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Abstract Background There is limited information in the literature on the presentation and prognosis of candidal urinary tract infection (UTI) in infants in the neonatal intensive care unit (NICU). Methods This was a prospective cohort study performed in 13 Canadian NICUs. Infants with candidal UTI without extra-renal candidal infection at presentation were enrolled. Results Thirty infants fit the study criteria. Median birth weight and gestational age were 2595 grams (range 575-4255) and 35 weeks (range 24-41) with 10 infants being < 30 weeks gestation. The most common primary underlying diagnosis was congenital heart disease (n = 10). The median age at initial diagnosis was 16 days (range 6-84 days). Renal ultrasonography findings were compatible with possible fungal disease in 15 of the 26 infants (58%) in whom it was performed. Treatment was variable, but fluconazole and either amphotericin B deoxycholate or lipid-based amphotericin B in combination or sequentially were used most frequently. Extra-renal candidiasis subsequently developed in 4 infants. In 2 of these 4 infants, dissemination happened during prolonged courses of anti-fungal therapy. Three of 9 deaths were considered to be related to candidal infection. No recurrences of candiduria or episodes of invasive candidiasis following treatment were documented. Conclusion Candidal UTI in the NICU population occurs both in term infants with congenital abnormalities and in preterm infants, and is associated with renal parenchymal disease and extra-renal dissemination. A wide variation in clinical approach was documented in this multicenter study. The overall mortality rate in these infants was significant (30%). In one third of the deaths, Candida infection was deemed to be a contributing factor, suggesting the need for antifungal therapy with repeat evaluation for dissemination in infants who are slow to respond to therapy.

Background This multicenter prospective study of invasive candidiasis (IC) was carried out to determine the risk factors for, incidence of, clinical and laboratory features, treatment and outcome of IC in infants of birth weight <1250 g. Methods Neonates <1250 g with IC and their matched controls (2:1) were followed longitudinally and descriptive analysis was performed. Survivors underwent neurodevelopmental assessment at 18 to 24 months corrected age. Neurodevelopmental impairment (NDI) was defined as blindness, deafness, moderate to severe cerebral palsy, or a score <70 on the Bayley Scales of Infant Development 2nd edition. Multivariable analyses were performed to determine risk factors for IC and predictors of mortality and NDI. Results Cumulative incidence rates of IC were 4.2%, 2.2% and 1.5% for birth-weight categories <750 g, <1000 g, <1500 g, respectively. Forty nine infants with IC and 90 controls were enrolled. Necrotizing enterocolitis (NEC) was the only independent risk factor for IC (p = 0.03). CNS candidiasis occurred in 50% of evaluated infants, while congenital candidiasis occurred in 31%. Infants with CNS candidiasis had a higher mortality rate (57%) and incidence of deafness (50%) than the overall cohort of infants with IC. NDI (56% vs. 33%; p = 0.017) and death (45% vs. 7%; p = 0.0001) were more likely in cases than in controls, respectively. IC survivors were more likely to be deaf (28% vs. 7%; p = 0.01). IC independently predicted mortality (p = 0.0004) and NDI (p = 0.018). Conclusion IC occurred in 1.5% of VLBW infants. Preceding NEC increased the risk of developing IC. CNS candidiasis is under-investigated and difficult to diagnose, but portends a very poor outcome. Mortality, deafness and NDI were independently significantly increased in infants with IC compared to matched controls. [ABSTRACT FROM AUTHOR]

Brucellosis is one of the most common laboratory-acquired infections, mostly because aerosolization is a mechanism of transmission in this setting. We report an exposure to Brucella melitensis that occurred in a large microbiology laboratory and describe the strategy chosen for antibiotic prophylaxis and serological follow-up of exposed workers. [ABSTRACT FROM AUTHOR]

Parainfluenza viruses are a major cause of hospitalization for respiratory illness in children. The spectrum of clinical illness associated with infection due to parainfluenza type 4 virus has not been well defined. It is technically difficult to isolate the virus in tissue culture, and because illness is generally reported to be mild, in many cases, patients may not seek medical attention. We describe a series of 10 children with parainfluenza type 4 virus infection who were seen at the Montreal Children's Hospital between 1988 and 1992. There were five males and five females whose average age was 29.7 months. Infection was associated with symptoms of bronchiolitis or pneumonia in 5 children, paroxysmal coughing in 3 infants, apnea in 1 newborn, and aseptic meningitis in 1 child. Hospitalization was required for 8 of the 10 children. It appears that infection with parainfluenza type 4 virus may be more common than previously recognized, and it may be associated with more severe infections. [ABSTRACT FROM PUBLISHER]

In recent years, there have been perceived changes in the political participation amongst young people in constituting the democracy systems, especially in developing countries like Malaysia. As we all know, young people represent a kind of seismograph for the state of a society, especially university students. University students refer to the group of students which were at the highest of education. Possessing a vast reservoir of potentials, the young people represent the majority in society. Positively, their enthusiasm and creativity, if further equipped with their ability in self-organization, would help ensure that their participation in politics contribute to a sustained success in the development of the country today. At the same time, this group of young people has also been reflecting social fragmentation and crisis in the country that eventually leads them to participate in political movements. The evolution of the political struggle of radical young generation in Malaysia begins as early as the day Malaysia attained its independence on the 31st August 1957. It is observed that the patterns and the trends of the young people's movement since Independence has been marked with clearly outlined objectives, specifically to voice their concerns for some issues pertaining to the majority in society and in appealing to the government to address the said issues. It is interesting to discuss on political participation in campus, despite there have been attempts to avoid peaceful demonstrations due to AUKU's constraints, yet the movement eventually evolved to protests on the campus ground. For this research, primary and secondary data were analyzed qualitatively and quantitatively. Hence, a total of 60 respondents were selected and the data was obtained through questionnaires completed by the respondents. The results showed the internal factors was identified as the most significant factor in influencing student's protests in university level. The involvement of young people is very important in democratization and the efforts towards the establishment of a new political landscape in Malaysia. [ABSTRACT FROM AUTHOR]

The Annual General Meeting of the Shakespeare Oxford Fellowship was held at the Hyatt Centric Hotel in New Orleans from 9:00 to 10:30 AM on Saturday, November 11, 2023. It [...]

INTRODUCTION I am honored and exceedingly pleased to have been invited by Dr. Don Ruch of Ball State University to compile the next article in this series, which features the [...]

A protein called agrin, released by nerve cells, helps trigger the formation of machinery by which nerve and muscle cells communicate; it may also play a role in learning and [...]