Clinical picture of meningitis in the adult patient and its relationship with age

To analyze the clinical characteristics of acute meningitis and their relationship with age in adult patients presenting to the emergency department. We retrospectively investigated consecutive adult patients admitted with a diagnosis of bacterial or viral meningitis from 2002 to 2006. Data about patient's history, symptoms and signs at presentation, etiology and clinical course were collected. To investigate the relationship of clinical presentation with age, we divided patients in four age quartiles (<30 years, between 30 and 36 years, between 37 and 56 years, >56 years). Among the 202 patients considered in the study (mean age 42.8 ± 18.7 years, range 14-90), 162 (80.2%) patients had viral and 40 (19.8%) bacterial meningitis. Specific signs, such as neck stiffness or Kernig or Brudzinski signs, were more common in the first than in the fourth quartile (73.1 vs. 45.7% P = 0.041). Conversely, altered consciousness expressed as Glasgow Coma Scale (GCS) <15 was more frequent in the fourth (80.4%) than in the first (9.6%) quartile (P < 0.001). The linear regression analysis confirmed a significant decrease of GCS with the increasing of patient's age (r = -0.69, P < 0.001). At multivariate analysis, aging was associated with altered level of consciousness (OR 16.7, P < 0.001) independent of viral or bacterial etiology of the presence of comorbidities and of clinical severity (presence of severe sepsis or septic shock). Meningitis presentation largely differs with aging in adult patients. Level of consciousness is frequently altered in the older patients, when other specific signs become more rare, independent of etiology, comorbidities and clinical severity.     

Verification of correct central venous catheter placement in the emergency department: comparison between ultrasonography and chest radiography

In 210 consecutive patients undergoing emergency central venous catheterization, we studied whether an ultrasonography examination performed at the bedside by an emergency physician can be an alternative method to chest X-ray study to verify the correct central venous catheter placement, and to identify mechanical complications. A prospective, blinded, observational study was performed, from January 2009 to December 2011, in the emergency department of a university-affiliated teaching hospital. Ultrasonography interpretation was completed during image acquisition; ultrasound scan was performed in 5 ± 3 min, whereas the time interval between chest radiograph request and its final interpretation was 65 ± 74 min p < 0.0001. We found a high concordance between the two diagnostic modalities in the identification of catheter position (Kappa = 82 %, p < 0.0001), and their ability to identify a possible wrong position showed a high correlation (Pearson’s r = 0.76 %, p < 0.0001) with a sensitivity of 94 %, a specificity of 89 % for ultrasonography. Regarding the mechanical complications, three iatrogenic pneumothoraces occurred, all were correctly identified by ultrasonography and confirmed by chest radiography (sensitivity 100 %). Our study showed a high correlation between these two modalities to identify possible malpositioning of a catheter resulting from cannulation of central veins, and its complications. The less time required to perform ultrasonography allows earlier use of the catheter for the administration of acute therapies that can be life-saving for the critically ill patients.     

5－硝基水杨醛亚胺合铜（Ⅱ）类螯合物的合成与抑菌活性

根据某些含氧、氮的希夫碱及其金属螯合物有明显的抗癌抑菌作用，为寻找新的抗癌抑菌药物设计合成了５－硝基－Ｎ－（２－羟基乙基）水杨醛亚胺希夫碱Ⅰ．氯（硝酸、乙酸）５－硝基－Ｎ－（２－羟基乙基）水杨醛亚胺合铜Ⅱ和双５－硝基－Ｎ－（２－羟基乙基）水杨醛亚胺合铜Ⅴ四种新化合物。其组成与结构已由元素分析和红外光谱所表征。初步抑菌试验表明化合物Ⅰ、Ⅱ、Ⅲ对多种细菌有抑菌活性。     

Co（Ⅱ）、Ni（Ⅱ）、Cu（Ⅱ）和Zn（Ⅱ）的5—硝基水杨醛缩甘氨酸Schiff碱配合物的合成及表征

合成了新的Ｓｃｈｉｆｆ碱５－肖基水杨醛缩甘氨酸及与Ｃｏ（Ⅱ），Ｎｉ（Ⅱ）、Ｃｕ（Ⅱ）和Ｚｎ（Ⅱ）的配合物，经元素分析、热分析、摩尔电导、红外和紫外－可见光谱研究了配合物的组成及性质。抑菌活性实验表明，Ｚｎ（Ⅱ）配合物对枯草杆菌、杂色霉菌，Ｃｏ（Ⅱ）配合物对腊样芽胞杆菌有抑菌活性。     

Establishment of B-lymphoblastoid cell lines from Marek's disease virus-induced tumors in turkeys

Four lymphoblastoid cell lines were established from tumors of turkeys inoculated with high doses of the GA strain of Marek's disease virus (MDV). Unlike other MD lymphoblastoid cell lines of chicken origin, these MDV transformed turkey lines appear to be B lymphocytes and produce immunoglobulin. Growth characteristics of these cell lines are slightly different; however, they all produce low levels of MDV-specific antigen and carry the complete genome of the virus as determined by virus rescue in the chicken or in duck embryo fibroblast cultures. These cell lines are pathogenic for chickens and produce virus-induced MD lesions. All four lines are free of the herpesvirus of turkeys, reticuloendotheliosis virus, and three lines are also free of avian leukosis virus. They all have typical normal turkey chromosomes and are positive for Marek's disease tumor-associated surface antigen.