Optimal management of urinary tract infections in older people

Urinary tract infections (UTI) occur frequently in older people. Unfortunately, UTI is commonly overdiagnosed and overtreated on the basis of nonspecific clinical signs and symptoms. The diagnosis of a UTI in the older patient requires the presence of new urinary symptoms, with or without systemic symptoms. Urinalysis is commonly used to diagnose infection in this population, however, the evidence for its use is limited. There is overwhelming evidence that asymptomatic bacteriuria should not be treated. Catheter associated urinary tract infection accounts for a significant amount of hospital-associated infection. Indwelling urinary catheters should be avoided where possible and alternatives sought. The use of narrow spectrum antimicrobial agents for urinary tract infection is advocated. Local guidelines are now widely used to reflect local resistance patterns and available agents. Guidelines need to be updated to reflect changes in antimicrobial prescribing and a move from broad to narrow spectrum antimicrobials

Stranded Structure Development in Thermally Produced Protein Concentrate Gel

Scanning electron micrographs of thermally induced whey protein concentrate gels were taken. Sample preparation was accomplished by glutaraldehyde fixation, osmium tetroxide post fixation and critical point dehydration. Stranded or beaded gel structures were observed on the external surface of a gas bubble, suggesting that a string-of-beads gel microstructure may result from bubble formation during thermal treatment

Cryogenic and room temperature strength of sapphire jointed by hydroxide-catalysis bonding

Hydroxide-catalysis bonding is a precision technique used for jointing components in opto-mechanical systems and has been implemented in the construction of quasi-monolithic silica suspensions in gravitational wave detectors. Future detectors are likely to operate at cryogenic temperatures which will lead to a change in test mass and suspension material. One candidate material is mono-crystalline sapphire. Here results are presented showing the influence of various bonding solutions on the strength of the hydroxide-catalysis bonds formed between sapphire samples, measured both at room temperature and at 77 K, and it is demonstrated that sodium silicate solution is the most promising in terms of strength, producing bonds with a mean strength of 63 MPa. In addition the results show that the strengths of bonds were undiminished when tested at cryogenic temperatures

Muon Catalyzed Fusion in 3 K Solid Deuterium

Muon catalyzed fusion in deuterium has traditionally been studied in gaseous and liquid targets. The TRIUMF solid-hydrogen-layer target system has been used to study the fusion reaction rates in the solid phase of D_2 at a target temperature of 3 K. Products of two distinct branches of the reaction were observed; neutrons by a liquid organic scintillator, and protons by a silicon detector located inside the target system. The effective molecular formation rate from the upper hyperfine state of $\mu d$ and the hyperfine transition rate have been measured: $\tilde{\lambda}_(3/2)=2.71(7)_{stat.}(32)_{syst.} \mu/s$, and $\tilde{\lambda}_{(3/2)(1/2)} =34.2(8)_{stat.}(1)_{syst.} \mu /s$. The molecular formation rate is consistent with other recent measurements, but not with the theory for isolated molecules. The discrepancy may be due to incomplete thermalization, an effect which was investigated by Monte Carlo calculations. Information on branching ratio parameters for the s and p wave d+d nuclear interaction has been extracted.Comment: 19 pages, 11 figures, submitted to PRA Feb 20, 199

Space Climate Manifestation in Earth Prices - from Medieval England Up to Modern Usa

In this study we continue to search for possible manifestations of space weather influence on prices of agricultural products and consumables. We note that the connection between solar activity and prices is based on the causal chain that includes several nonlinear transition elements. These non-linear elements are characterized by threshold sensitivity to external parameters and lead to very inhomogeneous local sensitivity of the price to space weather conditions. It is noted that "soft type" models are the most adequate for description of this class of connections. Two main observational effects suitable for testing causal connections of this type of sensitivity are considered: burst-like price reactions on changes in solar activity and price asymmetry for selected phases of the sunspot cycle. The connection, discovered earlier for wheat prices of Medieval England, is examined in this work on the basis of another 700-year data set of consumable prices in England. Using the same technique as in the previous part of our work (Pistilnik and Yom Din 2004) we show that statistical parameters of the interval distributions for price bursts of consumables basket and for sunspot minimum states are similar one to another, like it was reported earlier for wheat price bursts. Possible sources of these consistencies between three different multiyear samples are discussed. For search of possible manifestations of the "space weather - wheat market" connection in modern time, we analyze dynamics of wheat prices in the USA in the twentieth century. We show that the wheat prices revealed a maximum/minimum price asymmetry consistent with the phases of the sunspot cycle. We discuss possible explanations of this observed asymmetry, unexpected under conditions of globalization of the modern wheat market.Comment: First International Symposium on Space Climate: Direct and Indirect Observations of Long-Term Solar Activity, 20-23 June 2004, Oulu, Finlan

Genetic characterisation of Echinocephalus spp. (Nematoda: Gnathostomatidae) from marine hosts in Australia

We genetically characterised larval and adult specimens of species of Echinocephalus Molin, 1858 (Gnathostomatidae) collected from various hosts found within Australian waters. Adult specimens of Echinocephalus were collected from a dasyatid stingray [Pastinachus ater (Macleay); n = 2] from Moreton Bay, Queensland and larvae from a hydrophiine sea snake [Hydrophis peronii (Duméril); n = 3] from Cape York Peninsula, Queensland, from an octopus (Octopus djinda Amor & Hart; n = 3) from Fremantle, Western Australia and from a lucinid bivalve [Codakia paytenorum (Iredale); n = 5] from Heron Island, Queensland Australia. All nematode samples were identified morphologically and genetically characterised using the small subunit nuclear ribosomal DNA (SSU). Some morphological differences were identified between previous studies of Echinocephalus spp. and those observed herein but the significance of these differences remains unresolved. Molecular phylogenetic analyses revealed that larval Echinocephalus sp. from H. peronii and C. paytenorum in Australia were very similar (with strong nodal support) to larval Echinocephalus sp. infecting two fish species from Egypt, Saurida undosquamis (Richardson) (Synodontidae) and Pagrus pagrus (Linnaeus) (Sparidae). The SSU sequences of larval Echinocephalus sp. from O. djinda and adults from P. ater formed a well-supported clade with that of adult E. overstreeti Deardorff and Ko, 1983 from the Port Jackson shark, Heterodontus portusjacksoni (Meyer), as well as that of the larval Echinocephalus sp., from the common carp (Cyprinus carpio Linnaeus) from Egypt. This study extends the intermediate host range of Echinocephalus larvae by including a sea snake for the first time. Findings of this study highlight the importance of genetic characterisation of larval and adult specimens of Echinocephalus spp. to resolve the current difficulties in the taxonomy of this genus

Boosting BCG with recombinant modified vaccinia ankara expressing antigen 85A: Different boosting intervals and implications for efficacy trials

Objectives. To investigate the safety and immunogenicity of boosting BCG with modified vaccinia Ankara expressing antigen 85A (MVA85A), shortly after BCG vaccination, and to compare this first with the immunogenicity of BCG vaccination alone and second with a previous clinical trial where MVA85A was administered more than 10 years after BCG vaccination. Design. There are two clinical trials reported here: a Phase I observational trial with MVA85A; and a Phase IV observational trial with BCG. These clinical trials were all conducted in the UK in healthy, HIV negative, BCG naı¨ve adults. Subjects were vaccinated with BCG alone; or BCG and then subsequently boosted with MVA85A four weeks later (short interval). The outcome measures, safety and immunogenicity, were monitored for six months. The immunogenicity results from this short interval BCG prime–MVA85A boost trial were compared first with the BCG alone trial and second with a previous clinical trial where MVA85A vaccination was administered many years after vaccination with BCG. Results. MVA85A was safe and highly immunogenic when administered to subjects who had recently received BCG vaccination. When the short interval trial data presented here were compared with the previous long interval trial data, there were no significant differences in the magnitude of immune responses generated when MVA85A was administered shortly after, or many years after BCG vaccination. Conclusions. The clinical trial data presented here provides further evidence of the ability of MVA85A to boost BCG primed immune responses. This boosting potential is not influenced by the time interval between prior BCG vaccination and boosting with MVA85A. These findings have important implications for the design of efficacy trials with MVA85A. Boosting BCG induced anti-mycobacterial immunity in either infancy or adolescence are both potential applications for this vaccine, given the immunological data presented here. Trial Registration. ClinicalTrials.Oxford University was the sponsor for all the clinical trials reported here