Opinions, Views, and Expectations Concerning the Radiology Report: A Rural Medicine Report.

This study seeks to examine a potential agreement and/or discordance of specific aspects of the radiology report between referring clinicians and radiologists within a medical group in a predominately rural setting. This study also aims to compare results with similar studies conducted in other geographic regions. This was done using a previously validated survey tool that examines five different aspects of the radiology report: importance, clinical correlation, clinicians' satisfaction, content, structure, and style.

Recurrent, Idiopathic Spontaneous Hemoperitoneum Requiring Multiple Laparoscopic Evacuations: A Rare Case of Bleeding Adnexal Arteriovenous Malformation.

Arteriovenous malformations (AVMs) are abnormal vascular connections that can form in many anatomic locations. The adnexa are particularly rare sites of AVM formation and the symptomatology is heterogeneous. Herein we present a case of life-threatening adnexal AVM.

Post-prostate biopsy infection with Escherichia coli ST131 leading to epididymo-orchitis and meningitis caused by Gram-negative bacilli.

A 57-year-old man who had recently undergone a transrectal prostate biopsy for a rising prostate-specific antigen level developed postbiopsy necrotizing epididymo-orchitis (requiring orchiectomy) and then Gram-negative meningitis, despite fluoroquinolone administration for periprocedural prophylaxis and subsequent therapy. The causative organism proved to be a fluoroquinolone-resistant Escherichia coli strain from sequence type ST131.

Implementation of a pharmacist-led antimicrobial management team in a community teaching hospital: use of pharmacy residents and pharmacy students in a prospective audit and feedback approach.

Antimicrobial stewardship is an important process proven to combat antimicrobial resistance, improve patient outcomes, and reduce costs. The Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) have provided guidelines for the provision of antimicrobial stewardship. According to these recommendations, antimicrobial stewardship teams should be multidisciplinary in nature, with core members consisting of an infectious disease physician and an infectious disease-trained clinical pharmacist.

Two cases of daptomycin-induced eosinophilic pneumonia and chronic pneumonitis.

We present 2 elderly patients who developed lung infiltrates associated with eosinophilia during intravenous daptomycin treatment. Both patients improved quickly after daptomycin was stopped and steroid treatment was initiated. However, complete recovery did not occur, and both patients became chronically steroid dependent.

Extreme pyrexia and rapid death due to Staphylococcus aureus infection: analysis of 2 cases.

We describe unusual Staphylococcus aureus infections in 2 patients. The infections were characterized by extreme pyrexia and rapid death. Both causative organisms produced a deletion mutant form of toxic shock syndrome toxin-1 and variant enterotoxin C, which may have caused pyrexia and death.

A brief retrospective review of medical records comparing outcomes for inpatients treated via telehealth versus in-person protocols: is telehealth equally effective as in-person visits for treating neutropenic fever, bacterial pneumonia, and infected bacterial wounds?

The incidence of infectious diseases in the United States has been increasing since 1980. Re-emergent conditions, multidrug-resistant bacteria, newly identified infections, and bioterrorism have prompted public health surveillance and control initiatives, including the use of telehealth technology. Infectious diseases, such as West Nile Virus, pose a particular threat to rural areas, where access to infectious disease specialists (IDS) is limited.

Epidural abscess, discitis and vertebral osteomyelitis caused by Neiserria subflava.

Neisseria subflava is generally regarded as commensal flora of the oropharyngeal tract and usually non-pathogenic. There are, however, reports of invasive disease such as bacteremia, endocarditis, sepsis, meningitis, septic arthritis and discitis caused by this organism. This paper presents the first reported case of an epidural abscess caused by Neiserria subflava.

Design of a patient-centered, multi-institutional healthcare information network using peer-to-peer communication in a highly distributed architecture.

Objective: to design a community healthcare information network for all 450,000 citizen in the State of Geneva, Switzerland, connecting public and private healthcare professionals. Requirements include the decentralized storage of information at the source of its production, the creation of a virtual patient record at the time of the consultation, the control by the patient of the access rights to the information, and the interoperability with other similar networks at the national and european level.

Methods: a participative approach and real-world pilot projects are used to design, test and validate key components of the network, including its technical architecture and the strategy for the management of access rights by the patients.

Aggregation and binding substances enhance pathogenicity in rabbit models of Enterococcus faecalis endocarditis.

We investigated the importance of enterococcal aggregation substance (AS) and enterococcal binding substance (EBS) in rabbit models of Enterococcus faecalis cardiac infections. First, American Dutch belted rabbits were injected intraventricularly with 10(8) CFU and observed for 2 days. No clinical signs of illness developed in animals given AS- EBS- organisms, and all survived.

Acute group G streptococcal myositis associated with streptococcal toxic shock syndrome: case report and review.

The group G streptococcus (GGS) is a rare cause of deep soft-tissue infection. We report that we believe is the first case of acute diffuse GGS myositis in association with toxic shock. Although the causative organism did not contain the genes for group A streptococcal pyrogenic exotoxins (SPEs) or make SPEs, the organism produced at least one new toxin that shared the biologic properties of the SPEs.

Cord serum IgE and early detection of the atopic phenotype: suitable for routine screening?

Cord serum IgE has been shown to be a valuable marker for the prediction of atopy. Our study was designed to verify these findings for possible systematic screening recommendation. Our study consisted of 338 children who were followed from birth to 18 months.

Increased monokines in cytomegalovirus infected myelomonocytic cell cultures.

In an investigation of the role of monokines in CMV associated immunosuppression we document modulation of both TNF and IL-1 beta in CMV infected THP-1 cells. CMV infected cultures released almost two-fold more IL-1 beta protein and contained significantly higher IL-1 beta mRNA levels than uninfected cultures for 72-96 h after induction. In both CMV infected and uninfected cultures, significant amounts of IL-1 beta protein were not detected until 24 h post induction, while maximum amounts of TNF were detected in culture supernatants by 3 h post induction, suggesting that TNF may play a role in IL-1 beta induction.

[Blood pressure values during an exercise test].

High blood pressure readings are relatively frequent during dynamic exercise testing. However, because of the paucity of date concerning normal blood pressure values during exertion and the prognostic significance of exertion hypertension, the attitude to be adopted towards such patients is ill-defined. The present study proposes mean values for BP at a given workload, per age group (less than 20, 20-39, 40-59, greater than 60) and per sex.

Failure to predict six-month survival of patients with COPD requiring mechanical ventilation by analysis of simple indices. A prospective study.

We analyzed the outcome of 39 consecutive acute exacerbations of chronic obstructive pulmonary disease (COPD) in 35 patients requiring mechanical ventilation, in order to identify the features related to survival. Patients were divided into those surviving less (group A; n = 14) and more (group B; n = 24) than six months. Pulmonary function tests, arterial blood gas levels either on admission or while in a steady state, and nutritional parameters were similar in both groups.

Renal biopsy in SLE irrespective of clinical findings: long-term follow-up.

We analyzed data from 56 patients with Systemic Lupus Erythematosus (SLE) in whom renal biopsies were done systematically. The data taken into account for the study were: the histologic glomerular lesions at diagnosis, serum creatinine value, degree of proteinuria and qualitative urine sediment analysis at the time of biopsy, patient age at diagnosis and the evolution of renal function until the time the study was made. Therapy was prescribed according to the glomerular histologic lesion.

[Maternal serum gamma-glutamyltransferase and prenatal diagnosis of the fetal alcohol syndrome].

In order to investigate prospectively the relationship between maternal serum levels of a biologic marker of alcohol and the outcome of pregnancy, we measured serum gamma-glutamyltransferase in 541 women between 14 and 20 weeks of pregnancy. An abnormally elevated value was observed in 6.8% of the cases but only 16.

[Multidisciplinary study of the prolonged treatment of involution osteoporosis using sodium fluoride with calcium, phosphate and vitamin D].

A multidisciplinary study on the prolonged treatment of involution osteoporosis with fluoride was performed on a homogeneous population of 31 women aged 51 to 75 years (mean 64 years). The selection criteria were the following: significant backache, vertebral compression fractures on X-rays, bone biopsy evidence of osteoporosis, and absence of other risk factors after a complete workup. The patients were treated for a period of 3 to 6 years (mean 4 years) with daily doses of 30 mg (10 mg 3 times) fluorides ion associated during the last 3 years with 500 mg calcium twice daily, 750 mg phosphate and 1000 units vitamin D daily.

Factors affecting left ventricular function after correction of tetralogy of Fallot.

To investigate the possible causes of left ventricular dysfunction after total correction of tetralogy of Fallot, 84 patients, aged 1 1/2 to 16 years, were studied by left ventricular cineangiography both before and a mean of 4.6 months after operation. Left ventricular ejection fraction and mean velocity of circumferential fibre shortening were calculated; using multivariate analysis the results were correlated with age at operation, the degree of hypoxia and polycythaemia before operation, occurrence of hypoxic spells, and the duration of operative procedures (cardiopulmonary bypass and aortic cross clamping).