Bacterial infection profiles in lung cancer patients with febrile neutropenia

<p>Abstract</p> <p>Background</p> <p>The chemotherapy used to treat lung cancer causes febrile neutropenia in 10 to 40% of patients. Although most episodes are of undetermined origin, an infectious etiology can be suspected in 30% of cases. In view of the scarcity of data on lung cancer patients with febrile neutropenia, we performed a retrospective study of the microbiological characteristics of cases recorded in three medical centers in the Picardy region of northern France.</p> <p>Methods</p> <p>We analyzed the medical records of lung cancer patients with neutropenia (neutrophil count < 500/mm³) and fever (temperature > 38.3°C).</p> <p>Results</p> <p>The study included 87 lung cancer patients with febrile neutropenia (mean age: 64.2). Two thirds of the patients had metastases and half had poor performance status. Thirty-three of the 87 cases were microbiologically documented. Gram-negative bacteria (mainly enterobacteriaceae from the urinary and digestive tracts) were identified in 59% of these cases. <it>Staphylococcus </it>species (mainly <it>S. aureus</it>) accounted for a high proportion of the identified Gram-positive bacteria. Bacteremia accounted for 60% of the microbiologically documented cases of fever. 23% of the blood cultures were positive. 14% of the infections were probably hospital-acquired and 14% were caused by multidrug-resistant strains. The overall mortality rate at day 30 was 33% and the infection-related mortality rate was 16.1%. Treatment with antibiotics was successful in 82.8% of cases. In a multivariate analysis, predictive factors for treatment failure were age >60 and thrombocytopenia < 20000/mm³.</p> <p>Conclusion</p> <p>Gram-negative species were the most frequently identified bacteria in lung cancer patients with febrile neutropenia. Despite the success of antibiotic treatment and a low-risk neutropenic patient group, mortality is high in this particular population.</p

Use of Mangroves by Lemurs

Despite an increasing recognition of the ecosystem services provided by mangroves, we know little about their role in maintaining terrestrial biodiversity, including primates. Madagascar’s lemurs are a top global conservation priority with 94 % of species threatened with extinction, but records of their occurrence in mangroves are scarce. I used a mixed-methods approach to collect published and unpublished observations of lemurs in mangroves: I carried out a systematic literature search, and supplemented this with a targeted information request to 1243 researchers, conservation and tourism professionals and others who may have visited mangroves in Madagascar. I found references to, or observations of, at least 23 species in five families using mangroves, representing more than 20 % of lemur species and over 50 % of species whose distributions include mangrove areas. Lemurs used mangroves for foraging, sleeping and travelling between terrestrial forest patches, and some were observed as much as 3 km from the nearest permanently dry land. However most records were anecdotal and thus tell us little about lemur ecology in this habitat. Mangroves are more widely used by lemurs than has previously been recognised, and merit greater attention from primate researchers and conservationists in Madagascar

An in-vivo study exploring correlations between early-to-moderate disc degeneration and flexion mobility in the lumbar spine

Purpose: Early disc degeneration (DD) has been thought to be associated with loss of spine 6 stability. However, before this can be understood in relation to back pain, it is necessary to 7 know the relationship between DD and intervertebral motion in people without pain. This 8 study aimed to find out if early to moderate DD is associated with intervertebral motion in 9 people without back pain. 10 Methods: Ten pain free adults, aged 51-71 received recumbent and weight bearing MRI 11 scans and quantitative fluoroscopy (QF) screenings during recumbent and upright lumbar 12 flexion. Forty individual level and 10 composite (L2-S1) radiographic and MRI DD gradings 13 were recorded and correlated with intervertebral flexion ROM, translation, laxity, and 14 motion sharing inequality and variability for both positions. 15 Results: Kinematic values were similar to previous control studies. DD was evidenced up to 16 moderate levels by both radiographic and MRI grading. Disc height loss correlated slightly, 17 but negatively with flexion during weight bearing flexion (R=-0.356, p=0.0.025). Composite 18 MRI DD and T2 signal loss evidenced similar relationships (R= -0.305, R= -0.267) but did not 19 reach statistical significance (p=0.056, p=0.096). No significant relationships between any 20 other kinematic variables and DD were found. 21 Conclusion: This study found only small, indefinite associations between early-to-moderate 22 DD and intervertebral motion in healthy controls. Motion sharing in the absence of pain 23 was also not related to early DD, consistent with previous control studies. Further research 24 is needed to investigate these relationships in patients. 25 Key words: back pain, disc degeneration, instability, imagin