Severe infection in a lung transplant recipient caused by donor-transmitted carbapenem-resistant Acinetobacter baumannii

We describe a case of proven donor transmission of carbapenem-resistant Acinetobacter baumannii, which resulted in severe infectious complications after lung transplantation. A single bla(OXA-23) positive strain, belonging to a new multilocus sequence type (ST231), was isolated from donor and recipient, who died 65 days after transplantation. This report highlights the current challenges associated with the potential transmission of multidrug-resistant infections through organ transplantation.

Drought-mortality relationships for tropical forests

*The rich ecology of tropical forests is intimately tied to their moisture status. Multi-site syntheses can provide a macro-scale view of these linkages and their susceptibility to changing climates. Here, we report pan-tropical and regional-scale analyses of tree vulnerability to drought. *We assembled available data on tropical forest tree stem mortality before, during, and after recent drought events, from 119 monitoring plots in 10 countries concentrated in Amazonia and Borneo. *In most sites, larger trees are disproportionately at risk. At least within Amazonia, low wood density trees are also at greater risk of drought-associated mortality, independent of size. For comparable drought intensities, trees in Borneo are more vulnerable than trees in the Amazon. There is some evidence for lagged impacts of drought, with mortality rates remaining elevated 2 yr after the meteorological event is over. *These findings indicate that repeated droughts would shift the functional composition of tropical forests toward smaller, denser-wooded trees. At very high drought intensities, the linear relationship between tree mortality and moisture stress apparently breaks down, suggesting the existence of moisture stress thresholds beyond which some tropical forests would suffer catastrophic tree mortality.

Computer-vision-based extraction of neural dendrograms

This work introduces a new approach to the characterization of neural cells by means of semi-automated generation of dendrograms; data structures which describe the inherently hierarchical nature of neuronal arborizations. Dendrograms describe the branched structure of neurons in terms of the length, average thickness and bending energy of each of the dendritic segments and allow in a straightforward manner, the inclusion of additional measures. The bending energy quantifies the complexity of the shape and can be used to characterize the spatial coverage of the arborizations (the bending energy is an alternative for other complexity measures such as the fractal dimension). The new approach is based on the partitioning of the cell's outer contour as a function of the high curvature points followed by a syntactical analysis of the segmented contours. The semi-automated method is robust and is an improvement on the time consuming manual generation of the dendrograms. Several experimental results are included in this paper which illustrate and corroborate the effectiveness of the approach. The technique presented in this paper is limited to planar neurons but could be extended to a 3D approach.

[Use of papain in visceral infections]

This research was carried out at the University Hospital of the University of São Paulo and deals with the experiment of papain utilization for visceral irrigation in patients with severe infection. It was observed that seventy two hours after treatment, there was a considerable reduction of purulent secretion, and that the medium time of cicatrization of all lesions was thirty days.

Quality of life in patients 2 to 4 years after closed head injury

This study evaluated quality of life in 78 patients with closed head injury (CHI) 2 to 4 years postinjury. Using both interview data and mean data from the Sickness Impact Profile questionnaire, impaired quality of life was observed in the areas of psychosocial functioning, social role functioning, leisure activities, and, to a lesser extent, physical functioning, during chronic phases of recovery. Relatives and close friends reported by means of the Katz Adjustment Scale that the CHI patients showed a series of negative behavioral symptoms 2 to 4 years postinjury. These data suggest that CHI patients may experience impaired quality of life in a number of domains well beyond the acute postinjury phases. An attempt was also made to compare patients' and relatives' reports of patient quality of life. Preliminary analyses indicated modest correspondence between relatives' and patients' ratings of some areas of postinjury dysfunction, including cognitive and behavioral slowing and social withdrawal.

Predictors and indicators of quality of life in patients with closed-head injury

This study examined predictors and indicators of quality of life in 71 patients with closed-head injury (CHI), 2-4 years postinjury. Predictors included premorbid characteristics and acute injury-related data. Indicators included follow-up data, e.g., neuropsychological functioning. Exploratory canonical correlation analyses demonstrated that the combination of the predictor variable, initial Glasgow Coma Scale score, and indicator variables of neuropsychological data in the areas of motor functioning, memory, and constructional ability were related most strongly to quality of life as reported by the patients. Severity of head injury and motor disability also related strongly to quality of life, based on reports by relatives (n = 68) on the Katz Adjustment Scale (Relatives' Form). These findings suggest that quality of life is adversely affected by increased severity of head injury and greater residual motor deficits. Implications of these findings for treatment and recovery are discussed.

Interset variability on the raven coloured progressive matrices as an indicator of specific ability deficit in brain-lesioned patients

Patients with right cerebral lesions were found to have lower RCPM scores than a matched group of patients with left lesions. Analysis of interset patterns of performance demonstrated relatively greater difficulty for right lesion patients, especially those with posterior lesions on the Ab set. The findings were interpreted in terms of the abilities that Raven maintains underly test performance.

The relation of visuospatial dysfunction to digit span performance in patients with cerebral lesions

DSF and DSB performance was compared in hospitalized controls and right and left brain lesion groups dichotomized for the presence or absence of visuospatial deficits. Digit Span performance was also correlated with WAIS Similarities and Block Design and Raven Coloured Progressive Matrices. No differences between groups were observed on DSF. On DSB patients with brain lesions had lower scores than controls and brain-lesioned patients with visuospatial deficits had lower scores than those without. DSB correlated significantly with WAIS Block Design and Raven Coloured Progressive Matrices supporting the hypothesis that visuospatial ability is needed to mediate proper DSB performance. The correlation of DSB with WAIS Similarities, however, lends support to the idea that low DSB may merely reflect severity of cognitive deficit.

Test-retest reliability of serial pure-tone audiograms in children at a school for the deaf

Successive air-conduction audiograms obtained between ages 1¼ and 12 years and recorded in the charts of 75 children at a school for the deaf were analyzed statistically. Approximately half of 414 audiogram pairs differed by at least 20 dB for 2 or more frequencies, and 34% of 3203 paired frequency scores differed by at least 20 dB. Conductive losses, moderate hearing losses, and perhaps mild mental retardation were associated with unreliability. Audiograms performed at the school by a nonprofessional audiologist were especially unreliable. The desirability of retesting a child until a stable threshold is obtained and of indicating the zone of uncertainty around each threshold point was stressed. When the zone of uncertainty is wide, a verbal label describing the estimated severity of the loss might be preferable to possibly invalid numerical information.

Choice reaction time as a function of stimulus uncertainty in patients with brain lesions

Longer times and greater variabilities for 24 brain-damaged Ss than for normals were associated with increased stimulus information in a card-sorting task.