Mechanical bowel preparation and antimicrobial prophylaxis in elective colorectal surgery in Switzerland—a survey

Background: The aim of this study was to assess the use of mechanical bowel preparation (MBP) and antimicrobial prophylaxis in elective colorectal surgery in Switzerland. Methods: Ninety-eight heads of surgical departments in Switzerland and 42 visceral surgeons in private practice were asked to answer an 18-item questionnaire in October 2008 about arguments in favor of or against MBP. The participants also indicated whether they use MBP and antimicrobial prophylaxis in colorectal surgery, and if so, what agents were used. Of the participants, 117/140 (83%) responded. Additional data were collected pertaining to the respondents' experience and work situation. Results: MBP was used significantly more often for rectal surgery than for left colonic resections (83% vs. 53%; p < 0.001) and more often for left than for right colonic resections (53% vs. 43%; p = 0.001), regardless of the open or laparoscopic approach. Younger surgeons and surgeons with a higher case load in colorectal surgery used MBP significantly less frequently in open right colonic resections. For MBP, cathartics were used in 90% of patients, and enemas were used in 10% of patients. Of the respondents, 37% considered MBP to be useful, even very useful. Based on the literature, because of introduction of fast-track protocols or for considerations of patient comfort, 86% of the respondents had changed the bowel preparation regime during the last 10years in terms of a reduction of the quantity of cathartics or restricted the indications for MBP. Antimicrobial prophylaxis was used by 100% of the respondents, 88% used a single prophylactic dose only, while 70% administered the antibiotics 30-59min before the incision. Most of the surgeons used second-generation cephalosporins in combination with metronidazole, and 24% changed the antibiotic agent or reduced the duration of administration of antibiotics during the last 10years. Conclusions: MBP is often used in open and laparoscopic rectal surgery, but not in right colonic resections. Scientific evidence regarding MBP has yielded a rethinking about rigorous bowel preparation regimes. As of now, surgeons in Switzerland are not yet unanimously ready to abandon MBP in elective colorectal surgery. In Switzerland, surgeons are influenced by the benefit of antimicrobial prophylaxis in colorectal surger

Improving the metabolic fidelity of cancer models with a physiological cell culture medium

Currently available cell culture media may not reproduce the in vivo metabolic environment of tumors. To demonstrate this, we compared the effects of a new physiological medium, Plasmax, with commercial media. We prove that the disproportionate nutrient composition of commercial media imposes metabolic artifacts on cancer cells. Their supraphysiological concentrations of pyruvate stabilize hypoxia-inducible factor 1α in normoxia, thereby inducing a pseudohypoxic transcriptional program. In addition, their arginine concentrations reverse the urea cycle reaction catalyzed by argininosuccinate lyase, an effect not observed in vivo, and prevented by Plasmax in vitro. The capacity of cancer cells to form colonies in commercial media was impaired by lipid peroxidation and ferroptosis and was rescued by selenium present in Plasmax. Last, an untargeted metabolic comparison revealed that breast cancer spheroids grown in Plasmax approximate the metabolic profile of mammary tumors better. In conclusion, a physiological medium improves the metabolic fidelity and biological relevance of in vitro cancer models

Bariatric surgery in women in reproductive age: recommendations from the “Diabetes and Pregnancy” and “Diabetes and Obesity” working committees from the Argentine Society of Diabetes

El incremento de la obesidad en el mundo, a edades más tempranas, ha tenido un impacto negativo especialmente en las mujeres en edad reproductiva. Se ven afectadas tanto la fertilidad como la tasa de embarazos de riesgo, de niños con bajo peso al nacer, pretérmino e índice de cesáreas. La cirugía bariátrica como alternativa de tratamiento de la obesidad ha mejorado la fertilidad, pero el trastorno malabsortivo que provoca modifica la absorción de nutrientes en la madre y en el feto. El diagnóstico de diabetes gestacional se dificulta dado que la prueba de tolerancia oral a la glucosa estaría contraindicada en estos casos. El objetivo de estas recomendaciones es proveer herramientas para el control y seguimiento de mujeres en edad reproductiva sometidas a cirugía bariátrica.Worldwide increased obesity prevalence at early ages particularly affects women of reproductive ages. Both fertility and risk pregnancy rates are affected, of low birth weight infants, prematures and cesarean section rates have been modified considerably. Bariatric surgery is a validated tool to improve fertility but nutrient malabsorption as a consequence of surgery could affect mother and fetus nutrition and development. Gestational diabetes diagnosis turns difficult in this group of obese patients after bariatric surgery since oral glucose tolerance testing would be contraindicated in these cases. The aim of these recommendations was to offer tools for a good control and follow up of women at reproductive age.Fil: Gutt, Susana. Hospital Italiano de Buenos Aires; ArgentinaFil: Rovira, Gabriela. Universidad de Buenos Aires. Facultad de Medicina. Sede Hospital Britanico Bs.as; ArgentinaFil: Jawerbaum, Alicia Sandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos; Argentina. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Espinoza, Frank. Instituto Cardiovascular Lezica; ArgentinaFil: Mociulsky, Juliana. Clínica de Nutrición y Salud Dr. Cormillot; ArgentinaFil: Sucani, Stella. Provincia de Misiones. Hospital Escuela de Agudos Dr. Ramon Madariaga; ArgentinaFil: Kojdamanian, Verónica. Centro de Educación, Prevención y Asistencia al paciente diabético; ArgentinaFil: Aguirre Ackermann, Marianela. Centro Integral de Endocrinología y Nutrición; ArgentinaFil: Álvarez, María Graciela. Centro de Estudio y Tratamiento de la Obesidad Severa; ArgentinaFil: Camaño, Alejandro. Centro Médico de Especialidades y Diagnósticos Privado para la Salud; ArgentinaFil: Glatstein, Liliana. Centro Médico San Andrés; ArgentinaFil: Lifszyc, Paula. Hospital Carlos G. Durand; ArgentinaFil: Gómez Martin, Carolina. Centro Integral de Endocrinología y Diabetes; ArgentinaFil: Mendes, Patricio. Maternidad San Lucas; ArgentinaFil: Menéndez, Estrella. Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno; ArgentinaFil: Yuma, María. Hospital Italiano de Buenos Aires; ArgentinaFil: Bertona, Celina. Universidad Nacional de Cuyo; ArgentinaFil: Cafaro, Lilia. Obesidad y Cirugía Mini Invasiva; ArgentinaFil: Fuentes, Susana. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad En Red El Cruce Dr. Nestor Carlos Kirchner Samic; ArgentinaFil: Salzberg, Susana. Instituto Centenario; ArgentinaFil: Basualdo, Natalia. Hospital Materno Infantil Ramón Sardá; ArgentinaFil: González, Sandra . Cínica IMA; ArgentinaFil: Villarroel Parra, Beatriz. Hospital de Agudos Dalmacio Vélez Sarsfield; Argentina. Sanatorio Santa Isabel; ArgentinaFil: Musso, Carla. Fundacion Favaloro; Argentin

Semen quality, testicular B-mode and Doppler ultrasound, and serum testosterone concentrations in dogs with established infertility

Retrospective examination of breeding records enabled the identification of 10 dogs of normal fertility and 10 dogs with established infertility of at least 12 months of duration. Comparisons of testicular palpation, semen evaluation, testicular ultrasound examination, Doppler ultrasound measurement of testicular artery blood flow, and measurement of serum testosterone concentration were made between the two groups over weekly examinations performed on three occasions. There were no differences in testicular volume (cm3) between the two groups (fertile right testis = 10.77 ± 1.66; fertile left testis = 12.17 ± 2.22); (infertile right testis = 10.25 ± 3.33; infertile left testis = 11.37 ± 3.30), although the infertile dogs all had subjectively softer testes compared with the fertile dogs. Infertile dogs were either azoospermic or when they ejaculated, they had lower sperm concentration, sperm motility, and percentage of morphologically normal spermatozoa than fertile dogs. Furthermore, infertile dogs had reduced sperm membrane integrity measured via the hypoosmotic swelling test. Infertile dogs had significantly lower basal serum testosterone concentrations (1.40 ± 0.62 ng/mL) than fertile dogs (1.81 ± 0.87 ng/mL; P < 0.05). There were subjective differences in testicular echogenicity in some of the infertile dogs, and important differences in testicular artery blood flow with lower peak systolic and end-diastolic velocities measured in the distal supratesticular artery, marginal testicular artery, and intratesticular artery of infertile dogs (P < 0.05). Notably, resistance index and pulsatility index did not differ between infertile and fertile dogs. These findings report important differences between infertile and fertile dogs which may be detected within an expanded breeding soundness examination

Systemic Delivery of an Adjuvant CXCR4-CXCL12 Signaling Inhibitor Encapsulated in Synthetic Protein Nanoparticles for Glioma Immunotherapy

Glioblastoma (GBM) is an aggressive primary brain cancer, with a 5 year survival of ∼5%. Challenges that hamper GBM therapeutic efficacy include (i) tumor heterogeneity, (ii) treatment resistance, (iii) immunosuppressive tumor microenvironment (TME), and (iv) the blood-brain barrier (BBB). The C-X-C motif chemokine ligand-12/C-X-C motif chemokine receptor-4 (CXCL12/CXCR4) signaling pathway is activated in GBM and is associated with tumor progression. Although the CXCR4 antagonist (AMD3100) has been proposed as an attractive anti-GBM therapeutic target, it has poor pharmacokinetic properties, and unfavorable bioavailability has hampered its clinical implementation. Thus, we developed synthetic protein nanoparticles (SPNPs) coated with the transcytotic peptide iRGD (AMD3100-SPNPs) to target the CXCL2/CXCR4 pathway in GBM via systemic delivery. We showed that AMD3100-SPNPs block CXCL12/CXCR4 signaling in three mouse and human GBM cell cultures in vitro and in a GBM mouse model in vivo. This results in (i) inhibition of GBM proliferation, (ii) reduced infiltration of CXCR4+ monocytic myeloid-derived suppressor cells (M-MDSCs) into the TME, (iii) restoration of BBB integrity, and (iv) induction of immunogenic cell death (ICD), sensitizing the tumor to radiotherapy and leading to anti-GBM immunity. Additionally, we showed that combining AMD3100-SPNPs with radiation led to long-term survival, with ∼60% of GBM tumor-bearing mice remaining tumor free after rechallenging with a second GBM in the contralateral hemisphere. This was due to a sustained anti-GBM immunological memory response that prevented tumor recurrence without additional treatment. In view of the potent ICD induction and reprogrammed tumor microenvironment, this SPNP-mediated strategy has a significant clinical translation applicability.Fil: Alghamri, Mahmoud S.. University Of Michigan Medical School; Estados UnidosFil: Banerjee, Kaushik. University Of Michigan Medical School; Estados UnidosFil: Mujeeb, Anzar A.. University Of Michigan Medical School; Estados UnidosFil: Mauser, Ava. University of Michigan; Estados UnidosFil: Taher, Ayman. University Of Michigan Medical School; Estados UnidosFil: Thalla, Rohit. University Of Michigan Medical School; Estados UnidosFil: McClellan, Brandon L.. University Of Michigan Medical School; Estados UnidosFil: Varela, Maria L.. University Of Michigan Medical School; Estados UnidosFil: Stamatovic, Svetlana M.. University Of Michigan Medical School; Estados UnidosFil: Martinez Revollar, Gabriela. University Of Michigan Medical School; Estados UnidosFil: Andjelkovic, Anuska V.. University Of Michigan Medical School; Estados UnidosFil: Gregory, Jason V.. University of Michigan; Estados UnidosFil: Kadiyala, Padma. University Of Michigan Medical School; Estados UnidosFil: Calinescu, Alexandra. University Of Michigan Medical School; Estados UnidosFil: Jiménez, Jennifer A.. University of Michigan; Estados UnidosFil: Apfelbaum, April A.. University of Michigan; Estados UnidosFil: Lawlor, Elizabeth R.. University of Washington; Estados UnidosFil: Carney, Stephen. University of Michigan; Estados UnidosFil: Comba, Andrea. University Of Michigan Medical School; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Faisal, Syed Mohd. University Of Michigan Medical School; Estados UnidosFil: Barissi, Marcus. University Of Michigan Medical School; Estados UnidosFil: Edwards, Marta B.. University Of Michigan Medical School; Estados UnidosFil: Appelman, Henry. University Of Michigan Medical School; Estados UnidosFil: Sun, Yilun. Case Western Reserve University; Estados UnidosFil: Gan, Jingyao. University of Michigan; Estados UnidosFil: Ackermann, Rose. University of Michigan; Estados UnidosFil: Schwendeman, Anna. University of Michigan; Estados UnidosFil: Candolfi, Marianela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas; ArgentinaFil: Olin, Michael R.. University of Minnesota; Estados UnidosFil: Lahann, Joerg. University of Michigan; Estados UnidosFil: Lowenstein, Pedro R.. University of Michigan; Estados UnidosFil: Castro, Maria G.. University of Michigan; Estados Unido

Semen quality, testicular B-mode and Doppler ultrasound, and serum testosterone concentrations in dogs with established infertility

Retrospective examination of breeding records enabled the identification of 10 dogs of normal fertility and 10 dogs with established infertility of at least 12 months of duration. Comparisons of testicular palpation, semen evaluation, testicular ultrasound examination, Doppler ultrasound measurement of testicular artery blood flow, and measurement of serum testosterone concentration were made between the two groups over weekly examinations performed on three occasions. There were no differences in testicular volume (cm3) between the two groups (fertile right testis = 10.77 ± 1.66; fertile left testis = 12.17 ± 2.22); (infertile right testis = 10.25 ± 3.33; infertile left testis = 11.37 ± 3.30), although the infertile dogs all had subjectively softer testes compared with the fertile dogs. Infertile dogs were either azoospermic or when they ejaculated, they had lower sperm concentration, sperm motility, and percentage of morphologically normal spermatozoa than fertile dogs. Furthermore, infertile dogs had reduced sperm membrane integrity measured via the hypoosmotic swelling test. Infertile dogs had significantly lower basal serum testosterone concentrations (1.40 ± 0.62 ng/mL) than fertile dogs (1.81 ± 0.87 ng/mL; P < 0.05). There were subjective differences in testicular echogenicity in some of the infertile dogs, and important differences in testicular artery blood flow with lower peak systolic and end-diastolic velocities measured in the distal supratesticular artery, marginal testicular artery, and intratesticular artery of infertile dogs (P < 0.05). Notably, resistance index and pulsatility index did not differ between infertile and fertile dogs. These findings report important differences between infertile and fertile dogs which may be detected within an expanded breeding soundness examination

Intersocietal consensus on the treatment of obesity in adolescents in Argentina

En un contexto socioeconómico mundial de profundas desigualdades, mientras que poblaciones enteras están siendo arrasadas por la desnutrición, es notorio el aumento de la obesidad en niños, adolescentes y adultos. La prevalencia de obesidad ha aumentado a un ritmo alarmante y está afectando progresivamente a muchos países de bajos y medianos ingresos, sobre todo en el medio urbano. Preocupa, especialmente de bido a las severas complicaciones clínicas que ocasiona1,2. De manera coincidente con las tendencias internacionales, en la Argentina la 2º Encuesta Nacional de Nutrición y Salud ( ENNYS) del año 2019 revela cifras del 20,7% y 20,4% de sobrepeso y obesidad en niños de 5 a 17 años, y en la tercera Encuesta Mundial de Salud Escolar del 2018 ( EMSE) , las cifras de la población de 13 a 17 años fueron de 30,7 % de sobrepeso y 7,4 % de obesidad3,4. La obesidad es una enfermedad crónica. Recientemente, la Asociación Europea para el Estudio de la Obesidad (EASO), la resume como una enfermedad por exceso de tejido adiposo. Las severas consecuencias en la salud que provoca dependen de la cantidad, la distribución y la localización del tejido adiposo. La enfermedad se produce, tanto a partir de la alteración en la función endócrina e inmulogógica del organismo, como causando alteraciones anatómicas en el organismo a partir del espacio físico que ocupa...Fil: Kovalskys, Irina. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires"; ArgentinaFil: Mayer, Marcos Alejandro. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Patagonia Confluencia. Instituto de Ciencias de la Tierra y Ambientales de la Pampa. Grupo Vinculado Fundacion Centro de Salud E Investigaciones Medicas | Universidad Nacional de la Pampa. Facultad de Ciencias Exactas y Naturales. Instituto de Ciencias de la Tierra y Ambientales de la Pampa. Grupo Vinculado Fundacion Centro de Salud E Investigaciones Medicas.; ArgentinaFil: Armeno, Marisa. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Matto, Liliana. Asociación Psiquiátrica de América Latina; Argentina. Asociación de Psiquiatras Argentinos; ArgentinaFil: Roussos, Adriana. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; ArgentinaFil: Schuldberg, Jacqueline. Asociación Argentina de Dietistas- Nutricionistas Dietistas; ArgentinaFil: Tozzi, Karina. Sociedad Argentina de Endocrinología Ginecológica y Reproductiva; ArgentinaFil: Valenti, Claudia. Gobierno de la Ciudad Autonoma de Buenos Aires. Ministerio de Salud. Subsecretaria de Atencion Primaria Ambulatoria y Comunitaria.; ArgentinaFil: Anger, Vanesa E.. Universidad Maimónides; ArgentinaFil: Araujo, María Beatriz. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Bakalarz, Beatriz. Asociación Psiquiatras Argentinos; ArgentinaFil: Bazan, Nelio Eduardo. Universidad Nacional de Rosario; ArgentinaFil: Ganduglia Cazaban, Mercedes. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños Pedro Elizalde (ex Casa Cuna); Argentina. Asociación Argentina de Nutricionistas y Nutricionistas Dietistas; ArgentinaFil: Ozuna, Blanca Acela. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Rampi, Gabriela. Universidad Austral. Hospital Universitario Austral; ArgentinaFil: Ruiz, Laura. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Sarubbi, Susana. Sociedad Argentina de Nutrición; ArgentinaFil: Tonietti, Miriam. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; ArgentinaFil: Zonis, Luciana. Sociedad Argentina de Nutrición; ArgentinaFil: Salinas, Victoria. Sociedad Argentina de Nutrición; ArgentinaFil: Aguirre Ackermann, Marianela. Sociedad Argentina de Nutrición; Argentina. Universidad Nacional del Nordeste; Argentina. Universidad Favaloro; ArgentinaFil: Sguassero, Yanina. Sociedad Argentina de Nutrición; ArgentinaFil: Katz, Mónica. Sociedad Argentina de Nutrición; Argentina. Universidad Favaloro; Argentin

A communal catalogue reveals Earth's multiscale microbial diversity

Our growing awareness of the microbial world's importance and diversity contrasts starkly with our limited understanding of its fundamental structure. Despite recent advances in DNA sequencing, a lack of standardized protocols and common analytical frameworks impedes comparisons among studies, hindering the development of global inferences about microbial life on Earth. Here we present a meta-analysis of microbial community samples collected by hundreds of researchers for the Earth Microbiome Project. Coordinated protocols and new analytical methods, particularly the use of exact sequences instead of clustered operational taxonomic units, enable bacterial and archaeal ribosomal RNA gene sequences to be followed across multiple studies and allow us to explore patterns of diversity at an unprecedented scale. The result is both a reference database giving global context to DNA sequence data and a framework for incorporating data from future studies, fostering increasingly complete characterization of Earth's microbial diversity.Peer reviewe

A communal catalogue reveals Earth’s multiscale microbial diversity

Our growing awareness of the microbial world’s importance and diversity contrasts starkly with our limited understanding of its fundamental structure. Despite recent advances in DNA sequencing, a lack of standardized protocols and common analytical frameworks impedes comparisons among studies, hindering the development of global inferences about microbial life on Earth. Here we present a meta-analysis of microbial community samples collected by hundreds of researchers for the Earth Microbiome Project. Coordinated protocols and new analytical methods, particularly the use of exact sequences instead of clustered operational taxonomic units, enable bacterial and archaeal ribosomal RNA gene sequences to be followed across multiple studies and allow us to explore patterns of diversity at an unprecedented scale. The result is both a reference database giving global context to DNA sequence data and a framework for incorporating data from future studies, fostering increasingly complete characterization of Earth’s microbial diversity

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase&nbsp;1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation&nbsp;disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age&nbsp; 6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score&nbsp; 652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc&nbsp;= 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N&nbsp;= 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in&nbsp;Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in&nbsp;Asia&nbsp;and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701