No abstract

Backgroundand objectives: Burn patients represent a challenging cohort because the injuries entail a vulnerability to colonisation by microorganisms. The ensuing infections can lead to serious complications and, in many cases, to the death of the burn patient. Surgical intervention and wound dressings, as well as antibiotic treatment, are crucial for optimising the treatment of the patient. Materialand Methods: In this retrospective analysis, we analysed the treatment course, antibiotic therapy, and general complications of 252 burn patients with second- or third-degree burns over a time span of 7 years. Results: Patients who developed infections tended to have, on average, a higher total body surface area (TBSA), higher abbreviated burn severity index (ABSI) scores, and longer hospital stays. Patients who were admitted to the burn unit after 2006 had significantly shorter stays in the burn unit. TBSA and ABSI scores were lower in the patient cohort admitted after 2006. Patients exhibiting a TBSA greater than 30% had significantly longer hospital stays and antibiotic treatment periods. TBSA and ABSI scores were significantly higher in patients who died. The results of binary logistic regression indicate that a higher ABSI score increases the odds ratio of developing an infection. Bacteria number had no significant effect on the odds of patient death but positively influenced the odds ratio of developing an infection. TBSA was negatively associated with the risk of developing an infection and was an insignificant predictor of mortality. Conclusions: To gauge the optimal treatment for a burn patient, it is crucial for practitioners to correctly select, dose, and time antibiotics for the patient. Monitoring bacterial colonisation is vital to nip rising infection in the bud and ensure the correct antibiotic selection. This will help prevent the development of multi-resistant bacteria.

No abstract

Myelodysplastic syndromes (MDS) are classified by the WHO as myeloid neoplasms, and are characterized by cytopenia and dysplasia in one or more myeloid cell lines. Recently, a flow cytometric score (FCM-score) was published capable of discriminating low-grade MDS from non-clonal cytopenias (Della Porta et al., 2012). We tested the applicability of the FCM-score in a patient population from a large peripheral teaching hospital in The Netherlands.The evaluation of the proposed FCM score in low-grade MDS showed a high sensitivity and specificity, and clinically significant positive and negative likelihood ratios. The use of CD10 and CD19 positivity to identify progenitor B-cell blasts provided a specific and precize method to separate progenitor B-cell blasts from myeloid blasts within the CD341/low CD451 population and may be more convenient compared to the published method using low SSC and CD45 expression. This study confirms the value of utilizing the FCM-score in our patient population. Myelodysplastic syndromes (MDS) are classified by the WHO as myeloid neoplasms, and are characterized by cytopenia and dysplasia in one or more myeloid cell lines (1). They are the result of ineffective hematopoiesis that leads to an increased risk of developing acute myeloid leukemia. When patients lack specific diagnostic markers, such as clonal cytogenetic abnormalities and/or ringsideroblasts, the diagnosis MDS is not always straightforward. Recently, a flow cytometric score (FCM-score) was published capable of discriminating low-grade MDS from nonclonal cytopenias (2). We tested the applicability of the FCM-score in a patient population from a large peripheral teaching hospital in The Netherlands.The FCM algorithm as proposed by Della Porte et al. (2) measures four cardinal parameters (cutoff): CD341 myeloid blast cells (2%) and CD341 B-progenitorrelated cluster size (5%), lymphocyte/myeloid blast cell CD45 mean fluorescence intensity (MFI) ratio (4 or 7.5) and granulocyte/lymphocyte side scatter peak channel ratio (<7). Patients scored 1 point for each fulfilled criteria. An FCM-score of 2 or more was considered suggestive for the diagnosis of MDS.Separating B-progenitor blasts from myeloid blasts by sidescatter characteristics and CD45 expression, as proposed by this algorithm, can be difficult and may "pollute" the B-progenitor related cluster with myeloid blasts or vice versa. To improve the separation of B-