Comparison of wound culture and bronchial lavage in the severely burned child: implications for antimicrobial therapy

BACKGROUND: The relationship of the burn wound flora to microbial pathogens in the tracheobronchial tree has important implications for antimicrobial therapy in the severely burned patient. Management of septic complications is bolstered by surveillance quantitative wound cultures (QWC) and bronchial lavage fluid (BLF) cultures. OBJECTIVES: To compare the organisms present in BLF with those found in QWC and to determine if QWC can predict BLF results. DESIGN: Results of BLF cultures from all patients who underwent bronchial lavage from January 1, 1996, to December 31, 1996, at our institution were compared with QWC data from the same date. Criteria for a positive match included an identical antibiotic susceptibility pattern and biotype. Match rates were calculated qualitatively and quantitatively. RESULTS: In 30 (48%) of the 62 BLF cultures, there was a match between the organism identified in the BLF and the QWC. When strict quantitative criteria were applied, the match rate was only 9 (14%) of 62. Burn size and inhalation injury had no significant effect on match rate. CONCLUSIONS: Whereas the microbial pathogens were similar in the QWC and BLF, linear regression showed no value of QWC in predicting BLF culture results. The difference between qualitative and quantitative match rates suggests cross-colonization between the burn wound and tracheobronchial tree, but little to no cross-infection. The QWC and BLF cultures must be performed independently in determining antimicrobial specificity in the burned patient.     

Range of validity of alpha and beta for a generalized diversity index H (alpha, beta) due to Good

1. Many human fetuses have to adapt to a limited supply of nutrients. In doing so they permanently change their structure and metabolism. 2. These 'programmed' changes may be the origins of a number of diseases in later life, including coronary heart disease and the related disorders stroke, diabetes and hypertension. 3. This review examines the evidence linking these diseases to fetal undernutrition and provides an overview of previous studies in this area.     

Assessment of regional left ventricular long-axis motion with MR velocity mapping in healthy subjects

We present a case of trichothiodystrophy associated with a hypereosinophilic syndrome. This case had been followed for 30 years. Trichothiodystrophy was characterized by lamellar ichthyosis, hair and nail dystrophies, kyphoscoliosis, congenital luxation of the hip. The hypereosinophilic syndrome was characterized by an itching urticaria-like eruption. Although the patient's general condition had remaining stable for 30 years, during the last year it worsened and the patient suddenly died. The authors discuss about the significance of this association.     

Comparison of prefrontal architecture and connections

The advent of new technology has led to a proliferation of studies examining the functional roles of discrete prefrontal cortical areas. This has created a need for more precise information regarding the morphological characteristics of this region. Existing architectonic maps of human and monkey brains are not compatible with regard to areal delineations and topography, creating significant difficulty in interpreting comparative data. Therefore, we have re-examined the comparative morphological organization of the prefrontal cortex in humans and rhesus monkeys. Our analysis indicates that the architectonic areas in both species correspond in terms of morphological features as well as topographical locations. We have developed a common organizational schema for these areas, thereby allowing for a resolution of previous discrepancies. Moreover, in monkeys a connectional analysis has revealed that each of the newly designated areas is characterized by a unique pattern of cortical relationships. The present organizational schema provides a framework for interrelating findings such as those obtained from human brain imaging studies with those from behavioural investigations of non-human primates.     

Numerical solution of Fredholm integral equations with a logarithmic singularity

Generalized quadrature is used for the numerical solution of two Fredholm integral equations which occur in electrostatics and aerodynamics.