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Alladin A, Khawand-Azoulai M, Lipman K, Bland S, Ferrari C, Drice J, Van Zuilen MH. Analysis of Student Reflections on "What Matters Most" to Palliative Care Patients: A Narrative Medicine Exercise. J Palliat Med 2023; 26:1115-1120. [PMID: 37083420 DOI: 10.1089/jpm.2023.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Background: Effective communication with ill patients requires practice, yet, the traditional history overlooks patients' personal stories. This information is vital to determining goals of care and facilitates partnership by building trust. Objective: We implemented a narrative medicine exercise for students during their palliative medicine rotation to highlight humanism. Impact was determined through thematic analysis of students' reflections. Design: Students elicited "what matters most" to patients, transcribing this plus a personal reflection. Using an inductive and iterative approach, 100 reflections were analyzed, developing codes then broader themes. Results: Four main themes (Getting to know the patient, Student Reaction, Building-blocks of patient-physician relationship, Student Personal Insights) were identified, with 15 subthemes. Conclusion: The power of uncovering patients' backgrounds and values was demonstrated, reinforcing a palliative medicine approach. Analysis showed a positive impact and the possibility of change to future practice. The intervention was feasible, well received, and encouraged reflection on the physician-patient relationship beyond the medical domain.
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Affiliation(s)
- Amanda Alladin
- Division of Pediatric Critical Care, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mariana Khawand-Azoulai
- Division of Geriatrics and Palliative Medicine, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Kyra Lipman
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Sarah Bland
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Corinne Ferrari
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jenny Drice
- Division of Geriatrics and Palliative Medicine, Department of Medical Education, University of Miami Miller School of Medicine, Miami, Florida, USA
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2
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Kumnick A, Shah K, Muller C, Bornstein K, Perone H, Herweck A, Syms S, Gutierrez SM, Mendez P, Bland S, Agarwal G, Broome M, Belkowitz J. Developing Awareness and Allies: Simulating Difficult Conversations about Microaggressions for Faculty and Students. South Med J 2022; 115:283-289. [PMID: 35504606 DOI: 10.14423/smj.0000000000001396] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Discrimination and bias in clinical training often take the form of microaggressions, which, albeit unintentional, are detrimental to the learning environment and well-being of students. Although there are a few reports of medical schools training students to respond to microaggressions, none have included a complementery student-led faculty training module. The aim of this study was to develop and evaluate a case-based approach to improving student resilience and increasing faculty awareness of microaggressions in the clinical setting. METHODS We created four realistic cases of microaggressions and uncomfortable conversations, based on students' experiences on the wards, to implement training for incoming third-year students and their core faculty. Standardized patients were trained to effectively portray discriminatory faculty, residents, and patients. Institutional review board-approved surveys were administered and statistically analyzed to evaluate for efficacy. RESULTS Students had greater mean confidence scores for responding to microaggressions immediately and at 6 months after the sessions (P < 0.05). Faculty showed improved mean confidence and understanding of the definition of a microaggression (P < 0.05). CONCLUSIONS This approach had results similar to other studies, with the additional benefit of training faculty with the same scenarios. We believe that this method helped bridge the gap between students' notions of discrimination and faculty understanding of microaggressions.
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Affiliation(s)
- Allison Kumnick
- From the Gordon Center for Simulation and Innovation, the Departments of Medicine, Medical Education, and Pediatrics, and the Communications Skills Program, University of Miami Miller School of Medicine, Miami, Florida
| | - Khushali Shah
- From the Gordon Center for Simulation and Innovation, the Departments of Medicine, Medical Education, and Pediatrics, and the Communications Skills Program, University of Miami Miller School of Medicine, Miami, Florida
| | - Carly Muller
- From the Gordon Center for Simulation and Innovation, the Departments of Medicine, Medical Education, and Pediatrics, and the Communications Skills Program, University of Miami Miller School of Medicine, Miami, Florida
| | - Kasha Bornstein
- From the Gordon Center for Simulation and Innovation, the Departments of Medicine, Medical Education, and Pediatrics, and the Communications Skills Program, University of Miami Miller School of Medicine, Miami, Florida
| | - Hanna Perone
- From the Gordon Center for Simulation and Innovation, the Departments of Medicine, Medical Education, and Pediatrics, and the Communications Skills Program, University of Miami Miller School of Medicine, Miami, Florida
| | - Alexandra Herweck
- From the Gordon Center for Simulation and Innovation, the Departments of Medicine, Medical Education, and Pediatrics, and the Communications Skills Program, University of Miami Miller School of Medicine, Miami, Florida
| | - Samantha Syms
- From the Gordon Center for Simulation and Innovation, the Departments of Medicine, Medical Education, and Pediatrics, and the Communications Skills Program, University of Miami Miller School of Medicine, Miami, Florida
| | - Saily M Gutierrez
- From the Gordon Center for Simulation and Innovation, the Departments of Medicine, Medical Education, and Pediatrics, and the Communications Skills Program, University of Miami Miller School of Medicine, Miami, Florida
| | - Paul Mendez
- From the Gordon Center for Simulation and Innovation, the Departments of Medicine, Medical Education, and Pediatrics, and the Communications Skills Program, University of Miami Miller School of Medicine, Miami, Florida
| | - Sarah Bland
- From the Gordon Center for Simulation and Innovation, the Departments of Medicine, Medical Education, and Pediatrics, and the Communications Skills Program, University of Miami Miller School of Medicine, Miami, Florida
| | - Gauri Agarwal
- From the Gordon Center for Simulation and Innovation, the Departments of Medicine, Medical Education, and Pediatrics, and the Communications Skills Program, University of Miami Miller School of Medicine, Miami, Florida
| | - Monica Broome
- From the Gordon Center for Simulation and Innovation, the Departments of Medicine, Medical Education, and Pediatrics, and the Communications Skills Program, University of Miami Miller School of Medicine, Miami, Florida
| | - Julia Belkowitz
- From the Gordon Center for Simulation and Innovation, the Departments of Medicine, Medical Education, and Pediatrics, and the Communications Skills Program, University of Miami Miller School of Medicine, Miami, Florida
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3
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Glazer AM, Davogustto G, Shaffer CM, Vanoye CG, Desai RR, Farber-Eger EH, Dikilitas O, Shang N, Pacheco JA, Yang T, Muhammad A, Mosley JD, Van Driest SL, Wells QS, Shaffer LL, Kalash OR, Wada Y, Bland S, Yoneda ZT, Mitchell DW, Kroncke BM, Kullo IJ, Jarvik GP, Gordon AS, Larson EB, Manolio TA, Mirshahi T, Luo JZ, Schaid D, Namjou B, Alsaied T, Singh R, Singhal A, Liu C, Weng C, Hripcsak G, Ralston JD, McNally EM, Chung WK, Carrell DS, Leppig KA, Hakonarson H, Sleiman P, Sohn S, Glessner J, Denny J, Wei WQ, George AL, Shoemaker MB, Roden DM. Arrhythmia Variant Associations and Reclassifications in the eMERGE-III Sequencing Study. Circulation 2022; 145:877-891. [PMID: 34930020 PMCID: PMC8940719 DOI: 10.1161/circulationaha.121.055562] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Sequencing Mendelian arrhythmia genes in individuals without an indication for arrhythmia genetic testing can identify carriers of pathogenic or likely pathogenic (P/LP) variants. However, the extent to which these variants are associated with clinically meaningful phenotypes before or after return of variant results is unclear. In addition, the majority of discovered variants are currently classified as variants of uncertain significance, limiting clinical actionability. METHODS The eMERGE-III study (Electronic Medical Records and Genomics Phase III) is a multicenter prospective cohort that included 21 846 participants without previous indication for cardiac genetic testing. Participants were sequenced for 109 Mendelian disease genes, including 10 linked to arrhythmia syndromes. Variant carriers were assessed with electronic health record-derived phenotypes and follow-up clinical examination. Selected variants of uncertain significance (n=50) were characterized in vitro with automated electrophysiology experiments in HEK293 cells. RESULTS As previously reported, 3.0% of participants had P/LP variants in the 109 genes. Herein, we report 120 participants (0.6%) with P/LP arrhythmia variants. Compared with noncarriers, arrhythmia P/LP carriers had a significantly higher burden of arrhythmia phenotypes in their electronic health records. Fifty-four participants had variant results returned. Nineteen of these 54 participants had inherited arrhythmia syndrome diagnoses (primarily long-QT syndrome), and 12 of these 19 diagnoses were made only after variant results were returned (0.05%). After in vitro functional evaluation of 50 variants of uncertain significance, we reclassified 11 variants: 3 to likely benign and 8 to P/LP. CONCLUSIONS Genome sequencing in a large population without indication for arrhythmia genetic testing identified phenotype-positive carriers of variants in congenital arrhythmia syndrome disease genes. As the genomes of large numbers of people are sequenced, the disease risk from rare variants in arrhythmia genes can be assessed by integrating genomic screening, electronic health record phenotypes, and in vitro functional studies. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier; NCT03394859.
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Affiliation(s)
| | | | | | | | | | | | | | - Ning Shang
- Columbia University Irving Medical Center, New York NY
| | | | - Tao Yang
- Vanderbilt University Medical Center, Nashville TN
| | | | | | | | | | | | | | - Yuko Wada
- Vanderbilt University Medical Center, Nashville TN
| | - Sarah Bland
- Vanderbilt University Medical Center, Nashville TN
| | | | | | | | | | - Gail P. Jarvik
- Departments of Medicine (Medical Genetics) and Genome Sciences, University of Washington School of Medicine, Seattle, WA
| | | | | | | | | | | | | | - Bahram Namjou
- Cincinnati Children’s Hospital Medical Center, Cincinnati OH
| | - Tarek Alsaied
- Cincinnati Children’s Hospital Medical Center, Cincinnati OH
| | | | | | - Cong Liu
- Columbia University Irving Medical Center, New York NY
| | - Chunhua Weng
- Columbia University Irving Medical Center, New York NY
| | | | - James D. Ralston
- Departments of Medicine (Medical Genetics) and Genome Sciences, University of Washington School of Medicine, Seattle, WA
| | | | | | | | | | | | | | | | | | | | | | - Wei-Qi Wei
- Vanderbilt University Medical Center, Nashville TN
| | | | | | - Dan M. Roden
- Vanderbilt University Medical Center, Nashville TN
- Correspondence should be addressed to Dan M. Roden, MD, Vanderbilt University Medical Center, 2215B Garland Ave, 1285 MRBIV, Nashville, TN 37232,
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4
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Hubert M, Hooker G, Bland S, Celaya-Cobbs N, Andujar J, Orlando L, Wiesner G. eP489: Exploring engagement and uptake of a comprehensive family history-based cancer risk assessment tool. Genet Med 2022. [DOI: 10.1016/j.gim.2022.01.521] [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: 11/30/2022] Open
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5
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Pratap S, Marshall D, Bland S, Jones S, Orlando L, Alexander L, Duke J, Wiesner G. eP506: Implementing diverse community engagement studios: The Family History and Cancer Risk Study (FOREST) at Vanderbilt and Meharry Medical College. Genet Med 2022. [DOI: 10.1016/j.gim.2022.01.538] [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: 11/27/2022] Open
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6
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Perone HR, Dietz NA, Belkowitz J, Bland S. Intimate partner violence: analysis of current screening practices in the primary care setting. Fam Pract 2022; 39:6-11. [PMID: 34184740 DOI: 10.1093/fampra/cmab069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a largely undetected occurrence in the United States reported by 36-50% of women in their lifetime and associated with extensive physical and psychological implications. Currently, conflicting recommendations exist regarding screening practices with the United States Preventative Services Task Force (USPSTF) and the World Health Organization (WHO) advocating for and against universal screening, respectively. With research suggesting that women are seldom asked about IPV during clinic visits, further information is needed regarding current screening practices. OBJECTIVES To identify current IPV screening approaches in the primary care setting and factors that may impact screening completion. METHODS We retrospectively examined patients presenting for annual examinations at four university-associated primary care clinics in southeast Florida (n = 400). Patient demographics, screener demographics, screening completion, and screening results were collected from the medical record. Results were compared to depression and anxiety screenings due to comparable prevalence and screening recommendations. Pearson chi square and Fisher exact tests were utilized to compare screening rates by demographic characteristics. RESULTS IPV screening occurred at a much lower frequency (8.5%) compared to screenings for anxiety (37.3%) and depression (71.3%). Among documented IPV screenings, 64.7% of encounters resulted in patient refusal to be screened. Screening rates were found to be marginally impacted by patient ethnicity (P = 0.052). CONCLUSIONS Findings of both low screening rates and low screening success raise significant concerns for the shortcomings of advocating for universal IPV screening. Therefore, additional studies are necessary to identify covert barriers to screening completion before universal inquiry is advised.
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Affiliation(s)
- Hanna R Perone
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami
| | - Noella A Dietz
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami.,North Broward Hospital District d/b/a Broward Health, Fort Lauderdale
| | - Julia Belkowitz
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami.,Department of Medical Education, University of Miami Miller School of Medicine, Miami, USA
| | - Sarah Bland
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, USA
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7
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Sen JPB, Sandhu R, Bland S. Chemical incidents. BJA Educ 2021; 21:126-132. [PMID: 33777410 DOI: 10.1016/j.bjae.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- J P B Sen
- Sheffield Teaching Hospitals, Sheffield, UK
| | - R Sandhu
- Pinderfields Hospital, Wakefield, UK
| | - S Bland
- Queen Alexandra Hospital, Portsmouth, UK
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8
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Finn KS, Lynch J, Aufox S, Bland S, Chung W, Halverson C, Hebbring S, Hoell C, Holm I, Jarvik G, Kullo I, Leppig K, Myers M, Prows C, Rasouly HM, Singh R, Weisner G, Williams J, Wynn J, Smith M, Sharp R. Returning negative results from
large‐scale
genomic screening: Experiences from the
eMERGE III
network. Am J Med Genet A 2020; 185:508-516. [DOI: 10.1002/ajmg.a.62002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Kelsey Stuttgen Finn
- Biomedical Ethics Research Program Mayo Clinic Rochester Minnesota USA
- Department of Health Sciences Research Mayo Clinic Rochester Minnesota USA
| | - John Lynch
- Department of Communication University of Cincinnati Cincinnati Ohio USA
| | - Sharon Aufox
- Center for Genomic Medicine Feinberg School of Medicine, Northwestern University Chicago Illinois USA
| | - Sarah Bland
- Department of Biomedical Informatics Vanderbilt University Medical Center Nashville Tennessee USA
| | - Wendy Chung
- Department of Pediatrics Columbia University New York New York USA
| | - Colin Halverson
- School of Medicine Indiana University‐Purdue University Indianapolis Indiana USA
| | - Scott Hebbring
- Center for Human Genetics Marshfield Clinic Research Institute Marshfield Wisconsin USA
| | - Christin Hoell
- Center for Genomic Medicine Feinberg School of Medicine, Northwestern University Chicago Illinois USA
| | - Ingrid Holm
- Department of Pediatrics Harvard Medical School Boston Massachusetts USA
- Division of Genetics and Genomics Boston Children's Hospital Boston Massachusetts USA
| | - Gail Jarvik
- Division of Medical Genetics School of Medicine, University of Washington Seattle Washington USA
| | - Iftikhar Kullo
- Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA
| | - Kathleen Leppig
- Genetic Services Kaiser Permanente of Washington Seattle Washington USA
- Biomedical and Health Informatics University of Washington Seattle Washington USA
| | - Melanie Myers
- College of Medicine University of Cincinnati Cincinnati Ohio USA
- Department of Pediatrics Cincinnati Children's Hospital Medical Center, University of Cincinnati Cincinnati Ohio USA
| | - Cynthia Prows
- Department of Pediatrics Cincinnati Children's Hospital Medical Center, University of Cincinnati Cincinnati Ohio USA
| | - Hila Milo Rasouly
- Department of Medicine, Division of Nephrology Columbia University Irving Medical Center New York New York USA
| | - Rajbir Singh
- Department of Microbiology and Immunology Meharry Medical College Nashville Tennessee USA
- Department of Obstetrics and Gynecology Meharry Medical College Nashville Tennessee USA
| | - Georgia Weisner
- Department of Medicine Vanderbilt University Medical Center Nashville Tennessee USA
- Vanderbilt Clinical and Translational Hereditary Cancer Program Vanderbilt‐Ingram Cancer Center, Vanderbilt University Medical Center Nashville Tennessee USA
| | - Janet Williams
- Geisinger Genomic Medicine Institute Danville Pennsylvania USA
| | - Julia Wynn
- Department of Pediatrics Columbia University New York New York USA
| | - Maureen Smith
- Department of Medicine Feinberg School of Medicine, Northwestern University Chicago Illinois USA
| | - Richard Sharp
- Biomedical Ethics Research Program Mayo Clinic Rochester Minnesota USA
- Department of Health Sciences Research Mayo Clinic Rochester Minnesota USA
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9
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Piet E, Lejeune S, Maillet M, Tolsma V, Janssen C, Meynet E, Bland S, Petitprez H, Vitrat V. Effet d’une intervention de l’équipe opérationnelle d’infectiologie sur le traitement et le pronostic des infections à Clostridium difficile. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.037] [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: 10/26/2022]
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10
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Rees P, Waller B, Buckley AM, Doran C, Bland S, Scott T, Matthews J. REBOA at Role 2 Afloat: resuscitative endovascular balloon occlusion of the aorta as a bridge to damage control surgery in the military maritime setting. J ROY ARMY MED CORPS 2017; 164:72-76. [PMID: 29269480 DOI: 10.1136/jramc-2017-000874] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 11/18/2017] [Accepted: 11/20/2017] [Indexed: 11/04/2022]
Abstract
Role 2 Afloat provides a damage control resuscitation and surgery facility in support of maritime, littoral and aviation operations. Resuscitative endovascular balloon occlusion of the aorta (REBOA) offers a rapid, effective solution to exsanguinating haemorrhage from pelvic and non-compressible torso haemorrhage. It should be considered when the patient presents in a peri-arrest state, if surgery is likely to be delayed, or where the single operating table is occupied by another case. This paper will outline the data in support of endovascular haemorrhage control, describe the technique and explore how REBOA could be delivered using equipment currently available in the Royal Navy Role 2 Afloat equipment module. Also discussed are potential future directions in endovascular resuscitation.
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Affiliation(s)
- Paul Rees
- Academic Department of Military Medicine, London, UK.,University of St Andrews School of Medicine, St Andrews, UK
| | - B Waller
- Shackleton Department of Anaesthetics, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A M Buckley
- Academic Department of Military Medicine, London, UK
| | - C Doran
- Department of Surgery, Royal Centre for Defence Medicine, Birmingham, UK
| | - S Bland
- Department of Emergency Medicine, Queen Alexandra Hospital, Portsmouth, UK
| | - T Scott
- Department of Anaesthesia and Critical Care, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - J Matthews
- Department of Orthopaedics and Trauma Surgery, Royal Cornwall Hospitals NHS Trust, Truro, UK.,Clinical Director Role 2 Afloat, National Command Headquarters, Portsmouth, UK
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11
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Tolsma V, Bru J, Sirodot M, Beaune G, Cohen S, Bland S, Destrem A, Janssen C, Piet E. Les doses de cefazoline actuellement recommandées permettent-elles d’obtenir des concentrations plasmatiques suffisantes ? Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.044] [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: 11/28/2022]
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12
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Vitrat V, Piet E, Tolsma V, Bonnin P, Bland S, Chirpaz JM, Gaillat J. G-03: Connaître son écologie dans l’infection osseuse sur matériel, un bon moyen de préserver les antibiotiques ? Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70172-6] [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: 10/25/2022]
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13
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Bru JP, Pagani L, Vitrat V, Jehl F, Bland S, Baune G, Tolsma V. M-16: PK/PD de l’amoxicilline administrée par voie orale (Avo) chez des patients ayant des infections difficiles dues à des bactéries à gram + nécessitant des traitements de longue durée. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70253-7] [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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14
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Guillaume M, Garraffo R, Bensalem M, Janssen C, Bland S, Gaillat J, Bru JP. Pharmacokinetic and dynamic study of levofloxacin and rifampicin in bone and joint infections. Med Mal Infect 2012; 42:414-20. [DOI: 10.1016/j.medmal.2012.07.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 03/10/2012] [Accepted: 07/29/2012] [Indexed: 11/29/2022]
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15
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Abstract
The Haywood Medical Society met in June 2011 to discuss issues surrounding the preparedness of both civilian and military emergency services to deal with a CBRN threat.
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Affiliation(s)
- D Holdsworth
- Defence CBRN Centre, Winterbourne Gunner, Salisbury
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16
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Singer E, Calvet L, Mory F, Muller C, Chomarat M, Bézian MC, Bland S, Juvenin ME, Drugeon H, Fosse T, Goldstein F, Jaulhac B, Monteil H, Marchandin H, Jean-Pierre H, Dubreuil L. Surveillance de la résistance aux antibiotiques des anaérobies stricts à Gram négatif. Med Mal Infect 2008; 38:256-63. [DOI: 10.1016/j.medmal.2008.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2007] [Accepted: 03/10/2008] [Indexed: 11/16/2022]
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17
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McMorrow DF, Beale T, Bland S, Boothroyd AT, Ewings R, Forrest T, Hatton PD, Joly Y, Mannix D, Prabhakaran RD, Walker H, Wilkins SB. Probing novel order parameters in multiferroics with X-ray resonant scattering. Acta Crystallogr A 2007. [DOI: 10.1107/s0108767307097991] [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: 11/11/2022] Open
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18
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Behra-Miellet J, Calvet L, Mory F, Muller C, Chomarat M, Bézian MC, Bland S, Juvenin ME, Fosse T, Goldstein F, Jaulhac B, Dubreuil L. Antibiotic resistance among anaerobic Gram-negative bacilli: lessons from a French multicentric survey. Anaerobe 2007; 9:105-11. [PMID: 16887696 DOI: 10.1016/s1075-9964(03)00066-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2002] [Revised: 03/31/2003] [Accepted: 05/19/2003] [Indexed: 11/24/2022]
Abstract
Temporal changes of antibiotic susceptibilities among anaerobes in France are followed in our laboratory since 1992. For Bacteroides strains, resistance increased from 1992 to 1998 for amoxicillin-clavulanic acid, cefotetan and clindamycin. The present study evaluates the situation in 2000 for 434 Gram-negative anaerobic clinical isolates (obtained from 9 large university hospitals) by testing amoxicillin and ticarcillin alone or combined with clavulanic acid, cefoxitin, cefotetan, imipenem, clindamycin and metronidazole (using the NCCLS-approved method for MIC determination. The main genera tested included Bacteroides (359 strains of the fragilis group), Prevotella (40 strains), Fusobacterium (23 strains) and miscellaneous species (8 strains). Resistance rates within the B. fragilis group were: amoxicillin-clavulanic acid 5.6%, ticarcillin 33%, ticarcillin-clavulanic acid 2%, cefoxitin 13%, cefotetan 44%, clindamycin 33%, imipenem 1% and metronidazole <1%, respectively. Only one strain of B. fragilis was resistant to metronidazole (MIC=64 mg/L); due to the presence of the nimA gene on the chromosome. Resistance to imipenem or metronidazole was only found among the B. fragilis species. These two former drugs excepted, B. fragilis was less resistant to antibiotics than the other species. beta-lactamase production was detected for 357/359 strains of the fragilis group, 26/40 stains of Prevotella and 3/23 strains of Fusobacterium. Dynamic changes of antibacterial resistance are occurring within the B. fragilis group: decreased resistance to amoxicillin-clavulanic acid, ticarcillin-clavulanic acid, imipenem while resistance for cefoxitin, cefotetan, clindamycin continues to increase. Regular antibiotic surveys are needed as a source of information to guide the empirical therapy of anaerobic infections.
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Affiliation(s)
- J Behra-Miellet
- Laboratoire de Bactériologie, Faculte des Sciences Pharmaceutiques et Biologiques, 3, rue du Professeur, Laguesse BP83, Lille 59006, Cedex, France
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19
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Hansen LA, Vermeulen LC, Bland S, Wetterneck TB. Guideline for low-cost antimicrobial use in the outpatient setting. Am J Med 2007; 120:295-302. [PMID: 17398219 DOI: 10.1016/j.amjmed.2006.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2005] [Revised: 05/31/2006] [Accepted: 06/01/2006] [Indexed: 10/23/2022]
Abstract
In an effort to increase appropriate prescribing of low-cost antimicrobials in the outpatient setting, an evidence-based guideline was created to identify situations when low-cost medications can be used. A literature search identified relevant clinical trials describing the efficacy of antimicrobials used in the outpatient setting. These were analyzed to identify low-cost medications defined as $15 or less. The information was put into guideline format that includes the level of evidence for recommending the drug and information about cost. Sixteen common infections and their treatments were included in the guideline. The efficacy data were similar for the low-cost and higher-cost antimicrobials for all infections included. We created a low-cost antimicrobial guideline for common infections treated in the outpatient setting. The treatment options have similar efficacy to higher cost medications. This guideline will serve as an information source for providers to help them rapidly determine the low-cost treatments for common infections. In addition, it can serve as a template for the development of similar guidelines in other therapeutic classes. These guidelines should be customized before implementation at other health care organizations, with consideration of local resistance patterns, drug availability and patient factors. The effect of guideline implementation on future prescribing habits and providers' opinions about availability of cost information and subsequent conversations with patients and prescribers of medications deserves further study.
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Affiliation(s)
- Lizbeth A Hansen
- Department of Pharmacy, University of Wisconsin Hospital and Clinics, Madison, WI 53792, USA
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Dubreuil L, Behra-Miellet J, Vouillot C, Bland S, Sedallian A, Mory F. Corrigendum to “β-lactamase production in Prevotella and in vitro susceptibilities to selected β-lactam antibiotics”. Int J Antimicrob Agents 2003. [DOI: 10.1016/s0924-8579(03)00226-7] [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: 10/27/2022]
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Dubreuil L, Behra-Miellet J, Vouillot C, Bland S, Sedallian A, Mory F. Beta-lactamase production in Prevotella and in vitro susceptibilities to selected beta-lactam antibiotics [corrected]. Int J Antimicrob Agents 2003; 21:267-73. [PMID: 12636990 DOI: 10.1016/s0924-8579(02)00352-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [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: 10/27/2022]
Abstract
This study looked for beta-lactamase production in 100 Prevotella isolates. MICs were determined for amoxycillin, ticarcillin, amoxycillin+clavulanate, cephalothin, cefuroxime, cefixime, cefpodoxime and cefotaxime using the reference agar dilution method (standard M11 A4, NCCLS). Beta-lactamase activity was detected in 58 of the 100 isolates, 24 of 46 black-pigmented Provotella and 34 of 54 non-pigmented Prevotella. All beta-lactamase-negative strains were susceptible to all beta-lactam antibiotics with the exception of cefuroxime and cefixime. Overall, resistance rates of Prevotella strains were lower for ticarcillin (8%) and celefotaxime (12%) than for the other cephalosporins. All Prevotella isolates were susceptible to amoxycillin and were all inhibited by 2 mg/l or less amoxycillin [corrected].
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Affiliation(s)
- L Dubreuil
- Faculté de Pharmacie, 3 rue du Professeur Laguesse, BP83, Lille Cedex 59006, France.
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Li R, Serdula M, Bland S, Mokdad A, Bowman B, Nelson D. Trends in fruit and vegetable consumption among adults in 16 US states: Behavioral Risk Factor Surveillance System, 1990-1996. Am J Public Health 2000; 90:777-81. [PMID: 10800429 PMCID: PMC1446230 DOI: 10.2105/ajph.90.5.777] [Citation(s) in RCA: 118] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study examined trends in fruit and vegetable consumption among adults in 16 US states. METHODS Data from telephone surveys were used to stratify respondents by sociodemographic and health-related characteristics. RESULTS The proportion of adults who consumed fruits and vegetables at least 5 times daily was 19%, 22%, and 23% in 1990, 1994, and 1996, respectively. While the proportion increased among those with active leisure-time physical activities and normal weight, it remained almost the same among inactive people and dropped among the obese. CONCLUSIONS Progress in fruit and vegetable intake from 1990 to 1994 was encouraging, but it changed little between 1994 and 1996.
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Affiliation(s)
- R Li
- Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention (MS K25), Atlanta, GA 30341-3717, USA.
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Thierry J, Perrier-Gros-Claude JD, Clavier B, Dumas M, Aubert G, Barbe G, Bland S, Boucaud-Maitre Y, Boyer M, Carricajo A, Chomarat M, Clergeau P, Delubac F, Fevre D, Fuhrmann C, Gravagnat B, Lelievre H, Letouzey MN, Mandjee A, Martelet P, Meley R, Reverdy ME, Ros A, Roure C, Tixier A. [Pneumococcus observatory data in the Rhône-Alps region. Results from 1996]. Pathol Biol (Paris) 1999; 47:1060-4. [PMID: 10674259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Throughout 1996, 22 hospital-based laboratories in the Rhône-Alpes region of France collected pneumococcal strains and used a standardized protocol to record the following data; patient age and sex; type of specimen; and determination of susceptibility to at least the following antibiotics: oxacillin 1 microgram and 5 micrograms, erythromycin (Ery), tetracycline (Tet), chloramphenicol (Chl), rifampin (Rmp), and loracarbef. For penicillin-nonsusceptible strains (PNSSs), which were identified based on results with oxacillin, MICs for penicillin G, amoxicillin (Amx), and cefotaxime (Ctx) were determined using the E Test, at the study site and agar dilution at the coordinating center. Of the 1153 strains, 65.5% were from adults and 31.8% from children; patient age was unknown in 2.7% of cases. PNSPs (MIC > 0.06 mg/l) contributed 32.9% of strains (I: 23.3%; R: 9.6%) and were more common in children (41.1%) than in adults (28.1%). The frequency of PNSSs varied across specimen types: 27.9% in blood cultures (305 strains), 15.6% in cerebrospinal fluid (32), 38.7% in protected bronchopulmonary specimens (31), 31.5% in unprotected bronchopulmonary specimens (434), 50.8% in acute otitis media (118), and 34.4% in other specimens (221). Among PNSSs, nonsusceptibility (I + R) to other antibiotics was variable: Ery, 62.1%; Tet, 41.5%; Chl, 40.4%; Rmp, 1.1%. Corresponding figures for the overall strain population were Ery, 33.3%; Tet, 22.7%; Chl, 22.8%; Rmp, 0.9%. In addition, 56.5% of PNSSs exhibited multiple drug resistance. Resistance to amoxicillin (MIC > 2 mg/l) was demonstrated for only 5 strains. No strains were resistant to loracarbef or cefotaxime. Serotypes of the 379 PNSSs were as follows: 23F, 26.6%; 14 (25.6%); 9V (18.2%), 6 (8.7%), 15 (5%), 19 (4.5%).
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Affiliation(s)
- J Thierry
- Laboratoire de Biologie médicale, HIA Desgenettes, Lyon Armées, France
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Abstract
OBJECTIVES It has been proposed that individuals aged 55 to 64 years be allowed to buy into Medicare. This group is more likely than younger adults to have marginal health status, to be separating from the workforce, to face high premiums, and to risk financial hardship from major medical illness. The present study examined prevalence of health insurance coverage by demographic characteristics and examined how lack of insurance may affect use of preventive health services. METHODS Data were obtained from the Behavioral Risk Factor Surveillance System, an ongoing telephone survey of adults conducted by the 50 states and the District of Columbia. RESULTS Many near-elderly adults least likely to have health care coverage were Black or Hispanic, had less than a high school education and incomes less than $15,000 per year, and were unemployed or self-employed. Health insurance coverage was associated with increased use of clinical preventive services even when sex, race/ethnicity, marital status, and educational level were controlled. CONCLUSIONS Many near-elderly individuals without insurance will probably not be able to participate in a Medicare buy-in unless it is subsidized in some way.
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Affiliation(s)
- E Powell-Griner
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
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Mory F, Lozniewski A, Bland S, Sedallian A, Grollier G, Girard-Pipau F, Paris MF, Dubreuil L. Survey of anaerobic susceptibility patterns: a French multicentre study. Int J Antimicrob Agents 1998; 10:229-36. [PMID: 9832284 DOI: 10.1016/s0924-8579(98)00041-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [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: 11/16/2022]
Abstract
In 1996, the in vitro antibiotic susceptibility of 463 anaerobes was measured in five hospitals using the reference agar dilution method. None of the 209 B. fragilis group strains showed resistance to imipenem or ticarcillin-clavulanic acid. High resistance rates (29%) were observed for cefotetan and clindamycin. beta-Lactamase production was detected respectively in 64% of the Prevotella and 7% of the Fusobacterium strains. Because the same standardized methods were used for many years, the authors were able to evaluate the evolution of antibiotic resistance. Clindamycin resistance had increased within the B. fragilis group (from 14% in 1992 to 29% in 1996) and also among strains of clostridia (32%), P. acnes (18%) and Peptostreptococcus (28%). In the B. fragilis group multidrug resistance was unlikely to occur.
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Powell KE, Jacklin BC, Nelson DE, Bland S. State estimates of household exposure to firearms, loaded firearms, and handguns, 1991 through 1995. Am J Public Health 1998; 88:969-72. [PMID: 9618633 PMCID: PMC1508237 DOI: 10.2105/ajph.88.6.969] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [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: 11/04/2022]
Abstract
OBJECTIVES Variations among states in household exposure to firearms, loaded firearms, and handguns were examined. METHODS Data from the Behavioral Risk Factor Surveillance System in 22 states were used to estimate the prevalence of adults and children exposed to household firearms. RESULTS The prevalence of adults living in households with firearms ranged from 12% to 57%; the corresponding ranges were 1% to 23% for loaded firearms and 5% to 36% for handguns. The prevalence of children less than 18 years of age living in households with loaded firearms ranged from 2% to 12%. CONCLUSIONS Important variations among states exist in the prevalence of adults and children living in households with firearms, loaded firearms, and handguns.
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Affiliation(s)
- K E Powell
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Ga 30341-3724, USA
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Clavier B, Perrier-Gros-Claude JD, Foissaud V, Dumas M, Aubert G, Barbé G, Bland S, Boucaud Maitre Y, Boyer M, Chomarat M, Clergeau P, Delubac F, Févre D, Fuhrmann C, Gravagnat B, Letouzey MN, Mandjee A, Martelet P, Meley R, Reverdy ME, Ros A, Roure C, Sabot O, Tixier A, Thierry J. [Comparison of the results of the Etest and the method for determining minimum inhibitory concentrations in solid media for penicillin G, amoxicillin, and cefotaxime for S. pneumoniae. A multicenter study]. Pathol Biol (Paris) 1998; 46:369-74. [PMID: 9769863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
In 1996-1997 a multicentre study was carried out on 450 Streptococcus pneumoniae strains to compare the MICs and susceptibility categories obtained with the Etest (AB Biodisk) used under routine conditions in 22 hospital laboratories in the Rhône-Alpes region, France, with those obtained by the reference technique of agar dilution performed in a single coordinating centre. Each laboratory detected penicillin resistant pneumococci (PRP) by the oxacillin disk method (1 microgram and 5 micrograms) and determined the MICs of penicillin G (PG), amoxycillin (AMX) and cefotaxime (CTX) by the Etest. All the PRP strains were collected in the coordinating centre where MICs were carried out. The strains were classified as susceptible (S), intermediate (I) and resistant (R) according to the CASFM criteria (Comité de l'Antibiogramme de la Société Française de Microbiologie). The concordance results based on susceptibility categories are as follows: PG = 67.6%, AMX = 63.6%, CTX = 71.5%. Minor errors are as follows: PG = 31.2%, AMX = 36%, CTX = 28.5%. Major and very major errors are rare (0% to 0.6%). Agreement within 1 log2 dilution was obtained for about 80% of the strains. The minor errors results from strains clustering near the breakpoints 1 mg/l (PG) and 0.5 mg/l (AMX, CTX), and from practical difficulties in routine use of the Etest. These discrepancies may result in severe therapeutic problems. This study confirms the limits of the Etest. The authors insist on standardization and rigorous use of the Etest under routine conditions.
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Affiliation(s)
- B Clavier
- Laboratorie de Biologie Médicale, Hôpital d'Instruction des Armées Desgenettes, Lyon, France
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Charvier A, Gagnaire J, Karscher C, Sedaillan A, Bland S, Bru J, Gaillat J. Prévention de la transmission materno-foetale à streptocoque B au centre hospitalier d'Annecy : étude critique. Med Mal Infect 1997. [DOI: 10.1016/s0399-077x(97)80183-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bland S, Sedallian A, Grollier G, Mory F, Houcke I, Dubreuil L. [In vitro activity of carbapenems (biapenem, imipenem and meropenem) and some other antibiotics against strict anaerobic bacteria]. Pathol Biol (Paris) 1995; 43:289-293. [PMID: 7567117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
During 1994, the in vitro antibiotic susceptibility of 306 anaerobic bacteria was performed in 4 hospitals, by the reference agar dilution method. Among the 129 B. fragilis group strains, only two B. fragilis strains were resistant to the three carbapenems and all beta-lactams, even combined with beta-lactamase-inhibitors while metronidazole resistance could not be detected. Evolution in antibiotic resistance rates could be assessed only for piperacillin whose resistance rates increased to 20%. beta-lactamase production was detected respectively for 27% of Prevotella and 17% of Fusobacterium strains. No beta-lactamase activity was seen among Gram positive anaerobes. On the whole anaerobic strains resistance rates were: biapenem, imipenem, meropenem and piperacillin-tazobactam 0.7, amoxicillin-clavulanic acid or metronidazole 2, piperacillin 11.3, amoxicillin 31%, respectively. The three carbapenems demonstrated a good in vitro activity against most anaerobes with few differences between them.
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Affiliation(s)
- S Bland
- Centre Hospitalier, Annecy, France
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Bland S. Elective report: summer 1994--American Airlines. J R Nav Med Serv 1995; 81:138-141. [PMID: 7500316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
- S Bland
- Surgical Department, Royal Naval Hospital, Haslar
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Zambardi G, Reverdy ME, Bland S, Bes M, Freney J, Fleurette J. Laboratory diagnosis of oxacillin resistance in Staphylococcus aureus by a multiplex-polymerase chain reaction assay. Diagn Microbiol Infect Dis 1994; 19:25-31. [PMID: 7956009 DOI: 10.1016/0732-8893(94)90047-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A polymerase chain reaction (PCR) test was developed in which the mecA gene responsible for the intrinsic resistance to oxacillin in Staphylococcus aureus and the gyrA gene, always present in this species, were amplified in one operation. Among the 468 clinical isolates tested, the results obtained for 454 of the isolates (97%) were consistent with those of MIC determination. Discrepant results were noted for strains with low-level oxacillin resistance (MICs, 4-8 micrograms/ml) and mecA gene negative. For these strains, susceptibility to oxacillin was restored in the presence of a beta-lactamase inhibitor, which suggested a resistance by penicillinase hyperproduction. In contrast, all of the high-level resistant strains (MICs, > 8 micrograms/ml) carried the mecA gene. The presence of this gene has frequently been associated with resistance to gentamicin, tetracycline, erythromycin, lincomycin, and pefloxacin. The PCR assay described in this study can be accomplished with ease and total confidence in the clinical microbiologic laboratory for a rapid and effective establishment of antistaphylococcal chemotherapy.
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Affiliation(s)
- G Zambardi
- Department of Studies and Research of Medical Bacteriology, Alexis Carrel Faculty of Medicine, Lyons, France
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Freney J, Bland S, Etienne J, Desmonceaux M, Boeufgras JM, Fleurette J. Description and evaluation of the semiautomated 4-hour rapid ID 32 Strep method for identification of streptococci and members of related genera. J Clin Microbiol 1992; 30:2657-61. [PMID: 1400965 PMCID: PMC270494 DOI: 10.1128/jcm.30.10.2657-2661.1992] [Citation(s) in RCA: 59] [Impact Index Per Article: 1.8] [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: 12/26/2022] Open
Abstract
The rapid ID 32 Strep system (bioMérieux, La Balme les Grottes, France) is a new system which allows the identification in 4 h of most streptococci and members of related genera encountered in medical and veterinary bacteriology. Four hundred thirty-three isolates first identified by conventional methods and belonging to the genera Streptococcus, Lactococcus, Enterococcus, Aerococcus, Gemella, Leuconostoc, Erysipelothrix, Gardnerella, and Listeria were tested. Overall, rapid ID 32 Strep correctly identified 413 (95.3%) of the strains, with 109 (25.1%) requiring extra tests for complete identification. Sixteen strains (3.7%) were not identified, and 4 (1.0%) were misidentified. The rapid ID 32 Strep system is a suitable alternative for rapid identification of members of the genus Streptococcus and of related genera.
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Affiliation(s)
- J Freney
- Laboratoire Central de Microbiologie, Hôpital Edouard Herriot, Lyon, France
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Gerhard DS, Lawrence E, Wu J, Chua H, Ma N, Bland S, Jones C. Isolation of 1001 new markers from human chromosome 11, excluding the region of 11p13-p15.5, and their sublocalization by a new series of radiation-reduced somatic cell hybrids. Genomics 1992; 13:1133-42. [PMID: 1354639 DOI: 10.1016/0888-7543(92)90028-q] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The determination of the physical map of human chromosome 11 will require more clones than are currently available. We have isolated an additional 1001 new markers in a bacteriophage vector from a somatic cell hybrid cell line that contains most of chromosome 11, except the middle of the short arm. These markers were localized to five different regions, 11p15-pter, 11p12-cen, 11q11-q14, 11q14-q23, and 11q23-qter, by a panel of previously characterized somatic cell hybrids. The region 11q11-14 harbors genes that have been shown to be important in breast cancer, B-cell lymphomas, centrocytic lymphomas, asthma, and multiple endocrine neoplasia, type 1 (MEN1). To determine the positions of the recombinant clones located there, we developed a new series of radiation-reduced somatic cell hybrids. These hybrids, together with those previously characterized, allowed us to map the 11q11-q14 markers into 11 separate segregation groups.
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Affiliation(s)
- D S Gerhard
- Department of Genetics, Washington University School of Medicine, St. Louis, Missouri
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Krogh V, Trevisan M, Jossa F, Bland S, Jalowiec A, Celentano E, Farinaro E, Panico S, Fusco G, Mancini M. Coping and blood pressure. J Hum Hypertens 1992; 6:65-70. [PMID: 1583633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The relationship between psychological coping strategies and BP was analysed in a group of 158 southern Italian men and women aged 20-59, randomly selected from an epidemiological study on coronary heart disease risk factors. Coping strategies were evaluated by use of a self-administered questionnaire (Jalowiec Coping Scale) listing 40 frequently used strategies. Factor analysis revealed the reported use of 5 different coping strategies. Males, on average, reported seeking less external support than females. In both sexes, increased years of education were associated with increased use of solution-oriented coping strategies and decreased use of resignation and sympathy seeking. After adjustment for age, alcohol use, body mass index, education and smoking, increased use of resignation was associated with lowered BP in both sexes. Emotional coping was inversely related to BP in males, but not in females. The search for external support was associated with a higher BP only in males. These data provide some evidence to suggest that psychological coping modalities are related to blood pressure.
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Affiliation(s)
- V Krogh
- Department of Social and Preventive Medicine, State University of New York, Buffalo 14214-2699
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Bland S. Nursing: a woman's field. Imprint 1985; 32:37. [PMID: 3843963] [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: 01/07/2023]
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Bland S, Ackroyd DR, Marsh JG, Millward GE. Heavy metal content of oysters from the Lynher Estuary, U.K. Sci Total Environ 1982; 22:235-241. [PMID: 7043733 DOI: 10.1016/0048-9697(82)90067-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The concentrations of As, Cd, Hg, Pb and Zn have been determined in oysters and sediments from the Lynher Estuary, U.K. The sediments contained high levels of Cu, Fe, Pb and Zn probably associated with run off from a metalliferous catchment area and high Hg associated with a local sewage input. In contrast, the analyses of the oyster tissue showed that only Cu and Zn were concentrated in the flesh. The majority of samples contained coliform bacteria in excess of 1000 organisms per ml of tissue. It is concluded that the quality of the oysters from this fishery was limited by the bacteriological cleanliness rather than toxic metal content.
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