Presence of multiple bacterial markers in clinical samples might be useful for presumptive diagnosis of infection in cirrhotic patients with culture-negative reports

Bacterial infections in cirrhotic patients with ascites are associated with a severe prognosis and an increased risk of death. The microbiological standard tests for the diagnosis of suspected infection, based on culture test of blood and ascitic fluid, are, in many cases (30-40 %), negative, even when patients show symptoms of infection. A multiple culture-independent protocol was applied and evaluated as a diagnostic and prognostic tool for the detection of bacterial infection in cirrhotic patients. Sixty-four culture-negative samples obtained from 34 cirrhotic patients, with PMN < 250 cells/μl of ascitic fluid, were screened for the presence of bacterial DNA, endotoxin, peptidoglycan/β-glucan and microscopically visible bacterial cells. Correlations between the presence of multiple markers and various clinical and laboratory parameters were evaluated. Bacterial DNA was detected in 23 samples collected from 16 patients; a large part of these samples also showed the presence of other bacterial markers, which was associated with a worsening of liver functionality, a higher incidence of infections during the follow-up and a higher mortality rate in our cohort of cirrhotic patients. We believe that the detection of additional bacterial markers in bacterial DNA-positive clinical samples makes the bacterial presence and its clinical significance more realistic and might be useful as early markers of an ongoing bacterial infection and in establishing a clinical prognosis

Mortality in Vietnam, 1979-1989

Until not long ago, scanty information on the profile of the Vietnamese population and the poor quality of the available data have complicated efforts to present reliable estimates of mortality levels in Vietnam. Only recently, have official data on Vietnamese mortality become available through the 1979 and the 1989 population censuses. This paper makes use of such data to estimate Vietnam s mortality levels during the intercensal period

Acoustic Reconstruction of Eszterh\ue1za Opera House Following New Archival Research

The Eszterh\ue1za Opera House was a theatre built by the will of the Hungarian Prince Nikolaus Esterh\ue1zy in the second half of the 18th century that had to compete in greatness and grandeur against Austrian Empire. The composer that inextricably linked his name to this theatre was Haydn that served the prince and composed pieces for him for many years. The Opera House disappeared from the palace complex maps around 1865 and was destroyed permanently during the Second World War. This study aims to reconstruct the original shape and materials of the theatre, thanks to the documents founded by researchers in the library of the Esterh\ue1zy family at Forchtenstein, the Hungarian National Library, and analyze its acoustic behavior. With the 3D model of the theatre, acoustic simulations were performed using the architectural acoustic software Ramsete to understand its acoustical characteristics and if the architecture of the Eszterh\ue1za Opera House could favor the Prince\u2019s listening. The obtained results show that the union between the large volume of the theatre and the reflective materials makes the Opera House a reverberant space. The acoustic parameters are considered acoustically favorable both for the music and for the speech transmission too. Moreover, the results confirm that the geometry and the shape of the Eszterh\ue1za Opera House favored the Prince\u2019s view and listening, amplifying onstage voices and focusing the sound into his bo

Metabolic syndrome and cardiovascular risk after liver transplantation: a single-center experience.

Excessive weight gain, hypertension, hyperlipidemia, and diabetes are frequently observed among orthotopic liver transplantation (OLT) patients. These alterations, which are probably multifactorial in origin, contribute to posttransplantation metabolic syndrome (PTMS), which increases the risk of cardiovascular events. We assessed the prevalence of PTMS (diagnosed according to modified NCEP Adult Treatment Panel III criteria) in 156 OLT patients undergoing regular follow-up after transplantation (median 68 months; range, 6 to 234 months). Several pre- and post-OLT data were collected to identify the factors associated with the presence of PTMS which was found in 28% of cases. The only independent predictive factors for PTMS were diabetes mellitus and patients who were overweight or obese before-OLT. The prevalence of PTSM was lower among patients on tacrolimus immunosuppression. In our population, 21% of patients showed a high cardiovascular risk score with a 4% incidence of cardiovascular events, which was higher among subjects with PTMS. Close follow-up is mandatory to prevent the development of PTMS mainly among overweight and diabetic patients before transplantation

Novel therapeutic approaches to familial HLH (emapalumab in FHL)

Primary Hemophagocytic lymphohistiocytosis (pHLH) is a rare, life-threatening, hyperinflammatory disorder, characterized by uncontrolled activation of the immune system. Mutations affecting several genes coding for proteins involved in the cytotoxicity machinery of both natural killer (NK) and T cells have been found to be responsible for the development of pHLH. So far, front-line treatment, established on the results of large international trials, is based on the use of glucocorticoids, etoposide ± cyclosporine, followed by allogeneic hematopoietic stem cell transplantation (HSCT), the sole curative treatment for the genetic forms of the disease. However, despite major efforts to improve the outcome of pHLH, many patients still experience unfavorable outcomes, as well as severe toxicities; moreover, treatment-refractory or relapsing disease is a major challenge for pediatricians/hematologists. In this article, we review the epidemiology, etiology and pathophysiology of pHLH, with a particular focus on different cytokines at the origin of the disease. The central role of interferon-γ (IFNγ) in the development and maintenance of hyperinflammation is analyzed. The value of emapalumab, a novel IFNγ-neutralizing monoclonal antibody is discussed. Available data support the use of emapalumab for treatment of pHLH patients with refractory, recurrent or progressive disease, or intolerance to conventional therapy, recently, leading to FDA approval of the drug for these indications. Additional data are needed to define the role of emapalumab in front-line treatment or in combination with other drugs

Are French Individual Investors reluctant to realize their losses?

We analyze the presence of the disposition effect for 90 244 French individual investors based on a large brokerage account database between 1999 and 2006. Main results show that a) French investors demonstrate a strong preference for realizing their winning stocks rather than their losing ones (disposition effect).b) the behavioral bias is not eliminated for sophisticated individual investors (higher trading activity or international diversification) c) more originally, based on French account specificities, we demonstrate that the change of “fiscal account type” does not imply a change in investors’ behavior (at an individual level of the disposition effect).

Sexual Mixing in Shanghai: Are Heterosexual Contact Patterns Compatible With an HIV/AIDS Epidemic?

China’s HIV prevalence is low, mainly concentrated among female sex workers (FSWs), their clients, men who have sex with men, and the stable partners of members of these high-risk groups. We evaluate the contribution to the spread of HIV of China’s regime of heterosexual relations, of the structure of heterosexual networks, and of the attributes of key population groups with simulations driven by data from a cross-sectional survey of egocentric sexual networks of the general population of Shanghai and from a concurrent respondent-driven sample of FSWs. We find that the heterosexual network generated by our empirically calibrated simulations has low levels of partner change, strong constraints on partner selection by age and education, and a very small connected core, mainly comprising FSWs and their clients and characterized by a fragile transmission structure. This network has a small HIV epidemic potential but is compatible with the transmission of bacterial sexually transmitted infections (STIs), such as syphilis, which are less susceptible to structural breaks in transmission of infection. Our results suggest that policies that force commercial sex underground could have an adverse effect on the spread of HIV and other STIs