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Moore G, Barry A, Carter J, Ready J, Wan Y, Elsayed M, Haill C, Khashu M, Williams OM, Brown CS, Demirjian A, Ready D. Detection, survival, and persistence of Staphylococcus capitis NRCS-A in neonatal units in England. J Hosp Infect 2023; 140:8-14. [PMID: 37487793 DOI: 10.1016/j.jhin.2023.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND The multidrug-resistant Staphylococcus capitis clone, NRCS-A, is increasingly associated with late-onset sepsis in low birthweight newborns in neonatal intensive care units (NICUs) in England and globally. Understanding where this bacterium survives and persists within the NICU environment is key to developing and implementing effective control measures. AIM To investigate the potential for S. capitis to colonize surfaces within NICUs. METHODS Surface swabs were collected from four NICUs with and without known NRCS-A colonizations/infections present at the time of sampling. Samples were cultured and S. capitis isolates analysed via whole-genome sequencing. Survival of NRCS-A on plastic surfaces was assessed over time and compared to that of non-NRCS-A isolates. The bactericidal activity of commonly used chemical disinfectants against S. capitis was assessed. FINDINGS Of 173 surfaces sampled, 40 (21.1%) harboured S. capitis with 30 isolates (75%) being NRCS-A. Whereas S. capitis was recovered from surfaces across the NICU, the NRCS-A clone was rarely recovered from outside the immediate neonatal bedspace. Incubators and other bedside equipment were contaminated with NRCS-A regardless of clinical case detection. In the absence of cleaning, S. capitis was able to survive for three days with minimal losses in viability (<0.5 log10 reduction). Sodium troclosene and a QAC-based detergent/disinfectant reduced S. capitis to below detectable levels. CONCLUSION S. capitis NRCS-A can be readily recovered from the NICU environment, even in units with no recent reported clinical cases of S. capitis infection, highlighting a need for appropriate national guidance on cleaning within the neonatal care environment.
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Affiliation(s)
- G Moore
- UK Health Security Agency, UK.
| | - A Barry
- UK Health Security Agency, UK
| | | | - J Ready
- UK Health Security Agency, UK
| | - Y Wan
- UK Health Security Agency, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Imperial College London, London, UK
| | - M Elsayed
- Royal United Hospital, Bath NHS Foundation Trust, Bath, UK; Southmead Hospital, North Bristol Trust, Bristol, UK
| | - C Haill
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - M Khashu
- University Hospitals Dorset, Poole, UK
| | - O M Williams
- UK Health Security Agency, UK; Bristol Royal Infirmary, Bristol NHS Foundation Trust, UK
| | - C S Brown
- UK Health Security Agency, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Imperial College London, London, UK
| | - A Demirjian
- UK Health Security Agency, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Imperial College London, London, UK; Department of Paediatric Infectious Diseases & Immunology, Evelina London Children's Hospital, London, UK; Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - D Ready
- UK Health Security Agency, UK; Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
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Ready J, Negut V, Mihailescu L, Vetter K. MO-FG-CAMPUS-JeP1-01: Prompt Gamma Imaging with a Multi-Knife-Edge Slit Collimator: Evaluation for Use in Proton Beam Range Verification. Med Phys 2016. [DOI: 10.1118/1.4957338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ready J, Pak R, Mihailescu L, Vetter K. WE-EF-303-03: A New Aperture-Based Imaging System for Prompt-Gamma Range Verification of Proton Beam Therapy. Med Phys 2015. [DOI: 10.1118/1.4925994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Tanny S, Roth A, Peeler C, Rodrigues A, Ready J. SU-E-E-04: Assessment of Medical Physics Students and Trainees Interest and Awareness of Non-Clinical Careers. Med Phys 2015. [DOI: 10.1118/1.4923926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Lacin T, Ready J, DaSilva MC, Talbot S, Bueno R, Sugarbaker DJ, Jaklitsch M. 342-I * BIOLOGICAL STERNAL RECONSTRUCTION WITH ILIAC WING BONE AUTOGRAFT AND BIOABSORBABLE PLATES. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Raut CP, George S, Hornick JL, Butrynski JE, Morgan JA, Ready J, Nascimento AF, Fletcher CD, Demetri GD, Baldini EH. High rates of histopathologic discordance in sarcoma with implications for clinical care. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Jäger M, Begg M, Ready J, Bittersohl B, Millis M, Krauspe R, Thornhill T. Primary total hip replacement in childhood, adolescence and young patients: Quality and outcome of clinical studies. Technol Health Care 2008. [DOI: 10.3233/thc-2008-16305] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- M. Jäger
- Department of Orthopaedics, Heinrich-Heine University Medical School, Düsseldorf, Germany
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - M.J.W. Begg
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Orthopaedics, Queen Elisabeth Hospital, Woodville, SA, Australia
- The University of Adelaide, SA, Australia
| | - J. Ready
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - B. Bittersohl
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
- Department of Orthopaedic Surgery, Inspel Spital, University of Bern, Bern, Switzerland
| | - M. Millis
- Department of Orthopedic Surgery, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA
| | - R. Krauspe
- Department of Orthopaedics, Heinrich-Heine University Medical School, Düsseldorf, Germany
| | - T.S. Thornhill
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Jäger M, Begg MJW, Ready J, Bittersohl B, Millis M, Krauspe R, Thornhill TS. Primary total hip replacement in childhood, adolescence and young patients: quality and outcome of clinical studies. Technol Health Care 2008; 16:195-214. [PMID: 18641439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The present meta-analysis illustrates relevant information about hip replacement in young patients that has been published during the past 3 decades. MATERIAL AND METHODS Based on a MedLine literature review a total of 95 studies were evaluated. Parameters for evaluation of study quality and outcome were implant survival rates (ISR),number of patients, indications, follow-up, surgical approaches and number of surgeons. RESULTS Most studies consider patient numbers <50. In 33 studies one implant system was applied compared to 65 studies in which more than one system was used. Most studies include different surgical approaches. 20% of all studies contained neither the number of surgeons,nor the type of surgical approach. The overall ISR could be evaluated in 67 studies. Sufficient data about the ISR of stem and/or sockets were available in 50 papers. CONCLUSIONS Most published studies analyzed inhomogeneous study populations; study variables vary as do the implants used for treatment.
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Affiliation(s)
- M Jäger
- Department of Orthopaedics, Heinrich-Heine University Medical School, Düsseldorf, Germany.
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Abstract
This study examined daily reports of pain, medication use, health care use, and activity reduction in adults with sickle cell disease, and their association with stress. Participants were 53 adults with sickle cell disease. They completed the Daily Hassles questionnaire at the start of the study, and they kept daily records of pain and pain response over the following 14 days. On average, patients reported pain on 6.5 days of the 14-day study period. The average pain intensity rating during a painful episode was 4.4 on a 10-point scale. Pain was most often managed at home. Patients took medication (analgesics and/or narcotics) on 80% of the days they experienced pain, and they were more likely to use medication, particularly narcotics, as pain levels increased. At higher pain levels some patients also utilized a range of health care services. On average, patients also cut back considerably on household and social activities, especially when pain reached a level of over 5 on the 10-point scale. Those who were employed, however, were likely to continue to work, even when in pain. In addition, stress had significant positive associations with average pain intensity as well as reductions in household and social activities. Furthermore, stress predicted activity reductions even after controlling for pain intensity. Stress was unrelated to medication and health care use in this study.
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Affiliation(s)
- L S Porter
- Department of Psychology, University of North Carolina, Chapel Hill, NC 27599-3270, USA
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Gil KM, Wilson JJ, Edens JL, Workman E, Ready J, Sedway J, Redding-Lallinger R, Daeschner CW. Cognitive coping skills training in children with sickle cell disease pain. Int J Behav Med 1997; 4:364-77. [PMID: 16250724 DOI: 10.1207/s15327558ijbm0404_7] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This study was designed to examine whether brief training in cognitive coping skills would enhance pain coping strategies and alter pain perception in children and adolescents with sickle cell disease (SCD). Forty-nine participants with SCD were randomly assigned to either a cognitive coping skills condition or a standard care control condition. At pre- and posttesting, coping strategies and pain sensitivity using laboratory pain stimulation were measured. Results indicated that in comparison to the randomly assigned control condition, brief training in cognitive coping skills resulted in decreased negative thinking and lower pain ratings during low intensity laboratory pain stimulation.
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Affiliation(s)
- K M Gil
- Department of Psychology, University of North Carolina, Chapel Hill, NC, USA
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Ready J, Rector WG. Systemic hemodynamic changes in portal hypertension. Semin Gastrointest Dis 1995; 6:134-9. [PMID: 7551970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- J Ready
- Kaiser Permanente Medical Center, Santa Clara, CA 95051, USA
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Abstract
We report a non-randomized Phase II clinical trial to assess the efficacy and safety of liposomal daunorubicin (DaunoXome) in the treatment of AIDS related Kaposi's sarcoma. Eleven homosexual men with advanced Kaposi's sarcoma were entered in the trial. Changes in size, colour and associated oedema of selected 'target' lesions were measured. Clinical, biochemical and haematological toxicities were assessed. Ten subjects were evaluated. A partial response was achieved in four, of whom two subsequently relapsed. Stabilization of Kaposi's sarcoma occurred in the remaining six, maintained until the end of the trial period in four. The drug was generally well tolerated, with few mild symptoms of toxicity. The main problem encountered was haematological toxicity, with three subjects experiencing severe neutropenia (neutrophil count < 0.5 x 10(9)/l). There was no evidence of cardiotoxicity. In this small patient sample, liposomal daunorubicin was an effective and well tolerated agent in the treatment of Kaposi's sarcoma.
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Abstract
The hypothesis that a countercurrent multiplier within the intestinal villus increases osmolality in the distal villus tip was tested. Total sodium, potassium, and water content of intestinal tissue samples was measured. The results showed no significant difference in the total Na plus K concentration (millimoles per kilogram H2O +/- SEM) between the villi tips (185.1 +/- 7.7), whole villi (179.8 +/- 5.4), or intestine minus villi (177.2 +/- 1.7). In contrast, in the kidney (where the existence of a countercurrent multiplier has been demonstrated), the renal medulla had a total Na plus K concentration of 284 +/- 17.1 that was significantly more than the renal cortical concentration of 163 +/- 3.1. Villous tissue osmolality should be in osmotic equilibrium with intestinal luminal fluid. Sampling of intestinal luminal fluid revealed a total Na plus K concentration of 145-165 mmol/kg H2O, a figure compatible with normal luminal osmolality of 280-320 mosmol/kg H2O. These results deny the existence of a countercurrent multiplier in the intestinal villus of the dog.
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Affiliation(s)
- M N Eade
- Department of Physiology, School of Medicine, University of Auckland, New Zealand
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Bell RS, Ready J, Hudson A, O'Sullivan B, Mahoney J, Richards R, Davis A, Fornasier VL. Non-neurogenic soft tissue tumours of the axilla: prospective review of 16 cases. J Surg Oncol 1989; 42:73-9. [PMID: 2796350 DOI: 10.1002/jso.2930420203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Sixteen consecutive patients entered in a prospective study of non-neurogenic soft tissue tumours had lesions in the axilla. Delayed diagnosis and inappropriate biopsy prior to referral to a surgical oncologist were frequent findings. Sarcoma and fibromatosis were diagnosed in 14 cases, and the approaches used for these two diseases were fundamentally different. The functional outcome with limb salvage surgery in these patients is presented.
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Affiliation(s)
- R S Bell
- Orthopaedic Oncology Unit, St. Michael's Hospital, Toronto, Ontario, Canada
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