Heiric von Auxerre, Miracula sancti Germani – Buch II

Das Werk ist eine kritische Edition und deutsche Übersetzung des zweiten Buchs der "Miracula sancti Germani" des Heiric von Auxerre, geschrieben zwischen ca. 873 und 875 – eine bemerkenswerte Quelle für die Geschichte des Klosters Saint-Germain-d'Auxerre, aber auch für die Vorstellungsgeschichte, den Heiligenkult und die Idee der "drei Ordnungen" der Arbeiter, Kämpfer und Beter

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study

Background To date, few data on paediatric COVID-19 have been published, and most reports originate from China. This study aimed to capture key data on children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across Europe to inform physicians and health-care service planning during the ongoing pandemic. Methods This multicentre cohort study involved 82 participating health-care institutions across 25 European countries, using a well established research network—the Paediatric Tuberculosis Network European Trials Group (ptbnet)—that mainly comprises paediatric infectious diseases specialists and paediatric pulmonologists. We included all individuals aged 18 years or younger with confirmed SARS-CoV-2 infection, detected at any anatomical site by RT-PCR, between April 1 and April 24, 2020, during the initial peak of the European COVID-19 pandemic. We explored factors associated with need for intensive care unit (ICU) admission and initiation of drug treatment for COVID-19 using univariable analysis, and applied multivariable logistic regression with backwards stepwise analysis to further explore those factors significantly associated with ICU admission. Findings 582 individuals with PCR-confirmed SARS-CoV-2 infection were included, with a median age of 5·0 years (IQR 0·5–12·0) and a sex ratio of 1·15 males per female. 145 (25%) had pre-existing medical conditions. 363 (62%) individuals were admitted to hospital. 48 (8%) individuals required ICU admission, 25 (4%) mechanical ventilation (median duration 7 days, IQR 2–11, range 1–34), 19 (3%) inotropic support, and one (<1%) extracorporeal membrane oxygenation. Significant risk factors for requiring ICU admission in multivariable analyses were being younger than 1 month (odds ratio 5·06, 95% CI 1·72–14·87; p=0·0035), male sex (2·12, 1·06–4·21; p=0·033), pre-existing medical conditions (3·27, 1·67–6·42; p=0·0015), and presence of lower respiratory tract infection signs or symptoms at presentation (10·46, 5·16–21·23; p<0·0001). The most frequently used drug with antiviral activity was hydroxychloroquine (40 [7%] patients), followed by remdesivir (17 [3%] patients), lopinavir–ritonavir (six [1%] patients), and oseltamivir (three [1%] patients). Immunomodulatory medication used included corticosteroids (22 [4%] patients), intravenous immunoglobulin (seven [1%] patients), tocilizumab (four [1%] patients), anakinra (three [1%] patients), and siltuximab (one [<1%] patient). Four children died (case-fatality rate 0·69%, 95% CI 0·20–1·82); at study end, the remaining 578 were alive and only 25 (4%) were still symptomatic or requiring respiratory support. Interpretation COVID-19 is generally a mild disease in children, including infants. However, a small proportion develop severe disease requiring ICU admission and prolonged ventilation, although fatal outcome is overall rare. The data also reflect the current uncertainties regarding specific treatment options, highlighting that additional data on antiviral and immunomodulatory drugs are urgently needed. Funding ptbnet is supported by Deutsche Gesellschaft für Internationale Zusammenarbeit

Incidence of Gallstone Formation and Cholecystectomy 10 Years After Bariatric Surgery.

PURPOSE Rapid weight loss is a risk factor for gallstone formation, and postoperative treatment options for gallstone formation are still part of scientific discussion. No prospective studies monitored the incidence for gallstone formation and subsequent cholecystectomy after bariatric surgery longer than 5 years. The aim of the study was to determine the incidence of gallstone formation and cholecystectomy in bariatric patients over 10 years. MATERIALS AND METHODS One hundred nine patients were observed over 10 years after laparoscopic gastric banding or gastric bypass/gastric sleeve. The incidence of gallstone formation and cholecystectomy was correlated to longitudinal changes in anthropometric parameters. RESULTS In total, 91 female and 18 male patients were examined. Nineteen patients had postoperative gallstone formation, and 12 female patients required cholecystectomy. The number needed to harm for gallstone formation was 7.1 and 2.3 cases in the banding group and gastric bypass/gastric sleeve group, respectively. The number needed to harm for cholecystectomy was 11.6 and 2.5 cases in the banding group and the gastric bypass/gastric sleeve group, respectively. Weight loss was higher in patients requiring subsequent cholecystectomy. Mean follow-up to cholecystectomy was 21.5 months with the latest operation after 51 months. CONCLUSION Female gender and rapid weight loss were major risk factors for postoperative cholelithiasis. Ultrasound examinations within 2 to 5 years are recommended in every patient, independent of bariatric procedure. Pharmacologic treatment should be considered in high risk patients within 2 to 5 years to prevent postoperative cholelithiasis. This helps to optimize patient care and lowers postoperative morbidity

Relative rate of evolution of the UL32 gene based on amino acid-sequence.

<p>The mean evolutionary rate per amino acid site within the UL32 gene was calculated to identify genomic regions with a more than average genomic variation. Relative evolutionary rates are shown for each site next to the site number. These rates are scaled such that the average evolutionary rate across all sites is 1 (dotted line). This means that sites showing a rate < 1 are evolving slower than average and those with a rate > 1 are evolving faster than average. These relative rates were estimated with the use of MEGA under the Jones-Taylor-Thornton model (+G) (21). Known immunogenic epitopes are indicated by horizontal bars above the graph [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0078925#B28" target="_blank">28</a>-<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0078925#B30" target="_blank">30</a>].</p

Phylogenetic analysis of the CMV UL32 gene.

<p>(A) Analysis of the N-terminal aa50-784 of the UL32 gene from CMV strains detected in our study (CLL, n=7; multiple myeloma, n=1; immunocompetent patients with primary CMV infections, n=5). (B) Analysis of the C-terminal aa493-1037 of the UL32 gene from the same CMV strains (CLL, n=7; multiple myeloma, n=1; immunocompetent patients with primary CMV infections, n=3). Sequences were compared to the published sequences of 3 laboratory adapted CMV strains and 11 previously described clinical isolates (see methods section) using the Jones-Taylor-Thornton model for constructing the tree with the maximum likelihood algorithm in MEGA. Robustness of the nodes was assessed with the Kimura two-parameter model for neighbor-joining algorithms and bootstrap-resampling. Bootstrap values (% after 1000 iterations) are shown for major branches. </p

Kinetics of antibody levels in paired samples from CLL patients (n=64).

<p>The decay constant λ was calculated as mean change in log₁₀ titer per year. Positive values of λ indicate decay and negative values an increase in antibody levels over time. Statistical analysis was done using Spearman´s rho correlation coefficient which is shown for each comparison. (A) Decay per year of IgG subgroups plotted against total IgG decay. Lines indicate linear correlation and 95% confidence intervals, respectively. Decay of total IgG strongly correlated with that of IgG subgroups, p-values being <0.001 for all comparisons tested (not shown). (B) Decay constants of total IgG plotted against CMV-specific, VZV-specific, and EBV-specific IgG. Correlation between decay constants were statistically significant for total IgG and VZV- and EBV-specific IgG (p-values 0.003 and 0.001, respectively), while correlation between total IgG and CMV- specific IgG was not significant (p=0.087). (C) Decay constants of CMV-specific IgG plotted against CMV-subclass gB-specific and CMV-subclass pUL32-specific IgG. Correlations of decay constants were unspecific for both comparisons (p-values 0.068 and 0.405, respectively).</p