Fungi predatory activity on embryonated <Emphasis Type="Italic">Toxocara canis</Emphasis> eggs inoculated in domestic chickens (<Emphasis Type="Italic">Gallus gallus domesticus</Emphasis>) and destruction of second stage larvae

The objective of this study was to evaluate the infectivity of Toxocara canis eggs after interacting with isolated nematophagous fungi of the species Duddingtonia flagrans (AC001) and Pochonia chlamydosporia (VC4), and test the predatory activity of the isolated AC001 on T. canis second stage larvae after 7 days of interaction. In assay A, 5000 embryonated T. canis eggs previously in contact with the AC001 and VC4 isolated for 10 days were inoculated into domestic chickens (Gallus gallus domesticus), and then these animals were necropsied to collect material (digested liver, intestine, muscles and lungs) at 3-, 7-, 14-, and 21-day intervals after inoculation. In assay A, the results demonstrated that the prior interaction of the eggs with isolated AC001 and VC4 decreases the amount of larvae found in the collected organs. Difference (p?<?0.01) was observed in the medium larvae counts recovered from liver, lung, intestine, and muscle of animals in the treated groups when compared to the animals in the control group. At the end of assay A, a percentage reduction of 87.1 % (AC001) and 84.5 % (VC4) respectively was recorded. In the result of assay B, the isolated AC001 showed differences (p?<?0.01) compared to the control group, with a reduction of 53.4 % in the recovery of L₂. Through these results, it is justified to mention that prior interaction of embryonated T. canis eggs with the tested fungal isolates were efficient in reducing the development and migration of this parasite, in addition to the first report of proven predatory activity on L₂.     

Haematological and acute-phase response of dogs with experimental skin <Emphasis Type="Italic">Pseudomonas aeruginosa</Emphasis> infection to treatment with antibiotic and parthenolide

Changes in white blood cells, leukogram patterns, the positive acute-phase protein (APP) fibrinogen and negative APPs (albumin and arylesterase) were monitored to evaluate their potential as sensitive indicators throughout the course of therapy in canine skin Pseudomonas aeruginosa infection. The study was performed on 15 male mixed-breed dogs, divided in three groups of 5 dogs each. Dogs from group A were injected subcutaneously with P. aeruginosa bacterial culture (1?×?10⁸ CFU/mL) at a dose of 0.3 mL/kg and treated with enrofloxacin (5 mg/kg, s.c.) on post infection hour 48 for 10 consecutive days. Dogs from group B were infected and treated with a combination of enrofloxacin (at above-mentioned dose and intervals) and parthenolide (feverfew extract 90 mg, 0.7 % parthenolide). The schedule consisted of daily oral intake of two capsules of feverfew beginning on post infection hour 4 and continued for 6 days. The control group C included healthy dogs, injected s.c. with 0.3 mL/kg physiological saline. The haematological indices and APPs were assayed before infection and on 4th, 24th, 48th and 72nd hours and on 7th, 10th and 14th days after infection. Infected and antibiotic-treated dogs responded with significant leukocytosis, left shift, eosinopaenia and lymphopaenia between hours 24 and 72. In this group, fibrinogen increased substantially by post infection hours 24 (p?<?0.01 vs 0 h; p?<?0.05 vs group C), 48 (p?<?0.001 vs 0 h; p?<?0.05 vs group C) and 72 (p?<?0.001 vs 0 h; p?<?0.01 vs group C) while albumin reduction was marked by hours 48 (p?<?0.05 vs 0 h) and 72 (p?<?0.05 vs 0 h; p?<?0.001 vs group C) and day 7 (p?<?0.01 vs 0 h; p?<?0.001 vs group C). The combination of enrofloxacin and parthenolide modified, at a significant extent, the deviations in studied parameters except for eosinophil percentage, which persisted low.     

Prevalence, intensity and seasonality of gastrointestinal parasites in abattoir horses in Germany

Prevalence and intensity of gastrointestinal parasites were studied through a longitudinal survey in 400 horses over a 17-month period in an abattoir in Germany. Three hundred and ten horses (77.5 %) were demonstrated harbouring endoparasites either by direct recovery of parasites from the digestive tract and/or in terms of faecal egg counts (strongyles). The following parasites were found (percentage prevalence, range of counts): Gasterophilus intestinalis larvae (2.25 %, 1–154), Gasterophilus nasalis larvae (0.25 %, 44), Trichostrongylus axei (11.0 %, 1–3,620), Habronema majus (8.0 %; 1–422), Habronema muscae (26.5 %, 1–3,563), Habronema spp. fourth-stage larvae (5.5 %; 1–1,365), Parascaris equorum (total prevalence 11.3 %; adults 8.8 %, 1–178; fourth-stage larvae 2.5 %, 5–2,320), Anoplocephala perfoliata (28.5 %, 1–2,013) and Paranoplocephala mamillana (1.0 %, 1–11). Strongyle eggs (≥10 eggs per gram of faeces) were recorded in 60.8 % of the horses (10–6,450 eggs per gram of faeces). Prevalences of infection with T. axei, P. equorum and strongyles did not show a correlation to specific seasons. In contrast, a significant variation among seasons of collection was shown for the infection rates of Habronema spp. (p?<?0.05) and A. perfoliata (p?<?0.001). Seasonal prevalence of Habronema spp. infection was significantly (p?<?0.01) higher in summer (39.0 %), autumn (34.8 %) and winter (36.5 %) than in spring (18.7 %), and A. perfoliata were significantly (p?<?0.001) more often recorded during autumn (36.1 %) and winter (36.5 %) than in spring (17.3 %) and summer (15.9 %). Prevalences of T. axei, Habronema spp., strongyles and A. perfoliata in male and female horses were almost alike, but ascarids were significantly (p?=?0.025) more often recorded in male than in female horses.     

Influence of blood flow velocity on arterial distensibility of carotid artery in healthy men

Decreased distensibility of carotid artery is independently associated with the incidence of cardiovascular and cerebrovascular events. Arterial distensibility is determined by vascular tone. Since shear stress is an important driving force of vasodilatory substances production form endothelial cells, we hypothesized that local basal (i.e., resting) arterial blood flow velocity is associated with regional arterial distensibility. To test this hypothesis, we determined the influence of local blood flow velocity on carotid arterial distensibility in cross-sectional study design. In a total of 73 apparent healthy men (18–64 years), carotid arterial properties, including measures of carotid arterial distensibility and BFV at rest, were evaluated via B-mode and Doppler ultrasound imaging and applanation tonometry system. Carotid arterial peak BFV and the absolute and normalized pulsatile BFV significantly correlated with age (r = ?0.453 to ?0.600, p < 0.0001), whereas mean and minimum BFV were not influenced by age. Distensibility coefficient of carotid artery correlated with peak BFV (r = 0.305, p < 0.01) and more strongly with pulsatile (i.e., systolic minus end-diastolic) BFV (r = 0.406, p < 0.0001) and the normalized pulsatile BFV by time-averaged velocity (r = 0.591, p < 0.0001). Multi-regression analysis revealed that age (β = ?0.57, p < 0.0001) was the primary independent determinant for distensibility coefficient. In addition with this, carotid lumen diameter (β = ?0.202, p < 0.01) and the normalized pulsatile BFV (β = 0.237, p < 0.05) were significant independent determinants of distensibility coefficient. Qualitatively similar results (although inverse in direction) were obtained by use of β-stiffness index. These results suggest that greater gradient of blood flow velocity during a cardiac cycle are favorably associated with distensibility of carotid artery.     

Behavioral and electrophysiological evidence for attenuation of CNS by aqueous extract from <Emphasis Type="Italic">Citrus aurantium</Emphasis> (CaL) flowers in rat

Anxiety disorders have a relatively high prevalence in most countries. Chemical drugs used to treat anxiety have some unwanted side effects. Therefore, using medicinal plants is useful. Citrus aurantium L. (CaL) flowers are used in Iran to treat anxiety as a folk medicine. We investigated its anxiolytic and sedative effects. We used elevated plus maze and pentobarbital sodium sleeping time tests to evaluate the anxiolytic and sedative effects of CaL flowers on CNS, respectively. In addition, by using extracellular single unit recording technique, we evaluated the depressant action of CaL on neuronal activity of basolateral amygdale (BLA), one of the major structures involved in anxiety. CaL flower aqueous extract (62.5, 125 mg/kg) increased the percentage of time spent in open arms and reduced the percent of time spent in closed arms (p?<?0.05). It also reduced locomotor activity at 250 mg/kg (p?<?0.05). CaL flower aqueous extract (125, 250 mg/kg) prolonged the duration of pentobarbital sleeping time [(p?<?0.05) and (p?<?0.01), respectively] and shortened the onset of sleep in rats (p?<?0.05). CaL reduced the firing rate of BLA neurons (p?<?0.05). Our data suggests that CaL flowers have sedative and anxiolytic effects.     

Effect of Kalpaamruthaa on immunosuppression of both humoral and cell-mediated immunity in DMBA-induced mammary tumours of rats

The present study was carried out to elucidate the protective effect of Kalpaamruthaa on improving 7,12-dimethylbenz(a)anthracene (DMBA)-induced immunosuppression of both humoral and cell-mediated immunity in mammary carcinoma-induced rats. Breast cancer was induced in rats by administering DMBA orally (25 mg/rat) as a single dose. After 90 days of induction, SA (200 mg/kg body weight) and KA (300 mg/kg body weight) were administered for 14 days, by gastric intubation. Several immunotoxicological assays such as T cell rosette delayed type hypersensitivity (DTH) response, migration inhibition factor (MIF) assay, lymphocyte proliferation assay, plaque forming cell (PFC) assay and haemagglutination assay, plaque forming cell (PFC) assay, serum soluble immune complex and cytokine production, T and B cell mitogenesis induced by Con A and nonspecific cell-mediated immunity were evaluated using phagocytosis activity and NBT reduction. In cancer-induced animals (group II), the leukocyte migration inhibition declined markedly (p?<?0.001), the levels of cytokines IFN-γ and IL-2 were significantly decreased (p?<?0.001) and also the antibody titre level (p?<?0.001) was significantly reduced when compared with control rats. A marked decline in PFC (p?<?0.001) and serum soluble immune complex (PEG) formation (p?<?0.001) was also observed. Hence, the present study clearly demonstrates the immunoprotective effect of KA.     

Prognostic impact of hyperglycemia at onset of methicillin-sensitive <Emphasis Type="Italic">Staphylococcus aureus</Emphasis> bacteraemia

Previous reports have associated hyperglycemia to poor outcome among aged and comorbid Staphylococcus aureus bacteraemia (SAB) patients. However, the prognostic impact of hyperglycemia in SAB irrespective of age and underlying conditions including a diagnosis of diabetes has received little attention. The objective here was to evaluate the prognostic relevance of hyperglycemia at onset of methicillin-sensitive SAB (MS-SAB). It was a retrospective study of MS-SAB patients. Blood glucose was measured within 24 h of positive blood cultures. The patient cohort was analyzed en bloc and by categorization according to age, underlying conditions and a diagnosis of diabetes. Altogether 161 patients were identified. High initial blood glucose levels were observed among diabetics (p?<?0.001), patients with deep infections (p?<?0.05) and poor outcome at 28- or 90-days (p?<?0.05). Receiver operating characteristics presented the glucose cut-off level of 7.2 mmol/L as a significant predictor of mortality with an area under the curve of 0.63 (95% CI 0.52–0.75, p?<?0.05). Blood glucose ≥7.2 mmol/L connected to higher 28- (9 vs. 20%, p?<?0.05) and 90-day (14 vs. 29%, p?<?0.01) mortality. In Cox proportional hazard regression the blood glucose cut-off value of 7.2 mmol/L significantly predicted 90-day mortality (HR, 2.12; 95% CI, 1.01–4.46; p?<?0.05). Among young and healthy non-diabetics the negative prognostic impact of high glucose was further accentuated (HR 7.46, p?<?0.05). High glucose levels had no prognostic impact among diabetics. Hyperglycemia at SAB onset may associate to poor outcome. The negative prognostic impact is accentuated among young and healthy non-diabetics.     

The relevance of Tim-3 polymorphisms and F protein to the outcomes of HCV infection

Hepatitis C virus (HCV) is one of the major causes of liver inflammation. The aim of this study was to investigate the associations of T-cell immunoglobulin and mucin domain-3 (Tim-3) polymorphisms and the alternate reading frame protein (F protein) with the outcomes of HCV infection. Three single-nucleotide polymorphisms (SNPs; rs10053538, rs12186731, and rs13170556) of Tim-3 were genotyped in this study, which included 203 healthy controls, 558 hepatitis C anti-F-positive patients, and 163 hepatitis C anti-F-negative patients. The results revealed that the rs12186731 CT and rs13170556 TC and CC genotypes were significantly less frequent in the anti-F-positive patients [odds ratio (OR)?=?0.54, 95 % confidence interval (CI)?=?0.35–0.83, p?=?0.005; OR?=?0.26, 95 % CI?=?0.18–0.39, p?<?0.001; and OR?=?0.19, 95 % CI?=?0.10–0.35, p?<?0.001, respectively), and the rs13170556 TC genotype was more frequent in the chronic HCV (CHC) patients (OR?=?1.70, 95 % CI?=?1.20–2.40, p?=?0.002). The combined analysis of the rs12186731 CT and rs13170556 TC/CC genotypes revealed a locus-dosage protective effect in the anti-F-positive patients (OR?=?0.22, 95 % CI?=?0.14–0.33, p _trend?<?0.001). Stratified analyses revealed that the frequencies of the rs12186731 (CT?+?TT) genotypes were significantly lower in the older (OR?=?0.31, 95 % CI?=?0.15–0.65, p?=?0.002) and female (OR?=?0.30, 95 % CI?=?0.17–0.52, p?<?0.001) subgroups, and rs13170556 (TC?+?CC) genotypes exhibited the same effect in all subgroups (all p?<?0.001) in the anti-F antibody generations. Moreover, the rs13170556 (TC?+?CC) genotypes were significantly more frequent in the younger (OR?=?1.86, 95 % CI?=?1.18–2.94, p?=?0.007) and female (OR?=?2.38, 95 % CI?=?1.48–3.83, p?<?0.001) subgroups of CHC patients. These findings suggest that the rs12186731 CT and rs13170556 TC/CC genotypes of Tim-3 provide potential protective effects with the F protein in the outcomes of HCV infection and that these effects are related to sex and age.     

Efficacy evaluation of iclaprim in a neutropenic rat lung infection model with methicillin-resistant <Emphasis Type="Italic">Staphylococcus aureus</Emphasis> entrapped in alginate microspheres

The objective of this study was to demonstrate the efficacy of iclaprim in a neutropenic rat lung infection model with methicillin-resistant Staphylococcus aureus (MRSA) entrapped in alginate beads. An inoculum of 5.25?×?10⁵ colony-forming units (CFU)/mL of S. aureus strain AH1252 was administered intratracheally to rats with prepared alginate bacteria suspensions. Beginning 2 h post-infection, rats received: (1) iclaprim 80 mg/kg (n?=?16); (2) iclaprim 60 mg/kg (n?=?16), or (3) vancomycin 50 mg/kg (n?=?24), for 3 days via subcutaneous (SC) injection every 12 h. Twelve hours after the last treatment, rats were euthanized and lungs collected for CFU determination. Iclaprim administered at 80 mg/kg or 60 mg/kg or vancomycin 50 mg/kg SC twice a day for 3 days resulted in a 6.05 log₁₀ CFU reduction (iclaprim 80 mg/kg compared with control, p?<?0.0001), 5.11 log₁₀ CFU reduction (iclaprim 60 mg/kg compared with control, p?<?0.0001), and 3.42 log₁₀ CFU reduction, respectively, from the controls (p?<?0.0001). Iclaprim 80 mg/kg and 60 mg/kg resulted in 2.59 and 1.69 log₁₀ CFU reductions, respectively, from vancomycin-treated animals (80 mg/kg iclaprim vs. vancomycin, p?=?0.0005; 60 mg/kg iclaprim vs. vancomycin, p?=?0.07). Animals receiving iclaprim, vancomycin, and controls demonstrated 100%, 91.7%, and 48.3% survival, respectively. In this neutropenic rat S. aureus lung infection model, rats receiving iclaprim demonstrated a greater CFU reduction than the controls or those receiving vancomycin.     

Implementing a practice change: early initiation of continuous renal replacement therapy during neonatal extracorporeal life support standardizes care and improves short-term outcomes

Purpose

We hypothesized that a standardized approach to early continuous renal replacement therapy (CRRT) during neonatal extracorporeal life support (ECLS) results in greater homogeneity of CRRT initiation times with improvements in fluid balance and outcomes.

Methods

Retrospective analysis of data (2007–2015) obtained from neonates treated prior to (E1; n?=?32) and after (E2; n?=?31) a 2011 practice change: CRRT initiation within 48 h of ECLS.

Results

Birthweight, gestational age, ECLS mode, and age at ECLS initiation were similar to each epoch. Survival [E1: median 75%, E2: 71%] and length of ECLS [E1: median 221 h, E2: 180 h] were comparable. During E2, 100% of infants received CRRT (vs. E1: 37%; p?<?0.001) and 97% of infants initiated CRRT within 48 h of ECLS (vs. E1: 13%; p?<?0.001). Control charts demonstrate reduced practice variation. Elapsed time from ECLS to CRRT differed between Epochs [E1: median 105 h, E2: 9 h; p?<?0.001] as did weight at CRRT initiation [E1: 4.13 kg (29% above baseline), E2: 3.19 kg (0%); p?<?0.001]. Significant differences in weight change were noted on days 6 and 7 (E1: 14%, E2: 2%; raw data comparison yielded p?<?0.05) and curves were different (p?<?0.05).

Conclusions

We successfully implemented a practice change, initiating CRRT within 48 h of ECLS cannulation, leading to decreased practice variation and improved short-term outcomes including decreased weight gain at CRRT initiation and faster return to baseline weight during the first 7 days of ECLS. We did not demonstrate changes in duration of ECLS, invasive ventilation, or survival.

     

Prevalence and antibiotic susceptibility of <Emphasis Type="Italic">Ureaplasma urealyticum</Emphasis> and <Emphasis Type="Italic">Mycoplasma hominis</Emphasis> in Xi’an,China

This study analyzed the prevalence and antibiotic susceptibility of urogenital Ureaplasma urealyticum and Mycoplasma hominis isolated in Xi’an, China. A total of 2161 individuals from 2011 to 2015 were included, and antibiotic susceptibility tests were performed by using the Mycoplasma IST kit. Of the individuals studied, 1018 (47.11 %) were identified to be positive for urogenital mycoplasmas. The single U. urealyticum, single M. hominis, and dual U. urealyticum and M. hominis infections accounted for 772 (75.83 %), 66 (6.48 %), and 180 (17.68 %), respectively. The total positive rate was higher in females than in males (58.76 % vs. 28.86 %, p?<?0.001). The highest total positive rate (48.88 %) was observed in individuals aged 25 years to 30 years. In symptomatic and asymptomatic individuals, the positive rates were both higher in females than in males (67.36 % vs. 31.02 %, p?<?0.001 and 42.58 % vs. 7.69 %, p?<?0.001, respectively) and individuals aged 25 years to 30 years, and those aged 30 years to 35 years had the highest positive rates (54.35 and 57.14 %, respectively). The U. urealyticum and M. hominis identified from single or dual infections displayed low resistance rates to josamycin, doxycycline, and minocycline (<10 %) in both the symptomatic and asymptomatic groups. These results suggest that females and individuals with symptoms and younger age had higher mycoplasma infection rates and that josamycin, doxycycline, and minocycline may be recommended for the clinical treatment of patients infected with urogenital mycoplasmas, irrespective of the symptoms.     

Association of serum bilirubin with oxidant damage of human atherosclerotic plaques and the severity of atherosclerosis

Bilirubin has protective effects against atherosclerotic cardiovascular diseases hypothetically due to its antioxidant–antilipoperoxidative properties. Thus, we investigated whether serum bilirubin is associated with oxidant damage, namely lipid peroxidation, of human atherosclerotic plaques and the severity of atherosclerosis. In this regard, we correlated the levels of serum total bilirubin (STB), direct (conjugated) bilirubin (SDB) and indirect (unconjugated) bilirubin (SIB) with those of fluorescent damage products of lipid peroxidation (FDPL) and lipid hydroperoxides (LOOH) of 32 endarterectomy-derived carotid atherosclerotic plaques. Moreover, we compared the levels of serum bilirubin and plaque lipoperoxides between two groups of patients of the study population with different severity of atherosclerosis as judged by the carotid stenosis degree, i.e., <90% (group A, n = 23) and ≥90% (group B, n = 9). Remarkably, the levels of STB were strongly inversely correlated with those of plaque FDPL (rS = ?0.70, P < 0.0001) and LOOH (rS = ?0.66, P < 0.0001), as were those of SIB (FDPL: rS = ?0.68, P < 0.0001; LOOH: rS = ?0.63, P < 0.0001). SDB had a weaker association with plaque FDPL (rS = ?0.41, P < 0.05) and LOOH (rS = ?0.35, P < 0.05). Moreover, the levels of STB, SDB and SIB were lower and those of plaque lipoperoxides higher in group B than in group A, pointing to the association of serum bilirubin and plaque oxidant burden with the severity of atherosclerosis. In conclusion, lowered serum bilirubin is associated with oxidant damage of human atherosclerotic plaques and the severity of atherosclerosis.     

Comparing Clinicopathologic and Radiographic Findings Between TT-UMP,Classical, and Non-Encapsulated Follicular Variants of Papillary Thyroid Carcinomas

Thyroid tumors of uncertain malignant potential (TT-UMP) comprise an accepted subgroup of follicular-patterned thyroid tumors for which benignancy or malignancy cannot be precisely assessed. We aimed to evaluate the demographic characteristics, ultrasound (US) findings, and cytological results of patients with TT-UMP and compare these findings to a classical variant of papillary thyroid carcinoma (CV-PTC) and non-encapsulated follicular variant of PTC (NEFV-PTC) patients; we also evaluated the immunohistochemical characteristics of patients with TT-UMP. Twenty-four patients with TT-UMP, 672 with CV-PTC, and 132 with NEFV-PTC were included in the study. Mean longitudinal nodule size and median nodule volume were higher in the TT-UMP group than in the CV-PTC and NEFV-PTC groups (p?<?0.001 and p?<?0.001 for CV-PTC; p?<?0.001 and p?=?0.008 for NEFV-PTC). The presence of halo and peripheral vascularization was observed more frequently in the TT-UMP group than in the CV-PTC group (p?=?0.002 and p?=?0.024). Benign and follicular neoplasm/suspicious for follicular neoplasm cytological results were higher in the TT-UMP group than in the CV-PTC group (p?=?0.030 and p?=?0.001). US findings were similar between TT-UMP and NEFV-PTC groups (all, p?>?0.05). However, none of the patients with TT-UMP were called malignant; 105 patients (31.2 %) of CV-PTC and 11 patients (9.5 %) of NEFV-PTC (infiltrative FV) were classified as malignant cytologically. Tumor size was higher in the TT-UMP group than in the CV-PTC and NEFV-PTC groups (p?<?0.001 and p?=?0.006). In the TT-UMP group, positive expression of HBME-1, CK-19, and Gal-3 was found in 50, 33.3, and 25 % of patients, respectively. This study demonstrated that none of the TT-UMP patients were evaluated as malignant in preoperative cytology. However, patients with TT-UMP had higher nodule and tumor sizes than CV-PTC and NEFV-PTC patients; US features were similar between NEFV-PTC and TT-UMP patients.     

<Emphasis Type="Italic">CDKN1A</Emphasis> histone acetylation and gene expression relationship in gastric adenocarcinomas

CDKN1A is a tumor suppressor gene involved in gastric carcinogenesis and is a potential target for histone deacetylase inhibitor-based therapies. Upregulation of CDKN1A is generally observed in several cell lines after histone deacetylase inhibitor treatment; however, little is known about the histone acetylation status associated with this gene in clinical samples, including gastric tumor tissue samples. Therefore, our goal was to quantify the H3K9 and H4K16 acetylation levels associated with three CDKN1A regions in 21 matched pairs of gastric adenocarcinoma and corresponding adjacent non-tumor samples by chromatin immunoprecipitation and to correlate these data with the gene expression. Our results demonstrated that the ?402, ?20, and +182 CDKN1A regions showed a significantly increased acetylation level in at least one of the histones evaluated (p < 0.05, for all comparisons), and these levels were positively correlated in gastric tumors. However, an inverse correlation was detected between both H3K9 and H4K16 acetylation at the ?402 CDKN1A region and mRNA levels in gastric tumors (r = ?0.51, p = 0.02; r = ?0.60, p < 0.01, respectively). Furthermore, increased H4K16 acetylation at the ?20 CDKN1A region was associated with gastric tumors of patients without lymph node metastasis (p = 0.04). These results highlight the complexity of these processes in gastric adenocarcinoma and contribute to a better understanding of CDKN1A regulation in carcinogenesis.     

Clinical characteristics and pertussis costs in cases reported to epidemiological services and cases detected in household contacts in Catalonia (Spain)

Purpose

To assess the clinical characteristics and direct health costs associated with pertussis cases reported to and confirmed by epidemiological services and cases detected among household contacts in Catalonia (Spain) in 2012–2013.

Methods

All pertussis cases confirmed by the epidemiological services (n?=?641) and all cases detected among the household contacts (n?= 422) were included in the study. The chi-square test and odds ratios were used to compare percentages and the t-test was used to compare mean pertussis costs, with p?<?0.05 being considered statistically significant.

Results

Cases reported to epidemiological services had a higher percentage of hospitalizations (OR?=?32.2, p?<?0.001) and severe disease (OR?=?27.7, p?<?0.001) than cases detected among the household contacts. The total health costs associated with pertussis cases were €871,648, €799,704 (92 %) for cases reported to epidemiological services and €71,944 (8 %) for cases detected among the household contacts. Total treatment, detection, and quimiprophylaxis costs were € 809,702, € 44,312, and € 17,635, representing 92.5 %, 5.5 %, and 2 % of total pertussis costs respectively. The mean costs were significantly higher (p?<?0.001) in cases reported to epidemiological services than in cases detected among the household contacts, for all cases (€1248 vs €170), and for severe (€4546 vs €1073), moderate (€204 vs €165), and mild (€153 vs €133) disease.

Conclusions

The burden of pertussis in Catalonia was high in terms of health costs, especially in infants aged less than 1 year. Active epidemiological surveillance activities could prevent pertussis transmisison and reduce pertussis costs.

     

Abstracts 2016

Background

Musculoskeletal pain is associated with comorbidity, extensive use of health services, long-term disability and reduced quality of life. The scientific literature on effects of treatment for musculoskeletal pain is inconclusive.

Purpose

The purpose of this study is to compare a multidisciplinary intervention (MI), including use of the novel Interdisciplinary Structured Interview with a Visual Educational Tool (ISIVET), with a brief intervention (BI), on effects on mental and physical symptoms, functioning ability, use of health services and coping in patients sick-listed due to musculoskeletal pain.

Method

Two hundred eighty-four adults aged 18–60, referred to a specialist clinic in physical rehabilitation, were randomized to MI or BI. Patients received a medical examination at baseline and completed a comprehensive questionnaire at baseline, 3 months and 12 months.

Results

Both groups reported improvements in mental and physical symptoms, including pain, and improved functioning ability at 3 and 12 months, but the MI group improved faster than the BI group except from reports of pain, which had a similar course. Significant interactions between group and time were found on mental symptoms (anxiety (p?<?0.05), depression (p?<?0.01), somatization (p?<?0.01)) and functioning ability (p?<?0.01) due to stronger effects in the MI group at 3 months. At 3 and 12 months, the MI group reported significantly less use of health services (general practitioner (p?<?0.05)). At 12 months, the MI group reported better self-evaluated capability of coping with complaints (p?<?0.001) and they took better care of their own health (p?<?0.001), compared to the BI group.

Conclusion

The results indicate that the MI may represent an important supplement in the treatment of musculoskeletal pain.

     

Effect of <Emphasis Type="Italic">Citrullus vulgaris</Emphasis> on some functional indices of selected tissues of Wistar rats

Citrullus vulgaris (watermelon) is a fruit with prophylactic and therapeutic potentials. In an attempt to maximize these potentials, the seed and rind are now often consumed together with the pulp. This study aimed at evaluating the implications of such consumption. Study involved the use of 35 Wistar rats grouped into seven with a control group administered distilled water, and the other groups administered varying concentrations of the pulp and whole fruit for 28 days. Alanine and aspartate aminotransferase (ALT, AST) were assayed in the serum and liver. Total protein of the serum and selected tissues was determined and malondialdehyde (MDA) level measured. Phytochemical screening revealed the presence of steroids, saponin, alkaloids, flavonoids, and terpenoids in both whole fruit and pulp. Significant increases (p < 0.05) were seen in the liver ALT levels while there was a decreased (p < 0.05) intestinal total protein in the treatment groups. No significant (p ? 0.05) difference was seen in the serum and pancreas MDA levels while an increased (p < 0.05) intestinal MDA level was observed. Increased liver ALT levels in all the treatment groups might be due to high glutamate levels of C. vulgaris. Decreased (p ? 0.05) intestinal total protein might be indicative of protein loss, while elevated (p < 0.05) intestinal MDA levels in the groups administered whole fruit is suggestive of a defect in absorption at the intestinal epithelium. Hence, whole fruit consumption of C. vulgaris should be done with caution as it has potential to cause intestinal oxidative stress.     

Intrapulmonary percussive ventilation improves lung function in cystic fibrosis patients chronically colonized with <Emphasis Type="Italic">Pseudomonas aeruginosa</Emphasis>: a pilot cross-over study

High levels of shear stress can prevent and disrupt Pseudomonas aeruginosa biofilm formation in vitro. Intrapulmonary percussive ventilation (IPV) could be used to introduce shear stress into the lungs of cystic fibrosis (CF) patients to disrupt biofilms in vivo. We performed a first-of-its-kind pilot clinical study to evaluate short-term IPV therapy at medium (200 bursts per minute, bpm) and high frequency (400 bpm) as compared to autogenic drainage (AD) on lung function and the behavior of P. aeruginosa in the CF lung in four patients who are chronically colonized by P. aeruginosa. A significant difference between the three treatment groups was observed for both the forced expiratory volume in 1 s (FEV1) and the forced vital capacity (FVC) (p?<?0.05). More specifically, IPV at high frequency significantly increased FEV1 and FVC compared to AD (p?<?0.05) and IPV at medium frequency (p?<?0.001). IPV at high frequency enhanced the expression levels of P. aeruginosa planktonic marker genes, which was less pronounced with IPV at medium frequency or AD. In conclusion, IPV at high frequency could potentially alter the behavior of P. aeruginosa in the CF lung and improve lung function. Trial registration: The trail was retrospectively registered at the ISRCTN registry on 6 June 2013, under trial registration number ISRCTN75391385.     

Risk prediction in infective endocarditis by modified MELD-XI score

The suitability of the model for end-stage liver disease excluding international normalized ratio (MELD-XI) score to predict adverse outcomes in infective endocarditis (IE) patients remains uncertain. This study was performed to explore the prognostic value of the MELD-XI score and modified MELD-XI score for patients with IE. A total of 858 patients with IE were consecutively enrolled and classified into two groups: MELD-XI ≤?10 (n?=?588) and MELD-XI >?10 (n?=?270). Multivariate analysis was performed to determine risk factors independent of MELD-XI score. Higher MELD-XI score was associated with higher in-hospital mortality (15.6 vs. 4.8%, p?<?0.001) and major adverse clinical events (33.3 vs. 18.4%, p?<?0.001). MELD-XI score was an independent predictor of in-hospital death (odds ratio [OR]?=?1.06, 95% CI, 1.02–1.10, p?=?0.005). Based on a multivariate analysis, NYHA class III or IV (3 points), C-reactive protein >?9.5 mg/L (4 points), and non-surgical treatment (6 points) were added to MELD-XI score. Modified MELD-XI score produced higher predictive power than previous (AUC 0.823 vs. 0.701, p?<?0.001). The cumulative incidence of long-term mortality (median 29 months) was significantly higher in patients with modified MELD-XI score >?13 than those without (log-rank?=?25.30, p?<?0.001). Modified MELD-XI score was independently associated with long-term mortality (hazard ratio?=?1.08, 95% CI, 1.04–1.12, p?<?0.001). MELD-XI score could be used as a risk assessment tool in IE. Furthermore, modified MELD-XI score remained simple and more effective in predicting poor prognosis.