Use of investigations in lower respiratory tract infection in the community: a European survey

A questionnaire survey was performed on the use of investigations and their impact on treatment of adult lower respiratory tract infection in the community. Data on the management of 2,056 such infections were obtained simultaneously from general practitioners in France, Germany, Italy, Spain and the UK. Diagnostic tests were only performed in 29% of cases. Chest radiographs were performed most frequently (22%), followed by peripheral blood white cell count (15%) and microbiological examination of sputum (7%), with major differences being found in the frequency of these tests both by clinical diagnosis and country. A change in initial antibiotic therapy was made in 12% of cases, with use of investigation being significantly linked to such changes. Second- and third-line antibiotics were significantly different to first-line therapy, with macrolides the most frequently prescribed second-line and quinolones the most frequently prescribed third-line antibiotics.     

Hand injuries due to fireworks explosion

Two different series of patients with burst injuries of the hand were retrospectively reviewed: one series included 23 men, 15-55 years old, referred to the emergency department for the first-instance assessment of injuries of the right hand (13 patients) and left hand (10 patients). The other series included 44 patients (42 men and 2 women, aged 7-61 years) referred to our department for second-instance examinations: the latter patients had burst injuries involving only the hands in 43 cases and both the hand and the foot in one case. We report the radiologic patterns of traumatic bone injuries (fractures and amputations) and of musculotendinous and cutaneous injuries and discuss their mechanisms and pathogenesis. The two series were compared and the results follow: in both series the right hand was more frequently involved, metacarpal bones were most often fractured and phalanges most often amputated. In the first series, in the right hand the carpal bones were involved in one patient only, the 2nd and 3rd metacarpal bones were most frequently fractured and the 2nd finger was most frequently involved. In the left hand, the carpal bones were never affected, the 1st metacarpal bone was most often amputated and the 5th metacarpal bone most often fractured; the 2nd finger was most frequently involved. In the second series, in the right hand, the 1st metacarpal bone was most frequently fractured and the 2nd metacarpal bone most often amputated; the 2nd finger was most frequently involved. In the left hand, the 4th metacarpal bone was most frequently fractured and the 5th metacarpal bone most often amputated. The severity of the above injuries and the extent of tissue damage depend on several factors, including firecracker speed, shape, size, weight and characteristics. Radiologic exams are very useful for the accurate study of these traumatic injuries, providing indirect information about musculotendinous and cutaneous involvement. Prompted by the relative lack of information on the management of these injuries, we suggest that radiologic exams be quickly performed to help choose the most appropriate surgical approach for best cosmetic and functional results.     

Estimating probabilistic confidence for mixture components identified using a spectral search algorithm

Providing a confidence measure associated with the substance(s) identified in an unknown mixture by a spectral search technique is critical for non-expert users of devices and techniques based on spectroscopy. In this work, a technique for estimating probabilities associated with substances identified by spectral searching is described. In the proposed approach, a mixture analysis algorithm processes the spectrum of an unknown sample using a spectral library to generate a list of substances that may be present in the sample. The partial correlation of each of the substances in the list is then computed. The estimation of the probability is accomplished through a generalized linear model that converts the partial correlation values to a probability measure for each of the mixture components. The statistical properties of partial correlation allow probability estimation irrespective of whether a substance is present in a pure form or within a mixture. The technique was evaluated using both simulated and real Raman spectra of multi-component mixtures, and adequate performance was demonstrated.     

Dielectric study of the interaction between DNA and an oligopeptide (lysine-tyrosine-lysine)

Interaction between Na-DNA and the oligopeptide lysine-tyrosine-lysine (LTL) is studied by a dielectric method. The comparison between conductivities (at the frequence of 5MHz) of LTL alone and of the complex LTL-DNA allows us to show up an electrostatic interaction between LTL and phosphates sites of DNA. During the formation of the complex LTL-DNA, a certain fraction of Na+ counter-ions is ejected from the phosphates sites.