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While the early and asymptomatic recognition of treatable conditions offered by newborn screening confers clear health benefits for the affected child, the clinical referral of patients with screen positive results can cause significant harm for some families. The use of pivalate-containing antibiotics and more recently the inclusion of neopentanoate as a component within moisturising creams used as nipple balms by nursing mothers can result in a significant number of false positive results when screening for isovaleric acidaemia (IVA) by measuring C5 acylcarnitine. A recent survey conducted within centres from nine countries indicated that this form of contamination had been or was a significant confounding factor in the detection of IVA in seven of the nine who responded. In three of these seven the prominent cause was believed to derive from the use of moisturising creams and in another three from antibiotics containing pivalate; one country reported that the cause was mixed. As a result, four of these seven centres routinely perform second tier testing to resolve C5 isobars when an initial C5 result is elevated, and a fifth is considering making this change within their national programme. The use of creams containing neopentanoate by nursing mothers and evolving patterns in the prescription of pivalate-containing antibiotics during pregnancy require those involved in the design and operation of newborn screening programmes used to detect IVA and the doctors who receive clinical referrals from these programmes to maintain an awareness of the potential impact of this form of interference on patient results.
Während sich die einschlägige Forschung in verdienstvoller Detailarbeit bemüht, aus antiken Quellen die Feinheiten von Helden- oder Heldinnenerzählungen herauszuarbeiten, scheint der Antikfilm das Potential zum "Spielverderber" zu besitzen. Bei Titeln wie Coriolano, eroe senza patria wirkt die Aufgabe erledigt, bevor auch nur die ersten Bilder angelaufen sind. Die einschlägigen Produktionen sind so stark über ihre Helden definiert, dass sie umgangssprachlich mit Bezeichnungen wie "Muskelmänner-Filme" belegt werden. Trotz (oder gerade wegen) der Masse an starken Figuren wie Hercules, Goliath, Maciste, Samson und Spartacus sind es die "unwahrscheinlichen" Heldinnen, deren Analyse sich als besonders aufschlussreich erweist. Kaum irgendwo wird diese Kontrastwirkung deutlicher als bei den jugendlichen Detektivinnen des Antikfilms.
Für das Verständnis der Sonderrolle bedarf es einer kurzen Zusammenfassung des medialen Kontextes. Die jugendlichen Detektivinnen selbst werden in zwei Fallstudien vorgestellt, mit denen zugleich unterschiedliche Endpunkte in einer Entwicklung von "Heldinnen der Geschichte" sichtbar werden. Der vierte und letzte Teil kehrt zu den medialen Traditionen und den etablierten Geschlechterrollen zurück und versucht das Phänomen als nur vermeintliches Paradoxon zu erklären: ein Gegensatz, der sich durch das Fehlen eines Widerparts erklärt. Der Auftakt gehört jedoch einer Geschichte voller männlicher Heldenfiguren. ...
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) offers potential cure to acute myeloid leukemia (AML) patients. However, infections with commensal bacteria are an important cause for non-relapse mortality (NRM). We have previously described the impact of multidrug-resistant organism (MDRO) colonization on the survival of allo-HSCT patients. In the aforementioned publication, according to consensus, we there did not consider the opportunistic gram-negative bacterium Stenotrophomonas maltophilia (S. maltophilia) to be an MDRO. Since rate of S. maltophilia colonization is increasing, and it is not known whether this poses a risk for allo-HSCT patients, we here analyzed here its effect on the previously described and now extended patient cohort. We report on 291 AML patients undergoing allo-HSCT. Twenty of 291 patients (6.9%) were colonized with S. maltophilia. Colonized patients did not differ from non-colonized patients with respect to their age, remission status before allo-HSCT, donor type and HSCT-comorbidity index. S. maltophilia colonized patients had a worse overall survival (OS) from 6 months up to 60 months (85% vs. 88.1% and 24.7% vs. 59.7%; p = 0.007) due to a higher NRM after allo-HSCT (6 months: 15% vs. 4.8% and 60 months: 40.1% vs. 16.2% p = 0.003). The main cause of mortality in colonized patients was infection (46.2% of all deaths) and in non-colonized patients relapse (58.8% of all deaths). 5/20 colonized patients developed an invasive infection with S. maltophilia. The worse OS after allo-HSCT due to higher infection related mortality might implicate the screening of allo-HSCT patients for S. maltophilia and a closer observation of colonized patients as outpatients.