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Aden TA, Blevins P, York SW, Rager S, Balachandran D, Hutson CL, Lowe D, Mangal CN, Wolford T, Matheny A, Davidson W, Wilkins K, Cook R, Roulo RM, White MK, Berman L, Murray J, Laurance J, Francis D, Green NM, Berumen RA, Gonzalez A, Evans S, Hudziec M, Noel D, Adjei M, Hovan G, Lee P, Tate L, Gose RB, Voermans R, Crew J, Adam PR, Haydel D, Lukula S, Matluk N, Shah S, Featherston J, Ware D, Pettit D, McCutchen E, Acheampong E, Buttery E, Gorzalski A, Perry M, Fowler R, Lee RB, Nickla R, Huard R, Moore A, Jones K, Johnson R, Swaney E, Jaramillo J, Reinoso Webb C, Guin B, Yost J, Atkinson A, Griffin-Thomas L, Chenette J, Gant J, Sterkel A, Ghuman HK, Lute J, Smole SC, Arora V, Demontigny CK, Bielby M, Geeter E, Newman KAM, Glazier M, Lutkemeier W, Nelson M, Martinez R, Chaitram J, Honein MA, Villanueva JM. Rapid Diagnostic Testing for Response to the Monkeypox Outbreak - Laboratory Response Network, United States, May 17-June 30, 2022. MMWR Morb Mortal Wkly Rep 2022; 71:904-907. [PMID: 35834423 PMCID: PMC9290387 DOI: 10.15585/mmwr.mm7128e1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
As part of public health preparedness for infectious disease threats, CDC collaborates with other U.S. public health officials to ensure that the Laboratory Response Network (LRN) has diagnostic tools to detect Orthopoxviruses, the genus that includes Variola virus, the causative agent of smallpox. LRN is a network of state and local public health, federal, U.S. Department of Defense (DOD), veterinary, food, and environmental testing laboratories. CDC developed, and the Food and Drug Administration (FDA) granted 510(k) clearance* for the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set (non-variola Orthopoxvirus [NVO] assay), a polymerase chain reaction (PCR) diagnostic test to detect NVO. On May 17, 2022, CDC was contacted by the Massachusetts Department of Public Health (DPH) regarding a suspected case of monkeypox, a disease caused by the Orthopoxvirus Monkeypox virus. Specimens were collected and tested by the Massachusetts DPH public health laboratory with LRN testing capability using the NVO assay. Nationwide, 68 LRN laboratories had capacity to test approximately 8,000 NVO tests per week during June. During May 17-June 30, LRN laboratories tested 2,009 specimens from suspected monkeypox cases. Among those, 730 (36.3%) specimens from 395 patients were positive for NVO. NVO-positive specimens from 159 persons were confirmed by CDC to be monkeypox; final characterization is pending for 236. Prompt identification of persons with infection allowed rapid response to the outbreak, including isolation and treatment of patients, administration of vaccines, and other public health action. To further facilitate access to testing and increase convenience for providers and patients by using existing provider-laboratory relationships, CDC and LRN are supporting five large commercial laboratories with a national footprint (Aegis Science, LabCorp, Mayo Clinic Laboratories, Quest Diagnostics, and Sonic Healthcare) to establish NVO testing capacity of 10,000 specimens per week per laboratory. On July 6, 2022, the first commercial laboratory began accepting specimens for NVO testing based on clinician orders.
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2
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Adamkiewicz D, Maslesa A, Atri L, Berman L, Jones C, Broughton R, Lyon M. 188 Implementation of a Telemedicine Student Clinic. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.199] [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: 10/20/2022]
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3
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Nguyen-Van-Tam JS, Killingley B, Enstone J, Hewitt M, Pantelic J, Grantham ML, Bueno de Mesquita PJ, Lambkin-Williams R, Gilbert A, Mann A, Forni J, Noakes CJ, Levine MZ, Berman L, Lindstrom S, Cauchemez S, Bischoff W, Tellier R, Milton DK. Minimal transmission in an influenza A (H3N2) human challenge-transmission model within a controlled exposure environment. PLoS Pathog 2020; 16:e1008704. [PMID: 32658939 PMCID: PMC7390452 DOI: 10.1371/journal.ppat.1008704] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/29/2020] [Accepted: 06/14/2020] [Indexed: 12/22/2022] Open
Abstract
Uncertainty about the importance of influenza transmission by airborne droplet nuclei generates controversy for infection control. Human challenge-transmission studies have been supported as the most promising approach to fill this knowledge gap. Healthy, seronegative volunteer ‘Donors’ (n = 52) were randomly selected for intranasal challenge with influenza A/Wisconsin/67/2005 (H3N2). ‘Recipients’ randomized to Intervention (IR, n = 40) or Control (CR, n = 35) groups were exposed to Donors for four days. IRs wore face shields and hand sanitized frequently to limit large droplet and contact transmission. One transmitted infection was confirmed by serology in a CR, yielding a secondary attack rate of 2.9% among CR, 0% in IR (p = 0.47 for group difference), and 1.3% overall, significantly less than 16% (p<0.001) expected based on a proof-of-concept study secondary attack rate and considering that there were twice as many Donors and days of exposure. The main difference between these studies was mechanical building ventilation in the follow-on study, suggesting a possible role for aerosols. Understanding the relative importance of influenza modes of transmission informs strategic use of preventive measures to reduce influenza risk in high-risk settings such as hospitals and is important for pandemic preparedness. Given the increasing evidence from epidemiological modelling, exhaled viral aerosol, and aerobiological survival studies supporting a role for airborne transmission and the potential benefit of respirators (and other precautions designed to prevent inhalation of aerosols) versus surgical masks (mainly effective for reducing exposure to large droplets) to protect healthcare workers, more studies are needed to evaluate the extent of risk posed airborne versus contact and large droplet spray transmission modes. New human challenge-transmission studies should be carefully designed to overcome limitations encountered in the current study. The low secondary attack rate reported herein also suggests that the current challenge-transmission model may no longer be a more promising approach to resolving questions about transmission modes than community-based studies employing environmental monitoring and newer, state-of-the-art deep sequencing-based molecular epidemiological methods.
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Affiliation(s)
- Jonathan S. Nguyen-Van-Tam
- Health Protection and Influenza Research Group, Division of Epidemiology and Public Heath, University of Nottingham School of Medicine, Nottingham, United Kingdom
| | - Ben Killingley
- Health Protection and Influenza Research Group, Division of Epidemiology and Public Heath, University of Nottingham School of Medicine, Nottingham, United Kingdom
- * E-mail:
| | - Joanne Enstone
- Health Protection and Influenza Research Group, Division of Epidemiology and Public Heath, University of Nottingham School of Medicine, Nottingham, United Kingdom
| | - Michael Hewitt
- Health Protection and Influenza Research Group, Division of Epidemiology and Public Heath, University of Nottingham School of Medicine, Nottingham, United Kingdom
| | - Jovan Pantelic
- University of Maryland School of Public Health, Maryland Institute for Applied Environmental Health, College Park, Maryland, United States of America
| | - Michael L. Grantham
- University of Maryland School of Public Health, Maryland Institute for Applied Environmental Health, College Park, Maryland, United States of America
| | - P. Jacob Bueno de Mesquita
- University of Maryland School of Public Health, Maryland Institute for Applied Environmental Health, College Park, Maryland, United States of America
| | | | | | | | | | | | - Min Z. Levine
- Centers for Disease Control and Prevention, Influenza Division, Atlanta, Georgia, United States of America
| | - LaShondra Berman
- Centers for Disease Control and Prevention, Influenza Division, Atlanta, Georgia, United States of America
| | - Stephen Lindstrom
- Centers for Disease Control and Prevention, Influenza Division, Atlanta, Georgia, United States of America
| | - Simon Cauchemez
- Imperial College London, MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, London, United Kingdom
| | - Werner Bischoff
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | | | - Donald K. Milton
- University of Maryland School of Public Health, Maryland Institute for Applied Environmental Health, College Park, Maryland, United States of America
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Lee CT, Hagan JE, Jantsansengee B, Tumurbaatar OE, Altanchimeg S, Yadamsuren B, Demberelsuren S, Tserendorj C, Munkhtogoo O, Badarch D, Gunregjav N, Baatarkhuu B, Ochir C, Berman L, Anderson R, Patel MK, Gregory CJ, Goodson JL. Increase in Infant Measles Deaths During a Nationwide Measles Outbreak-Mongolia, 2015-2016. J Infect Dis 2020; 220:1771-1779. [PMID: 30923799 DOI: 10.1093/infdis/jiz140] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/23/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Surveillance data from a large measles outbreak in Mongolia suggested increased case fatality ratio (CFR) in the second of 2 waves. To confirm the increase in CFR and identify risk factors for measles death, we enhanced mortality ascertainment and conducted a case-control study among infants hospitalized for measles. METHODS We linked national vital records with surveillance data of clinically or laboratory-confirmed infant (aged <12 months) measles cases with rash onset during March-September 2015 (wave 1) and October 2015-June 2016 (wave 2). We abstracted medical charts of 95 fatal cases and 273 nonfatal cases hospitalized for measles, matched by age and sex. We calculated adjusted matched odds ratios (amORs) and 95% confidence intervals (CIs) for risk factors. RESULTS Infant measles deaths increased from 3 among 2224 cases (CFR: 0.13%) in wave 1 to 113 among 4884 cases (CFR: 2.31%) in wave 2 (P < .001). Inpatient admission, 7-21 days before measles rash onset, for pneumonia or influenza (amOR: 4.5; CI, 2.6-8.0), but not other diagnoses, was significantly associated with death. DISCUSSION Measles infection among children hospitalized with respiratory infections likely increased deaths due to measles during wave 2. Preventing measles virus nosocomial transmission likely decreases measles mortality.
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Affiliation(s)
- Christopher T Lee
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jose E Hagan
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA
| | | | | | - Samdan Altanchimeg
- Mongolia National Center for Communicable Disease, Ulaanbaatar, Mongolia
| | | | | | | | | | - Darmaa Badarch
- Mongolia National Center for Communicable Disease, Ulaanbaatar, Mongolia
| | - Nyamaa Gunregjav
- Mongolia National Center for Communicable Disease, Ulaanbaatar, Mongolia
| | | | - Chimedsuren Ochir
- School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - LaShondra Berman
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Raydel Anderson
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Minal K Patel
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA
| | - Christopher J Gregory
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA
| | - James L Goodson
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA
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5
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Doyle JD, Chung JR, Kim SS, Gaglani M, Raiyani C, Zimmerman RK, Nowalk MP, Jackson ML, Jackson LA, Monto AS, Martin ET, Belongia EA, McLean HQ, Foust A, Sessions W, Berman L, Garten RJ, Barnes JR, Wentworth DE, Fry AM, Patel MM, Flannery B. Interim Estimates of 2018-19 Seasonal Influenza Vaccine Effectiveness - United States, February 2019. MMWR Morb Mortal Wkly Rep 2019; 68:135-139. [PMID: 30763298 PMCID: PMC6375657 DOI: 10.15585/mmwr.mm6806a2] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In the United States, annual vaccination against seasonal influenza is recommended for all persons aged ≥6 months (https://www.cdc.gov/flu/protect/whoshouldvax.htm). Effectiveness of seasonal influenza vaccine varies by season. During each influenza season since 2004-05, CDC has estimated the effectiveness of seasonal influenza vaccine to prevent laboratory-confirmed influenza associated with medically attended acute respiratory illness (ARI). This interim report uses data from 3,254 children and adults enrolled in the U.S. Influenza Vaccine Effectiveness Network (U.S. Flu VE Network) during November 23, 2018-February 2, 2019. During this period, overall adjusted vaccine effectiveness against all influenza virus infection associated with medically attended ARI was 47% (95% confidence interval [CI] = 34%-57%). For children aged 6 months-17 years, overall vaccine effectiveness was 61% (44%-73%). Seventy-four percent of influenza A infections for which subtype information was available were caused by A(H1N1)pdm09 viruses. Vaccine effectiveness was estimated to be 46% (30%-58%) against illness caused by influenza A(H1N1)pdm09 viruses. CDC recommends that health care providers continue to administer influenza vaccine because influenza activity is ongoing and the vaccine can still prevent illness, hospitalization, and death associated with currently circulating influenza viruses, or other influenza viruses that might circulate later in the season. During the 2017-18 influenza season, in which influenza A(H3N2) predominated, vaccination was estimated to prevent 7.1 million illnesses, 3.7 million medical visits, 109,000 hospitalizations, and 8,000 deaths (1). Vaccination can also reduce the severity of influenza-associated illness (2). Persons aged ≥6 months who have not yet been vaccinated this season should be vaccinated.
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Johnson B, Collins J, Smith M, Jones L, Fan X, Berman L, Voors-Pette C. Characterization of the hormonal response to the novel kisspeptin analog, MVT-602, in the follicular phase of healthy premenopausal women. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.309] [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: 10/28/2022]
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Marinova-Petkova A, Laplante J, Jang Y, Lynch B, Zanders N, Rodriguez M, Jones J, Thor S, Hodges E, De La Cruz JA, Belser J, Yang H, Carney P, Shu B, Berman L, Stark T, Barnes J, Havers F, Yang P, Trock SC, Fry A, Gubareva L, Bresee JS, Stevens J, Daskalakis D, Liu D, Lee CT, Torchetti MK, Newbury S, Cigel F, Toohey-Kurth K, St George K, Wentworth DE, Lindstrom S, Davis CT. Avian Influenza A(H7N2) Virus in Human Exposed to Sick Cats, New York, USA, 2016. Emerg Infect Dis 2018; 23. [PMID: 29148400 PMCID: PMC5708219 DOI: 10.3201/eid2312.170798] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
An outbreak of influenza A(H7N2) virus in cats in a shelter in New York, NY, USA, resulted in zoonotic transmission. Virus isolated from the infected human was closely related to virus isolated from a cat; both were related to low pathogenicity avian influenza A(H7N2) viruses detected in the United States during the early 2000s.
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MESH Headings
- Animals
- Antigens, Viral/chemistry
- Antigens, Viral/genetics
- Antigens, Viral/metabolism
- Binding Sites
- Birds
- Cat Diseases/epidemiology
- Cat Diseases/transmission
- Cat Diseases/virology
- Cats
- Disease Outbreaks
- Genome, Viral
- Hemagglutinin Glycoproteins, Influenza Virus/chemistry
- Hemagglutinin Glycoproteins, Influenza Virus/genetics
- Hemagglutinin Glycoproteins, Influenza Virus/metabolism
- Housing, Animal
- Humans
- Influenza A Virus, H7N2 Subtype/classification
- Influenza A Virus, H7N2 Subtype/genetics
- Influenza A Virus, H7N2 Subtype/isolation & purification
- Influenza in Birds/epidemiology
- Influenza in Birds/transmission
- Influenza in Birds/virology
- Models, Molecular
- New York/epidemiology
- Polysaccharides/chemistry
- Protein Binding
- Protein Conformation, alpha-Helical
- Protein Conformation, beta-Strand
- Protein Interaction Domains and Motifs
- Receptors, Virus/chemistry
- Receptors, Virus/genetics
- Receptors, Virus/metabolism
- Veterinarians
- Zoonoses/epidemiology
- Zoonoses/transmission
- Zoonoses/virology
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8
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Flannery B, Chung JR, Belongia EA, McLean HQ, Gaglani M, Murthy K, Zimmerman RK, Nowalk MP, Jackson ML, Jackson LA, Monto AS, Martin ET, Foust A, Sessions W, Berman L, Barnes JR, Spencer S, Fry AM. Interim estimates of 2017-18 seasonal influenza vaccine effectiveness - United States, February 2018. Am J Transplant 2018. [DOI: 10.1111/ajt.14730] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Brendan Flannery
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
| | - Jessie R. Chung
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
| | | | | | - Manjusha Gaglani
- Baylor Scott & White Health; Texas A&M University Health Science Center College of Medicine; Temple TX USA
| | - Kempapura Murthy
- Baylor Scott & White Health; Texas A&M University Health Science Center College of Medicine; Temple TX USA
| | - Richard K. Zimmerman
- University of Pittsburgh Schools of the Health Sciences and University of Pittsburgh Medical Center; Pittsburgh PA USA
| | - Mary Patricia Nowalk
- University of Pittsburgh Schools of the Health Sciences and University of Pittsburgh Medical Center; Pittsburgh PA USA
| | | | - Lisa A. Jackson
- Kaiser Permanente Washington Health Research Institute; Seattle WA USA
| | | | | | - Angie Foust
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
| | - Wendy Sessions
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
| | - LaShondra Berman
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
| | - John R. Barnes
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
| | - Sarah Spencer
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
| | - Alicia M. Fry
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
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9
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Concepción-Acevedo J, Patel A, Luna-Pinto C, Peña RG, Cuevas Ruiz RI, Arbolay HR, Toro M, Deseda C, De Jesus VR, Ribot E, Gonzalez JQ, Rao G, De Leon Salazar A, Ansbro M, White BB, Hardy MC, Georgi JC, Stinnett R, Mercante AM, Lowe D, Martin H, Starks A, Metchock B, Johnston S, Dalton T, Joglar O, Stafford C, Youngblood M, Klein K, Lindstrom S, Berman L, Galloway R, Schafer IJ, Walke H, Stoddard R, Connelly R, McCaffery E, Rowlinson MC, Soroka S, Tranquillo DT, Gaynor A, Mangal C, Wroblewski K, Muehlenbachs A, Salerno RM, Lozier M, Sunshine B, Shapiro C, Rose D, Funk R, Pillai SK, O’Neill E. Initial Public Health Laboratory Response After Hurricane Maria - Puerto Rico, 2017. MMWR Morb Mortal Wkly Rep 2018; 67:333-336. [PMID: 29565842 PMCID: PMC5868205 DOI: 10.15585/mmwr.mm6711a5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Flannery B, Chung JR, Belongia EA, McLean HQ, Gaglani M, Murthy K, Zimmerman RK, Nowalk MP, Jackson ML, Jackson LA, Monto AS, Martin ET, Foust A, Sessions W, Berman L, Barnes JR, Spencer S, Fry AM. Interim Estimates of 2017-18 Seasonal Influenza Vaccine Effectiveness - United States, February 2018. MMWR Morb Mortal Wkly Rep 2018; 67:180-185. [PMID: 29447141 PMCID: PMC5815489 DOI: 10.15585/mmwr.mm6706a2] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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11
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Berman L, Miller RA. Problem Area Formation as an Element of Computer Aided Diagnosis: A Comparison of Two Strategies Within Quick Medical Reference (QMR). Methods Inf Med 2018. [DOI: 10.1055/s-0038-1634827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AbstractINTERNIST-I’s use of “partitioning” to group related diagnoses into problem areas (for competitive consideration and elimination during case analysis) is felt to be the source of many of its strengths as well as some of its weaknesses. QMR, INTERNIST-I’s successor program, embodies a homology function which can act as an alternative to the partitioner for problem area formation. This study undertakes a comparison of the problem areas generated by the INTERNIST-I partitioning algorithm, the QMR homology function, and expert clinicians; it finds the correlation to be poor. The authors then discuss another method of problem area formation which might better mimic a human clinician and provide an alternative approach in diagnostic computer-aided decision making.
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12
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Flannery B, Chung JR, Thaker SN, Monto AS, Martin ET, Belongia EA, McLean HQ, Gaglani M, Murthy K, Zimmerman RK, Nowalk MP, Jackson ML, Jackson LA, Foust A, Sessions W, Berman L, Spencer S, Fry AM. Interim Estimates of 2016-17 Seasonal Influenza Vaccine Effectiveness - United States, February 2017. MMWR Morb Mortal Wkly Rep 2017; 66:167-171. [PMID: 28207689 PMCID: PMC5657861 DOI: 10.15585/mmwr.mm6606a3] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
In the United States, annual vaccination against seasonal influenza is recommended for all persons aged ≥6 months (1). Each influenza season since 2004-05, CDC has estimated the effectiveness of seasonal influenza vaccine to prevent influenza-associated, medically attended, acute respiratory illness (ARI). This report uses data, as of February 4, 2017, from 3,144 children and adults enrolled in the U.S. Influenza Vaccine Effectiveness Network (U.S. Flu VE Network) during November 28, 2016-February 4, 2017, to estimate an interim adjusted effectiveness of seasonal influenza vaccine for preventing laboratory-confirmed influenza virus infection associated with medically attended ARI. During this period, overall vaccine effectiveness (VE) (adjusted for study site, age group, sex, race/ethnicity, self-rated general health, and days from illness onset to enrollment) against influenza A and influenza B virus infection associated with medically attended ARI was 48% (95% confidence interval [CI] = 37%-57%). Most influenza infections were caused by A (H3N2) viruses. VE was estimated to be 43% (CI = 29%-54%) against illness caused by influenza A (H3N2) virus and 73% (CI = 54%-84%) against influenza B virus. These interim VE estimates indicate that influenza vaccination reduced the risk for outpatient medical visits by almost half. Because influenza activity remains elevated (2), CDC and the Advisory Committee on Immunization Practices recommend that annual influenza vaccination efforts continue as long as influenza viruses are circulating (1). Vaccination with 2016-17 influenza vaccines will reduce the number of infections with most currently circulating influenza viruses. Persons aged ≥6 months who have not yet been vaccinated this season should be vaccinated as soon as possible.
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13
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Lawrence JE, Nasr P, Fountain DM, Berman L, Robinson AHN. Functional outcomes of conservatively managed acute ruptures of the Achilles tendon. Bone Joint J 2017; 99-B:87-93. [PMID: 28053262 DOI: 10.1302/0301-620x.99b1.bjj-2016-0452.r1] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 09/27/2016] [Indexed: 11/05/2022]
Abstract
AIMS This prospective cohort study aims to determine if the size of the tendon gap following acute rupture of the Achilles tendon shows an association with the functional outcome following non-operative treatment. PATIENTS AND METHODS All patients presenting within two weeks of an acute unilateral rupture of the Achilles tendon between July 2012 and July 2015 were considered for the study. In total, 38 patients (nine female, 29 male, mean age 52 years; 29 to 78) completed the study. Dynamic ultrasound examination was performed to confirm the diagnosis and measure the gap between ruptured tendon ends. Outcome was assessed using dynamometric testing of plantarflexion and the Achilles tendon Total Rupture score (ATRS) six months after the completion of a rehabilitation programme. RESULTS Patients with a gap ≥ 10 mm with the ankle in the neutral position had significantly greater peak torque deficit than those with gaps < 10 mm (mean 23.3%; 7% to 52% vs 14.3%; 0% to 47%, p = 0.023). However, there was no difference in ATRS between the two groups (mean score 87.2; 74 to 100 vs 87.4; 68 to 97, p = 0.467). There was no significant correlation between gap size and torque deficit (τ = 0.103), suggesting a non-linear relationship. There was also no significant correlation between ATRS and peak torque deficit (τ = -0.305). CONCLUSION This is the first study to identify an association between tendon gap and functional outcome in acute rupture of the Achilles tendon. We have identified 10 mm as a gap size at which deficits in plantarflexion strength become significantly greater, however, the precise relationship between gap size and plantarflexion strength remains unclear. Large, multicentre studies will be needed to clarify this relationship and identify population subgroups in whom deficits in peak torque are reflected in patient-reported outcome measures. Cite this article: Bone Joint J 2017;99-B:87-93.
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Affiliation(s)
- J E Lawrence
- Addenbrooke's Hospital, Department of Trauma and Orthopaedic Surgery, Addenbrooke's Hospital, Cambridge University NHS Foundation Trust, Hills Road, Cambridge, UK
| | - P Nasr
- Addenbrooke's Hospital, Department of Trauma and Orthopaedic Surgery, Addenbrooke's Hospital, Cambridge University NHS Foundation Trust, Hills Road, Cambridge, UK
| | - D M Fountain
- Addenbrooke's Hospital, Department of Trauma and Orthopaedic Surgery, Addenbrooke's Hospital, Cambridge University NHS Foundation Trust, Hills Road, Cambridge, UK
| | - L Berman
- Addenbrooke's Hospital, Department of Trauma and Orthopaedic Surgery, Addenbrooke's Hospital, Cambridge University NHS Foundation Trust, Hills Road, Cambridge, UK
| | - A H N Robinson
- Addenbrooke's Hospital, Department of Trauma and Orthopaedic Surgery, Addenbrooke's Hospital, Cambridge University NHS Foundation Trust, Hills Road, Cambridge, UK
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14
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Al-Abdallat MM, Rha B, Alqasrawi S, Payne DC, Iblan I, Binder AM, Haddadin A, Nsour MA, Alsanouri T, Mofleh J, Whitaker B, Lindstrom SL, Tong S, Ali SS, Dahl RM, Berman L, Zhang J, Erdman DD, Gerber SI. Acute respiratory infections among returning Hajj pilgrims-Jordan, 2014. J Clin Virol 2017; 89:34-37. [PMID: 28226273 PMCID: PMC7106359 DOI: 10.1016/j.jcv.2017.01.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/09/2017] [Accepted: 01/30/2017] [Indexed: 01/31/2023]
Abstract
Surveillance for respiratory illness in Hajj pilgrims took place in Jordan in 2014. 58% of the 125 subjects returning from Hajj tested positive for at least one virus. Rhino/enterovirus was the most commonly detected viral pathogen (47% of subjects). No cases of Middle East Respiratory Syndrome coronavirus were detected.
Background The emergence of Middle East Respiratory Syndrome coronavirus (MERS-CoV) has prompted enhanced surveillance for respiratory infections among pilgrims returning from the Hajj, one of the largest annual mass gatherings in the world. Objectives To describe the epidemiology and etiologies of respiratory illnesses among pilgrims returning to Jordan after the 2014 Hajj. Study design Surveillance for respiratory illness among pilgrims returning to Jordan after the 2014 Hajj was conducted at sentinel health care facilities using epidemiologic surveys and molecular diagnostic testing of upper respiratory specimens for multiple respiratory pathogens, including MERS-CoV. Results Among the 125 subjects, 58% tested positive for at least one virus; 47% tested positive for rhino/enterovirus. No cases of MERS-CoV were detected. Conclusions The majority of pilgrims returning to Jordan from the 2014 Hajj with respiratory illness were determined to have a viral etiology, but none were due to MERS-CoV. A greater understanding of the epidemiology of acute respiratory infections among returning travelers to other countries after Hajj should help optimize surveillance systems and inform public health response practices.
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Affiliation(s)
| | - Brian Rha
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sultan Alqasrawi
- Communicable Diseases Directorate, Jordan Ministry of Health, Amman, Jordan
| | - Daniel C Payne
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ibrahim Iblan
- Jordan Field Epidemiology Training Program, Amman, Jordan
| | - Alison M Binder
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Aktham Haddadin
- Directorate of Laboratories, Jordan Ministry of Health, Amman, Jordan
| | | | - Tarek Alsanouri
- Directorate of Laboratories, Jordan Ministry of Health, Amman, Jordan
| | - Jawad Mofleh
- Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Brett Whitaker
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stephen L Lindstrom
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Suxiang Tong
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sami Sheikh Ali
- Communicable Diseases Directorate, Jordan Ministry of Health, Amman, Jordan
| | | | - LaShondra Berman
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jing Zhang
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dean D Erdman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Susan I Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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15
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Schicker RS, Rossow J, Eckel S, Fisher N, Bidol S, Tatham L, Matthews-Greer J, Sohner K, Bowman AS, Avrill J, Forshey T, Blanton L, Davis CT, Schiltz J, Skorupski S, Berman L, Jang Y, Bresee JS, Lindstrom S, Trock SC, Wentworth D, Fry AM, de Fijter S, Signs K, DiOrio M, Olsen SJ, Biggerstaff M. Outbreak of Influenza A(H3N2) Variant Virus Infections Among Persons Attending Agricultural Fairs Housing Infected Swine — Michigan and Ohio, July–August 2016. MMWR Morb Mortal Wkly Rep 2016; 65:1157-1160. [DOI: 10.15585/mmwr.mm6542a1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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16
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van der Poll T, Keogh C, Helfgott D, Berman L, Buurman W, Lowry S. Effects of anti-interleukin 6 on inflammatory responses during murine septic peritonitis. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/096805199600300604] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Interleukin (IL)-6 has a limited role in the pathogenesis of the acute systemic inflammatory response syndrome elicited by bolus administration of bacteria or bacterial products. We sought to determine the role of IL-6 in septic peritonitis induced by cecal ligation and puncture (CLP). CLP led to a rapid and sustained induction of IL-6 in plasma and organ homogenates. Pretreatment (-2 h) with an anti-IL-6 mAb (1 mg) resulted in higher plasma and hepatic levels of tumor necrosis factor (TNF), as well as higher plasma concentrations of soluble TNF receptors and IL-10, while attenuating the acute phase protein response. Administration of anti-IL-6 did not influence survival. These results suggest that IL-6 production during septic peritonitis serves to inhibit the appearance of both agonist and antagonist members of the cytokine network. The importance of IL-6 in mediating the cytokine response to infection may be underestimated in more acute sepsis models.
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Affiliation(s)
- T. van der Poll
- Laboratory of Surgical Metabolism, Department of Surgery, Cornell University Medical College, New York, NY, USA, Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - C.V. Keogh
- Laboratory of Surgical Metabolism, Department of Surgery, Cornell University Medical College, New York, NY, USA
| | - D. Helfgott
- Laboratory of Surgical Metabolism, Department of Surgery, Cornell University Medical College, New York, NY, USA
| | - L. Berman
- Laboratory of Surgical Metabolism, Department of Surgery, Cornell University Medical College, New York, NY, USA
| | - W.A. Buurman
- Department of Surgery, University of Limburg, Maastricht, The Netherlands
| | - S.F. Lowry
- Laboratory of Surgical Metabolism, Department of Surgery, Cornell University Medical College, New York, NY, USA
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17
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Tomczyk S, Arriola CS, Beall B, Benitez A, Benoit SR, Berman L, Bresee J, da Gloria Carvalho M, Cohn A, Cross K, Diaz MH, Francois Watkins LK, Gierke R, Hagan JE, Harris AM, Jain S, Kim L, Kobayashi M, Lindstrom S, McGee L, McMorrow M, Metcalf BL, Moore MR, Moura I, Nix WA, Nyangoma E, Oberste MS, Olsen SJ, Pimenta F, Socias C, Thurman K, Waller J, Waterman SH, Westercamp M, Wharton M, Whitney CG, Winchell JM, Wolff B, Kim C. Multistate Outbreak of Respiratory Infections Among Unaccompanied Children, June 2014-July 2014. Clin Infect Dis 2016; 63:48-56. [PMID: 27001799 DOI: 10.1093/cid/ciw147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/07/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND From January 2014-July 2014, more than 46 000 unaccompanied children (UC) from Central America crossed the US-Mexico border. In June-July, UC aged 9-17 years in 4 shelters and 1 processing center in 4 states were hospitalized with acute respiratory illness. We conducted a multistate investigation to interrupt disease transmission. METHODS Medical charts were abstracted for hospitalized UC. Nonhospitalized UC with influenza-like illness were interviewed, and nasopharyngeal and oropharyngeal swabs were collected to detect respiratory pathogens. Nasopharyngeal swabs were used to assess pneumococcal colonization in symptomatic and asymptomatic UC. Pneumococcal blood isolates from hospitalized UC and nasopharyngeal isolates were characterized by serotyping and whole-genome sequencing. RESULTS Among 15 hospitalized UC, 4 (44%) of 9 tested positive for influenza viruses, and 6 (43%) of 14 with blood cultures grew pneumococcus, all serotype 5. Among 48 nonhospitalized children with influenza-like illness, 1 or more respiratory pathogens were identified in 46 (96%). Among 774 nonhospitalized UC, 185 (24%) yielded pneumococcus, and 70 (38%) were serotype 5. UC transferring through the processing center were more likely to be colonized with serotype 5 (odds ratio, 3.8; 95% confidence interval, 2.1-6.9). Analysis of core pneumococcal genomes detected 2 related, yet independent, clusters. No pneumococcus cases were reported after pneumococcal and influenza immunization campaigns. CONCLUSIONS This respiratory disease outbreak was due to multiple pathogens, including Streptococcus pneumoniae serotype 5 and influenza viruses. Pneumococcal and influenza vaccinations prevented further transmission. Future efforts to prevent similar outbreaks will benefit from use of both vaccines.
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Affiliation(s)
- Sara Tomczyk
- Epidemic Intelligence Service Respiratory Diseases Branch
| | | | | | | | | | | | | | | | | | | | | | | | | | - Jose E Hagan
- Epidemic Intelligence Service Global Immunizations Division, Centers for Disease Control and Prevention, Atlanta, Georgia US Public Health Service, Rockville, Maryland
| | - Aaron M Harris
- Respiratory Diseases Branch US Public Health Service, Rockville, Maryland
| | | | - Lindsay Kim
- Respiratory Diseases Branch US Public Health Service, Rockville, Maryland
| | | | | | | | | | | | - Matthew R Moore
- Respiratory Diseases Branch US Public Health Service, Rockville, Maryland
| | | | - W Allan Nix
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Edith Nyangoma
- Epidemic Intelligence Service Division of Global Migration and Quarantine
| | - M Steven Oberste
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Christina Socias
- Epidemic Intelligence Service National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | | | | | | | | | | | - Cynthia G Whitney
- Respiratory Diseases Branch US Public Health Service, Rockville, Maryland
| | | | | | - Curi Kim
- US Public Health Service, Rockville, Maryland Office of Refugee Resettlement, Administration for Children and Families, Washington D.C
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18
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Spencer S, Chung J, Thompson M, Piedra PA, Jewell A, Avadhanula V, Mei M, Jackson ML, Meece J, Sundaram M, Belongia EA, Cross R, Johnson E, Bullotta A, Rinaldo C, Gaglani M, Murthy K, Clipper L, Berman L, Flannery B. Factors associated with real-time RT-PCR cycle threshold values among medically attended influenza episodes. J Med Virol 2015; 88:719-23. [PMID: 26334765 DOI: 10.1002/jmv.24373] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2015] [Indexed: 11/07/2022]
Abstract
We evaluated the cycle threshold (CT) values of 1,160 influenza A positive and 806 influenza B positive specimens from two seasons of the US Flu VE Network to identify factors associated with CT values. Low CT values (high genomic load) were associated with shorter intervals between illness onset and specimen collection, young age (ages 3-8 years old), and self-rated illness severity for both influenza A and B. Low CT values were also associated with reported fever/feverishness and age ≥65 years for influenza A.
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Affiliation(s)
- Sarah Spencer
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia.,Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Jessie Chung
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia.,Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Mark Thompson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Pedro A Piedra
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Alan Jewell
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
| | - Vasanthi Avadhanula
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
| | - Minghua Mei
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
| | | | - Jennifer Meece
- Marshfield Clinic Research Foundation, Marshfield Wisconsin
| | - Maria Sundaram
- Marshfield Clinic Research Foundation, Marshfield Wisconsin
| | | | - Rachel Cross
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Emileigh Johnson
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Arlene Bullotta
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Charles Rinaldo
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | | | - LaShondra Berman
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brendan Flannery
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
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19
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Dawood FS, Jara J, Estripeaut D, Vergara O, Luciani K, Corro M, de León T, Saldaña R, Castillo Baires JM, Rauda Flores R, Cazares RA, Brizuela de Fuentes YS, Franco D, Gaitan M, Schneider E, Berman L, Azziz-Baumgartner E, Widdowson MA. What Is the Added Benefit of Oropharyngeal Swabs Compared to Nasal Swabs Alone for Respiratory Virus Detection in Hospitalized Children Aged <10 Years? J Infect Dis 2015; 212:1600-3. [PMID: 25943205 DOI: 10.1093/infdis/jiv265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 04/24/2015] [Indexed: 11/13/2022] Open
Abstract
We evaluated the added value of collecting both nasal and oropharyngeal swabs, compared with collection of nasal swabs alone, for detection of common respiratory viruses by reverse transcription-polymerase chain reaction in hospitalized children aged <10 years. Nasal swabs had equal or greater sensitivity than oropharyngeal swabs for detection of respiratory syncytial virus, adenovirus, human metapneumovirus, rhinovirus, and influenza virus but not parainfluenza virus. The addition of an oropharyngeal swab, compared with use of a nasal swab alone, increased the frequency of detection of each respiratory virus by no more than 10% in children aged <10 years.
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Affiliation(s)
| | - Jorge Jara
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City
| | | | | | | | - Mary Corro
- Hospital De Especialidades Pediátricas Omar Torrijos
| | - Tirza de León
- Hospital Materno Infantil José Domingo De Obaldía, David, Panama
| | - Ricardo Saldaña
- Hospital Materno Infantil José Domingo De Obaldía, David, Panama
| | | | | | | | | | - Danilo Franco
- Gorgas Memorial Institute for Health Studies, Panama City
| | - Melissa Gaitan
- Gorgas Memorial Institute for Health Studies, Panama City
| | - Eileen Schneider
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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20
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Flannery B, Clippard J, Zimmerman RK, Nowalk MP, Jackson ML, Jackson LA, Monto AS, Petrie JG, McLean HQ, Belongia EA, Gaglani M, Berman L, Foust A, Sessions W, Thaker SN, Spencer S, Fry AM. Early estimates of seasonal influenza vaccine effectiveness - United States, January 2015. MMWR Morb Mortal Wkly Rep 2015; 64:10-5. [PMID: 25590680 PMCID: PMC4584793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In the United States, annual vaccination against seasonal influenza is recommended for all persons aged ≥6 months. Each season since 2004-05, CDC has estimated the effectiveness of seasonal influenza vaccine in preventing medically attended acute respiratory illness (ARI) associated with laboratory-confirmed influenza. This season, early estimates of influenza vaccine effectiveness are possible because of widespread, early circulation of influenza viruses. By January 3, 2015, 46 states were experiencing widespread flu activity, with predominance of influenza A (H3N2) viruses. This report presents an initial estimate of seasonal influenza vaccine effectiveness at preventing laboratory-confirmed influenza virus infection associated with medically attended ARI based on data from 2,321 children and adults enrolled in the U.S. Influenza Vaccine Effectiveness Network (Flu VE) during November 10, 2014-January 2, 2015. During this period, overall vaccine effectiveness (VE) (adjusted for study site, age, sex, race/ethnicity, self-rated health, and days from illness onset to enrollment) against laboratory-confirmed influenza associated with medically attended ARI was 23% (95% confidence interval [CI] = 8%-36%). Most influenza infections were due to A (H3N2) viruses. This interim VE estimate is relatively low compared with previous seasons when circulating viruses and vaccine viruses were well-matched and likely reflects the fact that more than two-thirds of circulating A (H3N2) viruses are antigenically and genetically different (drifted) from the A (H3N2) vaccine component of 2014-15 Northern Hemisphere seasonal influenza vaccines. These early, low VE estimates underscore the need for ongoing influenza prevention and treatment measures. CDC continues to recommend influenza vaccination because the vaccine can still prevent some infections with the currently circulating A (H3N2) viruses as well as other viruses that might circulate later in the season, including influenza B viruses. Even when VE is reduced, vaccination still prevents some illness and serious influenza-related complications, including thousands of hospitalizations and deaths. Persons aged ≥6 months who have not yet been vaccinated this season should be vaccinated, including persons who might already have been ill with influenza this season.
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Affiliation(s)
- Brendan Flannery
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC,Corresponding author: Brendan Flannery, , 404-718-4276
| | - Jessie Clippard
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | | | | | | | | | - Arnold S. Monto
- University of Michigan School of Public Health, Department of Epidemiology
| | - Joshua G. Petrie
- University of Michigan School of Public Health, Department of Epidemiology
| | | | | | - Manjusha Gaglani
- Baylor Scott and White Health, Texas A&M University Health Science Center College of Medicine
| | - LaShondra Berman
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Angie Foust
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Wendy Sessions
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Swathi N. Thaker
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Sarah Spencer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia M. Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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21
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Nasr P, Berman L, Rehm A. Ultrasonographic findings after Achilles tenotomy during Ponseti treatment for clubfeet: Is ultrasound a reliable tool to assess tendon healing? J Child Orthop 2014; 8:405-11. [PMID: 25266550 PMCID: PMC4391046 DOI: 10.1007/s11832-014-0610-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 09/03/2014] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Several studies have claimed ultrasound to be useful and accurate in assessing the healing phase of Achilles tendons after tenotomy during Ponseti treatment for clubfoot deformity. The purpose of our study was to assess the healing process of Achilles tendons ultrasonographically after tenotomy as part of Ponseti clubfoot management and to assess the effects of previously not considered ultrasound properties (anisotropy, partial volume effect), and whether these practical considerations affect accurate measurements which have been claimed possible in previous studies. MATERIALS AND METHODS We monitored the post-tenotomy healing process in 15 patients (22 tendons) using high frequency ultrasound for a minimum of six months (range 6-14 months). The scanning was discontinued once a tendon looked normal or when the appearance remained unchanged between scans. We also studied nine patients (11 tendons) who had undergone Achilles tenotomies up to seven years previously (range 34-83 months). RESULTS In the immediate postoperative period, ultrasound showed large variations in the distance of the tenotomy from the calcaneum as well as the obliquity and completeness of the surgical division. We encountered pitfalls in the use of ultrasound to define healing stages that were not described previously. Sonography was inaccurate and subjective in assessing both completeness of the surgical division and tendon measurements. Despite ultrasonographically proven incomplete tendon division in 63 % of cases, the clinical effect of an immediate increase of passive foot dorsiflexion from the pretenotomy position with an obvious palpable tendon gap was achieved in all patients. At the end of the study, 65 % of tendons did not achieve a normal appearance. CONCLUSIONS We do not think that routine ultrasound studies are of any value as an adjunct to clinical assessment intra- and post-operatively. It can give misleading information regarding the need to complete the tenotomy, which may increase risks associated with a further pass of the scalpel blade.
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Affiliation(s)
- P. Nasr
- Addenbrookes University Hospital NHS Trust, Cambridge, UK
| | - L. Berman
- Addenbrookes University Hospital NHS Trust, Cambridge, UK
| | - A. Rehm
- Addenbrookes University Hospital NHS Trust, Cambridge, UK
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22
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Flannery B, Thaker SN, Clippard J, Monto AS, Ohmit SE, Zimmerman RK, Nowalk MP, Gaglani M, Jackson ML, Jackson LA, Belongia EA, McLean HQ, Berman L, Foust A, Sessions W, Spencer S, Fry AM. Interim estimates of 2013-14 seasonal influenza vaccine effectiveness - United States, February 2014. MMWR Morb Mortal Wkly Rep 2014; 63:137-42. [PMID: 24553196 PMCID: PMC4584757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In the United States, annual vaccination against seasonal influenza is recommended for all persons aged ≥6 months. Each season since 2004-05, CDC has estimated the effectiveness of seasonal influenza vaccine to prevent influenza-associated, medically attended acute respiratory illness (ARI). This report uses data from 2,319 children and adults enrolled in the U.S. Influenza Vaccine Effectiveness (Flu VE) Network during December 2, 2013-January 23, 2014, to estimate an interim adjusted effectiveness of seasonal influenza vaccine for preventing laboratory-confirmed influenza virus infection associated with medically attended ARI. During this period, overall vaccine effectiveness (VE) (adjusted for study site, age, sex, race/ethnicity, self-rated health, and days from illness onset to enrollment) against influenza A and B virus infection associated with medically attended ARI was 61%. The influenza A (H1N1)pdm09 (pH1N1) virus that emerged to cause a pandemic in 2009 accounted for 98% of influenza viruses detected. VE was estimated to be 62% against pH1N1 virus infections and was similar across age groups. As of February 8, 2014, influenza activity remained elevated in the United States, the proportion of persons seeing their health-care provider for influenza-like illness was lower than in early January but remained above the national baseline, and activity still might be increasing in some parts of the country. CDC and the Advisory Committee on Immunization Practices routinely recommend that annual influenza vaccination efforts continue as long as influenza viruses are circulating. Persons aged ≥6 months who have not yet been vaccinated this season should be vaccinated. Antiviral medications are an important second line of defense to treat influenza illness and should be used as recommended among suspected or confirmed influenza patients, regardless of patient vaccination status. Early antiviral treatment is recommended for persons with suspected influenza with severe or progressive illness (e.g., hospitalized persons) and those at high risk for complications from influenza, no matter how severe the illness.
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Affiliation(s)
- Brendan Flannery
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC,Corresponding author: Brendan Flannery, , 404-718-4276
| | - Swathi N. Thaker
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Jessie Clippard
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | | | | | | | | | - Manjusha Gaglani
- Baylor Scott and White Health, Texas A&M University Health Science Center College of Medicine
| | | | | | | | | | - LaShondra Berman
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Angie Foust
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Wendy Sessions
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Sarah Spencer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia M. Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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23
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Gerloff NA, Khan SU, Balish A, Shanta IS, Simpson N, Berman L, Haider N, Poh MK, Islam A, Gurley E, Hasnat MA, Dey T, Shu B, Emery S, Lindstrom S, Haque A, Klimov A, Villanueva J, Rahman M, Azziz-Baumgartner E, Ziaur Rahman M, Luby SP, Zeidner N, Donis RO, Sturm-Ramirez K, Davis CT. Multiple reassortment events among highly pathogenic avian influenza A(H5N1) viruses detected in Bangladesh. Virology 2014; 450-451:297-307. [DOI: 10.1016/j.virol.2013.12.023] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 11/17/2013] [Accepted: 12/17/2013] [Indexed: 11/25/2022]
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24
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Chubar O, Fluerasu A, Berman L, Kaznatcheev K, Wiegart L. Wavefront propagation simulations for beamlines and experiments with "Synchrotron Radiation Workshop". ACTA ACUST UNITED AC 2013. [DOI: 10.1088/1742-6596/425/16/162001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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25
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Lindstrom S, Garten R, Balish A, Shu B, Emery S, Berman L, Barnes N, Sleeman K, Gubareva L, Villanueva J, Klimov A. Human infections with novel reassortant influenza A(H3N2)v viruses, United States, 2011. Emerg Infect Dis 2013; 18:834-7. [PMID: 22516540 PMCID: PMC3358066 DOI: 10.3201/eid1805.111922] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
During July–December 2011, a variant virus, influenza A(H3N2)v, caused 12 human cases of influenza. The virus contained genes originating from swine, avian, and human viruses, including the M gene from influenza A(H1N1)pdm09 virus. Influenza A(H3N2)v viruses were antigenically distinct from seasonal influenza viruses and similar to proposed vaccine virus A/Minnesota/11/2010.
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Affiliation(s)
- Stephen Lindstrom
- Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
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Shu B, Garten R, Emery S, Balish A, Cooper L, Sessions W, Deyde V, Smith C, Berman L, Klimov A, Lindstrom S, Xu X. Genetic analysis and antigenic characterization of swine origin influenza viruses isolated from humans in the United States, 1990-2010. Virology 2011; 422:151-60. [PMID: 22078166 DOI: 10.1016/j.virol.2011.10.016] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Revised: 10/03/2011] [Accepted: 10/14/2011] [Indexed: 12/01/2022]
Abstract
Swine influenza viruses (SIV) have been recognized as important pathogens for pigs and occasional human infections with swine origin influenza viruses (SOIV) have been reported. Between 1990 and 2010, a total of twenty seven human cases of SOIV infections have been identified in the United States. Six viruses isolated from 1990 to 1995 were recognized as classical SOIV (cSOIV) A(H1N1). After 1998, twenty-one SOIV recovered from human cases were characterized as triple reassortant (tr_SOIV) inheriting genes from classical swine, avian and human influenza viruses. Of those twenty-one tr_SOIV, thirteen were of A(H1N1), one of A(H1N2), and seven of A(H3N2) subtype. SOIV characterized were antigenically and genetically closely related to the subtypes of influenza viruses circulating in pigs but distinct from contemporary influenza viruses circulating in humans. The diversity of subtypes and genetic lineages in SOIV cases highlights the importance of continued surveillance at the animal-human interface.
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Affiliation(s)
- Bo Shu
- Influenza Division, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
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Griffin MR, Monto AS, Belongia EA, Treanor JJ, Chen Q, Chen J, Talbot HK, Ohmit SE, Coleman LA, Lofthus G, Petrie JG, Meece JK, Hall CB, Williams JV, Gargiullo P, Berman L, Shay DK. Effectiveness of non-adjuvanted pandemic influenza A vaccines for preventing pandemic influenza acute respiratory illness visits in 4 U.S. communities. PLoS One 2011; 6:e23085. [PMID: 21857999 PMCID: PMC3155536 DOI: 10.1371/journal.pone.0023085] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 07/05/2011] [Indexed: 12/04/2022] Open
Abstract
We estimated the effectiveness of four monovalent pandemic influenza A (H1N1) vaccines (three unadjuvanted inactivated, one live attenuated) available in the U.S. during the pandemic. Patients with acute respiratory illness presenting to inpatient and outpatient facilities affiliated with four collaborating institutions were prospectively recruited, consented, and tested for influenza. Analyses were restricted to October 2009 through April 2010, when pandemic vaccine was available. Patients testing positive for pandemic influenza by real-time RT-PCR were cases; those testing negative were controls. Vaccine effectiveness was estimated in logistic regression models adjusted for study community, patient age, timing of illness, insurance status, enrollment site, and presence of high-risk medical conditions. Pandemic virus was detected in 1,011 (15%) of 6,757 enrolled patients. Fifteen (1%) of 1,011 influenza positive cases and 1,042 (18%) of 5,746 test-negative controls had record-verified pandemic vaccination >14 days prior to illness onset. Adjusted effectiveness (95% confidence interval) for pandemic vaccines combined was 56% (23%, 75%). Adjusted effectiveness for inactivated vaccines alone (79% of total) was 62% (25%, 81%) overall and 32% (-92%, 76%), 89% (15%, 99%), and -6% (-231%, 66%) in those aged 0.5 to 9, 10 to 49, and 50+ years, respectively. Effectiveness for the live attenuated vaccine in those aged 2 to 49 years was only demonstrated if vaccination >7 rather than >14 days prior to illness onset was considered (61%∶ 12%, 82%). Inactivated non-adjuvanted pandemic vaccines offered significant protection against confirmed pandemic influenza-associated medical care visits in young adults.
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MESH Headings
- Acute Disease
- Adolescent
- Adult
- Case-Control Studies
- Child
- Child, Preschool
- Female
- Humans
- Infant
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/immunology
- Influenza Vaccines/immunology
- Influenza Vaccines/therapeutic use
- Influenza, Human/epidemiology
- Influenza, Human/immunology
- Influenza, Human/prevention & control
- Logistic Models
- Male
- Middle Aged
- Pandemics/prevention & control
- Pregnancy
- Prospective Studies
- Reverse Transcriptase Polymerase Chain Reaction
- Treatment Outcome
- United States/epidemiology
- Vaccines, Attenuated/immunology
- Vaccines, Attenuated/therapeutic use
- Vaccines, Inactivated/immunology
- Vaccines, Inactivated/therapeutic use
- Young Adult
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Affiliation(s)
- Marie R Griffin
- Department of Preventive Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
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Shaftan T, Hulbert SL, Berman L. Comparison of calculated brightness and flux of radiation from a long-period wiggler and a short-period undulator. J Synchrotron Radiat 2008; 15:335-340. [PMID: 18552424 DOI: 10.1107/s0909049508008418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2007] [Accepted: 03/26/2008] [Indexed: 05/26/2023]
Abstract
In this article the calculation of brightness and flux for two insertion devices of the 2.8 GeV X-ray storage ring at the NSLS is discussed. The radiation properties from the X25 linearly polarized wiggler and the new X25 short-period undulator are compared at a fixed photon energy (11.3 keV) corresponding to emission from the fifth harmonic of the short-period undulator. For this computation, three commonly available synchrotron radiation programs are used. The capabilities of each of these codes are briefly discussed, and their range of applicability are commented on. It is concluded that special care is needed when modeling the radiation of the classes of insertion devices considered here.
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Affiliation(s)
- T Shaftan
- National Synchrotron Light Source, Brookhaven National Laboratory, Upton, NY 11973, USA.
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Gupta R, Markowitz Y, Berman L, Chapman P. High-resolution imaging of an ancient Egyptian mummified head: new insights into the mummification process. AJNR Am J Neuroradiol 2008; 29:705-13. [PMID: 18238847 PMCID: PMC7978190 DOI: 10.3174/ajnr.a0909] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2007] [Accepted: 10/17/2007] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Systematic facial mutilations during mummification have never been described before. The purpose of this work was to study a wrapped mummified head using high-resolution CT scanning. MATERIALS AND METHODS An isolated mummified head from the Egyptian Middle Kingdom was scanned at 200 mum isotropic resolution. A prototype flat panel CT scanner was used to generate 800 nonoverlapping CT sections at 120 kV and 50 mA. This dataset was analyzed to discern various surgical alterations during mummification. RESULTS There were large defects in the cribriform plate and the posterior fossa. Systematic mutilations of the facial bones and mandible, involving the anterior and inferior walls of the maxillary sinuses, the floor of both orbits, and the zygomatic arches with contiguous segments of the zygomas, were demonstrated. The coronoid processes of both mandibles had been sharply excised and the articular tubercles of the temporomandibular joints fractured. CONCLUSION Defects in the ethmoid and the posterior skull base are consistent with previous descriptions of excerebration. Mutilations of the facial skeleton and jaw, which are unrelated to the process of excerebration, have never been described previously. It is noteworthy that the osteotomies selectively include the insertions of the muscles of mastication. These mutilations apparently were designed for mobilization of lower jaw. The "Opening of the Mouth" ceremony, described in the ancient texts, would be difficult to perform in the presence of rigor mortis; it is probable that the observed osteotomies were performed to facilitate this ceremony. Our research suggests that by the Middle Kingdom, Egyptian embalmers had developed highly sophisticated surgical techniques that have not been appreciated previously.
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Affiliation(s)
- R Gupta
- Department of Neuroradiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
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Breeze ACG, Jessop FA, Whitehead AL, Set PAK, Berman L, Hackett GA, Lees CC. Feasibility of percutaneous organ biopsy as part of a minimally invasive perinatal autopsy. Virchows Arch 2007; 452:201-7. [DOI: 10.1007/s00428-007-0548-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2007] [Revised: 11/05/2007] [Accepted: 11/09/2007] [Indexed: 11/29/2022]
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Badran K, Jani P, Berman L. Accuracy of Otolaryngologist-performed ultrasound for neck masses. Clin Otolaryngol 2007. [DOI: 10.1111/j.1365-2273.2007.01419_4.x] [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: 11/29/2022]
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Balan KK, Wat SYJ, Seshadri N, Barkej M, English E, Berman L, Wishart GC. A large intrathyroidal parathyroid adenoma presenting as a cold lesion on thyroid scintigraphy. Clin Nucl Med 2007; 32:237-8. [PMID: 17314609 DOI: 10.1097/01.rlu.0000255225.02101.35] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rafique A, Set P, Berman L. Late presentation of developmental dysplasia of the hip following normal ultrasound examination. Clin Radiol 2007; 62:181-4. [PMID: 17207703 DOI: 10.1016/j.crad.2006.08.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2006] [Revised: 07/26/2006] [Accepted: 08/02/2006] [Indexed: 10/23/2022]
Affiliation(s)
- A Rafique
- Department of Radiology, Addenbrookes NHS Trust, Cambridge, UK.
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Abstract
This paper describes techniques for the visualization and processing of three-dimensional (3D) ultrasound data. The nature of such data demands specialized algorithms, which differ from those employed for other medical imaging modalities. In this paper, the emphasis is placed on generic processing techniques, which are relevant across a wide range of 3D ultrasound application domains.
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Affiliation(s)
- A Gee
- Department of Engineering, University of Cambridge, Trumpington Street, Cambridge, UK
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Gurnell EM, Thomas SK, McFarlane I, Munday I, Balan KK, Berman L, Chatterjee VKK, Wishart GC. Focused parathyroid surgery with intraoperative parathyroid hormone measurement as a day-case procedure. Br J Surg 2004; 91:78-82. [PMID: 14716798 DOI: 10.1002/bjs.4463] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [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: 11/10/2022]
Abstract
BACKGROUND This study assessed the feasibility, efficacy and safety of focused parathyroidectomy combined with intraoperative parathyroid hormone (IOPTH) measurement in a day-case setting. METHODS Over 28 months 50 consecutive patients (mean age 63 (range 33-92) years) with clear evidence of unifocal disease on sestamibi scanning or ultrasonography underwent unilateral neck exploration via a small lateral incision. Blood samples for measurement of IOPTH were taken at induction of anaesthesia, before adenoma excision and after adenoma excision (at 5, 10 and 20 min). Ten patients were discharged within 23 h and 40 patients on the day of surgery. RESULTS A solitary adenoma was identified in all but one patient, with a mean operating time of 30 (range 16-57) min. After parathyroidectomy, IOPTH levels fell appropriately except in one patient with multiglandular hyperplasia. No patient developed symptomatic hypocalcaemia during the 2 weeks after operation, enabling cessation of oral supplements. All patients remained normocalcaemic on follow-up (mean 26 (range 8-84) weeks) and histological examination confirmed parathyroid adenoma (48 patients), hyperplasia (one) or carcinoma (one). CONCLUSION After accurate preoperative localization of uniglandular disease, patients with primary hyperparathyroidism may be managed successfully and safely by focused parathyroidectomy with IOPTH measurement as a day-case procedure.
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Affiliation(s)
- E M Gurnell
- Department of Medicine, Addenbrooke's Hospital, Cambridge, UK
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37
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Allaire M, Aslantas M, Berntson A, Berman L, Cheung S, Clay B, Greene R, Jakoncic J, Johnson E, Kao CC, Lenhard A, Pjerov S, Siddons DP, Stober W, Venkatagiriyappa V, Yin Z, Stojanoff V. The NIGMS structural biology facility at the NSLS. ACTA ACUST UNITED AC 2003. [DOI: 10.1080/08940880308603063] [Citation(s) in RCA: 2] [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: 10/21/2022]
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38
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Berlin C, Berman L. The other partner: the young man's role in adolescent pregnancy. Fam Life Educ 2002; 12:4-10. [PMID: 12345686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Abstract
We present an algorithm which combines non-rigid image-based registration and conventional position sensing to correct probe-pressure-induced registration errors in freehand three-dimensional (3D) ultrasound volumes. The local accuracy of image-based registration enables the accurate freehand acquisition of high resolution (>15 MHz) 3D ultrasound data, opening the way for 3D musculoskeletal examinations. External position sensor readings guarantee the large-scale positional accuracy of the data. Pressure correction is shown to dramatically increase the perceived quality of extended-field-of-view data sets and reslices through volumetric data sets, while quantitative comparisons of multiple in vivo volumes demonstrate the superior precision of the corrected data.
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Affiliation(s)
- G M Treece
- Department of Engineering, Trumpington Street, Cambridge CB2 1PZ, UK.
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Billups KL, Berman L, Berman J, Metz ME, Glennon ME, Goldstein I. A new non-pharmacological vacuum therapy for female sexual dysfunction. J Sex Marital Ther 2001; 27:435-441. [PMID: 11554204 DOI: 10.1080/713846826] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Although Female Sexual Dysfunction (FSD) affects 40% of American women, there is no FDA-approved pharmaceutical therapy. The EROS-CTD (Clitoral Therapy Device, UroMetrics, Inc., St. Paul, MN) treatment is the first FDA cleared-to-market therapy for FSD. Clitoral engorgement is believed to play an important role in female sexual arousal and overall sexual satisfaction. The EROS-CTD is a small, battery-powered device designed to enhance clitoral engorgement, increase blood flow to the clitoris, and ultimately improve arousal in women with FSD. The objective of this study was to assess the effectiveness of the EROS-CTD on sexual arousal (genital sensation, vaginal lubrication, ability to reach orgasm, and sexual satisfaction) in normal volunteers and women with FSD.
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Affiliation(s)
- K L Billups
- University of Minnesota, Minneapolis, Minnesota, USA
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Abstract
AIM To prospectively assess the prevalence of paraurethral cystic structures in asymptomatic adult women. PATIENTS AND METHODS One hundred and forty consecutive women undergoing endovaginal sonography with no history of lower urinary tract symptoms. RESULTS Paraurethral cystic structures were identified in 4/140 subjects (2.9%). Ultrasound assessment allowed rapid definition of the site, size and vascularity of these lesions and was well tolerated by the patient. CONCLUSION This is the first prospective ultrasound study to determine the prevalence of paraurethral cystic structures in a large consecutive cohort of asymptomatic women. Our findings are in accordance with previously published post-mortem data and surgical series which have estimated the prevalence of paraurethral cystic structures to be between 1 and 6%.
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Affiliation(s)
- J J Cross
- University Department of Radiology, Cambridge University and Addenbrooke's Hospital, Cambridge, UK
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Abstract
Freehand 3D ultrasound is particularly appropriate for the measurement of organ volumes. For small organs, which can be fully examined with a single sweep of the ultrasound probe, the results are known to be much more accurate than those using conventional 2D ultrasound. However, large or complex shaped organs are difficult to quantify in this manner because multiple sweeps are required to cover the entire organ. Typically, there are significant registration errors between the various sweeps, which generate artifacts in an interpolated voxel array, making segmentation of the organ very difficult. This paper describes how sequential freehand 3D ultrasound, which does not employ an interpolated voxel array, can be used to measure the volume of large organs. Partial organ cross-sections can be segmented in the original B-scans, and then combined, without the need for image-based registration, to give the organ volume. The inherent accuracy (not including position sensor and segmentation errors) is demonstrated in simulation to be within +/- 2%. The in vivo precision of the complete system is demonstrated (by repeated observations of a human liver) to be +/- 5%.
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Affiliation(s)
- G Treece
- University of Cambridge, Department of Engineering, Trumpington Street, CB2 1PZ, Cambridge, UK.
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Connolly DJ, Berman L, McNally EG. The use of beam angulation to overcome anisotropy when viewing human tendon with high frequency linear array ultrasound. Br J Radiol 2001; 74:183-5. [PMID: 11718392 DOI: 10.1259/bjr.74.878.740183] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [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: 11/05/2022] Open
Abstract
Anisotropy is the property of tendons, nerves and muscles to vary in their ultrasound appearance depending on the angle of insonation of the incident ultrasound beam. Loss of reflectivity in tendons may also denote underlying disease. We describe beam angulation, a simple technique available with most modern ultrasound machines, which allows the operator to overcome the potential pitfall of anisotropy in ultrasound assessment of peripheral tendons.
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Affiliation(s)
- D J Connolly
- Department of Radiology, Nuffield Orthopaedic Centre, Headington, Oxford, UK
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Treece GM, Prager RW, Gee AH, Berman L. Surface interpolation from sparse cross sections using region correspondence. IEEE Trans Med Imaging 2000; 19:1106-1114. [PMID: 11204848 DOI: 10.1109/42.896787] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The ability to estimate a surface from a set of cross sections allows calculation of the enclosed volume and the display of the surface in three-dimensions. This process has increasingly been used to derive useful information from medical data. However, extracting the cross sections (segmenting) can be very difficult, and automatic segmentation methods are not sufficiently robust to handle all situations. Hence, it is an advantage if the surface reconstruction algorithm can work effectively on a small number of cross sections. In addition, cross sections of medical data are often quite complex. Shape-based interpolation is a simple and elegant solution to this problem, although it has known limitations when handling complex shapes. In this paper, the shape-based interpolation paradigm is extended to interpolate a surface through sparse, complex cross sections, providing a significant improvement over our previously published maximal disc-guided interpolation. The performance of this algorithm is demonstrated on various types of medical data (X-ray computed tomography, magnetic resonance imaging and three-dimensional ultrasound). Although the correspondence problem in general remains unsolved, it is demonstrated that correct surfaces can be estimated from a limited amount of real data, through the use of region rather than object correspondence.
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Affiliation(s)
- G M Treece
- Department of Engineering, University of Cambridge, UK.
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Berman L. Dealing with amalgam waste. J Can Dent Assoc 2000; 66:290; author reply 290-1. [PMID: 10927888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Abstract
Three-dimensional (3-D) ultrasound (US) data is typically visualised by any-plane slicing, volume rendering or surface rendering. Typical implementations of these techniques do not readily convey the spatial relationship between the visualised data and the patient's body, something that is particularly important when the data are reviewed after the scan has taken place, perhaps by a remote expert who did not even perform the scan. This paper describes a facility to register the 3-D US data to the patient's body and then display the data correctly superimposed on a rendered mannequin (rigid computer model). This way, the user can appreciate the position and orientation of any visualisation with respect to the patient's body. The facility relies on efficient implementation of progressive meshes to manage the level of detail of the mannequin model.
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Affiliation(s)
- P M Tuomola
- Department of Engineering, University of Cambridge, Trumpington Street, CB2 1PZ, Cambridge, UK
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Abstract
Three-dimensional freehand ultrasound imaging produces a set of irregularly spaced B-scans, which are typically reconstructed on a regular grid for visualization and data analysis. Most standard reconstruction algorithms are designed to minimize computational requirements and do not exploit the underlying shape of the data. We investigate whether an approximation with splines holds any promise as a better reconstruction method. A radial basis function approximation method is implemented and compared with three standard methods. While the radial basis approach is computationally expensive, it produces accurate reconstructions without the kind of visible artefacts common with the standard methods. The other potential advantages of radial basis functions, such as the direct computation of derivatives, make further investigation worthwhile.
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Affiliation(s)
- R Rohling
- Department of Engineering, Cambridge, UK
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48
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Berman JR, Berman L, Goldstein I. Female sexual dysfunction: incidence, pathophysiology, evaluation, and treatment options. Urology 1999; 54:385-91. [PMID: 10475340] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- J R Berman
- Division of Urology, Boston University Medical Center, Massachusetts 02110, USA
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Berman L. Letter across the pacific. Crisis 1999; 20:51-3. [PMID: 10434466 DOI: 10.1027/0227-5910.20.2.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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50
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Abstract
Volume measurements from ultrasound B-scans are useful in many clinical areas. It has been demonstrated previously that using three-dimensional (3-D) ultrasound can greatly increase the accuracy of these measurements. Freehand 3-D ultrasound allows freedom of movement in scanning, but the processing is complicated by having non-parallel scan planes. Two techniques are proposed for volume measurement from such data, which also improve surface and volume estimation from data acquired on parallel planes. Cubic planimetry is a more accurate extension of a volume measurement technique involving vector areas and centroids of cross-sections. Maximal-disc shape-based interpolation is an extension of shape-based interpolation which uses maximal disc representations to adjust the interpolation direction locally and hence improve the quality of the surface generated. Both methods are tested in simulation and in vivo. Volumes estimated using cubic planimetry are more accurate than step-section planimetry, and require fewer cross-sections, even for complex objects. Maximal-disc shape-based interpolation provides a reliable means of reconstructing surfaces from a handful of cross-sections, and can therefore be used to give confidence in the segmentation and hence also the cubic planimetry volume.
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Affiliation(s)
- G M Treece
- Department of Engineering, University of Cambridge, UK.
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