Comparison of micafungin MICs as determined by the Clinical and Laboratory Standards Institute broth microdilution method (M27-A3 document) and Etest for Candida spp. isolates

Micafungin Etest and Clinical and Laboratory Standards Institute (CLSI) MICs were compared for 337 Candida spp. isolates. The performance of Etest for testing the susceptibilities of Candida spp. to micafungin was evaluated by the assessment of both categorical (CA) and essential (EA) agreements. The CA was evaluated 2 ways: (i) by the ability of Etest to separate resistant (nontreatable) from susceptible (treatable) isolates by using the newly adjusted species-specific micafungin clinical breakpoints (CBPs) that are available for most of the common species tested and (ii) by the ability to separate wild type (WT) from non-WT isolates or those harboring FKS mutations (with reduced echinocandin susceptibility) by using micafungin epidemiologic cutoff values (ECVs). Etest and CLSI MICs were in EA when the MICs were within 2 log(2) dilutions. Based on agreement percentages, our data indicated that Etest is suitable to test micafungin for most of the Candida species evaluated (overall EA 94.7%; overall CA according to CBPs 97.2% and according to ECVs 97.3%). However, the number of resistant isolates was small, so further evaluations are needed with a higher number of such isolates including more resistant or those with known mechanisms of resistance (non-WT).     

A very human being: Sister Marie Simone Roach, 1922–2016

Sister (Sr.) Marie Simone Roach, of the Sisters of St. Martha of Antigonish, Nova Scotia, died at the Motherhouse on 2 July 2016 at the age of 93, leaving behind a rich legacy of theoretical and practical work in the areas of care, caring and nursing ethics. She was a humble soul whose deep and scholarly thinking thrust her onto the global nursing stage where she will forever be tied to a central concept in nursing, caring, through her Six Cs of Caring model. In Canada, she was the lead architect of the Canadian Nurses Association's first code of ethics, and her influence on revisions to it is still profound more than 35 years later. In this paper, four global scholars in nursing and ethics are invited to reflect on Sr. Simone's contribution to nursing and health‐care, and we link her work to nursing and health‐care going forward. 1     

三维彩色多普勒超声对慢性肾炎肾血流灌注观察的意义

目的通过三维彩色多普勒超声定量分析肾内血流的灌注参数和肾功能测值的关系,了解慢性肾炎患者肾脏损害的程度。方法根据美国肾脏疾病生存质量指导（K／DOQI）诊断及分期标准选择慢性肾炎患者60例,与正常对照组30例进行比较,应用三维彩色多普勒超声,观察肾脏形态结构,并利用血流分析技术观察肾脏的血流灌注,计算血管指数、血流指数。将肾血流灌注参数与肾功能测值及肾活检病理结果进行对照。结果慢性。肾炎组与正常对照组比较存在显著差异（P〈0．05）,并随着肾功能损害越严重,差异越显著。结论三维彩色多普勒超声对慢性肾炎各期肾血流灌注观察,可以监测慢性肾炎患者的。肾损害程度。     

B-Aware试验中BIS监测对远期生存率的影响

背景当使用脑电双频指数（bispectral index,Bis）监测指导麻醉药用量时,通常仅需要较低剂量的镇静药,如果用较低剂量的麻醉药,术中低血压和器官毒性作用也许能避免。然而,这是否能减少严重并发症和术后死亡率还存争议。B．Aware试验将2463例术中知晓高危的患者随机分为BIS指导麻醉组和常规麻醉组。我们假设使用BIS指导麻醉组患者死亡、心肌梗死（myocardial infarction,MI）和卒中的风险都低于常规麻醉组患者。方法对术后30天尚存活的所有患者的医疗记录进行回顾,记录他们的死亡日期、死亡原因以及心肌梗死或卒中的发生情况．然后对所有存活的点者主牛行由话随访．本研究的主要终点是存活。结果随访时间中位值4．1年（全距：0－6．5年）,参加试验的患者中有548例（22．2％）术后死亡,220例（8．9％）发生了心肌梗死,115例（4．7％）发生卒中。BIS监测组与常规麻醉组的死亡风险没有显著差异{危害比=0．86[95％可信区间（CI）：0．72-1．01];P=0．07]。但是,倾向性评分分析显示,BIS值〈40、持续时间〉5分钟的患者与其他BIS监测组的患者相比,死亡的危害比为1．41（95％CI：1．02-1．95;P=0．039）,并且心肌梗死的优势比（OR）为1．94（95％CI：1．12-3．35;P=0．01）,卒中的优势比为3．24（95％CI：1.29-8．07;P=0．01）。结论在B-Aware试验患者中,采用了BIS指导麻醉且从未出现BIS值低于40并持续超过5分钟,与存活率的增加及并发症的减少相关。     

Comparison between reference values for 201Thallium uptake and washout from the myocardium after exercise and after dipyridamole

Summary. A slow washout of ²⁰¹Thallium has a high diagnostic and prognostic value for coronary artery disease. The aim of the present work was to contribute with reference data on ²⁰¹T1 uptake and washout from the myocardium. With a quantitative method using circumferential profiles and interpolative background subtraction we performed ²⁰¹T1 myocardial imaging in two groups of subjects with a low probability of coronary artery disease. Washout in per cent is defined as (1-D/I) 100, where D is the delayed uptake rate and I the initial uptake rate. In group A (n=16) myocardial hyperaemia was induced by maximal exercise, in group B (n=15) by intravenous infusion of dipyridamole. In group A, the mean washout was 52%, and in group B it was 34% (P < 0.001). The delayed uptake rate D was significantly higher after dipyridamole, 58.4 cps, than after exercise, 44.5 cps (P < 0.05). There was no significant difference in I between the two groups. The findings regarding D and I explain that the washout is slower after dipyridamole than after exercise, as the mean D/I ratio was 0.48 in group A and 0.66 in group B (P < 00.1).     

Indirect estimation of pediatric Health Related Limits for serum thyrotropin using the ADVIA Centaur analyzer

OBJECTIVES: To determine pediatric reference values for thyrotropin using Advia Centaur analyzer. DESIGN AND METHODS: The study was conducted in a large regional hospital on TSH results obtained from 5741 females and 4332 males aged 0-17 years. After the exclusion of the results outside 4 standard deviations, we calculated the Health Related Limits (HRLs) following the indirect Kairisto's procedure and using the software GraphROC. RESULTS: The lower HRL of TSH concentration was 0.70 mU/L in the years 0-11 and 0.50 mU/L in the following years. The upper TSH HRL was 6.9 mU/L in males vs. 5.7 mU/L in females in the first year and 6.7 mU/L vs. 5.3 in the period 1-2 years. The upper HRLs in females and males were similar in the following years and the upper HRL in the 13-17 years class was 3.8 mU/L. CONCLUSIONS: The indirect methods appear reliable for calculating the pediatric HRLs for TSH.     

陕西贫困地区某县6～24月龄婴幼儿辅食及营养素添加现状分析

目的 分析陕西贫困地区某县6～24月龄婴幼儿辅食及营养素添加状况,为制定合理的膳食方案提供科学依据,为促进本地区婴幼儿营养健康水平提供参考依据。方法 2017年7-8月采用整群分层随机抽样方法对陕西贫困地区某县920名6～24月龄婴幼儿辅食及营养素添加现状进行问卷调查,并对数据进行分析。结果 陕西贫困地区某县6～24月龄婴幼儿辅食添加种类较少,主要是米面类(82.0%)和蛋类(54.0%),营养素以维生素A(8.8%)、维生素D(10.0%)摄入少,搭配不合理,在辅食添加时间上存在过早和过晚两种极端。断乳后婴幼儿平均每人每日三大营养素比不符合中国营养学会制定膳食参考摄入量(DRIS)标准,随月龄增加,三大营养素摄入量逐渐增加,占膳食营养素推荐摄入量(RNI)百分比呈上升趋势。断乳后12～18月龄婴幼儿钙、铁、锌、钠摄入分别为274.5、3.3、2.4、198.6 mg,18月龄以上分别为298.3、3.8、2.4、175.5 mg,两组婴幼儿维生素A、D、B₁、B₂、C、E实际摄入量均低于DRIS标准。结论 陕西贫困地区某县6～24月龄婴幼儿辅食及营养素添加不均衡,添加过早和过晚均存在;三大营养素摄入量比不符合中国营养学会制定DRIS标准;矿物质及维生素实际摄入量均低于DRIS标准;普及贫困地区婴幼儿辅食及营养素添加的相关知识很有必要。