Oneilbak4520

They should also simplify communication with referring physicians and support both acceptance and appreciation of the clinical value of oncologic hybrid imaging. CITATION FORMAT · Derlin T, Gatidis S, Krause BJ et al. Konsensusempfehlung zur strukturierten Befunderstellung onkologischer PET-Hybridbildgebung. Fortschr Röntgenstr 2020; DOI10.1055/a-1179-6603.Background We previously identified Pseudomonas aeruginosa isolates with characteristics typical of chronic infection in some early infections in children with Cystic Fibrosis (CF), suggesting these isolates may have been acquired from other patients. Our objective was to define the extent of P. aeruginosa strain sharing in early CF infections and its impact on antibiotic eradication treatment failure rates. Methods We performed whole genome sequencing on isolates from early pediatric CF pulmonary infections and from comparator groups in the same hospital chronic CF infection, sink drains, sterile site infections and asymptomatic carriage. Univariate logistic regression was used to assess factors associated with treatment failure. Results In this retrospective observational study, 1,029 isolates were sequenced. The CF clones Strain B and Clone C were present. In 70 CF patients with early infections, 14 shared strains infected 29 (41%) patients over five years; 16% (n=14) of infections had mixed-strains. In the 70 children, approximately one third of shared strain infections were likely due to patient-to-patient transmission. Mixed-strain infections were associated with strain sharing (odds ratio 8.50; 95% confidence interval 2.2 - 33.4, P = 0.002). Strain sharing was not associated with antibiotic eradication treatment failure; however, nosocomial strain transmission was associated with establishment of chronic infection in a CF sibling pair. Conclusions Although early P. aeruginosa CF infection is thought to reflect acquisition of diverse strains from community reservoirs, we identified frequent early CF strain sharing which was associated with the presence of mixed-strains and instances of possible patient-to-patient transmission.Background Stenotrophomonas maltophilia is increasingly common in patients with acute myeloid leukemia (AML). Relatively little is known about factors that drive S. maltophilia infection. We evaluated the utility of the microbiome and cumulative antibiotic use as predictors of S. maltophilia infection in AML patients receiving remission induction chemotherapy (RIC). Methods We performed a sub-analysis of a prospective, observational cohort of patients with AML receiving RIC between 9/2013 and 8/2015. Fecal and oral microbiome samples collected from the start of RIC until neutrophil recovery were assessed for the relative abundance of Stenotrophomonas via 16S rRNA gene quantitation. The primary outcome, microbiologically-proven S. maltophilia infection, was analyzed using a time-varying Cox proportional hazards model. Results Of 90 included patients, 8 (9%) developed S. maltophilia infection (pneumonia, n=6; skin/soft-tissue, n=2). 4/8 (50%) patients were bacteremic. 7/8 (88%) patients with S. maltophilia infection had detectable levels of Stenotrophomonas vs 22/82 (27%) without infection (p less then 0.01). An oral Stenotrophomonas relative abundance of 36% predicted infection (sensitivity 96%, specificity 93%). No association of S. maltophilia infection with fecal relative abundance was found. Cumulative meropenem exposure was associated with increased infection risk (hazard ratio [HR] 1.17, 95% CI 1.01 - 1.35, p = 0.03). Conclusions Herein, we identify the oral microbiome as a potential source for S. maltophilia infection and highlight cumulative carbapenem use as a risk factor for S. maltophilia in leukemia patients. These data suggest that real-time molecular monitoring of the oral cavity might identify patients at high risk for S. maltophilia infection.Background Increasing demand for musculoskeletal care necessitates efficient scheduling and matching of patients with the appropriate provider. However, up to 47% to 60% of orthopedic visits are made without formal triage. The purpose of this study was to develop a method to identify, prior to the initial office visit, the probability that a patient with shoulder symptoms will need surgery so that he or she can be appropriately matched with an operative or nonoperative provider. We hypothesized that patients who had an injury, previously saw an orthopedic provider, or previously underwent magnetic resonance imaging on the affected shoulder would be more likely to undergo surgery. Methods Drawing from expert opinion on potential risk factors (which could be identified prior to the initial office visit) for requiring operative intervention for a chief complaint of shoulder symptoms, we developed a branching-logic questionnaire that required a maximum of 7 responses from the patient during the scheduling process. We administered the questionnaire to patients calling with a chief complaint of shoulder symptoms at the time of initial appointment scheduling in a sports health network. A chart review was later completed to determine the ultimate treatment (operative vs. nonoperative) of each patient's complaint. A multivariate predictive model was then developed to determine the characteristics of patients with a higher surgical risk. Results We successfully developed a model capable of determining surgical risk from 7% to 90% based on patient sex, previous magnetic resonance imaging status, and injury status. Conclusions Our predictive model can aid in patient clinical scheduling and ensure optimal matching of a patient with the best provider for the patient's care. Decreased wait times and appropriate matching may lead to increased patient satisfaction, superior outcomes, and more efficient use of health care resources.Background Shoulder arthroplasty, especially reverse shoulder arthroplasty (RSA), continues to increase in volume. Limitations in internal rotation can be challenging following RSA. Current patient-reported outcome measures are limited in assessing a patient's functional internal rotation following shoulder arthroplasty. To address this limitation, a questionnaire was developed. A-485 manufacturer Methods A single-center prospective comparative cohort study was performed to determine the reliability of the questionnaire. A pilot group of patients who had at least 1 year of follow-up following shoulder arthroplasty was asked to complete the questionnaire. Reliability testing was performed using Cronbach's alpha test. Additionally, individual questions and total questionnaire scores were compared between patients who underwent anatomic total shoulder arthroplasty (TSA) and RSA. Results The questionnaire showed high reliability with all questions. A group of 23 anatomic TSA and 20 RSA patients were compared. RSA patients scored significantly lower on the questionnaire (35.