Staphylococcus aureus Bacteremia in Patients with Hematological Malignancies and/or Agranulocytosis

ABSTRACT. A total of 6 253 cases of Staphylococcus aureus bacteremia, including 274 (4.4%) endocarditis cases, were registered in Denmark in the period 1975–1984. Patients with hematological malignancies and/or agranulocytosis accounted for 479 of the bacteremia cases. The incidence of endocarditis in this group of patients was only 0.4% as compared to 4.7% in other patients with staphylococcal bacteremia (p<0.01). The lower incidence of endocarditis complicating bacteremia in these patients may justify a shorter course of therapy than usually recommended for suspected endocarditis. Patients with hematological malignancies and other patients with agranulocytosis had a higher mortality (49 and 46%, respectively) than other patients with S. aureus bacteremia (33%). The highest mortality was found in patients with multiple myeloma (71%, p<0.01), the lowest in patients with acute lymphocytic leukemia (28%, p<0.01). The higher mortality in these patients may indicate that empiric antibiotic regimens in granulocytopenic patients should include a specific anti-staphylococcal agent.     

PROFILE OF PATIENTS WHO SEEK THE BARIATRIC SURGERY

Background :

Nowadays obesity is a chronic disease considered one of the greatest problems in public healthy. Showing to be effective in a short and long term, the bariatric surgery has emerged as an optional treatment for morbid obesity.

Aim:

Identify the profile of patients seeking bariatric surgery.

Methods:

Were interviewed 100 patients in preoperative nutritional monitoring of bariatric surgery. The study was conducted by applying a questionnaire prepared according to the research objectives.

Results:

From the individuals that were seeking bariatric surgery, 78% were female, 62% were married and 69% reported physical activity. The average age of those surveyed was 37±10.83 years and mean body mass index (BMI) was 43.51± 6.25 kg/m². The comorbidity more prevalent in this group was high blood pressure (51%). In previous treatments for weight reduction, 92% have already done hypocaloric diet followed by anorectic drug (83%). The success of these treatments was reported by 92% of patients; however, the weight lost was recovered in less than one year of 75%. Patients with diabetes mellitus and dyslipidemia had higher BMI values. The patients with comorbidities showed lower levels of BMI.

Conclusion:

The profile of patients who sought surgical treatment for their obesity were predominantly women with a family background of obesity and obesity-related comorbidities, especially hypertension and diabetes mellitus.     

Addition of Drugs to Infusion Fluids Pharmaceutical Considerations on Preparation and Use

In most hospitals, the addition of drugs to infusion fluids is carried out by nurses. The preparation involves certain hazards both microbiologically and pharmaceutically. Incompatibilities between drug and fluid or between drugs may result in admixtures which have reduced therapeutic activity or which are even hazardous to the patient.
The all-in-one total parenteral nutrition mixtures represent a new way of administering nutrition and has achieved increased popularity both for in- and outpatients. During preparation, which takes place in the pharmacy, several precautions have to be taken to assure a product with acceptable stability. Some of the important incompatibilities are mentioned.     

Glucosyltransferase activity in human in vivo formed enamel pellicle and in whole saliva

Abstract – Two hour in vivo formed enamel pellicle samples and paraffin wax-stimulated saliva samples were collected from 10 volunteers for analyses of glucosyltransferase activity (GTF). GTF activity was recorded by monitoring incorporation of radioactivity from ¹⁴C-glucose labeled sucrose into glucan. Pellicle and saliva samples from all 10 subjects demonstrated GTF activity. The GTF activity in the pellicle samples was highest in subjects, with high GTF activity-producing adhesive glucan in saliva.     

A COMPARISON OF TWO TECHNIQUES TO REACH RELATIVES OF ALCOHOLICS FOR INFORMATION OF AVAILABLE SUPPORT

Two different information techniques to reach spouses and relativesof inpatient alcoholics for information of available support,one standardized and one individualized, were compared. Eachprocedure was tested during 6 months in the same ward. In thestandardized model 18% (20/112) and in the individualized model20% (21/104) of spouses/relatives/friends attended the informationsession. In those living with a spouse, the rates were 46% and41% respectively, and among those who were not cohabiting, buthad relatives or sober friends, the figures were 11% and 17%respectively. There were no sex differences. Among preferredsupport, individual support, marital and family support andprofessional group support received the highest ratings. Atthe 1 year follow-up, more subjects in the individualized informationgroup had received support compared with those in the standardizedgroup. The low rates of informed subjects are in agreement withthe literature and considerably lower than the rates in informationprogrammes for relatives of schizophrenic patients.     

Interleukin 1β Increases the Cytosolic Free Sodium Concentration in Isolated Rat Islets of Langerhans

Interleukin 1 (IL-1) exerts both stimulatory and inhibitory (cytotoxic) effects on insulin-producing beta cells in isolated pancreatic islets. Since alteration in ion fluxes is crucial for endocrine cell activation and is a denominator of cell death, and since IL-1 was recently shown to increase the total sodium content in a murine pre-B-lymphocyte cell line, we investigated the effect of recombinant human IL-1 beta (rhIL-1 beta) on the cytosolic free sodium concentration (fNa+i) in rat islets. Furthermore, long-term rhIL-1 beta effects on islet cell function were studied during exposure of islets to amiloride, a blocker of the plasma membrane Na+/H+ exchange. One hour of islet exposure to 60 U/ml of rhIL-1 beta caused a threefold increase in fNa+i in islet cells, and this effect was abolished by depletion of extracellular sodium. Blockade of Na+/H+ exchange with amiloride abolished the inhibitory effect of rhIL-1 beta on insulin release. In conclusion, rhIL-1 beta was found to increase sodium influx in pancreatic islet cells. This might underlie the widespread effects of rhIL-1 beta on beta-cell function and morphology, possibly related to IL-1-mediated toxic free radical formation.     

Retroperitoneal dismembered pyeloplasty: Initial experiences

AIM: To review the results of our first 40 cases of retroperitoneal dismembered pyeloplasty and to compare them with series of open and other minimally invasive treatments of pelviureteric junction (PUJ) obstruction. Also to compare our first 20 cases with the second 20 cases to see if there was an improvement in results with experience. METHODS: A retrospective review of the first 40 laparoscopic pyeloplasties performed by a single lead surgeon at two institutions was performed. The diagnosis of PUJ obstruction was confirmed with an intravenous urogram as well as a renogram prior to surgery. A retroperitoneal, dismembered pyeloplasty was routinely performed with three or four ports. All patients were followed up with an intravenous urogram, renogram and review of symptoms at 4 months and annual renogram after that. RESULTS: Average operation time was 236 min and this appeared to decrease with experience. Two cases had to be converted to open operations. The mean hospital stay was 3.4 days. Out of the 40 patients, 34 have had successful laparoscopic operations with total symptomatic relief as well as radiologically proven deobstruction. There were four major complications with 3 patients going on to have redo open pyeloplasty operations. There were seven minor complications. CONCLUSIONS: In our experience, retroperitoneal dismembered pyeloplasty is an effective and safe means of treating PUJ obstruction. Our results seem to be comparable with series of open pyeloplasty and other laparoscopic series and are better than some other minimally invasive techniques.