Pseudomonas aeruginosa serotypes in nosocomial pneumonia: prevalence and clinical outcomes.

INTRODUCTION: Pseudomonas aeruginosa frequently causes nosocomial pneumonia and is associated with poor outcome. The purpose of this study was to assess the prevalence and clinical outcome of nosocomial pneumonia caused by serotype-specific P. aeruginosa in critically ill patients under appropriate antimicrobial therapy management. METHODS: A retrospective, non-interventional epidemiological multicenter cohort study involving 143 patients with confirmed nosocomial pneumonia caused by P. aeruginosa. Patients were analyzed for a period of 30 days from time of nosocomial pneumonia onset. Fourteen patients fulfilling the same criteria from a phase IIa studyconducted at the same time/centers were included in the prevalence calculations but not in the clinical outcome analysis. RESULTS: The prevalence of serotypes was: O6 (29%), O11 (23%), O10 (10%), O2 (9%), and O1 (8%). Serotypes with a prevalence of less than 5% were found in 13% of patients, 8% were classified as not typeable. Across all serotypes, 19% mortality, 70% clinical resolution, 11% clinical continuation, and 5% clinical recurrence were recorded. Age and higher APACHE II (Acute Physiology and Chronic Health Evaluation II) were predictive risk factors associated with probability of death and lower clinical resolution for P. aeruginosa nosocomial pneumonia. Mortality tends to be higher with O1 (40%) and lower with O2 (0%); clinical resolution tends to be better with O2 (82%) compared to other serotypes. Persisting pneumonia with O6 and O11 was, respectively, 8% and 21%; clinical resolution with O6 and O11 was, respectively, 75% and 57%. CONCLUSIONS: In P. aeruginosa nosocomial pneumonia, the most prevalent serotypes were O6 and O11. Further studies including larger group sizes are needed to correlate clinical outcome with virulence factors of P. aeruginosa in patients with nosocomial pneumonia caused by various serotypes; and to compare O6 and O11, the two serotypes most frequently encountered in critically ill patients.

Development of projections from auditory to visual areas in the cat.

In newborn kittens, cortical auditory areas (including AI and AII) send transitory projections to ipsi- and contralateral visual areas 17 and 18. These projections originate mainly from neurons in supragranular layers but also from a few in infragranular layers (Innocenti and Clarke: Dev. Brain Res. 14:143-148, '84; Clarke and Innocenti: J. Comp. Neurol. 251:1-22, '86). The postnatal development of these projections was studied with injections of anterograde tracers (wheat germ agglutinin-horseradish peroxidase [WGA-HRP]) in AI and AII and of retrograde tracers (WGA-HRP, fast blue, diamidino yellow, rhodamine-labeled latex beads) in areas 17 and 18. It was found that the projections are nearly completely eliminated in development, this, by the end of the first postnatal month. Until then, most of the transitory axons seem to remain confined to the white matter and the depth of layer VI; a few enter it further but do not appear to form terminal arbors. As for other transitory cortical projections the disappearance of the transitory axons seems not to involve death of their neurons of origin. In kittens older than 1 month and in normal adult cats, retrograde tracer injections restricted to, or including, areas 17 and 18 label only a few neurons in areas AI and AII. Unlike the situation in the kitten, nearly all of these are restricted to layers V and VI. A similar distribution of neurons projecting from auditory to visual areas is found in adult cats bilaterally enucleated at birth, which suggests that the postnatal elimination of the auditory-to-visual projection is independent of visual experience and more generally of information coming from the retina.

The costs of disorders of the brain in Switzerland: an update from the European Brain Council Study for 2010.

BACKGROUND: In 2005, findings of the first "cost of disorders of the brain in Europe" study of the European Brain Council (EBC) showed that these costs cause a substantial economic burden to the Swiss society. In 2010 an improved update with a broader range of disorders has been analysed. This report shows the new findings for Switzerland and discusses changes. METHODS: Data are derived from the EBC 2010 census study that estimates 12-month prevalence of 12 groups of disorders of the brain and calculates costs (direct health-care costs, direct non-medical costs and indirect costs) by combining top-down and bottom up cost approaches using existing data. RESULTS: The most frequent disorder was headache (2.3 million). Anxiety disorders were found in 1 million persons and sleep disorders in 700,000 persons. Annual costs for all assessed disorders total to 14.5 billion Euro corresponding to about 1,900 EUR per inhabitant per year. Mood, psychotic disorders and dementias (appr. 2 billion EUR each) were most costly. Costs per person were highest for neurological/neurosurgery-relevant disorders, e.g. neuromuscular disorders, brain tumour and multiple sclerosis (38,000 to 24,000 EUR). CONCLUSION: The estimates of the EBC 2010 study for Switzerland provide a basis for health care planning. Increase in size and costs compared to 2005 are mostly due to the inclusion of new disorders (e.g., sleep disorders), or the re-definition of others (e.g., headache) and to an increase in younger cohorts. We suggest coordinated research and preventive measures coordinated between governmental bodies, private health-care and pharmaceutical companies.

Savoir, faire ? Les relations chimériques de la psychanalyse avec la psychiatrie publique et l'université en Suisse romande

C'est souvent dans les institutions psychiatriques que le médecin développe les premiers contacts avec la psychanalyse. L'institution entretient pourtant avec la psychanalyse un rapport chimérique que les sociétés de psychanalyse contribuent à pervertir en restant cloîtrées. Telle pourrait être la thèse de Nicolas Despland qui souhaite, par un article qui défriche le problème, ouvrir la discussion pour trouver des solutions qui importent à tous les protagonistes. (Tribune psychanalytique)

Phylogenetics of Olea (Oleaceae) based on plastid and nuclear ribosomal DNA sequences: tertiary climatic shifts and lineage differentiation times.

BACKGROUND AND AIMS: The genus Olea (Oleaceae) includes approx. 40 taxa of evergreen shrubs and trees classified in three subgenera, Olea, Paniculatae and Tetrapilus, the first of which has two sections (Olea and Ligustroides). Olive trees (the O. europaea complex) have been the subject of intensive research, whereas little is known about the phylogenetic relationships among the other species. To clarify the biogeographical history of this group, a molecular analysis of Olea and related genera of Oleaceae is thus necessary. METHODS: A phylogeny was built of Olea and related genera based on sequences of the nuclear ribosomal internal transcribed spacer-1 and four plastid regions. Lineage divergence and the evolution of abaxial peltate scales, the latter character linked to drought adaptation, were dated using a Bayesian method. KEY RESULTS: Olea is polyphyletic, with O. ambrensis and subgenus Tetrapilus not sharing a most recent common ancestor with the main Olea clade. Partial incongruence between nuclear and plastid phylogenetic reconstructions suggests a reticulation process in the evolution of subgenus Olea. Estimates of divergence times for major groups of Olea during the Tertiary were obtained. CONCLUSIONS: This study indicates the necessity of revising current taxonomic boundaries in Olea. The results also suggest that main lines of evolution were promoted by major Tertiary climatic shifts: (1) the split between subgenera Olea and Paniculatae appears to have taken place at the Miocene-Oligocene boundary; (2) the separation of sections Ligustroides and Olea may have occurred during the Early Miocene following the Mi-1 glaciation; and (3) the diversification within these sections (and the origin of dense abaxial indumentum in section Olea) was concomitant with the aridification of Africa in the Late Miocene.

Paleohydrological Reconstruction from Late Holocene Records in Interdune Lakes (N'Guigmi, Northern Bank of the Lake Chad, Niger)

An old erg covers the northern part of the Lake Chad basin. This dune landform allowed the formation of many inter- dune ponds of various sizes. Still present in certain zones where the groundwater level is high (e.g. Kanem, southern Manga), these ponds formed in the past a vast network of lacustrine microsystems, as shown by the nature and the dis- tribution of their deposits. In the Manga, these interdune deposits represent the main sedimentary records of the Holo- cene environmental succession. Their paleobiological (pollens, diatoms, ostracods) and geochemical (δ18O, δ13C, Sr/ Ca) contents are often the basis for paleoenvironmental reconstruction. On the other hand, their sedimentological char- acters are rarely exploited. This study of palustro-lacustrine deposits of the Holocene N'Guigmi lake (northern bank of the Lake Chad; Niger) is based on the relationships between the sedimentological features and the climato-hydrological fluctuations. The mineralogical parameters (e.g. calcium carbonate content, clay mineralogy) and the nature of autoch- thonous mineralization (i.e. amorphous silica, clays, calcium carbonates) can be interpreted using a straightforward hy- dro-sedimentary model. Established to explain the geochemical dynamics of Lake Chad, this model is based on a bio- geochemical cycle of the main elements (i.e. silicium, calcium) directly controlled by the local hydrological balance (i.e. rainfall/evaporation ratio). All these results show that a detailed study of sedimentological features can provide impor- tant paleohydrological informations about the regional aridification since ca 6500 14C BP.

Indicadores quantitativos da biologia reprodutiva de fêmeas de piau-vermelho no Rio Paraíba do Sul

O objetivo deste trabalho foi avaliar a dinâmica reprodutiva de fêmeas de piau-vermelho (Leporinus copelandii) na bacia do baixo Rio Paraíba do Sul. Os parâmetros foram determinados nos diferentes estádios do ciclo reprodutivo anual de 143 fêmeas obtidas mediante capturas mensais. Houve correlação positiva entre relação gonadossomática e fator de condição total, e correlação negativa entre relação gonadossomática e índice de gordura celomática. O fator de condição total e o fator somático apresentaram a mesma tendência, e a diferença entre os dois indicou o início do período reprodutivo. O índice hepatossomático apresentou correlação negativa com gordura celomática e correlação positiva com o índice de repleção estomacal. O índice de gordura celomática apresentou correlação positiva com os fatores de condição total e somático. O índice médio de gordura celomática foi máximo no estádio de maturação inicial, sugerindo a utilização destas reservas durante a maturação gonadal e/ou migração reprodutiva. Houve correlação negativa entre índice de gordura celomática e índice de repleção estomacal. Apesar de não ter ocorrido interrupção na alimentação, as fêmeas apresentaram-se em melhores condições alimentares após o período reprodutivo.

Optimización de la distribución de LNG en una red paneuropea de transporte pesado de mercancías de larga distancia por carretera por medio de programación lineal

Actualmente, el transporte por carretera de mercancías de larga distancia está dominado por vehículos propulsados por diésel. Este combustible fósil derivado del petróleo puede ser parcialmente sustituido por otro combustible alternativo: el gas natural licuado (LNG). Su uso proporcionará una disminución de la dependencia de los estados productores de petróleo, es comparable en energía específica y densidad energética al diésel, es seguro, disminuye las emisiones contaminantes, en nivel de ruido y es actualmente más económico. Recopilar datos reales sobre el transporte por carretera en la EU27 (energía utilizada por este tipo de transporte, localización de las terminales de LNG operativas, determinar las reservas disponibles, calcular la población que va a cubrir y calcular la energía necesaria disponible para dar cobertura a esa población según la cantidad de energía per cápita utilizada para este tipo de transporte). Determinar las interconexiones a cubrir por la red paneuropea de transporte propuesta y decidir las localizaciones de las EESS a ser construidas para cubrir las recomendaciones de la EC de manera que ningún tramo supere los 400 km dentro de esos itinerarios. Calcular todas las distancias que separan cada terminal de LNG operatica de cada EESS (1300 distancias calculadas). Construir el modelo de programación lineal. Resolver, interpretar, validar y comprobar que es posible su utilización para la puesta en práctica del modelo propuesto, asumiendo la distribución total del LNG disponible y la minimización de los costes globales de distribución del mismo, desde el punto de vista económico. Se procederá buscando los datos en fuentes fiables que nos permitan realizar los cálculos necesarios para construir el modelo y resolviéndolo con el software adecuado a un modelo de estas dimensiones. Se ha conseguido una solución óptima, con la distribución total del LNG y minimizando los costes globales. Además, se ha obtenido movimiento de combustible en 76 de las 1300 variables, que han mostrado un déficit de terminales de almacenamiento de LNG para su distribución en el norte y centro de Europa, que se ve compensando con un flujo de transporte de este combustible desde la península ibérica principalmente y, en menor medida, desde Italia.

Diagnostic potential of neutrophil elastase inhibitor complex in the routine care of critically ill newborn infants.

It has been suggested that determination of the neutrophil elastase alpha1-proteinase inhibitor complex (E-alpha1PI) improves the diagnosis of bacterial infection in newborns. We evaluated the use of E-alpha1PI measurements in 143 newborns, consecutively admitted to a tertiary intensive care unit, employing a new random access assay and a sampling procedure that minimises post-collection artefacts. The 95% range for noninfected newborns was 20-110 microg/l up to the 5th day of life and 20-85 microg/l thereafter. The sensitivity as to the diagnosis of culture-proven bloodstream infection was 80% for E-alpha1PI, 86% for the immature to total neutrophil ratio, 64% for C-reactive protein and 37% for the total white blood cell count. The corresponding specificity amounted to 97%, 85%, 85% and 86%, respectively. E-alpha1PI increases preceded elevations of C-reactive protein by 18 h. Like C-reactive protein, E-alpha1PI levels did not distinguish between bloodstream infection and non-bacterial inflammatory responses. Results of E-alpha1PI became available within 1 h of collection and usually 2-3 h before manual leucocyte counts. CONCLUSION: Determination of neutrophil elastase alpha1-proteinase inhibitor levels yields diagnostic advantages comparable to those of manual differential counts but provide faster turnaround times.

Location-independent and location-linked representations of sound objects.

For the recognition of sounds to benefit perception and action, their neural representations should also encode their current spatial position and their changes in position over time. The dual-stream model of auditory processing postulates separate (albeit interacting) processing streams for sound meaning and for sound location. Using a repetition priming paradigm in conjunction with distributed source modeling of auditory evoked potentials, we determined how individual sound objects are represented within these streams. Changes in perceived location were induced by interaural intensity differences, and sound location was either held constant or shifted across initial and repeated presentations (from one hemispace to the other in the main experiment or between locations within the right hemispace in a follow-up experiment). Location-linked representations were characterized by differences in priming effects between pairs presented to the same vs. different simulated lateralizations. These effects were significant at 20-39 ms post-stimulus onset within a cluster on the posterior part of the left superior and middle temporal gyri; and at 143-162 ms within a cluster on the left inferior and middle frontal gyri. Location-independent representations were characterized by a difference between initial and repeated presentations, independently of whether or not their simulated lateralization was held constant across repetitions. This effect was significant at 42-63 ms within three clusters on the right temporo-frontal region; and at 165-215 ms in a large cluster on the left temporo-parietal convexity. Our results reveal two varieties of representations of sound objects within the ventral/What stream: one location-independent, as initially postulated in the dual-stream model, and the other location-linked.

Règle de s. Augustin, suivie de constitutions et de pièces diverses se rapportant à la congrégation de Windesheim.

Abbé de Tersan (?); — abbaye de Saint-Jean de Rebdorf en Bavière d'après Ruf, Rebdorf, 261; Krämer, Rebdorf, 672

Histoire du monastère de Selby, dépendance de Saint-Germain d'Auxerre.

Donné par Châtre de Cangé en 1733, après la vente de ses manuscrits à la Bibliothèque du roi; cf. Catalogue des livres du Cabinet de M..., Paris, 1733, description à la main ajoutée sur les derniers feuillets de garde de plusieurs exemplaires de ce catalogue "Notice de quelques manuscrits d'elite qui n'étoient pas compris dans le catalogue et que M. du Cangé a donnés au roi... Histoire du monastère de Selby, ordre de St Benoît, dans la province d'Yorc. Ce vol. étoit sans inscription et sans n° et vient pourtant du fond de du Cangé"; Delisle, Cab. des mss., I, 411-412; n° 143 de la liste des manuscrits de Cangé établie par Méon; — ex-libris (XVIIe s.)"Monasterii S. Germain Autisiodorensis" de l'abbaye de Saint-Germain d'Auxerre (1), cf. Delisle, Cab. des mss., II, 405.

Actes relatifs au collège de Navarre.

Acquis le 3 août 1824 de M. de Bure, libraire, suite à la vente Chardin, n° 511, pour un prix non précisé; cf. B.n.F., département des Manuscrits, Archives Modernes 492ter, registre des acquisitions du département des Manuscrits 1821-1830, f. 142-143 "Statuts donnés par la reine Jeanne de Navarre femme du roi Philippe-le-Bel, au collège royal de Champagne, dit de Navarre, dont elle étoit fondatrice; ms. sur velin in 4°, relié proprement".

Marbles and stones of Hispania : exhibition catalogue = Marbres i pedres d'Hispania : catàleg de l'exposició = Mármoles y piedras de Hispania : catálogo de la exposición

Primera guia de materials lapidis hispànics explotats en època romana a la península Ibèrica. El treball recull 16 varietats, i té especial interès en la descripció de la geologia dels entorns de les explotacions. Entre els materials lapidis figuren, per exemple, marbres de la zona d’Estremoz (Portugal), broccatello (també anomanat jaspi de la Cinta, procedent de Tortosa), marbres de la zona de Macael (Andalusia) i la pedra de Buixcarró (València). També s'hi estudien amb detall els punts d’explotació (pedreres) i les diverses aplicacions donades a cada tipus de pedra. El llibre és trilingüe (anglès, català i castellà), està molt ben il·lustrat (en color) i s'ha publicat com a catàleg ampliat d'una exposició amb el mateix títol muntada en el marc de la IX Asmosia Internacional Conference (Tarragona, juny del 2009).