Epidemiology and Risk Factors for Bloodstream Infections in a Home Parenteral Nutrition Program

Background: An increasing number of patients with intestinal failure are receiving home parenteral nutrition (HPN). Associated complications include bloodstream infections (BSIs), but data on rates and risk factors for HPN‐related BSIs are scarce. Methods: A retrospective review was conducted of patients enrolled in the regional HPN program between 2001 and 2008. Demographic information and data on indication for HPN, duration of PN therapy, type and date of insertion of central venous access device, and blood culture results were recorded. Results: In total, 155 patients (165 courses of HPN) were included for a total of 45,876 catheter days. The mean patient age was 49 years, and 105 (64%) patients were female. A total of 105 organisms were cultured from 93 distinct episodes of BSIs. The rate of BSI was found to be 2.0 per 1000 catheter days, but excluding BSIs with a single positive culture of coagulase‐negative staphylococcus and diphtheroid bacilli, the rate of infection was 1.4 per 1000 catheter days. Male sex and underlying malignancy were significant predictors of BSI, with hazard ratios of 1.69 (95% confidence interval [CI], 1.14–2.60; P = .009) and 2.38 (95% CI, 1.53–3.50; P < .001). Conclusion: In a large heterogeneous group of HPN patients, the BSI rate ranged between 1.4 and 2.0 infections per 1000 catheter days. Isolated organisms were similar to those found in hospitalized patients. Male sex and underlying malignancy were significant risk factors for BSI. These high‐risk patients are likely to benefit from interventions aimed at reducing BSIs.     

New portable smartphone-based PDMS microfluidic kit for the simultaneous colorimetric detection of arsenic and mercury

A smartphone-based microfluidic platform was developed for point-of-care (POC) detection using surface plasmon resonance (SPR) of gold nanoparticles (GNPs). The simultaneous colorimetric detection of trace arsenic and mercury ions (As³⁺ and Hg²⁺) was performed using a new image processing application (app). To achieve this goal, a microfluidic kit was fabricated using a polydimethylsiloxane (PDMS) substrate with the configuration of two separated sensing regions for the quantitative measurement of the color changes in GNPs to blue/gray. To fabricate the microfluidic kit, a Plexiglas mold was cut using a laser based on the model obtained from AutoCAD and Comsol outputs. The colorimetric signals originated from the formation of nanoparticle aggregates through the interaction of GNPs with dithiothreitol – 10,12-pentacosadiynoic acid (DTT-PCDA) and lysine (Lys) in the presence of As³⁺ and Hg²⁺ ions. This assembly exhibited the advantages of simplicity, low cost, and high portability along with a low volume of reagents and multiplex detection. Heavy Metals Detector (HMD), as a new app for the RGB reader, was programmed for an Android smartphone to quantify colorimetric analyses. Compared with traditional image processing, this app provided significant improvements in sensitivity, time of analysis, and simplicity because the color intensity is measured through a new normalization equation by converting RGB to an Integer system. As a simple, real-time, and portable analytical kit, the fabricated sensor could detect low concentrations of As³⁺ (710 to 1278 μg L⁻¹) and Hg²⁺ (10.77 to 53.86 μg L⁻¹) ions in water samples at ambient conditions.

A smartphone-based microfluidic platform was developed for point-of-care (POC) detection using surface plasmon resonance (SPR) of gold nanoparticles (GNPs).     

Micro-array Analysis of Cold Tolerant Tomato Expressing Nicotiana tabacum Osmotin

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - Our earlier studies have established improved cold tolerance in the transgenic tomato (Solanum lycopersicum...     

Effect of different activations of silver nanoparticle irrigants on the elimination of Enterococcus faecalis

Clinical Oral Investigations - This study aimed to compare the efficacy of silver nanoparticles (AgNPs) irrigating solution alone and following activation with photon-induced photoacoustic...     

The effects of diode laser (660 nm) on the rate of tooth movements: an animal study

Lasers in Medical Science - Low-level laser has been indicated to have the capability to facilitate the differentiation of the osteoclastic and osteoblastic cells which are responsible for the bone...     

Parapharangeal edema: an uncommon complication of TMJ arthroscopy

Ohnishi in 1975 first described temporomandibular joint (TMJ) arthroscopy. Along with its extensive use, a range of complications has emerged. We describe a patient who experienced parapharyngeal swelling after undergoing arthroscopy. Prolonged intubation up to 1 hour postoperatively was required. The swelling resolved completely over 6 h without further intervention.     

The outcome and long-term follow-up of 94 patients with recurrent and refractory Clostridium difficile infection using single to multiple fecal microbiota transplantation via retention enema

Clostridium difficile infection (CDI) is one of the most frequent causes of healthcare-associated infections, and its rates are also increasing in the community. The management of CDI has become a major challenge, given growing rates of recurrences and failures with standard antibiotic therapy. Mounting evidence suggests that fecal microbiota transplantation (FMT) may be effective; however, as there is a paucity of data with regard to repeat FMT for primary non-response to this treatment, this study examined the outcome of multiple FMTs for recurrent CDI. Case records were reviewed for 94 patients who underwent FMT via retention enema for recurrent or refractory CDI during the period 2008–2012. Demographic information, treatment data, and clinical resolution rates were examined for single FMT and cumulative resolution was assessed for multiple FMTs in the context of ongoing symptoms. The cumulative clinical resolution following four or more FMTs was 86 %. When antibiotic therapy was used between FMTs, the clinical resolution rate increased to 92 %. There were no reported adverse events and no patients who were cured with FMT had further episodes of CDI at 6–24 months follow-up. Multiple FMTs administered through enemas is an effective, safe, and simple therapy for the management of recurrent or refractory CDI.     

Brain circuit imprints of developmental 17α-Ethinylestradiol exposure in guppies (Poecilia reticulata): Persistent effects on anxiety but not on reproductive behaviour

The effects of endocrine disruptors may vary with the timing of exposure. The physiological implications of adult exposure are present during and shortly after exposure while embryonic exposure can imprint changes manifested in adulthood. In this study, guppy (Poecilia reticulata) embryos were exposed to 2 and 20ng/L of 17α-ethinylestradiol during development via the mother and reared in clean water from gestation until 6months of age. As adults, fish exposed to 20ng/L during development showed significantly altered behaviour in the Novel Tank test, where anxiety is determined as the tendency to remain at the bottom upon introduction into an unfamiliar tank. 17α-ethinylestradiol treatment increased the latency time before swimming to the upper half of the tank and decreased the number of transitions to the upper half. In control females the basal stress behaviour responses were significantly higher than in males, as indicated by longer latency period and fewer and shorter visits to the upper half, supporting the importance of gonadal hormones for the behaviour. The anxiety increased, however, with treatment in both sexes, suggesting that the observed response is not entirely due to feminisation of the males. Shoaling behaviour, analysed as tendency to leave a shoal of littermates, was neither sex-differentiated nor changed by treatment. Also male reproductive behaviour, brain aromatase activity and testes histology, previously shown to respond to oestrogen exposure in adult guppy, were unaffected by the developmental treatment. This suggests that the stress system in the guppy is very sensitive to 17α-ethinylestradiol, which possibly causes an early organisational imprint on the brain circuit that regulates stress reactions.