Streptococcus pyogenes is an uncommon cause of community-acquired pneumonia and there have been few recent specific accounts of the condition. To describe the current nature of this disease in the UK, data was gathered on patients with clinical pneumonia from whom Streptococcus pyogenes was cultured principally from blood or other relevant normally sterile sites. In the Harrogate and Northallerton districts of North Yorkshire, pneumonia accounted for nine (20%) cases and a quarter of all deaths in a complete sequence of 45 patients with Streptococcus pyogenes bacteraemia detected during the 16-year-period 1981-1996. An analysis is presented of those cases together with eight recent cases from counties York, Durham and Isle of Wight during 1995-1997. Of the total 17 cases, nine occurred in women and eight in men; the age range was 30-92 years. The organism was isolated from blood culture in 15 (88%) patients. Eight (47%) patients died, five within 1 day of hospitalisation. Fourteen (82%) cases occurred in the winter months October to March, including all the fatal cases and all eight in which a clinical 'viral' prodrome was observed. Predisposing medical or surgical conditions were present in 65% of the patients. Major complications included septicaemia, pleural reaction, shock, pulmonary cavitation, osteomyelitis and metastatic abscesses. Seven serotypes of Streptococcus pyogenes were encountered, with M-type 1 predominating (the cause in 60% of cases). All infections were community acquired; two small clusters of fatal pneumonia were seen.

The present pilot study seems to indicate that bone and periodontal response and microbiological status around submerged dental implants in immunocompromised organ-transplanted patients do not differ 1 year after loading from those observed in control patients and that this particular population of patients may be successfully rehabilitated with dental implants.

The two treatments were begun on the first morning of life and continued daily until discharge. Infants on ward B were therefore bathed from day 1 during the treatment period whereas all other infants were not bathed until day 4, as is the normal unit practice. It was intended to continue the second treatment period for three months but it was discontinued after two months, and for the third month early bathing only was carried out with no chlorhexidine treatment.The umbilicus is recognised as the first site of colonisation and this usually occurs by 48 hours after birth.'4 Swabs were therefore taken from the base of the umbilicus on the morning of the third day of life. Infants staying longer than three days were swabbed a second time on discharge.Swabs were cultured on blood agar and mannitol salt agar and incubated for 48 hours. Levels of S aureus colonisation were recorded as: 0, no growth; 1, less than 100 colonies; 2, greater than 100 colonies; and 3, confluent growth. All positive swabs were sent to the public health laboratory services for phage typing.As the previous study had shown marked variation in S aureus incidence with time but not between the two wards the study was designed so that treatment and control periods were contemporaneous. The relative risk with 95% confidence intervals was calculated for an incidence study and p values by the x2 test with Yates's correction.All staff working on either ward had nasal swabs taken at the midpoint of the trial. After the end of each treatment period the nurses administering the treatment were asked to fill in a questionnaire on its acceptability.

The aim of the study was to evaluate the safety and efficacy of a new chemo-radiotherapy regimen for patients with locally advanced pancreatic cancer (LAPC). Patients were treated as follows: gemcitabine 1000 mg/m2 on day 1, and oxaliplatin 100 mg/m2 on day 2, every two weeks (GEMOX regimen) for 4 cycles, 15 days off, hypofractionated radiotherapy (35 Gy in 7 fractions in 9 consecutive days), 15 days off, 4 additional cycles of GEMOX, restaging. From April 2011 to August 2016, a total of 42 patients with non resectable LAPC were enrolled. Median age was 67 years (range 41–75). Radiotherapy was well tolerated and the most frequently encountered adverse events were mild to moderate nausea and vomiting, abdominal pain and fatigue. In total, 9 patients underwent surgical laparotomy (5 radical pancreatic resection 1 thermoablation and 3 explorative laparotomy), 1 patient became operable but refused surgery. The overall resectability rate was 25%, while the R0 resection rate was 12.5%. At a median follow-up of 50 months, the median progression-free survival and overall survival were 9.3 (95% CI 6.2–14.9) and 15.8 (95% CI 8.2–23.4) months, respectively. The results demonstrate the feasibility of a new chemo-radiotherapy regimen as a potential treatment for unresectable LAPC.