Severe nosocomial pneumonia – emphasis on nebulized tobramycin

ObjectiveTo estimate the efficacy and safety of nebulized tobramycin (NT) as an adjunct to systemic antibiotics in the treatment of severe nosocomial pneumonia (NP).Methods25 mechanically ventilated patients (out of 150 screened) were enrolled in the current observational single-center study. They were randomized to receive either NT (300 mg, BID; group 1, n=15) as an adjunct to systemic antibiotics or for a correction of the regimen of systemic antibiotics (group 2, n=10). The primary outcome measure was resolution of NP and acute respiratory insufficiency. The CPIS, signs of systemic inflammatory response syndrome (SIRS) and oxygenation index were used as objective indicators of the clinical progress.ResultsThe following signs of NT efficacy were detected in 87% of group 1 patients: a decrease of SIRS and CPIS scores within (2.3±1.2) d of NT therapy (P<0.05); decrease of microbes titer to 10³–10⁴ CFU/mL (P<0.05); increase of microbes sensitivity to systemic antibiotics in 40% of patients; positive X-ray dynamics in 60% of patients within (9.0±2.5) d of NT therapy. No serious side effects of NT were observed.ConclusionsAdministration of NT as an adjunct to systemic antibiotics is efficient and safe in 87% of patients with severe NP caused by multiresistant gram-negative bacteria.     

Prenatal express-diagnosis by the method of QF-PCR and automatic microelectroforesis with microarrays

The modern molecular-genetic methods have been implementing actively into the medical practiee.They improve diagnostic accuracy,help to prognosticate the course of oncological diseases,optimize the res...     

Pyroptosis is a drug target for prevention of adverse cardiac remodeling: The crosstalk between pyroptosis,apoptosis, and autophagy

Acute myocardial infarction (AMI) is one of the main reasons of cardiovascular disease-related death. The introduction of percutaneous coronary intervention to clinical practice dramatically decreased the mortality rate in AMI. Adverse cardiac remodeling is a serious problem in cardiology. An increase in the effectiveness of AMI treatment and prevention of adverse cardiac remodeling is difficult to achieve without understanding the mechanisms of reperfusion cardiac injury and cardiac remodeling. Inhibition of pyroptosis prevents the development of postinfarction and pressure overload-induced cardiac remodeling, and mitigates cardiomyopathy induced by diabetes and metabolic syndrome. Therefore, it is reasonable to hypothesize that the pyroptosis inhibitors may find a role in clinical practice for treatment of AMI and prevention of cardiac remodeling, diabetes and metabolic syndrome-triggered cardiomyopathy. It was demonstrated that pyroptosis interacts closely with apoptosis and autophagy. Pyroptosis could be inhibited by nucleotide-binding oligomerization domain-like receptor with a pyrin domain 3 inhibitors, caspase-1 inhibitors, microRNA, angiotensin-converting enzyme inhibitors, angiotensin Ⅱ receptor blockers, and traditional Chinese herbal medicines.     

Densovirus induces winged morphs in asexual clones of the rosy apple aphid,Dysaphis plantaginea

Winged morphs of aphids are essential for their dispersal and survival. We discovered that the production of the winged morph in asexual clones of the rosy apple aphid, Dysaphis plantaginea, is dependent on their infection with a DNA virus, Dysaphis plantaginea densovirus (DplDNV). Virus-free clones of the rosy apple aphid, or clones infected singly with an RNA virus, rosy apple aphid virus (RAAV), did not produce the winged morph in response to crowding and poor plant quality. DplDNV infection results in a significant reduction in aphid reproduction rate, but such aphids can produce the winged morph, even at low insect density, which can fly and colonize neighboring plants. Aphids infected with DplDNV produce a proportion of virus-free aphids, which enables production of virus-free clonal lines after colonization of a new plant. Our data suggest that a mutualistic relationship exists between the rosy apple aphid and its viruses. Despite the negative impact of DplDNV on rosy apple aphid reproduction, this virus contributes to their survival by inducing wing development and promoting dispersal.     

不同焦虑水平的操作员在有目的竞争活动中的心理生理参数

研究并讨论了在模拟状态下飞行员的心理－生理活动的焦虑水平。焦虑指的是一种特定的性格状态，从事危险职业的人由于经常性地受到紧张因素的影响，会产生长期的或暂时的焦虑。研究结果表明，当选拔在复杂环境条件下工作的操作者时，应优先考虑低焦虑水平的人；而当小组共同完成任务时，应着重考虑焦虑水平相当的人。     

Pre‐exposure prophylaxis: awareness,acceptability and risk compensation behaviour among men who have sex with men and the transgender population

Objectives

This exploratory study examined the facilitators of and barriers to acceptance of pre‐exposure prophylaxis (PrEP) and potential risk compensation behaviour emerging from its use among men who have sex with men (MSM) and transgender individuals (TGs) in India.

Methods

A questionnaire was administered to 400 individuals registered with a targeted intervention programme. Logistic regression models were used to identify facilitators of and barriers to PrEP acceptance.

Results

The respondents consisted of 68% MSM and 32% TGs. Risk behaviour categorization identified 40% as low risk, 41% as medium risk and, 19% as high risk for HIV infection. About 93% of the respondents were unaware of PrEP, but once informed about it, 99% were willing to use PrEP. The facilitators of PrEP acceptance were some schooling [odds ratio (OR) 2.16; P = 0.51], being married or in a live‐in relationship (OR 2.08; P = 0.46), having a high calculated risk (OR 3.12; P = 0.33), and having a high self‐perceived risk (OR 1.8; P = 0.35). Increasing age (OR 2.12; P = 0.04) was a significant barrier. TGs had higher odds of acceptance of PrEP under conditions of additional cost (OR 2.12; P = 0.02) and once‐daily pill (OR 2.85; P = 0.04). Individuals identified as low risk for HIV infection showed lower odds of potential risk compensation, defined as more sexual partners (OR 0.8; P = 0.35), unsafe sex with new partners (OR 0.71; P = 0.16), and decreased condom use with regular partners (OR 0.95; P = 0.84), as compared with medium‐risk individuals. The associations, although not statistically significant, are nevertheless important for public health action given the limited scientific evidence on PrEP use among MSM and TGs in India.

Conclusions

With high acceptability and a low likelihood of risk compensation behaviour, PrEP can be considered as an effective prevention strategy for HIV infection among MSM and TGs in India.

     

Benign Pneumatosis Intestinalis with Subcutaneous Emphysema in a Liver Transplant Recipient

Pneumatosis intestinalis (PI) occurred in a pediatric liver transplant recipient experiencing chronic rejection. Signs and symptoms included abdominal distention, subcutaneous emphysema, fever, and malaise. Antibiotic treatment and nasogastric decompression resulted in prompt relief of symptoms, and surgery was not necessary. The etiology, pathophysiology, and therapy of this rare condition are discussed.