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Infection with Borrelia miyamotoi in California, USA, has been suggested by serologic studies. We diagnosed B. miyamotoi infection in an immunocompromised man in California. Diagnosis was aided by plasma microbial cell–free DNA sequencing. We conclude that the infection was acquired in California.

Intratracheal administration of a single dose of the perfluorocarbon FC-100 improves lung function in surfactant-deficient animals. In this study we compared the response to repeated doses of FC-100 (3 mL/kg 3% solution, n = 5) with that observed after administration of Exosurf (5 mL/kg, n = 5) to mechanically ventilated preterm lambs of 125 d of gestation. The initial dose of FC-100 rapidly increased arterial PO2, decreased arterial PCO2, and improved arterial pH. Also dynamic lung compliance markedly improved with this agent. Administration of an additional dose of FC-100 resulted in relatively similar changes, albeit of lesser magnitude than those observed with the initial dose. In contrast, Exosurf did not improve these variables even after three doses. All lambs treated with FC-100 survived the 6-h study period, whereas one of the five Exosurf-treated lambs survived (p < 0.05). Mean arterial blood pressure and heart rate decreased in those lambs that received FC-100, but not in surviving lambs that received Exosurf. Our data demonstrate that repeated intratracheal administration of the perfluorocarbon FC-100 improves lung function and survival of surfactant-deficient lambs better than the synthetic surfactant Exosurf. We speculate that tensio-active agents with properties different from surfactant, such as FC-100, might improve lung function in preterm neonates with diseases due to surfactant deficiency.

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H O I P I I~~. B Y~~O S~l r e s , A r g e n r l n a obleflue t o dererm>ne r h e ~n c~d e n c e o f ENS ~n c h l l d r e n born m o r e t h a n 2L h i a i r e r PRM, and 1 0 e v a l u a r e t h e d l a g n o r t l c r e l l a b > l l r y o f 3 r e i r r a l t e r n a r l v e r o b l o o d c u l t u r e , namelv c u l t u r l n o e x t e r n a l a u d > o v e c a n a l (EAC) ruab. n a r a~h a r v n o e a l a i o > r a t e (NPII) and g a s t r 1 c arplrare ( G h ) . . Blood c u l t u r e war p e r i a r m e d u > r h l n t h e f~r r t 3 h o u r s of l l f e and EAC. NPA and 64 c u l t u r e s and b~i t h ENS uar c o n r~d e r e d p r e s e n t uhen c l l n r c a l m a n~f e r t a t ? a n r o f i e p s l r v e r e e u > d e n r u~i h > n t h e t > r r r A8 h i and b l o o d c u l t u r e proved ~o r~i l u e Newborn f r o m motherr on p r i o r a n r > b l a t l c t h e r a p y were e x c l u 1101146) u l r h p r e t e r m b , r t h ~r o l a r e d = r a n p o r i r , u e m~i r a o r g a n~r m s v e r e s a u r e u r ( n = 9 ) , s pneuma-nlae ( n = 3 ) , s v , r~d a n r ( n =~) , p n t e r o c o c i u r ( n = l ) and L m o n r i y r o g e n e i ( n = l ) .~r a m n e g a i~v e were K pneumon;ae l n = 5 ) . E c o t , l n = 2 ) and H ~n f l u e n l a e l n = l ). D~stance standars for height were constructed on a sample of 254 girls with T.S.. with different cariotypes (47% XO. 53% other types) and treated with oestrogens during puberty from a mean age of 13.98 yr. (SD 2.0). Patients were measured at intervals ranging from 0,5 to 1.5 years dur~ng 1 to 11 years at the division of Endocrinology Htal R. Gutierrez.Fiflieth centile was estimated by adjusting a 5 degree polynomial to the mean height obtained at each 0.5 year interval. Residual SD of the fitting was very low (0.8 cm ). First derivative of the median distance curve showed that adult he~ght (height velocity less than 0.2 cmlyear) is atta~ned at 18.2 yr. Mean adult height was 137.9 cm. with SD of 5,7 cm , very similar to the SD found in healthy argentine female population. Chi Square test for d~fferences between distribution of raw date among selected centiles and theoretical expected distribution was not significant The differences between adult height of local Turner girls and adult height of Turner girls from other population are similar to the population differences between normal girls Voto, M.Margulies. Neonatology Unit, Obstetrics Division, J u a n A.Fernandez Hospital, Buenos Aires, Argentma.Introduction: S e v e r e anti-D hemolytlc disease c a r r i e s a high n s k of fetal a n d neonatal moribiditv a n d mortality. A total of 30 neonates were studied. The level of hemoglobin a n d bilirubm at birth, t h e p r e s e n c e of h y d r o p s fetalis, a n d t h e need f o r mechanical ventilation a n d c o r r e d l o n of hematohqic -~~ parameters were assessed. Results: Hydrops fetalis was p r e s e n t i n 8 c a s e s (27%). Mean gestational a g e d e l i v e r y was 33.42 weeks, a n d mean b~h w e i g h t was 2017t348 g. In 63% of t h e c a s e s c...

Background: Febrile Neutropenia (FN) in cancer patients is associated with a high mortality rate yet identifying patients with FN at highest risk for short term morbidity and mortality remains challenging. The Rothman Index (RI) is a real-time composite measurement of a patient's condition using 26 clinical variables sensitive to signs of patient clinical decline. RI has been shown to predict intensive care unit (ICU) admission, hospital readmission and short term mortality among inpatients. A prior study from our institution demonstrated that hospitalized patients with hematological malignancies and RI < 60 have a greater likelihood of readmission or discharge to hospice rather than those with higher RI scores. The aim of this study was to explore RI as a predictor of adverse outcomes in patients with hematological malignancies who have FN. Methods: Chart records of all patients with hematological malignancies and FN who were hospitalized at Yale Cancer Center between February of 2013 and July of 2014 were reviewed. Clinical variables collected included demographics, malignancy type, comorbidities, admission condition and microbiological data related to the FN episode. The primary outcome measure was a composite of in-hospital mortality and discharge to hospice care. Variables associated with the primary outcome in univariate analysis were entered into a multivariate logistic regression model for analysis. Results: Of 308 patients with hematological malignancies, 180 (58.4%) developed FN during their admission and 38 (12.3%) died during the admission or were discharged to hospice. A total of 85 (27.6%) patients had a RI < 60, 155 (50.3%) had a RI between 60-80, and 71 (23.1%) had a RI > 80. Controlling for malignancy type, major medical comorbidities and microbiologically confirmed bacterial infection, RI < 60 was independently associated with this outcome (Odds ratio 3.02, 95% Confidence Interval 1.25-7.34). Baseline renal disease, pneumonia, respiratory failure and sepsis were also associated with the primary outcome. Conclusion: RI is an objective measure that can independently predict poor outcomes among inpatients with FN. RI can guide clinicians caring for patients with FN in both prognostication and identifying high risk patients with an RI < 60 who are at higher risk for mortality, discharge to hospice, or high risk of readmission. The utility of this scoring system should be compared to existing risk stratification systems used in Oncology to identify its optimal use in the clinical setting. Table 1. Factors associated with inpatient mortality or hospice discharge among hematologic malignancy inpatients with febrile neutropenia Variable OR 95% CI for OR p RI < 60 3.02 1.25-7.34 .015 Respiratory Failure 3.51 1.07-11.56 .039 Renal Disease 4.97 1.38-17.9 .014 Sepsis 8.18 1.63-41.2 .011 Pneumonia 8.01 1.42-45.1 .018 Disclosures No relevant conflicts of interest to declare.