Public Health Research Institute

About: Public Health Research Institute is a based out in . It is known for research contribution in the topics: Population & Randomized controlled trial. The organization has 4889 authors who have published 8149 publications receiving 276945 citations.

Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in 12 New York Hospitals

Abstract: Consecutive single-patient methicillin-resistant Staphylococcus aureus (MRSA) isolates (270) from 12 hospitals (8217 beds) in metropolitan New York City were collected during May 1996. In 11 of 12 hospitals, MRSA was most frequent in the general medical services. DNA typing ("fingerprinting") revealed that mecA:Tn554:PFGE (pulsed-field gel electrophoresis) type I:A:A accounted for 113 (42%) of 270 isolates, was detected in all hospitals, and was the predominant clone in 9. Thirteen of 15 I:E:F isolates were from 1 hospital, and the remaining 2 were from another hospital of the same health system. Type V:NH:E was isolated from 22 (79%) of the 28 patients with AIDS, including 8 of 9 patients from an additional hospital. Subtype V:NH:E2 was recovered from 11 patients, 9 of whom had AIDS, including all 5 AIDS patients from one floor of a nursing home affiliated with a third hospital. By using both mecA:Tn554 probes and PFGE, MRSA clusters and outbreaks may be detected and provide a rationale for appropriate infection control intervention.

The Mycobacterium tuberculosis iniA gene is essential for activity of an efflux pump that confers drug tolerance to both isoniazid and ethambutol

Abstract: Little is known about the intracellular events that occur following the initial inhibition of Mycobacterium tuberculosis by the first-line antituberculosis drugs isoniazid (INH) and ethambutol (EMB). Understanding these pathways should provide significant insights into the adaptive strategies M. tuberculosis undertakes to survive antibiotics. We have discovered that the M. tuberculosis iniA gene (Rv 0342) participates in the development of tolerance to both INH and EMB. This gene is strongly induced along with iniB and iniC (Rv 0341 and Rv 0343) by treatment of Mycobacterium bovis BCG or M. tuberculosis with INH or EMB. BCG strains overexpressing M. tuberculosis iniA grew and survived longer than control strains upon exposure to inhibitory concentrations of either INH or EMB. An M. tuberculosis strain containing an iniA deletion showed increased susceptibility to INH. Additional studies showed that overexpression of M. tuberculosis iniA in BCG conferred resistance to ethidium bromide, and the deletion of iniA in M. tuberculosis resulted in increased accumulation of intracellular ethidium bromide. The pump inhibitor reserpine reversed both tolerance to INH and resistance to ethidium bromide in BCG. These results suggest that iniA functions through an MDR-pump like mechanism, although IniA does not appear to directly transport INH from the cell. Analysis of two-dimensional crystals of the IniA protein revealed that this predicted transmembrane protein forms multimeric structures containing a central pore, providing further evidence that iniA is a pump component. Our studies elucidate a potentially unique adaptive pathway in mycobacteria. Drugs designed to inhibit the iniA gene product may shorten the time required to treat tuberculosis and may help prevent the clinical emergence of drug resistance.

Validation of automated screening for referable diabetic retinopathy with the IDx-DR device in the Hoorn Diabetes Care System

Abstract: Purpose To increase the efficiency of retinal image grading, algorithms for automated grading have been developed, such as the IDx-DR 2.0 device. We aimed to determine the ability of this device, incorporated in clinical work flow, to detect retinopathy in persons with type 2 diabetes. Methods Retinal images of persons treated by the Hoorn Diabetes Care System (DCS) were graded by the IDx-DR device and independently by three retinal specialists using the International Clinical Diabetic Retinopathy severity scale (ICDR) and EURODIAB criteria. Agreement between specialists was calculated. Results of the IDx-DR device and experts were compared using sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), distinguishing between referable diabetic retinopathy (RDR) and vision-threatening retinopathy (VTDR). Area under the receiver operating characteristic curve (AUC) was calculated. Results Of the included 1415 persons, 898 (63.5%) had images of sufficient quality according to the experts and the IDx-DR device. Referable diabetic retinopathy (RDR) was diagnosed in 22 persons (2.4%) using EURODIAB and 73 persons (8.1%) using ICDR classification. Specific intergrader agreement ranged from 40% to 61%. Sensitivity, specificity, PPV and NPV of IDx-DR to detect RDR were 91% (95% CI: 0.69-0.98), 84% (95% CI: 0.81-0.86), 12% (95% CI: 0.08-0.18) and 100% (95% CI: 0.99-1.00; EURODIAB) and 68% (95% CI: 0.56-0.79), 86% (95% CI: 0.84-0.88), 30% (95% CI: 0.24-0.38) and 97% (95% CI: 0.95-0.98; ICDR). The AUC was 0.94 (95% CI: 0.88-1.00; EURODIAB) and 0.87 (95% CI: 0.83-0.92; ICDR). For detection of VTDR, sensitivity was lower and specificity was higher compared to RDR. AUC's were comparable. Conclusion Automated grading using the IDx-DR device for RDR detection is a valid method and can be used in primary care, decreasing the demand on ophthalmologists.

Low physical functioning and impaired performance of activities of daily life in COVID-19 patients who survived hospitalisation.

Abstract: About half of the post-COVID-19 patients had severe impairments in physical functioning and during the ADLs at discharge home.This current results provide a clear rationale to study the safety and efficacy of rehabilitative interventions in these patients.