MRSA in a large German University Hospital: Male gender is a significant risk factor for MRSA acquisition

Background: The continually rising number of hospital acquired infections and particularly MRSA (Methicillin-resistant Staphylococcus aureus) colonization poses a major challenge from both clinical and epidemiological perspectives. The assessment of risk factors is vital in determining the best prevention, diagnosis and treatment strategies

How to Interpret Ambulatory 24 hr Esophageal pH Monitoring

Newer developing techniques for esophageal functional testing such as wireless pH capsule monitoring and esophageal impedance testing are currently available. However, ambulatory 24 hr esophageal pH monitoring is still widely used and provides quantitative data on esophageal acid exposure and the ability to correlate symptoms with acid exposure events. To properly analyze the result of pH monitoring, it is recommended to interpret in the order presented: visual inspection, computer calculation and symptom correlation

Diterpenes from coffee beans decrease serum levels of lipoprotein(a) in humans: results from four randomized controlled trials

Objective: Unfiltered coffee raises serum LDL cholesterol in humans, owing to the presence of the diterpenes cafestol and kahweol. Norwegians with a chronic high intake of unfiltered coffee also had elevated serum levels of lipoprotein(a), an LDL-like particle which is insensitive toward dietary interventions. We now experimentally studied the influence of coffee diterpenes on lipoprotein(a) levels. Design: Four randomised controlled trials. Subjects: Healthy, normolipidemic volunteers. Interventions: Coffee, coffee oil, and pure diterpenes for 4-24 weeks. Main outcome measures: The circulating level of lipoprotein(a). Results: In 22 subjects drinking five to six strong cups of cafetiere coffee per day, the median fall in lipoprotein(a) was 1.5 mg/dL after two months (P=0.03), and 0.5 mg/dL after half a year (P>0.05), relative to 24 filter coffee drinkers. Coffee oil doses equivalent to 10-20 cups of unfiltered coffee reduced lipoprotein(a) levels by up to 5.5 mg/dL (P<0.05) in two separate trials (n=12-16 per group). A purified mixture of cafestol and kahweol, as well as cafestol alone, were also effective in reducing Lp(a) levels (n=10). Averaged over the four trials, each 10 mg/d of cafestol (plus kahweol)?the amount present in two to three cups of cafetiere coffee?decreased Lp(a) levels by 0.5 mg/dL or 4% from baseline values after four weeks (n=63). Conclusions: Coffee diterpenes are among the few dietary exceptions shown to influence serum lipoprotein(a) levels. However, the Lp(a)-reducing potency of coffee diterpenes may subside in the long run, and their adverse side effects preclude their use as lipoprotein(a)-reducing agents. Sponsorship: Supported by the Netherlands Heart Foundation through grant No. 900-562-091 of the Netherlands Organization of Scientific Research (NWO), plus supplemental funding by the Institute for Scientific Information on Coffee

Chronic consumers of boiled coffee have elevated serum levels of lipoprotein(a)

OBJECTIVES: Lipoprotein(a) consists of an LDL-particle attached to apolipoprotein(a), which is made by the liver. Diterpenes present in boiled coffee raise serum levels of LDL cholesterol and of the liver enzyme alanine aminotransferase in man. We investigated the association between intake of boiled coffee and serum levels of lipoprotein(a). DESIGN, SETTING AND SUBJECTS: Healthy Norwegians 40-42 years of age, who habitually consumed five or more cups of boiled coffee per day (n = 150) were compared with matched filter coffee consumers (n = 159) in a cross-sectional study, as part of the Norwegian National Health Screening in 1992. RESULTS: The median lipoprotein(a) level was 13.0 mg dL-1 (10th and 90th percentile: 2.5 and 75.0 mg dL-1, respectively) on boiled and 7.9 mg dL-1 (10th and 90th percentile: 1.9 and 62.5 mg dL-1, respectively) on filter coffee (P = 0.048). Means /- SE were 25.8 /- 2.4 mg dL-1 and 19.6 /- 2.0 mg dL-1, respectively (P = 0.04). Although not statistically significant, subjects consuming nine or more cups of coffee per day had higher lipoprotein(a) levels than those drinking five to eight cups per day in both coffee groups. CONCLUSION: Chronic consumers of unfiltered, boiled coffee have higher serum levels of lipoprotein(a) than filter coffee drinkers