Candidaemia and a risk predictive model for overall mortality: a prospective multicentre study.

BACKGROUND: Candidaemia is associated with high mortality. Variables associated with mortality have been published previously, but not developed into a risk predictive model for mortality. We sought to describe the current epidemiology of candidaemia in Australia, analyse predictors of 30-day all-cause mortality, and develop and validate a mortality risk predictive model. METHODS: Adults with candidaemia were studied prospectively over 12 months at eight institutions. Clinical and laboratory variables at time of blood culture-positivity were subject to multivariate analysis for association with 30-day all-cause mortality. A predictive score for mortality was examined by area under receiver operator characteristic curves and a historical data set was used for validation. RESULTS: The median age of 133 patients with candidaemia was 62 years; 76 (57%) were male and 57 (43%) were female. Co-morbidities included underlying haematologic malignancy (n = 20; 15%), and solid organ malignancy in (n = 25; 19%); 55 (41%) were in an intensive care unit (ICU). Non-albicans Candida spp. accounted for 61% of cases (81/133). All-cause 30-day mortality was 31%. A gastrointestinal or unknown source was associated with higher overall mortality than an intravascular or urologic source (p < 0.01). A risk predictive score based on age > 65 years, ICU admission, chronic organ dysfunction, preceding surgery within 30 days, haematological malignancy, source of candidaemia and antibiotic therapy for ≥10 days stratified patients into < 20% or ≥ 20% predicted mortality. The model retained accuracy when validated against a historical dataset (n = 741). CONCLUSIONS: Mortality in patients with candidaemia remains high. A simple mortality risk predictive score stratifying patients with candidaemia into < 20% and ≥ 20% 30-day mortality is presented. This model uses information available at time of candidaemia diagnosis is easy to incorporate into decision support systems. Further validation of this model is warranted.

Plant size, latitude, and phylogeny explain within-population variability in herbivory.

Interactions between plants and herbivores are central in most ecosystems, but their strength is highly variable. The amount of variability within a system is thought to influence most aspects of plant-herbivore biology, from ecological stability to plant defense evolution. Our understanding of what influences variability, however, is limited by sparse data. We collected standardized surveys of herbivory for 503 plant species at 790 sites across 116° of latitude. With these data, we show that within-population variability in herbivory increases with latitude, decreases with plant size, and is phylogenetically structured. Differences in the magnitude of variability are thus central to how plant-herbivore biology varies across macroscale gradients. We argue that increased focus on interaction variability will advance understanding of patterns of life on Earth.

Taste disorders in Australian Aboriginal and non-Aboriginal children.

AIM: To assess the prevalence and type of taste disorders in Aboriginal and non-Aboriginal children matched for age, gender and living in the same general and educational environment. METHODS: Taste function was assessed in 432 Aboriginal (n = 166) and non-Aboriginal (n = 266) children aged 8-12 years from six public schools in a rural township using a three-choice taste identification test and a cross-sectional design. RESULTS: The prevalence of taste disorders was very high and significantly more common in Aboriginal (20/166; 12.0%) than in non-Aboriginal (21/266; 7.9%) children. Forty-one children had quality-specific disorders, of whom 27 (65.9%) had sweet disorders. Children often had more than one quality disorder. CONCLUSION: The prevalence of taste disorders in children was high and exceeded the level (4%) designated by the World Health Organisation as requiring immediate action by health authorities. As the cause of the disorders is unknown, there is a need for a wider investigation of the causes and the consequences.

Some temporal characteristics of processing during reading.

College students read passages displayed on a cathode-ray tube as their eye movements were being monitored. During occasional fixations, all letters to the left of the directly fixated letter or all letters more than four to the right of the fixated letter were replaced by other letters. This replacement occurred either for only the first 100 ms of the fixation or only after the first 100 ms of the fixation. The eye movement data indicated that the eyes can respond to change in the visual stimulus within less than 100 ms and to orthographic irregularity in the text within less than 160 ms. No evidence was found for a left-to-right attentional scan during a fixation. The results were interpreted within the framework of a chronology of processing events occurring during a fixation in reading.

Induced resistance to Mexican bean beetles in soybean: variation among genotypes and lack of correlation with constitutive resistance.

Fourteen genotypes (varieties) of soybean (Glycine max) were screened for levels of induced resistance to Mexican bean beetle (Epilachna varivestis) damage, and a subset of 6 of those varieties was screened for levels of constitutive resistance to Mexican bean beetles. Experiments were carried out in the greenhouse, with damage imposed by Mexican bean beetle larvae, and levels of resistance measured by a choice test bioassay with adult beetles. We found significant variation among soybean genotypes in levels of both induced and constitutive resistance. We found no significant correlation between levels of induced and constitutive resistance measured in the same genotypes. We compare these results to past work on resistance in the soybean-Mexican bean beetle system, consider the implications of variation in both types of resistance for plant-herbivore interactions in agricultural and natural systems, and discuss the relationship between induced and constitutive resistance.

Is kidney length a good predictor of kidney volume?

Kidney length is commonly used to determine kidney size; however, its relationship to kidney volume is not well established. This study evaluated the association between kidney length and kidney volume. Eighteen healthy adults (9 men and 9 women) consented to take part in this prospective study; all 18 underwent spiral computerized tomography (CT) of the kidneys, 14 of 18 also underwent kidney ultrasound. Kidney volume was measured by totaling the areas of the CT scan cuts, and kidney length was measured both on the kidney ultrasound and on the CT scan. Each independent variable, CT length (CTL) and ultrasound length (USL), was regressed against the dependent variable, kidney volume. Kidney length explained only 10% of the variability of the volume, although length x width was a better predictor of kidney volume (r = 0.72, P < 0.001). It was concluded that kidney length does not reliably predict kidney volume and that other methods, both clinical and radiologic, should be considered when a more exact determination of renal volume is clinically relevant.

Further Evidence That Orthographic Rime Usage in Nonword Reading Increases with Word-Level Reading Proficiency

This research investigated children's use of orthographic rime correspondences in nonword reading in association with word-level reading skills. Experiment 1 demonstrated an increase in the use of orthographic rime correspondences in two independent nonword reading tasks from second to fourth grade. There was no further increase from fourth to sixth grade. In an ambiguous nonword reading task, where grapheme-phoneme and orthographic rime correspondences yielded conflicting pronunciations, the use of orthographic rime correspondences varied with the orthographic onset employed. The use of orthographic rime correspondences in reading ambiguous nonwords was more strongly associated with word-level reading skills than was the use of grapheme-phoneme correspondences. Experiment 2 replicated the main findings of Experiment 1 concerning the association between word-level reading skills and the use of orthographic rime correspondences in nonword reading within second-grade children. These findings suggest that the use of orthographic rime correspondences in the phonological recoding process increases with word-level reading proficiency.

Comparative efficacy of flubendazole and a commercially available herbal wormer against natural infections of Ascaridia galli, Heterakis gallinarum and intestinal Capillaria spp. in chickens.

The efficacy of a commercially available flubendazole-based product and a commercially available herbal product were compared against three species of helminth parasites of chickens: Ascaridia galli, Heterakis gallinarum and Capillaria spp. A total of 48 naturally infected chickens were used in the study with 16 birds in each of three treatment groups (untreated control; flubendazole; and a herbal product). One bird from each treatment group was necropsied on Day 0 prior to first treatment to confirm the parasite species present in the birds. Treatments were administered as labelled and the 45 remaining birds were necropsied on Day 12 and worm counts performed. Average worm counts in the two treated groups were compared to the untreated controls to calculate efficacy. Flubendazole (Group A) achieved an overall efficacy of 99.4% for the three parasite species. The herbal product (Group B) achieved efficacies ranging from less than zero to 11.6% for the three parasites, with worm counts not significantly different to the untreated controls. At present, commercially available herbal products claiming anthelmintic properties do not require licencing as veterinary medicinal products (Directive 2004/28/EC: see Article 17 and 33-38) and thus are not required to meet specific efficacy thresholds. Products which do not appear to deliver acceptable anthelmintic efficacy, are obviously a concern from many aspects but specifically from an animal welfare perspective.

Acute ketamine intoxication treated by haloperidol: a preliminary study.

In an open, double-blind study of phencyclidine intoxication, 21 white male subjects were later found to have instead ingested ketamine. These subjects were divided into two cohorts, one treated with 5 mg intramuscular haloperidol and the second with an active placebo. Assessment with the Brief Psychiatric Rating Scale revealed significant reduction in symptoms with haloperidol.

Isolation of beauvericin as an insect toxin from Fusarium semitectum and Fusarium moniliforme var. subglutinans.

Nonpolar methylene chloride-soluble extracts from the mycelia of Fusarium semitectum and Fusarium moniliforme var. subglutinans were toxic to Colorado potato beetles. The major toxic metabolite was isolated and found to be the cyclodepsipeptide, beauvericin. This is the first report of the isolation of beauvericin from the genus Fusarium.

Quality of life on antihypertensive therapy: a double-blind trial comparing quality of life on pinacidil and nifedipine in combination with a thiazide diuretic. European Pinacidil Study Group.

The quality of life (QL) was evaluated in a 6 month double-blind trial in six European countries. Patients with a sustained supine diastolic blood pressure (SDBP), phase V, of 95 mm Hg or more on bendrofluazide, 5 mg daily (or an equivalent dose of a thiazide diuretic) were randomised to additional pinacidil (n = 127), 25 mg up to 100 mg daily, or nifedipine (n = 130), 20 mg up to 80 mg daily. The treatment groups were similar at entry for QL scores, average DBP of 103 +/- 6 (SD) mm Hg, and average age of 56 +/- 10 (SD) years. Eighteen patients on pinacidil and 12 on nifedipine withdrew due to side effects, such as oedema (both drugs) and flushing (nifedipine). The maximum antihypertensive effect was achieved within 6 weeks and maintained, resulting in a significant fall in SDBP of 13.7 mm Hg on pinacidil and 15.5 mm Hg on nifedipine at the end of the trial. There was no significant difference in the antihypertensive effect. The target SDBP was achieved in 57% of pinacidil-and 63% of nifedipine-treated patients. The average number of symptomatic complaints fell in both groups, with significant decreases in the reporting of blurred vision and headaches on nifedipine. Complaints of growth of body and facial hair increased on pinacidil but there were no significant between-drug comparisons with respect to side effects. In measures of psychological well being, patients on pinacidil showed a significant (p less than 0.05) improvement in total and cognitive function scores compared to nifedipine.(ABSTRACT TRUNCATED AT 250 WORDS)