Trends in ExPEC serogroups in the UK and their significance

We thank the British Society for Antimicrobial Chemotherapy for kindly providing E. coli bloodstream isolates from the BSAC Bacteraemia Resistance Surveillance Programme (2011), and all the staff at PHE’s Gastrointestinal Bacteria Reference Unit for their guidance and patience during the serogrouping process. This work was performed as part of a PhD study funded by PHE

Managing urinary tract infections

Urinary tract infections (UTI) are common in childhood. Presence of pyuria and bacteriuria in an appropriately collected urine sample are diagnostic of UTI. The risk of UTI is increased with an underlying urological abnormality such as vesicoureteral reflux, constipation, and voiding dysfunction. Patients with acute pyelonephritis are at risk of renal scarring and subsequent complications such as hypertension, proteinuria with and without FSGS, pregnancy-related complications and even end-stage renal failure. The relevance and the sequence of the renal imaging following initial UTI, and the role of antimicrobial prophylaxis and surgical intervention are currently undergoing an intense debate. Prompt treatment of UTI and appropriate follow-up of those at increased risk of recurrence and/or renal scarring are important

Curriculare Lehre für Studierende der Humanmedizin in einer Schwerpunktpraxis für Hämatologie und Onkologie 2010-2022

Aim: For several years now, medical students have also been taught general practice at academic medical teaching practices. Specialty practices have not yet been included in the curricular education. Since 1998, we have conducted a block seminar in hematology twice per semester for eighth-semester medical students. This block seminar was offered from 1998-2001 to students at the Philipps University in Marburg and since 2001 to students at the Johannes Gutenberg University in Mainz. Since 2010 our block seminar has been part of the curriculum at the Johannes Gutenberg University.Method: Standardized course evaluation by students who had attended our block seminar between January 2010 and March 2022. Courses that were held virtually due to corona were not included in the analysis. The questionnaire used to evaluate courses in the medical degree program at the Johannes Gutenberg University served as the evaluation instrument.Results: Since 1998 more than 1,000 students have attended our seminar. The systematic evaluation of the course by 500 students who participated in the curricular, classroom-based seminar sessions since 2010 shows that the highest ratings possible are given for practical relevance, learning atmosphere, teaching and effectiveness.Conclusion: High quality in teaching curricular courses to medical students at a specialty practice is possible. Insights into the possibilities connected with working in the outpatient setting at a medical practice broadens students' experience. This teaching format facilitates external university instructors in terms of teaching and, at the same time, relieves the university in terms of staff and financial budget.Zielsetzung: Die Ausbildung von Studierenden der Humanmedizin im Fach Allgemeinmedizin geschieht seit einigen Jahren auch in akademischen Lehrpraxen. Facharztpraxen sind bisher nicht an der curricularen Lehre beteiligt. Seit 1998 führen wir in unserer Gemeinschaftspraxis zweimal pro Semester ein Blockpraktikum Hämatologie für Studierende der Humanmedizin im 8. Fachsemester durch. Das Blockpraktikum wurde von 1998-2001 für Studierende der Philipps-Universität Marburg und seit 2001 für Studierende der Johannes-Gutenberg-Universität Mainz angeboten. Seit 2010 ist unser Blockpraktikum Teil der curricularen Lehre der Johannes-Gutenberg-Universität Mainz.Methodik: Standardisierte Evaluation der akademischen Lehre durch die Studierenden, die im Zeitraum 01/2010-03/2022 an unserem Blockpraktikum teilgenommen haben. Veranstaltungen, die coronabedingt in virtueller Form stattfanden, wurden in der Analyse nicht berücksichtigt. Als Evaluationsinstrument diente der Fragebogen zur Evaluation der Lehre des Fachbereichs Medizin der Universität Mainz.Ergebnisse: Seit 1998 haben mehr als 1.000 Studierende an unseren Seminaren teilgenommen. Die systematische Evaluation des Unterrichts durch 500 Studierende, die an den curricularen Präsenzveranstaltungen seit 2010 teilgenommen haben, ergibt Bestnoten für Praxisrelevanz, Unterrichtsatmosphäre, Didaktik und Effektivität.Schlussfolgerung: Die curriculare Lehre von Studierenden der Humanmedizin in einer Facharztpraxis ist auf hohem Qualitätsniveau möglich. Einblicke in die Möglichkeiten des ärztlichen Arbeitens im niedergelassenen Bereich erweitern den studentischen Erfahrungshorizont. Durch dieses Lehrmodell wird externen Hochschuldozenten der Unterricht erleichtert, gleichzeitig kann die Universität personell und finanziell entlastet werden

Moderate hypothermia during cardiopulmonary bypass reduces myocardial cell damage and myocardial cell death related to cardiac surgery.

OBJECTIVES: The goal of this study was to test the hypothesis that moderate hypothermia during cardiopulmonary bypass (CPB) provides myocardial protection by enhancing intra-myocardial anti-inflammatory cytokine balance. BACKGROUND: Moderate hypothermia during experimental CPB stimulates production of interleukin-10 (IL10) and blunts release of tumor necrosis factor-alpha (TNFalpha). METHODS: Twelve young pigs were assigned to a temperature (T degrees ) regimen during CPB: moderate hypothermia (T degrees : 28 degrees C; n = 6) and normothermia (T degrees : 37 degrees C; n = 6). Intra-myocardial TNFalpha- and IL10-messenger RNA were detected by competitive reverse transcriptase polymerase chain reaction and quantification of cytokine synthesis by Western blot. Levels of cardiac troponin I (cTnI) in cardiac lymph and in arterial and coronary venous blood were examined during and after CPB. Myocardial cell damage was assessed by histologic and ultrastructural anomalies of tissue probes taken 6 h after CPB. RESULTS: Synthesis of IL10 was significantly higher, while that of TNFalpha was significantly lower, in pigs that were in moderate hypothermia during surgery than in the others. In contrast with normothermia, moderate hypothermia was also associated with significantly lower cumulative cardiac lymphatic flow during and after CPB, significantly lower lymphatic cTnI concentrations after CPB, significantly lower percentages of myocardial cell necrosis and a significantly lower score of ultrastructural anomalies of myocardial cells. While the percentage of apoptotic cells was not different between groups, the apoptosis/necrosis ratio tended to be higher in animals that were in moderate hypothermia during surgery. In all animals, TNFalpha synthesis correlated positively while IL10 production correlated negatively with necrosis and total cell death, respectively. CONCLUSIONS: Our results suggest that moderate hypothermia during CPB provides myocardial protection by enhancing intra-myocardial anti-inflammatory cytokine balance