Paul J Drinka

..If the 25-OH-D level is less than 30 ng/mL, supplementation with vitamin D is recommended. Practitioners should consider supplementing most residents with vitamin D and calcium or follow NKF guidelines...

..05) and space (P < .05) (i.e., 2 separate statistically significant tests). Isolates from individual units were genetically related, with only the occasional unrelated isolate...

..Sources of aspiration, including pharyngeal dysphagia, periodontal disease, and gastric regurgitation, should be identified and treated in hopes of preventing recurrence...

..Although sensitivity is limited, a group of rapid tests provided early laboratory confirmation and facilitated the application of prophylaxis...

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..Hypercalcemia manifested when calcium carbonate was replaced with calcium citrate...

..Suprapubic catheters should be considered when urethral catheters are associated with discomfort or periurethral suppurative complications, especially in males...

..1 ng/mL versus 1.8 ng/mL for vitamin D(2). CONCLUSION: Nursing home residents should receive at least 800-1000 IU of D(3) per day in an effort to maintain optimal vitamin D levels...

..If reemergence of sensitivity follows discontinuation of rimantadine use, using rimantadine as prophylaxis and oseltamivir for treatment of symptomatic cases might be efficacious and economical on a national scale...

..DISCUSSION: Clinicians should be aware of the adverse effects of loop diuretics on urinary calcium excretion and PTH levels. Residents who ingest furosemide should be targeted to receive recommended doses of vitamin D and calcium...

..Genetic analysis may also demonstrate that apparent clusters are unrelated...

..An institutional programme to control influenza should include vaccination, and contingency plans for clinical surveillance, specimen processing and the rapid application of antiviral treatment and prophylaxis...

..The morbidity, mortality, excess staff effort, and measured expenditure justify efforts to prevent influenza...

..4%). During 3,294 resident-seasons, influenza was cultured in 208 single rooms (6.3%). Those who lived in double rooms with a culture-positive roommate had a 3.07 relative risk (CI95, 1.61-5.78) of acquiring influenza...

..CONCLUSION: Our analysis and previous reports suggest that replacement of TMP-sulfa by quinolones could be selecting MRSA in our facility. This conclusion, however, is speculative, based on association, and requires confirmation...

..The broad range of T-scores among subjects suggests that peripheral BMD measurement may be useful for clinical fracture risk stratification. Correlation among skeletal sites indicates that measuring a single site may be practical...

..This strategy could have prevented five examples of delayed prophylaxis. Rapid testing of multiple specimens while waiting for culture confirmation could have prevented three examples of delayed prophylaxis...

..CONCLUSION: IA is common in nursing home residents. A lower EPO response contributes to the high prevalence of anemia in this setting and may be due, in part, to occult renal dysfunction...

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