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Background. The guidelines of the Centers for Disease Control and Prevention do not recommend the use of an antimicrobial- or antiseptic-impregnated catheter for short-term use. In previous studies, we have found a higher incidence of central venous catheter-related bacteremia among patients with femoral and central jugular accesses than among patients with other venous accesses. Objective. The objective of our study was to determine the incidence of central venous catheter-related bacteremia associated with rifampicin-miconazole-impregnated catheters and standard catheters in patients with femoral and central jugular venous accesses. Methods. This was a cohort study, conducted in the 24-bed polyvalent medical-surgical intensive care unit of a university hospital. We included patients who were admitted to the intensive care unit from 1 June 2006 through 30 September 2007 and who underwent femoral or central jugular venous catheterization. Results. We inserted 184 femoral (73 rifampicin-miconazole-impregnated catheters and 111 standard catheters) and 241 central jugular venous catheters (114 rifampicin-miconazole-impregnated catheters and 127 standard catheters). We found a lower rate of central venous catheter-related bacteremia associated with rifampicin-miconazole- impregnated catheters than with standard catheters among patients with femoral access (0 vs. 8.62 cases per 1000 catheter-days; odds ratio, 0.13; 95% confidence interval, 0.00-0.86; P=.03) and among patients with central internal jugular access (0 vs. 4.93 cases per 1000 catheter-days; odds ratio, 0.13; 95% confidence interval, 0.00-0.93; P=.04). Conclusions. Rifampicin-minonazole-impregnated catheters are associated with a statistically significant reduction in the incidence of catheter-related bacteremia in patients with short-term catheter use at the central jugular and femoral sites. [ABSTRACT FROM AUTHOR]

We consider tilings of the plane with twelve-fold symmetry obtained by the cut-and-projection method. We compute their cohomology groups using the techniques introduced in [ 9 ]. To do this, we completely describe the window, the orbits of lines under the group action, and the orbits of 0-singularities. The complete family of generalized twelve-fold tilings can be described using two-parameters and it presents a surprisingly rich cohomological structure. To put this finding into perspective, one should compare our results with the cohomology of the generalized five-fold tilings (more commonly known as generalized Penrose tilings). In this case, the tilings form a one-parameter family, which fits in simply one of the two types of cohomology. [ABSTRACT FROM AUTHOR]

We study the behavior of the signature of colored links [6, 9] under the splice operation. We extend the construction to colored links in integral homology spheres and show that the signature is almost additive, with a correction term independent of the links. We interpret this correction term as the signature of a generalized Hopf link and give a simple closed formula to compute it. [ABSTRACT FROM AUTHOR]

A response to a letter to the editor about the article concerning the types of catheter in the previous issue is presented.

Background Quantitative (e.g. increasing recreational cannabinoid use) and qualitative (e.g. increasing availability and use of synthetic cannabinoids and cannabis preparations with increased tetrahydrocannabinol content) changes in cannabinoid use may be associated with changes in the prevalence of cannabinoid-related mental and behavioural disorders and, accordingly, changes in the need for medical care. We aimed to investigate if there are changes in the number of inpatient cases (ICs) due to cannabinoid-related disorders in Germany. Methods Data were obtained from the Federal Statistical Office of Germany (Destatis) and comprised type and number of hospital main diagnoses (according to ICD-10) of all ICs in Germany in the period 2000–18. Linear trend analysis of absolute and relative annual frequencies (AFs) of ICs with diagnoses related to the use of cannabinoids (DRUCs), and, as controls, alcohol-related psychiatric disorders and schizophrenia-spectrum disorders was performed. Results Absolute AFs of ICs with DRUCs increased statistically significantly (P <0.0001, trend analysis) in Germany between 2000 and 2018 and corresponding relative AFs increased considerably (4.8-fold increase when comparing 2000 and 2018). Specifically, absolute AFs of ICs with cannabinoid intoxications (P <0.0001), harmful use (P =0.0005), dependence syndrome (P < 0.0001), withdrawal state (P <0.0001), psychotic disorders (P < 0.0001) and residual and late-onset psychotic disorder (P <0.0001) statistically significantly increased. Absolute AFs of schizophrenia-spectrum disorders slightly, but statistically significantly decreased (P =0.008), and alcohol dependence did not statistically significantly change (P =0.844). Conclusions Our evaluation demonstrates increasing numbers of ICs with mental and behavioural disorders due to use of cannabinoids in Germany and emphasizes the need for adequate prevention of such disorders. [ABSTRACT FROM AUTHOR]

Evidence from magnetic resonance imaging (MRI) suggests early structural and functional brain changes in individuals with the Huntingtons disease (HD) gene mutation who are presymptomatic for the motor symptoms of the disorder (pre-HD subjects). The objective of this study was to investigate the functional neuroanatomy of verbal working memory (WM) in pre-HD subjects. By means of event-related functional MRI, we studied healthy controls (n = 16) and pre-HD subjects (n = 16) with a parametric WM paradigm comprising three different WM load levels. Voxel-based morphometry (VBM) was used to control potentially confounding brain atrophy. Although WM performance did not significantly differ between pre-HD subjects and healthy controls, pre-HD subjects showed a significantly decreased activation of the left dorsolateral prefrontal cortex (DLPFC) at intermediate and high WM load levels only. This region was not affected by early cortical atrophy, as revealed by VBM. Pre-HD individuals close to the onset of motor symptoms showed an increased activation of the left inferior parietal lobule and the right superior frontal gyrus compared with both pre-HD subjects far from symptom onset and healthy controls. In addition, the activation level in the left DLPFC was positively correlated with the UHDRS cognitive subscore in pre-HD subjects. Our findings demonstrate that early functional brain changes in pre-HD subjects may occur in the DLPFC before manifest cortical atrophy, and support a role of this region in the expression of clinical symptoms. Compensatory brain responses in pre-HD individuals may occur with closer proximity to the onset of manifest clinical symptoms. [ABSTRACT FROM AUTHOR]

Second-generation antipsychotics (SGA) are increasingly used in primary and secondary delusional parasitosis (DP) because of their better overall tolerability compared with first-generation antipsychotics (FGA) such as pimozide. Controlled clinical trials with antipsychotics in DP are lacking, owing to difficulties in obtaining informed consent and in securing adherence to a study protocol by patients with DP. We present the case of an 88-year-old man with a 12-year history of DP secondary to leucoencephalopathy. After 9 days of an age-adapted dose of paliperidone, the patient no longer experienced the presence of vermin on his skin and stopped showering at night to get rid off of them. Paliperidone was well tolerated. At follow-up after 2 weeks, the DP was still remitted. Paliperidone appears to expand the therapeutic arsenal in treating DP with modern SGAs; however, this finding needs to be replicated. [ABSTRACT FROM AUTHOR]