Enterococcus faecium

Background. Cardiac surgery offers multiple treatment options for children with congenital heart defects. However, infectious complications still remain a major cause of morbidity and mortality in these patients. Mediastinitis is a detrimental complication in children undergoing cardiac surgery. The risk of mediastinitis after delayed sternal closure is up to 10%. Case Presentation. We report a case of Enterococcus faecium mediastinitis in a 4-week-old female baby on extracorporeal membrane oxygenation after Norwood procedure. Although repeated antibiotic irrigation, debridement, and aggressive antibiotic treatment were started early, the pulmonary situation deteriorated. Candida parapsilosis was isolated from bronchoalveolar lavage after pulmonary hemorrhage. Disseminated C. parapsilosis infection with pulmonary involvement was treated with liposomal amphotericin B. Subsequently, inflammatory markers increased again and eventually C. parapsilosis was isolated from the central venous catheter. Conclusion. Children undergoing delayed sternal closure have a higher risk of mediastinitis. Therefore, antibiotic prophylaxis, for example, for soft tissue infection seems justified. However, long-term antibiotic treatment is a risk factor for fungal superinfection. Antifungal treatment of disseminated C. parapsilosis infection may fail in PICU patients with nonbiological material in place due to capacity of this species to form biofilms on medical devices. Immediate removal of central venous catheters and other nonbiological material is life-saving in these patients

Suspicion of respiratory tract infection with multidrug-resistant Enterobacteriaceae: epidemiology and risk factors from a Paediatric Intensive Care Unit

Enterobacteriaceae distribution. Distribution of Enterobacteriaceae isolates (n = 167) in lower respiratory tract material, MDR (n = 51) vs susceptible (n = 116) organisms during the study period. (XLSX 14 kb

Исследование изотопной селективности процесса кристаллизации NaCl из водного раствора, находящегося в магнитном поле

Объектом исследования являются кристаллы NaCl, выращенные под воздействием постоянного магнитного поля из водного раствора. В данной работе приведены теоретическое обоснование и результаты исследований по изменению изотопного эффекта в постоянном магнитном поле при кристаллизации NaCl из водных растворов.The object of study are NaCl crystals grown under the influence of a constant magnetic field from an aqueous solution. This paper presents the theoretical justification and research results on the change in the isotope effect in a constant magnetic field during crystallization of NaCl from aqueous solutions

Повышение эффективности использования аварийно-спасательного оборудования

Объектом исследования является работа двигателей внутреннего сгорания в условиях содержания в атмосфере продуктов горения, и с низким содержанием кислорода. Система функционирования аварийно-спасательного оборудования, оснащенного двигателями внутреннего сгорания в критических условиях задымленных помещений. Цель работы – Повышение эффективности аварийно-спасательного оборудования, оснащенного двигателями внутреннего сгорания. В процессе исследования проводились натурные полигонные испытания устройства подачи воздуха в двигатель внутреннего сгорания, с составлением акта технического освидетельствования. В результате исследования поставленная цель - повышение эффективности аварийно-спасательного оборудования, оснащенного двигателями внутреннего сгорания, достигнута.The object of research is the operation of internal combustion engines under conditions of combustion products in the atmosphere and with a low oxygen content. The functioning system of emergency equipment equipped with internal combustion engines in critical conditions of smoky rooms. Purpose of work - Improving the efficiency of emergency equipment equipped with internal combustion engines. In the course of the study, field tests of the device for supplying air to the internal combustion engine were carried out, with the drawing up of an act of technical inspection. As a result of the study, the goal - to increase the efficiency of emergency equipment equipped with internal combustion engines, has been achieved

Integrative medicine during the intensive phase of chemotherapy in pediatric oncology in Germany: a randomized controlled trial with 5-year follow up

Background: Integrative medicine is used frequently alongside chemotherapy treatment in pediatric oncology, but little is known about the influence on toxicity. This German, multi-center, open-label, randomized controlled trial assessed the effects of complementary treatments on toxicity related to intensive-phase chemotherapy treatment in children aged 1-18 with the primary outcome of the toxicity sum score. Secondary outcomes were chemotherapy-related toxicity, overall and event-free survival after 5 years in study patients. Methods: Intervention and control were given standard chemotherapy according to malignancy & tumor type. The intervention arm was provided with anthroposophic supportive treatment (AST); given as anthroposophic base medication (AMP), as a base medication for all patients and additional on-demand treatment tailored to the intervention malignancy groups. The control was given no AMP. The toxicity sum score (TSS) was assessed using NCI-CTC scales. Results: Data of 288 patients could be analyzed. Analysis did not reveal any statistically significant differences between the AST and the control group for the primary endpoint or the toxicity measures (secondary endpoints). Furthermore, groups did not differ significantly in the five-year overall and event-free survival follow up. Discussion: In this trial findings showed that AST was able to be safely administered in a clinical setting, although no beneficial effects of AST between group toxicity scores, overall or event-free survival were shown

The Crowdsourced Replication Initiative: Investigating Immigration and Social Policy Preferences. Executive Report.

In an era of mass migration, social scientists, populist parties and social movements raise concerns over the future of immigration-destination societies. What impacts does this have on policy and social solidarity? Comparative cross-national research, relying mostly on secondary data, has findings in different directions. There is a threat of selective model reporting and lack of replicability. The heterogeneity of countries obscures attempts to clearly define data-generating models. P-hacking and HARKing lurk among standard research practices in this area.This project employs crowdsourcing to address these issues. It draws on replication, deliberation, meta-analysis and harnessing the power of many minds at once. The Crowdsourced Replication Initiative carries two main goals, (a) to better investigate the linkage between immigration and social policy preferences across countries, and (b) to develop crowdsourcing as a social science method. The Executive Report provides short reviews of the area of social policy preferences and immigration, and the methods and impetus behind crowdsourcing plus a description of the entire project. Three main areas of findings will appear in three papers, that are registered as PAPs or in process

interleukin-8 concentrations in plasma and lysed whole blood in newborns and those with early-onset bacterial infection

Nach wie vor zählt die neonatale bakterielle Infektion (NBI) aufgrund der hohen Morbidität und Mortalität zu den Hauptgefahren für das neugeborene Kind. IL-8 in Plasma ist ein bedeutender Parameter für die Diagnostik einer neonatalen bakteriellen Infektion, besitzt aber nur eine kurze Halbwertszeit. IL-8, in Vollblut-Lysat bestimmt, setzt sich sowohl aus freiem extrazellulären als auch aus zellgebundenen IL-8 zusammen. Ziel dieser Arbeit war, die Kinetik von IL-8 in Plasma und in Lysat bei gesunden Neugeborenen und bei Neugeborenen mit Verdacht auf NBI zu untersuchen und zu testen, ob die Bestimmung von IL-8 in Lysat eine höhere Sensitivität für die Diagnostik der NBI ermöglicht. 61 Neugeborene mit NBI konnten untersucht werden; die Kontrollgruppe bestand aus 188 Neugeborenen, die Risikofaktoren für NBI zeigten, aber nicht erkrankten. In der Kontrollgruppe fanden sich bis zu 24 Stunden nach Geburt 280-fach höhere IL-8 Konzentrationen in Lysat (9599 pg/ml; SD 4433) als in Plasma (34,2 pg/ml; 18,1). Die Sensitivität von IL-8 in Lysat versus IL-8 in Plasma für NBI betrug innerhalb der ersten 6 Lebensstunden 97% versus 71% und nach 24 Stunden 70% versus 32%. Die zugehörige Spezifität lag innerhalb der ersten 6 Lebensstunden bei 95% versus 90% und nach 24 Stunden bei 92% versus 99%. Der negativ prädiktive Wert für IL-8 in Lysat versus IL-8 in Plasma war 80% versus 66%. IL-8 in Lysat zeigte im Vergleich zu IL-8 in Plasma zum Zeitpunkt des Verdachts auf NBI eine höhere Sensitivität und blieb länger erhöht. Bei gesunden Reifgeborenen waren die IL-8 Werte in Plasma und Lysat vom Geburtsmodus abhängig. Anhand der Kinetik bei unterschiedlichen Geburtsmodi und bei Neugeborenen mit NBI schien das „IL-8-Gedächtnis“ des Pools zirka 24 Stunden zu reichen. Die IL-8-Bestimmung in Lysat bedeutet somit einen entscheidenden Vorteil im kritischen Zeitfenster einer beginnenden NBI.Background and objective: In neonatal bacterial infection (NBI), circulating interleukin-8 (IL-8 ) is a highly potent cytokine, which is bound to specific IL-8-receptors. The Duffy antigen related chemokine receptor (DARC) on the surface of erythrocytes binds IL-8 as well. Therefore, IL-8 not only is detectable in plasma, but also in lysed whole blood. Kinetics and correlations between IL-8-concentrations in healthy newborns and neonates with NBI are yet not known. Patients and methods: IL-8 concentrations in plasma and lysed EDTA blood from term neonates were detected via ELISA (Immulite). Blood was gained by venipuncture and immediately lysed. 61 neonates showed clinical and serological signs of NBI. Samples were taken by the first clinical suspicion of NBI. Other parameters (white blood cell count, differential, CRP and I/T-ratio) were evaluated. The control group (CG) consisted of 188 neonates with risk factors (e.g. premature rupture of membranes) but no signs of NBI. Results: Compared to the control group, neonates with NBI showed significantly elevated plasma IL-8 levels in the first 12 hours of infection, ranging from 80 to 250 pg/ml (vs. 10 to 45 pg/ml in the CG) and quickly declining thereafter. Lysed EDTA-blood IL-8-concentrations were found to be 100-fold higher in both groups compared to the plasma levels. We found a significant elevation up to the first 24 hours in neonates with NBI (35200pg/ml +/- 18000pg/ml vs. 93054 pg/ml +/- 4300pg/ml in the CG) which existed already at the initial blood draw. After 12 hours IL-8 plasma concentrations declined in neonates with NBI. Lysed EDTA-blood IL-8-levels still remained elevated up to 18 hours compared to the CG, implicating a broader time frame for detecting NBI via IL-8. Other evaluated parameters , including I/T-ratio initially showed no differences between the groups. Conclusion: In neonates, the detection of IL-8 in lysed EDTA-blood is an early predictor of NBI, at least comparable to plasma-levels. As compared to plasma IL-8-concentrations, IL-8 in EDTA-blood from neonates with NBI show a prolonged interval of elevation and may thereby help to widen the time-frame for detecting neonatal infection