Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 37
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
2.
Am J Infect Control ; 51(3): 346-348, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-35914581

RESUMO

The Advisory Committee on Immunization Practices recommends all healthcare practitioners and hospital staff receive an annual influenza vaccination. Many challenges were noted in achieving this goal; especially during the last 2 influenza seasons throughout the COVID-19 pandemic. Over the past 3 years our institution has implemented a Drive-Thru fixed Point of Distribution (POD) event for this purpose. Drive-Thru PODs can be a safe and effective strategy for employee vaccination during a pandemic.


Assuntos
COVID-19 , Vacinas contra Influenza , Influenza Humana , Veteranos , Humanos , Influenza Humana/prevenção & controle , Influenza Humana/epidemiologia , Pandemias/prevenção & controle , COVID-19/prevenção & controle , Recursos Humanos em Hospital , Vacinação , Hospitais , Estações do Ano
3.
J Pers Med ; 12(11)2022 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-36573732

RESUMO

The landscape of human immunodeficiency virus (HIV) epidemiology and treatment is ever-changing, with the widespread and evolving use of antiretroviral therapy (ART). With timely ART, people living with HIV (PLWH) are nearing the life expectancies and the functionality of the general population; nevertheless, the effects of HIV and ART on cardiovascular health remain under investigation. The pathophysiology of HIV-related cardiomyopathy and heart failure (HF) have historically been attributed to systemic inflammation and changes in cardiometabolic function and cardiovascular architecture. Importantly, newer evidence suggests that ART also plays a role in modulating the process of HIV-related cardiomyopathy and HF. In the short term, newer highly active ART (HAART) seems to have cardioprotective effects; however, emerging data on the long-term cardiovascular outcomes of certain HAART medications, i.e., protease inhibitors, raise concerns about the potential adverse effects of these drugs in the clinical course of HIV-related HF. As such, the traditional phenotypes of dilated cardiomyopathy and left ventricular systolic failure that are associated with HIV-related heart disease are incrementally being replaced with increasing rates of diastolic dysfunction and ischemic heart disease. Moreover, recent studies have found important links between HIV-related HF and other clinical and biochemical entities, including depression, which further complicate cardiac care for PLWH. Considering these trends in the era of ART, the traditional paradigms of HIV-related cardiomyopathy and HF are being called into question, as is the therapeutic role of interventions such as ventricular assist devices and heart transplantation. In all, the mechanisms of HIV-related myocardial damage and the optimal approaches to the prevention and the treatment of cardiomyopathy and HF in PLWH remain under investigation.

6.
BMC Infect Dis ; 21(1): 884, 2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34454421

RESUMO

BACKGROUND: Transcatheter edge-to-edge mitral valve repair using the MitraClip device is increasingly used for high surgical risk patients with severe mitral regurgitation (MR). Previous guidelines for infective endocarditis prophylaxis prior to dental procedures focused on high-risk patients, but without explicit recommendation for MitraClip recipients. We believe this could be the first reported case to identify Streptococcus oralis as the causative organism. CASE PRESENTATION: An 87-year-old male with severe MR treated with two MitraClip devices three months prior to index admission, presented with worsening malaise and intermittent chills on a background of multiple comorbid conditions. The patient had dental work a month prior to presentation, including a root canal procedure, without antibiotic prophylaxis. Vitals were significant for fever and hypotension. On physical examination, there was a holosystolic murmur at the apex radiating to the axilla, bilateral pitting edema in the lower extremities, and elevated jugular venous pulsation. A transthoracic echocardiogram showed severe MR with a possible echodensity on the mitral valve, prompting a transesophageal echocardiogram, which demonstrated a pedunculated, mobile mass on the posterior leaflet of the mitral valve. Five blood cultures grew gram positive cocci in pairs and chains, later identified as Streptococcus oralis, with minimum inhibitory concentration to penicillin 0.06 mg/L. Initial empiric antibiotics were switched to ceftriaxone 2 gr daily and subsequent blood cultures remained negative. However, the patient developed pulmonary edema and worsening hemodynamic instability requiring vasopressors. As surgical risk for re-operation was considered prohibitive, the decision was made to continue medical management and comfort-directed care. The patient died a week later. CONCLUSIONS: Despite low incidence, infective endocarditis should be included in the differential among MitraClip recipients. The explicit inclusion of this growing patient population in the group requiring prophylaxis prior to dental procedures in the 2020 ACC/AHA valvular heart disease guidelines is an important step forward.


Assuntos
Endocardite , Implante de Prótese de Valva Cardíaca , Insuficiência da Valva Mitral , Idoso de 80 Anos ou mais , Humanos , Masculino , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/cirurgia , Streptococcus oralis , Resultado do Tratamento
8.
Am J Infect Control ; 49(9): 1210-1211, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34175364

RESUMO

An outbreak of SARS-CoV-2 involving four residents of a United States Veterans Affairs long term care facility occurred following administration of the first dose of the mRNA-1273 vaccine (Moderna) to thirty out of 33 residents. Three out of 4 positive cases were partially vaccinated and remained asymptomatic. One of 2 partially vaccinated patients who were tested for anti-spike protein antibodies had detectable levels at the time of diagnosis. The mortality rate was lower compared to a prior outbreak reported in this facility.


Assuntos
Infecções Assintomáticas , Vacinas contra COVID-19/administração & dosagem , COVID-19 , Veteranos , Vacina de mRNA-1273 contra 2019-nCoV , COVID-19/diagnóstico , COVID-19/prevenção & controle , Humanos , Assistência de Longa Duração , Estados Unidos/epidemiologia
11.
Am J Infect Control ; 49(1): 115-119, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33157181

RESUMO

A Veterans Affairs long term care facility on Long Island New York was confronted with a COVID-19 outbreak in late March to Mid-April 2020. Faced with a dwindling supply of PPE, the Infection Control team distributed supplies saved for a possible Ebola outbreak. A COVID unit was created within the nursing home facilitating the geographic isolation of cases; universal testing of residents and employees allowed for the implementation of proper quarantine measures. It was a multidisciplinary team approach led by the Infection Control team that successfully contained this outbreak.


Assuntos
Infecções Assintomáticas/epidemiologia , COVID-19/epidemiologia , Portador Sadio/epidemiologia , Controle de Infecções/organização & administração , Casas de Saúde/organização & administração , Equipamento de Proteção Individual/provisão & distribuição , Idoso , Idoso de 80 Anos ou mais , COVID-19/diagnóstico , COVID-19/prevenção & controle , COVID-19/transmissão , Teste para COVID-19 , Portador Sadio/diagnóstico , Portador Sadio/transmissão , Surtos de Doenças , Feminino , Pessoal de Saúde , Humanos , Controle de Infecções/métodos , Profissionais Controladores de Infecções , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Isolamento de Pacientes , SARS-CoV-2 , Estados Unidos/epidemiologia , United States Department of Veterans Affairs
12.
Am J Infect Control ; 48(9): 1119-1121, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32035688

RESUMO

Clostridium (or Clostridioides) difficile infection (CDI) is a common side effect of antimicrobial therapy and is increasingly linked with health care-associated transmissions. Antimicrobial stewardship programs (ASP) have demonstrated success in decreasing in-hospital CDI cases. We implemented an ASP targeting inappropriate or unnecessary use of all antibiotics especially empiric piperacillin-tazobactam and fluoroquinolone use. Concurrently, we monitored all health-care associated CDI. Our CDI cases were markedly decreased after initiation of our ASP.


Assuntos
Gestão de Antimicrobianos , Clostridioides difficile , Infecções por Clostridium , Hospitais de Veteranos , Antibacterianos/uso terapêutico , Infecções por Clostridium/tratamento farmacológico , Humanos , Estados Unidos
13.
J Glob Infect Dis ; 12(4): 231-233, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33888966

RESUMO

Staphylococcus lugdunensis is an emerging coagulase-negative Staphylococcus regarded as a formidable pathogen capable of causing significant infections at various body sites including bone and joints. We report the case of a Caucasian elderly male with recurrent lumbar osteomyelitis due to S. lugdunensis. He had a history of chronic low back pain. Besides chronic kidney failure and need for hemodialysis, he had no other history of immunosuppression. He did not have fever or leukocytosis; however, the erythrocyte sedimentation rate was elevated, and repeated blood cultures from the periphery and the hemodialysis access (tunneled catheter) were continuously positive for S. lugdunensis. The diagnosis was made by bone biopsy and culture. The bacteremia cleared after removing of the dialysis catheter. The patient received 8 weeks of antibiotic therapy for the osteomyelitis.

17.
J Glob Infect Dis ; 11(1): 47-49, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30814836

RESUMO

Spilled gallstones during laparoscopic cholecystectomy (LC) are common. Lost gallstones can lead to complications such as intra-abdominal abscesses, which can occur days, months, or even years after the procedure. Citrobacter koseri belongs to the family of Enterobacteriaceae. It is a low-virulence pathogen; however, it is linked to infections of the urinary tract and abdomen. We report the case of a 70-year-old diabetic male who presented with C. koseri- associated subhepatic abscess. Two years prior, he had emphysematous cholecystitis and liver abscess caused by C. koseri. During his LC, gallstones were spilled in the abdominal cavity and every effort was made to retrieve them. However, 2 years later, an aspiration of the subhepatic abscess revealed cholesterol fragments. We hypothesize that dislodged cholesterol gallstones and bile, contaminated with C. koseri, were the culprits for the appearance of the subhepatic abscess with the same organism 2 years after the LC.

20.
Ticks Tick Borne Dis ; 10(2): 407-411, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30573383

RESUMO

In North America, Lyme disease (LD) is caused predominantly by the spirochete Borrelia burgdorferisensu stricto, and is transmitted by blacklegged ticks. Long Island, New York, is highly endemic for the disease. The C6 peptide (C6P) is currently used as a screening test for LD in our institution. Our objective was to examine how screening with C6P concorded with diagnosis of LD at the Veterans Affairs Medical Center, Northport, Long Island. A retrospective chart-review of 2558 C6P tests was performed during the period of 1/1/2010 to 12/31/2016. Patients were categorized by Lyme Disease (LD) or no LD groups. LD group was defined as having an erythema migrans (EM) rash, or ≥ 2 IgM bands or ≥ 5 IgG bands on immunoblot. Out of the 409 patients with positive or equivocal C6P, 181 patients with LD were based on presence of EM, or Western blot IgM and IgG test results; 228 did not have LD. The positive predictive value of C6P was 44.5%. EM was the most common presentation. In the LD group, history of tick bite (P: 0.0001), headache (P: 0.0036), joint swelling (P: 0.0086) and myalgias (P: 0.0005) were more likely to be present. Zip code mapping of our cases mirrored those previously reported in the Suffolk County Department of Health. In our review we encountered a significant number of false positive C6 assays. False positive C6P tests were ordered by primary care physicians (PCP) (37%) followed by neurologists (33%). A history of tick exposure and clinical findings of early Lyme disease such as headaches or joint aches were more likely to denote a true positive C6 peptide test. Rigorous education of physicians about Lyme disease and pitfalls of our available diagnostic tests are needed for their proper utilization.


Assuntos
Proteínas de Bactérias/sangue , Doença de Lyme/epidemiologia , Peptídeos/sangue , Veteranos , Idoso , Anticorpos Antibacterianos/sangue , Artralgia/etiologia , Borrelia , Doenças Endêmicas , Eritema Migrans Crônico/microbiologia , Reações Falso-Positivas , Feminino , Cefaleia/etiologia , Humanos , Immunoblotting , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Doença de Lyme/diagnóstico , Masculino , Pessoa de Meia-Idade , New York/epidemiologia , Estudos Retrospectivos , Picadas de Carrapatos/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...