Streptococcus pneumoniae Serotypes Associated with Death,South Africa, 2012–2018

The Streptococcus pneumoniae polysaccharide capsule plays a role in disease severity. We assessed the association of serotype with case-fatality ratio (CFR) in invasive pneumococcal disease (IPD) and meningitis in South Africa, 2012–2018 (vaccine era), using multivariable logistic regression by manual backward elimination. The most common serotypes causing IPD were 8 and 19A. In patients <15 years of age, serotypes associated with increased CFR in IPD, compared with serotype 8 and controlling for confounding factors, were 11A, 13, 19F, 15A, and 6A. None of these serotypes were associated with increased CFR in meningitis. Among IPD patients >15 years of age, serotype 15B/C was associated with increased CFR. Among meningitis patients of all ages, serotype 1 was associated with increased CFR. PCV13 serotypes 1, 3, 6A, 19A, and 19F should be monitored, and serotypes 8, 12F, 15A, and 15B/C should be considered for inclusion in vaccines to reduce deaths caused by S. pneumoniae.     

A highly predictive autoantibody-based biomarker panel for prognosis in early-stage NSCLC with potential therapeutic implications

Background Lung cancer is the leading cause of cancer-related death worldwide. Surgical resection remains the definitive curative treatment for early-stage disease offering an overall 5-year survival rate of 62%. Despite careful case selection, a significant proportion of early-stage cancers relapse aggressively within the first year post-operatively. Identification of these patients is key to accurate prognostication and understanding the biology that drives early relapse might open up potential novel adjuvant therapies.Methods We performed an unsupervised interrogation of >1600 serum-based autoantibody biomarkers using an iterative machine-learning algorithm.Results We identified a 13 biomarker signature that was highly predictive for survivorship in post-operative early-stage lung cancer; this outperforms currently used autoantibody biomarkers in solid cancers. Our results demonstrate significantly poor survivorship in high expressers of this biomarker signature with an overall 5-year survival rate of 7.6%.Conclusions We anticipate that the data will lead to the development of an off-the-shelf prognostic panel and further that the oncogenic relevance of the proteins recognised in the panel may be a starting point for a new adjuvant therapy.Subject terms: Non-small-cell lung cancer, Tumour biomarkers     

Objective and perceptual comparisons of two bluetooth hearing aid assistive devices

Purpose: With the advent of Bluetooth technology, many of the assistive listening devices for hearing have become manufacturer specific, with little objective information about the performance provided.

Method: Thirty native English-speaking adults (mean age 29.8) with normal hearing were tested pseudo-randomly with two major hearing aid manufacturers’ proprietary Bluetooth connectivity devices paired to the accompanying manufacturer’s specific hearing aids. Sentence recognition performance was objectively measured for each system with signals transmitted via a land-line to the same iPhone in two conditions.

Results: There was a significant effect of participant’s performance according to listening condition. There was no significant effect between device manufacturers according to listening condition, but there was a significant effect in participant’s perception of “quality of sound”.

Conclusions: Despite differences in signal transmission for each devise, when worn by participants both the systems performed equally. In fact, participants expressed personal preferences for specific technology that was largely due to their perceived quality of sound while listening to recorded signals. While further research is necessary to investigate other measures of benefit for Bluetooth connectivity devices, preliminary data suggest that in order to ensure comfort and compatibility, not only should objective measures of the patient benefit be completed, but also assessing the patient’s perception of benefit is equally important.

• Implications for Rehabilitation

• All professionals who work with individuals with hearing loss, become aware of the differences in the multiple choices for assistive technology readily available for hearing loss.

• With the ever growing dispensing of Bluetooth connectivity devices coupled to hearing aids, there is an increased burden to determine whether performance differences could exist between manufacturers.

• There is a growing need to investigate other measures of benefit for Bluetooth hearing aid connectivity devices that not only include objective measures, but also patient perception of benefit.

     

The neuroendocrine effects of oral imipramine

The release of growth hormone, prolactin and cortisol following oral imipramine was studied in nine fit young men. Imipramine 100 mg, but not 40 mg, led to reliable rises in the circulating levels of all three hormones in the majority of subjects. These responses are likely due to the enhancement of central noradrenergic and serotonergic function as a result of reuptake inhibition. The safety, sensitivity and reliability of these responses make imipramine 100 mg orally a potentially valuable neuroendocrine challenge test.     

Understanding the physiological effects of unrelieved pain

Pain produces a physiological stress response that includes increased heart and breathing rates to facilitate the increasing demands of oxygen and other nutrients to vital organs. Failure to relieve pain produces a prolonged stress state, which can result in harmful multisystem effects. Good acute pain management is an essential part of holistic nursing care.     

Voluntary HIV-screening at the first prenatal visit

The evolution of screening mechanisms, the patient outcomes, and CNM reactions to a voluntary HIV screening at the first prenatal visit are briefly reviewed.     

Syringomyelia after decompressive laminectomy for cervical spondylosis

We describe a case of cervical spondylotic myelopathy in which deterioration occurred a month after decompressive laminectomy. Syringomyelia was then in evidence as seen by myelography and delayed metrizamide computed tomography scanning. The etiology of this finding and its possible relation to the course and treatment of cervical spondylotic myelopathy are discussed.