Clinical Implications of Azole Resistance in Aspergillus fumigatus, the Netherlands, 2007-2009

Contains fulltext : 95722.pdf (publisher's version ) (Open Access)The prevalence and spread of azole resistance in clinical Aspergillus fumigatus isolates in the Netherlands are currently unknown. Therefore, we performed a prospective nationwide multicenter surveillance study to determine the effects of resistance on patient management strategies and public health. From June 2007 through January 2009, all clinical Aspergillus spp. isolates were screened for itraconazole resistance. In total, 2,062 isolates from 1,385 patients were screened; the prevalence of itraconazole resistance in A. fumigatus in our patient cohort was 5.3% (range 0.8%-9.5%). Patients with a hematologic or oncologic disease were more likely to harbor an azole-resistant isolate than were other patient groups (p<0.05). Most patients (64.0%) from whom a resistant isolate was identified were azole naive, and the case-fatality rate of patients with azole-resistant invasive aspergillosis was 88.0%. Our study found that multiazole resistance in A. fumigatus is widespread in the Netherlands and is associated with a high death rate for patients with invasive aspergillosis

Dark energy as a mirage

Motivated by the observed cosmic matter distribution, we present the following conjecture: due to the formation of voids and opaque structures, the average matter density on the path of the light from the well-observed objects changes from Omega_M ~ 1 in the homogeneous early universe to Omega_M ~ 0 in the clumpy late universe, so that the average expansion rate increases along our line of sight from EdS expansion Ht ~ 2/3 at high redshifts to free expansion Ht ~ 1 at low redshifts. To calculate the modified observable distance-redshift relations, we introduce a generalized Dyer-Roeder method that allows for two crucial physical properties of the universe: inhomogeneities in the expansion rate and the growth of the nonlinear structures. By treating the transition redshift to the void-dominated era as a free parameter, we find a phenomenological fit to the observations from the CMB anisotropy, the position of the baryon oscillation peak, the magnitude-redshift relations of type Ia supernovae, the local Hubble flow and the nucleosynthesis, resulting in a concordant model of the universe with 90% dark matter, 10% baryons, no dark energy, 15 Gyr as the age of the universe and a natural value for the transition redshift z_0=0.35. Unlike a large local void, the model respects the cosmological principle, further offering an explanation for the late onset of the perceived acceleration as a consequence of the forming nonlinear structures. Additional tests, such as quantitative predictions for angular deviations due to an anisotropic void distribution and a theoretical derivation of the model, can vindicate or falsify the interpretation that light propagation in voids is responsible for the perceived acceleration.Comment: 33 pages, 2 figs; v2: minor clarifications, results unchanged; v3: matches the version published in General Relativity and Gravitatio

Quantum magnetism in two dimensions: From semi-classical N\'eel order to magnetic disorder

This is a review of ground-state features of the s=1/2 Heisenberg antiferromagnet on two-dimensional lattices. A central issue is the interplay of lattice topology (e.g. coordination number, non-equivalent nearest-neighbor bonds, geometric frustration) and quantum fluctuations and their impact on possible long-range order. This article presents a unified summary of all 11 two-dimensional uniform Archimedean lattices which include e.g. the square, triangular and kagome lattice. We find that the ground state of the spin-1/2 Heisenberg antiferromagnet is likely to be semi-classically ordered in most cases. However, the interplay of geometric frustration and quantum fluctuations gives rise to a quantum paramagnetic ground state without semi-classical long-range order on two lattices which are precisely those among the 11 uniform Archimedean lattices with a highly degenerate ground state in the classical limit. The first one is the famous kagome lattice where many low-lying singlet excitations are known to arise in the spin gap. The second lattice is called star lattice and has a clear gap to all excitations. Modification of certain bonds leads to quantum phase transitions which are also discussed briefly. Furthermore, we discuss the magnetization process of the Heisenberg antiferromagnet on the 11 Archimedean lattices, focusing on anomalies like plateaus and a magnetization jump just below the saturation field. As an illustration we discuss the two-dimensional Shastry-Sutherland model which is used to describe SrCu2(BO3)2.Comment: This is now the complete 72-page preprint version of the 2004 review article. This version corrects two further typographic errors (three total with respect to the published version), see page 2 for detail

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

Muscle Analyzer System: Exploring Correlation Between Novel Microwave Resonator and Ultrasound-based Tissue Information in the Thigh

A microwave sensor to safely measure quality of muscle tissue for diagnosis and screening of diseases and medical conditions characterized by fat infiltration in muscle is presented. Fat infiltration in muscle may be seen by a lower dielectric constant of muscle at microwave frequencies corresponding to the large contrast between fat and muscle tissues. A planar resonator based on a bandstop filter and optimized to noninvasively interrogate muscle in the thigh on tissue quality is proposed. Currently, a study based on clinical trials is carried out, and, here, we present a preliminary correlation between skin and fat thicknesses and rectus femoris cross sectional area (CSA) measured with ultrasound and the proposed sensor's resonance frequency. CST simulations based on the ultrasound information guide the analysis. We see that although there are signs of a potential correlation between CSA and resonance, skin and fat variability is still an issue to overcome

Muscle Analyzer System: Exploring Correlation Between Novel Microwave Resonator and Ultrasound-based Tissue Information in the Thigh

A microwave sensor to safely measure quality of muscle tissue for diagnosis and screening of diseases and medical conditions characterized by fat infiltration in muscle is presented. Fat infiltration in muscle may be seen by a lower dielectric constant of muscle at microwave frequencies corresponding to the large contrast between fat and muscle tissues. A planar resonator based on a bandstop filter and optimized to noninvasively interrogate muscle in the thigh on tissue quality is proposed. Currently, a study based on clinical trials is carried out, and, here, we present a preliminary correlation between skin and fat thicknesses and rectus femoris cross sectional area (CSA) measured with ultrasound and the proposed sensor's resonance frequency. CST simulations based on the ultrasound information guide the analysis. We see that although there are signs of a potential correlation between CSA and resonance, skin and fat variability is still an issue to overcome

Helicobacter Pylori İsolation, Serology And Caga, Cage And Virb11 Detection İn Patients With Non-Ulcer Dyspepsia From Turkey: Correlation With Histopathologic Findings

Colonization with Helicobacter pylori (HP) may have major clinical consequences and HP virulence factors are associated with more severe gastroduodenal pathologies. In this study, prevalence of HP in patients with Non-Ulcer Dyspepsia (NUD) was determined by rapid urease test and culture and correlations of histopathologic changes with bacterial virulence factors and serologic profiles were investigated. Gastric biopsies from sixty-nine patients admitted to Haydarpasa Training Hospital Department of Gastroenterology were evaluated for rapid urease, HP isolation and examined histopathologically. PCR was employed for HP confirmation and detection of HP cagA, cagE and virB11 genes. For each patient, IgG and IgA antibodies and anti-cagA antibodies were also determined by ELISA tests. HID was isolated and confirmed by PCR in 74% (51/69) of the patients. Anti-HP IgG and IgA were detected in 96% (49/51) and 53% (27/51), respectively. Anti- cagA were present in 51% (26/51). cagA, cagE and virB11 were positive in 56.8% (29/51), 60.7% (31/51) and 58.8% (30/51) of the patients, respectively. Statistically significant correlation was observed between cagA PCR and inflammation/activity scores. Detection of cagA by molecular assays can be an alternative test that can be employed for individual patient assessment.WoSScopu