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PubMed2004

[Pharyngitis due to Burkholderia cepacia. Person-to-person transmission].

Burkholderia cepacia is a Gram-negative bacillus that is widely distributed in nature; it is isolated from the ground, water, plants and vegetables. Generally, it produces nosocomial infection due to contamination of disinfectants, medical equipment, prosthetic material and drugs, such as anesthetics or liquids used in urological irrigation. The most probable mechanism of transmission is through hospital material or through fomites among people after contact for several weeks or months. Recently, it has been considered as an important pathogen in immunocompromised patients, or in those with significant underlying diseases, such as chronic granulomastosis or cystic fibrosis. We present a case of pharyngitis due to B. cepacia and its transmission within a few days in two immunocompetent twin siblings without previous underlying diseases. The infection disappeared after specific treatment for this microorganism was started. We believe that samples should be taken from the pharynx and nasal pits in patients with acute upper respiratory tract processes that do not respond to empiric antibiotic treatment, before classifying them as viral infection without etiologic diagnosis.

Burkholderia Infections↗
PubMed1996

From planning to articulation in speech production: what differentiates a person who stutters from a person who does not stutter?

The main purpose of the present study was to differentiate between people who stutter and control speakers regarding their ability to assemble motor plans and to prepare (and execute) muscle commands. Adult males who stutter, matched for age, gender, and educational level with a group of control speakers, were tested on naming words and symbols. In addition, their ability to encode and retrieve memory representations of combinations of a symbol and a word, was tested in a recognition task, using manual reaction times and sensitivity scores, as defined in signal detection theory, as performance measures. Group differences in muscle command preparation were assessed from electromyographic recordings of upper lip and lower lip. Results indicated no interaction between group and word size effects in choice reaction times or a group effect in the ability to recognize previously learned symbol-word combinations. However, they were significantly different in the timing of peak amplitudes in the integrated electromyographic signals of upper lip and lower lip (IEMG peak latency). Findings question the claim that people who stutter have problems in creating abstract motor plans for speech. In addition, it is argued that the group differences in IEMG peak latency that were found in the present study might be better understood in terms of motor control strategies than in terms of motor control deficits.

Adult↗
PubMed1994

The views and values of community nurses and their managers: research in progress--one person's pain, another person's vision.

This paper presents preliminary findings from research being carried out into how community nurses in three first-wave community trusts are responding to changes stemming from recent legislation. A Measure of Job Satisfaction was devised for the study for administration to the entire nursing workforce in the participating trusts and semi-structured interviews were carried out with managers at all levels in each of the trusts. This paper concentrates on the textual data arising from the study dealing with how nurses understood the values of managers and how managers viewed nurses' values. Nurses tended to express their beliefs about managers as a series of us-them oppositions while the comments of managers can be seen within a rational/irrational dualism. Some possible theoretical frameworks in which these texts can be further explored are briefly discussed, including Foucault's power/knowledge concept and the literature of 'colonization'.

Attitude of Health Personnel↗
PubMed2002

Campylobacter DNA is present in circulating myelomonocytic cells of healthy persons and in persons with Guillain-Barré syndrome.

Campylobacter jejuni is the prime cause of foodborne bacterial gastroenteritis. An important complication of C. jejuni enteritis is Guillain-Barré syndrome (GBS), an immune-mediated disorder of the peripheral nerve. The presence of C. jejuni DNA in peripheral blood mononuclear cells (PBMC) of patients with GBS, patients with C. jejuni enteritis, and healthy subjects was studied. Two target genes, the flagellin and the ceuE genes, were used for polymerase chain reaction (PCR) identification of Campylobacter species in DNA extracted from PBMC. Approximately 30% of the healthy subjects and 50% of the patients with GBS had PBMC containing C. jejuni DNA as verified by Southern blot analysis or sequencing of the PCR products. Cell sorting revealed that Campylobacter DNA was present in CD14(+) and CD33(+) populations, indicating that cells from the myelomonocytic lineage are the Campylobacter DNA-carrying cells. These findings show that Campylobacter DNA is present in blood cells of healthy humans, although viable bacteria could not be demonstrated.

Campylobacter jejuni↗
PubMed2004

Hepatotoxicity of rifampin and pyrazinamide in the treatment of latent tuberculosis infection in HIV-infected persons: is it different than in HIV-uninfected persons?

BACKGROUND: In 2000, results of a multinational trial demonstrated that a 2-month course of rifampin and pyrazinamide (RZ) was as effective as isoniazid (INH) in reducing tuberculosis in human immunodeficiency virus (HIV)-infected individuals with latent tuberculosis infection (LTBI). After the release of new guidelines, the Centers for Disease Control and Prevention received reports of severe hepatotoxicity associated with the use of the RZ regimen for the treatment of LTBI in the general population. To better understand the occurrence of hepatotoxicity in an HIV-infected population, we conducted a more detailed analysis of the liver function test results obtained in the multinational trial of RZ. METHODS: At study entry, patients were required to have a bilirubin level of < or =2.5 mg/dL and both an aspartate aminotransferase (AST) level and an alkaline phosphatase level of < or =5 times the upper limit of normal. Patients with acute hepatitis were excluded. At months 1 and 2 of the study, all patients had bilirubin and AST levels measured. RESULTS: There was no difference between the RZ and INH groups with regard to AST level or bilirubin level at baseline. An increase in the AST level of > or =40 U/L was associated with the use of INH and older age; and an increase in the bilirubin level of > or =0.5 mg/dL was associated with the use of RZ, male sex, and nonwhite race (P<.05). An absolute AST level of >250 U/L occurred in 12 of 745 INH recipients and in 15 of 721 RZ recipients (P=.56), and an absolute bilirubin level of >2.5 mg/dL occurred in 5 of 743 INH recipients and 13 of 718 RZ recipients (P=.06). CONCLUSIONS: These data demonstrate very little liver injury associated with either INH or RZ in the HIV-infected subjects, leaving unclear the reasons for serious RZ-related liver damage in the general population.

Adolescent↗
PubMed1998

Evidence for person-to-person transmission of Candida lusitaniae in a neonatal intensive-care unit.

Candida lusitaniae is an increasingly important nosocomial bloodstream pathogen. Epidemiological investigation and molecular typing techniques identified three neonates infected with identical strains of C lusitaniae that were distinguished readily from epidemiologically unrelated strains from other locations in the hospital. The results of this study provide evidence for nosocomial transmission of C lusitaniae in a neonatal intensive-care unit and suggest that these infants are at increased risk for infection with this agent.

Amphotericin B↗
PubMed2005

Person-to-person transmission of hepatitis A virus in an urban area of intermediate endemicity: implications for vaccination strategies.

Developing countries with an increasing hepatitis A disease burden may target vaccination to specific groups, such as young children, as an initial control strategy. To better understand transmission of hepatitis A virus in such countries, the authors prospectively studied household and day-care/school contacts of cases in Almaty, Kazakhstan. Overall, by the time of identification of symptomatic index cases, half of transmission had already occurred, having been detected retrospectively. The odds of household contacts' becoming infected were 35.4 times those for day-care/school contacts (95% confidence interval (CI): 17.5, 71.7). Within households, younger age of either index cases or susceptible contacts elevated the odds of secondary infection among susceptible contacts: The presence of a case under 6 years of age raised the odds 4.7 times (95% CI: 1.2, 18.7); and compared with contacts aged 14 years or older, the odds of infection were increased to 7.7 (95% CI: 1.5, 40.3) and 7.0 (95% CI: 1.4, 34.3) among contacts aged 0-6 years and 7-13 years, respectively. Young children are appropriate targets for sustainable hepatitis A vaccination programs in areas undergoing hepatitis A epidemiologic transition. If vaccine is determined to be highly effective postexposure and if it is feasible, vaccinating household contacts could be a useful additional control strategy.

Adolescent↗