Clinical decision making is improved by BioFire Pneumonia Plus in suspected lower respiratory tract infection after lung transplantation: Results of the prospective DBATE‐IT * study

Background: Lower respiratory tract infections (LRTIs) are a significant cause of morbidity and mortality in lung transplant (LTx) recipients. Timely and precise pathogen detection is vital to successful treatment. Multiplex PCR kits with short turnover times like the BioFire Pneumonia Plus (BFPPp) (manufactured by bioMérieux) may be a valuable addition to conventional tests. Methods: We performed a prospective observational cohort study in 60 LTx recipients with suspected LRTI. All patients received BFPPp testing of bronchoalveolar lavage fluid in addition to conventional tests including microbiological cultures and conventional diagnostics for respiratory viruses. Primary outcome was time‐to‐test‐result; secondary outcomes included time‐to‐clinical‐decision and BFPPp test accuracy compared to conventional tests. Results: BFPPp provided results faster than conventional tests (2.3 h [2–2.8] vs. 23.4 h [21–62], p < 0.001), allowing for faster clinical decisions (2.8 [2.2–44] vs. virology 28.1 h [23.1–70.6] and microbiology 32.6 h [4.6–70.9], both p < 0.001). Based on all available diagnostic modalities, 26 (43%) patients were diagnosed with viral LRTI, nine (15 %) with non‐viral LRTI, and five (8 %) with combined viral and non‐viral LRTI. These diagnoses were established by BFPPp in 92%, 78%, and 100%, respectively. The remaining 20 patients (33 %) received a diagnosis other than LRTI. Preliminary therapies based on BFPPp results were upheld in 90% of cases. There were six treatment modifications based on pathogen‐isolation by conventional testing missed by BFPPp, including three due to fungal pathogens not covered by the BFPPp. Conclusion: BFPPp offered faster test results compared to conventional tests with good concordance. The absence of fungal pathogens from the panel is a potential weakness in a severely immunosuppressed population

British Communists and the 1932 turn to the trade unions

The Comintern’s Third Period, 1928-1934, based on Stalin’s ‘second revolution’ in Russia, capitalist crisis and the claim that social democracy and fascism were twins, generated sectarian, ultra-left politics which proved inimical to Communist activity in trade unions. This article sheds new light on that issue by revisiting three connected episodes: the British party’s (CPGB) renewed turn to the unions, heralded in the January resolution of 1932; the roles Comintern staff and CPGB leader Harry Pollitt, played in this initiative; and the subsequent attempt by Pollitt to revise the politics of union work. This triptych reviews both primary sources and the recent historiography. It argues that some accounts have overestimated the novelty of the January resolution, blurred its meaning, and exaggerated Pollitt’s part in it. The resolution did not attempt to change the line but its application. Its impact was limited. Subsequent bids to go beyond it were muddled and unsuccessful. The 1933 move towards the united front, and the ensuing turn to the popular front, possessed more profound significance in the creation of an effective Communist presence in trade unions than the events of 1931- 1932

La noche quedo atras

Ante

Out of the night

Thomas S. Hansen2010112

Bend in the river Salpeter coast. A whale is dead. Gape horn. Juanita

CatalogingThomas S. Hansen2010121