Faculty Bibliography

Staphylococcal cassette chromosome mec (SCCmec) typing, in combination with genotyping of the Staphylococcus aureus chromosome, has become essential for defining methicillin-resistant S. aureus (MRSA) clones in epidemiological studies. We have developed a convenient system for SCCmec type assignment. The system consists of six multiplex PCRs (M-PCRs) for identifying the ccr gene complex (ccr), the mec gene complex (mec), and specific structures in the junkyard (J) regions: M-PCR with primer set 1 (M-PCR 1) identified five types of ccr genes; M-PCR 2 identified class A to class C mec; M-PCRs 3 and 4 identified specific open reading frames in the J1 regions of type I and IV and of type II, III, and V SCCmec elements, respectively; M-PCR 5 identified the transposons Tn554 and PsiTn554 integrated into the J2 regions of type II and III SCCmec elements; and M-PCR 6 identified plasmids pT181 and pUB110 integrated into J3 regions. The system was validated with 99 MRSA strains carrying SCCmec elements of different types. The SCCmec types of 93 out of the 99 MRSA strains could be assigned. The SCCmec type assignments were identical to those made with a PCR system that uses numerous primer pairs to identify genes or gene alleles. Our system of six M-PCRs is thus a convenient and reliable method for typing SCCmec elements

OBJECTIVE: To determine whether parental literacy is related to emergency department visits, hospitalizations, and days of school missed for children with asthma. METHODS: We performed a retrospective cohort study at a university pediatric clinic. We enrolled children between 3 and 12 years old with a diagnosis of asthma and a regular source of care at the site of the study and their parent or guardian. Primary asthma care measures included self-reported rates of emergency department visits, hospitalizations, and days of school missed. Secondary asthma care measures included rescue and controller medication use, classification of asthma severity, and parental asthma-related knowledge. RESULTS: We enrolled 150 children and their parents. Twenty-four percent of the parents had low literacy. Children of parents with low literacy had greater incidence of emergency department visits (adjusted incidence rate ratio [IRR] 1.4; 95% confidence interval 0.97, 2.0), hospitalizations (IRR 4.6; 1.8, 12), and days missed from school (IRR 2.8; 2.3, 3.4) even after adjusting for asthma-related knowledge, disease severity, medication use, and other sociodemographic factors. Parents with low literacy had less asthma-related knowledge, and their children were more likely to have moderate or severe persistent asthma and had greater use of rescue medications. CONCLUSIONS: Low parental literacy is associated with worse care measures for children with asthma.

Several new image-guidance tools and devices are being prototyped, investigated, and compared. These tools are introduced and include prototype software for image registration and fusion, thermal modeling, electromagnetic tracking, semiautomated robotic needle guidance, and multimodality imaging. The integration of treatment planning with computed tomography robot systems or electromagnetic needle-tip tracking allows for seamless, iterative, "see-and-treat," patient-specific tumor ablation. Such automation, navigation, and visualization tools could eventually optimize radiofrequency ablation and other needle-based ablation procedures and decrease variability among operators, thus facilitating the translation of novel image-guided therapies. Much of this new technology is in use or will be available to the interventional radiologist in the near future, and this brief introduction will hopefully encourage research in this emerging area.

As the pioneer drug in a class known as CETP (cholesterol ester transfer protein) inhibitors, torcetrapib had been shown previously by Pfizer to raise HDL, or good cholesterol, by more than 60%. Now Pfizer has taken a public relations hit because of its study discovery that the torcetrapib group had a higher death rate than the control group. But the criticism is hardly fair when you consider the pioneer spirit and resources of the company and how this spirit has so often led to great drugs

PURPOSE: We validate a grading system for urinary urgency. MATERIALS AND METHODS: A total of 225 subjects participated in a validation study of a fixed format question that examined the reasons why an individual usually voids. The response comprised 5 graded categories. The written questionnaire was completed by the subject twice in 3 to 14 days, during which there was no change in symptoms. Subjects included asymptomatic normal volunteers and consecutive patients with lower urinary tract symptoms without urinary urgency and those with overactive bladder with or without other lower urinary tract symptoms. Content validity was established by an expert panel. Discriminant validity was assessed by examining the frequency of responses in the various categories across the 3 groups (chi-square test) and by comparing average scores in each of the 3 groups using 1-way ANOVA, followed by LSD post hoc tests. Test-retest reliability was assessed using the intraclass correlation coefficient and kappa coefficient. RESULTS: A total of 83 normal subjects, 62 patients with lower urinary tract symptoms and 80 patients with overactive bladder were included in the study. Median age was 71 years (range 21 to 97). For test-retest reliability the intraclass correlation coefficient (0.86) and kappa coefficient (0.68) indicated a good level of agreement (p <0.001). The overactive bladder group achieved a significantly higher score than the normal and lower urinary tract symptoms groups (mean +/- SD 2.5 +/- 0.99 vs 1.6 +/- 0.93 and 1.8 +/- 0.93, respectively, each p <0.001). CONCLUSIONS: The urgency perception score appears to be a valid and reliable means of grading urinary urgency. We believe that this method of grading urgency will prove to be more clinically useful than the simple yes/no characterization of urgency as a sudden compelling desire to void and it will be a useful item for questionnaires and diary keeping

For decades, social scientists have relied on sibling correlations as indicative of the effect of "global family background" on socioeconomic status. This study advances this fine of inquiry by drawing on data from the Panel Study of Income Dynamics to analyze racial differences in siblings' labor market and socioeconomic outcomes. We find that Afiican Americans have lower sibling correlations in labor market earnings and family income than whites. Across the life course, African American siblings move toward greater resemblance than whites. These findings suggest that the effect of family background on socioeconomic outcomes is weAer for African Americans than for whites. Volatility in earlier career stages may suppress the effect of family background on labor market outcornes, and this dynamic is especially pronounced for African Americans who lack resources to insulate themselves from volatile events.

Fortunately, thanks in part to flu vaccines and other public health measures, the last three pandemics have been progressively milder from over 50 million dead worldwide in the worst flu pandemic in 1918,102 million dead in 1957, to 1 million fatalities in 1968 (see 'The World's 'Most Unwanted' List,' p. 14). You've probably heard your parents or teachers talk about the possibility of a bird flu pandemic. Or perhaps you even saw the frightening TV docudrama shown on a major network that followed the events of a fictitious bird flu outbreak among, humans, and the widespread panic that followed. However, our public discussions of a possible flu pandemic from the H5N1 bird flu have been informed largely by the ghost of the 1918 Spanish Flu, which was caused by a new flu virus, known as H1N1.