Fecal Microbiota Transplant for Relapsing Clostridium difficile Infection Using a Frozen Inoculum From Unrelated Donors: A Randomized, Open-Label, Controlled Pilot Study

Fecal microbiota transplant is increasingly used to treat recurrent or relapsing Clostridium difficile infection. In this randomized controlled study, using a frozen inoculum from unrelated donors was safe and effective, whether administered by nasogastric tube or by colonoscopy. Background. Recurrent Clostridium difficile infection (CDI) with poor response to standard antimicrobial therapy is a growing medical concern. We aimed to investigate the outcomes of fecal microbiota transplant (FMT) for relapsing CDI using a frozen suspension from unrelated donors, comparing colonoscopic and nasogastric tube (NGT) administration. Methods. Healthy volunteer donors were screened and a frozen fecal suspension was generated. Patients with relapsing/refractory CDI were randomized to receive an infusion of donor stools by colonoscopy or NGT. The primary endpoint was clinical resolution of diarrhea without relapse after 8 weeks. The secondary endpoint was self-reported health score using standardized questionnaires. Results. A total of 20 patients were enrolled, 10 in each treatment arm. Patients had a median of 4 (range, 2–16) relapses prior to study enrollment, with 5 (range, 3–15) antibiotic treatment failures. Resolution of diarrhea was achieved in 14 patients (70%) after a single FMT (8 of 10 in the colonoscopy group and 6 of 10 in the NGT group). Five patients were retreated, with 4 obtaining cure, resulting in an overall cure rate of 90%. Daily number of bowel movements changed from a median of 7 (interquartile range [IQR], 5–10) the day prior to FMT to 2 (IQR, 1–2) after the infusion. Self-ranked health score improved significantly, from a median of 4 (IQR, 2–6) before transplant to 8 (IQR, 5–9) after transplant. No serious or unexpected adverse events occurred. Conclusions. In our initial feasibility study, FMT using a frozen inoculum from unrelated donors is effective in treating relapsing CDI. NGT administration appears to be as effective as colonoscopic administration. Clinical Trials Registration. NCT01704937.National Institute of Allergy and Infectious Diseases (U.S.) (HHSN272200900018C)

Explaining Geographical Disparities in Educational Achievement: A case Study of East London

Research is reviewed showing that the educational achievement of British school children shows marked geographical disparities, particularly between innerurban and suburban /rural areas. These disparities are linked to differences in the socioeconomic characteristics of the populations of these areas, notably social class and ethnicity, which in turn are reflected in differences in material circumstances and cultural variables. Tower Hamlets in East London is one of the most disadvantaged boroughs in England, both socioeconomically and in terms of educational achievement. The large Bangladeshi community resident in Tower Hamlets is perhaps the most deprived minority ethnie group in the country, and both they and the indigenous working class community present an enormous challenge to the education service. However a careful examination of the data on achievement reveals that the Bangladeshi pupils are achieving better than would be expected given the disadvantages they suffer. Nonetheless principles of equal opportunity require that the education service respond more adequately to the particular needs of these children. This case study demonstrates the importance of examining processes and relationships specific to each locality.Les quartiers est de Londres : contribution à l'étude des disparités géographiques dans les performances éducatives. Ce papier présente un résumé des études qui ont mis en exergue des différences régionales de scolarité en Grande-Bretagne. On observe des écarts importants entre les élèves des zones rurales ou péri-urbaines et ceux qui habitent le centre des grandes villes. Ces écarts sont liés aux caractéristiques socio-économiques de ces populations, notamment à la classe socio-professionnelle et à l'ethnicité. Ces derniers facteurs sont aussi liés aux inégalités de conditions de vie et aux caractéristiques culturelles. On peut prendre comme exemple la population des Bengalis qui habitent l'arrondissement de Tower Hamlets à Londres. C'est une des populations les plus démunies de Grande-Bretagne, ce qui est cause de difficultés pour les responsables locaux de l'éducation. En dépit de leur situation très défavorisée, les élèves bengalis réussissent mieux à l'école que prévu. Néanmoins, leur formation n'est guère optimale. Le principe d'égalité nécessite un système local d'éducation qui soit mieux adapté aux besoins spécifiques des écoliers bengalis dans ce quartier.Curtis Sarah, Pindar Sorrel C. Explaining Geographical Disparities in Educational Achievement: A case Study of East London . In: Espace, populations, sociétés, 1990-1. Scolarité et scolarisation - School intendance and schooling. pp. 99-106

Towards direct electroanalysis in seawater: understanding the role of the buffer capacity of seawater in proton-coupled electron transfer reactions

The study of electrochemical reactions in seawater requires understanding of the associated coupled chemistry with the components of seawater, especially the role of the carbonate-bicarbonate buffer system in the case of proton coupled electron transfer reactions. We report the comparative paradigmatic voltammetric response of the reversible hydrogen oxidation reaction (HOR) in the absence or presence of dibasic phosphate, formate or bicarbonate. Electrochemically and chemically reversible voltammetry is seen in aqueous 0.7 M NaCl at platinum macro-electrodes in the absence of a buffer whilst the presence of a chemically stable buffer systems, such as phosphate or formate, leads either to a cathodic shift in the oxidation potential for high buffer concentrations or to a split wave for concentrations approximately a factor of two less than the dissolved H2. In the case of bicarbonate buffer the dehydration of carbonic acid on the voltammetric timescale leads to chemically irreversible voltammetric behaviour, with a similar response measured in authentic seawater. Numerical simulations based on a simple Nernstian model with literature values for kinetic and thermodynamic parameters are reported which display excellent agreement with experiment

Pindar [electronic resource] : the Nemean and Isthmian odes : with notes explanatory and critical, intro., and introductory essays /

"Edited for the syndics of the University Press."Includes indexes.Electronic text and image data.Mode of access: Internet

Pindar /

"Anacreon. Tr. by Thomas Bourne" has special t.-p. and separate paging.Mode of access: Internet