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Biomedical subjects

Richard A Martinello

Publications and source records attributed to Richard A Martinello.

9 recordsLinked to original sources
PubMed2007

Preparing for avian influenza.

PURPOSE OF REVIEW: Pandemic influenza is inevitable, will have significant impact on the population and will challenge healthcare delivery. Planning for an influenza pandemic will improve the ability of healthcare facilities to respond successfully. RECENT FINDINGS: Planning activities involve determining the role of the facility during an influenza pandemic, estimating resources necessary to fulfil this role and developing the infrastructure, material and human resources surge capacity necessary to meet the estimated needs. Plans to perform surveillance for potentially contagious individuals, handle clinical specimens, increase social distancing during a pandemic and the development of personal preparedness plans may be beneficial. SUMMARY: The goal of this review is to provide a framework for healthcare facility pandemic influenza planning.

Animals↗
PubMed2006

Life-threatening sepsis caused by Burkholderia cepacia from contaminated intravenous flush solutions prepared by a compounding pharmacy in another state.

We report 2 life-threatening cases of Burkholderia cepacia sepsis caused by infusate contamination during compounding. Bacterial isolates from the patients' blood cultures and the infusate were indistinguishable by pulsed-field gel electrophoresis. Proper quality controls at a local and national level are important for ensuring safe delivery of compounded medications to patients in all settings, including those outside health care facilities.

Bacteremia↗
PubMed2006

Human metapneumovirus and exacerbations of chronic obstructive pulmonary disease.

OBJECTIVE: Respiratory viruses are a common trigger for exacerbations of chronic obstructive pulmonary disease (COPD). Human metapneumovirus (hMPV) is a paramyxovirus associated with respiratory tract infections and wheezing. Our aim was to determine whether hMPV was associated with exacerbations of COPD. METHODS: The study was designed as an observational cohort study carried out in a 944-bed urban teaching hospital located in New Haven, Connecticut. Between December 2002 and May 2003, patients hospitalized due to an exacerbation of COPD were identified. Nasopharyngeal specimens obtained from these patients were tested for human metapneumovirus by RT-PCR and for respiratory syncytial virus, influenza A and B, parainfluenza-1, -2, and -3 and adenovirus by a cytospin-enhanced direct immunofluorescence assay and/or viral culture. RESULTS: Fifty individuals met enrollment criteria and hMPV was identified in 6 (12%), respiratory syncytial virus in 4 (8%), influenza A in 2 (4%) and parainfluenza type 3 in 1 (2%) patients. Both A and B hMPV genotypes were identified in patients hospitalized due to exacerbations of COPD. CONCLUSION: hMPV was frequently identified in patients hospitalized due to an exacerbation of COPD. Further studies are necessary to determine the epidemiology and the impact of hMPV in COPD patients.

Aged↗
PubMed2004

A 1-year experience with human metapneumovirus in children aged <5 years.

Human metapneumovirus (hMPV) is a recently discovered respiratory pathogen. We tested respiratory specimens for the presence of hMPV by reverse-transcription polymerase chain reaction. These specimens were obtained over a 1-year period from children aged <5 years and had negative results by the direct fluorescent antibody test for respiratory syncytial virus, influenza A and B, parainfluenza viruses 1-3, and adenovirus. Overall, 54 (8.1%) of 668 individuals tested positive for hMPV. During March and April of the study period, hMPV was detected in 17.6% and 25.0% of specimens tested, respectively. At least 2 distinct genotypes of hMPV circulated during the study period. Fever, tachypnea, cough, rhinorrhea, retractions of the chest wall, and wheezing were common findings. Of hMPV-positive children, 60.4% were aged <12 months. hMPV accounted for a small but significant proportion of respiratory-tract disease in infants and children.

Australia↗
PubMed2003

Cerebellar brain abscess associated with tongue piercing.

We describe a previously healthy adult who had a solitary cerebellar brain abscess diagnosed. This infection occurred 4 weeks after the patient underwent a tongue piercing procedure that was complicated by an apparent local infection. The clinical history, abscess culture results, and lack of an alternative explanation suggest that infection of the tongue piercing site was the source of the cerebellar abscess.

Adult↗
PubMed2003

Correlation between healthcare workers' knowledge of influenza vaccine and vaccine receipt.

OBJECTIVE: Influenza vaccine receipt by healthcare workers (HCWs) is important because HCWs are at risk for occupational exposure to influenza and may act as vectors in the nosocomial transmission of influenza. HCWs were surveyed to determine whether belief in commonly held influenza vaccine misconceptions was associated with influenza vaccine acceptance. DESIGN: Cross-sectional study. SETTING: A large urban teaching hospital. METHOD: A self-administered survey was used to assess nursing and physician staff influenza vaccine knowledge, current vaccination status, and potential reasons for vaccine declination. RESULTS: Two hundred twelve of 215 surveys were completed. The overall influenza vaccination rate was 73%. Physician staff were significantly more likely to have been vaccinated compared with nursing staff (82% vs 62%, respectively; P = .0009). HCWs answering the 5 influenza vaccine basic knowledge questions correctly were significantly more likely to have been vaccinated than those responding incorrectly to any question (84% vs 64%, respectively; P = .002). This association was present in the nursing group where 80% of those answering the knowledge questions correctly were vaccinated, but only 49% of those answering incorrectly were vaccinated (P = .000005). However, in the physician group, there was no significant difference in the influenza vaccination rates between those answering correctly and those answering incorrectly (P = .459). CONCLUSION: Belief in commonly held influenza vaccine misconceptions was significantly associated with influenza vaccine declination among nursing staff and may act as a barrier to greater rates of influenza vaccination. Reasons for influenza vaccine nonreceipt may differ between nursing and physician staff.

Academic Medical Centers↗
PubMed2003

Human metapneumovirus infection in the United States: clinical manifestations associated with a newly emerging respiratory infection in children.

OBJECTIVE: Respiratory tract infections are a leading cause of morbidity and mortality worldwide. Recently, a newly identified human respiratory virus, human metapneumovirus (hMPV), was reported by investigators in the Netherlands. We sought to determine whether hMPV was circulating in our community and to determine the clinical features associated with hMPV infection. METHODS: Respiratory specimens from children who were younger than 5 years and had a negative result for respiratory syncytial virus, influenza A and B, parainfluenza viruses 1 to 3, and adenovirus by direct fluorescent antibody test were screened for hMPV by reverse transcriptase-polymerase chain reaction. Samples were collected from October 30, 2001, to February 28, 2002. RESULTS: Of the 296 patients screened, 19 (6.4%) had evidence of hMPV infection. hMPV was identified in patients with either upper or lower respiratory tract infection or both. Clinical manifestations included wheezing, hypoxia, and abnormal findings on chest radiographs (eg, focal infiltrates, peribronchial cuffing). Nosocomial infection occurred in at least 1 patient. CONCLUSIONS: hMPV is circulating in the United States and is associated with respiratory tract disease in patients with respiratory illnesses not caused by respiratory syncytial virus, influenza, parainfluenza viruses, and adenovirus. Additional studies are required to define the epidemiology and the extent of disease in the general population caused by hMPV.

Adenoviridae↗
PubMed2002

Correlation between respiratory syncytial virus genotype and severity of illness.

Respiratory syncytial virus (RSV) causes seasonal outbreaks of respiratory tract infections, but the viral factors associated with virulence remain unknown. To determine whether RSV genotype correlated with severity of illness, isolates were characterized by phylogenetic analysis of the RSV G gene, and a composite score was used to quantify severity of illness. During the 1998-1999 and 1999-2000 winter seasons, 137 subgroup A and 84 subgroup B isolates were identified. The severity of illness caused by subgroup A isolates did not differ from that caused by subgroup B isolates (P=.086). However, the GA3 clade was associated with significantly greater severity of illness, compared with clades GA2 (P=.004) and GA4 (P=.016). In a subpopulation of patients < or =24 months old who had no known risk factors for severe RSV disease, clade GA3 was again associated with greater severity of illness, compared with clade GA2 (P=.018). Severity of RSV infection is associated with RSV genotype.

Child, Preschool↗