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P M Simone

Publications and source records attributed to P M Simone.

16 recordsLinked to original sources
PubMed2005

Monitoring and preventing healthcare-associated infections. The CDC approach.

The Centers for Disease Control and Prevention (CDC) is a federal agency in the United States charged with promoting health and quality of life by preventing and controlling disease, injury, and disability. Healthcare-associated infections (HAIs) are associated with substantial morbidity, mortality, and cost. To protect patients and health care personnel and promote safety, quality, and value of the health care delivery system in the United States, CDC provides leadership in surveillance, outbreak investigations, laboratory support and research, and prevention programs. Information from CDC programs are used to (1) assess the magnitude, trends, and risk factors of HAIs; (2) detect new patterns and mechanisms of antimicrobial resistance; (3) detect infections/adverse events related to new procedures performed in healthcare; and (4) develop new strategies to prevent HAIs. The CDC approach to monitor and prevent HAIs is described.

Centers for Disease Control and Prevention, U.S.↗
PubMed1999

Completion of tuberculosis therapy for patients reported in the United States in 1993.

SETTING: The highest priority for tuberculosis (TB) control is to ensure patients complete therapy. However, standardized, detailed evaluation of national performance on completion of therapy in the United States has been lacking. Since 1982, the Centers for Disease Control and Prevention (CDC) has had a program objective that at least 90% of TB cases complete therapy. Since 1986, the standard of practice for patients with drug-susceptible TB has been 6 months of therapy. OBJECTIVE: To determine completion of therapy rates and duration of therapy for US TB patients reported in 1993. DESIGN: Expanded TB surveillance data on all US TB patients reported to the CDC in 1993 with initial therapy of two or more drugs were analyzed with respect to completion and duration of therapy. RESULTS: A disposition (reason therapy stopped) was obtained on 98.7% of 23 489 treated patients. Overall, 91.2% of evaluable patients completed therapy. The overall completion rate at 12 months of therapy was 66.8%, and 90% completion was reached at 23 months. For patients with initially drug-susceptible TB, completion was 7.1% at 6 months, 66.5% at 12 months, and reached 90% at 22 months. CONCLUSION: While completion rates ultimately exceeded 90% nationwide, there was considerable delay in reaching this objective, especially in patients with drug-susceptible TB. It is critical that health departments and health care providers identify and remedy any deficiencies responsible for prolonged therapy.

Adolescent↗
PubMed1999

Tuberculosis prevention and control activities in the United States: an overview of the organization of tuberculosis services.

After a 20% increase in tuberculosis (TB) cases between 1986 and 1992, TB cases in the United States have declined from 1993 through 1997, an average of 5 to 7 per cent per year. In this paper, we review trends and the current epidemiology of TB in the US, present a brief history of TB control efforts in the country, and present the key strategies for TB control in the US. We describe the current organizational structure of TB services in the US, the role of the private sector in TB control, and how TB control is funded. Finally we discuss the mechanisms by which TB policy is developed. The US model represents a categorical disease program that combines a centralized role of the national government in development of policy, funding, and in the maintenance of national surveillance, and a decentralized role of state and local jurisdictions, which adapt and implement national guidelines and which are responsible for day-to-day program activities. Given the relative success of this combined approach, other countries facing the challenge of maintaining an effective TB control program in the face of increased decentralization of health services may find this description useful.

Adolescent↗
PubMed1997

Hospital infection control practices for tuberculosis.

Although completely eliminating the risk for transmission of M. tuberculosis in all health-care facilities may not be possible, adherence to the principles outlined in the CDC guidelines should reduce the risk to persons in such settings. The guidelines are designed to help health-care facilities develop an infection-control plan tailored to the individual circumstances and risk in each facility. The key to maintaining an effective TB infection control plan is periodic evaluation of the plan, with reassessment of risk and revision of the plan accordingly.

AIDS-Related Opportunistic Infections↗
PubMed1997

Selective attention in a reaching task: effect of normal aging and Alzheimer's disease.

This study examined the ability of young adults, older adults, and older adults suffering from Alzheimer's disease (AD) to perform a selective reaching task. Normal aging did not increase interference caused by distractors. In contrast, patients with AD showed massively increased effects of distractor interference. AD patients showed a high probability of making responses to distractor items. The proportion of these incorrect responses was related to the inability to use inhibitory processes, which increased with the severity of AD. Responses to distractors occurred despite the fact that patients could discriminate targets and distractors and knew that their responses to distractors were in error. These data suggest that AD patients are impaired in their ability to inhibit incorrect responses.

Adult↗
PubMed1997

The role of attention in a spatial memory task in Alzheimer disease patients.

Memory and attention are interrelated cognitive processes that most likely influence the functioning of each other, yet they are often difficult to distinguish in psychological experiments. Young, aged adults, and patients with Alzheimer disease (AD) were tested on a delay response task measuring spatial memory that also placed high demands on attentional resources. Aged adults performed as well as young, suggesting that neither attentional nor memory abilities were exceeded in either group. However, AD subjects were severely impaired on this task. Two further experiments with AD patients examined the relative contribution of attentional and memory deficits in the performance of this population. Both memory and attentional impairments were found; however, errors due to memory factors were more closely related to severity of disease as measured on the Folstein Mini-Mental State Examination than were errors of attentional origin. These studies demonstrate the necessity of accounting for attentional components in studies examining memory, especially in patients with AD.

Adult↗
PubMed1995

Respirators, recommendations, and regulations: the controversy surrounding protection of health care workers from tuberculosis.

Recent nosocomial outbreaks of tuberculosis have increased concern about the occupational acquisition of tuberculosis by health care workers. The Centers for Disease Control and Prevention (CDC), Department of Health and Human Services, and the Occupational Safety and Health Administration, Department of Labor, have issued recommendations and regulations in an effort to decrease health care workers' risk for exposure to patients with infectious tuberculosis. Within the CDC, the National Center for Infectious Diseases, the National Center for Prevention Services, and the National Institute for Occupational Safety and Health collaborated to produce the 1994 Guidelines for Preventing the Transmission of Tuberculosis in Health-Care Facilities. As stated in the Draft Guidelines, the major components of health care worker protection from Mycobacterium tuberculosis infection include administration or source controls, engineering controls, and respiratory protective devices. We review the evolution of the seemingly conflicting recommendations for respiratory protective devices made by these Centers of the CDC and explain how the recommendations in the current CDC Guidelines were reached.

Centers for Disease Control and Prevention, U.S.↗
PubMed1995

TB infection control recommendations from the CDC, 1994: considerations for dentistry. United States Centers for Disease Control and Prevention.

Between 1989 and 1992, reports of outbreaks and transmissions of tuberculosis in institutional settings prompted the Centers for Disease Control and Prevention to review the guidelines for TB infection control it had published in 1990. The CDC published an updated version of the guidelines in October 1994. This article gives dentists an overview of the guidelines' recommendations that are applicable to most outpatient dental settings.

Dental Care for Chronically Ill↗
PubMed1993

Prevention and control of tuberculosis in the 1990s.

Beginning in 1984, the long-term decline in tuberculosis (TB) cases stopped, and since 1985 the number of cases has actually increased by 18%, from 22,201 new cases in 1985 to 26,283 in 1991. The change in the morbidity trend appears to be primarily due to three factors: HIV coinfection, TB occurring in persons from countries where this disease is prevalent, and deterioration of the health care infrastructure with resultant outbreaks of TB. This article presents six interventions that address major areas where action is needed. These efforts will require coordinated action by health care providers, public health departments, and other public and private organizations. Protection of all workers and patients in health care settings is one important goal of these efforts.

Contact Tracing↗
PubMedDate not supplied

CT features of pulmonary Mycobacterium avium complex infection.

OBJECTIVE: The purposes of this study were to describe and compare the prevalence of disease features in subjects with Mycobacterium avium complex (MAC) disease with those of Mycobacterium tuberculosis infection (MTB), to compare the abilities of CT and chest radiography to identify the features of MAC disease, and to determine if sputum positivity is related to any of the CT features of MAC disease. METHODS: Computed tomographic scans of 15 subjects with MTB and 55 subjects with MAC were reviewed by 2 observers. Sputum culture results (obtained within 1.9 +/- 2.8 days of scanning) were available in 50 of the 55 subjects with MAC. RESULTS: Bronchiectasis involving four or more lobes (often associated with centrilobular nodules) was seen only in subjects with MAC. The combination of right middle lobe and lingular bronchiectasis was seen only in MAC (p = 0.015). Thirty-one of the 34 subjects (91%) with MAC who had cavities on CT had a positive sputum culture within 3 weeks of CT, compared with 7 of 12 subjects (58%) without cavities (p = 0.001). Similarly, 36 of 42 subjects (85%) with airspace disease, but only 2 of 8 subjects (25%) without airspace disease grew mycobacteria from their sputa (p < 0.001). Sputum positivity was not associated with the presence of bronchiectasis (p = 0.156) or nodules (p = 0.377). CONCLUSION: A subgroup of patients with MAC may be distinguished from those with MTB by the presence of widespread bronchiectasis, particularly if it involves the right middle lobe and lingula. Cavities and airspace opacification on CT are associated with positive sputum cultures for MAC.

Female↗
PubMedDate not supplied

The multidrug-resistant tuberculosis challenge to public health efforts to control tuberculosis.

After years of steady decline, there has been an unprecedented resurgence of tuberculosis (TB) in the United States and outbreaks of multidrug-resistant tuberculosis (MDR-TB). The authors assess the nature, epidemiology, and implications of MDR-TB; provide suggestions for preventing drug resistance among patients with drug-susceptible TB; and offer recommendations for managing patients with MDR-TB. They outline the National Action Plan to Combat MDR-TB. Close collaboration among medical practitioners and staff members of TB control programs is needed to ensure the most effective management of patients with TB and their contacts. This collaboration is one of the most important steps for successful control of MDR-TB.

Communicable Disease Control↗