Impact of computerized prescriber order entry on the incidence of adverse drug events in pediatric inpatients.

Objectives: This study was conducted to determine the impact of a computerized physician order entry system with substantial decision support on the incidence and types of adverse drug events in hospitalized children.

Methods: A prospective methodology was used for the collection of adverse drug events and potential adverse drug events from all patients admitted to the pediatric intensive care and general pediatric units over a 6-month period. Data from a previous adverse drug event study of the same patient care units before computerized physician order entry implementation were used for comparison purposes.

Colossal magnetocapacitance and colossal magnetoresistance in HgCr2S4.

We present a detailed study of the dielectric and charge transport properties of the antiferromagnetic cubic spinel HgCr2S4. Similar to the findings in ferromagnetic CdCr2S4, the dielectric constant of HgCr2S4 becomes strongly enhanced in the region below 60-80 K, which can be ascribed to polar relaxational dynamics triggered by the onset of ferromagnetic correlations. In addition, the observation of polarization hysteresis curves indicates the development of ferroelectric order below about 70 K.

Relaxor ferroelectricity and colossal magnetocapacitive coupling in ferromagnetic CdCr2S4.

Materials in which magnetic and electric order coexist--termed 'multiferroics' or 'magnetoelectrics'--have recently become the focus of much research. In particular, the simultaneous occurrence of ferromagnetism and ferroelectricity, combined with an intimate coupling of magnetization and polarization via magnetocapacitive effects, holds promise for new generations of electronic devices. Here we present measurements on a simple cubic spinel compound with unusual, and potentially useful, magnetic and electric properties: it shows ferromagnetic order coexisting with relaxor ferroelectricity (a ferroelectric cluster state with a smeared-out phase transition), both having sizable ordering temperatures and moments.

Orbital freezing and orbital glass state in FeCr2S4.

Low-temperature specific heat measurements and dielectric spectroscopy have been performed on polycrystalline and single-crystalline FeCr2S4, the single crystals showing a transition into a low-temperature orbital glass phase. The freezing of the orbital moments is revealed by a glasslike specific heat anomaly and by a clear relaxational behavior of the dielectric permittivity, exhibiting several hallmark features of glassy dynamics. The orbital relaxation dynamics continuously slows down over six decades in time, before at the lowest temperatures the glass transition becomes suppressed by quantum tunneling.

Modulation of T-cell costimulation as immunotherapy or immunochemotherapy in experimental visceral leishmaniasis.

CD40 ligand (CD40L)-deficient C57BL/6 mice failed to control intracellular Leishmania donovani visceral infection, indicating that acquired resistance involves CD40-CD40L signaling and costimulation. Conversely, in wild-type C57BL/6 and BALB/c mice with established visceral infection, injection of agonist anti-CD40 monoclonal antibody (MAb) induced killing of approximately 60% of parasites within liver macrophages, stimulated gamma interferon (IFN-gamma) secretion, and enhanced mononuclear cell recruitment and tissue granuloma formation. Comparable parasite killing was also induced by MAb blockade (inhibition) of cytotoxic T lymphocyte antigen-4 (CTLA-4) which downregulates separate CD28-B7 T-cell costimulation.

Incidence and impact of adverse drug events in pediatric inpatients.

Objectives: To determine the incidence and causes of adverse drug events (ADEs) and potential ADEs in hospitalized children, and to examine the consequences of these events.

Design: Prospective review of medical records and staff interviews were performed. The ADEs were defined as injuries from medications or lack of an intended medication, and potential ADEs, as errors with the potential to result in injury.

Surgical Infection Society position on vancomycin-resistant Enterococcus.

The risk of transfer of vancomycin resistance to staphylococci is a real possibility and has been achieved in the laboratory. Prolonged colonization occurs with vancomycin-resistant Enterococcus (VRE), and many more patients are colonized than infected. The failure to identify, isolate, and adhere to infection control measures when caring for VRE-colonized patients dooms to failure any means to control its spread.

Models of relapse of experimental visceral leishmaniasis.

To establish models for studying recurrence of visceral leishmaniasis, a growing problem in T cell-deficient patients, two approaches were investigated: treatment of euthymic BALB/c mice with quiescent Leishmania donovani infection with T cell-depleting or anti-cytokine antibodies and serial observation of acutely infected nude BALB/c mice after an initial antileishmanial response induced by amphotericin B treatment. In chronically infected euthymic mice, maintenance of acquired immunity and prevention of relapse required CD4 cells and a multicytokine-dependent mechanism involving endogenous interleukin-2, interferon-gamma, and tumor necrosis factor-alpha. Acutely infected nude mice responded to amphotericin B with a > or = 85% reduction in liver parasite burdens; however, after a brief lag, visceral infection readily recurred in the posttreatment period.

Treatment of experimental visceral leishmaniasis in a T-cell-deficient host: response to amphotericin B and pentamidine.

In experimental visceral leishmaniasis, euthymic but not athymic (nude) BALB/c mice respond to conventional treatment with pentavalent antimony, indicating that the in vivo efficacy of antimony is T cell dependent. This finding correlates with frequent antimony treatment failures for T-cell-deficient patients with visceral leishmaniasis. To determine whether the in vivo efficacies of alternative antileishmanial agents also require T cells, Leishmania donovani-infected euthymic and nude BALB/c mice were treated with pentamidine or amphotericin B.