Last data update: Jan 27, 2025. (Total: 48650 publications since 2009)
Records 1-12 (of 12 Records) |
Query Trace: Salinas JL[original query] |
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Development and evaluation of a structured guide to assess the preventability of hospital-onset bacteremia and fungemia
Schrank GM , Sick-Samuels A , Bleasdale SC , Jacob JT , Dantes R , Gokhale RH , Mayer J , Mehrotra P , Mehta SA , MenaLora AJ , Ray SM , Rhee C , Salinas JL , Seo SK , Shane AL , Nadimpalli G , Milstone AM , Robinson G , Brown CH , Harris AD , Leekha S . Infect Control Hosp Epidemiol 2022 43 (10) 1-7 OBJECTIVE: To assess preventability of hospital-onset bacteremia and fungemia (HOB), we developed and evaluated a structured rating guide accounting for intrinsic patient and extrinsic healthcare-related risks. DESIGN: HOB preventability rating guide was compared against a reference standard expert panel. PARTICIPANTS: A 10-member panel of clinical experts was assembled as the standard of preventability assessment, and 2 physician reviewers applied the rating guide for comparison. METHODS: The expert panel independently rated 82 hypothetical HOB scenarios using a 6-point Likert scale collapsed into 3 categories: preventable, uncertain, or not preventable. Consensus was defined as concurrence on the same category among 70% experts. Scenarios without consensus were deliberated and followed by a second round of rating.Two reviewers independently applied the rating guide to adjudicate the same 82 scenarios in 2 rounds, with interim revisions. Interrater reliability was evaluated using the (kappa) statistic. RESULTS: Expert panel consensus criteria were met for 52 scenarios (63%) after 2 rounds.After 2 rounds, guide-based rating matched expert panel consensus in 40 of 52 (77%) and 39 of 52 (75%) cases for reviewers 1 and 2, respectively. Agreement rates between the 2 reviewers were 84% overall (, 0.76; 95% confidence interval [CI], 0.64-0.88]) and 87% (, 0.79; 95% CI, 0.65-0.94) for the 52 scenarios with expert consensus. CONCLUSIONS: Preventability ratings of HOB scenarios by 2 reviewers using a rating guide matched expert consensus in most cases with moderately high interreviewer reliability. Although diversity of expert opinions and uncertainty of preventability merit further exploration, this is a step toward standardized assessment of HOB preventability. |
Long-term outcomes of Guillain-Barre syndrome possibly associated with Zika virus infection
Walteros DM , Soares J , Styczynski AR , Abrams JY , Galindo-Buitrago JI , Acosta-Reyes J , Bravo-Ribero E , Arteta ZE , Solano-Sanchez A , Prieto FE , Gonzalez-Duarte M , Navarro-Lechuga E , Salinas JL , Belay ED , Schonberger LB , Damon IK , Ospina ML , Sejvar JJ . PLoS One 2019 14 (8) e0220049 BACKGROUND: This prospective cohort investigation analyzed the long-term functional and neurologic outcomes of patients with Zika virus-associated Guillain-Barre syndrome (GBS) in Barranquilla, Colombia. METHODS: Thirty-four Zika virus-associated GBS cases were assessed a median of 17 months following acute GBS illness. We assessed demographics, results of Overall Disability Sum Scores (ODSS), Hughes Disability Score (HDS), Zung Depression Scale (ZDS), and Health Related Quality of Life (HRQL) questionnaires; and compared outcomes indices with a normative sample of neighborhood-selected control subjects in Barranquilla without GBS. RESULTS: Median age at time of acute neurologic onset was 49 years (range, 10-80); 17 (50%) were male. No deaths occurred. At long-term follow-up, 25 (73%) patients had a HDS 0-1, indicating complete / near complete recovery. Among the group, HDS (mean 1.4, range 0-4), ODSS (mean 1.9, range 0-9) and ZDS score (mean 34.4, range 20-56) indicated mild / moderate ongoing disability. Adjusting for age and sex, Zika virus-associated GBS cases were similar to a population comparison group (n = 368) in Barranquilla without GBS in terms of prevalence of physical or mental health complaints, though GBS patients were more likely to have an ODSS of >/= 1 (OR 8.8, 95% CI 3.2-24.5) and to suffer from moderate / moderate-severe depression (OR 3.89, 95% CI 1.23-11.17) than the comparison group. CONCLUSIONS: Long-term outcomes of Zika virus-associated GBS are consistent with those associated with other antecedent antigenic stimuli in terms of mortality and ongoing long-term morbidity, as published in the literature. Persons with Zika virus-associated GBS more frequently reported disability and depression after approximately one year compared with those without GBS. |
Bacillus Calmette-Guerin cases reported to the National Tuberculosis Surveillance System, United States, 2004-2015
Wansaula Z , Wortham JM , Mindra G , Haddad MB , Salinas JL , Ashkin D , Morris SB , Grant GB , Ghosh S , Langer AJ . Emerg Infect Dis 2019 25 (3) 451-456 Mycobacterium bovis bacillus Calmette-Guerin (BCG) is used as a vaccine to protect against disseminated tuberculosis (TB) and as a treatment for bladder cancer. We describe characteristics of US TB patients reported to the National Tuberculosis Surveillance System (NTSS) whose disease was attributed to BCG. We identified 118 BCG cases and 91,065 TB cases reported to NTSS during 2004-2015. Most patients with BCG were US-born (86%), older (median age 75 years), and non-Hispanic white (81%). Only 17% of BCG cases had pulmonary involvement, in contrast with 84% of TB cases. Epidemiologic features of BCG cases differed from TB cases. Clinicians can use clinical history to discern probable BCG cases from TB cases, enabling optimal clinical management. Public health agencies can use this information to quickly identify probable BCG cases to avoid inappropriately reporting BCG cases to NTSS or expending resources on unnecessary public health interventions. |
Factors associated with all-cause mortality among patients with multidrug-resistant tuberculosis - United States, 1993-2013
Salinas JL , Armstrong LR , Silk BJ , Haddad MB , Cegielski JP . Clin Infect Dis 2017 65 (11) 1924-1926 We assessed characteristics associated with all-cause mortality among U.S. patients with multidrug-resistant tuberculosis. Mortality decreased from 31% during 1993-2002 to 11% during 2003-2013. Directly observed therapy coverage increased from 74% to 95% and was protective against all-cause mortality after accounting for demographics, clinical characteristics, HIV status, and period of treatment. |
Zika virus disease-associated Guillain-Barre syndrome - Barranquilla, Colombia 2015-2016
Salinas JL , Walteros DM , Styczynski A , Garzon F , Quijada H , Bravo E , Chaparro P , Madero J , Acosta-Reyes J , Ledermann J , Arteta Z , Borland E , Burns P , Gonzalez M , Powers AM , Mercado M , Solano A , Sejvar JJ , Ospina ML . J Neurol Sci 2017 381 272-277 Background An outbreak of Guillain-Barre syndrome (GBS), a disorder characterized by acute, symmetric limb weakness with decreased or absent deep-tendon reflexes, was reported in Barranquilla, Colombia, after the introduction of Zika virus in 2015. We reviewed clinical data for GBS cases in Barranquilla and performed a case-control investigation to assess the association of suspect and probable Zika virus disease with GBS. Methods We used the Brighton Collaboration Criteria to confirm reported GBS patients in Barranquilla during October 2015-April 2016. In April 2016, two neighborhood and age range-matched controls were selected for each confirmed GBS case-patient. We obtained demographics and antecedent symptoms in the 2-month period before GBS onset for case-patients and the same period for controls. Sera were collected for Zika virus antibody testing. Suspected Zika virus disease was defined as a history of rash and >= 2 other Zika-related symptoms (fever, arthralgia, myalgia, or conjunctivitis). Probable Zika virus disease was defined as suspected Zika virus disease with laboratory evidence of a recent Zika virus or flavivirus infection. Conditional logistic regression adjusted for sex and race/ethnicity was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results We confirmed 47 GBS cases. Incidence increased with age (10-fold higher in those >= 60 years versus those < 20 years). We interviewed 40 case-patients and 79 controls. There was no significant difference in laboratory evidence of recent Zika virus or flavivirus infection between case-patients and controls (OR: 2.2; 95% CI: 0.9-5.1). GBS was associated with having suspected (OR: 3.0, 95% CI: 1.1-8.6) or probable Zika virus disease (OR: 4.6, CI: 1.1-19.0). Conclusions Older individuals and those with suspected and probable Zika virus disease had higher odds of developing GBS. Key points We confirmed a Guillain-Barre syndrome (GBS) outbreak in Barranquilla, Colombia, during October 2015-April 2016. A case-control investigation using neighborhood controls showed an association of suspected and probable Zika virus disease with GBS. |
Increased rates of Guillain-Barre syndrome associated with Zika virus outbreak in the Salvador metropolitan area, Brazil
Styczynski AR , Malta JMAS , Krow-Lucal ER , Percio J , Nobrega ME , Vargas A , Lanzieri TM , Leite PL , Staples JE , Fischer MX , Powers AM , Chang GJ , Burns PL , Borland EM , Ledermann JP , Mossel EC , Schonberger LB , Belay EB , Salinas JL , Badaro RD , Sejvar JJ , Coelho GE . PLoS Negl Trop Dis 2017 11 (8) e0005869 In mid-2015, Salvador, Brazil, reported an outbreak of Guillain-Barre syndrome (GBS), coinciding with the introduction and spread of Zika virus (ZIKV). We found that GBS incidence during April-July 2015 among those ≥12 years of age was 5.6 cases/100,000 population/year and increased markedly with increasing age to 14.7 among those ≥60 years of age. We conducted interviews with 41 case-patients and 85 neighborhood controls and found no differences in demographics or exposures prior to GBS-symptom onset. A higher proportion of case-patients (83%) compared to controls (21%) reported an antecedent illness (OR 18.1, CI 6.9-47.5), most commonly characterized by rash, headache, fever, and myalgias, within a median of 8 days prior to GBS onset. Our investigation confirmed an outbreak of GBS, particularly in older adults, that was strongly associated with Zika-like illness and geo-temporally associated with ZIKV transmission, suggesting that ZIKV may result in severe neurologic complications. |
Incidence and clinical characteristics of Guillain-Barre syndrome before the introduction of Zika virus in Puerto Rico
Salinas JL , Major CG , Pastula DM , Dirlikov E , Styczynski A , Luciano CA , Wojna V , Sharp TM , Sejvar JJ , Rivera-Garcia B . J Neurol Sci 2017 377 102-106 Background Zika virus has been associated with increases in Guillain-Barré syndrome (GBS) incidence. A GBS incidence estimation and clinical description was performed to assess baseline GBS epidemiology before the introduction of Zika virus in Puerto Rico. Methods Hospitalization administrative data from an island-wide insurance claims database and U.S. Census Bureau population estimates provided a crude GBS incidence for 2013. This estimate was adjusted using the proportion of GBS cases meeting Brighton criteria for confirmed GBS from nine reference hospitals. Characteristics of confirmed GBS cases in the same nine hospitals during 2012–2015 are described. Results A total of 136 GBS hospitalization claims were filed in 2013 (crude GBS incidence was 3.8 per 100,000 population). The adjusted GBS incidence was 1.7 per 100,000 population. Of 67 confirmed GBS cases during 2012–2015, 66% had an antecedent illness. Median time from antecedent illness to GBS onset was 7 days. Most cases (67%) occurred during July–September. Conclusions Puerto Rico's GBS incidence for 2013 was estimated using a combination of administrative data and medical records review; this method could be employed in other regions to monitor GBS incidence before and after the introduction of GBS infectious triggers. |
Guillain-Barre Syndrome and healthcare needs during Zika virus transmission, Puerto Rico, 2016
Dirlikov E , Kniss K , Major C , Thomas D , Virgen CA , Mayshack M , Asher J , Mier-Y-Teran-Romero L , Salinas JL , Pastula DM , Sharp TM , Sejvar J , Johansson MA , Rivera-Garcia B . Emerg Infect Dis 2017 23 (1) 134-136 To assist with public health preparedness activities, we estimated the number of expected cases of Zika virus in Puerto Rico and associated healthcare needs. Estimated annual incidence is 3.2-5.1 times the baseline, and long-term care needs are predicted to be 3-5 times greater than in years with no Zika virus. |
Tuberculosis among incarcerated Hispanic persons in the United States, 1993-2014
Mindra G , Wortham JM , Haddad MB , Salinas JL , Powell KM , Armstrong LR . J Immigr Minor Health 2016 19 (4) 982-986 We examined the National tuberculosis surveillance system to describe Hispanic persons who were incarcerated at time of tuberculosis (TB) diagnosis and to compare their characteristics with those of non-Hispanic incarcerated TB patients. After declines between 1993 and 2002, the annual proportion of Hispanic TB patients who were incarcerated grew from 4.9% in 2003 to 8.4% in 2014. During 2003-2014, 19% of incarcerated US-born TB patients were Hispanic, and 86% of the foreign-born were Hispanic. Most incarcerated TB patients were in local jails, but about a third of all foreign-born Hispanics were in the facility category that includes Immigration and Customs Enforcement detention centers. Foreign birth and recent U.S. arrival characterized many Hispanic persons receiving a TB diagnosis while incarcerated. Hispanic patients had twice the odds of being in federal prisons. Systematic efforts to identify TB infection and disease might lead to early diagnoses and prevention of future cases. |
Guillain-Barre syndrome during ongoing Zika virus transmission - Puerto Rico, January 1-July 31, 2016
Dirlikov E , Major CG , Mayshack M , Medina N , Matos D , Ryff KR , Torres-Aponte J , Alkis R , Munoz-Jordan J , Colon-Sanchez C , Salinas JL , Pastula DM , Garcia M , Segarra MO , Malave G , Thomas DL , Rodriguez-Vega GM , Luciano CA , Sejvar J , Sharp TM , Rivera-Garcia B . MMWR Morb Mortal Wkly Rep 2016 65 (34) 910-914 Guillain-Barre syndrome (GBS) is a postinfectious autoimmune disorder characterized by bilateral flaccid limb weakness attributable to peripheral nerve damage. Increased GBS incidence has been reported in countries with local transmission of Zika virus, a flavivirus transmitted primarily by certain Aedes species mosquitoes. In Puerto Rico, three arthropod-borne viruses (arboviruses) are currently circulating: Zika, dengue, and chikungunya. The first locally acquired Zika virus infection in Puerto Rico was reported in December 2015. In February 2016, the Puerto Rico Department of Health (PRDH), with assistance from CDC, implemented the GBS Passive Surveillance System (GBPSS) to identify new cases of suspected GBS). Fifty-six suspected cases of GBS with onset of neurologic signs during January 1-July 31, 2016, were identified. Thirty-four (61%) patients had evidence of Zika virus or flavivirus infection; the median age of these patients was 55 years (range = 21-88 years), and 20 (59%) patients were female. These 34 patients were residents of seven of eight PRDH public health regions. All 34 patients were hospitalized and treated with intravenous immunoglobulin G (IVIg), the standard treatment for GBS; 21 (62%) required intensive care unit admission, including 12 (35%) who required endotracheal intubation and mechanical ventilation. One patient died of septic shock after treatment for GBS. Additionally, 26 cases of neurologic conditions other than GBS were reported through GBPSS, including seven (27%) in patients with evidence of Zika virus or flavivirus infection. Residents of and travelers to Puerto Rico and countries with active Zika virus transmission should follow recommendations for prevention of Zika virus infections. Persons with signs or symptoms consistent with GBS should promptly seek medical attention. Health care providers in areas with ongoing local transmission seeing patients with neurologic illnesses should consider GBS and report suspected cases to public health authorities. |
Zika virus infection associated with severe thrombocytopenia
Sharp TM , Munoz-Jordan J , Perez-Padilla J , Bello-Pagan MI , Rivera A , Pastula DM , Salinas JL , Martinez Mendez JH , Mendez M , Powers AM , Waterman S , Rivera-Garcia B . Clin Infect Dis 2016 63 (9) 1198-1201 We report two patients who developed severe thrombocytopenia after Zika virus infection. The first had 1,000 platelets/mm3, and died following multiple hemorrhages. The second had 2,000 platelets/mm3, melena, ecchymoses, and recovered after receiving intravenous immunoglobulin. Physicians should be aware that Zika virus may be associated with immune-mediated severe thrombocytopenia. |
Leveling of tuberculosis incidence - United States, 2013-2015
Salinas JL , Mindra G , Haddad MB , Pratt R , Price SF , Langer AJ . MMWR Morb Mortal Wkly Rep 2016 65 (11) 273-278 After 2 decades of progress toward tuberculosis (TB) elimination with annual decreases of ≥0.2 cases per 100,000 persons (1), TB incidence in the United States remained approximately 3.0 cases per 100,000 persons during 2013-2015. Preliminary data reported to the National Tuberculosis Surveillance System indicate that TB incidence among foreign-born persons in the United States (15.1 cases per 100,000) has remained approximately 13 times the incidence among U.S.-born persons (1.2 cases per 100,000). Resuming progress toward TB elimination in the United States will require intensification of efforts both in the United States and globally, including increasing U.S. efforts to detect and treat latent TB infection, strengthening systems to interrupt TB transmission in the United States and globally, accelerating reductions in TB globally, particularly in the countries of origin for most U.S. CASES: |
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