Epidemiology of candidemia in Swiss tertiary care hospitals: secular trends, 1991-2000

Candida species are among the most common bloodstream pathogens in the United States, where the emergence of azole-resistant Candida glabrata and Candida krusei are major concerns. Recent comprehensive longitudinal data from Europe are lacking. We conducted a nationwide survey of candidemia during 1991-2000 in 17 university and university-affiliated hospitals representing 79% of all tertiary care hospital beds in Switzerland. The number of transplantations and bloodstream infections increased significantly (P<.001). A total of 1137 episodes of candidemia were observed: Candida species ranked seventh among etiologic agents (2.9% of all bloodstream isolates). The incidence of candidemia was stable over a 10-year period. C. albicans remained the predominant Candida species recovered (66%), followed by C. glabrata (15%). Candida tropicalis emerged (9%), the incidence of Candida parapsilosis decreased (1%), and recovery of C. krusei remained rare (2%). Fluconazole consumption increased significantly (P<.001). Despite increasing high-risk activities, the incidence of candidemia remained unchanged, and no shift to resistant species occurred.

Auriferous Tertiary Gravels Near Rocker, in Silver Bow County, Montana

Between the villages of Rocker and Silver Bow, in south­western Montana, are found an interesting group of placers. Gold occurs in Tertiary gravel beds that are interstratified with beds of rhyolitic volcanic ash. With the aid of a plane table and open-sight alidade, a small portion of the lake-bed area near Rocker was mapped; all distances were paced, but numerous checks assure a fairly accurate map.

Gender differences in patients referred for atrial fibrillation management to a tertiary center

BACKGROUND: Atrial fibrillation (AF) ablation is less frequently performed in women than in men. Although the prevalence of AF is slightly higher in men, this does not fully account for the lower number of AF ablations performed in women. This study sought to examine the effect of gender on referral for AF and subsequent AF management. METHODS: Consecutive patients referred to our tertiary arrhythmia outpatient clinic for AF management were retrospectively analyzed. RESULTS: Of 264 patients referred, only 27% were women. Women were older than men (63 +/- 9 vs 58 +/- 11 years, P = 0.002), more often had paroxysmal AF (78% vs 63% in men, P = 0.022), and women more frequently complained about palpitations (71% vs 49%, P = 0.002). In addition, they had more often experienced amiodarone side effects than men (56% vs 36%, P = 0.046). In this referred population, there was no difference in the proportion of women and men undergoing AF ablation immediately following the initial evaluation (21% vs 25%, P = ns), at any time during the follow-up (38% vs 44%, P = ns), and there was no difference in the proportion of patients undergoing atrioventricular node ablation in both sexes (6% of women vs 3% of men, P = ns). CONCLUSIONS: There is an important difference in the proportion of men and women referred for management of AF in a specialized outpatient arrhythmia clinic, with women being referred three times less often than men. However, there is no gender-related difference in the subsequent treatment decisions. These findings emphasize the importance of focusing on management of symptomatic AF in women.

A reinvestigation into the reaction of NH4OAc with acetyl derivatives of Bay-lis-Hillman adducts: Formation of tertiary and secondary allyl amines in-stead of primary allyl amines

A reinvestigation into the reaction between ammonium acetate and the acetyl derivatives of Baylis-Hillman adducts has led us to conclude that the products obtained are tertiary and secondary allyl amines and not the primary allyl amines. The unambiguous assignment of the structure of products using chemical and spectroscopic methods is described

Institutions, Anomie, and Violent Crime: Clarifying and Elaborating Institutional-Anomie Theory

A limited but accumulating body of research and theoretical commentary offers support for core claims of the “institutional-anomie theory” of crime (IAT) and points to areas needing further development. In this paper, which focuses on violent crime, we clarify the concept of social institutions, elaborate the cultural component of IAT, derive implications for individual behavior, summarize empirical applications, and propose directions for future research. Drawing on Talcott Parsons, we distinguish the “subjective” and “objective” dimensions of institutional dynamics and discuss their interrelationship. We elaborate on the theory’s cultural component with reference to Durkheim’s distinction between “moral” and “egoistic” individualism and propose that a version of the egoistic type characterizes societies in which the economy dominates the institutional structure, anomie is rampant, and levels of violent crime are high. We also offer a heuristic model of IAT that integrates macro- and individual levels of analysis. Finally, we discuss briefly issues for the further theoretical elaboration of this macro-social perspective on violent crime. Specifically, we call attention to the important tasks of explaining the emergence of economic dominance in the institutional balance of power and of formulating an institutional account for distinctive punishment practices, such as the advent of mass incarceration in the United States.