Polymyxin-Resistant Acinetobacter spp. Isolates: What is Next?

Univ Fed Sao Paulo, Div Infect Dis, Lab Especial Microbiol Clin, BR-04025010 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Div Infect Dis, Lab Especial Microbiol Clin, BR-04025010 Sao Paulo, SP, BrazilWeb of Scienc

Integration of molecular characterization of microorganisms in a global antimicrobial resistance surveillance program

© 2001 by the Infectious Diseases Society of America. All rights reserved.The SENTRY Antimicrobial Surveillance Program has incorporated molecular strain typing and resistance genotyping as a means of providing additional information that may be useful for understanding pathogenic microorganisms worldwide. Resistance phenotypes of interest include multidrug-resistant pathogens, extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, and fluoroquinolone-resistant (FQR) strains of gram-negative bacilli and Streptococcus pneumoniae. Clusters of 2 isolates within a given resistance profile that are linked temporally and by hospital location are flagged for DNA fingerprinting. Further characterization of organisms with respect to resistance genotype is accomplished with use of polymerase chain reaction and DNA sequencing. This process has been highly successful in identifying clonal spread within clusters of multiresistant pathogens. Between 50% and 90% of MRSA clusters identified by phenotypic screening contained evidence of clonal spread. Among the Enterobacteriaceae, ESBL-producing strains of Escherichia coli and Klebsiella pneumoniae are the most common pathogens causing clusters of infection, and 50% of recognized clusters demonstrate clonal spread. Clusters of Pseudomonas aeruginosa, Acinetobacter species, and Stenotrophomonas maltophilia have been noted with clonal spread among patients with urinary tract, respiratory, and bloodstream infections. Characterization of mutations in the FQR-determining region of phenotypically susceptible isolates of E. coli and S. pneumoniae has identified first-stage mutants among as many as 40% of isolates. The ability to characterize organisms phenotypically and genotypically is extremely powerful and provides unique information that is important in a global antimicrobial surveillance program.M. A. Pfaller, J. Acar, R. N. Jones, J. Verhoef, J. Turnidge, and H. S. Sade

Spectroscopy of vibrational modes in metal nanoshells

We study the spectrum of vibrational modes in metal nanoparticles with a dielectric core. Vibrational modes are excited by the rapid heating of the particle lattice that takes place after laser excitation, and can be monitored by means of pump-probe spectroscopy as coherent oscillations of transient optical spectra. In nanoshells, the presence of two metal surfaces results in a substantially different energy spectrum of acoustic vibrations than for solid particles. We calculated the energy spectrum as well as the damping of nanoshell vibrational modes. The oscillator strength of fundamental breathing mode is larger than that in solid nanoparticles. At the same time, in very thin nanoshells, the fundamental mode is overdamped due to instantaneous energy transfer to the surrounding medium

Lippen-Kiefer-Gaumen-Spalten: Individuelle Analyse der Lippenspalte durch 3-D-Lasertopometrie

Zusammenfassung: Hintergrund: Mit Gipsmodellen und Fotografien ist die dreidimensionale Analyse einer Lippen-Kiefer-Gaumen-Spalte meist nur unzureichend möglich. Ziel der vorliegenden Studie war es daher, die 3-D-Lasertopometrie auf ihre Anwendbarkeit zur dreidimensionalen Weichgewebserfassung bei Patienten mit Lippen-Kiefer-Gaumen-Spalten zu testen. Patienten und Methode: Bei 20 Patienten (3-35 Jahre), die eine einseitige, nicht operierte Lippen-, Lippen-Kiefer- oder Lippen-Kiefer-Gaumen-Spalte aufwiesen, wurde mit einem 3-D-Laserscanner die Gesichtsoberfläche prä- und postoperativ dreidimensional erfasst. Die dabei erzeugten digitalen Datensätze wurden in einer virtuellen Umgebung metrisch analysiert und anhand von Quotienten größenunabhängig wiedergegeben. Sie dienten der Auswahl der Operationstechnik und der Beurteilung des Operationsergebnisses. Ergebnisse: Mit dem 3-D-Laserscanner wurden 3-D-Oberflächen guter Qualität erstellt, die sich im Millimeterbereich ausmessen ließen. Die dreidimensionale Spaltmorphologie konnte in den Datensätzen reproduzierbar mit Landmarks versehen und vermessen werden. Auch die postoperative Symmetrie ließ sich so kontrollieren und objektivieren. Als nachteilig erwiesen sich die relativ lange Messzeit und die Notwendigkeit zur Kombination mehrerer Ansichten. Schlussfolgerung: Das vorgestellte 3-D-Laserverfahren ermöglicht eine präzise dreidimensionale Weichteilanalyse der Lippen- und Nasenregion bei Spaltpatienten. Es eignet sich jedoch nur bedingt für lebhafte Säuglinge und unkooperative Patiente

Prevalence and Characterization of Avoidant Restrictive Food Intake Disorder in a Paediatric Population

Peer reviewedPublisher PD

The Impact of Intravenous Lidocaine on ICP in Neurological Illness: A Systematic Review

Background. The goal of our study was to perform a systematic review of the literature to determine the effect that intravenous (IV) lidocaine had on ICP in patients with neurological illness. Methods. All articles are from MEDLINE, BIOSIS, EMBASE, Global Health, Scopus, Cochrane Library, the International Clinical Trials Registry Platform (inception to March 2015). The strength of evidence was adjudicated using both the Oxford and GRADE methodology. Results. Ten original articles were considered for the final review. There were 189 patients studied. Seven studies focused on prophylactic pretreatment with IV lidocaine to determine if there would be an attenuation of ICP spikes during stimulation, with 4 displaying an attenuation of ICP. Three studies focused on a therapeutic administration of IV lidocaine in order to determine ICP reduction effects. All therapeutic studies displayed a reduction in ICP. Conclusions. We cannot make a strong definitive recommendation on the effectiveness of IV lidocaine on the attenuation of ICP spikes during stimulation. There currently exists both Oxford 2b and GRADE B literature to support and refute the attenuation of ICP spikes with IV lidocaine during stimulation. There currently exists Oxford 2b, GRADE B evidence to support ICP reduction with lidocaine when used as a therapeutic agent

Like-charge attraction through hydrodynamic interaction

We demonstrate that the attractive interaction measured between like-charged colloidal spheres near a wall can be accounted for by a nonequilibrium hydrodynamic effect. We present both analytical results and Brownian dynamics simulations which quantitatively capture the one-wall experiments of Larsen and Grier (Nature 385, p. 230, 1997).Comment: 10 pages, 4 figure

Cryo-EM structure of the Rhodospirillum rubrum RC-LH1 complex at 2.5 Å.

The reaction centre light-harvesting 1 (RC-LH1) complex is the core functional component of bacterial photosynthesis. We determined the cryo-electron microscopy (cryo-EM) structure of the RC-LH1 complex from Rhodospirillum rubrum at 2.5 Å resolution, which reveals a unique monomeric bacteriochlorophyll with a phospholipid ligand in the gap between the RC and LH1 complexes. The LH1 complex comprises a circular array of 16 αβ-polypeptide subunits that completely surrounds the RC, with a preferential binding site for a quinone, designated QP, on the inner face of the encircling LH1 complex. Quinols, initially generated at the RC QB site, are proposed to transiently occupy the QP site prior to traversing the LH1 barrier and diffusing to the cytochrome bc1 complex. Thus, the QP site, which is analogous to other such sites in recent cryo-EM structures of RC-LH1 complexes, likely reflects a general mechanism for exporting quinols from the RC-LH1 complex