Novel 6-Month Treatment for Drug-Resistant Tuberculosis,United States

The US Food and Drug Administration approved a 6-month regimen of pretomanid, bedaquiline, and linezolid for extensively drug-resistant or multidrug-intolerant tuberculosis after a trial in South Africa demonstrated 90% effectiveness 6 months posttreatment. We report on a patient who completed the regimen using a lower linezolid dose.     

Cellular immune response to pulmonary infections in HIV-infected individuals hospitalized with diverse grades of immunosuppression

The lymphocyte profile of 521 HIV-infected subjects hospitalized at Jackson Memorial (2001-2002) was compared across main respiratory diseases. Study data included medical history and all laboratory evaluations performed during hospitalization. Community-acquired pneumonias (CAP, 52%), Pneumocystis jiroveci pneumonia (PCP, 24%), tuberculosis (TB, 9%) and non-tuberculous mycobacterial diseases (NTM, 12%) were the most frequent causes of admission. Patients hospitalized with PCP and NTM exhibited the lowest CD4 counts (P=0.003). PCP patients had the highest B-cell percentages (P=0.04). CAP patients had the highest CD8 and CD4 percentages and the lowest percentage of Natural Killer (NK) cells and viral burdens. TB patients exhibited the lowest NK-cell (11.4+/-6.3) and B-cell percentages (13.6+/-12) and the highest CD8 (59+/-14) percentage. NTM patients, in contrast, had the highest NK-cell percentages of the groups (19.1+/-11.6, P=0.01). Additionally, immune responses associated with respiratory pathogens differed in HIV-infected patients with CD4(+) cells above and below 200 counts.     

Design for an optical cw atom laser

A new type of optical cw atom laser design is proposed that should operate at high intensity and high coherence and possibly record low temperatures. It is based on an "optical-shepherd" technique, in which far-off-resonance blue-detuned swept sheet laser beams are used to make new types of high-density traps, atom waveguides, and other components for achieving very efficient Bose-Einstein condensation and cw atom laser operation. A shepherd-enhanced trap is proposed that should be superior to conventional magneto-optic traps for the initial collection of molasses-cooled atoms. A type of dark-spot optical trap is devised that can cool large numbers of atoms to polarization-gradient temperatures at densities limited only by three-body collisional loss. A scheme is designed to use shepherd beams to capture and recycle essentially all of the escaped atoms in evaporative cooling, thereby increasing the condensate output by several orders of magnitude. Condensate atoms are stored in a shepherd trap, protected from absorbing light, under effectively zero-gravity conditions, and coupled out directly into an optical waveguide. Many experiments and devices may be possible with this cw atom laser.     

Fertilization of bovine oocytes induced solely with combined laser microbeam and optical tweezers

Purpose: Our purpose was to show that fertilization of oocytes can be obtained solely by laser light-mediated manipulation of gametes. Method: A small channel was drilled into the zona pellucida of bovine oocytes using an ultraviolet (UV)-laser microbeam. Highly diluted cattle sperm were not able to fertilize the laser drilled oocytes. Results: Fertilization was achieved only when three to five cattle sperm were trapped with optical tweezers and inserted directly through the laser drilled hole into the perivitelline space. After 20 hr, 3 of 79 (3.8%) oocytes revealed two pronuclei and a sperm tail within their cytoplasm. Cattle sperm are difficult to catch. Therefore, the gametes had to remain for about 20 min in room atmosphere, which might be the reason for the low fertilization results. Conclusions: The results indicate that a combined UV-laser microbeam and optical tweezers trap can be used successfully for noncontact microinsemination procedures.Presented in part at the IXth World Congress on In Vitro Fertilization and Alternate Assisted Reproduction, April 3–7, 1995, Vienna, Austria.     

Medication documentation in a primary care network serving North Carolina medicaid patients: results of a cross-sectional chart review

ABSTRACT: BACKGROUND: Medical records that do not accurately reflect the patient's current medication list are an open invitation to errors and may compromise patient safety. METHODS: This cross-sectional study compares primary care provider (PCP) medication lists and pharmacy claims for 100 patients seen in 8 primary care practices and examines the association of congruence with demographic, clinical, and practice characteristics. Medication list congruence was measured as agreement of pharmacy claims with the entire PCP chart, including current medication list, visit notes, and correspondence sections. RESULTS: Congruence between pharmacy claims and the PCP chart was 65%. Congruence was associated with large chronic disease burden, frequent PCP visits, group practice, and patient age [greater than or equal to]45 years. CONCLUSION: Agreement of medication lists between the PCP chart and pharmacy records is low. Medication documentation was more accurate among patients who have more chronic conditions, those who have frequent PCP visits, those whose practice has multiple providers, and those at least 45 years of age. Improved congruence among patients with multiple chronic conditions and in group practices may reflect more frequent visits and reviews by providers.