Differential immunodetection of toxin B from highly virulent Clostridium difficile BI/NAP-1/027.

We developed a simple immunoassay capable of differentially detecting toxin B from highly virulent strains of Clostridium difficile (BI/NAP-1/027) in stool. This assay can simultaneously confirm the presence of in vivo toxin production and provide strain-related information relevant to infection control epidemiology and disease prognosis.

Influence of capsular repair versus unrepaired capsulotomy on 2-year clinical outcomes after arthroscopic hip preservation surgery.

Purpose: The primary objective of this study was to determine whether capsular management technique influences clinical outcomes at a minimum of 2 years after arthroscopic hip preservation surgery.

Methods: A retrospective review of prospectively collected data was conducted to determine the relative influence of 2 capsular management strategies on clinical outcomes: unrepaired capsulotomy (group A) and capsular repair (group B). Four hundred three patients who had undergone arthroscopic hip preservation surgery met the inclusion criteria and had 2-year outcome data available.

A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2014 Updates.

Since the publication of "A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals" in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts.

Traditional or Translational Research for Nursing: More PhDs Please.

In this column, the authors focus on the need for more PhD-prepared nurses as opposed to nurses receiving the Doctor of Nursing Practice (DNP). This would help to to facilitate an understanding between traditional research and translational research. The idea of a need for collaboration between these two terminal degrees is highlighted.

Development and validation of the actionable bladder symptom screening tool for multiple sclerosis patients.

Bladder symptoms such as urinary urgency, frequency, and incontinence are common in people with multiple sclerosis (MS). These symptoms, which often result from neurogenic detrusor overactivity (NDO), can have a major impact on patients' day-to-day lives. However, in many cases they are over-looked in the clinical management of MS.

Engaging, recruiting, and retaining black men who have sex with men in research studies: don't underestimate the importance of staffing--lessons learned from HPTN 061, the BROTHERS study.

Context: HIV/AIDS in the United States continues to primarily impact men who have sex with men (MSM), with disproportionately high rates among black MSM.

Objective: The purpose of this study was to identify factors that may influence engagement and retention of black MSM in HIV research.

Design And Participants: This was a qualitative evaluation of study implementation within a multisite, prospective, observational study (HIV Prevention Trials Network 061, BROTHERS) that enrolled 1553 black MSM in 6 cities throughout the United States.

Combined angiotensin inhibition for the treatment of diabetic nephropathy.

Combination therapy with angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) decreases proteinuria; however, its safety and effect on the progression of kidney disease are uncertain. Methods We provided losartan (at a dose of 100 mg per day) to patients with type 2 diabetes, a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 300, and an estimated glomerular filtration rate (GFR) of 30.0 to 89.

Pediatric sepsis: a case study.

Abdominal pain with vomiting is a common pediatric complaint in the emergency department setting that can lead to a more insidious disease state. The article depicts a case study of a 21-month-old male child presenting with these signs and symptoms that ultimately resulted in a diagnosis of septic shock. The importance of physical assessment, rapid response to findings with time-constrained empirical interventions, the relevance of pediatric sepsis to the provider, the consideration of access to health care, and a holistic approach to treatment of the patient and the family are highlighted.

Social-emotional delays at 2 years in extremely low gestational age survivors: correlates of impaired orientation/engagement and emotional regulation.

Background: Premature infants are less socially and emotionally competent at school age than infants born at term.

Aims: To evaluate the correlates of social and emotional delays at 2 years of age among prematurely born children.

Study Design: This is a prospective cohort study.

Combined radiation and burn injury results in exaggerated early pulmonary inflammation.

Events such as a nuclear meltdown accident or nuclear attack have potential for severe radiation injuries. Radiation injury frequently occurs in combination with other forms of trauma, most often burns. Thus far, combined injury studies have focused mainly on skin wound healing and damage to the gut.

Ventilatory failure, ventilator support, and ventilator weaning.

The development of acute ventilatory failure represents an inability of the respiratory control system to maintain a level of respiratory motor output to cope with the metabolic demands of the body. The level of respiratory motor output is also the main determinant of the degree of respiratory distress experienced by such patients. As ventilatory failure progresses and patient distress increases, mechanical ventilation is instituted to help the respiratory muscles cope with the heightened workload.

Reconstruction of the nasal soft triangle subunit.

Background: Of all nine subunits, the soft triangle is perhaps the most challenging to recreate. The complexity of soft triangle reconstruction resides in its proximity to such important structures as the nasal tip, nasal ala, and distal columella. If the soft triangle is not properly reconstructed, problems with nasal function and aesthetics often arise.

Co-morbidity between cardiovascular pathology and depression: role of inflammation.

Morbidity and mortality of cardiovascular disease is exceedingly high worldwide. Depressive illness is a serious psychiatric illness that afflicts a significant portion of the population worldwide. Epidemiological studies have confirmed the high co-morbidity between these two entities and the co-morbidity is bidirectional.

Is primary prevention of Clostridium difficile infection possible with specific probiotics?

Background: The efficacy of probiotics for the prevention of Clostridium difficile infection (CDI) is highly controversial, particularly with regard to the prevention of recurrent CDI. We hypothesize that primary prevention of CDI among patients receiving antibiotics might be a more achievable goal for probiotics than prevention in patients with previous CDI where the host flora is markedly altered.

Methods: We conducted a literature search for randomized, placebo-controlled efficacy studies of probiotic use among adults receiving antibiotics, in which CDI was one of the outcomes measured.

A meta-analysis of human acellular dermis and submuscular tissue expander breast reconstruction.

Background: Human acellular dermal matrix has become an increasingly used adjunct to traditional submuscular tissue expander/implant breast reconstruction, but there is no strong consensus regarding complication outcomes. This study stratified outcomes based on a meta-analysis of complications.

Methods: A query of the MEDLINE database for articles on human acellular dermal matrix and submuscular tissue expander breast reconstruction yielded 901 citations.

Post-traumatic stress disorder after weaning from prolonged mechanical ventilation.

Purpose: Weaning from prolonged mechanical ventilation may be associated with mental discomfort. It is not known whether such discomfort is linked with the development of post-traumatic stress disorder (PTSD). Accordingly, we investigated whether PTSD occurs in patients after weaning from prolonged ventilation.

Role of Endothelial Cells in Myocardial Ischemia-Reperfusion Injury.

Minimizing myocardial ischemia-reperfusion injury has broad clinical implications and is a critical mediator of cardiac surgical outcomes. "Ischemic injury" results from a restriction in blood supply leading to a mismatch between oxygen supply and demand of a sufficient intensity and/or duration that leads to cell necrosis, whereas ischemia-reperfusion injury occurs when blood supply is restored after a period of ischemia and is usually associated with apoptosis (i.e.

Endocrinological derangements in COPD.

Chronic obstructive pulmonary disease (COPD) is no longer considered to affect only the lungs and airways but also the rest of the body. The systemic manifestations of COPD include a number of endocrine disorders, such as those involving the pituitary, the thyroid, the gonads, the adrenals and the pancreas. The mechanisms by which COPD alters endocrine function are incompletely understood but likely involve hypoxaemia, hypercapnia, systemic inflammation and glucocorticoid administration.

Disparity in utilization of combined kidney-liver transplantation in the United States.

Background: Orthotopic liver transplantation (OLT) is performed as a definitive treatment of acute and chronic liver failure. The prevalence of acute and chronic kidney diseases is substantially higher in this population secondary to diverse etiologies. Combined kidney-liver transplantation (CKLT) is widely performed in some centers, even though there are no definitive studies which support or contradict this practice.

Hippocrates is alive and weaning in Brazil.

In a group of postoperative patients, Taniguchi and coworkers compared the effect of a computerized system for weaning against 'manual care'. The computerized system involved automatic adjustments to the level of pressure support to achieve a target respiratory rate. Manual care involved adjustments to the level of pressure support to keep the ratio of respiratory frequency to tidal volume below 80.

Fine-needle aspiration cytology of epithelioid leiomyoblastoma.

Purpose. Epithelioid leiomyoblastomas comprise the majority of gastric sarcomas and are uncommon in other parts of the gastrointestinal tract. Diagnosis of this lesion by fine-needle aspiration cytology has been occasionally described in the literature.

Sternomastoid, rib cage, and expiratory muscle activity during weaning failure.

We hypothesized that patients who fail weaning from mechanical ventilation recruit their inspiratory rib cage muscles sooner than they recruit their expiratory muscles, and that rib cage muscle recruitment is accompanied by recruitment of sternomastoid muscles. Accordingly, we measured sternomastoid electrical activity and changes in esophageal (DeltaPes) and gastric pressure (DeltaPga) in 11 weaning-failure and 8 weaning-success patients. At the start of trial, failure patients exhibited a higher DeltaPga-to-DeltaPes ratio than did success patients (P = 0.