Does Quinolone- or Macrolide-Resistant Streptococcus agalactiae Bacteremia Affect Patient Outcome? A Multicenter Cohort Study.

The prevalence of quinolone- and macrolide-resistant Group B Streptococcus (GBS) is increasing worldwide, but the relationship between the resistance of GBS to these antibiotics and patient outcome remains unclear. Therefore, we evaluated whether blood stream infection caused by quinolone- or macrolide-resistant GBS is associated with high mortality. Our findings in 77 patients with GBS bacteremia demonstrate that quinolone and macrolide resistance may not be risk factors for 30-day mortality.

[Effectiveness of Steroid Rotation in a Japanese Patient with Hiccups Caused by Dexamethasone: a Case Report].

The effectiveness of steroid rotation from dexamethasone to prednisolone for hiccups caused by dexamethasone for antiemetic chemotherapy has been reported overseas, but has not been reported in Japan. The effectiveness of steroid rotation in Japanese individuals is unclear because ethnic differences and variations in glucocorticoid receptors affect sensitivity to dexamethasone. We report a case of the effectiveness of steroid rotation in a Japanese patient with hiccups caused by dexamethasone for antiemetic chemotherapy. A 74-year-old man was diagnosed as having stage IV gastric cancer. Chemotherapy was initiated using S-1 (80 mg/d on Days 1-21) and cisplatin (80 mg on Day 8), with dexamethasone (8 mg/d on Day 8 intravenously and on Days 9-11 orally) as antiemetic. Severe hiccups developed on Day 10 and resolved on Day 11 by the 1st cycle of chemotherapy. Subcutaneous injection of atropine by the 5th cycle and ingestion of Syakuyakukanzouto (Glycyrrhiza extract) by the 6th cycle did not effectively relieve the hiccups. By the 7th cycle, the hiccups resolved after the dose of dexamethasone was decreased from 8 mg/d to 4 mg/d but recurred by the 8th cycle. We then changed to prednisolone 30 mg/d from dexamethasone 4 mg/d by the 9th cycle; the hiccups completely resolved thereafter. Steroid rotation from dexamethasone to prednisolone completely controlled the hiccups, with no further recurrence. No emetic episodes occurred during chemotherapy. Therefore, this demonstrates the effectiveness of steroid rotation in a Japanese patient with hiccups caused by dexamethasone for antiemetic chemotherapy.

Three-dimensional analysis of somatic mitochondrial dynamics in fission-deficient injured motor neurons using FIB/SEM.

Mitochondria undergo morphological changes through fusion and fission for their quality control, which are vital for neuronal function. In this study, we examined three-dimensional morphologies of mitochondria in motor neurons under normal, nerve injured, and nerve injured plus fission-impaired conditions using the focused ion beam/scanning electron microscopy (FIB/SEM), because the FIB/SEM technology is a powerful tool to demonstrate both 3D images of whole organelle and the intra-organellar structure simultaneously. Crossing of dynamin-related protein 1 (Drp1) gene-floxed mice with neuronal injury-specific Cre driver mice, Atf3:BAC Tg mice, allowed for Drp1 ablation specifically in injured neurons. FIB/SEM analysis demonstrated that somatic mitochondrial morphologies in motor neurons were not altered before or after nerve injury. However, the fission impairment resulted in prominent somatic mitochondrial enlargement, which initially induced complex morphologies with round regions and long tubular processes, subsequently causing a decrease in the number of processes and further enlargement of the round regions, which eventually resulted in big spheroidal mitochondria without processes. The abnormal mitochondria exhibited several degradative morphologies: local or total cristae collapse, vacuolization, and mitophagy. These suggest that mitochondrial fission is crucial for maintaining mitochondrial integrity in injured motor neurons, and multiple forms of mitochondria degradation may accelerate neuronal degradation.