Indicators of potentially drug-resistant bacteria in severe nursing home-acquired pneumonia.

Background: Knowledge of the determinant factors responsible for the presence of antimicrobial-resistant pathogens in severe nursing home-acquired pneumonia (NHAP) is deemed essential for antibiotic selection.

Methods: Data for institutionalized patients with cases of severe pneumonia confirmed by culture of protected bronchoalveolar lavage fluid samples (> or =10(3) cfu/mL) during a 36-month period were analyzed. A classification tree with a sensitivity of 100% was developed using binary recursive partitioning to predict which patients are unlikely to have drug-resistant pathogen (DRP)-related pneumonia.

Pain catastrophizing and interpersonal problems: a circumplex analysis of the communal coping model.

Using the circumplex model of interpersonal behavior [Handbook of research methods in clinical psychology, 1982], this study tested the communal coping model of catastrophizing (CCM) in a large (N = 179) sample of patients with irritable bowel syndrome (IBS), a common, benign chronic pain disorder associated with significant painful extraintestinal comorbidity (e.g. headache, low back pain).

Correction for intracranial volume in analysis of whole brain atrophy in multiple sclerosis: the proportion vs. residual method.

Two techniques that correct (normalize) regional and whole brain volumes according to head size-the proportion method (tissue-to-intracranial volume ratio) and the residual method (regression-based predicted brain tissue volumes)-are used pervasively in neuroimaging research, but have received little critical evaluation or direct comparison. Using a quantitatively derived MRI data set of patients with multiple sclerosis (n = 18) and age-/sex-matched normal controls (n = 18), we introduced various types of error into estimates of intracranial volume (ICV) and absolute parenchymal volume (APV) to observe how this error affected the final outcome of normalized brain measures and their ability to detect group differences, as computed by a proportion (brain parenchymal fraction [BPF]) and residual method (predicted parenchymal volume [PPV]). The results indicated that systemic error in ICV and APV values considerably affected BPF means based on the proportion method, except with dependent-related systematic APV error, but essentially did not change statistical power associated with group differences in BPF.

Association between traffic volume and health care use for asthma among residents at a U.S.-Canadian border crossing point.

Little information is available about health impacts of the North American Free Trade Agreement (NAFTA) traffic-related pollution on residents near the major traffic corridors along the U.S.-Canadian border.

Extubation failure in the elderly.

To determine the causes, risk factors and complications of planned extubation failure of critically ill elderly patients, we conducted a prospective study of 175 consecutive patients (> or = 70 years old) admitted with respiratory failure. Thirty-six (21%) failed extubation within 72 h after planned extubation. Compared to a younger age group (< 70 years old) matched for severity of illness, inability to handle secretions (20%) was the most common reason of airway causes leading to extubation failure in the elderly while upper airway obstruction (22%) was the predominant cause in the control group.

Phototoxicity and photoinactivation of blebbistatin in UV and visible light.

Blebbistatin was recently identified as a selective, cell-permeant inhibitor of myosin II. Because blebbistatin is likely to be used extensively with fluorescence imaging in studies of cytoskeletal dynamics, its compatibility with common excitation wavelengths was examined. Illumination of blebbistatin-treated bovine aortic endothelial cells at 365 and 450-490 nm, but not 510-560 or 590-650 nm, caused dose-dependent cell death.

Relationship between education and delay discounting in smokers.

Smokers are less educated and are more likely to discount future rewards than nonsmokers. We assessed the relationship between delay discounting and education level in 77 smokers entering smoking cessation treatment. There was an effect of education on computer task and the questionnaire measures of discounting, with participants having no college discounting delayed rewards significantly (P < .

Technique of forequarter (interscapulothoracic) amputation.

In the anterior approach to forequarter amputation, a segment of clavicle is removed and early dissection and division of the subclavian vessels are done. In the posterior approach after division of the trapezius and muscles attached to the vertebral border of the scapula, the trunks of the brachial plexus and the subclavian vessels are serially ligated and divided, while the pectoral muscles are intact. In both approaches, the dissection around the subclavian vessels can be slow and tedious to avoid bleeding, which could be difficult to control because the vessels have not been cleared circumferentially for application of a vascular clamp.

Depression and abdominal pain in IBS patients: the mediating role of catastrophizing.

Objective: Depression has been linked to irritable bowel syndrome (IBS), but the mechanism underlying this relationship is unknown. This cross-sectional study explores the possibility that negatively skewed beliefs patients hold regarding abdominal pain (ie, catastrophizing) mediate the relationship between depression and pain severity.

Methods: The sample included 244 consecutively evaluated individuals who met Rome II diagnosis for IBS without comorbid gastrointestinal disease and completed measures of pain severity, trait anxiety, catastrophizing, maladaptive beliefs, and depression as part of baseline assessment of an National Institutes of Health-funded randomized controlled trial of 2 nondrug treatments.

Open-loop feedback increases physical activity of youth.

Purpose: The number of youth that meet activity guidelines is decreasing and easy access to reinforcing sedentary behaviors competes with increasing physical activity. In the laboratory, open-loop feedback that used pedometer activity counts to gain access to sedentary alternatives doubled physical activity. This study evaluated the influence of open-loop feedback and reinforcement on physical activity and television (TV) time in a small clinical trial.

Imaging in head and neck oncology.

Evaluation of head and neck cancer with imaging is a topic that is far more extensive than can be covered in this article. The main reason for head and neck imaging is to evaluate the true extent of disease to best determine surgical and therapeutic options. This process includes evaluation of the size, location, and extent of tumor infiltration into surrounding vascular and visceral structures.

Influence of methylphenidate on eating in obese men.

Objective: Rapid synaptic dopamine transport or reduced brain dopamine receptor signaling may influence energy intake. Methylphenidate, a dopamine reuptake inhibitor, increases brain synaptic dopamine and produces anorexia, suggesting that it may reduce energy intake. We investigated the effects of two doses of short-acting methylphenidate on energy intake over one meal in obese adult males.

Working memory and processing speed deficits in systemic lupus erythematosus as measured by the paced auditory serial addition test.

As many as 66% of systemic lupus erythematosus (SLE) patients have been reported to have cognitive deficits. These deficits are often associated with information processing speed and working memory. Similarly, processing speed and working memory impairments are the hallmark of cognitive dysfunction in multiple sclerosis (MS).

Beyond abuse: the association among parenting style, abdominal pain, and somatization in IBS patients.

This study assessed the relative strength of the association between abuse, negative parenting style, and somatization in irritable bowel syndrome (IBS) patients. Drawing from preclinical stress physiology and abuse research identifying the family social climate as a frequently stronger and independent determinant of long-term health effects than abuse-specific variables, we predicted that negative parenting behaviors would more strongly correlate with somatization than abuse. Subjects were 81 consecutively evaluated patients, who at baseline underwent psychological testing, measuring perceived parental style, abuse history, somatization, and pain.

Traffic volumes and respiratory health care utilization among residents in close proximity to the Peace Bridge before and after September 11, 2001.

A recent study based on data over a 10-year period (1991-2000) showed a positive association between health care utilization and prevalence of asthma, and commercial traffic at a U.S.-Canada border crossing.

Who are patients on conventional antipsychotics?

The advent of atypical antipsychotics presented psychiatrists with an effective way of treating psychosis without the many side effects associated with conventional agents. Given the superiority of atypical antipsychotics, we examined demographic information and treatment histories of patients currently treated with conventional antipsychotics, especially in regard to treatment with atypical agents. Medication histories and demographic information for 276 patients admitted to an urban hospital were obtained by patient/family interviews and review of medical records.

Influence of an interpersonal laboratory stressor on youths' choice to be physically active.

Objective: To determine whether interpersonal stress reduces youths' motivation to exercise in a laboratory setting.

Research Methods And Procedures: Physical activity and sedentary behavior were measured in boys and girls across a control day, after reading children's magazines, and on a stress day, after giving a videotaped speech. For one analysis, children were divided into low (n = 12) and high (n = 13) heart-rate reactivity groups based on changes in heart rate to stress.

Asymmetric distribution of myosin IIB in migrating endothelial cells is regulated by a rho-dependent kinase and contributes to tail retraction.

All vertebrates contain two nonmuscle myosin II heavy chains, A and B, which differ in tissue expression and subcellular distributions. To understand how these distinct distributions are controlled and what role they play in cell migration, myosin IIA and IIB were examined during wound healing by bovine aortic endothelial cells. Immunofluorescence showed that myosin IIA skewed toward the front of migrating cells, coincident with actin assembly at the leading edge, whereas myosin IIB accumulated in the rear 15-30 min later.

Validity of the Beck Depression Inventory-Fast Screen in multiple sclerosis.

Introduction: The Beck Depression Inventory-Fast Screen (BDI-FS) is a brief self-report inventory designed to evaluate depression in patients with medical illness. As depressive disorder is especially prominent in multiple sclerosis (MS), a cost-effective procedure for identifying depressive disorder in MS is sorely needed. The BDI-FS may be useful in this regard although, to date, its validity in MS patients has not been assessed.

Swallowing disorders post orotracheal intubation in the elderly.

Objectives: The purpose of this study was to assess the prevalence and recovery time of swallowing dysfunction after prolonged endotracheal intubation in critically ill elderly patients compared to a younger cohort.

Design: This was a prospective, interventional, clinical study set in a medical intensive care unit in a university-affiliated hospital.

Subjects: The study involved 42 consecutive elderly patients (>/=65 years old) and 42 controls (<65 years) matched for severity of illness requiring endotracheal intubation for more than 48 h.

Role of cytokines in nasal polyposis.

Chronic hyperplastic sinusitis and nasal polyposis (CHS/NP) is associated with significant morbidity. The response to medical treatment is often unsatisfactory, and surgery often provides only temporary relief. The genesis and pathophysiology of polyps are poorly understood.