On constructions preserving the asymptotic topology of metric spaces

We prove that graph products constructed over infinite graphs with bounded clique number preserve finite asymptotic dimension. We also study the extent to which Dranishnikov's property C, and Dranishnikov and Zarichnyi's straight finite decomposition complexity are preserved by constructions such as unions, free products, and group extensions.Comment: 13 pages, accepted for publication in NC Journal of Mathematics and Statistic

Diagnosis and management of pneumonia in the emergency department.

Pneumonia is a condition that is often treated by emergency physicians. This article reviews the diagnosis and management of pneumonia in the emergency department and highlights dilemmas in diagnostic testing, use of blood and sputum cultures, hospital admission decisions, infection control, quality measures for pneumonia care, and empiric antimicrobial therapy

Antibiotic Prescribing Practices of Emergency Physicians and Patient Expectations for Uncomplicated Lacerations

<p>Introduction: Prophylactic antibiotics have not been found to have a benefit in the setting of uncomplicated lacerations. We evaluated the proportion of patients with uncomplicated lacerations who are prescribed prophylactic antibiotics in the emergency department (ED), factors that physicians considered when prescribing antibiotics, and factors associated with patient satisfaction.</p> <p>Methods: Adults and children presenting to 10 academic EDs with acute lacerations were enrolled. Enrolled patients were interviewed before and after their physician encounter in the ED and 2 weeks later. Physicians were interviewed in the ED after the patient encounter about factors that influenced their management decisions, including their perceptions of patients’ expectations. We included patients with uncomplicated lacerations (without contamination, infection, bone, tendon, or joint involvement) for analysis.</p> <p>Results: Of 436 patients enrolled, 260 had uncomplicated lacerations, and of these, 55 (21%) were treated with antibiotics in the ED or by prescription. Physicians were more likely to use antibiotics when the wound was more than 8 hours old, involved a puncture or amputation, and when the patient lacked medical insurance. A treatment course of 7 days or greater was given to 24 of 45 patients (53%) receiving outpatient prescriptions. Patient satisfaction was not associated with antibiotic use.</p> <p>Conclusion: Antibiotics were used for about one fifth of ED patients with uncomplicated lacerations despite a lack of evidence for efficacy. [West J Emerg Med. 2011;12(4):375–380.]</p

Neurocysticercosis in Radiographically Imaged Seizure Patients in U.S. Emergency Departments1

Neurocysticercosis appears to be on the rise in the United States, based on immigration patterns and published cases series, including reports of domestic acquisition. We used a collaborative network of U.S. emergency departments to characterize the epidemiology of neurocysticercosis in seizure patients. Data were collected prospectively at 11 university-affiliated, geographically diverse, urban U.S. emergency departments from July 1996 to September 1998. Patients with a seizure who underwent neuroimaging were included. Of the 1,801 patients enrolled in the study, 38 (2.1%) had seizures attributable to neurocysticercosis. The disease was detected in 9 of the 11 sites and was associated with Hispanic ethnicity, immigrant status, and exposure to areas where neurocysticercosis is endemic. This disease appears to be widely distributed and highly prevalent in certain populations (e.g., Hispanic patients) and areas (e.g., Southwest)

Association Between Appendectomy and Clostridium difficile Infection

BackgroundRecent theory proposes that the appendix functions as a reservoir for commensal bacteria, and serves to re-inoculate the colon with normal flora in the event of pathogen exposure or purging of intestinal flora. If true, we reasoned that flora from a normal appendix could provide protection against Clostridium difficile. We conducted this investigation to examine the protective effect of an intact appendix and test the hypothesis that prior appendectomy will be more common among patients with a positive test for C. difficile as compared with patients who test negative.MethodsWe contacted patients who had undergone C. difficile testing and asked them whether or not they had a prior appendectomy. Using their responses and results from Toxin A &amp; B EIA tests, we calculated the difference in appendectomy rates between those who tested positive for C. difficile, and those who tested negative. We considered a positive 15% absolute difference to represent a significant increase in appendectomy rate.ResultsWe enrolled 257 patients. Among the 136 who tested positive for C. difficile, 27 (19.9%) had prior appendectomies, while among 121 patients testing negative for C. difficile, 38 (31.4%) had prior appendectomies, yielding a difference in appendectomy rates of -11.6% (95% Confidence Interval: -21.6% to -0.9%).ConclusionsThe rate of prior appendectomy was actually lower among patients with a positive C. difficile test as compared to those with a negative test. Conversely, patients who tested positive for C. difficile were more likely to have an intact appendix than those who tested negative. These results suggest that rather than being protective, an intact appendix appears to promote C. difficile acquisition, carriage, and disease.KeywordsClostridium difficile; Appendix; Appendectomy; Microbial reservoir; Infection