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PubMed1983

Experience with "lipolysis": the Illouz technique of blunt suction lipectomy in North America.

"Lipolysis" or blunt suction lipectomy for modest to moderate deformities of localized fatty deposits has been carried out on a series of North American patients. The American patients were felt to be larger than the French patients with whom the procedure was developed, and thus required larger removals. Many patients showed a substantial drop in hematocrit levels following this procedure. Drains may add 400 ml to the blood loss. An obvious third space shift occurred into the operated area and can be of noteworthy magnitude. This often required hospitalization and colloid replacement. It should be anticipated that blood may have to be given. On the basis of our experience in North American patients, we have lowered our expectation for ambulatory discharge to patients undergoing removals of 650 ml or less. This may prove to be too optimistic on occasion. The "lipolysis" technique did not cause any seroma formation in patients as reported for other suction-assisted lipectomy techniques. All patients sensed early anxiety and then disappointment at the lack of "instant" results, and worry over uneven areas during weeks 2 through 6 and required constant reassurance. Prolonged massage therapy bridged this period both physically and psychologically, lightening the burden of both surgeon and patient.

Adipose Tissue↗
PubMed2001

Antibacterial activity of 41 antimicrobials tested against over 2773 bacterial isolates from hospitalized patients with pneumonia: I--results from the SENTRY Antimicrobial Surveillance Program (North America, 1998).

Pneumonia is the second most frequent cause of nosocomial infection, and hospitalization frequently is needed for community-acquired pneumonia. Knowledge of causative pathogens through periodic surveillance, and their prevailing antimicrobial susceptibility patterns becomes paramount in choosing appropriate empiric therapy. The SENTRY Antimicrobial Surveillance Program, tracks pathogen distribution worldwide since 1997 and documents emerging resistance to a wide range of antimicrobial agents. During the respiratory disease season in 1998, each of 30 medical centers (25 in the United States [US], and five in Canada [CAN]) contributed 100 consecutive isolates obtained from hospitalized patients with suspected pneumonia. The 2773 organisms, processed by the monitor consisted of a total of 35 species, with Staphylococcus aureus comprising 25.6% of all isolates and five other species (Pseudomonas aeruginosa 18.7%, Haemophilus influenzae 9.4%, Streptococcus pneumoniae 7.8%, Klebsiella spp. 7.0%, and Enterobacter spp. 6.7%) making up almost 50% of the total. In the US, pneumococci (8.5%) were more prevalent than in CAN (4.1%; p = 0.001). The US isolates of S. pneumoniae were variably susceptible to penicillin (76.8%), with non-susceptible strains demonstrating greater levels of cross resistance to macrolides (31.8%), cefepime (9.0%) and cefotaxime (6.8%), but remaining susceptible to gatifloxacin and quinupristin/dalfopristin. H. influenzae and Moraxella catarrhalis were generally ampicillin-resistant, 40.4-44.4% and 93.7-95.7%, respectively. P. aeruginosa remained very susceptible to amikacin (91.3-93.8%) > tobramycin > meropenem > piperacillin/tazobactam > gentamicin > piperacillin > cefepime (80.0-81.8%). Extended spectrum beta-lactamase phenotypes among the Klebsiella spp. were isolated from five medical centers in the US and were 4.8-6.0% overall; a rate similar to the previous year. Among the US isolates of Enterobacter spp., only 77.6% and 79.6% were susceptible to ceftazidime and cefotaxime, respectively, but >90% were inhibited by cefepime, imipenem, meropenem, aminoglycosides, and fluoroquinolones. Isolates from CAN were generally more susceptible, except for Pseudomonas isolates, where resistance to aminoglycosides, fluoroquinolones and imipenem was greater. The SENTRY Program results outline important national differences in the frequencies of pathogen occurrence, but more importantly, identify unstable patterns of resistance to available antimicrobial drugs, and serves as a reference for results of other local, national or international investigations.

Adolescent↗
PubMed2004

Relict snakes of North America and their relationships within Caenophidia, using likelihood-based Bayesian methods on mitochondrial sequences.

This paper focuses on the phylogenetic relationships of eight North American caenophidian snake species (Carphophis amoena, Contia tenuis, Diadophis punctatus, Farancia abacura, Farancia erytrogramma, Heterodon nasicus, Heterodon platyrhinos, and Heterodon simus) whose phylogenetic relationships remain controversial. Past studies have referred to these "relict" North American snakes either as colubrid, or as Neotropical dipsadids and/or xenodontids. Based on mitochondrial DNA ribosomal gene sequences and a likelihood-based Bayesian analysis, our study suggests that these North American snakes are not monophyletic and are nested within a group (Dipsadoidea) that contains the Dipsadidae, Xenodontidae, and Natricidae. In addition, we use the relationships proposed here to highlight putative examples of parallel evolution of hemipenial morphology among snake clades.

Animals↗
PubMed2000

Risk of giardiasis from consumption of wilderness water in North America: a systematic review of epidemiologic data.

OBJECTIVES: A meta-analytic study was conducted to test the hypothesis that consumption of water from North American backcountry sources poses a statistically significant risk for acquisition of giardiasis. METHODS: The biomedical literature was surveyed by accessing Medline, and identified studies were supplemented with references in current reviews, published dissertations, and prior communications with state health departments. Studies were classified by methodologic design and subjected to predetermined inclusion criteria. Odds ratios with 95% confidence intervals, chi-squares, and P-values for epidemiologic surveys were either computed from raw data or abstracted directly from the included studies. RESULTS: Of 104 articles identified in the initial screening, nine met the inclusion criteria. Neither of two case reports met the criteria of the Centers for Disease Control and Prevention (CDC) for waterborne disease outbreak. Two prospective studies were identified, but neither showed a significant association. Of four case-control studies providing data, three reported an odds ratio of greater than one. CONCLUSIONS: Published reports of confirmed giardiasis among outdoor recreationalists clearly demonstrate a high incidence among this population. However, the evidence for an association between drinking backcountry water and acquiring giardiasis is minimal. Education efforts aimed at outdoor recreationalists should place more emphasis on handwashing than on water purification. Further studies should attempt to separate the specific risk factor of drinking water from backcountry sources from other behaviors among this group that may contribute to the risk.

Animals↗
PubMed2005

Identity experience among progressive gay Muslims in North America: a qualitative study within Al-Fatiha.

This qualitative study aims to document the identity experience of progressive gay Muslim men in a North American context. Six in-depth interviews, supplemented with participant observation, were conducted of gay Muslim men who attended an international conference for lesbian, gay, bisexual, transgendered, and questioning (LGBTQ) Muslims. For progressive gay Muslims such as these, a Muslim identity appears three-dimensional (religious, ethno-cultural, and color) when integrated with a gay identity. As a religious identity, gay Muslim's relationship to Allah (God) and a reinterpretation of the Qur'an and traditional condemnation of homosexuality appears necessary. As a cultural identity, East-West ethno-cultural differences that impact on homo-sociality and gay identity construction, marriage and the impact of coming out on the Eastern family and siblings emerged as critical issues. As a color identity, internalized racism, dating relationships and social dynamics within gay subculture as Muslims of color in a white dominant context appear key challenges.

Adult↗
PubMed1982

Microsporum equinum in North America.

Microsporum equinum was isolated in Ontario, Canada, from five human and two equine cases of ringworm infection. This dermatophyte was previously recovered from North American horses on several occasions, but was considered to be M. canis. We regard M. equinum as distinct from M. canis. It can be differentiated from M. canis by the smaller size of its macroconidia, its failure to perforate hair in vitro, its poor growth and sporulation on bromocresol purple casein dextrose agar, and its incompatibility with Nannizzia otae, the telemorph of M. canis.

Animals↗