Early replacement of a new central venous catheter (CVC) may pose a risk of persistent or recurrent infection in patients with a catheter-related bloodstream infection (CRBSI). We evaluated the clinical impact of early CVC reinsertion after catheter removal in patients with CRBSIs.

We conducted a retrospective chart review of adult patients with confirmed CRBSIs in 2 tertiary-care hospitals over a 7-year period.

To treat their infections, 316 patients with CRBSIs underwent CVC removal. Among them, 130 (41.1%) underwent early CVC reinsertion (≤3 days after CVC removal), 39 (12.4%) underwent delayed reinsertion (>3 days), and 147 (46.5%) did not undergo CVC reinsertion. There were no differences in baseline characteristics among the 3 groups, except for nontunneled CVC, presence of septic shock, and reason for CVC reinsertion. The rate of persistent CRBSI in the early CVC reinsertion group (22.3%) was higher than that in the no CVC reinsertion group (7.5%; P = .002) but was similar to that in the delayed CVC reinsertion group (17.9%; P > .99). The other clinical outcomes did not differ among the 3 groups, including rates of 30-day mortality, complicated infection, and recurrence. After controlling for several confounding factors, early CVC reinsertion was not significantly associated with persistent CRBSI (OR, 1.59; P = .35) or 30-day mortality compared with delayed CVC reinsertion (OR, 0.81; P = .68).

Early CVC reinsertion in the setting of CRBSI may be safe. Replacement of a new CVC should not be delayed in patients who still require a CVC for ongoing management.

Visual hallucination (VH) is a common psychotic symptom in patients with Parkinson's disease (PD) and may be a significant predictor of cognitive impairment (CI) in such patients.

This study aimed to investigate the pattern of glucose metabolism of VH and the relationship between VH and CI in PD.

We studied 28 PD patients, including 15 with VH (PD-VH) and 13 without VH (PD-NVH). Of the 15 PD-VH patients, 8 patients had cognitive impairment (PD-VHCI) whereas 7 did not (PD-VHNCI). All patients underwent [18F] fluorodeoxyglucose positron emission tomography ([18F] FDG PET) followed by statistical parametric mapping (SPM) analyses.

Compared to the patients with PDNVH, PD-VHNCI patients showed glucose hypometabolism in the inferior and middle temporal cortices, fusiform gyri, and frontal areas, suggesting the involvement of the ventral visual pathway. Compared to the patients with PDNVH, PD-VHCI patients showed glucose hypometabolism in the temporoparietal association cortices with scattered frontal areas.

Dysfunction of ventral visual pathway involving the temporal lobe may play a key role in VH development in PD patients. The evolving distribution from the ventral visual pathway to more extensive posterior cortices in PD-VHCI patients suggests that VH may be a prodromal symptom occurring prior to CI in PD patients.

This is a copy of the slides presented at the meeting but not formally written up for the volume.

Recent advancements in various industries have necessitated the development of new engineering materials exhibiting superior properties of different character. For example, composite electroplating renders excellent corrosion- and wear-resistant materials with good lubrication behavior and chemical stability. Nanometer-sized diamond particles are expected to be good dispersion materials in electro-less composite plating. However, the processing conditions and characteristics of metal/diamond composites are not well understood so far. In this investigation, we developed new processes for co-deposition of Ni-P/diamond composite films on steel plates using the commercial electrolyte composed of nickel sulfate and sodium hypophosphite. No additives were applied in this process as in the conventional methods for the efficient dispersion of diamond particles. The diamond particles of a few hundred nanometer size were dispersed in an ultrasonic bath of de-ionized water. The zeta potential of the diamond solution was measured prior to the incorporation into the electrolyte. The morphology of the prepared films was characterized by FESEM. Based on the FESEM images, the size distribution of the diamond particles was determined using an image analyzer program. The micro-hardness, the coefficient of friction, and the corrosion potential were measured by Vickers hardness tester, tribometer and potentiometer, respectively. The present experimental results revealed remarkable differences in the values of the micro-hardness, the coefficient of friction, and the corrosion potential, compared to those of conventional diamond-free electro-less Ni-P plates. Process conditions were optimized in terms of the concentration of diamond particles, ultrasonic dispersion time, and pH of the electrolyte. As the concentration of diamond particles increased from 0.5to 3g/l, the zeta potential was decreasing with more particles aggregated. The higher the diamond concentration, the higher the volume fraction of diamond particles co-deposited in the nickel matrix. In turn, the coefficient of friction and corrosion potential increasd with the increasing diamond concentration. The particle size distribution was the most uniform in the samples prepared at the concentration of 1.0g/l. The best mechanical properties were obtained when the dispersion time was 30min. and the pH 5.