Journal ArticleAcad Med · September 6, 2024
PROBLEM: Incivility in the health care workplace is increasing and negatively impacts everyone in the environment, including health care team members and the patients and families they serve. This study examined the efficacy and impact of Civility Champion ...
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Journal ArticleBMJ Open Respir Res · August 3, 2024
BACKGROUND: Pneumonia due to typical bacterial, atypical bacterial and viral pathogens can be difficult to clinically differentiate. Host response-based diagnostics are emerging as a complementary diagnostic strategy to pathogen detection. METHODS: We used ...
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Journal ArticleAcad Med · November 1, 2022
PURPOSE: To quantify the extent to which internal medicine (IM) residents provided care for patients with COVID-19 and examine characteristics of residency programs with or without plans (at some point) to exclude residents from COVID-19 care during the fi ...
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Journal ArticleJ Gen Intern Med · August 2022
BACKGROUND: Training future clinicians in safe opioid prescribing (SOP) and treatment of opioid use disorder (OUD) is critical to address the opioid epidemic. The Accreditation Council on Graduate Medical Education requires all programs to provide instruct ...
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Journal ArticleJ Fungi (Basel) · April 22, 2022
Many aspects of the host response to invasive cryptococcal infections remain poorly understood. In order to explore the pathobiology of infection with common clinical strains, we infected BALB/cJ mice with Cryptococcus neoformans, Cryptococcus gattii, or s ...
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Journal ArticleJAMA Intern Med · April 1, 2022
This survey study examines the prevalence and sources of mistreatment toward internal medicine residents. ...
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Journal ArticleJ Grad Med Educ · April 2022
BACKGROUND: Burnout is common among physicians and physician leaders, including residency program directors (PDs). The effects of the COVID-19 pandemic and other stressors in 2020 on PDs is unknown. OBJECTIVE: To measure the prevalence of burnout among int ...
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Journal ArticleJ Grad Med Educ · April 2021
BACKGROUND: While the overall percentage of residents who withdraw (2.7%) or take extended leave (1.0%) are low, subgroup analysis has found that minority physicians are approximately 30% more likely to withdraw from residency than their white counterparts ...
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Journal ArticleJ Gen Intern Med · November 2020
BACKGROUND: The learning and working environment for resident physicians shifted dramatically over the past two decades, with increased focus on work hours, resident wellness, and patient safety. Following two multi-center randomized trials comparing 16-h ...
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Journal ArticleKidney360 · October 29, 2020
BACKGROUND: In graduate medical education (GME), there are many barriers to achieving a personalized learning process with standardized learning outcomes. One way to support this is through mobile-friendly digital blackboard videos. We sought to measure th ...
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Journal ArticleTransl Res · May 2020
Invasive aspergillosis (IA) is a major cause of critical illness in immunocompromised (IC) patients. However, current fungal tests are limited. Disease-specific gene expression patterns in circulating host cells show promise as novel diagnostics, however i ...
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Journal Article · April 17, 2020
ABSTRACTBackgroundHow human-associated microbial communities resist and respond to perturbations remains incompletely understood. Viral challenge provides one opportunity to test how human ...
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Journal ArticleAcad Med · October 2018
PURPOSE: To measure the association between institutional investment in high-value care (HVC) performance improvement and resident HVC experiences. METHOD: The authors analyzed data from two 2014 surveys assessing institutions' investments in HVC performan ...
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Journal ArticleJ Grad Med Educ · April 2017
BACKGROUND: Failure to follow up and communicate test results to patients in outpatient settings may lead to diagnostic and therapeutic delays. Residents are less likely than attending physicians to report results to patients, and may face additional barri ...
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Journal ArticleAm J Med Qual · 2017
Deficiencies in resident diabetes care quality may relate to continuity clinic design. This retrospective analysis compared diabetes care processes and outcomes within a traditional resident continuity clinic structure (2005) and after the implementation o ...
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Journal ArticleAm J Med Qual · 2017
This study sought to determine burnout prevalence and factors associated with burnout in internal medicine residents after introduction of the 2011 ACGME duty hour rules. Burnout was evaluated using an anonymized, abbreviated version of the Maslach Burnout ...
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Journal ArticleAcad Med · October 2016
PROBLEM: The Accreditation Council for Graduate Medical Education milestones were written by physicians and thus may not reflect all the behaviors necessary for physicians to optimize their performance as a key member of an interprofessional team. APPROACH ...
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Journal ArticleMed Educ · July 2016
CONTEXT: Graduate medical trainees have a critical role in the teaching of other trainees. Improving their teaching requires an understanding of their attitudes towards teaching and their motivation to teach. Both have been incompletely explored in this po ...
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Journal ArticleJ Grad Med Educ · May 2016
Background Patient-physician communication is an integral part of high-quality patient care and an expectation of the Clinical Learning Environment Review program. Objective This quality improvement initiative evaluated the impact of an educational audit a ...
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Journal ArticleBMC Bioinformatics · January 22, 2016
BACKGROUND: Consider the problem of designing a panel of complex biomarkers to predict a patient's health or disease state when one can pair his or her current test sample, called a target sample, with the patient's previously acquired healthy sample, call ...
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Journal ArticleSci Transl Med · January 20, 2016
Acute respiratory infections caused by bacterial or viral pathogens are among the most common reasons for seeking medical care. Despite improvements in pathogen-based diagnostics, most patients receive inappropriate antibiotics. Host response biomarkers of ...
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Journal ArticleOpen Forum Infect Dis · January 2016
Early, presymptomatic intervention with oseltamivir (corresponding to the onset of a published host-based genomic signature of influenza infection) resulted in decreased overall influenza symptoms (aggregate symptom scores of 23.5 vs 46.3), more rapid reso ...
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Journal ArticleEGEMS (Wash DC) · 2016
CONTEXT: In the emerging Learning Health System (LHS), the application and generation of medical knowledge are a natural outgrowth of patient care. Achieving this ideal requires a physician workforce adept in information systems, quality improvement method ...
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Journal ArticlePLoS One · 2015
BACKGROUND: Influenza infection is associated with myocardial infarction (MI), suggesting that respiratory viral infection may induce biologic pathways that contribute to MI. We tested the hypotheses that 1) a validated blood gene expression signature of r ...
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Journal ArticleTrends Mol Med · October 2014
Acute respiratory infection (ARI) is a common diagnosis in outpatient and emergent care settings. Currently available diagnostics are limited, creating uncertainty in the use of antibacterial, antiviral, or supportive care. Up to 72% of ambulatory care pat ...
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Journal ArticleJ Grad Med Educ · September 2014
BACKGROUND: Systematically engaging residents in large programs in quality improvement (QI) is challenging. OBJECTIVE: To coordinate a shared QI project in a large residency program using an online tool. METHODS: A web-based QI tool guided residents throug ...
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Journal ArticleAm J Respir Cell Mol Biol · May 2014
Pneumococcal pneumonia is a leading cause of bacterial infection and death worldwide. Current diagnostic tests for detecting Streptococcus pneumoniae can be unreliable and can mislead clinical decision-making and treatment. To address this concern, we deve ...
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Journal ArticleJournal of Applied Statistics · January 1, 2014
A Bayesian statistical model is developed for analysis of the time-evolving properties of infectious disease, with a particular focus on viruses. The model employs a latent semi-Markovian state process, and the state-transition statistics are driven by thr ...
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Journal ArticleJ Clin Virol · December 2013
BACKGROUND: Leukocyte counts and differentials are commonly acquired in patients with suspected respiratory viral infections and may contribute diagnostic information. However, most published work is limited to a single timepoint at initial presentation to ...
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Journal ArticleSci Transl Med · September 18, 2013
Improved ways to diagnose acute respiratory viral infections could decrease inappropriate antibacterial use and serve as a vital triage mechanism in the event of a potential viral pandemic. Measurement of the host response to infection is an alternative to ...
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Journal ArticleAcad Med · August 2013
PURPOSE: In competency-based medical education, the focus of assessment is on learner demonstration of predefined outcomes or competencies. One strategy being used in internal medicine (IM) is applying curricular milestones to assessment and reporting mile ...
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Journal ArticleAnal Chim Acta · July 5, 2013
In this paper, we describe a surface-enhanced Raman scattering (SERS)-based detection approach, referred to as "molecular sentinel" (MS) plasmonic nanoprobes, to detect an RNA target related to viral infection. The MS method is essentially a label-free tec ...
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Journal ArticleBMC Bioinformatics · March 19, 2013
BACKGROUND: This paper introduces a new constrained model and the corresponding algorithm, called unsupervised Bayesian linear unmixing (uBLU), to identify biological signatures from high dimensional assays like gene expression microarrays. The basis for u ...
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Journal ArticlePLoS One · 2013
There is great potential for host-based gene expression analysis to impact the early diagnosis of infectious diseases. In particular, the influenza pandemic of 2009 highlighted the challenges and limitations of traditional pathogen-based testing for suspec ...
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Journal ArticlePLoS One · 2013
Staphylococcus aureus causes a spectrum of human infection. Diagnostic delays and uncertainty lead to treatment delays and inappropriate antibiotic use. A growing literature suggests the host's inflammatory response to the pathogen represents a potential t ...
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Journal ArticleTranspl Infect Dis · August 2012
Mycobacterium immunogenum is a relatively new species within the Mycobacterium chelonae-Mycobacterium abscessus group of rapidly growing mycobacteria (RGM). M. immunogenum was first characterized in 2001 and, similar to other RGM, is an ubiquitous environm ...
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Journal ArticlePLoS One · 2012
BACKGROUND: Invasive candidiasis (IC) is a devastating disease. While prompt antifungal therapy improves outcomes, empiric treatment based on the presence of fever has little clinical impact. Β-D-Glucan (BDG) is a fungal cell wall component detectable in t ...
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Journal ArticlePLoS One · 2012
The molecular chaperone Hsp90 orchestrates regulatory circuitry governing fungal morphogenesis, biofilm development, drug resistance, and virulence. Hsp90 functions in concert with co-chaperones to regulate stability and activation of client proteins, many ...
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Journal ArticleInfect Immun · November 2011
Candida albicans is a fungal pathogen that causes severe disseminated infections that can be lethal in immunocompromised patients. Genetic factors are known to alter the initial susceptibility to and severity of C. albicans infection. We developed a next-g ...
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Journal ArticlePLoS Genet · August 2011
Exposure to influenza viruses is necessary, but not sufficient, for healthy human hosts to develop symptomatic illness. The host response is an important determinant of disease progression. In order to delineate host molecular responses that differentiate ...
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Journal ArticleIEEE Trans Biomed Eng · March 2011
We develop a new bayesian construction of the elastic net (ENet), with variational bayesian analysis. This modeling framework is motivated by analysis of gene expression data for viruses, with a focus on H3N2 and H1N1 influenza, as well as Rhino virus and ...
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Journal ArticleJ Am Stat Assoc · January 1, 2011
There is often interest in predicting an individual's latent health status based on high-dimensional biomarkers that vary over time. Motivated by time-course gene expression array data that we have collected in two influenza challenge studies performed wit ...
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Journal ArticleIEEE Transactions on Signal Processing · January 1, 2011
We present a novel factor analysis method that can be applied to the discovery of common factors shared among trajectories in multivariate time series data. These factors satisfy a precedence-ordering property: certain factors are recruited only after some ...
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Journal Article2010 IEEE Sensor Array and Multichannel Signal Processing Workshop, SAM 2010 · December 20, 2010
We present a factor analysis method that accounts for possible temporal misalignment of the factor loadings across the population of samples. Our main hypothesis is that the data contains a subset of variables with similar but delayed profiles obeying a co ...
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Journal ArticleBMC Bioinformatics · November 9, 2010
BACKGROUND: Nonparametric Bayesian techniques have been developed recently to extend the sophistication of factor models, allowing one to infer the number of appropriate factors from the observed data. We consider such techniques for sparse factor analysis ...
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Journal ArticleICML 2010 - Proceedings, 27th International Conference on Machine Learning · September 17, 2010
We present and derive a new stick-breaking construction of the beta process. The construction is closely related to a special case of the stick-breaking construction of the Dirich-let process (Sethuraman, 1994) applied to the beta distribution. We derive a ...
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Journal ArticlePLoS Pathog · September 2, 2010
Although it has recently been shown that A/J mice are highly susceptible to Staphylococcus aureus sepsis as compared to C57BL/6J, the specific genes responsible for this differential phenotype are unknown. Using chromosome substitution strains (CSS), we fo ...
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Journal ArticlePLoS Pathog · August 26, 2010
Fungal pathogens exploit diverse mechanisms to survive exposure to antifungal drugs. This poses concern given the limited number of clinically useful antifungals and the growing population of immunocompromised individuals vulnerable to life-threatening fun ...
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Journal ArticleJ Clin Microbiol · July 2010
For Candida species, a bimodal wild-type MIC distribution for echinocandins exists, but resistance to echinocandins is rare. We characterized isolates from patients with invasive candidiasis (IC) breaking through >or=3 doses of micafungin therapy during th ...
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Journal ArticleSci Transl Med · March 3, 2010
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Candidemia is the fourth most common bloodstream infection, with Candida albicans being the most common causative species. Success in reducing the associated morbidity and mortality has been limited by the inadequacy and time delay of currently available d ...
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Journal ArticleCell Host Microbe · September 17, 2009
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Acute respiratory infections (ARIs) are a common reason for seeking medical attention, and the threat of pandemic influenza will likely add to these numbers. Using human viral challenge studies with live rhinovirus, respiratory syncytial virus, and influen ...
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Journal ArticlePLoS Pathog · July 2009
Candida albicans is the leading fungal pathogen of humans, causing life-threatening disease in immunocompromised individuals. Treatment of candidiasis is hampered by the limited number of antifungal drugs whose efficacy is compromised by host toxicity, fun ...
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Journal ArticleCurr Biol · April 28, 2009
BACKGROUND: Hsp90 is an environmentally contingent molecular chaperone that influences the form and function of diverse regulators of cellular signaling. Hsp90 potentiates the evolution of fungal drug resistance by enabling crucial cellular stress response ...
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Journal ArticleProc Natl Acad Sci U S A · February 24, 2009
Invasive fungal infections are a leading cause of mortality among immunocompromised individuals. Treatment is notoriously difficult with the limited armamentarium of antifungal drugs, whose efficacy is compromised by host toxicity, a limited activity spect ...
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Journal ArticleEur J Clin Microbiol Infect Dis · October 2008
Cryptococcus neoformans is an uncommonly recognized cause of pneumonia in HIV-negative patients. Because of its propensity to disseminate to the meninges and other sites, a lumbar puncture is recommended for patients with pulmonary cryptococcosis, regardle ...
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Journal ArticleCurr Opin Infect Dis · August 2008
PURPOSE OF REVIEW: The recent decade has been a 'golden age' for antifungal therapy. The introduction of a novel class of antifungals, the echinocandins, has revolutionized the therapy for invasive candidiasis, provided increasing options for antifungal pr ...
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Journal ArticlePLoS Genet · June 20, 2008
Featured Publication
Invasive aspergillosis (IA) is a common and life-threatening infection in immunocompromised individuals. A number of environmental and epidemiologic risk factors for developing IA have been identified. However, genetic factors that affect risk for developi ...
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Journal ArticleAnnu Rev Med · 2008
Toll-like receptors (TLRs) enable innate immune recognition of endogenous and exogenous prototypic ligands. They also orchestrate innate and adaptive immune response to infection, inflammation, and tissue injury. Given their significance in the immune resp ...
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Journal ArticlePLoS One · December 26, 2007
Initiation of a protective immune response to infection by the pathogenic fungus Cryptococcus neoformans is mediated in part by host factors that promote interactions between immune cells and C. neoformans yeast. Surfactant protein A (SP-A) contributes pos ...
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Journal ArticleJ Heart Lung Transplant · December 2007
BACKGROUND: Cytomegalovirus (CMV) disease is a major cause of morbidity and mortality after lung transplantation despite ganciclovir prophylaxis. The emergence of ganciclovir-resistant CMV in lung transplant patients has been reported, although the optimal ...
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Journal ArticleInfection · October 2007
Ochroconis gallopavum, a dematiaceous fungus, is a rare cause disease in immunocompromised patients and epidemic encephalitis in poultry. We report the first case of active O. gallopavum pulmonary infection in an immunocompetent host with rapid and complet ...
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Journal ArticleInfections in Medicine · April 1, 2007
Since endemic mycoses can be contracted during a brief travel exposure, it is important to inquire about travel when a patient presents with symptoms of a respiratory infection. Most patients with blastomycosis present in the chronic phase, with cough, wei ...
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Journal ArticleAntimicrob Agents Chemother · March 2007
Voriconazole is a triazole antifungal agent used to treat serious, invasive fungal infections including aspergillosis and candidemia. Limitations with existing formulations of voriconazole including restricted utility in patients with renal dysfunction (in ...
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Chapter · January 1, 2007
Aspergillosis refers to infection with any of the approximately 185 recognized species of the genus Aspergillus, of which only 20 are known to cause human disease. Most human disease is primarily caused by Aspergillus fumigatus, Aspergillus flavus, Aspergi ...
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Journal ArticleGenomic Med · 2007
Whole blood gene expression profiling has the potential to be informative about dynamic changes in disease states and to provide information on underlying disease mechanisms. Having demonstrated proof of concept in animal models, a number of studies have n ...
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Journal ArticleAm J Med · November 2006
BACKGROUND: Caspofungin is emerging as first-line therapy for invasive candidiasis. Data on the use of caspofungin for treatment for invasive candidiasis are limited to clinical trials and case reports. We report a single-center experience with 104 consecu ...
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Journal ArticleMed Mycol · September 1, 2006
Invasive aspergillosis is a common and life-threatening infection in immunocompromised individuals. Epidemiologic risk factors do not fully explain susceptibility to disease amongst at-risk persons. Recently, the contribution of host genetics and genetic p ...
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Journal ArticleCurrent Opinion in Organ Transplantation · December 1, 2005
Purpose of review: Invasive fungal infections remain a predominant cause of morbidity and mortality in the immunocompromised population. Fungal diagnostics, namely the Platelia Aspergillus enzyme immunoassay (Bio-Rad, Redmond, WA) and the Fungitell 1→-β-D- ...
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Journal ArticleJ Infect · October 2005
OBJECTIVES: The optimal management of Candida infective endocarditis (IE) is unknown. METHODS: We reviewed all 879 cases of Candida IE reported from 1966-2002 in the peer-reviewed literature to better understand the role of medical and surgical therapies. ...
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Journal ArticleTrends Cardiovasc Med · August 2005
The lung serves as a major interface between the host and the external environment. As such, numerous lines of defense protect the host from inhaled potential pathogens. A breach in pulmonary innate immunity can lead to deleterious outcomes, such as pneumo ...
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Journal ArticleExpert Opin Pharmacother · August 2005
Novel therapies to treat invasive fungal infections have revolutionised the care of patients with candidiasis, aspergillosis and other less common fungal infections. Physicians in the twenty first century have access to safer versions of conventional drugs ...
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Journal ArticleExpert Rev Anti Infect Ther · April 2005
Invasive fungal infections cause considerable morbidity and mortality in nosocomial settings and amongst immunocompromised hosts. Invasive candidiasis and aspergillosis remain the most common invasive fungal infections, with Candida spp. constituting the f ...
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Journal ArticleRespir Care Clin N Am · December 2004
Infections remain a serious and common problem in lung transplant recipients. Recent years have seen an explosion in the knowledge regarding this major cause of morbidity and mortality. Novel diagnostic and therapeutic techniques are revolutionizing the ap ...
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Journal ArticleMed Mycol · October 2004
Animal models of invasive aspergillosis have been used for virulence studies and antifungal efficacy evaluations but results have been inconsistent. In an attempt to reproduce human infection, many Aspergillus animal models have utilized a 'pulmonary route ...
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Journal ArticleDrug Discovery Today: Disease Models · January 1, 2004
Fungal infections are increasing due to the growing number of immunocompromised patients. Because in vitro antifungal testing has limitations, animal models remain the essential tool to understand virulence and to optimize antifungal therapies. There are n ...
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Journal ArticleJ Clin Microbiol · November 2003
Rhodotorula infections occur among patients with immunosuppression and/or central venous catheters. Using standardized methods (NCCLS M27-A), we determined the antifungal susceptibilities of 10 Rhodotorula bloodstream infection isolates. Patient informatio ...
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Journal ArticleJournal of Respiratory Diseases · October 1, 2003
Since endemic mycoses can be contracted during a brief travel exposure, it is important to inquire about travel when a patient presents with symptoms of a respiratory infection. Most patients with blastomycosis present in the chronic phase, with cough, wei ...
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Journal ArticleAm J Med · May 2003
A 56-year-old black woman with diabetes mellitus was admitted for hypoglycemia and confusion. Her past medical history included breast cancer, for which she had undergone a left lumpectomy and then mastectomy for in-breast recurrence. Her oral intake had d ...
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Journal ArticleClin Infect Dis · April 1, 2003
Identification of risk factors for shunt infection and predictors of infectious pathogens may improve current methods to prevent and treat shunt infections. We reviewed data on 820 consecutive ventriculoperitoneal (VP) shunt placement procedures in 442 ped ...
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Journal ArticleAm J Med · February 1, 2003
A 37-year-old woman presented with increasing abdominal pain and jaundice. Six weeks before admission, she developed persistent diarrhea and jaundice of the skin. She also bruised easily, and her gums bled. In the subsequent weeks, her appetite decreased, ...
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Journal ArticleClin Infect Dis · November 15, 2002
Vancomycin-resistant Enterococcus faecium (VRE) is a common nosocomial isolate, especially among patients with cancer. VRE infections have substantial attributable mortality among patients with cancer. The purpose of this study was to identify risk factors ...
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Journal ArticleJ Rheumatol · May 2001
We describe 2 women who developed large artery vasculitis shortly after receiving recombinant hepatitis B vaccination. One patient developed Takayasu's arteritis, the other a vasculitis involving subclavian and renal arteries. Both developed renal failure. ...
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