ABSTRACT
OBJECTIVES: Alcohol is responsible for a proportion of emergency admissions to hospital, with acute alcohol intoxication and chronic alcohol dependency (CAD) implicated. This study aims to quantify the proportion of hospital admissions through our emergency department (ED) which were thought by the admitting doctor to be (largely or partially) a result of alcohol consumption. SETTING: ED of a UK tertiary referral hospital. PARTICIPANTS: All ED admissions occurring over 14â weeks from 1 September to 8 December 2012. Data obtained for 5497 of 5746 admissions (95.67%). PRIMARY OUTCOME MEASURES: Proportion of emergency admissions related to alcohol as defined by the admitting ED clinician. SECONDARY OUTCOME MEASURES: Proportion of emergency admissions due to alcohol diagnosed with acute alcohol intoxication or CAD according to ICD-10 criteria. RESULTS: 1152 (21.0%, 95% CI 19.9% to 22.0%) of emergency admissions were thought to be due to alcohol. 74.6% of patients admitted due to alcohol had CAD, and significantly greater than the 26.4% with 'Severe' or 'Very Severe' acute alcohol intoxication (p<0.001). Admissions due to alcohol differed to admissions not due to alcohol being on average younger (45 vs 56â years, p<0.001) more often male (73.4% vs 45.1% males, p<0.001) and more likely to have a diagnosis synonymous with alcohol or related to recreational drug use, pancreatitis, deliberate self-harm, head injury, gastritis, suicidal ideation, upper gastrointestinal bleeds or seizures (p<0.001). An increase in admissions due to alcohol on Saturdays reflects a surge in admissions with acute alcohol intoxication above the weekly average (p=0.003). CONCLUSIONS: Alcohol was thought to be implicated in 21% of emergency admissions in this cohort. CAD is responsible for a significantly greater proportion of admissions due to alcohol than acute intoxication. Interventions designed to reduce alcohol-related admissions must incorporate measures to tackle CAD.
Subject(s)
Alcoholic Intoxication/epidemiology , Alcoholism/epidemiology , Emergency Service, Hospital/statistics & numerical data , Patient Admission/statistics & numerical data , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Alcoholic Intoxication/diagnosis , Alcoholism/diagnosis , Cross-Sectional Studies , Female , Humans , International Classification of Diseases , Male , Middle Aged , Prospective Studies , Sex Distribution , Tertiary Care Centers , United Kingdom/epidemiology , Young AdultABSTRACT
Knowledge of critical care nurses' intravenous fluid bolus therapy (FBT) practice remains underexplored. Using a multi-choice online survey conducted between September and October 2014, we sought to describe the self-reported practice of critical care nurses located in Australia and New Zealand. Two hundred and ninety-five critical care nurses responded to the survey with most practising in adult ICUs. Overall, 0.9% saline solution was the preferred solution for FBT. However, more Australian than New Zealand respondents preferred 'albumin 4%' (31% versus 3.6%, P <0.01) for FBT. In contrast, more New Zealand respondents preferred 'Plasma-Lyte®' (33.3% versus 6.4%, P <0.01). Half of the respondents defined FBT as 250 ml administered as quickly as possible. However, FBT volumes ranged from 100 ml to >1000 ml and administration duration from as quickly as possible to 60 minutes. In response to FBT, almost half of the respondents expected an increase in mean arterial pressure of between 11 to 20 mmHg. Similarly, >40% expected a central venous pressure increase >3 mmHg, >70% expected a urinary output increase of 0.5 to 1.0 ml/kg/hr, and >60% expected a decrease in heart rate of >11 /min. Overall, 0.9% saline remains the most common solution for FBT, but there are significant national differences in the preference for albumin and Plasma-Lyte. A volume of 250 ml defines a fluid bolus, with a range from 100 ml to >1000 ml, and speed of delivery from stat to 60 minutes. Most nurses expect substantial physiological effects with FBT.
Subject(s)
Critical Care , Fluid Therapy , Nurses , Australia , Humans , New Zealand , Self ReportABSTRACT
The 2010 7th International Melanoma Congress sponsored by the Society for Melanoma Research and held in Sydney, Australia, was held together with the International Melanoma and Skin Cancer Centers group and the International Melanoma Pathology Study Group. As a consequence, there were over 900 registrants that included a wide range of clinicians (surgeons, medical oncologists, dermatologists) specialising in the management of melanoma as well as scientists and students carrying out laboratory-based research in melanoma. There was a general consensus that this grouping of clinicians, pathologists and scientists was mutually advantageous and plans are afoot to continue this grouping in future meetings. The meeting was dominated by the advances being made in treatment of melanoma with selective BRAF inhibitors but interest in epithelial mesenchymal transition and phenotypic changes in melanoma was apparent in many of the talks. The authors have attempted to capture many of the new developments in melanoma research but apologize to those speakers and poster presenters who had equally important findings not captured in these summaries.
Subject(s)
Congresses as Topic , Melanoma/pathology , Animals , Clinical Trials as Topic , Disease Models, Animal , Drug Screening Assays, Antitumor , Humans , Immunotherapy , Melanoma/drug therapy , Melanoma/genetics , Melanoma/therapy , Mice , Mitogen-Activated Protein Kinase Kinases/antagonists & inhibitors , Mitogen-Activated Protein Kinase Kinases/metabolism , Neoplastic Stem Cells/drug effects , Neoplastic Stem Cells/pathology , New South Wales , Protein Kinase Inhibitors/pharmacology , Protein Kinase Inhibitors/therapeutic use , Proto-Oncogene Proteins B-raf/antagonists & inhibitors , Proto-Oncogene Proteins B-raf/metabolism , Zebrafish/geneticsABSTRACT
We report here the first six cases of leprosy associated with HLA-identical allogeneic SCT in different phases and with different findings and outcomes. Skin and peripheral nerves may be sites of leprosy associated with SCT, stressing the importance of differential diagnosis between leprosy and GVHD or drug reactions. Clinical manifestations of leprosy before or after transplantation did not influence the outcome of SCT in our cases.
Subject(s)
Hematopoietic Stem Cell Transplantation/adverse effects , Leprosy/etiology , Adult , Diagnosis, Differential , Female , Humans , Leprosy/diagnosis , Leprosy/pathology , Male , Peripheral Nervous System Diseases/diagnosis , Peripheral Nervous System Diseases/etiology , Skin Diseases/diagnosis , Skin Diseases/etiology , Transplantation, Homologous , Treatment OutcomeABSTRACT
We report two cases of refractory chronic graft-versus-host disease after donor lymphocyte infusions in which the skin lesions improved dramatically with the use of intravenous pulses of lidocaine. This form of therapy has been used successfully for the cutaneous involvement of scleroderma and may have vasodilator and anti-inflammatory effects.
Subject(s)
Graft vs Host Disease/pathology , Lidocaine/administration & dosage , Lymphocyte Transfusion/adverse effects , Skin Diseases/drug therapy , Adult , Bone Marrow Transplantation , Child , Chronic Disease , Female , Graft vs Host Disease/drug therapy , Graft vs Host Disease/etiology , Humans , Injections, Intravenous , Leukemia/complications , Leukemia/therapy , Male , Recurrence , Scleroderma, Localized/drug therapy , Scleroderma, Localized/etiology , Scleroderma, Localized/pathology , Skin Diseases/etiology , Skin Diseases/pathology , Transplantation, HomologousABSTRACT
An approach for determination of cytotoxicity of chemical and biological drugs which combine the estimation of quality and quantity of cells after their treatment are proposed by the authors. The visual control of cellular minicultures permits one: 1) to register specific and pathologic alterations of cell morphology, 2) to trace their development in dynamics under the action of individual or complex drugs and 3) to choose the optimum time for the experiment fixation. The special staining of the treated cells and measurement of the optical density of absorbed histological dye permits one to make a conclusion about the changing of the cells quantity. A combined method of double estimation gives the opportunity to detect the artefacts taking place after staining the cells treated by some drugs and extracts of natural origin in high concentrations.
Subject(s)
Antineoplastic Agents/toxicity , Cell Culture Techniques/methods , Dose-Response Relationship, Drug , Drug Screening Assays, Antitumor/methods , Humans , Staining and Labeling/methods , Tumor Cells, CulturedABSTRACT
Regulatory interaction of the L10 protein and translation operator of L10 mRNA was studied in vivo using a double-plasmid system. Feedback regulation of rplJ gene expression in Thermotoga maritima was proved, and the possibility of feedback cross-regulation was demonstrated in a heterologous system containing T. maritima and enterobacterial components.
Subject(s)
Enterobacteriaceae/genetics , Gene Expression Regulation, Bacterial/physiology , Genes, Bacterial , Gram-Negative Anaerobic Bacteria/genetics , Base Sequence , Feedback , Molecular Sequence DataABSTRACT
Comparative analysis of the structural organization of an untranslated sequence upstream from the rplJ gene in Thermotoga maritima revealed a potential binding site for the L10 ribosomal protein. The structure of the site detected is highly homologous to that of the 23S rRNA L10 target sequence. Structural organization of the potential mRNA L10 target site detected in T. Maritima is similar to that of mRNA targets of seven species of Enterobacteria and Synechocystis PCC 6803. Additional elements of structural homology between the mRNA and rRNA L10 targets in T. maritima are also shown. Location of the target site within the rplJ mRNA leader and ability of this region to form alternative conformations show that expression of the rplJ gene is autogenously controlled by the L10 ribosomal protein.
Subject(s)
Bacterial Proteins/metabolism , Gene Expression Regulation, Bacterial/physiology , Genes, Bacterial , Gram-Negative Anaerobic Bacteria/genetics , Protein Biosynthesis , Ribosomal Proteins/metabolism , Base Sequence , Binding Sites , Molecular Sequence Data , Protein Sorting Signals/genetics , Ribosomal Protein L10ABSTRACT
Construction of the recombinant plasmids, containing the antisense sequence of the E. coli rplJ gene under control of lac promoter has shown their effect on the level of the detector rplJ-lacZ gene expression.
Subject(s)
Escherichia coli/genetics , Gene Expression Regulation, Bacterial/physiology , RNA, Antisense/genetics , Lac Operon/genetics , Plasmids/genetics , Promoter Regions, Genetic/geneticsABSTRACT
Genes rplJ, coding for ribosomal protein L10 of Salmonella typhimurium and Klebsiella pneumoniae, have been cloned on pUC plasmid. The resultant multicopy recombinant plasmids were detrimental for the growth of normal JM101 E. coli host cells and harmless for the mutant JF3029 host. This negative effect is the evidence for the ability of heterologous L10 proteins to regulate expression of rplJL genes in E. coli. Nucleotide sequence was determined completely for S. typhimurium rplJL' DNA portion and partially for rplJL' genes of K. pneumoniae. According to the nucleotide sequence data obtained three amino acid substitutions differ L10 proteins of S. typhimurium and E. coli and the long range, providing for the coupled translations of L10 and L7/L12 cistrons in E. coli mRNA is also valid for S. typhimurium and K. pneumoniae.
Subject(s)
Escherichia coli/genetics , Gene Expression Regulation, Bacterial , Genes, Bacterial , Klebsiella pneumoniae/genetics , Ribosomal Proteins/genetics , Ribosomal Proteins/metabolism , Salmonella typhimurium/genetics , Amino Acid Sequence , Base Sequence , Cloning, Molecular/methods , Escherichia coli/metabolism , Molecular Sequence Data , Operon , Plasmids , Recombinant Proteins/metabolism , Ribosomal Protein L10ABSTRACT
A recombinant phage mp9MW/rpoB containing the BglII-B fragment of the Escherichia coli rplJL-rpoBC gene cluster was constructed on the basis of filamentous phage M13. Stability of the phage was increased by insertion of a transcription terminator t beta' which blocked transcription of cloned genes from the Plac of the vector.
Subject(s)
Coliphages/genetics , Escherichia coli/genetics , Genes, Bacterial , Recombination, Genetic , Cloning, Molecular , Gene Expression Regulation, Viral , Genes, Viral , PlasmidsABSTRACT
A mutation in lac-operator region of pUC19 plasmid causing an increase in beta-galactosidase activity was observed. The plasmid was used as a vector to provide high level of expression of the cloned E. coli rplL gene.
Subject(s)
Escherichia coli/genetics , Gene Expression Regulation, Bacterial , Genes, Bacterial , Plasmids/genetics , Cloning, Molecular/methods , DNA, Bacterial/genetics , DNA, Bacterial/isolation & purification , Escherichia coli/enzymology , Genetic Vectors , Lac Operon , Mutation , Phenotype , beta-Galactosidase/geneticsABSTRACT
The recombinant plasmids pUC and pNM481 were constructed. The efficiency of P1ac promoter of the vector plasmid pUC and PL10. supporting the transcription of rplJL-rpoBC-operons of Escherichia coli was compared. It was found that the stronger promoter P1ac, due to convergent transcription directed by the promoter, makes possible the cloning on the multicopy plasmid pUC of the DNA fragment (the gene rplJ controlled by its own promoter PL10), coding for the synthesis of the regulatory ribosomal protein L10.
