522 research outputs found

    A Case Report of Multiple Aseptic Facial and Spinal Abscesses in a 45-Year-Old with Inflammatory Bowel Disease

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    INTRODUCTION Sterile abscess syndrome is a rarely described entity that is often associated with auto-inflammatory disorders. Although clinically similar to septic abscesses, sterile abscesses are known to be unaffected by antibiotic regimens and instead highly sensitive to steroids. The association of sterile abscesses with inflammatory bowel disease has been well-described. The majority of sterile abscess syndromes described in the literature are intraabdominal abscesses related to a primary gastrointestinal inflammatory disease. We describe a unique case of extra-abdominal sterile abscess syndrome associated with inflammatory bowel disease presenting as facial and paraspinal lesions

    Mood disorders in high-functioning autism : the importance of alexithymia and emotional regulation

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    KPM received support from MH018268-31 and receives support from K01DA042937. SJ received support from MH018268-33. MNP receives support from the Connecticut Council on Problem Gambling, and the Connecticut Department of Mental Health and Addiction Services.Individuals with autism spectrum disorder (ASD) often have co-morbid anxiety and depression. Alexithymia and emotion regulation difficulties are commonly seen in individuals with ASD and in mood disorders. We hypothesized that alexithymia and emotional regulation would mediate the relationship between autistic features and anxiety/depression symptom severity. We collected data about emotional regulation, alexithymia, autistic symptoms and depression/anxiety in a sample of 64 young adults with ASD. We constructed two serial multiple mediator models, using autistic features as the independent variable and anxiety/depression symptoms as outcome variables. The serial relationship between alexithymia and emotional regulation mediated associations between autistic features and depression and anxiety, separately. The findings suggest that targeting alexithymia may benefit therapies designed to alleviate mood disorders in ASD.PostprintPeer reviewe

    Success With Extended-Infusion Meropenem After Recurrence of Baclofen Pump-Related Achromobacter Xylosoxidans Meningitis in an Adolescent

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    A 13-year-old female experienced a recurrence of baclofen pump-related central nervous system (CNS) infection caused by Achromobacter, despite absence of retained foreign material. Due to the failure of meropenem (120 mg/kg/d in divided doses every 8 hours and infused over 30 minutes) in the initial infection, the dose was infused over 4 hours during the recurrence. Meropenem is an antibiotic for which efficacy is time dependent, and 4-hour versus 30-minute infusions have been shown to prolong the time the concentration of the antibiotic exceeds the minimum inhibitory concentration (MIC) of the organism at the site of infection (T\u3eMIC). Meropenem serum concentrations were obtained and indicated that T\u3eMIC was at least 75% of the dosing interval. Our patient improved with no noted recurrences or adverse effects on the extended-infusion meropenem regimen. Utilization of extended-infusion beta-lactam dosing whenever possible in the treatment of serious infections caused by gram-negative organisms should be considered, as this dosing appears to be safe and improves the probability of achieving pharmacokinetic/pharmacodynamic goals

    The effect of adding comorbidities to current centers for disease control and prevention central-line–associated bloodstream infection risk-adjustment methodology

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    BACKGROUNDRisk adjustment is needed to fairly compare central-line–associated bloodstream infection (CLABSI) rates between hospitals. Until 2017, the Centers for Disease Control and Prevention (CDC) methodology adjusted CLABSI rates only by type of intensive care unit (ICU). The 2017 CDC models also adjust for hospital size and medical school affiliation. We hypothesized that risk adjustment would be improved by including patient demographics and comorbidities from electronically available hospital discharge codes.METHODSUsing a cohort design across 22 hospitals, we analyzed data from ICU patients admitted between January 2012 and December 2013. Demographics and International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) discharge codes were obtained for each patient, and CLABSIs were identified by trained infection preventionists. Models adjusting only for ICU type and for ICU type plus patient case mix were built and compared using discrimination and standardized infection ratio (SIR). Hospitals were ranked by SIR for each model to examine and compare the changes in rank.RESULTSOverall, 85,849 ICU patients were analyzed and 162 (0.2%) developed CLABSI. The significant variables added to the ICU model were coagulopathy, paralysis, renal failure, malnutrition, and age. The C statistics were 0.55 (95% CI, 0.51–0.59) for the ICU-type model and 0.64 (95% CI, 0.60–0.69) for the ICU-type plus patient case-mix model. When the hospitals were ranked by adjusted SIRs, 10 hospitals (45%) changed rank when comorbidity was added to the ICU-type model.CONCLUSIONSOur risk-adjustment model for CLABSI using electronically available comorbidities demonstrated better discrimination than did the CDC model. The CDC should strongly consider comorbidity-based risk adjustment to more accurately compare CLABSI rates across hospitals.Infect Control Hosp Epidemiol 2017;38:1019–1024</jats:sec

    What Made Me the Teacher I Am Today? A Reflection by Selected Leonore Annenberg-Woodrow Wilson Teaching Fellows

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    The report offers a series of short essays from 18 teachers, each reflecting on what inspired and guided them into the teaching profession. Some of the highlights include:"I've come to realize that my learning process in the classroom actually feels a whole lot like the science I practiced at the bench: engineering experimental procedures, collecting and analyzing data, and formulating questions about next steps. It turns out that my scientific worldview can really improve learning outcomes for my students," said Kristin Milks, a biology and earth science teacher in Bloomington, IN, who enrolled in a teacher preparation program shortly after completing her Ph.D. in biochemistry."What transforms someone from being a good teacher to being a great teacher is the passion to make connections with students, to constantly evaluate and adjust their practice to do what is in the students' best interest," said Catherine Ann Haney, a Virginia Spanish teacher who has recently been teaching in Santiago, Chile."Enrolling in a teacher education program, instead of starting my career as a teacher first and then obtaining my master's degree after, meant I had a cohort of other soon-to-be teachers to learn with as we persevered through a very rigorous and demanding year," said Jeremy Cress, a math teacher in Philadelphia."I realized that being a good math teacher does not mean explaining clearly, making kids like me, or making math fun. Rather, it means giving students the opportunity to solve problems by themselves from start to finish, to struggle and persevere, and to learn from each other's particular strengths," said Brittany Leknes, a math teacher from Sunnyvale, CA."Together my students and I co-create their identities, their sense of themselves, and their understanding of their place in society. Because I believe wholly in my students' own power, I teach to disrupt school cultures that suggest that students need to be anything less than their whole selves," said Kayla Vinson, who taught social students in the Harlem Children's Zone.Created in 2007, the Leonore Annenberg-Woodrow Wilson Teaching Fellowship was designed to serve as the equivalent of a national "Rhodes Scholarship" for teaching. Working with Stanford University, the University of Pennsylvania, the University of Virginia, and the University of Washington, the Woodrow Wilson Foundation provided $30,000 stipends for exceptionally able candidates to complete a yearlong master's degree program. In exchange, the teacher candidates agreed to teach for three years in high-need secondary schools across the country. The Leonore Annenberg Teaching Fellowship was funded through grants from the Annenberg Foundation and Carnegie Corporation of New York. It served as the basis for the Woodrow Wilson Foundation's successful Teaching Fellowship program, which now operates in five states (Georgia, Indiana, Michigan, New Jersey, and Ohio), operating in partnership with 28 universities. Woodrow Wilson Teaching Fellows complete a rigorous yearlong master's degree program, coupled with a robust yearlong clinical experience. Once they earn their degrees, Woodrow Wilson Teaching Fellows teach in high-need STEM classrooms, while receiving three years of coaching and mentoring

    Chlamydia trachomatis Serology in Women with and without Ovarian Cancer

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    Pelvic inflammation has been implicated in the genesis of ovarian cancer. We conducted serologic measurements of Chlamydia trachomatis antibodies as a surrogate marker of chlamydial pelvic inflammatory disease. Women with ovarian cancer (n = 521) and population-based controls (n = 766) were tested. IgG antibodies to serovar D of chlamydia elementary bodies (EBs) were detected using an ELISA assay. The odds of having ovarian cancer among women with the highest titers (≥0.40 OD units) were 0.6 (95% CI 0.4–0.9). These data do not support our earlier finding of elevated titers for antibodies to C. trachomatis among women with ovarian cancer

    Development of Critical Consciousness Scale for Civil Engineering Students

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    Recent research shows the engineers continue to think less critically at the end of their undergraduate engineering degrees and fail ro adhere to their professional responsibility. A key component to addressing these issues includes assessing engineers\u27 critical consciousness (CC). The development of a Critical Consciousness Scale (CCS) is important for civil engineering education as it assists practitioners and educators with better means to assess whether ant interventions (e.g. ABET) and indeed efficacious.https://openprairie.sdstate.edu/asee_nmws_2020_posters/1004/thumbnail.jp
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