Sepsis in previously healthy neonates discharged home after delivery in Soweto, South Africa

Background. There is a paucity of data on the aetiology of neonatal sepsis in sub-Saharan Africa.Objectives. To investigate the incidence, aetiology and outcomes of physician-diagnosed sepsis in hospitalised neonates who had previously been discharged home after delivery in Soweto, South Africa.Methods. A retrospective review using data abstracted from clinical and laboratory databases identified physician-diagnosed sepsis cases in neonates admitted to the general paediatric wards at Chris Hani Baragwanath Academic Hospital from January 2015 to September 2016. Neonates with physician-diagnosed sepsis were categorised into two groups based on putative pathogens recovered from blood and/or cerebrospinal fluid specimens: (i) culture-confirmed sepsis; and (ii) culture-negative sepsis.Results. Of 1 826 neonatal admissions, 1 025 (56.2%) had physician-diagnosed sepsis: 166 (16.2%) with culture-confirmed sepsis and 859 (83.8%) with culture-negative neonatal sepsis. The commonest pathogens causing culture-confirmed neonatal sepsis were Streptococcus viridans (n=53; 26.5%), S. agalactiae (n=38; 19.0%), and Staphylococcus aureus (n=25; 12.5%). The case fatality rates for culture-confirmed sepsis and culture-negative sepsis were 10.8% (18/166) and 2.6% (22/859), respectively. The odds of death occurring during hospitalisation was 10-fold (95% confidence interval 3.7 - 26.9) higher in neonates with culture-confirmed sepsis compared with culture-negative sepsis.Conclusions. In our setting, physician-diagnosed sepsis represents a huge disease burden in previously healthy neonates hospitalised from home. Most sepsis cases were attributed to S. viridans, S. agalactiae and S. aureus

Potassium currents in the heart: functional roles in repolarization, arrhythmia and therapeutics

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Complex electrophysiological remodeling in postinfarction ischemic heart failure

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Detection of Multi-TeV Gamma Rays from Markarian 501 during an Unforeseen Flaring State in 1997 with the Tibet Air Shower Array

In 1997, the BL Lac Object Mrk 501 entered a very active phase and was the brightest source in the sky at TeV energies, showing strong and frequent flaring. Using the data obtained with a high density air shower array that has been operating successfully at Yangbajing in Tibet since 1996, we searched for gamma-ray signals from this source during the period from February through August in 1997. Our observation detected multi-TeV $\gamma$-ray signals at the 3.7-Sigma level during this period. The most rapid increase of the excess counts was observed between April 7 and June 16 and the statistical significance of the excess counts in this period was 4.7-Sigma. Among several observations of flaring TeV gamma-rays from Mrk 501 in 1997, this is the only observation using a conventional air shower array. We present the energy spectrum of gamma-rays which will be worthy to compare with those obtained by imaging atmospheric Cerenkov telescopes.Comment: 9 pages, 7 figures, To appear in Ap

Observation of Multi-Tev Gamma Rays from the Crab Nebula Using the Tibet Air Shower Array

The Tibet experiment, operating at Yangbajing (4,300 m above sea level), is the lowest energy air shower array and the new high density array constructed in 1996 has sensitivity to $\gamma$-ray air showers at energies as low as 3 TeV. With this new array, the Crab Nebula was observed in multi-TeV $\gamma$-rays and a signal was detected at the 5.5 $\sigma$ level. We also obtained the energy spectrum of $\gamma$-rays in the energy region above 3 TeV which partially overlaps those observed with imaging atmospheric Cherenkov telescopes. This is the first observation of $\gamma$-ray signals from point sources with a conventional air shower array using scintillation detectors.Comment: 9 pages, 4 figures, Accepted for publication in ApJ Letter

Primary proton spectrum between 200 TeV and 1000 TeV observed with the Tibet burst detector and air shower array

Since 1996, a hybrid experiment consisting of the emulsion chamber and burst detector array and the Tibet-II air-shower array has been operated at Yangbajing (4300 m above sea level, 606 g/cm^2) in Tibet. This experiment can detect air-shower cores, called as burst events, accompanied by air showers in excess of about 100 TeV. We observed about 4300 burst events accompanied by air showers during 690 days of operation and selected 820 proton-induced events with its primary energy above 200 TeV using a neural network method. Using this data set, we obtained the energy spectrum of primary protons in the energy range from 200 to 1000 TeV. The differential energy spectrum obtained in this energy region can be fitted by a power law with the index of -2.97 $\pm$ 0.06, which is steeper than that obtained by direct measurements at lower energies. We also obtained the energy spectrum of helium nuclei at particle energies around 1000 TeV.Comment: 25 pages, 22 figures, Accepted for publication in Phys. Rev.

Observation of Multi-Tev Diffuse Gamma Rays from the Galactic Plane with the Tibet Air Shower Array

Data from the Tibet-III air shower array (with energies around 3 TeV) and from the Tibet-II array (with energies around 10 TeV) have been searched for diffuse gamma rays from the Galactic plane. These arrays have an angular resolution of about 0.9 degrees. The sky regions searched are the inner Galaxy, 20 degrees <= l <= 55 degrees, and outer Galaxy, 140 degrees <= l <= 225 degrees, and |b| <= 2 degrees or <= 5 degrees. No significant Galactic plane gamma-ray excess was observed. The 99% confidence level upper limits for gamma-ray intensity obtained are (for |b| <= 2 degrees) 1.1 times 10^{-15} cm^{-2}s^{-1}sr^{-1}MeV^{-1} at 3 TeV and 4.1 times 10^{-17} cm^{-2}s^{-1}sr^{-1}MeV^{-1} at 10 TeV for the inner Galaxy, and 3.6 times 10^{-16} cm^{-2}s^{-1}sr^{-1}MeV^{-1} at 3 TeV and 1.3 times 10^{-17} cm^{-2}s^{-1}sr^{-1}MeV^{-1} at 10 TeV for the outer Galaxy, assuming a differential spectral index of 2.4. The upper limits are significant in the multi-TeV region when compared to those from Cherenkov telescopes in the lower energy region and other air shower arrays in the higher energy region; however, the results are not sufficient to rule out the inverse Compton model with a source electron spectral index of 2.0.Comment: 22 pages, 8 figures, Accepted for publication in Ap

Deranged sodium to sudden death

In February 2014, a group of scientists convened as part of the University of California Davis Cardiovascular Symposium to bring together experimental and mathematical modelling perspectives and discuss points of consensus and controversy on the topic of sodium in the heart. This paper summarizes the topics of presentation and discussion from the symposium, with a focus on the role of aberrant sodium channels and abnormal sodium homeostasis in cardiac arrhythmias and pharmacotherapy from the subcellular scale to the whole heart. Two following papers focus on Na⁺ channel structure, function and regulation, and Na⁺/Ca²⁺ exchange and Na⁺/K⁺ ATPase. The UC Davis Cardiovascular Symposium is a biannual event that aims to bring together leading experts in subfields of cardiovascular biomedicine to focus on topics of importance to the field. The focus on Na⁺ in the 2014 symposium stemmed from the multitude of recent studies that point to the importance of maintaining Na⁺ homeostasis in the heart, as disruption of homeostatic processes are increasingly identified in cardiac disease states. Understanding how disruption in cardiac Na⁺-based processes leads to derangement in multiple cardiac components at the level of the cell and to then connect these perturbations to emergent behaviour in the heart to cause disease is a critical area of research. The ubiquity of disruption of Na⁺ channels and Na⁺ homeostasis in cardiac disorders of excitability and mechanics emphasizes the importance of a fundamental understanding of the associated mechanisms and disease processes to ultimately reveal new targets for human therapy.Centro de Investigaciones Cardiovasculare