Publications by authors named "Lawrence P Martinelli"

Clostridium difficile infection is increasing in incidence, severity, and mortality. Treatment options are limited and appear to be losing efficacy. Recurrent disease is especially challenging; extended treatment with oral vancomycin is becoming increasingly common but is expensive.

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The Centers for Medicare and Medicaid Services (CMS) has proposed to eliminate payments for the Inpatient and Outpatient Consultation codes beginning on 1 January 2010. The intent appears to be to promote an increase in the supply of primary physicians by increasing payments for other Evaluation and Management services. This will worsen an already inequitable disparity in the payments for complex cognitive services in comparison to procedure-based specialties, to the detriment of infectious diseases physicians.

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Recent developments in health care have focused efforts on both the national and local levels to reduce unnecessary health care costs and the number of hospital stays while increasing the quality of care, particularly in the context of hospital-associated infections. Infectious diseases specialists who contract to oversee infection-control and antibiotic-stewardship programs are uniquely positioned to play a pivotal role in helping hospitals to prosper in this new environment. This article will detail the available data supporting the value of infectious diseases specialists in their roles of directing antimicrobial-management and infection-control programs, maintaining health care workers' well-being, and minimizing exposure.

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Background: Despite the increasing use of outpatient parenteral antimicrobial therapy (OPAT), little is known about the role of infectious diseases consultants in the process or their perceptions of OPAT.

Methods: In May 2004, the Infectious Diseases Society of America Emerging Infections Network (EIN) surveyed its members to characterize their involvement and experiences with OPAT.

Results: Of the 454 respondents (54%) who completed the questionnaire, 426 (94%) indicated that patients in their primary inpatient facility were "frequently" discharged while receiving OPAT, estimating that, on average, 19 patients are discharged from their hospitals while receiving OPAT each month.

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Purpose: Arboviral diseases, such as West Nile virus (WNV) epizootics, tend to be geographically unique because of the biomes that support the vector(s) and reservoir host(s). Understanding such details aids in preventive efforts. We studied the 2003 epidemic of human West Nile neuroinvasive disease (WNND) in Texas because it initially appeared that incidence was not uniform across regions of the state.

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Infectious diseases (ID) specialists have played a major role in patient care, infection control, and antibiotic management for many years. With the rapidly changing nature of health care, it has become necessary for ID specialists to articulate their value to multiple audiences. This article summarizes the versatile attributes possessed by ID specialists and delineates their value to patients, hospitals, and other integral groups in the health care continuum.

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