Double blind, randomised, placebo controlled study of oral vancomycin in prevention of necrotising enterocolitis in preterm, very low birthweight infants

AIMS: To evaluate the effectiveness of oral vancomycin in the prophylaxis of necrotising enterocolitis in preterm, very low birthweight infants. METHODS: A prospective, double blind, randomised, placebo controlled study in a tertiary referral centre of a university teaching hospital was conducted on 140 very low birthweight infants consecutively admitted to the neonatal unit. The babies were randomly allocated to receive oral vancomycin (15 mg/kg every 8 hours for 7 days) or an equivalent volume of placebo solution. Prophylaxis was started 24 hours before the start of oral feeds. All suspected cases of necrotising enterocolitis were investigated with a full sepsis screen and serial abdominal radiographs. Necrotising enterocolitis was diagnosed and staged according to modified Bell's criteria. RESULTS: Nine of 71 infants receiving oral vancomycin and 19 of 69 infants receiving the placebo solution developed necrotising enterocolitis (p = 0.035). Infants with necrotising enterocolitis were associated with a significant increase in mortality (p = 0.026) and longer duration of hospital stay (p = 0.002). CONCLUSIONS: Prophylactic oral vancomycin conferred protection against necrotising enterocolitis in preterm, very low birthweight infants and was associated with a 50% reduction in the incidence. However, widespread implementation of this preventive measure is not recommended, as it would only be effective in necrotising enterocolitis caused by Gram positive organisms and could increase the danger of the emergence of vancomycin resistant or dependent organisms. Its use should be restricted to a high prevalence nursery for a short and well defined period in a selected group of high risk patients.     

Attentional control within 3-D space

Four experiments investigated whether directing attention to a particular plane in depth enables observers to filter out information from another depth plane. Observers viewed stereoscopic displays and searched for a red line segment among green line segments. The results showed that directing attention to a particular depth plane cannot prevent attentional capture from another depth plane when the colors of the target and distractor are identical. However, it can prevent attentional capture by a singleton from another depth plane when the colors of the target and distractor are different. These results indicate that only when both color and depth information are selective in guiding attention to the target singleton can attentional capture by irrelevant singletons be prevented. The results also suggest that retinal disparity does not have the same special status as location information in two dimensions and should be considered as just another feature along which selection may occur.     

Clinical and functional evaluation of health status of workers exposed to infrasound, noise and general vibration

The article covers complex evaluation of health state in building industry workers engaged into ferro-concrete production in St. Petersburg. The health state was considered under combined action of infrasound, noise and general vibration. Clinical and functional evaluation included medical examination by doctors, blood biochemistry and CBC, ECG, computer integral rheography, voice audiometry. Data for 62 moulders helped to assess acoustic environment at workplace and to reveal the morbidity structure.     

Breed group effects on milk production of Brazilian crossbred dairy cows

Lactation records (n = 2362) of 1402 crossbred cows in 22 cooperating dairy herds in southeastern Brazil were evaluated. Cows were mixtures of Zebu (Gir, Guzera, and unknown) and European breeding (mostly Holstein). Lactation milk yields were expressed as total, 3050-d, or deviated 305-d yields, either adjusted or unadjusted for days in milk (DIM). Mean DIM was 280. Arithmetic means unadjusted for DIM were 1942, 1666, and 5 kg per record. Milk yields of daughters from sires of 6/8 and 7/8 European breeds were higher than yields of daughters from sires of 5/8 European breeds when data were either adjusted or unadjusted for DIM. The differences associated with breed group of sire were only slightly reduced when records were adjusted for DIM. There was no evidence of a decline in milk yield as the fraction of European breeding of the sire increased from 6/8 to 7/8. For a given breed group of sire, whether the grandsire was purebred or crossbred had no detectable effect. These results should be useful in determining strategies for crossbreeding of dairy cows in tropical areas, particularly when crossbred sires are used.     

扫描速度对硼铸铁气缸套表面钨极氩弧硬化效果的影响

研究了钨极氩弧扫描速度对硼铸铁表面硬化效果的影响规律。结果表明：扫描速度增加,硬化层宽度、深度减小,而硬度提高,裂纹率增大；硬化层硬度沿层深的分布是从表及里由高而低,在过渡区下降缓慢；沿层宽的分布是层中心最高,向两侧逐渐降低,直至硼铸铁基体达到最低值；在保证不出现裂纹的条件下,硬化层表面的最高硬度值可达61．4HRC,硬化层最高显微硬度值可达1156．4HV0．1；硼铸铁材料采用氩弧热源淬火时,淬硬层与基体之间过渡区明显,硬化区组织为莱氏体,过渡区为马氏体、残余奥氏体和少量石墨。     

INVESTIGATION ON CRYSTALLIZATION KINETICS OF Pd-Cu-Si GLASS

The crystallization kinetics of Pd-Cu-Si glass was studied by means of diferential scanningcalorimetry-Ⅱ.According to Kissinger peak shift meth(?)d and Arrhenius equation,theapparent activation energy was calculated.The crystallization kinetics follows Johnson-Mehl-Avrami equation with n=3.0 within 0.15相似文献   

Strength Analysis of Steam Turbine Diaphragm with a Crack

The diaphragm of steam turbine is one of the main parts of the passage unit for air flowing and the diaphragm of steam turbine is generally made by welding, but during the course of welding, some cracks often have happened, these cracks threaten safety production on the spot, so it is necessary to analyze the strength of steam turbine diaphragm with a crack. For studying its working condition and performance with a crack, the three-dimensional finite element model(FEM) with the software ANSYS 10.0 is established according to the actual working parameters. With the model, the deformation results and stress field results are analyzed and the maximum displacement and stress value are calculated, meanwhile, the maximum stress change with crack depth of steam turbine diaphragm is analyzed. It provides a good foundation for solving the problem in production.     

Breast micro-opacities of lead origin mimicking microcalcifications

After a surgical excision of focal mammary "microcalcification" we noticed that in fact they represented fine lead deposits (mean diameter: 100 microns) resulting from an attempted suicide (22 long rifle) 10 years previously. The leaded nature of these foreign microbodies was demonstrated by a micro-analysis by energy dispersion on histological slides.     

US-guided core breast biopsy: use and cost-effectiveness

OBJECTIVES: We sought to determine, using serial echocardiography, the hydrodynamic mechanisms involved in the occurrence of hemolysis after mitral valve repair. BACKGROUND: Recently, fluid dynamic simulation models have identified distinct patterns of mitral regurgitant flow disturbances in patients with mitral prosthetic hemolysis that were associated with high shear stress and may therefore produce clinical hemolysis. Rapid acceleration, fragmentation, and collision jets were associated with high shear stress and hemolysis whereas slow deceleration and free jets were not. METHODS: We reviewed serial echocardiographic studies of 13 consecutive patients with hemolytic anemia after mitral valve repair who were referred for mitral reoperation between January 1985 and December 1996 (group 1). Thirteen patients undergoing reoperation for mitral regurgitation after mitral valve repair but without hemolysis served as controls (group 2). RESULTS: The mitral regurgitant jet was central in origin in 12 group 1 patients and 9 group 2 patients (Fisher exact test, p= 0.3). The other patients had para-ring regurgitation. Group 1 patients had collision (n=11), rapid acceleration (n=2) or fragmentation (n=1) jets whereas group 2 patients had slow deceleration (n=11) or free jets (n=2) (Fisher exact test, p < 0.0001). One patient with hemolysis had both collision and rapid acceleration jets. The "culprit" jet could be identified on the postbypass transesophageal echocardiography (TEE) study in only 1 patient at the time of initial mitral repair. Twelve group 1 patients underwent reoperation, with subsequent resolution of hemolysis in all patients. At reoperation, the initial repair was found to be intact in 8 (67%) patients. CONCLUSION: Distinct patterns of flow disturbance associated with high shear stress were identified by color Doppler imaging in patients with hemolysis after mitral valve repair. The majority (92%) of these color flow disturbances were not present during intraoperative postbypass TEE study after initial mitral repair and subsequently developed in the early postoperative period.