Multicenter Evaluation of the Cepheid Xpert Xpress SARS-CoV-2/Flu/RSV Test.

With the approach of respiratory virus season in the Northern Hemisphere, clinical microbiology and public health laboratories will need rapid diagnostic assays to distinguish severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from influenza virus and respiratory syncytial virus (RSV) infections for diagnosis and surveillance. In this study, the clinical performance of the Xpert Xpress SARS-CoV-2/Flu/RSV test (Cepheid, Sunnyvale, CA, USA) for nasopharyngeal swab specimens was evaluated in four centers: Johns Hopkins Medical Microbiology Laboratory, Northwell Health Laboratories, NYC Public Health Laboratory, and Los Angeles County/University of Southern California (LAC+USC) Medical Center. A total of 319 nasopharyngeal swab specimens, positive for SARS-CoV-2 ( = 75), influenza A virus ( = 65), influenza B virus ( = 50), or RSV ( = 38) or negative ( = 91) by the standard-of-care nucleic acid amplification tests at each site, were tested using the Cepheid panel test.

The influence of obesity on operating room time and perioperative complications in cochlear implantation.

Objective: The rising incidence of obesity in the United States is associated with increased healthcare expenditures and resource allocation. Obesity has been associated with prolonged operating times during surgical procedures. The primary objective of this study is to compare body mass index (BMI) to length of surgery during cochlear implantation.

Hearing Loss in Pediatric Patients With Cerebral Palsy.

Objective: This study evaluates the prevalence, type, and severity of hearing impairment in children with cerebral palsy (CP) and to analyze audiologic and otologic outcomes in these patients.

Study Design: Retrospective analysis of the AudGen Database.

Setting: Tertiary academic referral center.

Characteristics and Progression of Hearing Loss in Children with Down Syndrome.

Objectives: To evaluate hearing impairment in children with Down syndrome, and to describe the factors that influence the severity of hearing loss or changes in hearing over time.

Study Design: Using the Audiological and Genetic Database (AudGenDB), audiograms of children with Down syndrome were analyzed retrospectively for type, severity, and laterality of hearing loss, as well as changes over time. Medical charts and imaging results were reviewed to identify factors influencing hearing loss.

Hearing loss in children with growth hormone deficiency.

Objective: Although insulin-like growth factor 1 (IGF-1) has been shown to be important for inner-ear development in animal models, little is known about the otologic and audiologic findings of children with growth hormone deficiency (GHD). The goal of this study is to evaluate the prevalence, type, and severity of hearing impairment in children with GHD.

Methods: Audiologic, otologic, and demographic data were recorded for children with a diagnosis of GHD in the AudGen database.

Otologic and Audiologic Outcomes in Pediatric Patients With Velo-Cardio-Facial (22q11 Deletion) Syndrome.

Objective: The focus of this study was to evaluate the prevalence, type, and severity of hearing impairment in patients with velo-cardio-facial syndrome (VCFS) and to compare these characteristics with patient demographics and other otologic factors.

Study Design: Retrospective analysis of the AudGen Database.

Setting: Tertiary academic referral center.

Audiologic and otologic phenotype in children with Duane's Retraction Syndrome: A rare ophthalmologic disorder.

Objective: The focus of this study was to evaluate the prevalence, type, and severity of hearing impairment in patients with Duane's Retraction Syndrome and to relate these measures to patient demographics and other otologic and audiologic factors.

Study Design: Retrospective AudGen Database analysis

Setting: Tertiary academic referral center

Patients: Pediatric patients in AudGenDB with a diagnosis of Duane's Retraction Syndrome (DRS).

Interventions: Appropriate audiologic, otologic, and demographic data were recorded.

Audiologic Outcomes in Ehlers-Danlos Syndrome.

Objective: The focus of this study was to evaluate the prevalence, type, and severity of hearing impairment in patients with Ehlers-Danlos Syndrome (EDS) and to compare these characteristics with patient demographics and other otologic factors.

Study Design: Retrospective analysis of the AudGen Database.

Setting: Tertiary academic referral center.

Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-infected Pregnant Women and Adverse Infant Outcomes.

Background: Sexually transmitted infections (STIs) in pregnancy such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) may lead to adverse infant outcomes.

Methods: Individual urine specimens from HIV-infected pregnant women diagnosed with HIV during labor were collected at the time of infant birth and tested by polymerase chain reaction for CT and NG. Infant HIV infection was determined at 3 months with morbidity/mortality assessed through 6 months.

Chlamydia and Gonorrhea in HIV-Infected Pregnant Women and Infant HIV Transmission.

Background: Sexually transmitted infections (STIs) such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) can lead to adverse pregnancy and neonatal outcomes. The prevalence of STIs and its association with HIV mother-to-child transmission (MTCT) were evaluated in a substudy analysis from a randomized, multicenter clinical trial.

Methodology: Urine samples from HIV-infected pregnant women collected at the time of labor and delivery were tested using polymerase chain reaction testing for the detection of CT and NG (Xpert CT/NG; Cepheid, Sunnyvale, CA).

Detection of colonization by carbapenemase-producing Gram-negative Bacilli in patients by use of the Xpert MDRO assay.

Detecting colonization of patients with carbapenemase-producing bacteria can be difficult. This study compared the sensitivity and specificity of a PCR-based method (Xpert MDRO) for detecting blaKPC, blaNDM, and blaVIM carbapenem resistance genes using GeneXpert cartridges to the results of culture with and without a broth enrichment step on 328 rectal, perirectal, and stool samples. The culture method included direct inoculation of a MacConkey agar plate on which a 10-μg meropenem disk was placed and plating on MacConkey agar after overnight enrichment of the sample in MacConkey broth containing 1 μg/ml of meropenem.

Cancer of the proximal colon after a "normal" colonoscopy.

In common with other diagnostic tests, colonoscopy has a false negative rate which is infrequently assessed. The available literature suggests that lesion miss rate is higher for proximal colonic tumors. A total of 367 patients were diagnosed with cancer of the colon and rectum over a period of 2 years.

Democratizing molecular diagnostics: the GeneXpert(®) enterovirus assay.

Background: Few clinical scenarios are as diagnostically demanding as the workup of acute meningitis in the emergency room setting. In humans, most cases of meningitis are due to enteroviral infection, which usually resolves with supportive care and does not generally require hospitalization. The difficulty in evaluating meningitis is often related to its nonspecific presentation; rapid identification of the underlying etiologic agent is critical to selection of the most appropriate course of therapy.

Comparison of P-POSSUM and O-POSSUM in predicting mortality after oesophagogastric resections.

Background: P-POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and morbidity) predicts mortality and morbidity in general surgical patients providing an adjunct to surgical audit. O-POSSUM was designed specifically to predict mortality and morbidity in patients undergoing oesophagogastric surgery.

Aim: To compare P-POSSUM and O-POSSUM in predicting surgical mortality in patients undergoing elective oesophagogastric cancer resections.

Multicenter beta trial of the GeneXpert enterovirus assay.

The GeneXpert Dx system (Cepheid, Sunnyvale, CA) is a fully integrated and automated nucleic acid sample preparation, amplification, and real-time detection system. It consists of an instrument, a personal computer, and disposable fluidic cartridges. The analytical sensitivity and specificity of the GeneXpert enterovirus assay (GXEA) were determined with a panel of 63 different enterovirus serotypes and 24 other microorganisms, respectively.

Molecular analysis of polymerase gamma gene and mitochondrial polymorphism in fertile and subfertile men.

CAG trinucleotide repeat length in the nuclear polymerase gamma gene (POLgamma) has been shown to be associated with men with reduced fertility. The present study investigated the frequency of CAG repeat length genotypes and three exonuclease motifs of the POLgamma in relation to the frequency of mitochondrial nucleotide substitutions. DNA from semen samples of 93 normozoospermic men and 192 non-normozoospermic men was isolated and the specific regions of the genes were amplified by polymerase chain reactions (PCR) and sequenced to identify mutations.

Base administration or fluid bolus for preventing morbidity and mortality in preterm infants with metabolic acidosis.

Background: Metabolic acidosis in the early newborn period is associated with adverse outcomes in preterm infants. The most commonly used strategies to correct metabolic acidosis are intravascular infusion of base, for example sodium bicarbonate, and intravascular infusion of a fluid bolus, usually a crystalloid or colloid solution.

Objectives: To evaluate the available evidence from randomised controlled trials that either infusion of base, or of a fluid bolus, reduces mortality and adverse neurodevelopmental outcomes in preterm infants with metabolic acidosis.

Asbestos exposure from gaskets during disassembly of a medium duty diesel engine.

Diesel engines have historically used asbestos-containing gaskets leading to concerns of fiber release and mechanic exposure. Other published studies regarding asbestos fiber release during gasket removal have reported on short-duration events; were conducted under simulated work conditions; or had other limitations. There are no comprehensive studies relating to diesel engine gaskets under conditions similar to those reported herein, evaluating asbestos fiber release from gaskets during all facets of a complete disassembly and cleaning of a medium duty diesel engine in a busy repair and service shop by a journeyman mechanic.

Human genomic DNA analysis using a semi-automated sample preparation, amplification, and electrophoresis separation platform.

The growing importance of analyzing the human genome to detect hereditary and infectious diseases associated with specific DNA sequences has motivated us to develop automated devices to integrate sample preparation, real-time PCR, and microchannel electrophoresis (MCE). In this report, we present results from an optimized compact system capable of processing a raw sample of blood, extracting the DNA, and performing a multiplexed PCR reaction. Finally, an innovative electrophoretic separation was performed on the post-PCR products using a unique MCE system.

The neorule: a new instrument to measure linear growth in preterm infants.

Objectives: To compare measurements of crown-heel length (CHL) made with the neorule with CHL measurements made with a stadiometer in term infants. To examine safety and reproducibility of CHL measurements in infants < 32 weeks gestational age (GA) using the neorule.

Methods: Three measurements of CHL were made by three teams during the first 2 days of life in healthy term infants.

Morphological characteristics of asbestos fibers released during grinding and drilling of friction products.

There has been considerable interest during the past 30 years regarding the potential for exposure to asbestos fibers generated during asbestos-containing automobile and light-duty truck brake replacement and repair operations. Less attention has been directed to asbestos fiber exposures resulting from servicing of brakes on heavy-duty trucks and other machinery. Potential for the generation of respirable fibers as a result of using a rotary bench grinder and the drilling of asbestos-containing friction pads was investigated to assess the characteristics of the fibers generated from these procedures.

Characterization of vehicular brake service personnel exposure to airborne asbestos and particulate.

Evaluation of fibers and total particulate generated during the servicing of drum brakes on motor vehicles as well as during the resurfacing (arcing) of brake shoes was conducted. Conditions for the studies were based on review of contemporary (approximately 1950-1980) working practices in the industry. This work was conducted in two parts.

Conversational responsiveness in specific language impairment: evidence of disproportionate pragmatic difficulties in a subset of children.

Eighteen children with specific language impairment (SLI), from 6 to 8 years of age, were compared with 9 control children matched on age and nonverbal ability (CA controls) and with 9 younger control children of comparable language level (LA controls). Half of the SLI group were rated on a teacher checklist as having pragmatic difficulties: these were referred to as the pragmatic language impairment (PLI) group; the remainder were the typical (SLI-T) group. Children's responses to adult soliciting utterances were compared.

A patent ductus arteriosus is associated with reduced middle cerebral artery blood flow velocity.

Unlabelled: The study objective was to determine the effect of a patent ductus arteriosus (PDA) on cerebral blood flow velocity in ventilated, very low birth weight neonates, in the first 5 days of life. Sonography of the right middle cerebral artery and ductus arteriosus was performed using a colour Doppler technique. Statistical analysis was by stepwise regression.

Does endothelin-1 reduce superior mesenteric artery blood flow velocity in preterm neonates?

Aim: To compare plasma endothelin-1 (ET-1) concentrations in preterm neonates from pre-eclamptic and normal mothers; and to evaluate whether ET-1 has a role in altered arterial blood flow velocity.

Methods: Umbilical arterial blood and neonatal arterial blood were sampled on days 1 and 3 for gas analysis and measurement of plasma ET-1. Doppler ultrasonography of the middle cerebral, renal, and superior mesenteric arteries (SMA) was performed.