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Long-term implications of cancer in childhood are well documented regarding medical conditions. Sequelae on mental health and on response to stress are yet not well understood.
This study analyzes the association between stress responses and the experience of cancer in childhood, through biological and subjective measures of stress observed during a psychosocial experimental stress (TSST - Trier Social Stress Test)
We expected that:
(1) the clinical group shows an accentuation of both biological and subjective stress responses;
(2) the response among the childhood cancer subjects would differ according to presence/absence of depressive symptoms; and finally to find a correlation between the disease severity/treatment intensity and the response to stress.
53 subjects, 18 to 48 y.o (n = 25 survivors of childhood cancer, n = 28 controls) submitted to the TSST. Subjects provided before and after the TSST repeated evaluations of perceived stress and blood samples.
The clinical group showed a higher plasma cortisol level and a higher amplitude in the response to the TSST. The differences were amplified when depression symptoms were present. The subjective perception of stress and the plasma cortisol were only marginally correlated in both groups. The severity of the oncological disease predicted a higher endocrine response.
The presence of avoidant coping is suggested in cancer survivors, accounting for the lack of correspondence between psychological perception of stress and cortisol response. A better knowledge of the dysregulations of the stress responses is important since they have been associated to psychological vulnerability.
To investigate an outbreak of Pseudomonas aeruginosa infections and colonization in a neonatal intensive care unit.
Infection control assessment, environmental evaluation, and case-control study.
Newly built community-based hospital, 28-bed neonatal intensive care unit.
Neonatal intensive care unit patients receiving care between June 1, 2013, and September 30, 2014.
Case finding was performed through microbiology record review. Infection control observations, interviews, and environmental assessment were performed. A matched case-control study was conducted to identify risk factors for P. aeruginosa infection. Patient and environmental isolates were collected for pulsed-field gel electrophoresis to determine strain relatedness.
In total, 31 cases were identified. Case clusters were temporally associated with absence of point-of-use filters on faucets in patient rooms. After adjusting for gestational age, case patients were more likely to have been in a room without a point-of-use filter (odds ratio [OR], 37.55; 95% confidence interval [CI], 7.16–∞). Case patients had higher odds of exposure to peripherally inserted central catheters (OR, 7.20; 95% CI, 1.75–37.30) and invasive ventilation (OR, 5.79; 95% CI, 1.39–30.62). Of 42 environmental samples, 28 (67%) grew P. aeruginosa. Isolates from the 2 most recent case patients were indistinguishable by pulsed-field gel electrophoresis from water-related samples obtained from these case-patient rooms.
This outbreak was attributed to contaminated water. Interruption of the outbreak with point-of-use filters provided a short-term solution; however, eradication of P. aeruginosa in water and fixtures was necessary to protect patients. This outbreak highlights the importance of understanding the risks of stagnant water in healthcare facilities.
The adsorption of cerium(IV) by both natural and Na-exchanged kaolinite from aqueous solutions of ceric ammonium nitrate was studied in equilibrium systems. Cerium may be adsorbed either as a monomeric species or as a polymeric hydroxy cation. The species adsorbed depends on the concentration of cerium in the stock solution, the age of this solution prior to the preparation of the equilibrium system and on the equilibration period. Adsorbed cations undergo polymerization on the surface of the kaolinite; the resulting polymeric species forms strong bonds with the clay surface—it is not desorbed by sulphuric acid—and may be considered fixed. Adsorption of cerium reaches a maximum in solutions containing 0·15 M sulphuric acid.
Short period oscillations (with periods less than 150 s) are shown to be non-uniformly distributed on the solar surface, and in time. Rather, they appear concentrated in short bursts which preferentially occur in regions with strong instantaneous downflow motion throughout the observed extent of the solar atmosphere.
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