Retrospective Analysis of Candida-related Conditions in Infancy and Early Childhood Caries.

Purpose: The purpose of this study was to assess whether there is an association between oral thrush or other Candida-related conditions in infancy and early childhood caries (ECC) diagnosed by pediatricians.

Methods: We conducted a retrospective cohort study using electronic health records from six national children's hospitals that participate in the PEDSnet research network. There were 1,012,668 children with a visit at ages one to 12 months and another visit at ages 13 to 71 months.

Facilitating emergency hospital evacuation through uniform discharge criteria.

Background: Though hospitals' operational continuity is crucial, full institutional evacuation may at times be unavoidable. The study's objective was to establish criteria for discharge of patients during complete emergency evacuation and compare scope of patients suitable for discharge pre/post implementation of criteria.

Basic Procedures: Standards for patient discharge during an evacuation were developed based on literature and disaster managers.

[LESSONS FROM PREPAREDNESS OF HOSPITALS TO SNOWSTORMS].

Snowstorms are not a usual scene in Israel, which normally enjoys relatively warm weather, even in the winter. In the last two years we faced three severe snowstorms that had a major impact on the routine daily life in Israel. Roads were blocked, people experienced long electricity power failures, and secondary to slippery conditions, there was more than a threefold increase of orthopedic injuries.

Predictors of Prolonged Hospital Length of Stay Following Stage II Palliation of Hypoplastic Left Heart Syndrome (and Variants): Analysis of the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) Database.

The objective of this study is to identify predictors of prolonged hospital length of stay (LOS) for single ventricle patients following stage 2 palliation (S2P), excluding patients who underwent a hybrid procedure. We explore the impact of demographic features, stage 1 palliation (S1P), interstage I (IS1) management, S2P, and post-surgical care on hospital LOS following S2P. We conducted a retrospective analysis of the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) database.

Adults with congenital heart disease and heart transplantation: optimizing outcomes.

The growing population of adults with congenital heart disease (ACHD) present a distinct set of challenges in the evaluation, listing, and safe performance of heart transplantation. We review existing literature to (1) describe the complex anatomic and physiologic features that characterize this group of patients, (2) discuss factors contributing to high waiting list times and waiting list morbidity and mortality experienced by this population, and finally, (3) identify risk factors for the elevated post-transplant morbidity and mortality reported in ACHD patients. We conclude with a discussion of critical areas in need of further investigation as well as ways to amend the current listing criteria to better accommodate ACHD patients in need of heart transplantation.

A Medicaid and commercial insured claims-based study to estimate improved antipsychotic medication adherence among patients with schizophrenia.

Compliance with antipsychotic medication is clinically important but challenging for schizophrenia patients. Clinical trials and epidemiological studies strongly suggest that improved compliance results in reduced hospitalizations and other adverse outcomes. Examination of Medicaid and commercial claim data suggests that a significant portion of schizophrenia patients have a regular pattern of visits with one outpatient professional, yet are noncompliant with their medication.

An actuarial approach to comparing early stage and late stage lung cancer mortality and survival.

Comparing the mortality characteristics of different cohorts is an essential process in the life insurance industry. Pseudodisease, lead-time bias, and length bias, which are critical to determining the value of cancer screening, have close analogues in life insurance company management, including the temporal impact of underwriting. Ratios of all-cause mortality rates for cancer cohorts relative to standard population mortality rates can provide insights into early stage and late stage mortality differences, differences by age, sex, race, and histology, and allow modeling of biases associated with early stage detection or screening protocols.

Estimates of commercial population at high risk for cardiovascular events: impact of aggressive cholesterol reduction.

Objectives: To model the financial and health outcomes impact of intensive statin therapy compared with usual care in a high-risk working-age population (actively employed, commercially insured health plan members and their adult dependents). The target population consists of working-age people who are considered high-risk for cardiovascular disease events because of a history of coronary heart disease.

Study Design: Three-year event forecast for a sample population generated from the National Health and Nutrition Examination Survey data.

Civilian hospital response to a mass casualty event: the role of the intensive care unit.

Background: We studied the response of the Shaare Zedek Medical Center (SZMC) in Jerusalem, Israel, to terrorist multiple- or mass-casualty events (TMCEs) that occurred between 1983 and 2004, to document the role of the intensive care unit (ICU) in this response.

Methods: The SZMC Disaster Plan was reviewed in detail. Hospital and ICU records were retrospectively reviewed for all patients presenting to SZMC between 1983 and 2004 after a TMCE.

Structured Assessment of Correctional Adaptation (SACA): a measure of the impact of incarceration on the mentally ill in a therapeutic setting.

Clinicians have observed that psychiatric patients with correctional histories evidence attitudes and behaviors that seem adaptive in penal environments but are maladaptive in mental health settings. This study sought to assess the reliability and concurrent validity of a rating scale designed to measure correctional adaptation using a sample of 64 patients from a state psychiatric hospital. Scale ratings were obtained through structured interviews, whereas predictor variables were gleaned from chart review and self-report.

Applications of neuroreceptor imaging to psychiatry research.

Over the past two decades, there have been significant advances in the ability to study the neurochemistry of the living brain using neuroreceptor radiotracers with Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT) imaging modalities. The greater availability of radiotracers for neurotransmitter synthesis/metabolism, enzymes, transporters and receptors, as well as neuromodulators and second messengers has enabled the evaluation of hypotheses regarding neurotransmitter function and regulation that are generated from basic neuroscience studies in animals, and the investigation of the neurochemical substrates of psychiatric disorders and the mechanism of action of psychotropic medications. This review will focus on the status of radiotracer development, on the clinical and methodological considerations regarding neurochemical brain imaging study design and data interpretation.

Serotonin modulation of cerebral glucose metabolism in normal aging.

Age-related alterations in serotonin function may increase the vulnerability to psychiatric and neurodegenerative disorders in late life. The neuroendocrine and cerebral metabolic response to the acute administration of the selective serotonin reuptake inhibitor, citalopram (40mg, IV), was measured in 17 normal control subjects using positron emission tomography (PET) to evaluate changes in serotonin function with normal aging. The citalopram-induced change in cerebral metabolism was positively correlated with age in the right precuneus, right paracentral lobule, and left middle temporal gyrus and negatively correlated with age in the left anterior cingulate gyrus, right inferior and middle frontal gyri, right insula, and right inferior parietal lobule.

Acute and chronic effects of citalopram on cerebral glucose metabolism in geriatric depression.

Objective: In vivo studies of serotonin function have been limited by the lack of safe and selective pharmacologic agents and availability of suitable radiotracers. In the present study, the authors evaluated the cerebral metabolic effects of acute and continued administration of the selective serotonin reuptake inhibitor citalopram in patients with geriatric depression as a potential marker of serotonin dysfunction.

Methods: Six patients with geriatric depression and five comparison subjects underwent two resting positron emission tomography (PET) studies, performed after administration of a placebo infusion (Day 1) and a citalopram infusion (40 mg, Day 2).

Invasive group a streptococcal infections, Israel.

We conducted a prospective, nationwide, population-based study of invasive group A streptococcal infections in Israel. We identified 409 patients (median age 27 years; range <1-92), for an annual incidence of 3.7/100,000 (11/100,000 in Jerusalem).