16 results on '"Rosemary She"'
Search Results
2. Natural history of Acinetobacter baumannii infection in mice.
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Brian M Luna, Jun Yan, Zeferino Reyna, Eugene Moon, Travis B Nielsen, Hernan Reza, Peggy Lu, Robert Bonomo, Arnold Louie, George Drusano, Jürgen Bulitta, Rosemary She, and Brad Spellberg
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Medicine ,Science - Abstract
In 2017, the WHO identified Acinetobacter baumannii as the top priority for the development of new antibiotics. Despite the need for new antibiotics, there remains a lack of well validated preclinical tools for A. baumannii. Here, we characterize and validate a mouse model for A. baumannii translational research. Antibiotic sensitivity for meropenem, amikacin, and polymyxin b was determined by the broth microdilution MIC assay. LD100 inoculums, in both blood and lung infection models, were determined in male and female C3HeB/FeJ mice that were challenged with various A. baumannii clinical isolates. Blood (blood infection model) or blood and lung tissue (lung infection model) were collected from infected mice at 2 and 18 hours and the bacterial burden was determined by quantitative culture. Blood chemistry was analyzed using the iStat system. Cytokines (IL-1ß, TNF, IL-6, and IL-10) were measured in the blood and lung homogenate by ELISA assay. Lung sections (H&E stains) were scored by a pathologist. In the blood infection model, the cytokines and physiological data indicate that mice become moribund due to sepsis (low blood pH, falling bicarbonate, and a rising base deficit), whereas mice become moribund due to respiratory failure (low blood pH, rising bicarbonate, and a falling base deficit) in the oral aspiration pneumonia model. We also characterized the timing of changes in various clinical and biomarker endpoints, which can serve as a basis for future interventional studies. Susceptibility was generally similar across gender and infection route. However, we did observe that female mice were approximately 2-fold more sensitive to LAC-4 ColR in the blood infection model. We also observed that female mice were more than 10-fold more resistant to VA-AB41 in the oral aspiration pneumonia model. These results establish parameters to follow in order to assess efficacy of novel preventative and therapeutic approaches for these infections.
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- 2019
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3. Impact of Bacteria Types on the Clinical Outcomes of Spontaneous Bacterial Peritonitis
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Cameron Furey, Selena Zhou, Joo Hye Park, Andrew Foong, Aneesa Chowdhury, Lillian Dawit, Vivian Lee, Maria Vergara-Lluri, Rosemary She, Jeffrey Kahn, Jennifer L. Dodge, and Takeshi Saito
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Physiology ,Gastroenterology - Published
- 2023
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4. Multicenter Evaluation of the BIOFIRE Blood Culture Identification 2 Panel for Detection of Bacteria, Yeasts, and Antimicrobial Resistance Genes in Positive Blood Culture Samples
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Daniel D. Rhoads, Spyros Pournaras, Amy Leber, Joan-Miquel Balada-Llasat, Amanda Harrington, Vittorio Sambri, Rosemary She, Gregory J. Berry, Judy Daly, Caryn Good, Aikaterini Tarpatzi, Kathy Everhart, Tai Henry, Kathleen McKinley, Silvia Zannoli, Pil Pak, Fan Zhang, Rebecca Barr, Kristen Holmberg, Bart Kensinger, and Daisy Y. Lu
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Microbiology (medical) - Abstract
Diagnostic tools that can rapidly identify and characterize microbes growing in blood cultures are important components of clinical microbiology practice because they help to provide timely information that can be used to optimize patient management. This publication describes the bioMérieux BIOFIRE Blood Culture Identification 2 (BCID2) Panel clinical study that was submitted to the U.S.
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- 2023
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5. Antimicrobial Susceptibility Testing Performed in RPMI 1640 Reveals Azithromycin Efficacy against Carbapenem-Resistant Acinetobacter baumannii and Predicts In Vivo Outcomes in Galleria mellonella
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Sarah Miller, Kristine Goy, Rosemary She, Brad Spellberg, and Brian Luna
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Pharmacology ,Infectious Diseases ,Pharmacology (medical) - Abstract
Antimicrobial susceptibility testing (AST) in RPMI 1640, a more physiologically relevant culture medium, revealed that a substantial proportion of carbapenem-resistant Acinetobacter baumannii isolates were susceptible to azithromycin, a macrolide antibiotic not currently considered effective against A. baumannii . Experiments using Galleria mellonella validated these in vitro data.
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- 2023
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6. Antimicrobial Susceptibility Testing Performed in RPMI 1640 Reveals Azithromycin Efficacy against Carbapenem-Resistant Acinetobacter baumannii and Predicts
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Sarah, Miller, Kristine, Goy, Rosemary, She, Brad, Spellberg, and Brian, Luna
- Abstract
Antimicrobial susceptibility testing (AST) in RPMI 1640, a more physiologically relevant culture medium, revealed that a substantial proportion of carbapenem-resistant Acinetobacter baumannii isolates were susceptible to azithromycin, a macrolide antibiotic not currently considered effective against A. baumannii. Experiments using Galleria mellonella validated these
- Published
- 2022
7. 1076. The Role of Bronchoalveolar Lavage in COVID-19 Diagnoses and Management
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Edie Zhang, Shuman Liu, and Rosemary She
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Infectious Diseases ,Oncology - Abstract
Background In the diagnosis of SARS-COV-2, upper respiratory tract specimens are primarily used for PCR testing. This study aims to evaluate the clinical and diagnostic role of bronchoalveolar lavage (BAL) in diagnosing and managing COVID-19. Methods Patients admitted to Keck Medical Center (Los Angeles, CA) during March 2020-May 2021 who had SARS-CoV-2 PCR tested on both nasopharyngeal swab (NPS) and BAL specimens (QIAGEN QIAstat-Dx RP) were included. Four patient groups were designated by PCR results: (A) NPS+/BAL+ (n=34), (B) NPS+/BAL- (n=26), (C) NPS-/BAL+ (n=5), (D) NPS-/BAL- (n=89). Clinical and laboratory data were retrospectively reviewed. Statistical analysis included the use of one-way ANOVA with Tukey HSD and Fisher’s exact test. Results 154 inpatients had NPS and BAL tested for SARS-CoV-2 RNA (mean age 55.1 y, 59.6% male). BAL was performed mainly to further assess abnormal respiratory function (n=43) or chest imaging findings (n=27), or for COVID-19 work-up (n=17). Mean turnaround time for BAL PCR was 4 h 5 min. Ct values, available on 28 BAL+ samples, did not significantly differ between patients who died (mean Ct 29.9, n=18) vs. survived (mean Ct 28.7, n=10). Time from symptom onset to BAL was significantly longer in Group B (34.2 d) vs. D (13.7 d, p< 0.01) or C (12.8 d, p< 0.05) but not vs. A (23.9 d). Groups did not differ significantly in patient comorbidities, mortality, length of hospital stay, or immunosuppressive status. SARS-CoV-2 NPS+/BAL+ patients were more likely to have diffuse or bilateral chest radiographic opacities (p< 0.01), respiratory culture with Aspergillus spp. (p< 0.05), and ARDS diagnosis than those who were NPS+/BAL- (p< 0.01). Conclusion BALs were an important specimen source for the detection of SARS-CoV-2 in the lower respiratory tract particularly when NPS at admission was PCR-negative and for ruling out COVID-19 pneumonia as a cause of abnormal pulmonary findings or declining respiratory status. BAL positivity for SARS-CoV-2 RNA was associated with higher frequency of diffuse or bilateral opacities on CXR, culture recovery of Aspergillus spp., and ARDS. Ct values of BAL+ samples did not predict mortality though sample size was limited. Further studies on the role of viral detection in BALs in patient management and prognosis are warranted. Disclosures All Authors: No reported disclosures.
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- 2022
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8. Raising the Bar: Improving Antimicrobial Resistance Detection by Clinical Laboratories by Ensuring Use of Current Breakpoints
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Patricia J Simner, Carol A Rauch, Isabella W Martin, Kaede V Sullivan, Daniel Rhoads, Robin Rolf, Rosemary She, Rhona J Souers, Christina Wojewoda, and Romney M Humphries
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Infectious Diseases ,Oncology - Abstract
Background Antimicrobial resistance (AMR) is a pressing global challenge detected by antimicrobial susceptibility testing (AST) performed by clinical laboratories. AST results are interpreted using clinical breakpoints, which are updated to enable accurate detection of new and emerging AMR. Laboratories that do not apply up-to-date breakpoints impede global efforts to address the AMR crisis, but the extent of this practice is poorly understood. Methods A total of 1490 clinical laboratories participating in a College of American Pathologists proficiency testing survey for bacterial cultures were queried to determine use of obsolete breakpoints. Results Between 37.9% and 70.5% of US laboratories reported using obsolete breakpoints for the antimicrobials that were queried. In contrast, only 17.7%–43.7% of international laboratories reported using obsolete breakpoints (P Conclusions These data demonstrate a significant gap in the ability to detect AMR in the US, and to a lesser extent internationally. Improved application of current breakpoints by clinical laboratories will require combined action from regulatory agencies, laboratory accreditation groups, and device manufacturers.
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- 2022
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9. 1312. Evaluation of a Multiplexed PCR Pneumonia Panel in a Tertiary Care Medical Center
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Erin Su and Rosemary She
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Infectious Diseases ,Oncology - Abstract
Background Syndromic PCR testing for lower respiratory pathogens may give rapid, actionable results to aid in management decisions for suspected pneumonia cases. We sought to evaluate the performance of a multiplexed PCR pneumonia panel compared to routine microbiologic work-up in a tertiary care patient population. Methods Sputum and bronchoalveolar lavage (BAL) samples from Keck Medical Center (Los Angeles, CA) inpatients submitted for clinical microbiology work-up Dec 2019-Jun 2020 were tested by a multiplexed PCR panel (FilmArray Pneumonia Panel, BioFire Diagnostics). We compared panel results for typical bacterial pathogens to those of quantitative culture and susceptibility testing. We retrospectively determined the incidence of non-panel respiratory pathogens as detected by standard of care tests in this patient cohort. Results 68 of 180 samples yielded 80 positive bacterial PCR results: 34 were detected by both PCR panel and culture and 46 by PCR panel only, yielding a sensitivity of 100% (34/34) for pathogens detected and specificity of 73.1% (114/156) among negative cultures (normal flora or no growth). Concordant results had PCR Bin values ≥10^5 copies/mL whereas all 18 targets detected at 10^4 copies/mL were culture-negative. Among resistance gene targets, the panel detected 12 MRSA specimens, of which MRSA grew in only 4 cultures; E. coli and CTX-M in 1 specimen from which grew normal flora; and multiple gram-negative organisms and KPC in 1 specimen from which culture isolated carbapenem-resistant P. aeruginosa. Quantitation from positive BAL cultures (n=25) correlated weakly with PCR Bin values (R-squared=0.17). Non-PCR panel pathogens were detected in 22 of 180 (12.2%) specimens through routine methods (16 molds, 3 AFB, and 3 non-fermenter gram-negative bacteria). Conclusion The pneumonia panel had excellent sensitivity for its target bacterial pathogens, but results were often positive in negative cultures. This could be due to antecedent antibiotic therapy, differences in reporting threshold versus culture, or inability of PCR to discern results from normal flora. Non-panel pathogens were detected in a significant proportion in our population. The pneumonia panel should be implemented and interpreted carefully with consideration of antimicrobial stewardship. Disclosures All Authors: No reported disclosures
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- 2021
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10. Cryptococcal disease in the solid organ transplant setting: review of clinical aspects with a discussion of asymptomatic cryptococcal antigenemia
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Noah Wald-Dickler, Emily Blodget, and Rosemary She
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0301 basic medicine ,medicine.medical_specialty ,Antigens, Fungal ,030106 microbiology ,Cryptococcus ,Disease ,Asymptomatic ,03 medical and health sciences ,0302 clinical medicine ,Epidemiology ,medicine ,Immunology and Allergy ,Humans ,030212 general & internal medicine ,Intensive care medicine ,Transplantation ,biology ,business.industry ,Clinical course ,Cryptococcosis ,Organ Transplantation ,biology.organism_classification ,Survival Analysis ,Surgery ,medicine.symptom ,Solid organ transplantation ,business - Abstract
Cryptococcal infections are an important cause of morbidity and mortality in solid organ transplant patients. Here, we review the microbiology, epidemiology, clinical course, treatment, and outcomes of Cryptococcus in solid organ transplant recipients.We identify the unique findings in solid organ transplant patients when compared to other immunocompromised patients such as those with HIV. We also describe our experience and outcomes with regard to solid organ transplant patients who do not have positive fungal cultures, but cryptococcal antigen positivity and concern for cryptococcal disease.Our review will highlight the importance of these new diagnostic techniques in those with Cryptococcus and solid organ transplant, which will be the subject of new research.
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- 2017
11. Carcinosarcoma of the Liver: A Case Report and Review of the Literature
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Rosemary, She and Juliana, Szakacs
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Carcinoma, Hepatocellular ,Hepatorenal Syndrome ,Liver Neoplasms ,Antineoplastic Agents ,Sarcoma ,General Medicine ,Middle Aged ,Piperazines ,Pathology and Forensic Medicine ,Diagnosis, Differential ,Medical Laboratory Technology ,Fatal Outcome ,Pyrimidines ,Carcinosarcoma ,Benzamides ,Imatinib Mesylate ,Humans ,Female - Abstract
No more than 11 cases of carcinosarcoma of the liver have been reported in the past 40 years that fulfill the definition of hepatocellular carcinoma combined with differentiated sarcomatous elements. Most cases consist of hepatocellular carcinoma with 1 to 2 heterologous elements. We report a case of a 51-year-old woman with liver carcinosarcoma consisting of 3 carcinomatous components and 4 sarcomatous components. Hepatocellular carcinoma, fibrolamellar type, was accompanied by neuroendocrine carcinoma (neuron-specific enolase and synaptophysin positive) and adenocarcinoma (cytokeratin 7 and 20 positive). The sarcomatous elements consisted of poorly differentiated spindle cell neoplasm (vimentin positive), leiomyosarcoma (smooth muscle actin positive), rhabdomyosarcoma (desmin positive), and osteosarcoma. To our knowledge, this is the first case of liver carcinosarcoma with this many differentiated heterologous features. There are differing views on the pathogenesis of this tumor. Findings in this case support the view that metaplasia of carcinomatous cells gives rise to the sarcomatous elements.
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- 2005
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12. Microbial keratitis in los angeles: the doheny eye institute and the los angeles county hospital experience
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Daniel, Sand, Rosemary, She, Ira A, Shulman, David S, Chen, Mathew, Schur, and Hugo Y, Hsu
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Adult ,Aged, 80 and over ,Hospitals, County ,Male ,Adolescent ,Bacteria ,Levofloxacin ,Microbial Sensitivity Tests ,Middle Aged ,Los Angeles ,Eye Infections, Bacterial ,Anti-Bacterial Agents ,Ciprofloxacin ,Humans ,Female ,Child ,Corneal Ulcer ,Gram-Negative Bacterial Infections ,Gram-Positive Bacterial Infections ,Aged ,Retrospective Studies - Abstract
To evaluate the spectrum and antibiotic susceptibility panel of infectious keratitis at a major tertiary care referral eye center and a major county hospital in Southern California.Retrospective case series.All cultured infectious keratitis cases from July 1, 2008, through December 31, 2012, from the Doheny Eye Institute (DEI) and the Los Angeles County + University of Southern California Medical Center (LAC+USC) were evaluated.Microbiology records were reviewed retrospectively.Microbial isolates as well as antibiotic susceptibility patterns were analyzed.One hundred eighty-four (63%) of 290 cases showed positive culture results at DEI and 152 (82%) of 186 cases showed positive culture results at LAC+USC. Gram-positive pathogens were found to be the most common at both DEI (70%) and LAC+USC (68%), with coagulase-negative Staphylococcus being the most common gram-positive organism (58% at DEI and 44% at LAC+USC). Pseudomonas aeruginosa was the most common gram-negative organism (57% at DEI and 43% at LAC+USC). Ciprofloxacin and levofloxacin susceptibility for all tested pathogens was 73% at DEI and 81% at LAC+USC (P = 0.16). Oxacillin-resistant Staphylococcus aureus (ORSA) was found in 42% of cases at DEI and in 45% of cases at LAC+USC (P = 1.00).There is no significant difference in the spectrum of pathogens or antibiotic susceptibility of pathogens at DEI versus LAC+USC, and ORSA was found in approximately half of all S. aureus samples.
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- 2014
13. The in vitro activity and specificity of human endothelial cell-specific promoters in porcine cells
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Suchitra Sumitran-Holgersson, Jan Holgersson, Rosemary She, Zhong He, Khalid B. Islam, and Pontus Blomberg
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Transplantation ,Endothelium ,Transgene ,Xenotransplantation ,medicine.medical_treatment ,Immunology ,Transfection ,Biology ,Thrombomodulin ,Molecular biology ,Endothelial stem cell ,medicine.anatomical_structure ,Cell culture ,cardiovascular system ,medicine - Abstract
The chronic shortage of human organs, tissues and cells for transplantation has inspired research on the possibility of using animal donor tissue instead. Transplantation over a species barrier is associated with rejections which are difficult to control. Therefore, it is generally agreed that successful pig to human xenotransplantation requires donor pigs to be genetically modified. Vascular endothelium is the most immediate barrier between the xenogeneic donor organ and host immune and nonimmune defense systems. Thus, these cells are the prime targets for such genetic modifications. Luciferase assays were used to evaluate the activity and specificity of human endothelial-cell specific promoters in porcine aortic-, microvascular- and nonendothelial cells. The promoters for human Flk-1 (fetal liver kinase-1), Flt-1 (fms-like tyrosine kinase), ICAM-2 (intercellular adhesion molecule-2), thrombomodulin and vWf (von Willebrand factor) supported similar levels of luciferase expression in human and porcine aortic endothelial cells, with the Flk-1 promoter being the strongest followed by the thrombomodulin promoter. Relative to the activity of the CMV promoter, the human endothelial cell-specific promoters all showed less activity in porcine kidney microvascular endothelial cells than in liver or brain microvascular endothelial cells. The thrombomodulin and Flk-1 promoters exhibited similar activity in liver and kidney microvascular endothelial cells, whereas the Flk-1 promoter was stronger in aortic and brain microvascular endothelial cells. Human endothelial cell-specific promoters also showed some degree of specificity in pig, because they supported less luciferase activity in porcine nonendothelial cell lines. Based on the in vitro data and previously published in vivo data, the human Flk-1 and thrombomodulin promoters are good candidate promoters for strong endothelial cell-specific gene expression in transgenic pigs.
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- 2001
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14. Hyperostosis frontalis interna: case report and review of literature
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Rosemary, She and Juliana, Szakacs
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Humans ,Female ,Middle Aged ,Hyperostosis Frontalis Interna - Abstract
Hyperostosis frontalis interna (HFI) has been reported in high frequency among post-menopausal elderly women. Although it was widely discussed in the past, this entity is rarely mentioned in the current pathology literature. We report a postmortem case of a 56 yr-old post-menopausal woman with irregular thickening of the internal surface of the frontal bone. Histology revealed an organized trabecular pattern with overall thickening of the cancellous bone. The periosteum and cortical bone were unaffected. The finding was considered to be unrelated to her death. HFI should be recognized as a benign entity and distinguished from other disorders that involve the frontal skull bone, such as Paget's disease, acromegaly, and malignancy. The etiology of HFI is unknown, but current hypotheses implicate hormonal stimulation.
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- 2004
15. Evaluation of Enzyme Immunoassays to Detect Clostridium difficile Toxin From Anaerobic Stool Culture.
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Rosemary She and Robert Durrant
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CLOSTRIDIOIDES difficile , *TOXINS , *BIOLOGICAL assay , *ENZYME-linked immunosorbent assay , *POLYMERASE chain reaction , *CELL culture - Abstract
Stool culture for Clostridium difficile, while necessary for strain typing and antimicrobial surveillance, cannot determine toxin production. We prospectively tested in triplicate 91 C difficile cultured isolates for toxin production by 2 enzyme immunoassays (EIAs) (Meridian Premier Toxins A&B, Meridian Bioscience, Cincinnati, OH; and TechLab Tox A/B II, TechLab, Blacksburg, VA) and cytotoxin neutralization bioassay (CTN). By CTN, 88% (80/91) were toxigenic. Reproducibility was 93% (85/91) for CTN, 80% (73/91) for Meridian EIA, and 79% (72/91) for TechLab EIA. Compared with CTN, sensitivities were 87.1% and 89.2% for the Meridian and TechLab EIAs, respectively. In an additional 115 stool specimens, CTN detected toxin more frequently from cultured isolates (96/115) than stool (84/115). For C difficile toxin detection from isolates, EIA was less reproducible than CTN. EIA methods can be falsely negative in 10% to 12% of isolates, and these should be tested by CTN or polymerase chain reaction. When positive, EIA is fast and reliable for detecting C difficile toxin from culture. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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16. Mental Illness in Children: Childhood Illness and Supporting the Family
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Rosemary Sheehan
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n/a ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Childhood is a stage of life that is filled with potential for development, and the early years of childhood see immense physical changes in growth; mastery over body functions like movement; the acquisition of language and cognitive development to understand their own and others’ thinking and reasoning; and the psychosocial development of trust in the world, comfort in the care they receive from parents and caregivers, and the sense of being secure in themselves that this engenders. [...]
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- 2017
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