Incidence, complications, and costs of peripheral venous catheter-related bacteraemia: a retrospective, single-centre study.

BACKGROUND: Peripheral venous catheter (PVC) complications occur on average in approximately half of patients, necessitating premature PVC removal, suspending administration of ongoing therapies, and catheter replacement. AIM: To estimate the current incidence, complications, and costs of bloodstream infection (BSI) attributable to PVCs. METHODS: Patients with PVC-related BSI (cases) were matched with patients without PVC-related BSI (controls). FINDINGS: From January 1st, 2018 to March 31st, 2020, a total of 9833 out of 113,068 patients visiting the emergency department (9%) were hospitalized in a medical ward after insertion of a PVC. Among them, 581 (6%) had at least one positive blood culture. Twenty-five (4%) of these were judged as having a PVC-related BSI. Major complications were noted in nine patients. One patient presented severe sepsis requiring admission to intensive care unit for eleven days followed by thoracic (T4-T7) spondylodiscitis requiring prolonged antimicrobial therapy. Another patient developed mitral valve endocarditis also requiring prolonged antimicrobial therapy. One patient developed a pre-sacral abscess three months after initial PVC infection and required hospital readmission for 19 days for drainage. Median (interquartile range) hospital stay costs were €11,597 (8,479-23,759) for cases and €6,789 (4,019-10,764) for controls, leading to median additional costs of €5,587. CONCLUSION: Though the risk of developing PVC-related BSI in patients admitted to medical wards may seem low, complications of PVC-related BSI are severe, and associated mortality remains high. The financial resources used to treat these complications could be better spent on prevention, including the use of high-quality materials and technologies, and improved training of healthcare providers.

Na2VO(HPO4)2: an original phase solved by continuous 3D electron diffraction and powder X-ray diffraction.

The new phase Na2VO(HPO4)2 was synthesized by sodium/proton ion exchange between NaI and VO(H2PO4)2 in hexanol. The exchange of two protons by two sodium ions causes a structural reorganization leading to a new original phase. The crystal structure was solved by continuous 3D Electron Diffraction, consisting of recording a video in diffraction mode during the continuous sample holder rotation in order to acquire a complete dataset in a shortest time in order to avoid the deterioration of this electron beam sensitive material. The individual Electron Diffraction patterns were extracted from the video, processed by conventional electron diffraction crystallography programs (PETS, JANA2006) and the resulting structural model calculated by the charge flipping algorithm was refined from powder X-ray diffraction data. This material crystallizes in an orthorhombic unit cell in the Iba2 (45) space group, with the cell parameters a = 13.86852(19), b = 13.7985(2), c = 7.47677(9). Electrochemical studies show that up to 0.66 Na f.u.-1 could be removed from Na2VO(HPO4)2.

Taylor-vortex flow in shear-thinning fluids.

This paper deals with the Taylor-Couette flow of shear-thinning fluids. It focuses on the first principles understanding of the influence of the viscosity stratification and the nonlinear variation of the effective viscosity µ with the shear rate γ[over ̇] on the flow structure in the Taylor-vortex flow regime. A wide gap configuration (η=0.4) is mainly considered. A weakly nonlinear analysis, using the amplitude expansion method at high order, is adopted as a first approach to study nonlinear effects. For the numerical computation, the shear-thinning behavior is described by the Carreau model. The rheological parameters are varied in a wide range. The results indicate that the flow field undergoes a significant change as shear-thinning effects increase. First, vortices are squeezed against the inner wall and the center of the patterns is shifted axially toward the radial outflow boundaries (z=0,z/λ_{z}=1). This axial shift leads to increasing concentration of vorticity at these positions. The outflow becomes stronger than the inflow and the extent of the inflow zone where the vorticity is low increases acoordingly. Nevertheless, the strength of the vortices relative to the velocity of the inner cylinder is weaker. Second, the pseudo-Nusselt number, ratio of the torque to that obtained in the laminar flow, decreases. Third, higher harmonics become more relevant and grow faster with Reynolds number. Finally, the modification of the viscosity field is described.

Differences during the first lactation between cows cloned by somatic cell nuclear transfer and noncloned cows.

Lactation performance is dependent on both the genetic characteristics and the environmental conditions surrounding lactating cows. However, individual variations can still be observed within a given breed under similar environmental conditions. The role of the environment between birth and lactation could be better appreciated in cloned cows, which are presumed to be genetically identical, but differences in lactation performance between cloned and noncloned cows first need to be clearly evaluated. Conflicting results have been described in the literature, so our aim was to clarify this situation. Nine cloned Prim' Holstein cows were produced by the transfer of nuclei from a single fibroblast cell line after cell fusion with enucleated oocytes. The cloned cows and 9 noncloned counterparts were raised under similar conditions. Milk production and composition were recorded monthly from calving until 200d in milk. At 67d in milk, biopsies were sampled from the rear quarter of the udder, their mammary epithelial cell content was evaluated, and mammary cell renewal, RNA, and DNA were then analyzed in relevant samples. The results showed that milk production did not differ significantly between cloned and noncloned cows, but milk protein and fat contents were less variable in cloned cows. Furthermore, milk fat yield and contents were lower in cloned cows during early lactation. At around 67 DIM, milk fat and protein yields, as well as milk fat, protein, and lactose contents, were also lower in cloned cows. These lower yields could be linked to the higher apoptotic rate observed in cloned cows. Apoptosis is triggered by insulin-like factor growth binding protein 5 (IGFBP5) and plasminogen activator inhibitor (PAI), which both interact with CSN1S2. During our experiments, CSN1S2 transcript levels were lower in the mammary gland of cloned cows. The mammary cell apoptotic rate observed in cloned cows may have been related to the higher levels of DNA (cytosine-5-)-methyltransferase 1 (DNMT1) transcripts, coding for products that maintain the epigenetic status of cells. We conclude, therefore, that milk production in cloned cows differs slightly from that of noncloned cows. These differences may be due, in part, to a higher incidence of subclinical mastitis. They were associated with differences in cell apoptosis and linked to variations in DNMT1 mRNA. However, milk protein and fat contents were more similar among cloned cows than among noncloned cows.

[Child dental care: what's about parental presence?]. / Présence des parents au cours des soins dentaires.

The coping capacity of the children during dental care depends on different factors such as age, cognitive development, personal history and social background. A good knowledge and understanding of child developmental stages will help the dentist to treat them successfully. Parental presence during treatment has been largely discussed in pediatrics and pediatric dentistry. Dentists often let parents stay in the office during the first consultation but prefer them to be in the waiting room during treatment. Depending on the case, parental presence may be needed, essential, or advised against. Parental presence during child treatment must be analyzed, but the ultimate decision is the dentist's.

Diversity of O-linked glycosylation patterns between species. Characterization of 25 carbohydrate chains from oviducal mucins of Rana ridibunda.

Amphibia egg jelly coats are formed by components secreted along the oviduct. These secretion products overlay the oocytes as they pass along the different oviducal portions. Mucin type glycoproteins are the major constituents of the egg jelly coats. In this study, the O-linked carbohydrate chains of the jelly coats surrounding the eggs of Rana ridibunda were released by alkaline borohydride treatment. Fractionation of the mixture of O-linked oligosaccharide-alditols was achieved by a combination of chromatographic techniques including gel-permeation chromatography, ion-exchange chromatography and high-performance liquid chromatography using an amino-bonded silica column. The primary structures of these O-glycans were determined by one-dimensional and two-dimensional 1H-NMR spectroscopy and matrix-assisted laser-desorption-ionization-time-of flight mass spectrometry. 25 oligosaccharide structures, possessing a core consisting of Gal(beta1-3)GalNAc-ol with or without branching through a GlcNAc residue linked (beta1-6) to the GalNAc residue (core type 2 or core type 1, respectively) are described. The most representative antennae are: HSO3(6)[Fuc(alpha1-3)]GlcNAc; Gal(beta1-2)Gal; Gal(beta1-2)Gal(alpha1-3)[Fuc(alpha1-2)]Gal; GlcA(beta1-3)-Gal(beta1-3)[Fuc(alpha1-2)]Gal; GalNAc(alpha1-4)Gal(beta1-4)Gal; Gal(beta1-3)GalNAc(alpha1-4)Gal(beta1-4)Gal and GlcA(beta1-3)Gal(beta1-3)GalNAc. These results confirm the species-specific O-glycosylation of Amphibia oviducal mucins. The significance of this observation should be linked to a symbiotic role of carbohydrates involved in host-parasite interactions.

Coordination of primary health care for back pain. A randomized controlled trial.

STUDY DESIGN: A randomized controlled trial comparing usual care with a program for the coordination of primary health care (CORE) for the treatment of subacute low-back pain patients. OBJECTIVES: To measure the effectiveness of the CORE program as a mean for implementing clinical practice guidelines for low-back pain in an urban community. SUMMARY OF BACKGROUND DATA: Clinical practice guidelines have been developed for primary care physicians and patients on the clinical management of low-back pain. The implementation of the guidelines in a large community is difficult with the multiplicity of medical and nonmedical back care providers and products. The CORE program was designed to make the guidelines fit in this complex environment. METHODS: One hundred ten workers compensated for low-back pain for 4 to 8 weeks in metropolitan Montreal were randomized in two groups: usual care (N = 56) and the CORE program (N = 54). Coordination of primary health care was performed by two primary care physicians and a nurse in liaison with the treating physicians, and included a complete examination, recommendations for the clinical management, and support to carry out the recommendations. All workers were followed for 6 months. Back pain and functional status were assessed at baseline, 3 months, and 6 months. RESULTS: In the 6-month follow-up, the CORE group returned to work 6.6 days (standard error = 8.9) quicker than the control group, a difference that was not statistically significant. However, the CORE group showed a sustained improvement in pain and functional status with two-fold differences at the end of the 6 months of follow-up. This represented nine points on the Oswestry scale (P = 0.02) and 12 points on the Quebec Back Pain Disability Scale (P = 0.01). The CORE group also used three times less specialized imaging tests of the spine at 3 months (P < 0.01) and exercised twice as much at 6 months (P < 0.05) than the controls. CONCLUSIONS: The therapeutic results for workers with low-back pain could be improved by implementing the clinical practice guidelines with primary care physicians in a large community, without delaying the return to work. The CORE intervention for back pain patients is highly relevant to primary care practice. It is simple in its application, flexible to accommodate physicians' and- patients' preferences in health care, and it is effective on patients' clinical outcome.

New insecticidal cyclodepsipeptides from the fungus Isaria felina. I. Production, isolation and insecticidal properties of isariins B, C and D.

Three new cyclodepsipeptides related to the previously described isariin were isolated from a strain of Isaria felina. They were named isariins B, C and D. Isariin D and, to a lesser extent, isariin C, exhibited insecticidal activity against Galleria mellonella larvae, whereas isariin B and isariin itself proved inactive.

New insecticidal cyclodepsipeptides from the fungus Isaria felina. II. Structure elucidation of isariins B, C and D.

Isariins B, C and D, isolated from a strain of Isaria felina, were shown to be cyclodepsipeptides constituted by a pentapeptide cyclized through a beta-hydroxyacid. The nature of the latter and the sequence of the peptide were determined for each compound. Relations between insecticidal activity and structure of the depsipeptides were pointed out.

New antibiotics from the fungus Epicoccum nigrum. I. Fermentation, isolation and antibacterial properties.

An atmosphere isolate of the fungus Epicoccum nigrum was found to exhibit an activity against Staphylococcus aureus. A more active, non-sporulating variant of this strain was selected. From its fermentation broth, two novel compounds, epicorazines A and B, were isolated by preparative TLC and tested against a series of bacteria.