An evaluation of systemic inflammatory response syndrome signs in the Sepsis Occurrence In Acutely Ill Patients (SOAP) study.

Objective: To define the frequency and prognostic implications of SIRS criteria in critically ill patients hospitalized in European ICUs.

Design And Setting: Cohort, multicentre, observational study of 198 ICUs in 24 European countries.

Patients And Interventions: All 3,147 new adult admissions to participating ICUs between 1 and 15 May 2002 were included.

Human T cells armed with Her2/neu bispecific antibodies divide, are cytotoxic, and secrete cytokines with repeated stimulation.

Purpose: Cancer immunotherapy has been limited by anergy of patient T cells, inadequate numbers of precursor tumor-specific CTL, and difficulty in producing therapeutic doses of CTL. To overcome these limitations, bispecific antibodies have been used to create artificial antibody receptors that direct polyclonal activated T cells (ATC) to target tumor antigens. Studies reported herein were designed to characterize bispecific antibody-armed ATC functions during multiple rounds of targeted cell stimulation.

Sepsis in European intensive care units: results of the SOAP study.

Objective: To better define the incidence of sepsis and the characteristics of critically ill patients in European intensive care units.

Design: Cohort, multiple-center, observational study.

Setting: One hundred and ninety-eight intensive care units in 24 European countries.

Subnuclear organelles: new insights into form and function.

The cell nucleus is a complex and highly dynamic environment with many functionally specialized regions of substructure that form and maintain themselves in the absence of membranes. Relatively little is known about the basic physical properties of the nuclear interior or how domains within the nucleus are structurally and functionally organized and interrelated. Here, we summarize recent data that shed light on the structural and functional properties of three prominent subnuclear organelles--nucleoli, Cajal bodies (CBs) and speckles.

Mortality prediction using SAPS II: an update for French intensive care units.

Introduction: The standardized mortality ratio (SMR) is commonly used for benchmarking intensive care units (ICUs). Available mortality prediction models are outdated and must be adapted to current populations of interest. The objective of this study was to improve the Simplified Acute Physiology Score (SAPS) II for mortality prediction in ICUs, thereby improving SMR estimates.

Intensive care in patients with newly diagnosed malignancies and a need for cancer chemotherapy.

Objective: Patients with newly diagnosed cancer responsible for organ failures may require intensive care unit (ICU) admission and immediate chemotherapy. Outcomes in this population have not been studied.

Design: Prospective observational cohort study.

SAPS 3--From evaluation of the patient to evaluation of the intensive care unit. Part 1: Objectives, methods and cohort description.

Objective: Risk adjustment systems now in use were developed more than a decade ago and lack prognostic performance. Objective of the SAPS 3 study was to collect data about risk factors and outcomes in a heterogeneous cohort of intensive care unit (ICU) patients, in order to develop a new, improved model for risk adjustment.

Design: Prospective multicentre, multinational cohort study.

SAPS 3--From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admission.

Objective: To develop a model to assess severity of illness and predict vital status at hospital discharge based on ICU admission data.

Design: Prospective multicentre, multinational cohort study.

Patients And Setting: A total of 16,784 patients consecutively admitted to 303 intensive care units from 14 October to 15 December 2002.

Continuing education programme - Victorian Institute of Forensic Medicine and Department of Forensic Medicine, Monash University.

Given the increasing requirement of the courts for forensic experts to engage in ongoing education, a continuing education programme was developed in forensic medicine at the Victorian Institute of Forensic Medicine to cater for both clinicians and pathologists. The programme consists of a series of cases which are circulatged several times per year. All are actual cases and are reflective of the types of presentations experienced in forensic medicine.

A profile of deaths in custody in Victoria, 1991-96.

In Victoria, all deaths in custody are investigated and a coronial inquest is held. The findings are entered into a data base held at the Victorian Institute of Forensic Medicine. Utilizing this data base, all listed cases of deaths in custody during the 6-year period, January 1991-December 1996, were reviewed.

Outcome of cancer patients considered for intensive care unit admission: a hospital-wide prospective study.

Purpose: To evaluate the outcome of cancer patients considered for admission to the intensive care unit (ICU).

Patients And Methods: Prospective, one-year hospital-wide study of all cancer and hematology patients, including bone marrow transplantation patients, for whom admission to the ICU was requested.

Results: Of the 206 patients considered for ICU admission, 105 patients (51%) were admitted.

Anaerobic purification and crystallization to improve the crystal quality: ferredoxin II from Desulfovibrio gigas.

Sulfate-reducing bacteria (SRB), which are strict anaerobes, contain an electron-transfer chain from pyridine nucleotides to molecular oxygen. This unique enzymatic equipment allows the bacterium to produce ATP when exposed to air from the degradation of internal reserves of polyglucose. Ferredoxin II (Fd II) is a small electron-transfer protein isolated from the strict anaerobic sulfate-reducing bacterium Desulfovibrio gigas.

[Epidemiology of infection and sepsis in intensive care unit patients].

Since 1992, epidemiological and clinical studies have classified severe infections into three categories: sepsis, severe sepsis and septic shock. Microbiological documentation is not always provided. We used a different approach, focusing on the infection itself, whether or not it is microbiologically documented or associated with sepsis.

T cells armed with anti-CD3 x anti-CD20 bispecific antibody enhance killing of CD20+ malignant B cells and bypass complement-mediated rituximab resistance in vitro.

Objective: Resistance to rituximab, a chimeric monoclonal antibody that binds to CD20, is a major limitation for the successful treatment of patients with non-Hodgkin lymphoma and other CD20+ B-cell malignancies. To circumvent rituximab resistance in these patient populations, we have constructed a bispecific antibody (BiAb), anti-CD3 x anti-CD20 (CD20Bi), that combines rituximab targeting with non-major histocompatibility complex (non-MHC)-restricted cytotoxicity mediated by activated T cells (ATC).

Materials And Methods: Activated T cells were obtained from anti-CD3 activated peripheral blood mononuclear cells (PBMC) of normal donors or the leukapheresis products of patients by culturing in the presence of interleukin-2 for 6-14 days.

"Binkie flutter," an apparently voluntary behavior of infants, possibly related to vibratory jaw movements in dogs: report of 4 cases.

Four cases of apparently voluntary rapid vibratory pacifier movements occurring in normal, unstressed infants up to 1 year of age and captured on video are presented. I speculate on the possible relationship of the movements to similar vibratory jaw movements in dogs, in which species they may represent a neuromuscular mechanism for rapid feedback control.

Development of ecdysone-regulated lentiviral vectors.

We have engineered a lentivirus-based gene transfer system to achieve ecdysone-regulated transgene expression. The method combines the wide tropism of lentiviral vectors and the possibility of gene regulation by a small molecule with an excellent pharmacological profile. Using the hematopoietic tissue as a model, we transduced mouse progenitors with an ecdysone-regulated GFP expression cassette.

Systemic inflammatory response and progression to severe sepsis in critically ill infected patients.

Rationale: The systemic inflammatory response syndrome has low specificity to identify infected patients at risk of worsening to severe sepsis or shock.

Objective: To examine the incidence of and risk factors for worsening sepsis in infected patients.

Methods: A 1-year inception cohort study in 28 intensive care units of patients (n = 1,531) having a first episode of infection on admission or during the stay.

Post-ICU mortality in critically ill infected patients: an international study.

Objective: To determine the incidence and risk factors for post-ICU mortality in patients with infection.

Design And Setting: International observational cohort study including 28 ICUs in eight countries.

Patients: All 1,872 patients discharged alive from the ICU over a 1-year period were screened for infection at ICU admission and daily throughout the ICU stay.

The prognosis of acute respiratory failure in critically ill cancer patients.

Acute respiratory failure (ARF) in patients with cancer is frequently a fatal event. To identify factors associated with survival of cancer patients admitted to an intensive care unit (ICU) for ARF, we conducted a prospective 5-year observational study in a medical ICU in a teaching hospital in Paris, France. The patients were 203 cancer patients with ARF mainly due to infectious pneumonia (58%), but also noninfectious pneumonia (9%), congestive heart failure (12%), and no identifiable cause (21%).

Cajal bodies, nucleoli, and speckles in the Xenopus oocyte nucleus have a low-density, sponge-like structure.

Nuclear organelles, unlike many cytoplasmic organelles, lack investing membranes and are thus in direct contact with the surrounding nucleoplasm. Because the properties of the nucleoplasm and nuclear organelles influence the exchange of molecules from one compartment to another, it is important to understand their physical structure. We studied the density of the nucleoplasm and the density and permeability of nucleoli, Cajal bodies (CBs), and speckles in the Xenopus oocyte nucleus or germinal vesicle (GV).

[Should we support large-scale screening for genetic haemochromatosis in France?].

Genetic hemochromatosis meets the principal World Health Organization criteria for diseases warranting systematic population screening. Indeed, it is a frequent, late-onset, severe disease that is easy to diagnose and cure. However, its penetrance is much lower than thought prior to the discovery of the HFE1 gene, whose C282 Y mutation is responsible for more than 95% of cases with phenotypic expression.

[Genetics of hereditary iron overload].

The classification of hereditary abnormalities of iron metabolism was recently expanded and diversified. Genetic hemochromatosis now corresponds to six diseases, namely classical hemochromatosis HFE 1; juvenile hemochromatosis HFE 2 due to mutations in an unidentified gene on chromosome 1; hemochromatosis HFE 3 due to mutations in the transferrin receptor 2 (TfR2); hemochromatosis HFE 4 caused by a mutation in the H subunit of ferritin; and hemochromatosis HFE 6 whose gene is hepcidine (HAMP). Systemic iron overload is also associated with aceruloplasminemia, atransferrinemia and the "Gracile" syndrome caused by mutations in BCS1L.

Measuring performance in health care: case-mix adjustment by boosted decision trees.

Objective: The purpose of this paper is to investigate the suitability of boosted decision trees for the case-mix adjustment involved in comparing the performance of various health care entities.

Methods: First, we present logistic regression, decision trees, and boosted decision trees in a unified framework. Second, we study in detail their application for two common performance indicators, the mortality rate in intensive care and the rate of potentially avoidable hospital readmissions.