Mortality and gram-negative rod bacteraemia in the intensive care unit.

This study identified 37 intensive care unit (ICU) patients with gram-negative rod (GNR) bacteraemia. The sources, causative organisms and mortality of gram-negative bacteraemia were consistent with historical series. Antibiotic resistance among well-described species with a propensity for antimicrobial resistance was the most common reason for ineffective antibiotic administration. This study emphasizes the importance of antibiotic resistance in antimicrobial selection and the power of Acute Physiology and Chronic Health Evaluation criteria for predicting patient mortality.

Differential effects of exhaustive cycle ergometry on concentric and eccentric torque production.

The purpose of this study was to investigate the potential differences in peak isokinetic concentric end eccentric torque following low- and high-intensity cycle exercise fatigue protocols. Ten healthy, recreationally-active men were tested in a balanced, randomized testing sequence for peak eccentric and concentric isokinetic torque (60 degrees/sec) immediately before and after three experimental conditions each separated by 48 hours: 1) a bout of high intensity cycling consisting of a maximal 90-second sprint; 2) a bout of low-intensity cycling at 60 rpm equated for total work with the high-intensity protocol: and 3) no exercise (control bout). Blood was drawn from an antecubital vein and plasma lactate concentrations were determined immediately before and after each experimental bout. Post-exercise plasma lactate concentrations were 15.1 +/- 2.5 and 4.7 +/- 1.9 mmol l(-1), respectively, following the high- and low-intensity protocols. The high intensity exercise bout resulted in the only post-exercise decrease in concentric and eccentric isokinetic peak torque. The percent decline in maximal force production was significantly (P< 0.05) greater for concentric muscle actions compared to eccentric (29 vs 15%, respectively). In conclusion, a 90-second maximal cycling sprint results in a significant decline in maximal torque of both concentric and eccentric muscle actions with the greatest magnitude observed during concentric muscle actions.

Laboratory diagnosis of mycobacterial infections.

This paper reviews the recent US history of infection with Mycobacterium tuberculosis and discusses the emergence of drug-resistant strains. The paper continues with brief discussions of the clinical presentation of tuberculosis, tuberculosis in the pediatric population, and nontuberculous pulmonary disease. We discuss laboratory techniques that will rapidly identify Mycobacterium tuberculosis and provide susceptibility test results. The advances and limitations of currently available diagnostic techniques are presented. The chapter concludes with an explanation of the current strengths and limitations of molecular diagnosis of disease and resistance.