Shift in bacterial etiology from the CAPNETZ cohort in patients with community-acquired pneumonia: data over more than a decade.

To determine the most relevant pathogens for CAP in Germany, patients with radiologically confirmed pulmonary infiltrates and at least one clinical sign of lung infection were prospectively recruited within the CAPNETZ cohort from 2004 until 2016. In 990 out of 4.672 patients (21%) receiving complete diagnostics the most prominent change of pathogens was a decrease of S. pneumoniae (58% in 2004 to 37.5% in 2016; p ≤ 0.001, ρ = - 0.148) and an increase of H. influenzae (12.2% to 20.8%; p = 0.001, ρ = 0.104).

Bacterial aetiology and mortality in COPD patients with CAP: results from the German Competence Network, CAPNETZ.

BACKGROUND: Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality, and chronic obstructive pulmonary disease (COPD) is a frequent comorbidity. The bacterial aetiology of CAP-COPD and its possible associations with serum markers and mortality are incompletely understood. OBJECTIVES: 1) To assess the bacterial aetiology of CAP only and CAP-COPD, and 2) to study the association between bacterial aetiology, empirical antibiotic treatment, serum markers and mortality. METHODS: Of 1288 patients with CAP (57.0% males, age 59.0 years ± 18.5), 262 (20.3%) fulfilled the diagnostic criteria for COPD. Differences between subgroups were investigated using univariate analyses and corrected for multiple comparisons. RESULTS: Streptococcus pneumoniae was the most common pathogen (30.8% CAP only vs. 26.0% CAP-COPD, not significant). Haemophilus influenzae was significantly more frequent in CAP-COPD (5.6% CAP only vs. 26.0% CAP-COPD, P < 0.001). The number given adequate empirical antibiotic treatment was comparable (83.3% CAP only vs. 83.6% CAP-COPD, P > 0.05). The CAP-COPD group had worse CURB-65 and partial pressure of arterial oxygen levels than the CAP only group (P < 0.001). Partial pressure of arterial carbon dioxide levels were increased in CAP-COPD patients without pathogen detection (P < 0.001). Short- (P = 0.011) and long-term mortality (P = 0.006) were highest in CAP-COPD without pathogen detection. CONCLUSION: It is important to identify COPD patients with CAP. In particular, those without bacterial pathogen detection have more severe CAP and are at higher risk of dying. Better understanding of the aetiology could contribute to improved management and treatment of CAP in COPD patients.

Characterization of spiral ganglion neurons cultured on silicon micro-pillar substrates for new auditory neuro-electronic interfaces.

OBJECTIVE: One of the strategies to improve cochlear implant technology is to increase the number of electrodes in the neuro-electronic interface. The objective was to characterize in vitro cultures of spiral ganglion neurons (SGN) cultured on surfaces of novel silicon micro-pillar substrates (MPS). APPROACH: SGN from P5 rat pups were cultured on MPS with different micro-pillar widths (1-5.6 µm) and spacings (0.6-15 µm) and were compared with control SGN cultures on glass coverslips by immunocytochemistry and scanning electron microscopy (SEM). MAIN RESULTS: Overall, MPS support SGN growth equally well as the control glass surfaces. Micro-pillars of a particular size-range (1.2-2.4 µm) were optimal in promoting SGN presence, neurite growth and alignment. On this specific micro-pillar size, more SGN were present, and neurites were longer and more aligned. SEM pictures highlight how cells on micro-pillars with smaller spacings grow directly on top of pillars, while at wider spacings (from 3.2 to 15 µm) they grow on the bottom of the surface, losing contact guidance. Further, we found that MPS encourage more monopolar and bipolar SGN morphologies compared to the control condition. Finally, MPS induce longest neurite growth with minimal interaction of S100+ glial cells. SIGNIFICANCE: These results indicate that silicon micro-pillar substrates create a permissive environment for the growth of primary auditory neurons promoting neurite sprouting and are a promising technology for future high-density three-dimensional CMOS-based auditory neuro-electronic interfaces.

Glutamate sensing with enzyme-modified floating-gate field effect transistors.

Neurotransmitter release is the key factor of chemical messaging in the brain. Fast, sensitive and in situ detection of single cell neurotransmitter release is essential for the investigation of synaptic transmission under physiological or pathophysiological conditions. Although various techniques have been developed for detecting neurotransmitter release both in vitro and in vivo, the sensing of such events still remains challenging. First of all, the amount of neurotransmitter released during synaptic transmission is unknown because of the limited number of molecules released and the fast diffusion and reuptake of these molecules after release. On the other hand, advances in microelectronic biosensor devices have made possible the fast detection of various analytes with high sensitivity and selectivity. Specifically, enzyme-modified field-effect (ENFET) devices are attractive for such applications due to their fast response, small dimensions and the possibility to integrate a large number of sensors on the same chip. In this paper, we present a floating-gate FET device coated with glutamate oxidase (GLOD) layer. The surface chemistry was optimized for maximal enzyme loading and long-term stability, and characterized by quartz crystal microbalance and colorimetric assays. Enzyme loading was largest on poly-L-lysin-based surfaces combined with glutaraldehyde. The surface chemistry showed excellent stability for at least one month in Tris buffers stored at 4 degrees C. A glutamate detection limit of 10(-7) M has been obtained with the GLOD-coated FET and our sensor proved to be selective to glutamate only. We show that this biosensor is a promising tool for the in vitro detection of glutamate and can be extended to other neurotransmitters.

Peptide-functionalized microfabricated structures for improved on-chip neuronal adhesion.

Extracellular, high signal-to-noise ratio recordings from electrogenic cells require a tight coupling between the cellular membrane and the recording electrode. Self assembled monolayers (SAMs) of alkanethiols functionalized with peptides were used in combination with micro- and nano-structured features on the sensor surface. This combination of surface chemistry and topography triggers a phagocytosis-like engulfment and ensures tight coupling. In this paper we report the results concerning usage of different SAMs and the influence of the peptide concentration towards cell adhesion and outgrowth. Later on, the optimized peptide functionalized SAMs were applied on micro- and nano-structured sensor surfaces. As a result, phagocytosis-like events could be shown using focused ion beam SEM and confocal fluorescence imaging.

Access to sexual and reproductive health care: adolescents and young people.

Obstetricians and gynecologists at the FIGO pre-congress workshop on adolescents deliberated on their role as clinicians, educators and advocates in upholding young peoples' sexual and reproductive health rights. Comprehensive services to adolescents should include emergency contraception, safe abortion and also provide care for survivors of sexual violence. Key to successful access to youth friendly services consist of providers' attitudes and addressing consent, confidentiality, evolving capacities of young people and youth participation.

Metamorphosis of the FPA.

PIP: World contraceptive prevalence has gone form 9% in 1960-65 to an estimated 50% by 1990. In 1976 there were 97 governments providing direct support for family planning; in 1988 that number grew to 125. To date, the single largest problem facing family planning associations (FPAs) has been too low a level of government funding. FPAs have traditionally only dealt with birth control and pregnancy avoidance,m but as the world has changed, so will the role of FPAs. In developing countries FPAs can either continue providing information, services, research, and advocacy or they can expand into new territory and become facilitators of community based services rather than service providers, become an innovating forced to develop new service strategies, and act as an advocate to increase government's awareness of sexual and reproductive issues. In developed countries the responsibility of contraceptive distribution has been largely taken over by general practitioners (GPs) so FPAs are moving into new territory such as education, STD/AIDS prevention, sexuality training, psychosexual counselling, and handling of sexual abuse and violence cases. Other new strategies for FPAs in developed countries include: public information and education, sexual education for youths, training of health care professionals, organization networking, community based education programs, and raising awareness of policy makers and planners. Eastern Europe provides a unique opportunity for FPAs. In many, democracy is making family planning less available. As market economies replace centrally planned economies, government involvement in people lives is being reduced. In many of these countries contraceptives were unavailable because of their high cost and low priority. In their place women relied upon abortion as their primary method of fertility control. However, abortion is becoming less and less available. The void this creates in terms of fertility control is not being filled which means that FPAs have a tremendous opportunity.^ieng