Detection of vancomycin resistances in enterococci within 3 1/2 Hours

Vancomycin resistant enterococci (VRE) constitute a challenging problem in health care institutions worldwide. Novel methods to rapidly identify resistances are highly required to ensure an early start of tailored therapy and to prevent further spread of the bacteria. Here, a spectroscopy-based rapid test is presented that reveals resistances of enterococci towards vancomycin within 3.5 hours. Without any specific knowledge on the strain, VRE can be recognized with high accuracy in two different enterococci species. By means of dielectrophoresis, bacteria are directly captured from dilute suspensions, making sample preparation very easy. Raman spectroscopic analysis of the trapped bacteria over a time span of two hours in absence and presence of antibiotics reveals characteristic differences in the molecular response of sensitive as well as resistant Enterococcus faecalis and Enterococcus faecium. Furthermore, the spectroscopic fingerprints provide an indication on the mechanisms of induced resistance in VRE

Short high-accuracy tritium data time series for assessing groundwater mean transit times in the vadose and saturated zones of the Luxembourg Sandstone aquifer

Among the manifold of environmental tracers at hand, tritium is the only one that can give information on groundwater age within the timescale of 100 years for the entire flow system, i.e., unsaturated and saturated. However, while in the Southern Hemisphere, a single water sample is sufficient for tritium-based young groundwater dating, several tritium measurements spanning multiple years are still needed in the Northern Hemisphere to disentangle the natural cosmogenic tritium input from that caused by the atmospheric thermonuclear weapons tests mainly carried out in the early 1960s. Although it is advised to focus tritium dating on sites where long chronicles of tritium data are available, in this study we tested the potential for short high-accuracy tritium data series (∼4 years) to date groundwater from 35 springs draining the Luxembourg Sandstone aquifer (central western Europe). We determined groundwater mean transit times using the lumped-parameter model approach in a Monte Carlo uncertainty estimation framework to provide uncertainty ranges inherent to the low number of tritium data at hand and their related analytical errors. Our results show that unambiguous groundwater mean transit time assessments cannot be determined solely based on such recent short tritium time series, given that several ranges of mean transit times appeared theoretically possible. Nonetheless we succeeded in discriminating groundwater mean transit times in the vadose and saturated zones of the aquifer through a stepwise decision process guided with several supplementary data. The mean transit time required for water to cross the vadose zone was estimated to be between 0.5±0.5 and 8.1±1.2 years depending on the spring, while for water to flow through the saturated zone, it varied from 5.7±2.4 to 18.9±4.6 years (median ± half of the 5–95 percentile range). Our findings are consistent with both the tritium measurements of individual springs and the hydrogeological context of the study area. We specifically corroborated the dating results using the known hydrogeological properties of the Luxembourg Sandstone aquifer, the hydrochemistry of the studied springs, and their discharge dynamics. When translated into water velocities (which average ∼12 and ∼170 m yr−1 for the vadose and the saturated zones, respectively), the tritium dating results mirrored the horizontal–vertical anisotropy of the aquifer's hydraulic properties caused by the bedded character of the Luxembourg Sandstone. In addition to improving our understanding of water transit times in the Luxembourg Sandstone aquifer, this study demonstrates how it is currently possible to use short tritium time series to date young groundwater bodies at new sites in central Europe.</p

Unenhanced helical computed tomography vs intravenous urography in patients with acute flank pain: accuracy and economic impact in a randomized prospective trial

Abstract.: Unenhanced helical computed tomography (UHCT) has evolved into a well-accepted alternative to intravenous urography (IVU) in patients with acute flank pain and suspected ureterolithiasis. The purpose of our randomized prospective study was to analyse the diagnostic accuracy of UHCT vs IVU in the normal clinical setting with special interest on economic impact, applied radiation dose and time savings in patient management. A total of 122 consecutive patients with acute flank pain suggestive of urolithiasis were randomized for UHCT (n=59) or IVU (n=63). Patient management (time, contrast media), costs and radiation dose were analysed. The films were independently interpreted by four radiologists, unaware of previous findings, clinical history and clinical outcome. Alternative diagnoses if present were assessed. Direct costs of UHCT and IVU are nearly identical (310/309 Euro). Indirect costs are much lower for UHCT because it saves examination time and when performed immediately initial abdominal plain film (KUB) and sonography are not necessary. Time delay between access to the emergency room and start of the imaging procedure was 32h 7min for UHCT and 36h 55min for IVU. The UHCT took an average in-room time of 23min vs 1h 21min for IVU. Mild to moderate adverse reactions for contrast material were seen in 3 (5%) patients. The UHCT was safe, as no contrast material was needed. The mean applied radiation dose was 3.3mSv for IVU and 6.5mSv for UHCT. Alternative diagnoses were identified in 4 (7%) UHCT patients and 3 (5%) IVU patients. Sensitivity and specificity of UHCT and IVU was 94.1 and 94.2%, and 85.2 and 90.4%, respectively. In patients with suspected renal colic KUB and US may be the least expensive and most easily accessable modalities; however, if needed and available, UHCT can be considered a better alternative than IVU because it has a higher diagnostic accuracy and a better economic impact since it is more effective, faster, less expensive and less risky than IVU. In addition, it also has the capability of detecting various additional renal and extrarenal pathologie

A Case Series on Genotype and Outcome of Liver Transplantation in Children with Niemann-Pick Disease Type C

Background: To report on clinical presentation and outcomes of children who underwent liver transplantation (LTx) and were subsequently diagnosed to have Niemann-Pick type C (NPC). Methods: Retrospective, descriptive, multi-centre review of children diagnosed with NPC who underwent LTx (2003–2018). Diagnosis was made by filipin skin test or genetic testing. Results: Nine children were identified (six centres). Neonatal acute liver failure was the most common indication for LTx (seven children). Median age at first presentation: 7 days (range: 0–37). The most prevalent presenting symptoms: jaundice (8/9), hepatosplenomegaly (8/9) and ascites (6/9). 8/9 children had a LTx before the diagnosis of NPC. Genetic testing revealed mutations in NPC1 correlating with a severe biochemical phenotype in 5 patients. All 9 children survived beyond early infancy. Seven children are still alive (median follow-up time of 9 (range: 6–13) years). Neurological symptoms developed in 4/7 (57%) patients at median 9 (range: 5–13) years following LTx. Conclusion: Early diagnosis of NPC continues to be a challenge and a definitive diagnosis is often made only after LTx. Neurological disease is not prevented in the majority of patients. Genotype does not appear to predict neurological outcome after LTx. LTx still remains controversial in NPC

HITRAP: A facility at GSI for highly charged ions

An overview and status report of the new trapping facility for highly charged ions at the Gesellschaft fuer Schwerionenforschung is presented. The construction of this facility started in 2005 and is expected to be completed in 2008. Once operational, highly charged ions will be loaded from the experimental storage ring ESR into the HITRAP facility, where they are decelerated and cooled. The kinetic energy of the initially fast ions is reduced by more than fourteen orders of magnitude and their thermal energy is cooled to cryogenic temperatures. The cold ions are then delivered to a broad range of atomic physics experiments.Comment: 8 pages, 11 figure

Scanning Tunneling Microscope-Induced Luminescence Spectroscopy on Semiconductor Heterostructures

Scanning tunneling microscope (STM)-induced luminescence is explored as a technique for the characterization of semiconductor quantum wells and quantum wire heterostructures. By injecting minority carriers into the cleaved cross section of these structures, luminescence excitation on a nanometer scale is demonstrated. Using spectrally resolved STM-induced luminescence for the tip placed at various positions across the cleaved heterostructure, it is possible to obtain local spectroscopic information on closely spaced quantum structures

Prognostic impact of systemic inflammatory diseases in elderly patients with congestive heart failure

Background and aims: Inflammation is part of the pathophysiology of congestive heart failure (CHF). However, little is known about the impact of the presence of systemic inflammatory disease (SID), defined as inflammatory syndrome with constitutional symptoms and involvement of at least two organs as co-morbidity on the clinical course and prognosis of patients with CHF. Methods and results: This is an analysis of all 622 patients included in TIME-CHF. After an 18 months follow-up, outcomes of patients with and without SID were compared. Primary endpoint was all-cause hospitalization free survival. Secondary endpoints were overall survival and CHF hospitalization free survival. At baseline, 38 patients had history of SID (6.1%). These patients had higher N-terminal pro brain natriuretic peptide and worse renal function than patients without SID. SID was a risk factor for adverse outcome [primary endpoint: hazard ratio (HR) = 1.73 (95% confidence interval: 1.18-2.55, P = 0.005); survival: HR = 2.60 (1.49-4.55, P = 0.001); CHF hospitalization free survival: HR = 2.3 (1.45-3.65, P < 0.001)]. In multivariate models, SID remained the strongest independent risk factor for survival and CHF hospitalization free survival. Conclusions: In elderly patients with CHF, SID is independently accompanied with adverse outcome. Given the increasing prevalence of SID in the elderly population, these findings are clinically important for both risk stratification and patient managemen