Multidrug-Resistant Organism Infections in US Nursing Homes: A National Study of Prevalence, Onset, and Transmission across Care Settings, October 1, 2010-December 31, 2011

Objective.To understand the prevalence of multidrug-resistant organism (MDRO) infections among nursing home (NH) residents and the potential for their spread between NHs and acute care hospitals (ACHs).Methods.Descriptive analyses of MDRO infections among NH residents using all NH residents in the Long-Term Care Minimum Data Set (MDS) 3.0 between October 1, 2010 and December 31, 2011.Results.Analysis of MDS data revealed a very high volume of bidirectional patient flow between NHs and ACHs, indicating the need to study MDRO infections in NHs as well as in hospitals. A total of 4.24% of NH residents had an active MDRO diagnosis on at least 1 MDS assessment during the study period. This rate significantly varied by sex, age, urban/rural status, and state. Approximately 2% of NH discharges to ACHs involved a resident with an active diagnosis of infection due to MDROs. Conversely, 1.8% of NH admissions from an ACH involved a patient with an active diagnosis of infection due to MDROs. Among residents who acquired an MDRO infection during the study period, 57% became positive in the NH, 41% in the ACH, and 2% in other settings (eg, at a private home or apartment).Conclusion.Even though NHs are the most likely setting where residents would acquire MDROs after admission to an NH (accounting for 57% of cases), a significant fraction of NH residents acquire MDRO infection at ACHs (41%). Thus, effective MDRO infection control for NH residents requires simultaneous, cooperative interventions among NHs and ACHs in the same community.</jats:sec

The estimation of withers height of ancient horse : New estimation formulations by using the metacarpal measurements of living horse

In this study, a total of 150 horses have been used from different modern (living) breeds. They include Arab, Thoroughbred, German-Holstein, Haflinger and Hungarian Warmblood horse breeds. Thirty individuals have been chosen (15 mares and 15 stallions) from each of these breeds. Following the withers height measurements, gender and age of the horses, the radiography of the metacarpals were taken. Metacarpal measurements were taken radiographically in third metacarpal bones of the living horses by using a mobile X-Ray device with DR System Flat Panel detector. Then, regression formulae to be used in the estimation of withers height were determined by using the metacarpal measurements. "Stepwise regression", in particular, was preferred in this analysis. Thus, models possessing the highest coefficient of determination with the least factors were formed. Also, multipliers were obtained according to the height of the withers/greatest length and lateral length on the outer side model. These formulations and multipliers were models including joint space, muscle and skin, in relation to the formulation and multipliers reported in the very limited and debatable literary data. Therefore, the debatable points and shortcomings of old formulations obtained from montage skeletons were rectified