Der Stellenwert von Muttermilch für die gesunde Entwicklung Frühgeborener – aktuelle Übersicht und praktische Aspekte

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - In den letzten Jahren konnte der immense Vorteil der Muttermilchernährung für Frühgeborene belegt werden: in Bezug...     

Efflux-mediated resistance to florfenicol and/or chloramphenicol in Bordetella bronchiseptica: identification of a novel chloramphenicol exporter

OBJECTIVES: Twenty florfenicol- and/or chloramphenicol-resistant Bordetella bronchiseptica isolates of porcine and feline origin were investigated for the presence of floR and cml genes and their location on plasmids. METHODS: The B. bronchiseptica isolates were investigated for their susceptibility to antimicrobial agents by broth micro- or macrodilution and for their plasmid content. Hybridization experiments and PCR assays were conducted to identify resistance genes. Transformation and conjugation studies were performed to show their transferability. Representatives of both types of genes including their flanking regions were sequenced. Moreover, inhibitor studies with the efflux pump inhibitor Phe-Arg-beta-naphthylamide (PAbetaN) were performed. RESULTS: The gene floR was found in the chromosomal DNA of 9 of the 18 florfenicol/chloramphenicol-resistant isolates. Sequence analysis revealed that the deduced FloR protein sequence differed by a single amino acid exchange from FloR of Vibrio cholerae. A chloramphenicol-resistant, but florfenicol-susceptible isolate carried a novel plasmid-borne cml gene, designated cmlB1. The CmlB1 protein revealed only 73.8-76.5% identity to known CmlA proteins. The gene cmlB1 was not part of a gene cassette. The results of inhibitor studies with PAbetaN suggested that a so-far unidentified efflux system might play a role in phenicol resistance of the remaining florfenicol- and/or chloramphenicol-resistant isolates. CONCLUSIONS: This is to the best of our knowledge the first report of a floR gene in B. bronchiseptica isolates. The identification of the first member of a new subclass of cml genes, cmlB1 from B. bronchiseptica, extends our knowledge on specific chloramphenicol exporters.     

More habitual physical activity is linked to the use of specific,more adaptive cognitive reappraisal strategies in dealing with stressful events

Physical activity may improve stress resilience and well‐being. However, specific links to individuals' coping abilities with stressful events are sparse. This study tested whether individuals reporting more physical activity in daily life showed a higher capacity for cognitive reappraisal in dealing with potential stressors. Ninety‐eight participants reported their regular physical activity in the Freiburger Questionnaire on Physical Activity and completed a maximum performance test of their inventiveness in generating reappraisals for situations depicting real‐life stressors. The latter provides scores for overall cognitive reappraisal capacity (quantity of ideas) and preference for specific cognitive reappraisal strategies (quality of ideas; positive reinterpretation; problem‐oriented, de‐emphasizing reappraisals). Additionally, participants' anxious and depressive dispositions and general creative abilities were assessed. Results showed no association between time spent on physical activities per week and total quantity of generated reappraisal ideas. However, a higher degree of physical activity was specifically linked to a greater relative preference for the reappraisal strategy of positive reinterpretation. Opposite associations emerged for the strategy of de‐emphasizing reappraisals. The findings support the notion of more adaptive cognitive reappraisal use in more physically active individuals and may advance research on interrelationships between physical activity and cognitive and affective functions implicated in stress management.     

The economic burden of kidney graft failure in the United States

Despite improvements in outcomes for kidney transplant recipients in the past decade, graft failure continues to impose substantial burden on patients. However, the population‐wide economic burden of graft failure has not been quantified. This study aims to fill that gap by comparing outcomes from a simulation model of kidney transplant patients in which patients are at risk for graft failure with an alternative simulation in which the risk of graft failure is assumed to be zero. Transitions through the model were estimated using Scientific Registry of Transplant Recipients data from 1987 to 2017. We estimated lifetime costs, overall survival, and quality‐adjusted life‐years (QALYs) for both scenarios and calculated the difference between them to obtain the burden of graft failure. We find that for the average patient, graft failure will impose additional medical costs of $78 079 (95% confidence interval [CI] $41 074, $112 409) and a loss of 1.66 QALYs (95% CI 1.15, 2.18). Given 17 644 kidney transplants in 2017, the total incremental lifetime medical costs associated with graft failure is $1.38B (95% CI $725M, $1.98B) and the total QALY loss is 29 289 (95% CI 20 291, 38 464). Efforts to reduce the incidence of graft failure or to mitigate its impact are urgently needed.     

TMPRSS2-ERG Fusions Are Strongly Linked to Young Patient Age in Low-grade Prostate Cancer

Based on next-generation sequencing of early-onset prostate cancer (PCa), we earlier demonstrated that PCa in young patients is prone to rearrangements involving androgen-regulated genes—such as transmembrane protease, serine 2 (TMPRSS2)–v-ets avian erythroblastosis virus E26 oncogene homolog (ERG) fusion—and provided data suggesting that this situation might be caused by increased androgen signaling in younger men. In the same study, an accumulation of chromosomal deletions was found in cancers of elderly patients. To determine how age-dependent molecular features relate to cancer phenotype, an existing data set of 11 152 PCas was expanded by additional fluorescence in situ hybridization analyses of phosphatase and tensin homolog (PTEN), 6q15 and 5q21. The results demonstrate that the decrease in TMPRSS2–ERG fusions with increasing patient age is limited to low-grade cancers (Gleason ≤3 + 4) and that the significant increase in the deletion frequency with age was strictly limited to ERG-negative cancers for 6q15 and 5q21 but to ERG-positive cancers for PTEN. These data suggest that the accumulation of non–androgen-linked genomic alterations with advanced patient age may require an appropriate microenvironment, such as a positive or negative ERG status. The strong link of ERG activation to young patient age and low-grade cancers may help to explain a slight predominance of low-grade cancers in young patients.     

Sekundäre Individualprävention von Rückenschmerzen bei Pflegepersonal

Background

To prevent occupational disability due to low back pain, nursing staff is offered a secondary prevention activity by the statutory accident insurance.

Objectives

The efficacy regarding the development of back pain was examined and risk factors for the development of adverse back pain were identified.

Materials and methods

In this retrospective cohort study, persons who participated in secondary prevention activities from 2009–2011 were interviewed in 2012.

Results

Of the 1282 participants (response rate: 80?%), pain scores were statistically reduced for both the overall group and for subgroups. For employees of nursing homes and persons who did not participate in the refresher course, increased odds ratios for adverse pain development were observed (OR?=?1.9, 1.4, respectively).

Conclusion

In the framework of the study design, the multimodal concept of the back school shows significant efficacy in the context of back pain reduction. For nursing home employees, the training seems to be less effective than for hospital nurses.     

Effects of Dietary Exposure to Zearalenone (ZEN) on Carp (Cyprinus carpio L.)

The mycotoxin zearalenone (ZEN) is frequently contaminating animal feeds including feed used in aquaculture. In the present study, the effects of dietary exposure to ZEN on carp (Cyprinus carpio L.) were investigated. ZEN at three different concentrations (low dose: 332 µg kg⁻¹, medium dose: 621 µg kg⁻¹ and high dose: 797 µg kg⁻¹ final feed, respectively) was administered to juvenile carp for four weeks. Additional groups received the mycotoxin for the same time period but were fed with the uncontaminated diet for two more weeks to examine the reversibility of the ZEN effects. No effects on growth were observed during the feeding trial, but effects on haematological parameters occurred. In addition, an influence on white blood cell counts was noted whereby granulocytes and monocytes were affected in fish treated with the medium and high dose ZEN diet. In muscle samples, marginal ZEN and α-zearalenol (α-ZEL) concentrations were detected. Furthermore, the genotoxic potential of ZEN was confirmed by analysing formation of micronuclei in erythrocytes. In contrast to previous reports on other fish species, estrogenic effects measured as vitellogenin concentrations in serum samples were not increased by dietary exposure to ZEN. This is probably due to the fact that ZEN is rapidly metabolized in carp.