Summary Defervescence of sepsis after removal of culture-positive central venous catheters (CVCs) has been advocated for diagnosis of catheter-related bloodstream infection (CRBSI) even without ...positive blood culture. However, most studies report CRBSI incidence only when blood cultures, and CVC tip, are positive (standard definition). We examined the effect of inclusion of defervescence criteria on CRBSI incidence in a total parenteral nutrition (TPN) population. The study was carried out in a 525 bed tertiary referral hospital for a period of 12 years. CRBSI incidence was compared between standard definition (positive CVC tip culture and positive blood culture) and when ‘defervescence criteria’ were included. Sepsis defervescence was defined as a fall in temperature, white cell count and sepsis resolution after CVC removal, with positive CVC tip culture, but negative blood cultures. CRBSI episodes in which a blood culture was omitted were excluded. The study population included 1365 patients in whom 2536 CVCs were used over a period of 15 234 CVC-days. There were 192 CRBSI episodes in 165 patients. In all, 152 CRBSI episodes met only the standard criteria for CRBSI whereas 40 episodes met the defervescence criteria. The standard definition alone resulted in a mean (± SD) incidence of 10.6 ± 5.8 per 1000 CVC-days. This increased to 13 ± 6.4 per 1000 CVC-days when defervescence criteria were included. Inclusion of defervescence criteria increased CRBSI incidence by a mean of 2.5 ± 1.4 episodes per 1000 days or 27% (95% CI: 1.61–3.339; P < 0.001). This study implies that the scale of CRBSI may be higher than is currently recognised and that the blood culture positivity rate for CRBSI is 79% (152/192).
A recently developed risk calculator for bipolar disorder (BD) accounts for clinical and parental psychopathology. Yet, it is understood that both familial predisposition and early life adversity ...contribute to the development of BD. How the interplay between these two factors influence emotion and reward processing networks in youth at risk for BD remains unclear. In this exploratory analysis, offspring of BD parents performed emotion and reward processing tasks while undergoing a fMRI scan. Risk calculator score was used to assess risk for developing BD in the next 5 years. Environmental risk was tabulated using the Stressful Life Events Schedule (SLES). Emotion and reward processing networks were investigated for genetic and/or environment interactions. Interaction effects were found between risk calculator scores, negative SLES score and activity in right amygdala and bilateral fusiform gyri during the emotion processing task, as well as activity in the fronto-, striatal, and parietal regions during the reward processing task. Our findings are preliminary; however, they support the unique and interactive contributions of both familial and environmental risk factors on emotion and reward processing within OBP. They also identify potential neural targets to guide development of interventions for youth at greatest risk for psychiatric disorders.
Fathering in the first few months Thomas, Jan E.; Bonér, Ann-Kathrine; Hildingsson, Ingegerd
Scandinavian journal of caring sciences,
September 2011, Letnik:
25, Številka:
3
Journal Article
Recenzirano
Scand J Caring Sci; 2011; 25; 499–509
Fathering in the first few months
Becoming a parent is a major event in life. Pregnancy is a time when both physical and emotional changes affect the lives of ...expectant parents as they prepare for parenthood. The aim of this study was to focus on fathers during and shortly after pregnancy. A prospective longitudinal study was conducted in all hospital prenatal clinics in the county council of Västernorrland, Sweden. Participating were 827 partners of women who had been pregnant and given birth during the period of June 2007 to June 2008. Data were collected using three questionnaires. Regression analysis showed that fathers who were most concerned about their new role were those that were university educated, first‐time fathers, and those with financial worries. Support from the midwife or others close to the father did not impact fathers’ thoughts about the difficulties of being a parent during pregnancy, but lack of support from the partners after the birth increased fathers’ concern. This study suggests that more research is needed on fathers’ own needs for support in parenting.
Asthma is the leading chronic disease among children in most industrialized countries. However, the evidence base on specific aspects of pediatric asthma, including therapeutic strategies, is limited ...and no recent international guidelines have focused exclusively on pediatric asthma. As a result, the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology nominated expert teams to find a consensus to serve as a guideline for clinical practice in Europe as well as in North America. This consensus report recommends strategies that include pharmacological treatment, allergen and trigger avoidance and asthma education. The report is part of the PRACTALL initiative ** , which is endorsed by both academies.
•Prairie voles are an integrative model linking stress, cellular aging, and depression.•Social isolation increased glucocorticoids, anhedonia, and cellular aging.•Oxytocin treatment prevents the ...negative consequences of social isolation.
Chronic stressors, such as chronic isolation in social mammals, can elevate glucocorticoids, which can affect cellular mechanisms of aging, including increased levels of oxidative stress and shortened telomere lengths. Recent work in the selectively social prairie vole (Microtus ochrogaster) suggests that oxytocin and social support may mitigate some of the negative consequences of social isolation, possibly by reducing glucocorticoid levels. We investigated the influences of isolation, social support, and daily oxytocin injections in female prairie voles. Glucocorticoid levels, oxidative damage, telomere length, and anhedonia, a behavioral index of depression, were measured throughout the study. We found that six weeks of chronic isolation led to increased glucocorticoid levels, oxidative damage, telomere degradation and anhedonia. However, daily oxytocin injections in isolated voles prevented these negative consequences. These findings demonstrate that chronic social isolation in female prairie voles is a potent stressor that results in depression-like behavior and accelerated cellular aging. Importantly, oxytocin can completely prevent the negative consequences of social isolation.
Previous studies provide evidence for an association between modifications of the gut microbiota in early life and the development of food allergies. We studied the faecal microbiota composition (16S ...rRNA gene amplicon sequencing) and faecal microbiome functionality (metaproteomics) in a cohort of 40 infants diagnosed with cow's milk allergy (CMA) when entering the study. Some of the infants showed outgrowth of CMA after 12 months, while others did not. Faecal microbiota composition of infants was analysed directly after CMA diagnosis (baseline) as well as 6 and 12 months after entering the study. The aim was to gain insight on gut microbiome parameters in relation to outgrowth of CMA. The results of this study show that microbiome differences related to outgrowth of CMA can be mainly identified at the taxonomic level of the 16S rRNA gene, and to a lesser extent at the protein-based microbial taxonomy and functional protein level. At the 16S rRNA gene level outgrowth of CMA is characterized by lower relative abundance of Lachnospiraceae at baseline and lower Bacteroidaceae at visit 12 months.
Habitat quality can have far‐reaching effects on organismal fitness, an issue of concern given the current scale of habitat degradation. Many temperate upland streams have reduced nutrient levels due ...to human activity. Nutrient restoration confers benefits in terms of invertebrate food availability and subsequent fish growth rates. Here we test whether these mitigation measures also affect the rate of cellular ageing of the fish, measured in terms of the telomeres that cap the ends of eukaryotic chromosomes. We equally distributed Atlantic salmon eggs from the same 30 focal families into 10 human‐impacted oligotrophic streams in northern Scotland. Nutrient levels in five of the streams were restored by simulating the deposition of a small number of adult Atlantic salmon Salmo salar carcasses at the end of the spawning period, while five reference streams were left as controls. Telomere lengths and expression of the telomerase reverse transcriptase (TERT) gene that may act to lengthen telomeres were then measured in the young fish when 15 months old. While TERT expression was unrelated to any of the measured variables, telomere lengths were shorter in salmon living at higher densities and in areas with a lower availability of the preferred substrate (cobbles and boulders). However, the adverse effects of these habitat features were much reduced in the streams receiving nutrients. These results suggest that adverse environmental pressures are weakened when nutrients are restored, presumably because the resulting increase in food supply reduces levels of both competition and stress.
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