Competition between and

Syftet med denna litteraturstudie var att beskriva behov av information och stöd hos kvinnor med bröstcancer. Metoden som användes var en litteraturstudie och inkluderade både kvalitativa och kvantitativa artiklar. Tio studier inkluderades och resultatet presenterades i tre huvudkategorier: Information, stöd och sjuksköterskans uppfattning om behov av information och stöd, detta behov måste identifieras individuellt efter varje kvinna med bröstcancer. Dessa kvinnor uppskattade information om möjligheten att bli botad, behandlingsalternativ samt recidiv. Yngre kvinnor hade större behov av information om sexualitet än äldre. Detta informationsbehov beräknades ändå som mindre viktigt av alla kvinnor med bröstcancer oberoende av ålder. Det var många studier som visade samma resultat att kvinnor med bröstcancer har stort behov av information och stöd. Resultatet av litteraturstudien kan ge sjuksköterskorna ökad förståelse om vilka behov av information och stöd kvinnor med bröstcancer har. Ökad medvetenhet om dessa behov kan ligga till grund för en god omvårdnad.The aim of this study was to describe the need for information and support in women with breast cancer. The method used is a literature study with both of qualitative and quantitative articles. Ten studies were included and the results were presented in three main categories: information, support, and the nurse's perception of the need for information and support, this need must be identified individually by each woman with breast cancer. These women appreciated the information about chances of cure, treatment and recurrence. Young women had a greater need for information about sexuality than older. This information was calculated, however, as less important for all women with breast cancer regardless of age. There were many studies that showed the same results that women with breast cancer have great need for information and support. The results of the literature study can give nurses greater understanding of the needs for information and support women with breast cancer have. Increased awareness of these needs can be the basis for good care

Competition between Burkholderia pseudomallei and B. thailandensis.

BACKGROUND: Burkholderia pseudomallei is a Gram-negative bacterium that causes melioidosis, an often fatal disease in tropical countries. Burkholderia thailandensis is a non-virulent but closely related species. Both species are soil saprophytes but are almost never isolated together. RESULTS: We identified two mechanisms by which B. pseudomallei affects the growth of B. thailandensis. First, we found that six different isolates of B. pseudomallei inhibited the growth of B. thailandensis on LB agar plates. Second, our results indicated that 55% of isolated strains of B. pseudomallei produced a secreted compound that inhibited the motility but not the viability of B. thailandensis. Analysis showed that the active compound was a pH-sensitive and heat-labile compound, likely a protein, which may affect flagella processing or facilitate their degradation. Analysis of bacterial sequence types (STs) demonstrated an association between this and motility inhibition. The active compound was produced from B. pseudomallei during the stationary growth phase. CONCLUSION: Taken together, our results indicate that B. pseudomallei inhibits both the growth and motility of its close relative B. thailandensis. The latter phenomenon appears to occur via a previously unreported mechanism involving flagellar processing or degradation

Patient Characteristics, Management, and Predictors of Outcome from Severe Community-Onset Staphylococcal Sepsis in Northeast Thailand: A Prospective Multicenter Study.

AbstractStaphylococcus aureus infection is a persistent threat in resource-restricted settings in southeast Asia but informative data about this disease remain limited. We analyzed characteristics, management, and predictors of outcome in severely septic patients with community-onset S. aureus infection in northeast Thailand. We performed a prospective, multicenter observational cohort study of community-onset S. aureus sepsis in four referral hospitals recruiting patients at least 14 years of age admitted between March 2010 and December 2013. One hundred and nineteen patients with severe staphylococcal sepsis were enrolled. Diabetes was the most common underlying condition. Methicillin-resistant infection was rare. Twenty-eight-day mortality was 20%. Ninety-two percent of patients received appropriate antibiotic therapy and 82% were administered intravenous fluids on the first hospital day, although only 14% were managed in an intensive care unit (ICU). On univariable analysis, clinical variables at enrollment significantly associated with death at 28 days were coagulopathy or respiratory failure. Plasma interleukin (IL)-8 concentration alone accurately predicted mortality (area under the receiver operating curve = 0.82, 95% confidence interval = 0.73-0.90). In multivariable analysis, addition of IL-8 concentration to a mortality prediction model containing clinical variables further improved the predictive ability of the model. We conclude that severe staphylococcal sepsis in northeast Thailand causes significant mortality. Diabetes is a common preexisting condition and most patients are managed outside the ICU even if they receive vasoactive/inotropic agents or mechanical ventilation. While clinical factors apparent on presentation including coagulopathy and respiratory failure predict death, plasma IL-8 improves this prediction

Survival of Burkholderia pseudomallei in distilled water for 16 years

Burkholderia pseudomallei was examined after being maintained in distilled water at 25 °C for 16 years. The Gram stain was atypical (pale pink cocci or coccobacilli). The estimated number of live and dead B. pseudomallei was 3.8 × 107 cells/ml and 1.4 × 105 cells/ml, respectively. A colony count on agar of 1.0 × 106 cfu/ml suggested that a proportion of cells were in a viable but non-culturable state. Colony morphology was different from the parental isolate for 84% of colonies. Pulsed-field gel electrophoresis analysis of AvrII DNA restriction fragments revealed six different but related banding patterns, which may represent genomic rearrangement

Evaluation of Polysaccharide-Based Latex Agglutination Assays for the Rapid Detection of Antibodies to Burkholderia pseudomallei.

Melioidosis is a severe disease caused by the Gram-negative bacterium Burkholderia pseudomallei. Diagnosis of melioidosis currently relies on the isolation of B. pseudomallei from clinical samples, which can take several days. An indirect hemagglutination assay (IHA) is widely used for serodiagnosis, but it has a short shelf life, is poorly standardized, and requires a viable bacteria culture performed in a biosafety level 3 (BSL-3) laboratory. To improve the diagnostic methods, we have developed two rapid latex agglutination tests based on purified B. pseudomallei O-polysaccharide (OPS) and capsular polysaccharide (CPS) antigens. The immunodiagnostic potential of these tests was evaluated using serum from culture-confirmed melioidosis patients (N = 143) and healthy donors from either endemic (N = 199) or non-endemic areas (N = 90). The sensitivity of the OPS-based latex agglutination assay (OPS-latex; 84.4%) was significantly higher than both the CPS-latex (69.5%) (P \u3c 0.001) and IHA (69.5%) (P = 0.001). When evaluated with Thai donor serum, the OPS-latex had comparable specificity (56.9%) to the CPS-latex (63.8%) (P = 0.053), but was significantly lower than the IHA (67.6%) (P = 0.002). In contrast, all tests with U.S. donor serum were highly specific (≥ 97.8%). These results suggest that polysaccharide-based latex agglutination assays may be useful for serodiagnosis of melioidosis in non-endemic areas

Colony morphology variation of Burkholderia pseudomallei is associated with antigenic variation and O-polysaccharide modifications

This work was supported by the Thailand Research Fund (grantTRG5580004), the Wellcome Trust, United Kingdom, and the Department of Energy-funded Center for Plant and Microbial Complex Carbohydrates (grant DE-FG09-93ER-20097). N.C. was supported by the Wellcome Trust (grant 087769/Z/08/Z).Burkholderia pseudomallei is a CDC Tier 1 select agent that causes melioidosis, a severe disease in humans and animals. Persistent infections are common and there is currently no vaccine available. Lipopolysaccharide (LPS) is a potential vaccine candidate. B. pseudomallei expresses three serologically distinct LPS types. The predominant O-polysaccharide (OPS) is an unbranched heteropolymer with repeating d-glucose and 6-deoxy-l-talose residues in which the 6-deoxy-l-talose residues are variably substituted with O-acetyl and O-methyl modifications. We observed that primary clinical B. pseudomallei isolates with mucoid and non-mucoid colony morphologies from the same sample expressed different antigenic types distinguishable using a LPS-specific monoclonal antibody (Mab). Mab reactive (non-mucoid) and non-reactive (mucoid) strains from the same patient exhibited identical LPS banding patterns by silver staining and indistinguishable genotypes. We hypothesized that LPS antigenic variation reflected modification of the OPS moieties. Mutagenesis of three genes involved in LPS synthesis was performed in B. pseudomallei K96243. Loss of Mab reactivity was observed in both wbiA (encoding a 2-O-acetyltransferase) and wbiD (putative methyl transferase) mutants. The structural characteristics of the OPS moieties from isogenic non-mucoid strain 4095a and mucoid strain 4095c were further investigated. Utilizing NMR spectroscopy, we found that B. pseudomallei 4095a and 4095c OPS antigens exhibited substitution patterns that differed from the prototypic OPS structure. Specifically, 4095a lacked 4-O-acetylation while 4095c lacked both 4-O-acetylation and 2-O-methylation. Our studies indicate that B. pseudomallei OPS undergoes antigenic variation and suggest that the 9D5 Mab recognizes a conformational epitope that is influenced by both O-acetyl and O-methyl substitution patterns.PostprintPeer reviewe