The purpose of this study was to evaluate risk factors, protective factors, and outcomes associated with Clostridium difficile-associated disease (CDAD) in allogeneic hematopoietic stem cell transplant (HSCT) recipients. A case-control study was performed with 37 CDAD cases and 67 controls. In the multivariable logistic regression analysis, receipt of a 3 rd or 4 th generation cephalosporin was associated with increased risk of CDAD (OR=4.6, 95% CI 1.6 -13.1). Receipt of growth factors was associated with decreased risk of CDAD (OR=0.1, 95% CI 0.02 -0.3). Cases were more likely to develop a blood stream infection after CDAD than were controls at any point before discharge (p<0.001). CDAD cases were more likely than controls to develop new onset GVHD (p<0.001), new onset severe GVHD (p<0.001), or new onset gut GVHD (p=0.007) after CDAD/discharge. Severe CDAD was a risk factor for death at 180 days in multivariable Cox proportional hazards regression (HR=2.6, 95% CI 1.1 -6.2). CDAD is a significant cause of morbidity and mortality in allogeneic HSCT patients, but modifiable risk factors exist. Further study is needed to determine the best methods of decreasing patients' risk of CDAD.

The purpose of this retrospective study was to compare the outcome of primary endodontic treatment using a standardized cleaning and shaping technique and obturation with either lateral compaction or carrier-based obturation. Patients received primary endodontic treatment in the predoctoral dental clinic using a standardized cleaning and shaping protocol. All root canals were obturated using AH PlusTMsealer with lateral compaction of gutta-percha (LC) or carrier-based obturation (CBO). A total of 205 cases met the inclusion criteria. 71 teeth in 60 patients were recalled after 2 years and evaluated both clinically and radiographically by two independent examiners. Success was defined as a lack of clinical symptoms and a normal periodontal ligament space or reduction in size of a previously existing periapical radiolucency. Chi-square and logistic regression were used for statistical analysis with a significance level ofP<0.05. There was no difference in success rates between cases obturated with LC or CBO (P=0.802); overall success rate was 83%. Molars had a significantly lower success rate (53%) than premolar and anterior teeth (89%) (P=0.005), irrespective of the obturation technique used. When a standardized cleaning and shaping protocol was used by predoctoral dental students in a controlled university setting, there was no difference in success rates between cases obturated with LC or CBO.

The purpose of this study was to develop and test a Clostridium difficile-associated disease (CDAD) grading system based on presenting symptoms in allogeneic stem cell transplant recipients. Patients with severe CDAD had significantly shorter median survival times and more adverse outcomes than patients with mild or moderate CDAD.

A Bayesian network is developed to embed the probabilistic reasoning dependencies of the demographics on the incidence of infectious diseases. Influenza epidemics occur every year in both hemispheres during the winter. The Bayesian learning paradigm is used to create synthetic data sets that simulate an outbreak of influenza for a geographic area. The Bayesian prior and posterior probabilities can be altered to represent an outbreak for various demographics in different geographic regions. Epidemic curves are generated, via time series analysis of the data sets, for the temporal flow of influenza on different variants of the demographics. The analysis of the demographic-based epidemic curves facilitates in the identification of the risk levels among the different demographic sections. Spread vaccination lowers the impact of the epidemic, depending on the efficacy of the vaccine. Our model is equipped to analyze the effects of spread vaccination and design vaccination strategies, that optimize the use of public health resources, by identifying high-risk demographic groups. Our results show that application of the vaccine in the order of risk levels will further lower the epidemic impact as compared to uniform spread vaccination.