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Nardi G, Piredda D, Cossu A, Cingolani E, Cristofani M, Ghezzi I. Hemodynamics in the severely injured patient with significant hemorrhage. Crit Care 2012. [PMCID: PMC3363869 DOI: 10.1186/cc11058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Bertazzoni G, Cristofani M, Ponzanetti A, Trabalzini A, Attalla H, De Vito C, Villari P. Scant justification for interhospital transfers: a cause of reduced efficiency in the emergency department. Emerg Med J 2008; 25:558-61. [PMID: 18723701 DOI: 10.1136/emj.2007.052415] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Interhospital transfers are one of the critical points of the emergency system, which often cause overcrowding of the emergency department (ED) and limit its effectiveness. METHODS A retrospective study was carried out, analyzing the clinical case files concerning the ED of the Policlinico "Umberto I" in Rome (Latium region, Italy) with the aim of establishing the reasons for the numerous unjustified transfers. RESULTS From 1 January to 30 June 2006, 77 597 admissions to the ED occurred, and 861 patients (1.1%) were sent from other hospitals. 361 patients out of 861 (41.9%) were transferred with critical clinical conditions. The remaining 500 patients (58.1%) were transferred requiring specialised care. The need for specialised care was confirmed in 230 cases (46.0%) and therefore these transfers could be considered justified. The other 270 transfers (54.0%) were unjustified: 138 patients remained in the hospital to which they had been sent, contributing to crowding of the ED; 132 patients were returned, thereby placing them at additional risk. CONCLUSION Unfamiliarity with the regulations governing interhospital transfers is the main cause of scantly justified transfers and the consequent reduction in efficiency of the ED in the receiving hospital.
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Affiliation(s)
- G Bertazzoni
- Emergency Department, Policlinico Umberto I Rome, Via del Policlinico 155, 00161 Rome, Italy.
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Simpson AJ, Reinach FC, Arruda P, Abreu FA, Acencio M, Alvarenga R, Alves LM, Araya JE, Baia GS, Baptista CS, Barros MH, Bonaccorsi ED, Bordin S, Bové JM, Briones MR, Bueno MR, Camargo AA, Camargo LE, Carraro DM, Carrer H, Colauto NB, Colombo C, Costa FF, Costa MC, Costa-Neto CM, Coutinho LL, Cristofani M, Dias-Neto E, Docena C, El-Dorry H, Facincani AP, Ferreira AJ, Ferreira VC, Ferro JA, Fraga JS, França SC, Franco MC, Frohme M, Furlan LR, Garnier M, Goldman GH, Goldman MH, Gomes SL, Gruber A, Ho PL, Hoheisel JD, Junqueira ML, Kemper EL, Kitajima JP, Krieger JE, Kuramae EE, Laigret F, Lambais MR, Leite LC, Lemos EG, Lemos MV, Lopes SA, Lopes CR, Machado JA, Machado MA, Madeira AM, Madeira HM, Marino CL, Marques MV, Martins EA, Martins EM, Matsukuma AY, Menck CF, Miracca EC, Miyaki CY, Monteriro-Vitorello CB, Moon DH, Nagai MA, Nascimento AL, Netto LE, Nhani A, Nobrega FG, Nunes LR, Oliveira MA, de Oliveira MC, de Oliveira RC, Palmieri DA, Paris A, Peixoto BR, Pereira GA, Pereira HA, Pesquero JB, Quaggio RB, Roberto PG, Rodrigues V, de M Rosa AJ, de Rosa VE, de Sá RG, Santelli RV, Sawasaki HE, da Silva AC, da Silva AM, da Silva FR, da Silva WA, da Silveira JF, Silvestri ML, Siqueira WJ, de Souza AA, de Souza AP, Terenzi MF, Truffi D, Tsai SM, Tsuhako MH, Vallada H, Van Sluys MA, Verjovski-Almeida S, Vettore AL, Zago MA, Zatz M, Meidanis J, Setubal JC. The genome sequence of the plant pathogen Xylella fastidiosa. The Xylella fastidiosa Consortium of the Organization for Nucleotide Sequencing and Analysis. Nature 2000; 406:151-9. [PMID: 10910347 DOI: 10.1038/35018003] [Citation(s) in RCA: 538] [Impact Index Per Article: 22.4] [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: 11/08/2022]
Abstract
Xylella fastidiosa is a fastidious, xylem-limited bacterium that causes a range of economically important plant diseases. Here we report the complete genome sequence of X. fastidiosa clone 9a5c, which causes citrus variegated chlorosis--a serious disease of orange trees. The genome comprises a 52.7% GC-rich 2,679,305-base-pair (bp) circular chromosome and two plasmids of 51,158 bp and 1,285 bp. We can assign putative functions to 47% of the 2,904 predicted coding regions. Efficient metabolic functions are predicted, with sugars as the principal energy and carbon source, supporting existence in the nutrient-poor xylem sap. The mechanisms associated with pathogenicity and virulence involve toxins, antibiotics and ion sequestration systems, as well as bacterium-bacterium and bacterium-host interactions mediated by a range of proteins. Orthologues of some of these proteins have only been identified in animal and human pathogens; their presence in X. fastidiosa indicates that the molecular basis for bacterial pathogenicity is both conserved and independent of host. At least 83 genes are bacteriophage-derived and include virulence-associated genes from other bacteria, providing direct evidence of phage-mediated horizontal gene transfer.
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Affiliation(s)
- A J Simpson
- Instituto Ludwig de Pesquisa sobre o Câncer, São Paulo, SP, Brazil
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