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BACKGROUND The incidence of tuberculosis and drug resistance is increasing in the United States, but it is not clear how much of the increase is due to reactivation of latent infection and how much to recent transmission. METHODS We performed DNA fingerprinting using restriction-fragment-length polymorphism (RFLP) analysis of at least one isolate from(More)
Effective chemotherapy of tuberculosis requires rapid assessment of drug sensitivity because of the emergence of multidrug-resistant Mycobacterium tuberculosis. Drug susceptibility was assessed by a simple method based on the efficient production of photons by viable mycobacteria infected with specific reporter phages expressing the firefly luciferase gene.(More)
The widespread use of highly active antiretroviral therapy (HAART) since 1996 has led to a substantial decline in morbidity and mortality in patients infected with HIV, although its effect on the incidence of HIV-associated malignancies is unknown. We retrospectively reviewed the annual number of outpatient visits to our HIV clinic, inpatient admissions for(More)
The Centers for Medicare & Medicaid Services recently started publicly reporting hospital readmission rates. Health care reform proposals include readmission provisions as vehicles to promote care coordination and achieve savings. Current approaches ascribe variability in hospital readmission primarily to differences in patient medical risk and hospital(More)
The incidence of tuberculosis--and, more important, that of multidrug-resistant tuberculosis--have risen drastically in the past decade. Nosocomial outbreaks have alerted health-care workers to the hazards of the spread of tuberculosis. The use of environmental control modalities (e.g., ventilation, air filtration, and ultraviolet irradiation) and personal(More)
BACKGROUND On August 14, 2003, the United States and Canada suffered the largest power failure in history. We report the effects of this blackout on New York City's healthcare system by examining the following: 1) citywide 911 emergency medical service (EMS) calls and ambulance responses; and 2) emergency department (ED) visits and hospital admissions to(More)
PURPOSE OF REVIEW The treatment of HIV infection has been transformed by the introduction of highly active antiretroviral therapy. For patients who respond and can tolerate lifelong therapy, HIV infection may become a chronic disease requiring long-term ambulatory care follow-up. The current management of antiretrovirals is increasingly complex because of(More)
OBJECTIVE To evaluate systems for estimating and preventing wrong-patient electronic orders in computerized physician order entry systems with a two-phase study. MATERIALS AND METHODS In phase 1, from May to August 2010, the effectiveness of a 'retract-and-reorder' measurement tool was assessed that identified orders placed on a patient, promptly(More)
Current guidelines call for Papanicolaou (Pap) smear screening of HIV-infected women at least annually. After the initiation of a weekly computer based Pap smear reminder list in an HIV care clinic, the prevalence of scheduled women with up-to-date Pap smears was calculated for the one-year project period and was compared to the prevalence preceding the(More)
BACKGROUND Venous thromboembolism (VTE) disease prophylaxis rates among medical inpatients have been noted to be <50%. OBJECTIVE Our objective was to evaluate the effectiveness and safety of a computerized decision support application to improve VTE prophylaxis. DESIGN Observational cohort study. SETTING Academic medical center. PATIENTS Adult(More)