During the period from April 2012 to May 2013, 13 newborns (1 to 4 weeks of age) and 1 child in a pediatric hospital ward in Germany were colonized with
producing an extended-spectrum beta-lactamase ...(ESBL) (CTX-M-15). A microbiological source-tracking analysis with human and environmental samples was carried out to identify the source and transmission pathways of the
clone. In addition, different hygienic intervention methods were evaluated.
isolates were detected in the detergent drawer and on the rubber door seal of a domestic washer-extractor machine that was used in the same ward to wash laundry for the newborns, as well as in two sinks. These strains were typed using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing. The environmental findings were compared with those for the human strains and the isolates detected on clothing. The results from both techniques showed that the strains were identical (sequence type 201 and PFGE type 00531, a clone specific to this hospital and not previously isolated in Germany), emphasizing the washing machine as a reservoir and fomite for the transmission of these multidrug-resistant bacteria. After the washing machine was taken out of use, no further colonizations were detected during the subsequent 4-year period.
Washing machines should be further investigated as possible sites for horizontal gene transfer (ESBL genes) and cross-contamination with clinically important Gram-negative strains. Particularly in the health care sector, the knowledge of possible (re-)contamination of laundry (patients' clothes and staff uniforms) with multidrug-resistant Gram-negative bacteria could help to prevent and to control nosocomial infections. This report describes an outbreak with a single strain of a multidrug-resistant bacterium (
sequence type 201) in a neonatal intensive care unit that was terminated only when the washing machine was removed. In addition, the study implies that changes in washing machine design and processing are required to prevent accumulation of residual water where microbial growth can occur and contaminate clothes.
Objective. Enlarged perihilar lymph nodes have been described in patients with primary sclerosing cholangitis (PSC). The aim of the study was to determine the clinical relevance of perihilar lymph ...nodes in PSC patients with and without cholangiocellular carcinoma (CCC). Material and methods. The status of perihilar lymph nodes was investigated in 117 patients with PSC using "high-end" ultrasound. Thirty-five of the 117 PSC patients had histologically proven CCC. Lymph node status was correlated with the presence of CCC and inflammatory bowel disease (IBD). Results. Seventy-three percent of PSC patients without CCC and 86% of patients with CCC had enlarged perihilar lymph nodes (NS). In CCC patients, the width of lymph nodes was significantly larger (12±6 mm versus 8±4 mm; p=0.0001), and the length:width ratio (2.15±0.7:1 versus 2.5±0.6:1; p=0.004) of the lymph nodes was significantly lower. Thirty-seven percent of PSC patients without CCC and 57% of patients with PSC and CCC had multiple perihilar lymph nodes (p=0.04). In all patients, the presence versus absence of IBD had no influence on the number (84% versus 74%,) and size of perihilar lymph nodes (length: 21±10 mm versus 19±7 mm). Lymph node status did not correlate with the number of episodes of cholangitis. Conclusions. Enlarged perihilar lymph nodes are characteristic of patients with PSC. Since perihilar lymph nodes are not predictive of the presence of complicating CCC, such patients should not be excluded from liver transplantation.
Here, we describe a 20-yr-old woman with COACH syndome (hypoplasia of Cerebellar vermis, Oligophrenia, congenital Ataxia, Coloboma, and Hepatic fibrosis) developing multiple liver lesions. Epigastric ...and right upper abdominal pain and lack of appetite led to clinical evaluation. Liver function tests showed an increase in transaminases and cholestatic parameters; alpha-fetoprotein was in the normal range. Ultrasound and magnetic resonance imaging examinations revealed multiple liver lesions. Histological examinations of ultrasonographically guided biopsies were consistent with regenerative hepatic nodules without features of malignant or dysplastic cells. The sizes of these tumors did not change over a period of 12 months. Our report presents the 10th case of COACH syndrome with a hitherto undescribed association with hepatic tumors.
Das Buch behandelt die Situation von Geisteswissenschaftlern und Geisteswissenschafterlinnen auf dem Arbeitsmarkt. Ausgangspunkt der sieben empirischen Beiträge des Sammelbandes sind ...Benachteiligungen von Absolventen geisteswissenschaftlicher Studiengänge im Vergleich zu anderen Hochschulabsolventen. Konsens aller Beiträge, die einen Einblick in die ökonomische Situation der Geisteswissenschaftler geben, ist 'dass AbsolventInnen dieser Fächer im Vergleich zu anderen Akademikergruppen größere Schwierigkeiten haben, sich im Berufsleben zu etablieren'. Der Sammelband gliedert sich in drei Teile. Der erste Teil befasst sich mit der allgemeinen Verortung der Geisteswissenschaften. Teil zwei widmet sich der beruflichen Spezialisierung durch weiterbildende Maßnahmen sowie der Situation einzelner Berufsgruppen. Der dritte Teil richtet den Blick auf die Situation der Geisteswissenschaften in den USA und zieht einen europäischen Vergleich zwischen den Arbeitsmarktchancen von Geisteswissenschaftler in Deutschland und Großbritannien. (IAB) Inhalt: Annette Schavan: Grußwort (7); Heike Solga, Denis Huschka, Patricia Eilsberger, Gert G. Wagner: Findigkeit in unsicheren Zeiten - Einleitung und Anliegen des Buches (9-13); I. Die berufliche Situation von GeisteswissenschaftlerInnen. Maria Kräuter, Willi Oberlander, Frank Wießner: Zurück in die Zukunft - berufliche Chancen und Alternativen für GeisteswissenschaftlerInnen (17-39); Manuel Schandock, Nancy Scharpff: Erwerbschancen im Wandel der Zeit - eine empirische Analyse der Entwicklung des beruflichen Erfolgs von GeisteswissenschaftlerInnen in Deutschland von 1985 - 2004 (41-63); II. Vom Allgemeinen zum Besonderen - Berufsspezialisierung und besondere Berufsgruppen. Kathrin Leuze, Susanne Strauß: Berufliche Spezialisierung und Weiterbildung - Determinanten des Arbeitsmarkterfolgs von GeisteswissenschaftlerInnen (67-93); Gabriele Gramelsberger, Kristina Vaillant: "Freie ForscherInnen statt Low Budget Academics" - Entwicklung eines (Berufs-)bildes "Freie Forscher/in" an der Schnittstelle zwischen Universität und Wissensgesellschaft (95-116); Jens A. Forkel: Bononia Docet. Hochschule und wissenschaftliches Volontariat am Museum im Wandel der Europäischen Hochschulreform (117-152); III. Deutsche GeisteswissenschaftlerInnen im internationalen Vergleich. Michael Gebel, Johannes Gernandt: Soziale Ungleichheit von Geisteswissenschaftlern im Beruf (155-173); Eva Bosbach: Geisteswissenschaftler in den USA - Promotion und Karriereweg im Spiegel der Bildungsforschung (175-200). Die Untersuchung enthält quantitative Daten. Forschungsmethode: deskriptive Studie.
PDF
