Fieber, Husten und Dyspnoe bei einer nierentransplantierten 38-jährigen Patientin

Zusammenfassung: Eine 38-jährige nierentransplantierte Patientin stellte sich mit Fieber, Husten und Dyspnoe vor. Sie stand unter Immunsuppression mit Mycophenolat und Prednison. Aufgrund der Klinik wurde bei Nachweis pulmonaler Infiltrate die Diagnose einer ambulant erworbenen Pneumonie gestellt und eine antibiotische Therapie begonnen. Bei klinischer Verschlechterung musste die Patientin auf die Intensivstation verlegt werden. Trotz antibiotischer Therapie verbesserte sich der Zustand kaum. Im Verlauf wurde eine bronchoalveoläre Lavage durchgeführt, in der das Parainfluenza-1-Virus nachgewiesen werden konnte. Infektionen mit respiratorischen Viren können bei immunsupprimierten Patienten schwer verlaufen und gehen mit einer hohen Mortalität einher. Humane Parainfluenza-Viren sind die dritthäufigsten Erreger viraler Pneumonien. Molekulargenetische Nachweismethoden ermöglichen eine schnelle und sensitive Diagnostik an respiratorischen Materialien. Da die therapeutischen Möglichkeiten limitiert sind, kommt prophylaktischen Maßnahmen eine besondere Bedeutung z

An empirical temperature calibration for the Delta a photometric system. II. The A-type and mid F-type star

With the Delta a photometric system, it is possible to study very distant galactic and even extragalactic clusters with a high level of accuracy. This can be done with a classical color-magnitude diagram and appropriate isochrones. The new calibration presented in this paper is a powerful extension. For open clusters, the reddening is straightforward for an estimation via Isochrone fitting and is needed in order to calculate the reddening-free, temperature sensitive, index (g1-y)0. As a last step, the calibration can be applied to individual stars. Because no a-priori reddening-free photometric parameters are available for the investigated spectral range, we have applied the dereddening calibrations of the Stromgren uvbybeta system and compared them with extinction models for the Milky Way. As expected from the sample of bright stars, the extinction is negligible for almost all objects. As a next step, already established calibrations within the Stromgren uvbybeta, Geneva 7-color, and Johnson UBV systems were applied to a sample of 282 normal stars to derive a polynomial fit of the third degree for the averaged effective temperatures to the individual (g1-y)0 values with a mean of the error for the whole sample of Delta T(eff) is 134K, which is lower than the value in Paper I for hotter stars. No statistically significant effect of the rotational velocity on the precision of the calibration was found.Comment: 5 pages, 2 figures, accepted by A&

Acute traumatic aortic rupture: early stent-graft repair

Objective: Prospective evaluation of early stent-graft repair of acute traumatic aortic rupture. Methods: Twelve patients with acute traumatic aortic rupture of the descending aorta, out of a series of 337 endovascular aortic procedures, were treated by implantation of self-expanding stent-grafts. The procedures were performed within a mean post-injury time-period of 5±7 days (median: 1 day). The feasibility of stent-grafting was assessed by CT scanning and echography. Implantation was performed under local (n=6), or general anesthesia (n=6) if patients were already intubated (n=5) or required a common iliac artery access (n=1). Results: The immediate technical success rate was 100%. There were no post-procedure complications in all but one patient, who died 12 h postoperatively (8% mortality). Complete sealing of the aortic rupture in the remaining 11 patients was confirmed by postoperative CT scans. There were no intervention-related morbidity or mortality during the mean follow-up of 17 months. One patient with peri-graft leakage was successfully repaired with an additional stent-graft 12 months postoperatively. Conclusion: Non-delayed or early stent-grafting in acute traumatic rupture of the descending aorta is feasible. This technique seems to be a valuable option, in particular when associated lesions may interfere with the surgical outcome. Immediate post-procedural CT scanning and/or echography should be performed, in order to rule out residual leakag

Heart rate variability in association with frequent use of household sprays and scented products in SAPALDIA

Background: Household cleaning products are associated with adverse respiratory health outcomes, but the cardiovascular health effects are largely unknown.Objective: We determined if long-term use of household sprays and scented products at home was associated with reduced heart rate variability (HRV), a marker of autonomic cardiac dysfunction.Methods: We recorded 24-hr electrocardiograms in a cross-sectional survey of 581 Swiss adults, 1, 1-3, or 4-7 days/week, unexposed (reference)] of using cleaning sprays, air freshening sprays, and scented products.Results: Decreases in 24-hr SDNN and TP were observed with frequent use of all product types, but the strongest reductions were associated with air freshening sprays. Compared with unexposed participants, we found that using air freshening sprays 4-7 days/week was associated with 11% [95% confidence interval (CI): -20%, -2%] and 29% (95% CI: -46%, -8%) decreases in 24-hr SDNN and TP, respectively. Inverse associations of 24-SDNN and TP with increased use of cleaning sprays, air freshening sprays, and scented products were observed mainly in participants with obstructive lung disease (p > 0.05 for interactions).Conclusions: In predominantly older adult women, long-term frequent use of household spray and scented products was associated with reduced HRV, which suggests an increased risk of cardiovascular health hazards. People with preexisting pulmonary conditions may be more susceptibl

On the formation and evolution of magnetic chemically peculiar stars in the solar neighborhood

In order to put strict observational constraints on the evolutionary status of the magnetic chemically peculiar stars (CP2) of the upper main sequence, we have investigated a well established sample of galactic field CP2 objects within a radius of 200pc from the Sun in the (X,Y) plane. In total, 182 stars with accurate parallax measurements from the Hipparcos satellite were divided into Si, SiCr and SrCrEu subgroups based on classification resolution data from the literature. Primarily, it was investigated if the CP2 phenomenon occurs at very early stages of the stellar evolution, significantly before these stars reach 30% of their life-time on the main sequence. This result is especially important for theories dealing with stellar dynamos, angular momentum loss during the pre- as well as main sequence and stellar evolutionary codes for CP2 stars. For the calibration of the chosen sample, the well-developed framework of the Geneva 7-color and Stromgren uvbybeta photometric system was used. We are able to show that the CP2 phenomenon occurs continuously at the zero age main sequence for masses between 1.5 and 4.5M(sun}. The magnetic field strengths do not vary significantly during the evolution towards the terminal age main sequence. Only the effective temperature and magnetic field strength seem to determine the kind of peculiarity for those stars. We found several effects during the evolution of CP2 stars at the main sequence, i.e. there are two "critical" temperatures where severe changes take place. There is a transition between Si, SiCr and SrCrEu stars at 10000K whereas a significant decrease to almost zero of evolved SrCrEu objects with masses below 2.25M(sun) at 8000K occurs.Comment: 7 pages, 4 figures, accepted by A&

Health impact assessment of transport policies in Rotterdam:Decrease of total traffic and increase of electric car use

BACKGROUND: Green house gas (GHG) mitigation policies can be evaluated by showing their co-benefits to health.METHOD: Health Impact Assessment (HIA) was used to quantify co-benefits of GHG mitigation policies in Rotterdam. The effects of two separate interventions (10% reduction of private vehicle kilometers and a share of 50% electric-powered private vehicle kilometers) on particulate matter (PM2.5), elemental carbon (EC) and noise (engine noise and tyre noise) were assessed using Years of Life Lost (YLL) and Years Lived with Disability (YLD). The baseline was 2010 and the end of the assessment 2020.RESULTS: The intervention aimed at reducing traffic is associated with a decreased exposure to noise resulting in a reduction of 21 (confidence interval (CI): 11-129) YLDs due to annoyance and 35 (CI: 20-51) YLDs due to sleep disturbance for the population per year. The effects of 50% electric-powered car use are slightly higher with a reduction of 26 (CI: 13-116) and 41 (CI: 24-60) YLDs, respectively. The two interventions have marginal effects on air pollution, because already implemented traffic policies will reduce PM2.5 and EC by around 40% and 60% respectively, from 2010 to 2020.DISCUSSION: The evaluation of planned interventions, related to climate change policies, targeting only the transport sector can result in small co-benefits for health, if the analysis is limited to air pollution and noise. This urges to expand the analysis by including other impacts, e.g. physical activity and well-being, as a necessary step to better understanding consequences of interventions and carefully orienting resources useful to build knowledge to improve public health.</p

Comprehensive study of the magnetic stars HD 5797 and HD 40711 with large chromium and iron overabundances

We present the results of a comprehensive study of the chemically peculiar stars HD 5797 and HD 40711. The stars have the same effective temperature, Teff = 8900 K, and a similar chemical composition with large iron (+1.5 dex) and chromium (+3 dex) overabundances compared to the Sun. The overabundance of rare-earth elements typically reaches +3 dex. We have measured the magnetic field of HD 5797. The longitudinal field component Be has been found to vary sinusoidally between -100 and +1000 G with a period of 69 days. Our estimate of the evolutionary status of the stars suggests that HD 5797 and HD 40711, old objects with an age t \approx 5 \times 108 yr, are near the end of the core hydrogen burning phase.Comment: 26 pages, 5 Encapsulated Postscript figure

Multiple air pollutants exposure and leukaemia incidence in Tehran, Iran from 2010 to 2016: a retrospective cohort study

OBJECTIVE: Leukaemia is one of the most common cancers and may be associated with exposure to environmental carcinogens, especially outdoor air pollutants. The objective of this study was to investigate the association of ambient air pollution and leukaemia in Tehran, Iran. DESIGN: In this retrospective cohort study, data about the residential district of leukaemia cases diagnosed from 2010 to 2016 were inquired from the Ministry of Health cancer database. Data from a previous study were used to determine long-term average exposure to different air pollutants in 22 districts of Tehran. Latent profile analysis (LPA) was used to classify pollutants in two exposure profiles. The association between air pollutants and leukaemia incidence was analysed by negative binomial regression. SETTING: Twenty-two districts of Tehran megacity. PARTICIPANTS: Patients with leukaemia. OUTCOME MEASURES: The outcome variables were incidence rate ratios (IRR) of acute myeloid and lymphoid leukaemia across the districts of Tehran. RESULTS: The districts with higher concentrations for all pollutants were near the city centre. The IRR was positive but non-significant for most of the air pollutants. However, annual mean NOx was directly and significantly associated with total leukaemia incidence in the fully adjusted model (IRR (95% CI): 1.03 (1.003 to 1.06) per 10 ppb increase). Based on LPA, districts with a higher multiple air-pollutants profile were also associated with higher leukaemia incidence (IRR (95% CI): 1.003 (0.99 to 1.007) per 1 ppb increase). CONCLUSIONS: Our study shows that districts with higher air pollution (nitrogen oxides and multipollutants) have higher incidence rates of leukaemia in Tehran, Iran. This study warrants conducting further research with individual human data and better control of confounding

Lambda Boo stars with composite spectra

We examine the large sample of lambda Boo candidates collected in Table 1 of Gerbaldi et al. (2003) to see how many of them show composite spectra. Of the 132 lambda Boo candidates we identify 22 which definitely show composite spectra and 15 more for which there are good reasons to suspect a composite spectrum. The percentage of lambda Boo candidates with composite spectra is therefore > 17 and possibly considerably higher. For such stars the lambda Boo classification should be reconsidered taking into account the fact that their spectra are composite. We argue that some of the underabundances reported in the literature may simply be the result of the failure to consider the composite nature of the spectra. This leads to the legitimate suspicion that some, if not all, the lambda Boo candidates are not chemically peculiar at all. A thorough analysis of even a single one of the lambda Boo candidates with composite spectra, in which the composite nature of the spectrum is duly considered, which would demonstrate that the chemical peculiarities persist, would clear the doubt we presently have that the stars with composite spectra may not be lambda Boo at all.Comment: Accepted for publication by A&A on June 3rd 200

Acute traumatic aortic rupture: early stent-graft repair

Objective: Prospective evaluation of early stent-graft repair of acute traumatic aortic rupture. Methods: Twelve patients with acute traumatic aortic rupture of the descending aorta, out of a series of 337 endovascular aortic procedures, were treated by implantation of self-expanding stent-grafts. The procedures were performed within a mean post-injury time-period of 5±7 days (median: 1 day). The feasibility of stent-grafting was assessed by CT scanning and echography. Implantation was performed under local (n=6), or general anesthesia (n=6) if patients were already intubated (n=5) or required a common iliac artery access (n=1). Results: The immediate technical success rate was 100%. There were no post-procedure complications in all but one patient, who died 12 h postoperatively (8% mortality). Complete sealing of the aortic rupture in the remaining 11 patients was confirmed by postoperative CT scans. There were no intervention-related morbidity or mortality during the mean follow-up of 17 months. One patient with peri-graft leakage was successfully repaired with an additional stent-graft 12 months postoperatively. Conclusion: Non-delayed or early stent-grafting in acute traumatic rupture of the descending aorta is feasible. This technique seems to be a valuable option, in particular when associated lesions may interfere with the surgical outcome. Immediate post-procedural CT scanning and/or echography should be performed, in order to rule out residual leakag