Pseudo-outbreak of vancomycin-resistant-enterococcus (VRE) Colonization in a neonatal intensive care unit using spectra VRE surveillance medium.

From November 2011 through March 2012, we surveyed 272 babies in our neonatal intensive care unit for rectal colonization with vancomycin-resistant enterococci (VRE). Using Spectra VRE medium (Remel Diagnostics, Lenexa, KS), we identified one neonate colonized with vancomycin-resistant Enterococcus faecium. In addition, 55 (13%) of the surveillance cultures yielded false-positive results with vancomycin-susceptible Enterococcus faecalis.

Reflective journaling and development of cultural humility in students.

Cultural humility requires self-evaluation and the awareness that one's own culture is not the only or best one. Teaching health care providers to become culturally humble includes the development of critical thinking skills and the ability to reflect on practice. Journaling as a teaching strategy helps students develop these skills.

Impact of blood cultures drawn by phlebotomy on contamination rates and health care costs in a hospital emergency department.

We conducted a prospective comparison of blood culture contamination rates associated with dedicated phlebotomists and nonphlebotomy staff in the emergency department (ED) at Parkland Memorial Hospital in Dallas, TX. In addition, hospital charges and lengths of stay were determined for patients with negative, false-positive, and true-positive blood culture results. A total of 5,432 blood culture collections from two ED areas, the western wing of the ED (ED west) and the nonwestern wing of the ED (ED nonwest), were evaluated over a 13-month period.

Aerosolization of methicillin-resistant Staphylococcus aureus during an epidemic in a burn intensive care unit.

Despite prompt identification of cases, rigorous isolation techniques, negative environmental samples, and largely negative personnel cultures, an epidemic of methicillin-resistant Staphylococcus aureus (MRSA) continued in our Burn Intensive Care Unit (BICU). We sought to determine whether there was any aerosolization of that organism in the unit and if there were air quality characteristics that might have enabled its transmission to patients. We measured air exchange and flow rates into rooms and using a Burkhard air sampler measured MRSA generated inside and just outside the rooms before, during, and after dressing changes in burned patients and in controls.

Lessons learned: integrating a service learning community-based partnership into the curriculum.

Auburn University School of Nursing (AUSON) has been in a partnership with the Auburn Housing Authority (AHA), a low-income public housing provider, for several years by providing a weekly nursing care clinic. AUSON was convinced expansion of the clinics would be beneficial to all. This article describes the process and lessons learned in expanding the scope and depth of the partnership and how this service learning experience was integrated throughout the nursing curriculum.

Growth hormone determines sexual dimorphism of hepatic cytochrome P450 3A4 expression in transgenic mice.

The impact of age and sex on the expression of hepatic cytochrome P450 3A4 (CYP3A4) was recently determined in a transgenic mouse line carrying the human CYP3A4 gene. To further investigate the physiological regulation of human CYP3A genes, a novel transgenic mouse line was generated using a bacterial artificial chromosome clone containing both CYP3A4 and CYP3A7 genes. CYP3A7 expression was observed in transgenic mouse fetal livers, whereas CYP3A4 exhibited developmental expression characterized by sexual dimorphism in postpubertal livers.

Informed consent for research participation in frail older persons.

Informed consent has been the most scrutinized and controversial aspect of clinical research ethics. Institutional review boards (IRBs), government regulatory agencies, and the threat of litigation have all contributed to increasingly detailed consent documents that hope to ensure that subjects are not misled or coerced. Unfortunately, the growing regulatory burden on researchers has not succeeded in protecting subjects, but has rather made the consent process less effective and has discouraged research on vulnerable populations.

Regeneration of serotonin from 5-methoxytryptamine by polymorphic human CYP2D6.

Polymorphic cytochrome P450 2D6 (CYP2D6) is expressed in several types of central neurons but its function in human brain is currently unknown. Using recombinant enzymes and CYP2D6-transgenic mice, we established that 5-methoxytryptamine (5-MT), a metabolite and precursor of melatonin, is a specific and high-turnover endogenous substrate of CYP2D6. This potent serotonergic neuromodulator in numerous physiological systems binds tightly to recombinant CYP2D6 enzyme with an equilibrium dissociation constant (K(s)) of 23.

Community-based service learning in the engaged university.

The engaged university expands the concept of service learning to include a redesigned approach to teaching, research, and service functions that leads to a productive involvement with communities. This article describes an ongoing community partnership that models the best-practice aspects of the engaged university.