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* BACKGROUND Infected central venous catheters cause morbidity and mortality. * OBJECTIVE To compare the risk for colonization of central venous catheters used for total parenteral nutrition with that of [...]

Presents a study that compared the risk for colonization of central venous catheters used for total parenteral nutrition (TPM) with that of catheters used for other purposes. Rates of colonization for catheters used for TPM; Methods used; Results of the study.

Lists brief medical reports for various studies and findings. Occupational fatigue and preterm premature rupture of membranes; Blood pressure in late pregnancy and work outside the home; Cesarean delivery rates; Appendectomy and protection against ulcerative colitis; Neurocognitive performance enhanced by highly active antiretroviral therapy in HIV-infected women; Preoperative depression and mortality in coronary artery bypass surgery; Others.

Abstract: We evaluated whether the likelihood of developing invasive candidiasis (IC) differed depending upon the anatomic site of Candida colonization in 182 surgical intensive care unit (SICU) patients who participated in a randomized trial of fluconazole to prevent candidiasis. We also determined the impact of Candida colonization of different anatomic sites on all-cause SICU and hospital mortality. A total of 2851 surveillance fungal cultures collected from 5 anatomic sites were analyzed. There was a statistically significant difference in the frequency of IC comparing patients with and without urinary (13.2% versus 2.8%, P = .02), respiratory (8.0% versus 1.2%, P = .04), and rectum/ostomy (8.4% versus 0%, P = .01) colonization. Patients with negative rectum/ostomy cultures and patients with both negative urine and respiratory tract cultures did not develop IC. Candiduria detected at any time in the SICU was independently associated with SICU mortality (odds ratio, 2.86; 95% confidence interval, 1.05–7.74). Surveillance fungal cultures of particular anatomic sites may help differentiate patients at higher risk of developing IC from those at low risk. [Copyright &y& Elsevier]

The HLA-B*27 allele is overrepresented in patients who control HIV-1 replication without antiretroviral therapy. CD8(+) T cell responses that target the immunodominant KK10 epitope in Gag are thought to play a major role in this control, and escape at R264 of KK10 is often associated with dramatic virologic breakthrough. We present a case in which an HLA-B*27-positive chronic progressor transmitted HIV-1 to an HLA-B*27-positive viremic controller who was temporarily on HAART, but who has since controlled viremia for over 4 years. We hypothesized that differences in the KK10 epitope of these patients would affect pathogenesis and viral fitness, but found no correlation between autologous KK10 mutations and disease progression or between the predicted fitness impact of autologous HLA-B*27-associated mutations and the actual fitness of autologous virus. This case of viral transmission between two HLA-B*27-positive individuals provides further evidence that prolonged control of fully pathogenic HIV-1 is possible.