The objective of this study was to investigate the clinical significance of isolates from blood stream infection known to be blood culture contaminants in pediatric patients. Microbiological reports and medical records of all blood culture tests issued from 2002 to 2012 ( = 76,331) were retrospectively reviewed. Evaluation for potential contaminants were done by reviewing medical records of patients with the following isolates: coagulase-negative Staphylococcus, viridans group Streptococcus, , and species. Repeated cultures with same isolates were considered as a single case. Cases were evaluated for their status as a pathogen. Coagulase-negative Staphylococcus had clinical significance in 23.8% of all cases. Its rate of being a true pathogen was particularly high in patients with malignancy (43.7%). Viridans group Streptococcus showed clinical significance in 46.2% of all cases. Its rate of being a true pathogen was similar regardless of the underlying morbidity of the patient. The rate of being a true pathogens for remaining isolates was 27.7% for and 19.0% for species. Coagulase-negative Staphylococcus and viridans group Streptococcus isolates showed high probability of being true pathogens in the pediatric population, especially in patients with underlying malignancy.
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http://dx.doi.org/10.3390/medicina55100696 | DOI Listing |
JMIR Med Inform
January 2025
Department of Systems Design Engineering, Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada.
Background: While expert optometrists tend to rely on a deep understanding of the disease and intuitive pattern recognition, those with less experience may depend more on extensive data, comparisons, and external guidance. Understanding these variations is important for developing artificial intelligence (AI) systems that can effectively support optometrists with varying degrees of experience and minimize decision inconsistencies.
Objective: The main objective of this study is to identify and analyze the variations in diagnostic decision-making approaches between novice and expert optometrists.
JAMA Cardiol
January 2025
Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia.
Importance: A comprehensive lipid panel is recommended by guidelines to evaluate atherosclerotic cardiovascular disease risk, but uptake is low.
Objective: To evaluate whether direct outreach including bulk orders with and without text messaging increases lipid screening rates.
Design, Setting, And Participants: Pragmatic randomized clinical trial conducted from June 6, 2023, to September 6, 2023, at 2 primary care practices at an academic health system among patients aged 20 to 75 years with at least 1 primary care visit in the past 3 years who were overdue for lipid screening.
JAMA Dermatol
January 2025
Department of Dermatology, School of Medicine, University of North Carolina at Chapel Hill.
Importance: Surgery is frequently required for hidradenitis suppurativa (HS) treatment, but the impact of common comorbidities such as obesity, diabetes, and smoking on outcomes has been sparsely studied.
Observations: A total of 12 studies met final inclusion criteria for investigating complication rates associated with at least 1 comorbidity. Complication rates were associated with obesity in 3 of 10 studies.
JAMA
January 2025
Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis.
Importance: Care management benefits community-dwelling patients with dementia, but studies include few patients with moderate to severe dementia or from racial and ethnic minority populations, lack palliative care, and seldom reduce health care utilization.
Objective: To determine whether integrated dementia palliative care reduces dementia symptoms, caregiver depression and distress, and emergency department (ED) visits and hospitalizations compared with usual care in moderate to severe dementia.
Design, Setting, And Participants: A randomized clinical trial of community-dwelling patients with moderate to severe dementia and their caregivers enrolled from March 2019 to December 2020 from 2 sites in central Indiana (2-year follow-up completed on January 7, 2023).
JAMA Cardiol
January 2025
Ifakara Health Institute, Ifakara Branch, Ifakara, United Republic of Tanzania.
Importance: Hypertension is the primary cardiovascular risk factor in Africa. Recently revised World Health Organization guidelines recommend starting antihypertensive dual therapy; clinical efficacy and tolerability of low-dose triple combination remain unclear.
Objectives: To compare the effect of 3 treatment strategies on blood pressure control among persons with untreated hypertension in Africa.
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