Breakthrough candidaemia caused by phenotypically susceptible Candida spp. in patients with haematological malignancies does not correlate with established interpretive breakpoints.

In a study of 27,864 patients with haematological malignancies, 40 patients with candidaemia were identified, among whom 21 developed candidaemia while receiving systemic antifungal therapy [breakthrough candidaemia (BTC)]. Demographic, clinical, microbiological and molecular features of these episodes were analysed. Compared with 19 patients with de novo candidaemia, patients with BTC were more likely to have neutropenia (81% vs.

Optimal triage test characteristics to improve the cost-effectiveness of the Xpert MTB/RIF assay for TB diagnosis: a decision analysis.

Background: High costs are a limitation to scaling up the Xpert MTB/RIF assay (Xpert) for the diagnosis of tuberculosis in resource-constrained settings. A triaging strategy in which a sensitive but not necessarily highly specific rapid test is used to select patients for Xpert may result in a more affordable diagnostic algorithm. To inform the selection and development of particular diagnostics as a triage test we explored combinations of sensitivity, specificity and cost at which a hypothetical triage test will improve affordability of the Xpert assay.

Continuous spike and wave in slow-wave sleep in a patient with Rett syndrome and in a patient with Lhermitte-Duclos syndrome and neurofibromatosis 1.

Continuous spike and wave in slow-wave sleep (CSWS) is an electroencephalographic (EEG) pattern characterized by generalized spike-wave discharges occurring for at least 85% of non-rapid eye movement (non-REM) sleep, with marked attenuation during rapid eye movement (REM) sleep. It has been described in a large number of structural and nonstructural neurologic conditions and is associated with epilepsy, behavioral disturbances, and severe neuropsychiatric impairment. We describe continuous spike and wave in slow-wave sleep in 2 patients (one with Rett syndrome and the other with Lhermitte-Duclos syndrome).

Depression impairs learning, whereas the selective serotonin reuptake inhibitor, paroxetine, impairs generalization in patients with major depressive disorder.

To better understand how medication status and task demands affect cognition in major depressive disorder (MDD), we evaluated medication-naïve patients with MDD, medicated patients with MDD receiving the selective serotonin reuptake inhibitors (SSRI) paroxetine, and healthy controls. All three groups were administered a computer-based cognitive task with two phases, an initial phase in which a sequence is learned through reward-based feedback (which our prior studies suggest is striatal-dependent), followed by a generalization phase that involves a change in the context where learned rules are to be applied (which our prior studies suggest is hippocampal-region dependent). Medication-naïve MDD patients were slow to learn the initial sequence but were normal on subsequent generalization of that learning.

Detection of Mycobacterium tuberculosis in blood by use of the Xpert MTB/RIF assay.

We have developed a novel blood lysis-centrifugation approach for highly sensitive Mycobacterium tuberculosis detection in large volumes of blood with the Xpert MTB/RIF assay. One through 20 ml of blood was spiked with 0.25 to 10 CFU/ml of the M.

Challenges and Practices in Building and Implementing Biosafety and Biosecurity Programs to Enable Basic and Translational Research with Select Agents.

Select agent research in the United States must meet federally-mandated biological surety guidelines and rules which are comprised of two main components: biosecurity and biosafety. Biosecurity is the process employed for ensuring biological agents are properly safeguarded against theft, loss, diversion, unauthorized access or use/release. Biosafety is those processes that ensure that operations with such agents are conducted in a safe, secure and reliable manner.

Multilocus sequence typing of Candida albicans isolates from candidemia and superficial candidiasis in Israel.

Forty two Candida albicans isolates were collected from clinical samples in Israel. Twenty strains were isolated from blood cultures and 22 from superficial candidiasis. Isolates were typed by MLST analysis.

Thoracic aortic dissection and mycotic pseudoaneurysm in the setting of an unstable upper thoracic type b2 fracture.

Thoracic type B2 fractures are high-energy injuries. It is crucial to maintain a high index of suspicion for concomitant visceral injuries. A 33-year-old man presented after a motor vehicle accident with a T4 type B2.

Pain control following breast augmentation: a qualitative systematic review.

Breast augmentation is among the most popular plastic surgery procedures in the United States. Postoperative pain management following breast surgery has traditionally involved intravenous and oral narcotics. However, pain control is not always adequately achieved through these means and may cause unwanted side effects, including headache, nausea, vomiting, constipation, altered mental status, sleep disturbance, and respiratory depression.

Epidemiology and echinocandin susceptibility of Candida parapsilosis sensu lato species isolated from bloodstream infections at a Spanish university hospital.

Objectives: The aims of this work were to study the epidemiological profiles, differences in echinocandin susceptibilities and clinical relevance of the Candida parapsilosis sensu lato species isolated from proven fungaemia cases at La Fe University Hospital of Valencia (Spain) from 1995 to 2007.

Results: The prevalence of these species was: C. parapsilosis sensu stricto, 74.

Negative pressure wound therapy: an algorithm.

Negative pressure wound therapy (NPWT) has overwhelmed the wound-healing world. A systematic review puts it into perspective. The authors have developed an algorithm after careful evaluation and analysis of the scientific literature supporting the use of these devices.

Debridement of chronic wounds: a qualitative systematic review of randomized controlled trials.

This article reviews the current evidence available regarding wound debridement of chronic wounds and collates data from existing randomized controlled trials.

Visual field and ocular safety during short-term vigabatrin treatment in cocaine abusers.

Purpose: To evaluate the ocular safety of short-term vigabatrin treatment of cocaine abuse.

Design: Multicenter, prospective, randomized, placebo-controlled, double-masked, parallel assignment study.

Methods: Cocaine addicts were randomized to receive vigabatrin 3000 mg/day, cumulative dose 218 g (n = 92), or placebo (n = 94) for 12 weeks.

The functional SYNTAX score - a huge step forward or research in motion?

In a recent manuscript in the Journal of the American College of Cardiology, the newly introduced "functional SYNTAX score" (FSS) was found to be a better tool to assess the extent and severity of coronary artery disease than the SYNTAX score (SS) and has reclassified 1/3 of the studied cohort into lower-risk categories. Besides being more invasive, costly, and time consuming, FSS still suffers from inherent deficiencies of its own. Like SS, FSS does not incorporate clinical risk predictors and consequently is a suboptimal tool for predicting PCI risk.

Evaluation of fungal-specific fluorescent labeled echinocandin probes as diagnostic adjuncts.

The diagnosis of invasive fungal infections from radiographic imaging is non-specific and problematic. As a first step toward increasing specificity, we describe the development of a broad-spectrum fungal-specific targeting molecule, which when modified with a fluorescent label fully retains its targeting properties, and provides a basis for future imaging applications.

Glucose sensing neurons in the ventromedial hypothalamus.

Neurons whose activity is regulated by glucose are found in a number of brain regions. Glucose-excited (GE) neurons increase while glucose-inhibited (GI) neurons decrease their action potential frequency as interstitial brain glucose levels increase. We hypothesize that these neurons evolved to sense and respond to severe energy deficit (e.

Assessment of two new molecular methods for identification of Candida parapsilosis sensu lato species.

Candida parapsilosis sensu stricto, C. orthopsilosis, and C. metapsilosis replaced C.

Fractional CO(2) laser resurfacing.

Fractionated CO(2) lasers are a new treatment modality for skin resurfacing. These lasers have been shown efficacious in treating facial photoaging changes and scars. These lasers have an improved safety and recovery profile compared with traditional CO(2) laser resurfacing.

Defective neuromuscular transmission in the SOD1 G93A transgenic mouse improves after administration of human umbilical cord blood cells.

To assess the effect of human umbilical cord blood (hUCB) transplantation on neuromuscular transmission in SOD1(G93A) transgenic mice, we studied the probability of neuromuscular transmission (PNMT), a relevant physiological indicator of motor nerve function, in 3 SOD1(G93A) mice transplanted with hUCB and compared to PNMT in 4 SOD1(G93A) mice without cell transplantation and 3 non-mutant SOD1 transgenic mice. For preparations isolated from non-mutant SOD1 transgenic mice, PNMT was 0.93 and 0.

Current perspectives on echinocandin class drugs.

It has been nearly a decade since caspofungin was approved for clinical use as the first echinocandin class antifungal agent, followed by micafungin and anidulafungin. The echinocandin drugs target the fungal cell wall by inhibiting the synthesis of β-1,3-D-glucan, a critical cell wall component of many pathogenic fungi. They are fungicidal for Candida spp.