Shaikh Khalifa Medical City

About: Shaikh Khalifa Medical City is a healthcare organization based out in Abu Dhabi, United Arab Emirates. It is known for research contribution in the topics: Population & Health care. The organization has 195 authors who have published 200 publications receiving 3792 citations.

A field guide to pandemic, epidemic and sporadic clones of methicillin-resistant Staphylococcus aureus

Abstract: In recent years, methicillin-resistant Staphylococcus aureus (MRSA) have become a truly global challenge. In addition to the long-known healthcare-associated clones, novel strains have also emerged outside of the hospital settings, in the community as well as in livestock. The emergence and spread of virulent clones expressing Panton-Valentine leukocidin (PVL) is an additional cause for concern. In order to provide an overview of pandemic, epidemic and sporadic strains, more than 3,000 clinical and veterinary isolates of MRSA mainly from Germany, the United Kingdom, Ireland, France, Malta, Abu Dhabi, Hong Kong, Australia, Trinidad & Tobago as well as some reference strains from the United States have been genotyped by DNA microarray analysis. This technique allowed the assignment of the MRSA isolates to 34 distinct lineages which can be clearly defined based on non-mobile genes. The results were in accordance with data from multilocus sequence typing. More than 100 different strains were distinguished based on affiliation to these lineages, SCCmec type and the presence or absence of PVL. These strains are described here mainly with regard to clinically relevant antimicrobial resistance- and virulence-associated markers, but also in relation to epidemiology and geographic distribution. The findings of the study show a high level of biodiversity among MRSA, especially among strains harbouring SCCmec IV and V elements. The data also indicate a high rate of genetic recombination in MRSA involving SCC elements, bacteriophages or other mobile genetic elements and large-scale chromosomal replacements.

The Influence of Food Texture and Liquid Consistency Modification on Swallowing Physiology and Function: A Systematic Review

Abstract: Texture modification has become one of the most common forms of intervention for dysphagia, and is widely considered important for promoting safe and efficient swallowing. However, to date, there is no single convention with respect to the terminology used to describe levels of liquid thickening or food texture modification for clinical use. As a first step toward building a common taxonomy, a systematic review was undertaken to identify empirical evidence describing the impact of liquid consistency and food texture on swallowing behavior. A multi-engine search yielded 10,147 non-duplicate articles, which were screened for relevance. A team of ten international researchers collaborated to conduct full-text reviews for 488 of these articles, which met the study inclusion criteria. Of these, 36 articles were found to contain specific information comparing oral processing or swallowing behaviors for at least two liquid consistencies or food textures. Qualitative synthesis revealed two key trends with respect to the impact of thickening liquids on swallowing: thicker liquids reduce the risk of penetration–aspiration, but also increase the risk of post-swallow residue in the pharynx. The literature was insufficient to support the delineation of specific viscosity boundaries or other quantifiable material properties related to these clinical outcomes. With respect to food texture, the literature pointed to properties of hardness, cohesiveness, and slipperiness as being relevant both for physiological behaviors and bolus flow patterns. The literature suggests a need to classify food and fluid behavior in the context of the physiological processes involved in oral transport and flow initiation.

Estimating modifiable coronary heart disease risk in multiple regions of the world: the INTERHEART Modifiable Risk Score

Abstract: Aims Summating risk factor burden is a useful approach in the assessment of cardiovascular risk among apparently healthy individuals. We aimed to derive and validate a new score for myocardial infarction (MI) risk using modifiable risk factors, derived from the INTERHEART case–control study ( n = 19 470). Methods and results Multiple logistic regression was used to create the INTERHEART Modifiable Risk Score (IHMRS). Internal validation was performed using split-sample methods. External validation was performed in an international prospective cohort study. A risk model including apolipoproteins, smoking, second-hand smoke exposure, hypertension, and diabetes was developed. Addition of further modifiable risk factors did not improve score discrimination in an external cohort. Split-sample validation studies showed an area under the receiver-operating characteristic (ROC) curve c -statistic of 0.71 [95% confidence interval (CI): 0.70, 0.72]. The IHMRS was positively associated with incident MI in a large cohort of people at low risk for cardiovascular disease [12% increase in MI risk (95% CI: 8, 16%) with a 1-point increase in score] and showed appropriate discrimination in this cohort (ROC c -statistic 0.69, 95% CI: 0.64, 0.74). Results were consistent across ethnic groups and geographic regions. A non-laboratory-based score is also supplied. Conclusions Using multiple modifiable risk factors from the INTERHEART case–control study, we have developed and validated a simple score for MI risk which is applicable to an international population.

HIV as an Independent Risk Factor for Incident Lung Cancer

Abstract: Lung cancer is the most common non-AIDS defining cancer (NADC) and leading source of NADC mortality among HIV infected individuals[1,2]. Increased rates of lung cancer in HIV infected patients, compared to uninfected patients, have been demonstrated in multiple prior studies[3–10]. This increased incidence has not been clearly explained, and could potentially be attributed to higher smoking rates or increased healthcare surveillance in the HIV infected population compared to uninfected populations. The relative contribution of smoking to the increased risk of lung cancer associated with HIV infection remains a major question. A number of studies have shown a higher prevalence of smoking in HIV infected patients compared to most of the general US population[9,11], although some cohorts have demonstrated similar smoking prevalence in HIV infected and uninfected participants[12,13]. Several cohort studies reporting lung cancer incidence rates adjusted for smoking prevalence were variously affected by important limitations including lack of complete smoking data or use of estimated smoking rates only; small numbers of lung cancer cases; lack of an uninfected comparison group; or reporting from early in the combination anti-retroviral therapy (cART) era when mortality due to AIDS events still dominated clinical outcomes[4,6,14,15]. Surveillance bias could also result in a higher rate of lung cancer detected in HIV infected individuals, who generally tend to have more contact with the healthcare system than uninfected individuals[16]. Despite this, some studies have suggested that HIV infected patients with lung cancer are more likely to present with advanced stage disease, suggesting cancer diagnosis may be delayed in this group[4,17]. Because no previous study has had sufficient lung cancer cases or an appropriate uninfected comparison group to adequately characterize the pattern of lung cancer stage at presentation in HIV infected patients, the role of surveillance bias in assessing lung cancer incidence in these patients is unclear. To overcome some of the limitations of previous studies, we used data from a large, national, cART-era cohort to compare the incidence of lung cancer between HIV infected patients and a demographically-similar uninfected comparison group, adjusting for smoking and other lung cancer risk factors.

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium. 15-18 March 2016

Abstract: [This corrects the article DOI: 10.1186/s13054-016-1208-6.].