The Clinical Safety and Effectiveness Course: Ten Years of Experiential Training in Quality Improvement for Practicing Professionals.

Training in quality improvement (QI) and patient safety for clinicians are needed for continued progress in health care quality. A project-based QI curriculum training faculty, residents, and staff in an academic health center for >10 years are reviewed and evaluated. Didactic curriculum includes QI knowledge domains, and QI methods are applied to a project during the course.

Advanced primary care in San Antonio: linking practice and community strategies to improve health.

Improving health among people living in poverty often transcends narrowly focused illness care. Meaningful success is unlikely without confronting the complex social origins of illness. We describe an emerging community of solution to improve health outcomes for a population of 6000 San Antonio, Texas, residents enrolled in a county health care program.

Acute hepatitis associated with autochthonous hepatitis E virus infection--San Antonio, Texas, 2009.

Locally acquired hepatitis E infection is increasingly being observed in industrialized countries. We report 2 cases of autochthonous acute hepatitis E in the United States. Hepatitis E virus genotype 3a related to US-2 and swine hepatitis E virus strains was isolated from one of the patients, indicating potential food-borne or zoonotic transmission.

Meningococcal disease in infants: a potentially difficult and serious diagnosis.

Most children with meningococcal disease have apparent clinical signs of illness, but some do not initially present with clinical toxicity. These children with unsuspected meningococcal disease may potentially be discharged after outpatient evaluation and may deteriorate rapidly. We present the case of a 15-week-old infant boy who was brought to a private physician with symptoms of a common cold and was sent home.

Household transmission of pandemic (H1N1) 2009, San Antonio, Texas, USA, April-May 2009.

To assess household transmission of pandemic (H1N1) 2009 in San Antonio, Texas, USA, during April 15-May 8, 2009, we investigated 77 households. The index case-patient was defined as the household member with the earliest onset date of symptoms of acute respiratory infection (ARI), influenza-like illness (ILI), or laboratory-confirmed pandemic (H1N1) 2009. Median interval between illness onset in index and secondary case-patients was 4 days (range 1-9 days); the index case-patient was likely to be < or =18 years of age (p = 0.

Symptomatic respiratory syncytial virus infection in previously healthy young adults living in a crowded military environment.

Background: Respiratory syncytial virus (RSV) infection is a potentially important cause of acute respiratory illness in many populations, including military recruits receiving basic training. Understanding the full impact of RSV infection is challenging because of difficulties in diagnosis and the limitations of past epidemiologic studies. In this study, we set out to determine the prevalence and clinical characteristics of RSV infection and infection caused by other common viral agents in a population of previously healthy young adults, namely, military recruits receiving basic training.

An outbreak of pneumococcal pneumonia among military personnel at high risk: control by low-dose azithromycin postexposure chemoprophylaxis.

In the winter of 1998-1999 an outbreak of pneumococcal pneumonia occurred among Ranger students undergoing high-intensity training. Thirty pneumonia cases (attack rate = 12.6%) were identified among a group of 239 students.