Bacteraemia due to carbapenemase-producing Enterobacteriaceae is an emerging medical problem. Management of this entity is complicated by the difficulty in Identifying resistance patterns and the ...limited therapeutic options. A cohort study was performed including all episodes of bloodstream infection due to OXA-48-producing Enterobacteriaceae (O48PE), occurring between July 2010 and April 2012. Data on predisposing factors, clinical presentation, therapy and outcome were collected from medical records. There were 40 cases of bacteraemia caused by O48PE, 35 Klebsiella pneumoniae and five Escherichia coli. Patients were elderly with significant comorbidities (57.5% underlying malignancy). Thirty-five cases (87.5%) were nosocomial, and five (12.5%) were healthcare-associated. Patients had frequently been exposed to antibiotics and to invasive procedures during hospitalization. The most common source of bacteraemia was the urinary tract followed by deep intra-abdominal surgical site infection. Clinical presentation was severe sepsis or shock in 18 cases (45%). Extended-spectrum β-lactamase production was detected in 92.5% of isolates. MIC90 for ertapenem, imipenem and meropenem were 32, 16 and 16 mg/L, respectively. Most frequently preserved antibiotics were amikacin, colistin, tigecycline and fosfomycin. These antibiotics combined are the basis of targeted therapies, including carbapenem in selected cases. Median delay in starting clinically adequate and microbiologically appropriate treatment was 3 days. Crude mortality during admission and within 30 days from bacteraemia was 65% and 50%, respectively. Bloodstream infections caused by O48PE have a poor prognosis. Delay in diagnosis and in initiation of optimal antimicrobial therapy is frequent. Suspicion and rapid identification could contribute to improving outcomes.
Yebes 40m radio telescope is the main and largest observing instrument at Yebes Observatory and it is devoted to Very Long Baseline Interferometry (VLBI) and single dish observations since 2010. It ...has been covering frequency bands between 2 GHz and 90 GHz in discontinuous and narrow windows in most of the cases, to match the current needs of the European VLBI Network (EVN) and the Global Millimeter VLBI Array (GMVA).
Nanocosmos project, a European Union funded synergy grant, opened the possibility to increase the instantaneous frequency coverage to observe many molecular transitions with single tunnings in single dish mode. This reduces the observing time and maximises the output from the telescope.
We present the technical specifications of the recently installed 31.5 - 50GHz (Q band) and 72 - 90.5 GHz (W band) receivers along with the main characteristics of the telescope at these frequency ranges. We have observed IRC+10216, CRL 2688 and CRL 618, which harbour a rich molecular chemistry, to demonstrate the capabilities of the new instrumentation for spectral observations in single dish mode.
The results show the high sensitivity of the telescope in the Q band. The spectrum of IRC+10126 offers a signal to noise ratio never seen before for this source in this band. On the other hand, the spectrum normalised by the continuum flux towards CRL 618 in the W band demonstrates that the 40 m radio telescope produces comparable results to those from the IRAM 30 m radio telescope, although with a smaller sensitivity. The new receivers fulfil one of the main goals of Nanocosmos and open the possibility to study the spectrum of different astrophysical media with unprecedented sensitivity.
The risk factors for complications in patients with influenza A (H1N1)v virus infection have not been fully elucidated. We performed an observational analysis of a prospective cohort of hospitalized ...adults with confirmed pandemic influenza A (H1N1)v virus infection at 13 hospitals in Spain, between June 12 and November 10, 2009, to identify factors associated with severe disease. Severe disease was defined as the composite outcome of intensive‐care unit (ICU) admission or in‐hospital mortality. During the study period, 585 adult patients (median age 40 years) required hospitalization because of pandemic (H1N1) 2009. At least one comorbid condition was present in 318 (54.4%) patients. Pneumonia was diagnosed in 234 (43.2%) patients and bacterial co‐infection in 45 (7.6%). Severe disease occurred in 75 (12.8%) patients, of whom 71 required ICU admission and 13 (2.2%) died. Independent factors for severe disease were age <50 years (OR, 2.39; 95% CI, 1.05–5.47), chronic comorbid conditions (OR, 2.93; 95% CI, 1.41–6.09), morbid obesity (OR, 6.7; 95% CI, 2.25–20.19), concomitant and secondary bacterial co‐infection (OR, 2.78; 95% CI, 1.11–7) and early oseltamivir therapy (OR, 0.32; 95% CI 0.16–0.63). In conclusion, although adults hospitalized for pandemic (H1N1) 2009 suffer from significant morbidity, mortality is lower than that reported in the earliest studies. Younger age, chronic comorbid conditions, morbid obesity and bacterial co‐infection are independent risk factors for severe disease, whereas early oseltamivir therapy is a protective factor.
Nanoparticles exhibiting a cooperative spin transition, prepared using the reverse micelle technique, are reported. A 40 K magnetic hysteresis is observed near room temperature for ...Fe(Htrz)2(trz)(BF4) nanoparticles (where trz is a triazole derivative) of 11 ± 5 nm in diameter. The figure shows the nanoparticles in octane in the low‐spin state (left) and the high‐spin state (right).
We report the detection for the first time in space of three new pure hydrocarbon cycles in TMC-1:
c
-C
3
HCCH (ethynyl cyclopropenylidene),
c
-C
5
H
6
(cyclopentadiene), and
c
-C
9
H
8
(indene). We ...derive a column density of 3.1 × 10
11
cm
−2
for the first cycle and similar values, in the range (1−2) × 10
13
cm
−2
, for the second and third. This means that cyclopentadiene and indene, in spite of their large size, are exceptionally abundant, only a factor of five less abundant than the ubiquitous cyclic hydrocarbon
c
-C
3
H
2
. The high abundance found for these two hydrocarbon cycles together with the high abundance previously found for the propargyl radical (CH
2
CCH) and other hydrocarbons, such as vinyl and allenyl acetylene (Agúndez et al. 2021, A&A, 647, L10; Cernicharo et al. 2021a, A&A, 647, L2; Cernicharo et al. 2021b, A&A, 647, L3), start to allow us to quantify the abundant content of hydrocarbon rings in cold dark clouds and to identify the intermediate species that are probably behind the in situ bottom-up synthesis of aromatic cycles in these environments. While
c
-C
3
HCCH is most likely formed through the reaction between the radical CCH and
c
-C
3
H
2
, the high observed abundances of cyclopentadiene and indene are difficult to explain through currently proposed chemical mechanisms. Further studies are needed to identify how five- and six-membered rings are formed under the cold conditions of a cloud such as TMC-1.
In a randomized trial involving patients with acute pancreatitis, early aggressive fluid resuscitation resulted in increased fluid overload without improvement in clinical outcomes.
We report on the first detection of C3N- and C5N- towards the cold dark core TMC-1 in the Taurus region, using the Yebes 40 m telescope. The observed C3N/C3N- and C5N/C5N- abundance ratios are ~140 ...and ~2, respectively; that is similar to those found in the circumstellar envelope of the carbon-rich star IRC +10216. Although the formation mechanisms for the neutrals are different in interstellar (ion-neutral reactions) and circumstellar clouds (photodissociation and radical-neutral reactions), the similarity of the C3N/C3N- and C5N/C5N- abundance ratios strongly suggests a common chemical path for the formation of these anions in interstellar and circumstellar clouds. We discuss the role of radiative electronic attachment, reactions between N atoms and carbon chain anions C n -, and that of H- reactions with HC3N and HC5N as possible routes to form C n N-. The detection of C5N- in TMC-1 gives strong support for assigning to this anion the lines found in IRC +10216, as it excludes the possibility of a metal-bearing species, or a vibrationally excited state. New sets of rotational parameters have been derived from the observed frequencies in TMC-1 and IRC +10216 for C5N- and the neutral radical C5N.
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