Epidemiology and laboratory diagnosis of infection with viral and bacterial pathogens in infants hospitalized for suspected sepsis

A prospective study was conducted to determine the frequency and distribution of bacterial and viral pathogens in infants hospitalized with suspected sepsis and to evaluate the potential of virus detection for improving patient management. A causative organism was detected in 157 (67%) of 233 previously healthy infants less than 3 months of age, who had been hospitalized for suspected sepsis: 19 (8%) had bacterial infections, 135 (58%) had viral infections, and 3 (1%) had mixed viral-bacterial infections. Viral infections occurred in a seasonal pattern: enteroviruses were responsible for most of the hospitalizations during summer and fall (65/110; 63%) and respiratory syncytial and influenza A viruses were responsible for most of the infections during winter (44/81; 55%). In contrast, bacterial infections were not seasonally distributed. Virus was detected in 33% of the 138 infected infants within 24 hours, and in 64% within 3 days. We conclude that viral infections are prevalent among infants hospitalized for suspected sepsis, and most can be detected early enough to influence patient management.     

The functioning and well-being of depressed patients. Results from the Medical Outcomes Study

We describe the functioning and well-being of patients with depression, relative to patients with chronic medical conditions or no chronic conditions. Data are from 11,242 outpatients in three health care provision systems in three US sites. Patients with either current depressive disorder or depressive symptoms in the absence of disorder tended to have worse physical, social, and role functioning, worse perceived current health, and greater bodily pain than did patients with no chronic conditions. The poor functioning uniquely associated with depressive symptoms, with or without depressive disorder, was comparable with or worse than that uniquely associated with eight major chronic medical conditions. For example, the unique association of days in bed with depressive symptoms was significantly greater than the comparable association with hypertension, diabetes, and arthritis. Depression and chronic medical conditions had unique and additive effects on patient functioning.     

Is endometrial infection with Candida albicans a cause of recurrent vaginal thrush?

OBJECTIVE--It was hypothesised that the endometrium might act as a reservoir for candida, thus infecting the vagina as the endometrium is shed during menstruation. DESIGN--A prospective study of women with recurrent vulvo-vaginal candidiasis. The endometrium was sampled and cultured for candida species. SETTING--Central London STD clinic. SUBJECTS--26 women were enrolled, of whom 20 completed the study. RESULTS--One patient had a positive endometrial culture for candida species, the isolate being Candida krusei. CONCLUSIONS--The endometrium is not a common resevoir for candida species and therefore, infection at this site is an unlikely cause of recurrent vaginal candidiasis.     

儿童癌症试验性疗法是否优于标准疗法：儿童肿瘤研究组的多项随机临床对照试验的观察研究

目的:比较儿童期癌症标准疗法与Ⅲ期随机化临床试验阶段所验证的新疗法,研究新疗法优于或劣于标准疗法的概率;此类临床试验中,纳入患者的民族因素可能对试验结果造成不确定性影响,所以,本文还研究新疗法的成功和失败模式是否与前述不确定性影响之间存在一致性。试验设计:临床观     

Aerobic power of competitive paraplegic road racers.

The purpose of this study was to determine peak aerobic power and associated physiological responses in highly competitive spinal cord injured (SCI) paraplegic road racers. Seven (6 male and one female) active paraplegic (lesions T4-T12) road racers and 9 healthy untrained able-bodied males performed continuous graded arm crank ergometer tests to exhaustion for determinations of peak power output (PO), oxygen uptake (VO2), pulmonary ventilation (VE), heart rate (HR), and respiratory exchange ratio (RER). Compared to able-bodied subjects, male paraplegic road racers elicited significantly (p less than or equal to .05) higher mean (+/- SD) peak levels of PO (141.6 +/- 8.8 vs 111.4 +/- 27.7 W), absolute VO2 (2.72 +/- .52 vs 2.22 +/- .381/min), and VO2 per unit of body weight (43.06 +/- 7.4 vs 30.33 +/- 4.3 ml/kg/min). Although peak HR (180.3 +/- 9.5 vs 173.2 +/- 8.5 bpm) and VE (92.8 +/- 17.2 vs 74.6 +/- 20.3 l/min) tended to be higher for male paraplegic road racers than able-bodied subjects, the differences were not statistically significant. The female paraplegic road racer achieved the highest peak levels of PO (119 W) and VO2 (1.99 l/min; 38.0 ml/kg/min) reported to date for wheelchair-dependent women. These data suggest that intense physical training via wheelchair propulsion can markedly enhance upper body cardiovascular fitness in SCI paraplegics. However, the correlational analysis between 10 km time and peak VO2 was nonsignificant (p greater than .05) indicating that factors other than peak upper body aerobic power may influence wheelchair road racing performance.     

A developmental role for ataxia-telangiectasia mutated in protecting the embryo from spontaneous and phenytoin-enhanced embryopathies in culture.

Ataxia-telangiectasia (A-T) is characterized by impaired recognition and repair of DNA damage and increased sensitivity to ionizing radiation (IR), cancer, and neurodegeneration. We previously showed pregnant knockout mice lacking the A-T gene product ataxia-telangiectasia mutated (Atm) are highly susceptible to the embryopathic effects of IR, which damages DNA, possibly via generation of reactive oxygen species (ROS). Here we show that Atm more broadly protects against both spontaneous and phenytoin-enhanced embryopathies. In the absence of drug exposure, cultured embryos from pregnant Atm knockout mice showed more embryopathies than wild-type littermates, with a gene dose-dependent decrease in susceptibility from -/- to +/- to +/+ embryos (p < 0.05). A similar but significantly enhanced gene dose-dependent pattern of embryopathic susceptibility was evident in Atm knockout embryos exposed to the ROS-initiating teratogen phenytoin (p < 0.05). These results provide the first evidence that Atm has a broad developmental importance beyond IR embryopathies, possibly by protecting the embryo from constitutive and xenobiotic-enhanced oxidative stress, with even heterozygotes showing increased risk. This developmental role of Atm further implicates DNA damage in ROS-mediated teratogenesis and DNA damage response and repair as risk factors for individual susceptibility.     

Dactylocyclines, novel tetracycline derivatives produced by a Dactylosporangium sp. I. Taxonomy, production, isolation and biological activity.

A screen for antibiotics with activity against tetracycline-resistant microorganisms has led to the isolation of Dactylosporangium sp. (ATCC 53693), a producer of several novel tetracycline derivatives. The major fermentation products, dactylocyclines A and B, were purified and MIC values determined against tetracycline-resistant and tetracycline-sensitive Gram-positive bacteria. The dactylocyclines represent the first naturally occurring tetracycline C2 amides which lack cross resistance with tetracycline.