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  • 1
    Online Resource
    Online Resource
    Ledipasvir and Sofosbuvir in the Treatment of Early Hepatitis C Virus Infection in HIV-Infected Men
    Oxford University Press (OUP) ; 2018
    In:  Open Forum Infectious Diseases Vol. 5, No. 10 ( 2018-10-01)
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 5, No. 10 ( 2018-10-01)
    Abstract: Treatment of HIV-infected men during early hepatitis C virus (HCV) infection with interferon results in a higher cure rate with a shorter duration of treatment than during chronic HCV infection. We recently demonstrated that this phenomenon applied to interferon-free treatment as well, curing most participants with short-course sofosbuvir and ribavirin. Due to the significantly higher potency of the ledipasvir/sofosbuvir (LDV/SOF) combination, we hypothesized that we would be more successful in curing early HCV infections using a shorter course of LDV/SOF than that used for treating chronic HCV infections. Methods We performed a prospective, open-label, consecutive case series study of 8 weeks of LDV/SOF in HIV-infected men with early genotype 1 HCV infection. The primary end point was aviremia at least 12 weeks after completion of treatment. Results We treated 25 HIV-infected men with early sexually acquired HCV infection with 8 weeks of LDV/SOF, and all 25 (100%) were cured. Twelve (48%) reported sexualized drug use with methamphetamine. Conclusions Eight weeks of LDV/SOF cured all 25 HIV-infected men with early HCV infection, including those who were actively using drugs. Based on these results, we recommend treatment of newly HCV-infected men during early infection, regardless of drug use, to both take advantage of this 8-week treatment and to decrease further HCV transmission among this group of men.
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofy238
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2018
    detail.hit.zdb_id: 2757767-3
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  • 2
    Online Resource
    Online Resource
    Anal Dysplasia in Human Immunodeficiency Virus-Infected Men Who Have Sex With Men With Sexually Acquired Early Hepatitis C Virus Infection
    Oxford University Press (OUP) ; 2019
    In:  Open Forum Infectious Diseases Vol. 6, No. 11 ( 2019-11-01)
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 6, No. 11 ( 2019-11-01)
    Abstract: Human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) are at increased risk of anorectal infection with high-risk human papillomavirus and subsequent high-grade squamous intraepithelial lesions (HSIL), the putative precursor to anal cancer. Recently, an epidemic of sexually transmitted hepatitis C virus (HCV) has emerged that shares this anorectal route of transmission. We hypothesized that the prevalence of anal HSIL would be high in HIV-infected MSM with sexually acquired early HCV infection. Methods High-resolution anoscopy (HRA) findings from a cohort of HIV-infected MSM with sexually acquired early HCV infection were compared with HRA findings from a contemporary cohort of HIV-infected MSM without HCV infection who underwent HRA due to abnormal anal cytology found during routine screening. Results Sixty HIV-infected MSM with sexually acquired early HCV infection and the comparator group of 1150 HIV-infected MSM with abnormal anal cytology but without HCV underwent HRA. The HIV-infected MSM with sexually acquired early HCV had higher CD4 counts compared with the comparator group (656 and 541 cells/μL, respectively; P = .02). Despite this, the prevalence of anal dysplasia was as high among MSM with early HCV as in the comparator group of MSM with abnormal cytology (47 [78%] and 941 [82%] , respectively; P = .50), as was the proportion with HSIL (25 [42%] and 379 [33%] , respectively; P = .17). Conclusions The prevalence of anal dysplasia in HIV-infected MSM with sexually acquired early HCV infection was as high as that of HIV-infected MSM with abnormal anal cytology. These findings suggest that primary screening with HRA may be warranted for HIV-infected MSM with early HCV.
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofz339
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2757767-3
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  • 3
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    Online Resource
    Correlation between Identification of β-Lactamase Resistance Genes and Antimicrobial Susceptibility Profiles in Gram-Negative Bacteria: a Laboratory Data Analysis
    American Society for Microbiology ; 2022
    In:  Microbiology Spectrum Vol. 10, No. 2 ( 2022-04-27)
    Details
    In: Microbiology Spectrum, American Society for Microbiology, Vol. 10, No. 2 ( 2022-04-27)
    Abstract: We reported the frequency of resistance gene detection in Gram-negative blood culture isolates and correlated these findings with corresponding antibiograms. Data were obtained from 1045 isolates tested on the GenMark Dx ePlex Blood Culture Identification Gram-Negative Panels at the Mount Sinai Hospital Clinical Microbiology Laboratory in New York from March 2019 to February 2021. Susceptibilities were performed using Vitek 2 (bioMérieux Clinical Diagnostics) or Microscan (Beckman Coulter Inc.). bla CTX-M was detected in 26.4% Klebsiella pneumoniae , 23.5% Escherichia coli , and 16.4% Proteus mirabilis isolates. As would be expected, both bla CTX-M and bla CTX-M negative isolates were likely to be susceptible to newer agents while bla CTX-M positive isolates were more likely to be resistant to earlier generations of beta-lactam antibiotics. 3/204 bla CTX-M -positive isolates were found to be ceftriaxone-susceptible. Conversely, 2.8% ceftriaxone nonsusceptible strains were negative for all β-lactamase genes on the ePlex BCID-GN panel, including bla CTX-M . The prevalence of CTX-M-producing Enterobacterales remains high in the United States. A small number of bla CTX-M -positive isolates were susceptible to ceftriaxone, and a small number of ceftriaxone nonsusceptible isolates were negative for bla CTX-M . Further studies are needed to determine the optimal management when an isolate is phenotypically susceptible to ceftriaxone, but bla CTX-M is detected. IMPORTANCE There is limited literature on corresponding results obtained from rapid molecular diagnostics with the antibiotic susceptibility profile. We reported a correlation between the results obtained from ePlex and the antibiograms against a large collection of Gram-negative bacteria. We reported that there can be a discrepancy in a small number of cases, but the clinical significance of that is unknown.
    Type of Medium: Online Resource
    ISSN: 2165-0497
    URL: Article
    DOI: 10.1128/spectrum.01485-21
    Language: English
    Publisher: American Society for Microbiology
    Publication Date: 2022
    detail.hit.zdb_id: 2807133-5
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  • 4
    Online Resource
    Online Resource
    Low Adherence of HIV Providers to Practice Guidelines for Hepatocellular Carcinoma Screening in HIV/Hepatitis B Coinfection
    Oxford University Press (OUP) ; 2015
    In:  Clinical Infectious Diseases
    Details
    In: Clinical Infectious Diseases, Oxford University Press (OUP)
    Type of Medium: Online Resource
    ISSN: 1058-4838 , 1537-6591
    URL: Article
    DOI: 10.1093/cid/civ654
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2015
    detail.hit.zdb_id: 2002229-3
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  • 5
    Online Resource
    Online Resource
    Associations of maternal preterm birth with subsequent risk for type 2 diabetes in women from the women’s health initiative
    Cambridge University Press (CUP) ; 2023
    In:  Journal of Developmental Origins of Health and Disease Vol. 14, No. 3 ( 2023-06), p. 333-340
    Details
    In: Journal of Developmental Origins of Health and Disease, Cambridge University Press (CUP), Vol. 14, No. 3 ( 2023-06), p. 333-340
    Abstract: Preterm birth has been associated with insulin resistance and beta-cell dysfunction, a hallmark characteristic of type 2 diabetes. However, studies investigating the relationship between a personal history of being born preterm and type 2 diabetes are sparse. We sought to investigate the potential association between a personal history of being born preterm and risk for type 2 diabetes in a racially and ethnically diverse population. Baseline and incident data ( 〉 16 years of follow-up) from the Women’s Health Initiative ( n = 85,356) were used to examine the association between personal history of being born preterm (born 1910–1940s) and prevalent (baseline enrollment; cross-sectional) or incident (prospective cohort) cases of type 2 diabetes. Logistic and Cox proportional hazards regression models were used to estimate odds and hazards ratios. Being born preterm was significantly, positively associated with odds for prevalent type 2 diabetes at enrollment (adjOR = 1.79, 95% CI 1.43–2.24; P 〈 0.0001). Stratified regression models suggested the positive associations at baseline were consistent across race and ethnicity groups. However, being born preterm was not significantly associated with risk for incident type 2 diabetes. Regression models stratified by age at enrollment suggest the relationship between being born preterm and type 2 diabetes persists only among younger age groups. Preterm birth was associated with higher risk of type 2 diabetes but only in those diagnosed with type 2 diabetes prior to study enrollment, suggesting the association between preterm birth and type 2 diabetes may exist at earlier age of diagnosis but wane over time.
    Type of Medium: Online Resource
    ISSN: 2040-1744 , 2040-1752
    URL: Article
    DOI: 10.1017/S2040174423000089
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2554780-X
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  • 6
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    Online Resource
    569. Pre-retained: Early Intervention for HIV Patients at High Risk of Becoming Un-retained
    Oxford University Press (OUP) ; 2018
    In:  Open Forum Infectious Diseases Vol. 5, No. suppl_1 ( 2018-11-26), p. S211-S211
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 5, No. suppl_1 ( 2018-11-26), p. S211-S211
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofy210.577
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2018
    detail.hit.zdb_id: 2757767-3
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  • 7
    Online Resource
    Online Resource
    Health Care and Social Issues of Immigrant Rescue and Recovery Workers at the World Trade Center Site
    Ovid Technologies (Wolters Kluwer Health) ; 2008
    In:  Journal of Occupational & Environmental Medicine Vol. 50, No. 12 ( 2008-12), p. 1329-1334
    Details
    In: Journal of Occupational & Environmental Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. 12 ( 2008-12), p. 1329-1334
    Type of Medium: Online Resource
    ISSN: 1076-2752
    URL: Article
    DOI: 10.1097/JOM.0b013e31818ff6fd
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2008
    detail.hit.zdb_id: 2070230-9
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  • 8
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    84. T2Candida Panel Use Evaluation: a Quality Improvement Project
    Oxford University Press (OUP) ; 2020
    In:  Open Forum Infectious Diseases Vol. 7, No. Supplement_1 ( 2020-12-31), p. S59-S59
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 7, No. Supplement_1 ( 2020-12-31), p. S59-S59
    Abstract: Invasive candidiasis is a life-threatening infection with 40% mortality despite antifungal therapy[1] A retrospective chart review of results from our T2Candida Panels from March 2019 to March 2020 was conducted. We compared demographics, co-morbidities, days of antifungal use, length of stay (LOS) and mortality in patients with positive and negative assays. Results 271 assays were performed, 27 were positive and were compared to 81 negatives. Baseline demographics and co-morbidities were similar in both groups. All patients tested had & gt;1 risk factor for candidemia. 78% were positive for C. albicans/C. tropicalis and 11% positive for C. glabrata/C. krusei and C. parapsilosis respectively. Blood cultures were positive in 8 individuals, of which 5 had a positive assay; among the other 3, one grew C. auris. All species in the T2Candida matched the blood cultures when available. β-D-glucan was positive in 82% of patients with positive T2 results vs 46% in the T2 negative group (p = 0.016). Antifungal administration within the time of assay collection was 54% in the negative group vs 74% in the positive group (p = 0.030). Mean duration of antifungal use were significantly lower in the negative group than the positive group (5.98 vs 17.55 days, p = 0.04). Demographics and Comorbidities Outcomes Cultures Conclusion T2Candida was an effective diagnostic and antimicrobial stewardship tool, leading to testing in high risk patients and reducing unnecessary antifungal use. Additional education is required for improved ordering of concurrent blood cultures. Negative results should be interpreted with caution in suspected invasive candidiasis with consideration for species not included in the panel. Disclosures All Authors: No reported disclosures
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofaa439.129
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2757767-3
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  • 9
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    Online Resource
    316. Use of (1-3)-β-D-Glucan Assay for Diagnosis of Candidemia in Patients Hospitalized with SARS-CoV-2 Infection
    Oxford University Press (OUP) ; 2021
    In:  Open Forum Infectious Diseases Vol. 8, No. Supplement_1 ( 2021-12-04), p. S264-S264
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 8, No. Supplement_1 ( 2021-12-04), p. S264-S264
    Abstract: Candidemia is a rare but serious complication of SARS-CoV-2 hospitalization. Combining non-culture and culture-based diagnostics allows earlier identification of candidemia. Given higher reported incidence during COVID-19 surges, we investigated the use of (1-3)-β-D-glucan (BDG) assay at our institution in those who did and did not develop candidemia. Methods Retrospective study of adults admitted to The Mount Sinai Hospital between March 15-June 30 2020 for SARS-CoV-2 infection, with either ≥1 BDG assay or positive fungal blood culture. Data was collected with the electronic medical record and Vigilanz. A BDG value ≥ 80 was used as a positivity cutoff. Differences in mortality were assessed by univariate logistic regression using R (version 4.0.0). Statistical significance was measured by P value & lt; .05. Results There were 75 patients with ≥1 BDG assay resulted and 28 patients with candidemia, with an overlap of 9 between the cohorts. Among the 75 who had BDG assay, 23 resulted positive and 52 negative. Nine of 75 patients developed candidemia. Of the 23 with a positive assay, 5 developed candidemia and 18 did not. Seventeen of the 18 had blood cultures drawn within 7 days +/- of BDG assay. Four patients with candidemia had persistently negative BDG; 2 had cultures collected within 7 days +/- of BDG assay. With a cut-off of & gt;80, the negative predictive value (NPV) was 0.92. When the cut-off increased to & gt;200, NPV was 0.97 and positive predictive value (PPV) was 0.42. Average antifungal days in patients with negative BDG was 2.6 vs. 4.2 in those with a positive. Mortality was 74% in those with ≥1 positive BDG vs. 50% in those with persistently negative BDGs. There was a trend towards higher odds of death in those with positive BDG (OR = 2.83, 95% CI: 1.00-8.90, p & lt; 0.06). Conclusion There was substantial use of BDG to diagnose candidemia at the peak of the COVID-19 pandemic. Blood cultures were often drawn at time of suspected candidemia but not routinely. When cultures and BDG were drawn together, BDG had a high NPV but low PPV. High NPV of BDG likely contributed to discontinuation of empiric antifungals. The candidemic COVID-19 patients had high mortality, so further investigation of algorithms for the timely diagnosis of candidemia are needed to optimize use of antifungals while improving mortality rates. Disclosures All Authors: No reported disclosures
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofab466.518
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2757767-3
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  • 10
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    Candidemia in the Intensive Care Unit
    Elsevier BV ; 2017
    In:  Clinics in Chest Medicine Vol. 38, No. 3 ( 2017-09), p. 493-509
    Details
    In: Clinics in Chest Medicine, Elsevier BV, Vol. 38, No. 3 ( 2017-09), p. 493-509
    Type of Medium: Online Resource
    ISSN: 0272-5231
    URL: Article
    DOI: 10.1016/j.ccm.2017.04.010
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2017
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