Vaginal anaerobes are associated with cervicitis: A case-control study.

Objectives: Cervicitis is associated with important reproductive sequelae. Primary causes include chlamydia and gonorrhoea, but a known sexually transmitted infection (STI) is not identified in >50% of cases (i.e.

Postmortem Genetic Testing Is an Increasingly Utilized Tool in Death Investigation.

Introduction: Postmortem genetic testing (PMGT) can provide valuable information about an individual's cause of death and potentially allow at-risk relatives to discern their risks for inherited cardiac disease. Postmortem genetic testing is most often successful with certain specimens.

Methods: Investigators collected data on postmortem referrals to GeneDx, LLC for PMGT.

Provision of Onsite Childcare in US Academic Health Centers: What Factors Make a Difference?

Introduction: Challenges to work-life balance, including childcare, have been cited as major barriers to career advancement for women in academic medicine.

Methods: We performed a cross-sectional study to investigate the availability of onsite childcare at academic health centers (AHCs) for US medical schools and examined institutional characteristics associated with its provision. Data from the Association of American Medical Colleges (AAMC) were used to identify US medical schools by region, type (private vs.

The clinical indications for testing women for .

Background: While the contribution of (MG) to symptoms in men is well described, less is known about its association with common genital symptoms in women. We aimed to determine the prevalence of MG and macrolide resistance, and its association with common genital symptoms in women attending a sexual health service, to inform indications for testing and clinical practice.

Methods: We undertook a cross-sectional study of symptomatic and asymptomatic women attending Melbourne Sexual Health Centre (MSHC), between April 2017 and April 2019.

Are Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum Associated With Specific Genital Symptoms and Clinical Signs in Nonpregnant Women?

Background: There is limited evidence supporting an association between Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum with symptoms or disease in nonpregnant women. However, testing and reporting of these organisms frequently occurs, in part due to their inclusion in multiplex-PCR assays for sexually transmitted infection (STI) detection. We investigated if M.

Incorporation of the Transverse Thoracic Plane Block Into a Multimodal Early Extubation Protocol for Cardiac Surgical Patients.

Background: The aim for early extubation remains an important goal in cardiac surgical patients. Therefore, employment of a multimodal approach to pain management that includes a transverse thoracic plane block was retrospectively examined at a single-center tertiary care hospital on the effects of time to extubation, opioid consumption, and length of stay in patients undergoing cardiac surgery via median sternotomy.

Methods: Blocks were performed on all cardiac surgical patients except for those undergoing left ventricular assist device placement, thoracic transplant, emergent surgery, or redo sternotomy.

A Native Hawaiian Behavioral Health Initiative at The Queen's Medical Center.

Although acute care facilities have not typically focused on resolving the psychosocial determinants of health, new models are emerging. This article provides details of the (KKN) Native Hawaiian Behavioral Health Initiative implemented in 2016 at The Queen's Medical Center in Honolulu, Hawai'i. The program is focused on reducing hospital readmissions for socially and economically vulnerable Native Hawaiian adults and improving their health care outcomes after hospitalization.

Extragenital infections among men who have sex with men.

Objectives: There are limited data on the prevalence of (Mgen) coinfection with rectal chlamydia ( (CT)) and rectal gonorrhoea ( (NG)) infections and few studies examining the prevalence of pharyngeal Mgen in men who have sex with men (MSM). Using transcription-mediated amplification assay, this study aimed to determine the proportion of rectal CT and rectal NG infections in MSM who are coinfected with rectal Mgen, and the proportion of MSM with Mgen detected in the pharynx in order to inform clinical practice.

Methods: This was a cross-sectional study conducted at Melbourne Sexual Health Centre in Australia.

Clinical Features and Therapeutic Response in Women Meeting Criteria for Presumptive Treatment for Pelvic Inflammatory Disease Associated With Mycoplasma genitalium.

Background: There are limited published data describing clinical features and therapeutic response in women meeting the criteria for presumptive treatment of pelvic inflammatory disease associated with Mycoplasma genitalium (MG-PID). The MG-PID has been reported to respond poorly to standard PID treatment regimens and while moxifloxacin is recommended in several treatment guidelines, published data to support its use are scant.

Methods: We conducted a retrospective study of women at Melbourne Sexual Health Centre between 2006 and 2017, who met the Centers for Disease Control and Prevention criteria for presumptive treatment of PID, and had MG detected as the sole pathogen.

Non-consensual condom removal, reported by patients at a sexual health clinic in Melbourne, Australia.

Background: Non-consensual removal of condoms, colloquially referred to as 'stealthing', is the removal of a condom during sex by a sexual partner when consent has been given for sex with a condom only.

Methods: We conducted a cross-sectional survey to determine how commonly women and men who have sex with men (MSM) attending Melbourne Sexual Health Centre had experienced stealthing, and analysed situational factors associated with the event. Responses were linked to demographic information extracted from patient files.

Right-to-Left Shunt During Transseptal Mitral Valve-in-Valve Replacement: A Case Report.

The following case report details an 88-year-old woman with severe mitral stenosis and moderate mitral regurgitation who presented with worsening dyspnea on exertion. The patient had undergone 4-vessel coronary artery bypass graft and mitral valve replacement 14 years before and was deemed high risk for redo sternotomy. A transseptal mitral valve-in-valve replacement was performed which resulted in intraoperative hypoxia and hypotension after atrial septal defect creation for valve deployment.

Global Sources of Fine Particulate Matter: Interpretation of PM Chemical Composition Observed by SPARTAN using a Global Chemical Transport Model.

Exposure to ambient fine particulate matter (PM) is a leading risk factor for the global burden of disease. However, uncertainty remains about PM sources. We use a global chemical transport model (GEOS-Chem) simulation for 2014, constrained by satellite-based estimates of PM to interpret globally dispersed PM mass and composition measurements from the ground-based surface particulate matter network (SPARTAN).

Secondary Conditions Among Males With Duchenne or Becker Muscular Dystrophy.

Duchenne and Becker muscular dystrophy are X-linked neuromuscular disorders characterized by progressive muscle degeneration. Despite the involvement of multiple systems, secondary conditions among affected males have not been comprehensively described. Two hundred nine caregivers of affected males (aged 3-31 years) identified by the Muscular Dystrophy Surveillance, Tracking, and Research Network completed a mailed survey that included questions about secondary conditions impacting multiple body functions.

Successfully Coaching Nursing Staff to Publish Outcomes.

There is a need for bedside nurses to disseminate the results of evidence-based practice quality initiatives to a wider audience through publications in peer-reviewed journals. Barriers to publication are common and include lack of time, skills, experience, confidence, and tangible support. This article describes the structured approach, timeline, writing activities, and coaching guidance used to support the publication of 12 quality improvement articles in 1 nursing journal.

Adapting SugarWatch to manage metabolic syndrome in a partial hospitalization program: a feasibility study.

A successful worksite diabetes prevention program, SugarWatch,was adapted for a seriously mentally ill patient population in a partial hospitalization program in Hawai'i. A feasibility study was implemented using an intervention with 3 components: SugarWatch curriculum, structured physical activity,and Create a Plate lunch. Twenty participants completed the three month intervention.

Part I: triggers for an evidence based practice project: managing peri-operative hyperglycemia in total hip and total knee replacement surgeries.

A descriptive study of risk factors for surgical site infection (SSI) in patients receiving total knee arthroplasty discovered an infection rate higher than the benchmark. Although no risk factors were significant predictors of SSI in this population, an important finding was that, despite a patient population with comorbid diabetes, a lack of standardized practice related to the identification and management of hyperglycemia was identified. These findings identified and validated an important practice issue and led to the continued commitment to improve glucose management.

Hawaii's statewide evidence-based practice program.

Hawaii's innovative statewide evidence-based practice program facilitates practice change across multiple health care systems. The innovation eliminated duplicative efforts and provided resources, was compatible with the values of health care organizations, and had experience with a pilot program. Interpersonal and mass media communication promoted and embedded the practice change.

A theoretical and practical evaluation of struvite control and recovery.

Struvite accumulation is a costly problem in many water resource recovery facilities (WRRFs) that use anaerobic digestion, causing significant labor and equipment costs and potentially impacting facility performance and permit compliance. A comprehensive study was undertaken to evaluate possible solutions to struvite control at two similar Miami-Dade County, Florida, WRRFs. Alternatives analyzed included periodic cleaning and repair of damaged piping and equipment; optimum ferric salt dosing, use of in situ scaling coupons; and engineered struvite precipitation.

Cytokine phenotype, genotype, and renal outcomes at cardiac surgery.

Background: Cardiac surgery modulates pro- and anti-inflammatory cytokine balance involving plasma tumour necrosis factor alpha (TNFα) and interleukin-10 (IL-10) together with urinary transforming growth factor beta-1 (TGFβ1), interleukin-1 receptor antagonist (IL1ra) and tumour necrosis factor soluble receptor-2 (TNFsr2). Effects on post-operative renal function are unclear. We investigated if following cardiac surgery there is a relationship between cytokine (a) phenotype and renal outcome; (b) genotype and phenotype and (c) genotype and renal outcome.

Partnership to build research capacity.

Today's nursing leaders are setting the stage for the next evolution--bringing together skilled clinicians and administrators with peers in education to create new approaches to leading the profession forward. Partnerships share goals, common purpose, mutual respect, willingness to negotiate and compromise, informed participation, information giving, and shared decision making. The shared practice academia effort between a public university and a private health care system situated in the island state of Hawai'i is described.

Nursing research fellowship: building nursing research infrastructure in a hospital.

The largest private hospital in Hawaii was recently awarded Magnet Recognition, partly due to its exemplary nursing research culture. The hospital fostered and sustained a strong research environment through the establishment of a nursing institute, nursing research council, and, most recently, a nursing research fellowship. The authors describe the fellowship that was designed to educate nurses on the research process and enable nurses to lead research projects.

Chloramphenicol biosynthesis: the structure of CmlS, a flavin-dependent halogenase showing a covalent flavin-aspartate bond.

Chloramphenicol is a halogenated natural product bearing an unusual dichloroacetyl moiety that is critical for its antibiotic activity. The operon for chloramphenicol biosynthesis in Streptomyces venezuelae encodes the chloramphenicol halogenase CmlS, which belongs to the large and diverse family of flavin-dependent halogenases (FDH's). CmlS was previously shown to be essential for the formation of the dichloroacetyl group.

Improving compliance with diabetes clinical practice guidelines in military medical treatment facilities.

Background: A multidisciplinary, multifaceted approach to disease management that incorporates the health system, the provider, and the patient is supported in the literature. There was a need to improve patient outcomes to meet or to exceed the Health Plan Employer Data and Information Set (HEDIS) benchmarks for the management of patients with diabetes.

Objectives: The purpose of this study was to implement a process improvement effort using practice guidelines on the basis of an evidence-based practice model for the management of type II diabetes mellitus at two primary care clinics at two military medical facilities in Hawaii.