Reducing Inappropriate Antibiotics for Urinary Tract Infections in Long-Term Care: A Replication Study.

Background: Nursing home providers face challenges in urinary tract infection assessment and treatment, often prescribing unnecessary antibiotics for asymptomatic bacteriuria, a practice that can result in adverse drug reactions, drug resistance, and an increase in antibiotic-associated diarrhea.

Purpose: The purpose of this project was to replicate the Cooper Urinary Tract Infection Program in another facility and measure its effectiveness.

Methods: Using a pre-post design, this project was implemented at a 120-bed, long-term care and rehabilitation facility located in the Midwest United States.

Successful interventions for smoking cessation in pregnancy.

The purpose of this article is to evaluate research regarding beneficial approaches to smoking cessation interventions during pregnancy. Research about nicotine replacement, nurse-managed counseling sessions, hypnosis, and behavioral modifications are presented. One of the most useful types of program for smoking cessation in pregnancy (as measured by cotinine-validated abstinence) described in the literature thus far has been the nurse-managed smoking cessation program, which includes a 15-minute individualized counseling session combined with a telephone contact 7-10 days after the prenatal visit.

Metabolic reduction of chromium as a threshold mechanism limiting its in vivo activity.

Various mechanisms tend to reduce hexavalent chromium (Cr(VI] in the organism, both outside and inside target cells. A reducing activity has been demonstrated in the blood (mainly in erythrocytes), in secretions of the alimentary tract (saliva, gastric juice) and in the lumen of terminal airways (epithelial-lining fluid and alveolar macrophages). Preparations of several types of cells from various animal species--including human liver, lung parenchyma and bronchial tree cells--are capable of metabolically reducing Cr(VI) to a variable extent.

Metabolic reduction of chromium by alveolar macrophages and its relationships to cigarette smoke.

Pulmonary alveolar macrophages (PAM), obtained by bronchoalveolar lavage from 47 individuals, reduced hexavalent chromium [Cr(VI)] and decreased its mutagenicity. Their specific activity--mostly mediated by cytosolic, enzyme-catalyzed mechanisms--was significantly higher than in corresponding preparations of mixed-cell populations from human peripheral lung parenchyma or bronchial tree, or from rat lung or liver. At equivalent number of PAM, Cr(VI) reduction, total protein, and some oxidoreductase activities were significantly increased in smokers.

Specificity and inducibility of the metabolic reduction of chromium(VI) mutagenicity by subcellular fractions of rat tissues.

The mutagenicity of sodium dichromate in the Ames test was decreased as a consequence of chromium(VI) reduction by tissue postmitochondrial (S-9 or S-12) fractions from untreated rats with the following rank of efficiency: liver; kidney; and lung. The effects of lung preparations were significantly enhanced following the intratracheal administration of high doses (0.25 mg/kg) of dichromate itself, 5 times per week for 4 weeks (i.

Interaction between polycyclic aromatic hydrocarbons, crude oil and oil dispersants in the Salmonella mutagenesis assay.

Mutagenicity assays were carried out in the Salmonella/microsome test, using five S. typhimurium his(-) strains (TA1535, TA1537, TA1538, TA98 and TA100), both in the presence and absence of post-mitochondrial preparations from Aroclor-induced rat livers and suitable co-factors. Seven oil dispersants showed a wide range of toxicity towards the bacterial strains, without eliciting any mutagenic response at sub-lethal concentrations.

Oxidation of inactive trivalent chromium to the mutagenic hexavalent form.

Soluble trivalent chromium compounds (chromium potassium sulfate, chromium nitrate, chromium chloride, neochromium and chromium alum) were inactive for Salmonella typhimurium TA100, even at milligram amounts per plate. No effect could be detected either in the absence or in the presence of rat-liver, lung or muscle microsomal fractions, of rat-muscle mitochondria (with or without ATP), of oxidized glutathione (GSSG), or of human serum, plasma or erythrocyte lysates. Conversely, addition of a strongly oxidizing agent (potassium permanganate) resulted in toxic effects in plates incorporating more than 40--80 microgram of compounds and elicited a dose-effect mutagenic response at 10--40 microgram per plate.

Toxicity and mutagenicity of hexavalent chromium on Salmonella typhimurium.

Four hexavalent and two trivalent chromium compounds were tested for toxicity and mutagenicity by means of the Salmonella typhimurium/mammalian-microsome test. All hexavalent compounds yielded a complete inhibition of bacterial growth at doses of 400 to 800 mug/plate, a significant increase of his(+) revertant colonies at doses ranging from 10 to 200 mug, and no effect at doses of less than 10 mug. The distinctive sensitivity of the four Salmonella strains tested (TA1535, TA1537, TA98, and TA100) suggested that hexavalent chromium directly interacts with bacterial deoxyribonucleic acid by causing both frameshift mutations and basepair substitutions.

Hepatitis B in subjects treated with a drug containing immunoglobulins.

In late 1974 and early 1975, several cases of viral hepatitis were reported in Italy among subjects who had received subcutaneous injections of a drug containing human immunoglobulins that was prescribed for the treatment of allergies. Epidemiologic and laboratory investigations provided evidence that the original immunoglobulins, the series of the drug containing these immunoglobulins, and sera from a number of patients were all positive for hepatitis B surface antigen (HBs Ag) of the adw subtype, which is relatively rare in Italy. Some sera from patients and healthy subjects treated with the HBs Ag-positive drug were also found to be positive for antibody to HBs Ag of the adw subtype.

Oral influenza vaccination with live attenuated viruses. 2. Protective efficacy during a type A(H3N2) epidemic.

151 subjects, orally immunized with live attenuated influenza virus of the Institute for Viral Preparations of Moscow (bivalent A(H3N2) England 72 and B vaccine) and 66 non vaccinated cohabitants were studied during an epidemic caused by strains similar to A/Port Chalmers/73. 5 cases of disease were virologically or serologically ascertained among the vaccinated (morbidity 3.3%) and 8 among the non-immunized cohabitants (12.

Oral influenza vaccination with live attenuated viruses. 1. Acceptability, immunogenicity and transmissibility.

151 subjects were vaccinated by oral route with live attenuated influenza virus vaccine, bivalent A and B, prepared in the U.S.S.

Quantitative detection and typing of HBs Ag and anti-HBs by radioimmunoassay techniques.

Small polystyrene tubes coated with purified anti-HBs were used as solid-phase substrate for the detection of HBsAg and anti-HBs by RIA procedures. This substrate yields highly sensitive, reproducible and homogeneous results. The sensitivity and the kinetics of various solid-phase RIA procedures for anti-HBs detection were explored.