Ultraviolet Extinction Properties in the Milky Way

We have assembled a homogeneous database of 417 ultraviolet (UV) extinction curves for reddened sightlines having International Ultraviolet Explorer (IUE) spectra. We have combined these with optical and 2MASS photometry allowing estimates of the ratio of total-to-selective extinction, R(V), for the entire sample. Fitzpatrick-Massa (FM) parameters have also been found for the entire sample. This is the largest study of parameterized UV extinction curves yet published and it covers a wide range of environments, from dense molecular clouds to the diffuse interstellar medium (ISM), with extinctions A(V) ranging from 0.50 to 4.80. It is the first to extend far beyond the solar neighborhood and into the Galaxy at large, with 30 sightlines having distances > 5 kpc. Previously, the longest sightlines with FM parameters and R(V) extended ~ 1 kpc. We find that (1.) the CCM extinction law applies for 93% of the sightlines, implying that dust processing in the Galaxy is efficient and systematic; (2.) the central wavelength of the 2175 A bump is constant; (3.) the 2175 A bump width is dependent on environment. Only four sightlines show systematic deviations from CCM, HD 29647, 62542, 204827, and 210121. These sightlines all sample dense, molecule-rich clouds. The new extinction curves and values of R(V) allow us to revise the CCM law.Comment: 32 pages, 12 figure

Determinants of mortality in non-neutropenic ICU patients with candidaemia

Introduction: Candidaemia in critically-ill intensive care unit (ICU) patients is associated with high crude mortality. Determinants of mortality – particularly those amenable to potential modification – are incompletely defined. Methods: A nationwide prospective clinical and microbiological cohort study of all episodes of ICU-acquired candidaemia occurring in non-neutropenic adults was undertaken in Australian ICUs between 2001 and 2004. Multivariate Cox regression analyses were performed to determine independently significant variables associated with mortality. Results: 183 episodes of ICU-acquired candidaemia occurred in 183 patients during the study period. Of the 179 with microbiological data, Candida albicans accounted for 111 (62%) episodes and Candida glabrata, 32 (18%). Outcome data were available for 173: crude hospital mortality at 30 days was 56%. Host factors (older age, ICU admission diagnosis, mechanical ventilation and ICU admission diagnosis) and failure to receive systemic antifungal therapy were significantly associated with mortality on multivariate analysis. Among the subset who received initial fluconazole therapy (n = 93), the crude mortality was 52%. Host factors (increasing age and haemodialysis receipt), but not organism- (Candida species, fluconazole MIC), pharmacokinetic- (fluconazole dose, time to initiation), or pharmacodynamic-related parameters (fluconazole dose:MIC ratio) were associated with mortality. Process of care measures advocated in recent guidelines were implemented inconsistently: follow-up blood cultures were obtained in 68% of patients, central venous catheters removed within five days in 80% and ophthalmological examination performed in 36%. Conclusions: Crude mortality remains high in Australian ICU patients with candidaemia and is overwhelmingly related to host factors but not treatment variables (the time to initiation of antifungals or fluconazole pharmacokinetic and pharmacodynamic factors). The role and timing of early antifungal intervention in critically-ill ICU patients requires further investigation.Deborah J.E. Marriott, E. Geoffrey Playford, Sharon Chen, Monica Slavin, Quoc Nguyen, David Ellis and Tania C. Sorrell for the Australian Candidaemia Stud