aimed to examine the long-term consequences of the disease in patients, quantify the health and economic impact, and investigate the local practice of consuming raw pig blood, one of the main risk factors for S. suis infection in Viet Nam.
A systematic review and meta-analysis conducted in this thesis showed that hearing loss and vestibular dysfunction were the most common health sequelae in patients surviving S. suis infection. In a patient follow-up study at a referral hospital in Ha Noi, I found that severe hearing loss and vestibular dysfunction both occurred, and persisted over a long period in 40% of patients. Morbidity caused by these two conditions accounted for about half of the disability adjusted life years lost due to the infection. The analysis of disease impact showed that S. suis infection caused a considerable impact on the patients and their family. The direct cost of hospitalization was estimated to be 35 million VND per episode (~ 1600 USD), which was greater than the average annual per-capita income in Viet Nam. The total annual cost of the disease was 54-70 billion VND (2.5-3.3 million USD), more than 80% of which was attributed to productivity loss due to premature deaths and long-term disability.
A mixed-methods community-based study, consisting of both quantitative survey and focus group discussion, showed that raw pig blood consumption was common in Viet Nam (reported in 35% of rural and 8.6% of urban participants). Many misperceptions about food safety and risk of disease transmission existed in the community; most importantly was the belief that apparently healthy or free-ranging pigs did not pose health risks to consumers.
Data from this thesis can be used by public health and policy makers to prioritise and justify resource allocation and to identify options for disease prevention and control.</p
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