The association between corticosteroid therapy and subsequent infections was calculated by pooling data from 71 controlled clinical trials. The overall rate of infectious complications was 12.7010 in the 2,111 patients randomly allocated to systemic corticosteroids and 8.0070 in the 2,087 controls (relative risk [RR], 1.6; 95% confidence interval reI], 1.3-1.9; P < .001). The risk of infection was particularly high in patients with neurologic diseases (RR, 2.8; 95% CI, 1.9-4.3; P< .001) and less pronounced in patients with intestinal (RR, 1.4; 95% CI, 1.1-1.7; P = .02), hepatic (RR, 1.4; 95% CI, 0.9-2.3; P = .25), and renal (RR> 1; P = .03) diseases. The rate was not increased in patients given a daily dose of <10 mg or a cumulative dose of <700 mg of prednisone. With increasing doses the rate of occurrence of infectious complications increased in patients given corticosteroids as well as in patients given placebo, a finding suggesting that not only the corticosteroid but also the underlying disease state account for the steroid-associated infectious complications observed in clinical practice.Corticosteroids in pharmacologic doses are commonly used to inhibit the immunologic network [1, 2]. As a consequence one might expect that the resistance to a wide variety of bacterial, viral, protozoal, and fungal agents is depressed, as was clearly demonstrated by numerous investigations in animals [3][4][5]. The effect of corticosteroids on the rate of infection was shown to depend upon many variables, including the dosage of the steroid and the resistance of the animal. These observations in animals were in accordance with the clinical impression of an increased rate of infections in patients treated with glucocorticoids.Toxicologic studies in animals allow in many but not all instances for the prediction of potential adverse effects of a drug in humans and for the establishment of the underlying mechanism for such unwanted effects. However, such studies cannot provide a quantitative estimate of the rate of occurrence of a given adverse effect in humans. This might also be true for corticosteroids. For instance, a large number of the investigations dealing with the enhance-

DW and BOLD MR imaging are feasible and reproducible in patients with renal allografts.

The present investigation provides no evidence for a survival benefit of continuous vs intermittent RRT in ICU patients with ARF.

Although essential for many cellular processes, the sequence of structural and molecular events during clathrin-mediated endocytosis remains elusive. While it was long believed that clathrin-coated pits grow with a constant curvature, it was recently suggested that clathrin first assembles to form flat structures that then bend while maintaining a constant surface area. Here, we combine correlative electron and light microscopy and mathematical growth laws to study the ultrastructural rearrangements of the clathrin coat during endocytosis in BSC-1 mammalian cells. We confirm that clathrin coats initially grow flat and demonstrate that curvature begins when around 70% of the final clathrin content is acquired. We find that this transition is marked by a change in the clathrin to clathrin-adaptor protein AP2 ratio and that membrane tension suppresses this transition. Our results support the notion that BSC-1 mammalian cells dynamically regulate the flat-to-curved transition in clathrin-mediated endocytosis by both biochemical and mechanical factors.

TAVI is feasible in patients with a high burden of comorbidities and in patients with pre-existing end-stage renal disease who would be otherwise not considered as candidates for conventional aortic valve replacement. Although GFR improved in more than half of the patients, this benefit was associated with a risk of postinterventional AKI. Future investigations should define preventive measures of peri-procedural kidney injury.