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Clostridium difficile-associated disease:Adherence with current guidelines at a tertiary medical center

World Journal of Gastroenterology 2013年第46期19卷 8647-8651页

作者： bryan F curtin Yousef Zarbalian Mark H Flasar Erik von Rosenvinge Resident in Internal Medicine Department of Medicine University of Maryland School of Medicine Baltimore Division of Gastroenterology and Hepatology Department of Medicine University of Maryland School of Medicine and VA Maryland Health Care System Baltimore

AIM:To assess adherence with the the Society for Healthcare Epidemiology of America(SHEA)/the Infectious Diseases Society of America(IDSA)guidelines for management of Clostridium difficile(***)-associated disease(CDAD)at a tertiary medical ***:All positive *** stool toxin assays in adults between May 2010 and May 2011 at the University of Maryland Medical Center were *** episodes were classified as guideline adherent or nonadherent and these two groups were compared to determine demographic and clinical factors predictive of *** regression analysis was performed to assess the effect of multiple predictors on guideline ***:320 positive *** stool tests were identified in 290 *** by disease severity criteria set forth by the SHEA/IDSA guidelines,42.2%of cases were mild-moderate,48.1%severe,and 9.7%*** adherence with the guidelines was observed in only 43.4%of *** was65.9%for mild-moderate CDAD,which was significantly better than in severe cases(25.3%)or severe-complicated cases(35.5%)(P<0.001).There was no difference in demographics,hospitalization,ICU exposure,recurrence or 30-d mortality between adherent and non-adherent groups.A multivariate model revealed significantly decreased adherence for severe or severecomplicated episodes(OR=0.18,95%CI:0.11-0.30)and recurrent episodes(OR=0.46,95%CI:0.23-0.95).CONCLUSION:Overall adherence with the SHEA/IDSA guidelines for management of CDAD at a tertiary medical center was poor;this was most pronounced in severe,severe-complicated and recurrent *** interventions aimed at improving guideline adherence are warranted.

关键词： Clostridium difficile Metronidazole Vanco-mycin Adherence to the Infectious Diseases Society of America Guidelines Hospital Acquired Infections

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Characteristics of Clostridium difficile infection in patients hospitalized with myelodysplastic syndrome or acute myelogenous leukemia

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World Journal of Clinical Oncology 2017年第5期8卷 398-404页

作者： Kamini Shah bryan F curtin Christopher Chu Daniel Hwang Mark H Flasar Erik von Rosenvinge Division of Infectious Diseases Department of MedicineUniversity of Maryland School of Medicine Digestive Diseases Branch National Institute of Diabetes and Digestive and Kidney Diseases Department of Medicine University of Maryland School of Medicine Division of Gastro-enterology and Hepatology Department of MedicineUniversity of Maryland School of Medicine and VA Maryland Health Care System

AIM To evaluate factors associated with Clostridium difficile infection (CDI) and outcomes of CDI in the myelodysplastic syndrome(MDS) and acute myeloid leukemia (AML) *** After IRB approval,all MDS/AML patients hospitalized at the University of Maryland Greenebaum Comprehensive Cancer Center between August 2011 and December 2013 were *** charts were reviewed for demographics,clinical information,development of CDI,complications of CDI,and *** with CDI,defined as having a positive stool PCR done for clinical suspicion of CDI,were compared to those without CDI in order to identify predictors of disease.A t-test was used for comparison of continuous variables and chisquare or Fisher's exact tests were used for categorical variables,as *** Two hundred and twenty-three patients (60.1% male,mean age 61.3 years,13% MDS,87% AML) had 594 unique hospitalizations during the study *** patients (15.2%) were diagnosed with *** significantly associated with CDI included lower albumin at time of hospitalization (P < 0.0001),prior diagnosis of CDI (P < 0.0001),receipt of cytarabine-based chemotherapy (P = 0.015),total days of neutropenia (P = 0.014),and total days of hospitalization (P = 0.005).Gender (P = 0.10),age (P = 0.77),proton-pump inhibitor use (P = 0.73),receipt of antibiotics (P = 0.66),and receipt of DNA hypomethylating agent-based chemotherapy (P = 0.92) were not significantly associated with *** CDI is common in the MDS/AML *** significantly associated with CDI in this population include low albumin,prior CDI,use of cytarabine-based chemotherapy,and prolonged *** this study,we have identified a subset of patients in which prophylaxis studies could be targeted.

关键词： Clostridium difficile Acute myeloid leukemia Cytarabine-based chemotherapy Myelodysplastic syndrome Neutropenia

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The response to vedolizumab in chronic granulomatous disease-related inflammatory bowel disease

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Gastroenterology Report 2020年第5期8卷 404-406,I0003页

作者： Natasha Kamal Beatriz Marciano bryan curtin Anna Strongin Suk See DeRavin Athos Bousvaros Christopher Koh Harry L.Malech Steven M.Holland Christa Zerbe Theo Heller Digestive Disease Branch National Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthBethesdaMDUSA Laboratory of Host Defenses National Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMDUSA Division of Gastroenterology Hepatology and NutritionBoston Children’s HospitalBostonMAUSA Liver Disease Branch National Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthBethesdaMDUSA Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMDUSA

Introduction Chronic granulomatous disease(CGD)is a rare immunodeficiency affecting approximately 1 in 200,000 people[1].Patients with CGD are unable to produce normal amounts of neutrophil superoxide and other phagocyte reactive oxygen *** a result,phagocytes have decreased microbicidal activity and patients develop recurrent bacterial and fungal infections.

关键词：慢性肉芽肿单抗治疗炎症性肠病 immunodeficiency

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内蒙锡林浩特晚石炭世辉长质岩体的成因：陆内伸展背景下富水地幔源区熔融的产物

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岩石学报 2018年第10期34卷 2956-2972页

作者：庞崇进王选策温淑女 Krapez bryan 王炎阳廖闻桂林理工大学地球科学学院、广西有色金属隐伏矿床勘查及材料开发协同创新中心、广西隐伏金属矿产勘查重点实验室桂林541004 澳大利亚科廷大学地球与行星科学学院、地球科学研究所珀斯WA6845 长安大学地球与资源学院西安710054 北京大学造山带与地壳演化教育部重点实验室、北京大学地球与空间科学学院北京100871

内蒙中部晚石炭世岩浆活动的成因及动力学背景对于揭示古亚洲洋俯冲和兴蒙造山带演化的具有重要意义。本文选取锡林浩特南部晚石炭世辉长质侵入体为研究对象,开展高精度SIMS锆石U-Pb定年、全岩主微量和Sr-Nd-Hf同位素分析,旨在讨论其岩... 详细信息

内蒙中部晚石炭世岩浆活动的成因及动力学背景对于揭示古亚洲洋俯冲和兴蒙造山带演化的具有重要意义。本文选取锡林浩特南部晚石炭世辉长质侵入体为研究对象,开展高精度SIMS锆石U-Pb定年、全岩主微量和Sr-Nd-Hf同位素分析,旨在讨论其岩石成因,为制约兴蒙造山带的演化和理解深部流体循环过程提供更多信息。辉长质岩体样品的锆石CL图像呈弱环状结构、条带状或岩浆生长带(Th/U=0. 3～2. 5)。SIMS锆石U-Pb定年结果表明,锡林浩特辉长质岩体的侵位年龄为316. 9±2. 2Ma,为兴蒙造山带晚石炭世区域性岩浆活动的产物。该岩体经历了橄榄石和单斜辉石的分离结晶作用,但受堆晶作用和地壳物质混染作用的影响较小;同时具有较低的87Sr/86Sr初始比值(0. 7034～0. 7041),但相对高的εNd(t)(+5. 58～+6. 88)和εHf(t)值(+12. 07～+13. 44),并显示Rb、Sr、U和Pb等流体活动性元素相对富集,但Nb和Ta等非流体活动性元素相对亏损的特征,暗示其起源于遭受含水流体交代富集的地幔源区。流体交代富集作用很可能发生在源区部分熔融过程中或者在部分熔融之前较短的时间内,即反映较为年轻的交代事件。锡林浩特辉长闪长岩具有相对较高的Si O_2(51. 7%～53. 2%)、Cr (138. 4×10^(-6)～757. 2×10^(-6))和Ni (50. 4×10-6～141. 1×10^(-6))含量以及Zn/Fe比值(10. 8～11. 5),但相对较低的Al2O3(13. 1%～16. 8%)含量,暗示源区可能富含斜方辉石,由橄榄岩+辉石岩脉组成。通过对比总结兴蒙造山带晚石炭世岩浆岩岩石组合的地球化学特征以及其他地质资料,本文认为古亚洲洋在晚石炭世之前已经闭合,而锡林浩特辉长质岩体形成于陆内伸展的构造背景。结合同期玄武岩母岩浆的高含水量特征(高达4. 41%),本文认为锡林浩特及其邻区晚石炭世岩浆活动是遭受地幔转换带滞留俯冲板块析出富水流体交代的地幔源区部分熔融的产物,从而建立了深部流体循环过程与造山后伸展背景下岩浆活动的成因联系。

关键词：晚石炭世侵入岩流体活动性元素辉长岩深部流体循环兴蒙造山带

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Mojave desert tortoise(Gopherus agassizii)thermal ecology and reproductive success along a rainfall cline

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Integrative Zoology 2015年第3期10卷 282-294页

作者： Annette E.SIEG Megan M.GAMBONE bryan P.WALLACE Susana CLUSELLATRULLAS James R.SPOTILA Harold W.AVERY Department of Natural Sciences University of Michigan-DearbornDearbornMichiganUSA HDR Plymouth MeetingPennsylvaniaUSA Nicholas School of the Environment Duke University Marine LaboratoryBeaufortNorth CarolinaUSA Stratus Consulting BoulderColoradoUSA Centre for Invasion Biology Department of Botany and ZoologyStellenbosch UniversityPrivate Bag X1Matieland 7602South Africa Department of Biodiversity Earth and Environmental ScienceDrexel UniversityPhiladelphiaPennsylvaniaUSA Department of Biology The College of New JerseyEwingNew JerseyUSA

Desert resource environments(***,food)are tied to limited,highly localized rainfall regimes which generate microgeographic variation in the life histories of ***,enhanced growth rates,reproduction and survivorship are observed in response to increased resource availability in a variety of desert plants and short-lived *** examined the thermal ecology and reproduction of US federally threatened Mojave desert tortoises(Gopherus agassizii),long-lived and large-bodied ectotherms,at opposite ends of a 250-m elevation-related rainfall cline within Ivanpah Valley in the eastern Mojave Desert,California,*** operative environments in both the upper-elevation,“Cima,”and the lower-elevation,“Pumphouse,”plots corresponded with daily and seasonal patterns of incident solar *** received 22%more rainfall and contained greater perennial vegetative cover,which conferred 5°C-cooler daytime shaded *** a monitored average rainfall year,Cima tortoises had longer potential activity periods by up to several hours and greater ephemeral *** resource availability in Cima was associated with larger-bodied females producing larger eggs,while still producing the same number of eggs as Pumphouse ***,reproductive success was lower in Cima because 90%of eggs were depredated versus 11%in Pumphouse,indicating that predatory interactions produced counter-gradient variation in reproductive success across the rainfall ***-use impacts on deserts(*** energy generation)are increasing rapidly,and conservation strategies designed to protect and recover threatened desert inhabitants,such as desert tortoises,should incorporate these strong ecosystem-level responses to regional resource variation in assessments of habitat for prospective development and mitigation efforts.

关键词： Gopherus agassizii operative environments reproductive ecology resource gradient

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内蒙锡林浩特晚石炭世辉长质岩体的成因:陆内伸展背景下富水地幔源区熔融的产物

内蒙锡林浩特晚石炭世辉长质岩体的成因:陆内伸展背景下富水地幔...

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2018年中国地球科学联合学术年会

作者：庞崇进王选策温淑女 bryan Krapez 王炎阳廖闻桂林理工大学地球科学学院广西有色金属隐伏矿床勘查及材料开发协同创新中心广西隐伏金属矿产勘查重点实验室 The Institute for Geoscience Research (TIGeR) School of Earth and Planetary Sciences Curtin University 北京大学造山带与地壳演化教育部重点实验室北京大学地球与空间科学学院

内蒙中部晚石炭世岩浆活动的成因及动力学背景对于揭示古亚洲洋俯冲和兴蒙造山带演化的具有重要意义。本研究选取锡林浩特南部晚石炭世辉长质侵入体为研究对象,开展高精度SIMS锆石U-Pb定年、全岩主微量和Sr-Nd-Hf同位素分析,旨在讨论其... 详细信息

内蒙中部晚石炭世岩浆活动的成因及动力学背景对于揭示古亚洲洋俯冲和兴蒙造山带演化的具有重要意义。本研究选取锡林浩特南部晚石炭世辉长质侵入体为研究对象,开展高精度SIMS锆石U-Pb定年、全岩主微量和Sr-Nd-Hf同位素分析,旨在讨论其岩石成因,为制约兴蒙造山带的演化和理解深部流体循环过程提供更多信息。辉长质岩体样品的锆石CL图像呈弱环状结构、条带状或岩浆生长带

关键词：锡林浩特晚石炭世地幔源区部分熔融伸展背景

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