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1. Clinical impact of human metapneumovirus infections before and during the COVID-19 pandemic

Author: Mandy Jongbloed, Catharina F. M. Linssen, Martijn D. de Kruif, Bernadette G. van den Hoogen, Wouter T Leijte, Eric C. M. van Gorp, and Virology
Subjects: 0301 basic medicine, Microbiology (medical), 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), viruses, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 030106 microbiology, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Human metapneumovirus, Pandemic, Humans, Medicine, Metapneumovirus, 030212 general & internal medicine, Pandemics, Respiratory Tract Infections, Aged, Paramyxoviridae Infections, General Immunology and Microbiology, biology, SARS-CoV-2, business.industry, Incidence (epidemiology), COVID-19, Infant, virus diseases, Outbreak, General Medicine, biology.organism_classification, Virology, respiratory tract diseases, Europe, Infectious Diseases, Female, business
Abstract: Background: The first outbreak of coronavirus disease 2019 (COVID-19) occurred in March 2020 in Europe, which is normally the peak incidence period of human metapneumovirus (HMPV) infections, implying cocirculation and potentially causing competition between them. Methods: We investigated differences in clinical characteristics and outcomes of HMPV infections in hospitalized patients before (January 2016–28 February, 2020) and HMPV and COVID-19 during part of the COVID-19 pandemic (28 February, 2020–1 April, 2020). Results: A total of 239 HMPV patients and 303 COVID-19 patients were included. Incidence of HMPV peaked in March. Despite a 324% increase in HMPV testing during the COVID-19 outbreak, incidence of HMPV remained stable. Clinical characteristics showed 25 (11%) ICU admissions and 14 (6%) deaths. History of myocardial infarction, higher age and lower BMI were independently associated with increased 30-day mortality. Clinical characteristics of HMPV-infected patients did not differ between the non-COVID-19 period and the examined COVID-19 period except for length of hospital stay (7 vs. 5 days). HMPV infection and COVID-19 shared many clinical features but HMPV was associated with female gender, elderly patients and chronic conditions (COPD and chronic heart failure). Clinical outcomes did not differ between the viruses during the COVID-19 period. Conclusions: The clinical impact of HMPV infection did not change during the COVID-19 outbreak in terms of incidence and/or disease severity; hence, HMPV and SARS-CoV-2 are probably co-circulating independently. Despite the current clinical focus on the COVID-19 pandemic, clinicians should keep in mind that HMPV-infection may mimic COVID-19 and is also associated with serious adverse outcomes.
Published: 2021
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2. Stenotrophomonas maltophiliaventilator-associated pneumonia. A retrospective matched case-control study

Author: Helke A. van Dessel, Gernot Rohde, Walther N.K.A. van Mook, Dennis C J J Bergmans, Tan Lai Zhou, Paul Roekaerts, Catharina F. M. Linssen, Tom P J Dormans, Johannes B. J. Scholte, Paul H. M. Savelkoul, Bjorn Winkens, Medical Microbiology and Infection Prevention, AII - Infectious diseases, Promovendi CD, RS: CARIM - R3.01 - Vascular complications of diabetes and the metabolic syndrome, Intensive Care, MUMC+: MA Medische Staf IC (9), Pulmonologie, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, MUMC+: MA Med Staf Spec Longziekten (9), RS: CAPHRI - R6 - Promoting Health & Personalised Care, FHML Methodologie & Statistiek, Medische Microbiologie, MUMC+: DA MMI Management (9), MUMC+: DA Medische Microbiologie en Infectieziekten (5), and RS: CAPHRI - R4 - Health Inequities and Societal Participation
Subjects: Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Stenotrophomonas maltophilia, medicine.medical_treatment, multidrug-resistant, 030106 microbiology, mechanical ventilation, law.invention, ventilator-associated pneumonia, 03 medical and health sciences, law, Internal medicine, Prevalence, medicine, Humans, Intensive care unit, Intensive care medicine, Aged, Retrospective Studies, Mechanical ventilation, General Immunology and Microbiology, medicine.diagnostic_test, biology, business.industry, Case-control study, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, General Medicine, bacterial infections and mycoses, biology.organism_classification, medicine.disease, mortality, Survival Analysis, Bacterial Load, respiratory tract diseases, Pneumonia, Infectious Diseases, Bronchoalveolar lavage, Health evaluation, Case-Control Studies, Female, Gram-Negative Bacterial Infections, business, Bronchoalveolar Lavage Fluid
Abstract: BACKGROUND: Stenotrophomonas maltophilia is increasingly identified in critically ill patients, but it is considered a pathogen with limited pathogenicity and it is therefore infrequently targeted. This study explores whether S. maltophilia may cause ventilator-associated pneumonia (VAP) and whether it affects intensive care unit (ICU) mortality and 28-day mortality when compared to VAP caused by other Gram-negative bacilli.METHODS: Retrospective analysis of a 19-year prospectively collected database. Stenotrophomonas maltophilia as a cause was considered in VAP-suspected cases when S. maltophilia growth of ≥10(4) cfu/ml was detected in bronchoalveolar lavage fluid analysis. Cases were matched on hospital, gender, age and acute physiology and chronic health evaluation II score in a 1:3 ratio with controls from the same database suffering from VAP caused by other Gram-negative bacilli.RESULTS: Eight cases met the inclusion criteria, of which three were labelled as 'probable' SM-VAP and three as 'possible' SM-VAP. These six patients constitute 1.8% of all VAPs in the studied period. No significant differences in baseline characteristics and duration of mechanical ventilation (p = 0.68), length of stay in the ICU (p = 0.55) and hospital (p = 0.84) between cases and controls were identified between cases and controls. Intensive care unit mortality odds ratio was 1.7 (p = 0.55; 95% CI 0.3-10.5) and 28-day mortality odds ratio was 1.4 (p = 0.70; 95% CI 0.2-9.1).CONCLUSIONS: Stenotrophomonas maltophilia is a possible, yet infrequent cause of VAP. No outcome differences were found when compared to matched VAP caused by other Gram-negative bacilli.
Published: 2016
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3. Empirical antibiotic therapy for pneumonia in intensive care units: a multicentre, retrospective analysis of potentially pathogenic microorganisms identified by endotracheal aspirates cultures

Author: W. N. K. A. van Mook, H. Van Dessel, H. L. Duong, Johannes B. J. Scholte, R. van der Horst, Catharina F. M. Linssen, Dennis C J J Bergmans, Paul Roekaerts, Paul H. M. Savelkoul, Medische Microbiologie, Anesthesiologie, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, RS: CAPHRI School for Public Health and Primary Care, Intensive Care, and RS: CAPHRI - R4 - Health Inequities and Societal Participation
Subjects: Adult, Male, Microbiology (medical), Pediatrics, medicine.medical_specialty, Time Factors, FLUOROQUINOLONES, EARLY-ONSET, Microbial Sensitivity Tests, GUIDELINES, Tazobactam, law.invention, law, Clavulanic acid, Intensive care, medicine, Pneumonia, Bacterial, Humans, STENOTROPHOMONAS-MALTOPHILIA, Hospitals, Teaching, Aged, Netherlands, Retrospective Studies, SURVEILLANCE CULTURES, RISK, VENTILATOR-ASSOCIATED PNEUMONIA, Bacteria, business.industry, Ventilator-associated pneumonia, CONSUMPTION, General Medicine, Amoxicillin, Middle Aged, medicine.disease, Intensive care unit, Anti-Bacterial Agents, Trachea, Pneumonia, Intensive Care Units, ACQUIRED PNEUMONIA, Infectious Diseases, Original Article, Female, business, RESISTANCE, medicine.drug, Piperacillin
Abstract: The purpose of this investigation was to explore the presumed relationship between the days of hospitalisation and microorganisms identified by endotracheal aspirate cultures in relation to adequate empirical treatment strategies of pneumonia in the intensive care unit (ICU). All potentially pathogenic microorganisms identified by (surveillance) cultures of endotracheal aspirates obtained in the ICUs of two Dutch teaching hospitals in 2007 and 2012 were retrospectively collected and analysed. Antibiotic susceptibilities to 11 antibiotics were calculated for several time points (days or weeks) after hospital admission and expressed per patient-day. In total, 4184 potentially pathogenic microorganisms identified in 782 patients were analysed. Prevalence of the classic early-onset pneumonia-causing microorganisms decreased from 55 % on the first four days to 34 % on days 4–6 after hospital admission (p
Published: 2015
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4. Molecular epidemiology of Pneumocystis jiroveci in human immunodeficiency virus-positive and -negative immunocompromised patients in The Netherlands

Author: Vera E. J. Knops, Walther N.K.A. van Mook, Marijke Vanspauwen, Cathrien A. Bruggeman, Catharina F. M. Linssen, Med Microbiol, Infect Dis & Infect Prev, RS: CAPHRI School for Public Health and Primary Care, Intensive Care, and RS: CAPHRI - Public Health: Infectious diseases and antibiotic resistance
Subjects: Male, RIBOSOMAL-RNA GENES, HIV Infections, DHPS, Pneumocystis carinii, Pneumocystis pneumonia, NUCLEOTIDE-SEQUENCE VARIATIONS, Genotype, REAL-TIME PCR, Mycological Typing Techniques, Netherlands, Aged, 80 and over, Molecular Epidemiology, Pneumonia, Pneumocystis, General Medicine, Middle Aged, INTERNAL TRANSCRIBED SPACER, Real-time polymerase chain reaction, Female, Adult, Microbiology (medical), F-SP HOMINIS, Adolescent, HIV-INFECTED PATIENTS, Biology, Real-Time Polymerase Chain Reaction, OBSTRUCTIVE PULMONARY-DISEASE, Microbiology, DIHYDROPTEROATE SYNTHASE GENE, Fungal Proteins, Immunocompromised Host, Young Adult, DNA, Ribosomal Spacer, medicine, Humans, Typing, BRONCHOALVEOLAR LAVAGE FLUID, Genotyping, Aged, Glycoproteins, Retrospective Studies, Dihydropteroate Synthase, Molecular epidemiology, Genetic Variation, Membrane Proteins, medicine.disease, Virology, MAJOR SURFACE GLYCOPROTEIN, Molecular Typing, Dihydropteroate synthase
Abstract: Pneumocystis jiroveci infections can cause pneumocystis pneumonia (PCP) or lead to colonization without signs of PCP. Over the years, different genotypes of P. jiroveci have been discovered. Genomic typing of P. jiroveci in different subpopulations can contribute to unravelling the pathogenesis, transmission and spread of the different genotypes. In this study, we wanted to determine the distribution of P. jiroveci genotypes in immunocompetent and immunocompromised patients in The Netherlands and determine the clinical relevance of these detected mutations. A real-time PCR targeting the major surface glycoprotein gene (MSG) was used as a screening test for the presence of P. jiroveci DNA. Samples positive for MSG were genotyped based on the internal transcribed spacer (ITS) and dihydropteroate synthase (DHPS) genes. Of the 595 included bronchoalveolar lavage fluid samples, 116 revealed the presence of P. jiroveci DNA. A total of 52 of the 116 samples were ITS genotyped and 58 DHPS genotyped. The ITS genotyping revealed 17 ITS types, including two types that have not been described previously. There was no correlation between ITS genotype and underlying disease. All ITS- and DHPS-genotyped samples were found in immunocompromised patients. Of the 58 DHPS-genotyped samples, 50 were found to be WT. The other eight samples revealed a mixed genotype consisting of WT and type 1. The majority of the latter recovered on trimethoprim–sulfamethoxazole suggesting no clinical relevance for this mutation.
Published: 2014
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5. Comparison of three different techniques for the isolation of viral RNA in sputum

Author: C.A. Bruggeman, M. J. Vanspauwen, Frits M.E. Franssen, Petra F. G. Wolffs, Catharina F. M. Linssen, Emiel F.M. Wouters, Medische Microbiologie, Pulmonologie, RS: CAPHRI School for Public Health and Primary Care, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, RS: CAPHRI - Asthma and COPD, and RS: CAPHRI - Public Health: Infectious diseases and antibiotic resistance
Subjects: POLYMERASE-CHAIN-REACTION, viruses, Real-Time Polymerase Chain Reaction, DIAGNOSIS, Virus, Specimen Handling, SERUM, law.invention, chemistry.chemical_compound, RNA Virus Infections, Viral Respiratory Tract Infection, law, Virology, INFECTION, medicine, Humans, Respiratory Tract Infections, Polymerase chain reaction, Retrospective Studies, biology, Sputum, Respiratory infections, RNA, COMMUNITY-ACQUIRED PNEUMONIA, RNA virus, DNA, biology.organism_classification, Molecular biology, RNA isolation, Infectious Diseases, chemistry, RNA, Viral, EXTRACTION METHODS, RNA extraction, medicine.symptom
Abstract: Background Respiratory infections are a major cause of morbidity and mortality worldwide. A high percentage of all respiratory tract infections are caused by RNA viruses. Real-time PCR is a highly sensitive method for the detection of respiratory viruses in clinical samples. A good RNA isolation protocol is of high importance, since RNA is more unstable than DNA and many clinical samples contain RNAses. Objectives To evaluate the performance of three different RNA extraction protocols for the extraction of respiratory viral RNA from sputum samples obtained from patients with the suspicion of a viral respiratory tract infection. Study design A total of 50 sputum samples, PCR positive for a respiratory RNA virus, were used for viral RNA isolation with the phenol/chloroform method, RTP ® DNA/RNA virus mini kit and the automated MagNa Pure LC (MPLC) extraction system. After isolation, real-time PCR was performed for the detection of viral RNA in the sputum samples. Results The MPLC extraction increased the detection probability from 82% (phenol/chloroform) and 86% (RTP ® DNA/RNA virus mini kit) to 94%. In 16% the RTP ® DNA/RNA virus mini kit resulted in lower C t values compared to the phenol/chloroform method, while in 32% the phenol/chloroform resulted in lower C t values. Conclusions The extraction of viral RNA performed with the MPLC extraction method was superior to the extraction with the RTP ® DNA/RNA virus mini kit and to the extraction with phenol/chloroform. In general, there was no difference in the detection of viral RNA between the phenol/chloroform extraction method and the RTP ® DNA/RNA virus mini kit.
Published: 2014
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6. Alternative diagnosis in the putative ventilator-associated pneumonia patient not meeting lavage-based diagnostic criteria

Author: Walther N.K.A. van Mook, Guy J. Oudhuis, Ronny M. Schnabel, Rik J Schoemakers, Catharina F. M. Linssen, Dennis C J J Bergmans, Annelies Verbon, Med Microbiol, Infect Dis & Infect Prev, RS: CAPHRI School for Public Health and Primary Care, Intensive Care, RS: CAPHRI - Public Health: Infectious diseases and antibiotic resistance, RS: SHE - R1 - Research (OvO), and Internal Medicine
Subjects: Adult, Male, Microbiology (medical), medicine.medical_specialty, Time Factors, Adolescent, Fever, Pneumonia, Viral, Herpesvirus 1, Human, Diagnostic evaluation, Sensitivity and Specificity, Broncho-alveolar lavage, Diagnosis, Differential, Tertiary Care Centers, Young Adult, SDG 3 - Good Health and Well-being, Intensive care, Internal medicine, Pneumonia, Bacterial, Humans, Medicine, Medical diagnosis, Intensive care medicine, Lung, Aged, Retrospective Studies, Aged, 80 and over, General Immunology and Microbiology, business.industry, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, General Medicine, Middle Aged, bacterial infections and mycoses, medicine.disease, respiratory tract diseases, Intensive Care Units, Pneumonia, Infectious Diseases, Flow chart, Female, Quantitative culture, business, Bronchoalveolar Lavage Fluid
Abstract: Background: The clinical picture of ventilator-associated pneumonia (VAP) can be mimicked by other infectious and non-infectious diseases. The aim of this study was to determine the alternative diagnoses and to develop a diagnostic flow chart for patients suspected of having VAP not meeting the diagnostic broncho-alveolar lavage (BAL) criteria. Methods: Adult intensive care patients with a clinical suspicion of VAP and negative BAL results were included. The clinical suspicion of VAP was based on the combination of clinical, radiological, and microbiological criteria. BAL was considered positive if cell differentiation revealed >= 2% cells with intracellular organisms and/or quantitative culture results of >= 10(4) cfu/ml. The most likely alternative diagnosis of fever and pulmonary densities was retrospectively determined by two authors independently. Results: In all, 110 of 207 patients with suspected VAP did not meet the diagnostic BAL criteria and required further diagnostic evaluation. In 67 patients an alternative diagnosis for fever could be found. In 51 patients an alternative diagnosis of both fever and pulmonary densities could be established. In almost 40% of patients no alternative diagnosis could be provided. Non-bacterial pneumonia was diagnosed in 10 patients with Herpes simplex virus 1 (HSV-1) as the most common pathogen. In eight patients non-infectious pneumonitis was diagnosed. Conclusion: Due to the wide range of alternative diagnoses and applied tests the diagnostic work-up proved to be necessarily individualized and guided by repeated clinical assessment. The most frequently found alternative diagnoses were viral pneumonia and non-infectious pneumonitis.
Published: 2014
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7. Mimivirus is not a frequent cause of ventilator-associated pneumonia in critically ill patients

Author: Marijke Vanspauwen, W. N. K. A. van Mook, Dennis C J J Bergmans, Marjolein Drent, Cathrien A. Bruggeman, Ronny M. Schnabel, and Catharina F. M. Linssen
Subjects: Mechanical ventilation, medicine.medical_specialty, Mimivirus, biology, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Ventilator-associated pneumonia, Retrospective cohort study, medicine.disease, biology.organism_classification, Virology, Intensive care unit, respiratory tract diseases, law.invention, Pneumonia, Infectious Diseases, Bronchoalveolar lavage, law, Internal medicine, Intensive care, Immunology, medicine, business
Abstract: Acanthamoeba polyphaga mimivirus (APMV) belongs to the amoebae-associated microorganisms. Antibodies to APMV have been found in patients with pneumonia suggesting a potential role as a respiratory pathogen. In addition, positive serology for APMV was associated with an increased duration of mechanical ventilation and intensive care unit stay in patients with ventilator-associated pneumonia. The aim of the present study was to assess the presence of APMV in bronchoalveolar lavage fluid samples of critically ill patients suspected of ventilator-associated pneumonia. The study was conducted in the intensive care unit of the Maastricht University Medical Centre. All consecutive bronchoalveolar lavage fluid samples obtained between January 2005 and October 2009 from patients suspected of ventilator-associated pneumonia were eligible for inclusion. All samples were analyzed by real-time PCR targeting the APMV. A total of 260 bronchoalveolar lavage fluid samples from 214 patients (139 male, 75 female) were included. Bacterial ventilator-associated pneumonia was confirmed microbiologically in 105 out of 260 (40%) suspected episodes of ventilator-associated pneumonia (86 patients). The presence of APMV DNA could not be demonstrated in the bacterial ventilator-associated pneumonia positive or in the bacterial ventilator-associated pneumonia negative bronchoalveolar lavage fluid samples. Although suspected, APMV appeared not to be present in critically ill patients suspected of ventilator-associated pneumonia, and APMV does not seem to be a frequent cause of ventilator-associated pneumonia.
Published: 2013
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8. Infections with mimivirus in patients with chronic obstructive pulmonary disease

Author: Emiel F.M. Wouters, Catharina F. M. Linssen, Marijke Vanspauwen, Cathrien A. Bruggeman, Didier Raoult, Frits M.E. Franssen, Medische Microbiologie, Pulmonologie, RS: CAPHRI School for Public Health and Primary Care, and RS: NUTRIM - R3 - Chronic inflammatory disease and wasting
Subjects: Adult, Male, Pulmonary and Respiratory Medicine, Acute exacerbations, medicine.medical_treatment, Antibodies, Viral, Virus, 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, Medicine, COPD, Humans, Giant Virus, Pulmonary rehabilitation, 030304 developmental biology, Aged, Aged, 80 and over, 0303 health sciences, Mimivirus, Viral infections, biology, 030306 microbiology, business.industry, Reverse Transcriptase Polymerase Chain Reaction, Sputum, Middle Aged, medicine.disease, biology.organism_classification, DNA Virus Infections, 3. Good health, respiratory tract diseases, Pneumonia, Immunology, biology.protein, Female, medicine.symptom, Antibody, business, Mimiviridae
Abstract: Summary Introduction Antibodies against mimivirus, a recently discovered giant virus, have been found in patients presenting with pneumonia suggesting a potential role for this virus as a respiratory pathogen. Several bacterial and viral pathogens have been associated with the occurrence of acute exacerbations in COPD. However, a large part of these exacerbations have an unknown cause. In the present study we evaluated the presence of mimivirus in sputum samples of COPD patients. Methods From March 2009 until January 2010 all sputum samples collected during stable conditions and during exacerbations of COPD patients, referred for pulmonary rehabilitation, were included. All sputum samples were analysed by real-time PCR targeting mimivirus. Furthermore, serum samples were analysed for the presence of antibodies against mimivirus. Results A total of 220 sputum samples from 109 patients were eligible for inclusion. None of the sputum samples showed the presence of mimivirus DNA. Antibodies against mimivirus were detected in 3 serum samples from 3 patients, of which one showed an increase in antibody-titre. Conclusions Although mimivirus was suggested as a potential respiratory pathogen, its presence could not be confirmed in the present study-population of patients with COPD.
Published: 2012
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9. Impact of Latent Viral Infections in Mechanically Ventilated Patients

Author: Dennis C J J Bergmans, Catharina F. M. Linssen, and Walther N.K.A. van Mook
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, Internal medicine, medicine, business
Published: 2012
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10. Positive cultures from cardiopulmonary bypass: prevalence and relevance regarding postoperative infection

Author: Marcus D. Lancé, Dennis C J J Bergmans, Jos G. Maessen, Patrick W. Weerwind, Catharina F. M. Linssen, Walther N.K.A. van Mook, Linda A. C. Hamers, Bjorn Winkens, CTC, FHML Methodologie & Statistiek, Intensive Care, Medische Microbiologie, Anesthesiologie, Interne Geneeskunde, RS: CARIM School for Cardiovascular Diseases, and RS: CAPHRI School for Public Health and Primary Care
Subjects: Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Bacteremia, Fever of Unknown Origin, law.invention, Postoperative Complications, law, Bacterial infections, Epidemiology, medicine, Cardiopulmonary bypass, Prevalence, Heart-lung machine, Endocarditis, Humans, Surgical Wound Infection, Fever of unknown origin, Cardiac Surgical Procedures, Aged, Netherlands, Retrospective Studies, Skin, Cross Infection, Bacteria, business.industry, Retrospective cohort study, General Medicine, Perioperative, Endocarditis, Bacterial, Middle Aged, medicine.disease, Surgery, Perfusion, surgical procedures, operative, Cardiothoracic surgery, Anesthesia, Catheter-Related Infections, Equipment Contamination, Female, Cardiology and Cardiovascular Medicine, business, circulatory and respiratory physiology
Abstract: Objective: Postoperative infections due to cardiopulmonary bypass (CPB) are associated with high morbidity and mortality. The value of positive cultures taken from CPB priming fluid and CPB blood samples, however, is unclear. This study investigates the epidemiology of positive culturesfromCPBand theirrelationto theoccurrenceof postoperative infection.Methods:Thestudywasconductedat theMaastricht University Medical Centre, a 715-bed teaching hospital with 900—1000 surgeries requiring CPB annually. From 1 January 1998 until 31 March 2010, all patients with positive CPB cultures drawn either from priming fluid or blood were retrospectively studied. Second, 335 patients with a positive CPB culturewere compared with 335 randomly assignedpatients who underwentcardiovascular surgery usingCPB and had negativeCPB cultures. Patientswith activeendocarditis were excluded.Demographic dataand perioperative parameters were documented. Outcomemeasures were:a relevant infection (acute infectious valve endocarditis, wound infection, intravascular catheter-related infection, and bloodstream infection), occurrence of fever of unknown origin, and 30-day mortality. Results: A total of 21 840 cultures were analyzed, half being priming fluid and half CPB blood cultures. As many as 111 out of 10 920 (1.0%) priming fluid cultures and 598 out of 10 920 (5.6%) blood cultures tested positive. Grampositive cocci predominated both priming fluid and blood cultures. Relevant postoperative infections within 30 days after surgery were seen in 47/663 (7.1%) of patients overall, in 27/330 in the CPB-culture-positive group (8.2%) and 20/333 in the CPB-culture-negative group (6.0%), p = 0.275. As many as 38 out of 363 patients (5.7%) were affected by fever of unknown origin (CPB-culture-positive group 4.5%, and CPB-culturenegative 6.9%; p = 0.191). The 30-day mortality was 16/330 (4.8%) in the CPB-culture-positive group and 13/333 (3.9%) in the CPB-culturenegative group (p = 0.552). Conclusions: Positive cultures from both CPB priming fluid and CPB blood samples were not a rarity and mainly involvedskinbacteria,arguingthatcontaminationmayhaveplayedarole.Theriskofpostoperativeinfectionwithin30daysaftersurgerywasnot increased in CPB-culture-positive patients. Therefore, no evidence was found to support routine culturing of CPB samples in patients undergoing cardiothoracic surgery. # 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
Published: 2011
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11. Variant VKORC1 and CYP2C9 Alleles in Patients with Diffuse Alveolar Hemorrhage Caused by Oral Anticoagulants

Author: Marjolein Drent, Petal A. Wijnen, Catharina F. M. Linssen, Otto Bekers, Guido R.M.M. Haenen, MUMC+: DA CDL Algemeen (9), Med Microbiol, Infect Dis & Infect Prev, Farmacologie & Toxicologie, Pulmonologie, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, RS: NUTRIM - R4 - Gene-environment interaction, and RS: CARIM School for Cardiovascular Diseases
Subjects: Lung Diseases, medicine.medical_specialty, Genotype, Administration, Oral, Hemorrhage, Polymerase Chain Reaction, Polymorphism, Single Nucleotide, Mixed Function Oxygenases, Pharmacotherapy, Coumarins, Vitamin K Epoxide Reductases, Genetics, Humans, Medicine, Genetic Predisposition to Disease, In patient, Allele, CYP2C9, Oral anticoagulation, Cytochrome P-450 CYP2C9, Pharmacology, Acenocoumarol, business.industry, fungi, Anticoagulants, food and beverages, Diffuse alveolar hemorrhage, General Medicine, respiratory system, Surgery, Pulmonary Alveoli, Molecular Medicine, Aryl Hydrocarbon Hydroxylases, VKORC1, business, medicine.drug
Abstract: Diffuse alveolar hemorrhage (DAH) is a life-threatening bleeding complication that can occur as a result of oral anticoagulation therapy. We hypothesized that in patients treated with coumarins, alveolar hemorrhage is associated with vitamin K epoxide reductase (VKORC1) and cytochrome P450 (CYP) 2C9 (CYP2C9) variant alleles. In addition, in the case of acenocoumarol use, CYP2C19 allelic variants also play a role. During a 7-year period, data on patients using coumarins with confirmed DAH were gathered. Of 173 confirmed DAH cases, 75 received oral anticoagulants, and 63 (84%) of these 75 patients were included because their DNA was available. For genotyping the CYP2C9*2 (430C>T), CYP2C9*3 (1075A>C), CYP2C19*2 (681G>A), CYP2C19*3 (636G>A), VKORC1 (-1639G>A), and VKORC1 (1173C>T) single nucleotide polymorphisms (SNPs), real-time PCRs were performed. In 62 (98.4%) of 63 patients with DAH, variant alleles were found. In 51 (81.0%) of the 63 patients, VKORC1 allelic variants (20 homozygotes and 31 heterozygotes) were present. In 31 (49.2%) of the 63 DAH cases, CYP2C9 allelic variants (three homozygotes, 26 heterozygotes, and two compound heterozygotes) were observed, and in 20 (32.0%) of the 63 patients, variant alleles of both genes were observed. Genotyping of four SNPs for VKORC1 and CYP2C9 polymorphisms is useful in predicting a high probability of the occurrence of DAH in patients receiving oral anticoagulants. Early and timely use of genotyping is recommended to prevent a fatal outcome and to provide safer and more individualized anticoagulant therapy.
Published: 2010
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12. Role of microorganisms in interstitial lung disease

Author: Catharina F M Linssen, Lowie E.G.W. Vanfleteren, Pulmonologie, Med Microbiol, Infect Dis & Infect Prev, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, and RS: CAPHRI School for Public Health and Primary Care
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Pulmonary infection, behavioral disciplines and activities, Immune system, medicine, Humans, In patient, Intensive care medicine, Pneumonitis, Lung, business.industry, Pneumonia, Pneumocystis, Interstitial lung disease, food and beverages, Bacterial Infections, respiratory system, medicine.disease, Connective tissue disease, respiratory tract diseases, body regions, Pneumonia, medicine.anatomical_structure, Immune System, Immunology, Legionnaires' Disease, business, Lung Diseases, Interstitial
Abstract: Purpose of review To review the role of microorganisms in interstitial lung disease (ILD) and to emphasize their importance in initiation and course of ILD. Recent findings ILD can be idiopathic but often causality such as drugs or connective tissue disease can be found. Multiple microorganisms have been associated with ILD. On the one hand, pulmonary infection can cause extensive pulmonary damage with patterns of an ILD. On the other hand, microorganisms can trigger the immune system and provoke an abnormal response- not directed against the causative pathogen- that may result in ILD. Moreover, patients with ILD often are susceptible to infection, and infections can importantly influence the course of ILD. Furthermore, not only an infection but also its treatment can result in a drug-induced pneumonitis, eventually resulting in long-term lung damage. Summary Microorganisms can initiate and/or influence the course of ILD. Early recognition, adequate diagnostic evaluation and therapy are essential to prevent permanent damage. Prevention of infection in patients with established ILD is strongly recommended.
Published: 2010
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13. Soluble Triggering Receptor Expressed on Myeloid cells-1 in bronchoalveolar lavage fluid is not predictive for ventilator-associated pneumonia

Author: Judith Beuving, Guy J. Oudhuis, Annelies Verbon, Guul ten Velde, Catharina F. M. Linssen, Dennis C J J Bergmans, Ellen E. Stobberingh, Medische Microbiologie, Pulmonologie, and RS: NUTRIM - R3 - Chronic inflammatory disease and wasting
Subjects: Male, Myeloid, Enzyme-Linked Immunosorbent Assay, Respiratory tract infections, Critical Care and Intensive Care Medicine, Artificial respiration, Risk Assessment, Sepsis, Intensive care, medicine, Humans, Receptors, Immunologic, Aged, Membrane Glycoproteins, medicine.diagnostic_test, business.industry, Brief Report, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, Middle Aged, bacterial infections and mycoses, medicine.disease, Triggering Receptor Expressed on Myeloid Cells-1, respiratory tract diseases, Biological marker, Pneumonia, Early Diagnosis, Bronchoalveolar lavage, medicine.anatomical_structure, Gene Expression Regulation, Immunology, Biomarker (medicine), Female, business, Bronchoalveolar Lavage Fluid, Biomarkers, Forecasting
Abstract: PURPOSE: Soluble Triggering Receptor Expressed on Myeloid cells-1 (sTREM-1) has proven to be a good biomarker for sepsis. For the diagnosis ventilator-associated pneumonia (VAP), however, there have only been a few, relatively small, studies on the role of this receptor. The aim of the study was to evaluate the usefulness of sTREM-1 in bronchoalveolar lavage fluid (BALF) from Intensive Care Unit patients as rapid diagnostic test for VAP. METHODS: The concentration of sTREM-1 in 240 BALF samples was measured using a quantitative sandwich enzyme immunoassay. Two researchers who were blind to the assay results determined whether a VAP was present or not. Clinical suspicion of a VAP was confirmed by the presence of > or = 2% cells containing intracellular organisms and/or a quantitative culture result of > or = 10(4) colony forming units per millilitre BALF. RESULTS: The mean concentration of sTREM-1 was significantly higher in the BALF of patients with confirmed VAP than in that of patients without confirmed VAP. However, the area under the receiver-operating characteristic curve was 0.58 (95% confidence interval 0.50-0.65, P = 0.04). CONCLUSIONS: The results imply that the sTREM-1 assay in BALF may not be discriminative for VAP.
Published: 2009
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14. Influence of antibiotic therapy on the cytological diagnosis of ventilator-associated pneumonia

Author: Catharina F. M. Linssen, Walther N.K.A. van Mook, Jan Jacobs, Graham Ramsay, Marjolein Drent, Jan S. A. G. Schouten, Medische Microbiologie, Epidemiologie, Algemene Heelkunde, Pulmonologie, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, and RS: CAPHRI School for Public Health and Primary Care
Subjects: Male, medicine.medical_specialty, medicine.drug_class, Antibiotics, Colony Count, Microbial, Critical Care and Intensive Care Medicine, law.invention, Leukocyte Count, law, Predictive Value of Tests, Intensive care, Internal medicine, Cytology, medicine, Humans, Prospective Studies, medicine.diagnostic_test, business.industry, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, Reproducibility of Results, Middle Aged, medicine.disease, Intensive care unit, Surgery, Anti-Bacterial Agents, Pneumonia, Bronchoalveolar lavage, ROC Curve, Predictive value of tests, Case-Control Studies, Female, business, Bronchoalveolar Lavage Fluid
Abstract: OBJECTIVE: To assess the influence of antibiotics on the value of various cytological parameters, and their combinations, in diagnosing ventilator-associated pneumonia (VAP). DESIGN: Prospective study. SETTING: The general intensive care unit (17 beds) of the University Hospital Maastricht. PATIENTS: Three hundred and thirty-five episodes of clinically suspected VAP (defined by the clinical and radiological criteria previously described by Bonten et al.) in 282 patients were studied. INTERVENTIONS: No additional interventions were conducted. MEASUREMENTS AND RESULTS: Bronchoalveolar lavage fluid cytology included a total cell count per millilitre, differential cell count and the percentage of infected cells (cells containing phagocytised organisms). Antibiotic therapy from 72 h prior to lavage was recorded. Areas under the curve (AUCs) of receiver operating characteristic curves were calculated for various cytological parameters and their combinations, in patients with and without antibiotic therapy. In 126 episodes (37.6%) in 106 patients, VAP was confirmed. There was no difference in AUCs between patients with and without antibiotic therapy for any parameter studied. The most prominent AUCs were (for patient groups with and without antibiotics combined): total cell count, 0.65; percentage polymorphonuclear neutrophils, 0.71; and percentage infected cells, 0.90. The combination of percentage infected cells with any other cytological parameter did not increase the AUC. CONCLUSION: Antibiotic therapy did not influence the predictive value of the percentage infected cells in BALF in diagnosing VAP.
Published: 2008
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15. Ventilator-associated Pneumonia caused by commensal oropharyngeal Flora; [corrected] a retrospective Analysis of a prospectively collected Database

Author: Helke A. van Dessel, Paul Roekaerts, Dennis C J J Bergmans, Walther N.K.A. van Mook, Johan I. M. van der Velde, Paul H. M. Savelkoul, Johannes B. J. Scholte, Catharina F. M. Linssen, Med Microbiol, Infect Dis & Infect Prev, Anesthesiologie, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, RS: CAPHRI School for Public Health and Primary Care, and RS: CAPHRI - R4 - Health Inequities and Societal Participation
Subjects: Male, medicine.medical_treatment, Oropharynx, SOFA SCORE, law.invention, law, Risk Factors, Hospital Mortality, Netherlands, Incidence (epidemiology), Incidence, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, Middle Aged, Commensal oropharyngeal flora, INTENSIVE-CARE UNITS, Intensive care unit, PULMONARY INFECTIONS, Intensive Care Units, SOFA score, Female, Erratum, CRITICALLY-ILL PATIENTS, Bronchoalveolar Lavage Fluid, Research Article, Bronchoalveolar lavage, Pulmonary and Respiratory Medicine, medicine.medical_specialty, ANTIBIOTIC-THERAPY, DIAGNOSIS, Internal medicine, NEUTROPENIC PATIENTS, medicine, Humans, Intensive care medicine, METAANALYSIS, Retrospective Studies, Mechanical ventilation, CYSTIC-FIBROSIS, Bacteria, business.industry, Retrospective cohort study, medicine.disease, MALDI-TOF-MS, Respiration, Artificial, respiratory tract diseases, Pneumonia, Standardized mortality ratio, business
Abstract: BACKGROUND: The significance of commensal oropharyngeal flora (COF) as a potential cause of ventilator-associated pneumonia (VAP) is scarcely investigated and consequently unknown. Therefore, the aim of this study was to explore whether COF may cause VAP. METHODS: Retrospective clinical, microbiological and radiographic analysis of all prospectively collected suspected VAP cases in which bronchoalveolar lavage fluid exclusively yielded >/= 10(4) cfu/ml COF during a 9.5-year period. Characteristics of 899 recent intensive care unit (ICU) admissions were used as a reference population. RESULTS: Out of the prospectively collected database containing 159 VAP cases, 23 patients were included. In these patients, VAP developed after a median of 8 days of mechanical ventilation. The patients faced a prolonged total ICU length of stay (35 days [P < .001]), hospital length of stay (45 days [P = .001]), and a trend to higher mortality (39 % vs. 26 %, [P = .158]; standardized mortality ratio 1.26 vs. 0.77, [P = .137]) compared to the reference population. After clinical, microbiological and radiographic analysis, COF was the most likely cause of respiratory deterioration in 15 patients (9.4 % of all VAP cases) and a possible cause in 2 patients. CONCLUSION: Commensal oropharyngeal flora appears to be a potential cause of VAP in limited numbers of ICU patients as is probably associated with an increased length of stay in both ICU and hospital. As COF-VAP develops late in the course of ICU admission, it is possibly associated with the immunocompromised status of ICU patients.
Published: 2015

16. Surveillance cultures in healthcare-associated pneumonia: sense or nonsense?

Author: Johannes B. J. Scholte, Catharina F. M. Linssen, Walther N.K.A. van Mook, Intensive Care, MUMC+: MA Medische Staf IC (9), and RS: SHE - R1 - Research (OvO)
Subjects: Pulmonary and Respiratory Medicine, Male, Methicillin-Resistant Staphylococcus aureus, medicine.medical_specialty, medicine.drug_class, Cost effectiveness, Antibiotics, multidrug-resistant, Large population, Drug resistance, ventilator-associated pneumonia, Healthcare associated, surveillance cultures, Risk Factors, ICUs, Drug Resistance, Multiple, Bacterial, medicine, Prevalence, Humans, guidelines, Intensive care medicine, Cross Infection, Infection Control, business.industry, healthcare-associated pneumonia, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, medicine.disease, respiratory tract diseases, Pneumonia, Practice Guidelines as Topic, Female, Surveillance culture, business, Sentinel Surveillance
Abstract: Purpose of review This review explores the usefulness of surveillance cultures in healthcare-associated pneumonia (HCAP). Recent findings The definition of HCAP is controversial. Causative micro-organisms of HCAP resemble those found in hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). Some types of surveillance cultures have proven useful in hospitalized patients. Whereas numerous studies have investigated the role of surveillance cultures in VAP, one may wonder whether surveillance culture implementation should belong in HCAP management guidelines. Summary Studies exploring the usefulness of obtaining surveillance cultures in VAP are numerous, but are mostly retrospective, observational and/or quasi-experimental in nature. Surveillance cultures may be useful for antibiotic guidance, but positive predictive value and specificity of surveillance cultures are low, obviously negatively impacting on cost effectiveness, especially in the large population at risk for HCAP. On the other hand, multidrug-resistance is increasing and surveillance cultures for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci in ICU-admitted patients appeared useful and cost-effective. Furthermore, surveillance cultures for the presence of multidrug-resistant Gram-negative bacilli might be useful for antibiotic guidance. Currently, neither community-acquired pneumonia, HCAP, HAP nor VAP guidelines incorporate surveillance cultures. In the future, surveillance cultures in populations at risk for HCAP may be able to differentiate HCAP from other kinds of pneumonia and authorize its reason for existence.
Published: 2014

17. Candida pneumonia in intensive care unit?

Author: Walther N.K.A. van Mook, Dennis C J J Bergmans, Catharina F. M. Linssen, Nele Guion, Ronny M. Schnabel, MUMC+: MA Medische Staf IC (9), Intensive Care, and RS: FHML non-thematic output
Subjects: medicine.medical_specialty, Population, Autopsy, Major Articles, law.invention, law, bronchoalveolar lavage, pneumonia, Medicine, education, Intensive care medicine, Candida, education.field_of_study, medicine.diagnostic_test, business.industry, Critically ill, Zenker's diverticulum, medicine.disease, Intensive care unit, respiratory tract diseases, Pneumonia, Infectious Diseases, Bronchoalveolar lavage, Oncology, Respiratory failure, Histopathology, business
Abstract: It has been questioned if Candida pneumonia exists as a clinical entity. Only histopathology can establish the definite diagnosis. Less invasive diagnostic strategies lack specificity and have been insufficiently validated. Scarcity of this pathomechanism and nonspecific clinical presentation make validation and the development of a clinical algorithm difficult. In the present study, we analyze whether Candida pneumonia exists in our critical care population. We used a bronchoalveolar lavage (BAL) specimen database that we have built in a structural diagnostic approach to ventilator-associated pneumonia for more than a decade consisting of 832 samples. Microbiological data were linked to clinical information and available autopsy data. We searched for critically ill patients with respiratory failure with no other microbiological or clinical explanation than exclusive presence of Candida species in BAL fluid. Five cases could be identified with Candida as the likely cause of pneumonia.
Published: 2014

18. Endotracheal aspirate and bronchoalveolar lavage fluid analysis: interchangeable diagnostic modalities in suspected ventilator-associated pneumonia?

Author: H. Van Dessel, W. N. K. A. van Mook, Catharina F. M. Linssen, Johannes B. J. Scholte, Paul H. M. Savelkoul, Dennis C J J Bergmans, Paul Roekaerts, Medical Microbiology and Infection Prevention, CCA - Innovative therapy, Medische Microbiologie, Anesthesiologie, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, RS: CAPHRI School for Public Health and Primary Care, Intensive Care, RS: CAPHRI - Public Health: Infectious diseases and antibiotic resistance, and RS: SHE - R1 - Research (OvO)
Subjects: Microbiology (medical), Pathology, medicine.medical_specialty, INTENSIVE-CARE-UNIT, MICROSCOPIC EXAMINATION, CULTURES, THERAPY, Specimen Handling, law.invention, Hospitals, University, Endotracheal aspirate, law, medicine, Humans, NOSOCOMIAL PNEUMONIA, Prospective cohort study, METAANALYSIS, High-power field, Bacteriological Techniques, INTRACELLULAR ORGANISMS, medicine.diagnostic_test, business.industry, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, Bacteriology, ANTIBIOTIC-RESISTANCE, respiratory system, medicine.disease, Intensive care unit, RANDOMIZED-TRIAL, respiratory tract diseases, Trachea, Intensive Care Units, Pneumonia, Gram staining, Bronchoalveolar lavage, TRACHEAL ASPIRATE, business, Bronchoalveolar Lavage Fluid
Abstract: Authoritative guidelines state that the diagnosis of ventilator-associated pneumonia (VAP) can be established using either endotracheal aspirate (ETA) or bronchoalveolar lavage fluid (BALF) analysis, thereby suggesting that their results are considered to be in accordance. Therefore, the results of ETA Gram staining and semiquantitative cultures were compared to the results from a paired ETA-BALF analysis. Different thresholds for the positivity of ETAs were assessed. This was a prospective study of all patients who underwent bronchoalveolar lavage for suspected VAP in a 27-bed university intensive care unit during an 8-year period. VAP was diagnosed when ≥2% of the BALF cells contained intracellular organisms and/or when BALF quantitative culture revealed ≥10 4 CFU/ml of potentially pathogenic microorganisms. ETA Gram staining and semiquantitative cultures were compared to the results from paired BALF analysis by Cohen's kappa coefficients. VAP was suspected in 311 patients and diagnosed in 122 (39%) patients. In 288 (93%) patients, the results from the ETA analysis were available for comparison. Depending on the threshold used and the diagnostic modality, VAP incidences varied from 15% to 68%. For the diagnosis of VAP, the most accurate threshold for positivity of ETA semiquantitative cultures was moderate or heavy growth, whereas the optimal threshold for BALF Gram staining was ≥1 microorganisms per high power field. The Cohen's kappa coefficients were 0.22, 0.31, and 0.60 for ETA and paired BALF Gram stains, cultures, and BALF Gram stains, respectively. Since the ETA and BALF Gram stains and cultures agreed only fairly, they are probably not interchangeable for diagnosing VAP.
Published: 2014
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19. Does the day of the week predict the presence of microbiologically confirmed ventilator-associated pneumonia?

Author: H. Van Dessel, Catharina F. M. Linssen, and W. N. K. A. van Mook
Subjects: medicine.medical_specialty, medicine.diagnostic_test, business.industry, Names of the days of the week, animal diseases, Technician, Ventilator-associated pneumonia, respiratory system, Critical Care and Intensive Care Medicine, medicine.disease, respiratory tract diseases, Pneumonia, Bronchoalveolar lavage, Poster Presentation, Emergency medicine, medicine, business
Abstract: At our hospital, ventilator-associated pneumonia (VAP) is diagnosed by microbiological and cytological analysis of bronchoalveolar lavage fluid (BALF). Opening hours of the in-house microbiological laboratory are between 8:00 am and 5:00 pm. During off-hours a laboratory technician is on call for urgent samples including BALF. The total laboratory work-up of the BALF takes 2 hours. The aim of the present study was to detect patterns in the submission time of BALF samples.
Published: 2012
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20. HIV-Related Diarrhea

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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21. HBO2T

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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22. Heart Failure

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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23. Hemofiltration in the ICU

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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24. HIV-Related Hepatitis

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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25. HemoSonic 100

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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26. Hemodialysis in ICU

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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27. Hemorrhage

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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28. Humoral Immune Response

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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29. Heart–Kidney Interaction

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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30. Hyperbarics

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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31. Hemodynamic monitoring

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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32. Hollow Fiber Membranes

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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33. High-Frequency Ventilation

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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34. HIV-Related Gastrointestinal Obstruction

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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35. HIV, Pneumonic Complications

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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36. High-Frequency Oscillatory Ventilation (HFOV)

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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37. Humidification

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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38. Hepatic Trisegmentectomy

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
Full Text: View/download PDF

39. Herpes Simplex

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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40. Herpes Zoster

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
Full Text: View/download PDF

41. HIV, Hematogenous Tuberculosis

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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42. Hemoperfusion

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
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43. Hemorrhagic Fever Virus

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
Full Text: View/download PDF

44. Hepatotomy

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
Full Text: View/download PDF

45. Hyperinsulinemic Euglycemia Therapy (HIET)

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
Full Text: View/download PDF

46. Hypoxic Hypoxia

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
Full Text: View/download PDF

47. Hypothalamic-Pituary-Adrenal (HPA) Disorder

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
Full Text: View/download PDF

48. High Altitude Syndromes

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
Full Text: View/download PDF

49. HIV-Related Diseases of the Stomach, Intestines, and Colon

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
Full Text: View/download PDF

50. Hangman’s Fracture

Author: Jeffrey N. Harr, Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, Alan S. Maisel, Derek S. Wheeler, Hector R. Wong, Mark A. Malangoni, Gili Kenet, Gideon Paret, Tiffany Tello, Jason M. Phillips, Fernando J. Kim, Christophe Vinsonneau, John R. Prowle, Rinaldo Bellomo, Sacha Zeerleder, Mini Michael, Frederick A. Moore, Hunter B. Moore, Ernest E. Moore, Andrew Davenport, J. P. J. Wester, Carlton C. Barnett, Sarah E. Judkins, Constantine Karvellas, Mustafa Hussain, H. Leon Pachter, Catharina F. M. Linssen, Natalia Mendoza, Blanca Ochoa, Katie Morrison, Beau Willison, Stephen K. Tyring, Kristy M. Walsh, Catherine T. Shoff, Suzanne M. Shepherd, William H. Shoff, Othman Solaiman, Niall D. Ferguson, Christopher H. Mody, Alison Morris, Laurence Huang, Philip LoBue, James Riddell, Julius Larioza, Daniel J. Skiest, Davide Chiumello, Antonella Marino, Kai Singbartl, Alexander Zarbock, Caesar A. Anderson, Brigitte M. Baumann, Itoro Elijah, Jong O. Lee, David N. Herndon, and Laura J. Porro
Published: 2012
Full Text: View/download PDF

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