Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016

OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012". DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy wasdeveloped at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroupsand among the entire committee served as an integral part of the development. METHODS: The panel consisted of five sections: hemodynamics, infection, adjunctive therapies, metabolic, and ventilation. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low, and to formulate recommendations as strong or weak, or best practice statement when applicable. RESULTS: The Surviving Sepsis Guideline panel provided 93 statements on early management and resuscitation of patients with sepsis or septic shock. Overall, 32 were strong recommendations, 39 were weak recommendations, and 18 were best-practice statements. No recommendation was provided for four questions. CONCLUSIONS: Substantial agreement exists among a large cohort of international experts regarding many strong recommendations for the best care of patients with sepsis. Although a significant number of aspects of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality.(AU)

A multicenter phase II study of XRP6258 administered as a 1-h i.v. infusion every 3 weeks in taxane-resistant metastatic breast cancer patients.

BACKGROUND: XRP6258 is a novel taxoid with a low affinity for P-glycoprotein. This multicenter phase II study assessed the activity of XRP6258 in the treatment of taxane-resistant metastatic breast cancer (MBC). PATIENTS AND METHODS: XRP6258 was administered as a 1-h i.v. infusion every 3 weeks at 20 mg/m(2) (then, in the absence of severe toxicity, at 25 mg/m(2) from cycle 2). The primary end point was the objective response rate (ORR) assessed according to response evaluation criteria in solid tumours (RECIST) guidelines. RESULTS: Seventy-one patients were enrolled. The median relative dose intensity was 0.98. The ORR was 14% (two complete, eight partial responses). Eighteen patients (25%) had stable disease of >3 months duration. At a median follow-up of 20.0 months, the median time to progression was 2.7 months, and the median overall survival 12.3 months. The most common grade 3/4 adverse events (AEs) were neutropenia (73%) and leucopenia (55%), with a low febrile neutropenia rate (3%) and infrequent grade 3/4, treatment-related, non-hematological AEs (<5% patients for any AE). Two deaths were reported, one related to study drug and one to unknown cause. CONCLUSIONS: XRP6258 was active and well tolerated in this group of MBC patients with taxane-resistant disease. These results support the further clinical development of this agent.

Determination of Mo(VI) in tap-water and sea-water by differential-pulse polarography and co-flotation.

A new method is described for the microdetermination of Mo(VI) in natural waters and sea-water by differential-pulse polarography based on the catalytic wave caused by Mo(VI) in nitrate medium following preconcentration by co-flotation on Fe(III) hydroxide. In the case of sea-water samples, hexadecyltrimethylammonium bromide (HTAB) was used together with octadecylamine as the surfactant. For the analysis of natural water samples only HTAB is needed. Molybdenum in the range 0.7-5.7 ng/ml has been determined.

Six new leptospiral serovars isolated from wild animals in Peru.

Six new serovars of Leptospira interrogans were isolated from opossums (Didelphis marsupialis and Philander opossum) trapped in the Peruvian jungle. The proposed names, type strain designation, and serogroup of the serovars, respectively, were: huallaga, strain M-7, Djasiman serogroup; luis, strain M-6, Tarassovi serogroup; machiguenga, strain MMD-3, Icterohaemorrhagiae serogroup; rioja, strain MR-12, Bataviae serogroup; rupa rupa, strain M-3, Sejroe serogroup; and tingomaria, strain M-13, Cynopteri serogroup.

Leptospirosis en Tingo Maria, Departamento de Huanico, Peru. I. Estudo en el hombre y animales domesticos. / Leptospirosis in Tingo Maria, Departamento de Huanico, Peru. I. Study in man and domestic animals

Durante una investigacion en Tingo Maria, en la Ceja de Selva de Peru, se aislaron los siguientes serotipos en vacunos y porcinos: ricardi y jules del serogrupo Hebdomanis; kobbe del serogrupo Bataviae; un serotipo nuevo del serogrupo Sherman y una cepa del serogrupo Canicola; se detectaron anticuerpos en el hombre y los animales

Leptospirosis en Iquitos, Departamento de Loreto, Peru. / Leptospirosis in Iquitos, Departamento de Loreto, Peru

En la ciudad de Iquitos, localizada en la Amazonia peruana, se aislo conpenhageni de Rattus norvegicus y R.rattus; pomona, goiano y un serotipo nuevo del serogrupo Sherman de cerdos; asimismo, se determino la presencia de anticuerpos leptospirales tanto en el hombre, como en animales