Colonisation in adult patients with nosocomial candidemia

The aim of this prospective study was to investigate the association between Candida spp. isolated from blood culture and the colonisation of different anatomical sites of patients with candidemia, and to evaluate the colonisation dynamics and Pittet's index. Cultures were collected from the different anatomical sites of all the patients within 24 h of diagnosis of candidemia. Molecular similarities between identical species colonised with Candida species were evaluated via karyotyping. The colonisation index, as developed by Pittet et al. was calculated using screening culture results from patients. Among the 40 patients screened for colonisation, 35 (87.5%) had colonisation of at least one anatomical site. Twenty-six (74.3%) of the 35 patients with colonisation in any of the three anatomical sites (respiratory, rectum and urinary sites) were shown to be colonised with the same species that caused candidemia. When the anatomical sites were compared with each other, no significant difference was observed at the species level in terms of colonisation index. The colonisation index (≥ 0.5) positivity rate was 74% in patients with candidemia. The investigation of Candida colonisation of at least three anatomical (respiratory, rectum and urinary) sites could help in the selection of empirical antifungal therapy when nosocomial candidemia is suspected.     

A survey of point of care testing in Irish hospitals: room for improvement

Background  

“Guidelines for safe and effective management and use of point of care testing” have been recently launched in Ireland.     

Aspergillus fumigatus spondylodiskitis in renal transplant patient: voriconazole experience

The incidence of invasive aspergillosis has increased after solid organ transplant. However, aspergillus osteomyelitis in vertebrae is rare. We report a case of aspergillus spondylodiskitis after pulmonary aspergillosis in a renal transplant recipient. He was treated by antifungal therapy and surgical intervention. The transplantist should be alert for a diagnosis of aspergillus spondylodiskitis in recipients who developed back pain after aspergillosis infection in other sites.     

Anti-inflammatory activity of 2,5-dihydroxycyclohepta-2,4,6-trienone in rats

In this study, the anti-inflammatory effects of a tropolone derivative, 2,5-dihydroxycyclohepta-2,4,6-trienone (AD-4), were investigated. The anti-inflammatory potency of AD-4 was compared with that of indomethacin in carrageenan-induced inflammation models in rats. The effect on vascular permeability was also determined by hyaluronidase-induced capillary permeability. AD-4 decreased carrageenan-induced paw edema at doses of 3.62 × 10², 7.24 × 10², and 14.48 × 10² μmol/kg by 45% (p < 0.001), 79% (p < 0.001), and 83% (p < 0.001), respectively, compared with the value of 49% (p < 0.001) for indomethacin (69.8 μmol/kg). Additionally, AD-4 decreased hyaluronidase-induced capillary permeability significantly. In conclusion, AD-4 was determined to have anti-inflammatory effects with lower toxicity than indomethacin. Anti-inflammatory effect of AD-4 may be related to its effects on vascular permeability.     

Sudden cardiac death in Air Force recruits. A 20-year review

We reviewed the clinical and autopsy records of the 19 sudden cardiac deaths that occurred among the 1,606,167 US Air Force healthy, medically screened recruits (90% male; 17 to 28 years old) during a 42-day basic training period between 1965 and 1985. Sixteen (all male) died suddenly of underlying structural heart disease, whereas no anatomic cause of death was identified in the remaining three. Thirty-two nonsudden, noncardiac deaths occurred during the same period, and only two had structural heart disease. Strenuous physical exertion was associated with sudden death in 17 of 19 cases (0.017 deaths per 50,000 exercise-hours), and the most frequent underlying etiology was myocarditis. Sudden cardiac death, a rare event in healthy young adults, is usually associated with exertion.     

The effects of estrogen, progesterone, and C-erbB-2 receptor states on 18F-FDG uptake of primary breast cancer lesions.

The purpose of this prospective study was to investigate whether correlations exist between 18F-FDG uptake of primary breast cancer lesions and predictive and prognostic factors such as estrogen receptor (ER), progesterone receptor (PR), and C-erbB-2 receptor (C-erbB-2R) states. METHODS: Before undergoing partial or total mastectomy, 213 patients with newly diagnosed breast cancer underwent 18F-FDG PET (5.2 MBq/kg of body weight). The maximum standardized uptake value (SUV) of the primary lesion was measured in each patient. Standard immunohistochemistry was performed on a surgical specimen of the cancer lesion to characterize the receptor state of the tumor cells. Pearson chi2 tests were performed on the cross-tables of different receptor states to test any association that may exist among ER, PR, and C-erbB-2R. Maximum SUV measurements for different receptor states were compared using factorial ANOVA in a completely random design. RESULTS: After exclusion of certain lesions, 118 lesions were analyzed for this study. The mean maximum SUVs of ER-positive and ER-negative lesions were 3.03 +/- 0.26 and 5.64 +/- 0.75, whereas those of PR were 3.24 +/- 0.29 and 4.89 +/- 0.67, respectively, and those of C-erbB-2R were 4.64 +/- 0.70 and 3.70 +/- 0.35, respectively. Chi2 tests for ER and PR showed that if one is positive then the other tends to be positive as well (chi2 = 71.054, P < 0.01). For ER and C-erbB-2R states, if ER is positive, C-erbB-2R will more likely be negative (chi2 = 13.026, P < 0.01). No relationship was detected between PR and C-erbB-2R states (chi2 = 3.695, P > 0.05). ANOVAs showed that PR state alone (F = 0.095, P > 0.05) and C-erbB-2R state alone (F = 0.097, P > 0.05) had no effect on 18F-FDG uptake but ER state alone had an effect (F = 9.126, P < 0.01). ER and PR being together had no additional effect on 18F-FDG uptake. Our study also demonstrated that interactions exist between ER and C-erbB-2R state and between PR and C-erbB-2R state. CONCLUSION: SUV measurements may provide valuable information about the state of ER, PR, and C-erbB-2R and the associated glucose metabolism as measured by 18F-FDG uptake of the primary breast cancer lesions. Such an association may be of importance to treatment planning and outcome in these patients.     

半导体激光间质内热毁损兔脑的实验研究

目的 探讨半导体激光间质内热毁损脑组织范围与激光输出功率和作用时间的对应关系。方法 半导体激光裸光纤分别以输出功率１、２、３、４、５Ｗ及作用时间６０、１２０、１８０、２４０、３００ｓ进行不同组合，作用于兔脑组织，同时动态进行红外热图监测。激光热毁损后即刻以空气栓塞法处死兔，取完整兔脑制备切片，光镜下观察热毁损灶病理变化，测量毁损范围，利用目标规划模型进行统计学分析，并将热毁损实际范围这红外热图所示     

Herpes zoster oticus associated with varicella zoster virus encephalitis

Ramsay‐Hunt syndrome, herpes zoster oticus (HZO), derived its name from James Ramsay Hunt, who first described it in 1907. It is classically characterized by acute peripheral facial paralysis, herpetic eruptions on the auricle, and vestibulocochlear dysfunction due to the reactivation of varicella zoster virus (VZV). In this Case Report, the authors describe an HZO patient with simultaneous VZV encephalitis. To date, only eight cases of HZO associated with VZV encephalitis have been reported in the English literature. Therefore, the authors discuss all the aspects of this rare entity, including clinical examination, radiological evaluation, laboratory evaluation, and treatment options. Laryngoscope, 2009