Optimal management of urinary tract infections in older people

Urinary tract infections (UTI) occur frequently in older people. Unfortunately, UTI is commonly overdiagnosed and overtreated on the basis of nonspecific clinical signs and symptoms. The diagnosis of a UTI in the older patient requires the presence of new urinary symptoms, with or without systemic symptoms. Urinalysis is commonly used to diagnose infection in this population, however, the evidence for its use is limited. There is overwhelming evidence that asymptomatic bacteriuria should not be treated. Catheter associated urinary tract infection accounts for a significant amount of hospital-associated infection. Indwelling urinary catheters should be avoided where possible and alternatives sought. The use of narrow spectrum antimicrobial agents for urinary tract infection is advocated. Local guidelines are now widely used to reflect local resistance patterns and available agents. Guidelines need to be updated to reflect changes in antimicrobial prescribing and a move from broad to narrow spectrum antimicrobials

Infrared spectrum and stability of a π-type hydrogen-bonded complex between the OH and C2H2 reactants

A hydrogen-bonded complex between the hydroxyl radical and acetylene has been stabilized in the reactant channel well leading to the addition reaction and characterized by infrared action spectroscopy in the OH overtone region. Analysis of the rotational band structure associated with the a-type transition observed at 6885.53(1) cm−1 (origin) reveals a T-shaped structure with a 3.327(5) Å separation between the centers of mass of the monomer constituents. The OH (v = 1) product states populated following vibrational predissociation show that dissociation proceeds by two mechanisms: intramolecular vibrational to rotational energy transfer and intermolecular vibrational energy transfer. The highest observed OH product state establishes an upper limit of 956 cm−1 for the stability of the π-type hydrogen-bonded complex. The experimental results are in good accord with the intermolecular distance and well depth at the T-shaped minimum energy configuration obtained from complementary ab initio calculations, which were carried out at the restricted coupled cluster singles, doubles, noniterative triples level of theory with extrapolation to the complete basis set limit

Systematic review of antimicrobial drug prescribing in hospitals.

Prudent antibiotic prescribing to hospital inpatients has the potential to reduce the incidences of antimicrobial resistance and healthcare-associated infection. We reviewed the literature from January 1980 to November 2003 to identify rigorous evaluations of interventions to improve hospital antibiotic prescribing. We identified 66 studies with interpretable data of which 16 reported 20 microbiological outcomes: Gram negative resistant bacteria (GNRB), 10 studies; Clostridium difficile associated diarrhoea (CDAD), 5 studies; vancomycin resistant enterococci (VRE), 3 studies and methicillin resistant Staphylococcus aureus (MRSA), 2 studies. Four studies provide good evidence that the intervention changed microbial outcomes with low risk of alternative explanations, eight studies provide less convincing evidence and four studies were negative. The strongest and most consistent evidence was for CDAD but we were able to analyse only the immediate impact of interventions because of nonstandardised durations of follow up. The ability to compare results of studies could be substantially improved by standardising methodology and reporting

Dynamic Load and Storage Integration

Modern technology combined with the desire to minimize the size and weight of a ship’s power system are leading to renewed interest in more electric or all electric ships. An important characteristic of the emerging ship power system is an increasing level of load variability, with some future pulsed loads requiring peak power in excess of the available steady– state power. This inevitably leads to the need for some additional energy storage beyond that inherent in the fuel. With the current and evolving technology, it appears that storage will be in the form of batteries, rotating machines, and capacitors. All of these are in use on ships today and all have enjoyed significant technological improvements over the last decade. Moreover all are expected to be further enhanced by today’s materials research. A key benefit of storage is that, when it can be justified for a given load, it can have additional beneficial uses such as ride-through capability to restart a gas turbine if there is an unanticipated power loss; alternatively, storage can be used to stabilize the power grid when switching large loads. Knowing when to stage gas turbine utilization versus energy storage is a key subject in this paper. The clear need for storage has raised the opportunity to design a comprehensive storage system, sometimes called an energy magazine, that can combine intermittent generation as well as any or all of the other storage technologies to provide a smaller, lighter and better performing system than would individual storage solutions for each potential application.Center for Electromechanic

Podoconiosis in East and West Gojam Zones, Northern Ethiopia

Background: Podoconiosis is a neglected tropical disease (NTD) that is prevalent in red clay soil-covered highlands of tropical Africa, Central and South America, and northern India. It is estimated that up to one million cases exist in Ethiopia. This study aimed to estimate the prevalence of podoconiosis in East and West Gojam Zones of Amhara Region in northern Ethiopia. Methodology/Principal Findings: A cross-sectional household survey was conducted in Debre Eliyas and Dembecha woredas (districts) in East and West Gojam Zones, respectively. The survey covered all 17,553 households in 20 kebeles (administrative subunits) randomly selected from the two woredas. A detailed structured interview was conducted on 1,704 cases of podoconiosis identified in the survey. Results: The prevalence of podoconiosis in the population aged 15 years and above was found to be 3.3% (95% CI, 3.2% to 3.6%). 87% of cases were in the economically active age group (15–64 years). On average, patients sought treatment five years after the start of the leg swelling. Most subjects had second (42.7%) or third (36.1%) clinical stage disease, 97.9% had mossy lesions, and 53% had open wounds. On average, patients had five episodes of acute adenolymphangitis (ALA) per year and spent a total of 90 days per year with ALA. The median age of first use of shoes and socks were 22 and 23 years, respectively. More men than women owned more than one pair of shoes (61.1% vs. 50.5%; x2 = 11.6 p = 0.001). At the time of interview, 23.6% of the respondents were barefoot, of whom about two-thirds were women. Conclusions: This study showed high prevalence of podoconiosis and associated morbidities such as ALA, mossy lesions and open wounds in northern Ethiopia. Predominance of cases at early clinical stage of podoconiosis indicates the potential for reversing the swelling and calls for disease prevention interventions

A potential role for the cerebellar nuclei in absence seizures

© 2013 Alva et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Poster presented ar CNS 2013Non peer reviewe

Towards a generalisation of formal concept analysis for data mining purposes

In this paper we justify the need for a generalisation of Formal Concept Analysis for the purpose of data mining and begin the synthesis of such theory. For that purpose, we first review semirings and semimodules over semirings as the appropriate objects to use in abstracting the Boolean algebra and the notion of extents and intents, respectively. We later bring to bear powerful theorems developed in the field of linear algebra over idempotent semimodules to try to build a Fundamental Theorem for K-Formal Concept Analysis, where K is a type of idempotent semiring. Finally, we try to put Formal Concept Analysis in new perspective by considering it as a concrete instance of the theory developed

Are "EIT Waves" Fast-Mode MHD Waves?

We examine the nature of large-scale, coronal, propagating wave fronts (``EIT waves'') and find they are incongruous with solutions using fast-mode MHD plane-wave theory. Specifically, we consider the following properties: non-dispersive single pulse manifestions, observed velocities below the local Alfven speed, and different pulses which travel at any number of constant velocities, rather than at the ``predicted'' fast-mode speed. We discuss the possibility of a soliton-like explanation for these phenomena, and show how it is consistent with the above-mentioned aspects.Comment: to be published in the Astrophysical Journa