Comparison of cefazolin versus oxacillin for treatment of complicated bacteremia caused by methicillin-susceptible Staphylococcus aureus.

Contrary to prior case reports that described occasional clinical failures with cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infections, recent studies have demonstrated no difference in outcomes between cefazolin and antistaphylococcal penicillins for the treatment of MSSA bacteremia. While promising, these studies described low frequencies of high-inoculum infections, such as endocarditis. This retrospective study compares clinical outcomes of cefazolin versus oxacillin for complicated MSSA bacteremia at two tertiary care hospitals between January 2008 and June 2012.

Chronic inflammation in benign prostate tissue is associated with high-grade prostate cancer in the placebo arm of the prostate cancer prevention trial.

Background: Chronic inflammation is hypothesized to influence prostate cancer development, although a definitive link has not been established.

Methods: Prostate cancer cases (N = 191) detected on a for-cause (clinically indicated) or end-of-study (protocol directed) biopsy, and frequency-matched controls (N = 209), defined as negative for cancer on an end-of-study biopsy, were sampled from the placebo arm of the Prostate Cancer Prevention Trial. Inflammation prevalence and extent in benign areas of biopsy cores were visually assessed using digital images of hematoxylin and eosin-stained sections.

Statin drug use is not associated with prostate cancer risk in men who are regularly screened.

Purpose: Prospective cohort studies support the hypothesis that statin drug users have a lower risk of aggressive prostate cancer. Whether statin drug use influences the risk of screen detected disease is less clear, possibly because of complex detection biases. Thus, we investigated this association in a setting in which men had low baseline serum prostate specific antigen concentration and were screened annually.

Interventions to prevent adverse fetal programming due to maternal obesity during pregnancy.

Maternal obesity is a global epidemic affecting both developed and developing countries. Human and animal studies indicate that maternal obesity adversely programs the development of offspring, predisposing them to chronic diseases later in life. Several mechanisms act together to produce these adverse health effects.

Parental tobacco and alcohol use and risk of hepatoblastoma in offspring: a report from the children's oncology group.

Background: Hepatoblastoma is a rare pediatric liver tumor that has significantly increased in incidence over the last several decades. The International Agency for Research on Cancer (IARC) recently classified hepatoblastoma as a tobacco-related cancer. Parental alcohol use has shown no association.

Exercise in obese female rats has beneficial effects on maternal and male and female offspring metabolism.

Background: Maternal obesity (MO) impairs maternal and offspring health. Mechanisms and interventions to prevent adverse maternal and offspring outcomes need to be determined. Human studies are confounded by socio-economic status providing the rationale for controlled animal data on effects of maternal exercise (MEx) intervention on maternal (F0) and offspring (F1) outcomes in MO.

Synthetic oleanane triterpenoids: magic bullets or not?

A recent clinical trial in patients with chronic kidney disease (CKD) and diabetic nephropathy demonstrated that bardoxolone methyl (CDDO-ME) increases estimated glomerular filtration rate (eGFR) by an unknown mechanism. The paper by Ding et al. suggests that short-term administration of a CDDO-ME analog increases GFR by increasing glomerular surface area.

Total anomalous pulmonary venous connection: factors associated with mortality and recurrent pulmonary venous obstruction.

Background: Surgical repair of total anomalous pulmonary venous connection (TAPVC) is associated with high rates of mortality and need for reintervention. The purpose of this study was to identify variables associated with surgical mortality and, in particular, to define predictors of recurrent pulmonary venous obstruction.

Methods: All patients who underwent surgical repair for TAPVC from 2005 to 2010 at a single institution were included in our analysis.

Laparoscopic intraoperative biliary ultrasonography: findings during laparoscopic cholecystectomy for acute disease.

Laparoscopic cholecystectomy (LC) is one of the most commonly performed operations, yet the frequency of bile duct injury remains unacceptably high, and up to 25% of urgent LCs are converted to the open approach. Intraoperative laparoscopic biliary ultrasonography (IOUS) allows identification of portal structures before division of any structure, but the impact of IOUS on LC for acute biliary disease has not been clearly reported. A retrospective review was conducted of all patients who underwent cholecystectomy over a 29-month period.

Unfulfilled postpartum sterilization requests.

Objective: To determine individual and delivery characteristics of women least likely to obtain a requested postpartum tubal ligation (PPTL) and, secondarily, to compare the postpartum contraceptive choices of women with an unfulfilled sterilization request to women not requesting a PPTL.

Study Design: Record review ofwomen delivering a liveborn singleton between December 2007 and May 2008 at the University of Texas San Antonio. Primary outcomes were risk factors for not receiving a requested PPTL.

Effect of acculturation on the acceptability of potential microbicides and sexual risk-taking.

Background: The objective was to determine the acceptability and use patterns of potential microbicides among African American (AA), acculturated Hispanic (AH), and less acculturated Hispanic (LAH) women. We measured baseline sexual risk-taking and the likelihood of behavioral change, given effective microbicides.

Methods: Interview of 506 Mexican-American and AA women, all of whom have a sexually transmitted infection enrolled in Project Sexual Awareness for Everyone.

Methicillin-resistant Staphylococcus aureus as a common cause of vulvar abscesses.

Objective: To estimate the incidence of methicillin-resistant Staphylococcus aureus (MRSA) among women with vulvar abscesses and to describe clinical factors associated with inpatient compared with outpatient treatment.

Methods: We reviewed all women with a vulvar abscess who were treated with incision and drainage between October 2006 to March 2008. We reviewed the abscess cultures and evaluated clinical and laboratory variables associated with inpatient compared with outpatient treatment.

Preventing recurrent sexually transmitted diseases in minority adolescents: a randomized controlled trial.

Objective: To compare the efficacy of a randomized controlled trial of the Sexual Awareness For Everyone (SAFE) behavioral intervention on teenagers (aged 14 to 18 years) compared with adult rates of reinfection with Neiserria gonorrhea or Chlamydia trachomatis cervicitis, and to identify behaviors associated with recurrent infection.

Methods: Mexican-American and African-American females with a nonviral sexually transmitted disease (STD) were enrolled in SAFE or assigned to the control group. All participants were interviewed and examined at baseline, 6, and 12 months.

Partner notification of sexually transmitted infections among pregnant women.

The object of this study was to determine the factors associated with partner notification (PN) of sexually transmitted infection (STI) exposure among pregnant, low income, Mexican-American (MA) and African-American (AA) women and their male sexual partners. We used a cross-sectional analysis of 166 pregnant women with an STI, enrolled in a randomized controlled trial of behavioural intervention to prevent recurrent STIs. The primary outcome, PN, is notification of, or intent to notify male sexual partner(s) of STI exposure.

Partner notification of sexually transmitted infections: a large cohort of Mexican American and African American women.

Objectives: To determine factors associated with partner notification (PN) of sexually transmitted infection (STI) exposure among low-income Mexican American and African American women and their male sexual partners.

Goal: To identify women most likely to notify their partners about an STI exposure.

Study Design: Cross-sectional analysis of 775 women with a nonviral STI.

Current age and race adjusted prostate specific antigen threshold values delay diagnosis of high grade prostate cancer.

Purpose: Age specific prostate specific antigen ranges have been advocated to increase the predictive value of prostate specific antigen based on increases that occur with aging. We suggest that prostate specific antigen is not a dichotomous biomarker and age specific reference ranges delays the diagnosis of high grade prostate cancer in older and black American men.

Materials And Methods: Using the Prostate Cancer Prevention Trial risk calculator we evaluated the impact of age on the risk of high grade prostate cancer in white and black men.

Chronic endometritis in DMPA users and Chlamydia trachomatis endometritis.

Objective: This study was conducted to determine the prevalence of Chlamydia trachomatis (CT) in the endometrium of depot medroxyprogesterone acetate (DMPA) users with and without breakthrough bleeding (BTB) (unscheduled bleeding) and/or chronic endometritis (CE).

Methods: Cross-sectional study. Endometrial biopsies were performed on 20 DMPA users who were having BTB and 20 DMPA users who were amenorrheic.

Who needs the surgical headlight?

Objective: The use of surgical headlights may lead to awkward posture and limit the mobility and visibility of the operating team. Despite the vast availability of fiber-optic instruments, many surgeons continue to use the surgical headlight, which may be harmful to their health and career. We report the use of the Lumitex LightMat surgical illuminator instead of the conventional surgical headlight in cleft palate surgery.

Isolated herpes simplex keratoconjunctivitis in a neonate born by cesarean delivery.

Herpes simplex virus (HSV) infection can be devastating in the neonate. The disease most commonly presents as 1 of 3 clinical manifestations: disseminated visceral infection (with and without central nervous system involvement), isolated meningoencephalitis, and infection limited to the skin, eyes, and/or mucous membranes (SEM). Exposure leading to neonatal infection typically occurs as peripartum vertical transmission, most typically by direct contact with urogenital lesions or infected genital secretions, or as an ascending infection exploiting disrupted chorioamniotic membranes.

Cutaneous hypopigmentation following a posterior sub-tenon triamcinolone injection.

Purpose: To report a case of cutaneous skin hypopigmentation following a posterior sub-Tenon triamcinolone acetonide injection for uveitis.

Design: Observational case report.

Methods: A 28-year-old African American female with Adamantiades-Behcet disease and panuveitis was administered a posterior sub-Tenon injection of triamcinolone acetonide and developed cutaneous hypopigmentation.

The effect of the bovine hemoglobin oxygen therapeutic HBOC-201 on human neutrophil activation in vitro.

Background: We previously demonstrated that HBOC-201 is an efficient resuscitation fluid. However, little is known about its immunomodulatory effects. The goal of this study was to investigate human neutrophil activation after exposure to HBOC-201 and other low-volume resuscitation fluids.

Stage of change advancement for diabetes self-management behaviors and glucose control.

Purpose: This study was conducted to evaluate whether patients with type 2 diabetes who participated in diabetes education advanced through stages of change for self-management behaviors and to determine if movement was related to glucose control.

Methods: A cohort of 428 patients with type 2 diabetes participated in a traditional diabetes education program in a large urban center in the Southwest. The sample was predominantly female with less than a high school education, a mean age of 52 years, and a mean duration of diabetes of 7 years.

Continuity and quality of care in type 2 diabetes: a Residency Research Network of South Texas study.

Objective: We investigated the relationship between continuity of care and the quality of care received by patients with type 2 diabetes mellitus.

Study Design: We used a cross-sectional patient survey and medical record review.

Population: Consecutive patients with an established diagnosis of type 2 diabetes mellitus presented to 1 of 6 clinics within the Residency Research Network of South Texas, a network of 6 family practice residencies affiliated with the University of Texas Health Science Center at San Antonio.