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BACKGROUND: The enterococci have become important nosocomial pathogens. They can cause multiple site infections and enterococcal bacteremia becomes more frequently associated with a high mortality rate. Previous studies of enterococcal bacteremia showed a variety of results. To establish the significance and importance of enterococci as nosocomial pathogens in this hospital, to characterize their clinical pictures and to search for the risk factors for mortality, this retrospective study was performed. METHODS: There were 208 cases of enterococcal bacteremia which occurred from 1988 to 1992. Twenty-seven cases had no medical charts, dismissing possibility of evaluation. Finally, 181 cases of enterococcal bacteremia were analysed. RESULTS: One hundred and eighteen episodes were nosocomial infections. Polymicrobial bacteremia occurred in 68.5% of the patients and the most common co-isolate was Pseudomonas aeruginosa. Those patients (78.5%) with underlying diseases and malignancies were the most common underlying problems. The portal of entry could be found in 69.6 percent of patients, with the gastrointestinal tract the most common sources. Antimicrobial susceptibility testing showed high gentamicin resistance rate (89.5%), and ampicillin still had about 80 percent sensitivity rate. The group who received specific antibiotic therapy for enterococcus showed lower mortality (36.4% versus 47.6%). Only one case had infective endocarditis. Forty-nine patients suffered from septic shock, the cause of 30 deaths. Totally 75 patients died during hospitalization. Besides sepsis, another major cause of death was their underlying diseases itself. CONCLUSIONS: Enterococci have no doubt become important nosocomial pathogens and enterococcal bacteremia were associated with high mortality, especially in elderly patients with underlying diseases such as malignancy or diabetes. When clinically dealing with sepsis from the gastrointestinal or biliary tract, especially when previous cephalosporins therapy showed no response, the possibility of enterococcal bacteremia should always be considered. 相似文献
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NF Saba JD Sweeney LC Penn JC Lawton RL Yankee CH Huang MS Schanfield 《Canadian Metallurgical Quarterly》1997,37(3):321-324
PURPOSE: We report a case of postoperative reparalysis in the recovery room, following nebulized epinephrine. The patient was pharmacologically reversed with edrophonium after paralysis with rocuronium. CLINICAL FINDINGS: A 12-yr-old girl developed postoperative reparalysis following the intraoperative administration of rocuronium. A total of 0.92 mg.kg-1 rocuronium was administered. After surgery, pharmacological reversal was achieved with 20 mg edrophonium with 0.15 mg atropine sulfate iv 35 min after the last administration of rocuronium. Muscular relaxation was monitored using an ulnar peripheral nerve stimulator (PNS). After reversal, a full train-of-four and sustained tetanus at 50 Hz were present. In the recovery room, following nebulized epinephrine, the patient became apneic. The patient was paralyzed and an ulnar PNS demonstrated only one faint twitch. The paralysis was reversed with 1.5 mg neostigmine with 0.3 mg glycopyrrolate. CONCLUSION: Postoperative reparalysis following rocuronium may be a cause of postoperative respiratory distress. The definitive diagnosis is made using PNS and observing the response to pharmacological reversal. Nebulized epinephrine may have a previously undescribed role in the development of postoperative reparalysis. 相似文献
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Sensory activity mediates regulation of tyrosine hydroxylase (TH), the first enzyme in the dopamine biosynthetic pathway, in the rodent olfactory bulb. The current studies established for the first time primary cultures of neonatal mouse olfactory bulb expressing TH and tested whether L-type calcium channels mediate the activity-dependent regulation of the dopamine phenotype. After 1 d in vitro (DIV), a small population of TH-immunostained neurons that lacked extensive processes could be demonstrated. After an additional 2 DIV in serum-free medium, the number of TH neurons had doubled, and they exhibited long interdigitating processes. Membrane depolarization for 48 hr with 50 mM KCl produced a further 2.4-fold increase in the number of TH-immunoreactive neurons compared with control cultures. Increased TH neuron number required at least 36 hr of exposure to KCl. Forskolin, which increases intracellular cAMP levels, induced a 1.5- to 1.6-fold increase in the number of TH-immunostained neurons. Combined treatment with KCl and forskolin was not additive. Nifedipine, an L-type calcium channel blocker, completely prevented the depolarization-mediated increase in TH expression but did not block the response to forskolin. Treatment with Bay K8644, an L-type calcium channel agonist, also significantly increased the number of TH-expressing neurons. Depolarization also induced alterations in neuritic outgrowth, resulting in a stellate versus an elongate morphology that, in contrast, was not prevented by nifedipine. These results are the first demonstration that in vitro, as in vivo, depolarization increases TH expression in olfactory bulb and that L-type calcium channels mediate this activity-dependent regulation of the dopamine phenotype. 相似文献
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Structural engineers use design codes formulated to consider uncertainty for both reinforced concrete and structural steel
design. For a simple one-bay structural steel frame, we survey typical uncertainties and compute an interval solution for
displacements and forces. The naive solutions have large over-estimations, so we explore the Mullen-Muhanna assembly strategy,
scaling, and constraint propagation to achieve tight enclosures of the true ranges for displacements and forces in a fraction
of the CPU time typically used for simulations. That we compute tight enclosures, even for large parameter uncertainties used
in practice, suggests the promise of interval methods for much larger structures. 相似文献
8.
Norris Fran H.; Murphy Arthur D.; Baker Charlene K.; Perilla Julia L.; Rodriguez Francisco Gutiérrez; Rodriguez José de Jesús Gutiérrez 《Canadian Metallurgical Quarterly》2003,112(4):646
Prevalence rates of trauma and posttraumatic stress disorder (PTSD) were estimated from a probability sample of 2,509 adults from 4 cities in Mexico. PTSD was assessed according to Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) criteria using the Composite International Diagnostic Interview (CIDI; WHO, 1997). Lifetime prevalence of exposure and PTSD were 76% and 11.2%, respectively. Risk for PTSD was highest in Oaxaca (the poorest city), persons of lower socioeconomic status, and women. Conditional risk for PTSD was highest following sexual violence, but nonsexual violence and traumatic bereavement had greater overall impact because of their frequency. Of lifetime cases, 62% became chronic; only 42% received medical or professional care. The research demonstrates the importance of expanding the epidemiologic research base on trauma to include developing countries around the world. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献
9.
M. A. Amer D. B. Kupranycz B. E. Baker 《Journal of the American Oil Chemists' Society》1985,62(11):1551-1557
Both summer and winter butterfats were fractionated using a laboratory procedure which was designed to simulate a commercial
fractionation process. The process is based on a slow, controlled cooling of the melted fat, a short stabilization time at
the fractionation temperature, and separation of the crystals from the liquid oil by vacuum filtration using a stainless steel
perforated disc. Fractionation temperatures of 29, 26, 23 and 19 C for winter butterfat and 29 and 19 C for summer butterfat
were used to obtain solid and liquid fractions at each temperature. Three replications at each temperature showed good reproducibility
of results. The fractions were characterized by their fatty acid and triglyceride compositions, melting and crystallization
behavior, iodine value, peroxide value and melting point.
Presented at the AOCS meeting in Philadelphia in May 1985. 相似文献
10.
The performance of netted radar is evaluated in terms of a netted version of the radar equation and the ambiguity function. A software simulation has been developed to allow assessment of netted radar sensitivity and ambiguity properties in both two-and three-dimensional space. Simulation results demonstrate that coherent netted radar sensitivity depends not only on the radar parameters, but also on the numbers, locations and specification of transmit and receive nodes. The netted radar ambiguity function is affected by a combination of many factors. In addition to those that determine the form of the monostatic ambiguity function, the locations of transmit and receive nodes as well as the position and velocity of the target all are shown to play an important role in evaluating system performance. As a result of these dependencies, it is shown that there is severe degradation of range and Doppler resolution when a target crosses sufficiently close to a transmit-receive baseline. 相似文献