Faculty Bibliography

Many institutions are evaluating their inpatient patterns of care for patients with diabetes mellitus and hyperglycemia, based upon compelling evidence that strict glycemic control improves outcomes in a variety of hospital settings. In 2005, a multidisciplinary task force was established at the University of Kentucky Chandler Medical Center in Lexington, Kentucky, to guide a process to improve the quality and safety of inpatients with hyperglycemia. This article describes the stepwise process including an examination of our procedures, adoption of standards, and establishment of common protocols and procedures. Successful implementation of the protocols was preceded by extensive educational efforts. Refinement of the protocols based on early experience and feedback from staff has resulted in improvements in glycemic parameters and less reliance on sliding scale insulin regimens

The efforts ''weren't fast enough,'' Dr. [Martin S. Cetron] said, adding that ''we certainly will be learning lessons and looking to improve'' current systems. ''It's irresponsible in active tuberculosis for anyone to be on an airplane -- whether it's multi-resistant or not,'' said Dr. [Richard P. Wenzel], an infectious disease expert at Virginia Commonwealth University in Richmond. At a time when airline passengers have to discard shampoo bottles in the airport security line, Dr. Wenzel said, ''We don't have a simple sort of wand at the airport to wave to say, 'You have tuberculosis.' It really counts on the responsibility of the individual.''

The man, who declined to be identified in the newspaper article because of the stigma attached to his diagnosis, said he and his wife had decided to sneak back into the United States via Canada rather than have him be treated in isolation in Italy. 'I'm a very well-educated, successful, intelligent person,' he told the paper. 'This is insane to me that I have an armed guard outside my door when I've cooperated with everything other than the whole solitary- confinement-in-Italy thing.' That appraisal was based on tests showing that the number of tuberculosis bacteria in the man's sputum were too low to be detected but still enough to infect others. [Julie Gerberding] said her agency was erring on the side of caution because the form of tuberculosis, known as XDR TB, is often fatal and is a growing public health threat in many countries. The advisory applies only to crew members on the man's flight and to his fellow passengers, particularly those who were seated next to him and in the two rows behind him and the two rows in front of him. 'We're not concerned about a generic threat to travelers,' Gerberding said

That appraisal was based on tests showing that the number of tuberculosis bacteria in the man's sputum were too low to be detected but still enough to infect others. Dr. [Julie L. Gerberding] said her agency was erring on the side of caution because the form of tuberculosis, known as XDR TB, was often fatal and a growing public health threat in many countries. ''We're not concerned about a generic threat to travelers,'' Dr. Gerberding said. Dr. Gerberding said doctors had not determined the source of the man's infection. Molecular fingerprints used to distinguish among bacterial strains so far do not match that of any other known case, she said. People who think they may have been exposed to TB or XDR TB can call (800) CDC-INFO for more information

Epidemiologists from the Centers for Disease Control and Prevention have linked the acanthamoeba keratitis outbreak to AMO Complete Moisture Plus Multi-Purpose Solution. Advanced Medical Optics of Santa Ana, Calif., manufactures the solution, which is used to clean and store soft contact lenses

The outbreak resembles one last year that was linked to a different manufacturer's lens solution and a different microbe. In both instances, the cornea, the eye's transparent outer covering, is at risk. But why two different microbes caused the outbreaks is not known. ''It is beyond comprehension,'' said Dr. Dan B. Jones, the chairman of ophthalmology at Baylor College of Medicine in Houston, who detected a case of acanthamoeba keratitis, which is behind the current outbreak, on Friday. Acanthamoeba infections have been reported in many countries. Dr. Jones's team is credited for first identifying a corneal infection from acanthamoeba in the United States, in a rancher who was injured in an accident in Texas in 1973. That case did not involve contact lenses: while the rancher was working in a field, a piece of wire and hay hit his eye

Epidemiologists from the Centers for Disease Control and Prevention have linked the acanthamoeba keratitis outbreak to AMO Complete Moisture Plus Multi-Purpose Solution. Advanced Medical Optics of Santa Ana, Calif., manufactures the solution, used to clean and store soft contact lenses