It is widely believed that Clostridium difficile (C. difficile)-associated diarrhea is a more severe disease in the elderly than in the young, associated with increased morbidity and mortality. These ...beliefs are largely anecdotal, and there are few data supporting them.
We conducted an evaluation in an urban, tertiary care hospital of 89 inpatients in whom C. difficile-associated diarrhea was identified. These patients were evaluated prospectively, and the group was divided by age into those < 60 yr of age (younger) and those > or = 60 yr (elderly).
There was no difference in mortality or morbidity in elderly individuals with C. difficile-associated diarrhea when compared with younger persons similarly infected. The response to standard treatment was similar in both groups. Older patients were more likely to have an elevated white blood cell count in association with C. difficile-associated diarrhea (60% vs 26%, p < 0.05), and were more likely to have acquired their infection in the hospital (89% vs 50%, p < 0.0001).
In the elderly, C. difficile-associated diarrhea is almost always acquired in institutions, and may not be obvious among patients' other problems. The elderly do not seem to have an increase in C. difficile diarrhea-associated morbidity or mortality. There is no evidence that C. difficile-associated diarrhea is more severe in the elderly than it is in the young.
Purpose of Review
Biologic agents such as adalimumab, etanercept, golimumab, certolizumab, ustekinumab, brodalumab, secukinumab, ixekizumab, dupilumab, alefacept, rituximab, omalizumab, ...tildrakizumab, and guselkumab are now indicated in the treatment of dermatologic disorders. This review reports on current prevention, risk, and management of infection in patients receiving biologic therapy for dermatologic disorders.
Recent Findings
Although risk of infection in patients receiving biologic agents for management of a dermatologic disorder is well-known, it appears to continue to be a low risk. However, optimal prevention and management of some infection risks remain an unmet need.
Summary
Although the overall risk for infection during biologic therapy for dermatologic disorders appears to remain low, there remains concern about the level of risk for reactivation of tuberculosis, as well as hepatitis B and C, and the risk for other, often uncommon, serious infection remains unknown. Continued pharmacovigilance serves to mitigate risk as well as promote optimal management of dermatologic disorders with biologic agents.
Human δ globin is expressed at approximately 1–2% of the level of human β globin in erythroid cells despite the marked homology between these two globins. To determine the DNA sequences responsible ...for this effect, δ and β globin genes and fusion products of these genes constructed in vitro were transfected and expressed in HeLa cells. The results indicate that when the small intervening sequence of the β gene (β IVS 1) is replaced by β IVS 1, expression of the chimeric gene is the same as that of the normal β globin gene. By contrast, when the large intervening sequence of the β gene (β IVS 2) is replaced by δ IVS 2, expression of the chimeric gene is markedly reduced. These results suggest that there are signals within IVS 2 of the δ and β genes which affect their relative expression.
Using the ARGUS detector at the
e
+
e
− storage ring DORIS II, we have searched for the real and imaginary part of the electric dipole formfactor
d
τ
of the
τ lepton in the production of
τ pairs at
q
...2=100
GeV
2
. This is the first direct measurement of this
CP
violating formfactor. We applied the method of optimised observables which takes into account all available information on the observed
τ decay products. No evidence for
CP
violation was found, and we derive the following results:
Re(d
τ)=(1.6±1.9)·10
−16
e
cm
and
Im(d
τ)=(−0.2±0.8)·10
−16
e
cm
, where statistical and systematic errors have been combined.
Using the ARGUS detector at the
e
+
e
− storage ring DORIS II at DESY, we have found evidence for the production of the excited charmed baryon state
Λ
c
(2593)
+ in the channel
Λ
c
+
π
+
π
−. Its ...mass was determined to be (2594.6±0.9±0.4) MeV/c
2, and the natural width measured to be Γ = (2.9
−2.1−1.4
+2.9+1.8) MeV. The production cross section times the branching ratios of
σ(
e
+
e
− →
Λ
c
(2593)
+
X) ×
Br(
Λ
c
(2593)
+ →
Λ
c
+
π
+
π
−) ×
Br(
Λ
c
+ →
pK
−
π
+) was measured to be (0.25
−0.13
+0.24 ±0.13) pb. The fractions of
Λ
c
(2593)
+ decays proceeding through the
Σ
c
0
π
+ and
Σ
c
++
π
− channels were determined to be 0.29±0.10±0.11 and 0.37±0.12±0.13, respectively.
Using the ARGUS detector at the
e
+
e
− storage ring DORIS II, we have measured the Michel parameters
ρ,
ξ, and
ξδ for
τ
±→l
±ν
ν
̄
decays in
τ-pair events produced at center of mass energies in the ...region of the
ϒ resonances. Using
τ
∓→
ρ
∓
ν as spin analyzing tags, we find
ρ
e
=0.68±0.04±0.08,
ξ
e
=1.12±0.20±0.09,
ξδ
e
=0.57±0.14±0.07,
ρ
μ
=0.69±0.06±0.08,
ξ
μ
=1.25±0.27±0.14 and
ξδ
μ
=0.72±0.18±0.10. In addition, we report the combined ARGUS results on
ρ,
ξ, and
ξδ using this work und previous measurements.
Using the ARGUS detector at the
e
+
e
− storage ring DORIS II, we have determined the Michel parameters ξ and δ of
τ
∓ → l
∓ν
ν
-
decays. With an integrated luminosity of 445 pb
−1 around
s
= 10
GeV, ...we have produced approximately 415000 τ-pairs. From this data sample, 3262 events were selected with
e
+e
− → τ
+τ
− → (l
±ν
ν
-
) (π
∓π
+π
−ν)
. The semihadronic decay was used as analyser of the τ-spin and made possible - owing to the spin correlations - the determination of the parity-violating Michel parameters ξ and δ in the decay
τ
∓ → l
∓ν
ν
-
. Simultaneously to the determination of the Michel parameters, a measurement of the τ-neutrino helicity
h
ν
τ
in the decay
τ
∓ →
π
∓
π
+
π
−
ν was obtained. We observed
h
ν
τ
= −0.85
−0.17
+0.15 ± 0.05,
ϱ = 0.721 ± 0.040 ± 0.021,
ξ = 1.26
−0.26
+0.30 ± 0.09, and
ξδ = 0.77
−0.16
+0.18 ± 0.05. In addition, the combined ARGUS result on
h
ν
τ
, ϱ, ξ, and ξδ are reported using this work and previous measurements.
Using the ARGUS detector at the
e
+
e
− storage ring DORIS II at DESY, we have studied lepton energy spectra in τ decays. We present a “pseudo-rest-frame” technique in which the second τ in the ...event, decaying into a heavy hadronic system, is used as reference. This method allows for the first measurement of the Michel Parameter η in τ decays. We also determine the Michel Parameter ρ in τ →
ev̄v decays with a precision comparable to the present world average. The measured values of the parameters ρ=0.735±0.036±0.020 and η=0.03±0.18±0.12 are in good agreement with standard V-A coupling at the τ-ν-W vertex.
A β globin gene from a patient with homozygous β+ thalassemia has been cloned and completely sequenced. No changes from normal are found in the 200 nucleotides 5′ to the cap site, in the 3′ ...untranslated region up to the poly A addition site, in the small intervening sequence (IVS 1), or in the coding sequence except for a third base change in codon 2. The only other differences are in the large intervening sequence (IVS 2). One of these, at a position 16 nucleotides from the 5′ end of IVS 2, has been reported previously in normal individuals, and is probably a polymorphism. Four other changes, at positions 74, 81, 666, and 705 are also seen in IVS 2. Abnormal β globin mRNA precursors detected in the bone marrow cells of this patient, and abnormal β globin RNA splicing observed when this gene is transcribed in a tissue culture system taken together with these IVS 2 changes, suggest that the β+ thalassemia phenotype is produced by a decrease in normal β globin mRNA processing.
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