Sick and Injured Bodies : Medical Imagery and Media Practices of Care

Peer reviewedPublisher PD

Risk factors for gram-negative bacterial infection of cardiovascular implantable electronic devices: Multicentre observational study (CarDINe Study)

Background: Infections of cardiovascular implantable electronic devices (CIED) are mainly due to Gram-positive bacteria (GPB). Data about Gram-negative bacteria CIED (GNB-CIED) infections are limited. This study aimed to investigate risk factors, clinical and diagnostic characteristics, and outcome of patients with GNB-CIED. Methods: A multicentre, international, retrospective, case-control-control study was performed on patients undergoing CIED implantation from 2015 to 2019 in 17 centres across Europe. For each patient diagnosed with GNB-CIED, one matching control with GPB-CIED infection and two matching controls without infection were selected. Results: A total of 236 patients were enrolled: 59 with GNB-CIED infection, 59 with GPB-CIED infection and 118 without infection. No between-group differences were found regarding clinical presentation, diagnostic and therapeutic management. A trend toward a higher rate of fluorodeoxyglucose positron emission computed tomography (FDG PET/CT) positivity was observed among patients with GNB than in those with GPB-CIED infection (85.7% vs. 66.7%; P = 0.208). Risk factors for GNB-CIED infection were Charlson Comorbidity Index Score (relative risk reduction, RRR = 1.211; P = 0.011), obesity (RRR = 5.122; P = 0.008), ventricular-pacing ventricular-sensing inhibited-response pacemaker implantation (RRR = 3.027; P = 0.006) and right subclavian vein site of implantation (RRR = 5.014; P = 0.004). At 180-day survival analysis, GNB-CIED infection was associated with increased mortality risk (HR = 1.842; P = 0.067). Conclusions: Obesity, high number of comorbidities and right subclavian vein implantation site were associated with increased risk of GNB-CIED infection. A prompt therapeutic intervention that may be guided using FDG PET/CT is suggested in patients with GNB-CIED infection, considering the poorer outcome observed in this group

Predictive model for bacterial co-infection in patients hospitalized for COVID-19: a multicenter observational cohort study

Objective: The aim of our study was to build a predictive model able to stratify the risk of bacterial co-infection at hospitalization in patients with COVID-19. Methods: Multicenter observational study of adult patients hospitalized from February to December 2020 with confirmed COVID-19 diagnosis. Endpoint was microbiologically documented bacterial co-infection diagnosed within 72 h from hospitalization. The cohort was randomly split into derivation and validation cohort. To investigate risk factors for co-infection univariable and multivariable logistic regression analyses were performed. Predictive risk score was obtained assigning a point value corresponding to β-coefficients to the variables in the multivariable model. ROC analysis in the validation cohort was used to estimate prediction accuracy. Results: Overall, 1733 patients were analyzed: 61.4% males, median age 69 years (IQR 57-80), median Charlson 3 (IQR 2-6). Co-infection was diagnosed in 110 (6.3%) patients. Empirical antibiotics were started in 64.2 and 59.5% of patients with and without co-infection (p = 0.35). At multivariable analysis in the derivation cohort: WBC ≥ 7.7/mm3, PCT ≥ 0.2 ng/mL, and Charlson index ≥ 5 were risk factors for bacterial co-infection. A point was assigned to each variable obtaining a predictive score ranging from 0 to 5. In the validation cohort, ROC analysis showed AUC of 0.83 (95%CI 0.75-0.90). The optimal cut-point was ≥2 with sensitivity 70.0%, specificity 75.9%, positive predictive value 16.0% and negative predictive value 97.5%. According to individual risk score, patients were classified at low (point 0), intermediate (point 1), and high risk (point ≥ 2). CURB-65 ≥ 2 was further proposed to identify patients at intermediate risk who would benefit from early antibiotic coverage. Conclusions: Our score may be useful in stratifying bacterial co-infection risk in COVID-19 hospitalized patients, optimizing diagnostic testing and antibiotic use

Mouse aldehyde-oxidase-4 controls diurnal rhythms, fat deposition and locomotor activity

Aldehyde-oxidase-4 (AOX4) is one of the mouse aldehyde oxidase isoenzymes and its physiological function is unknown. The major source of AOX4 is the Harderian-gland, where the enzyme is characterized by daily rhythmic fluctuations. Deletion of the Aox4 gene causes perturbations in the expression of the circadian-rhythms gene pathway, as indicated by transcriptomic analysis. AOX4 inactivation alters the diurnal oscillations in the expression of master clock-genes. Similar effects are observed in other organs devoid of AOX4, such as white adipose tissue, liver and hypothalamus indicating a systemic action. While perturbations of clock-genes is sex-independent in the Harderian-gland and hypothalamus, sex influences this trait in liver and white-adipose-tissue which are characterized by the presence of AOX isoforms other than AOX4. In knock-out animals, perturbations in clock-gene expression are accompanied by reduced locomotor activity, resistance to diet induced obesity and to hepatic steatosis. All these effects are observed in female and male animals. Resistance to obesity is due to diminished fat accumulation resulting from increased energy dissipation, as white-adipocytes undergo trans-differentiation towards brown-adipocytes. Metabolomics and enzymatic data indicate that 5-hydroxyindolacetic acid and tryptophan are novel endogenous AOX4 substrates, potentially involved in AOX4 systemic actions

The Representation and Care of Illness. Visual Culture, Trauma, and Medical Humanities

For a long time, scholars in the Humanities have been trying to move towards a boundary space that touches upon the medical and scientific disciplines. More than others, the topic of representation/visualisation, the relationship between ways of seeing, images, and the techniques to create them has emerged as a fertile and valuable ground for dialogue. This special issue of Cinema & Cie sets itself the ambitious goal of opening an interdisciplinary discussion reflecting on the images of illness, wound, pain, scar, and cure, which are shared today more than ever and go beyond the narrow medical field. In order to develop a new interdisciplinary methodology suitable for capturing the emotions, material dimensions, bodily practices, performative dynamics, and intersubjective systems that, as a whole, consolidate the mise en discourse of the body as an object of care, we have called upon the traditions of Trauma Studies, Medical Humanities and Visual Culture of science and medicine. In this perspective, images are not only the starting point for understanding knowledge production processes but also a valuable restorative tool for care and therapeutic practices

Sick and Injured Bodies: Medical Imagery and Media Practices of Care

Peer reviewedPublisher PD

Microstructure and phase evolution of micronized ceramic colorants from a pilot plant for inks production

The advent of inkjet printing as digital decoration of ceramic materials has irreversibly modified the industrial decoration technology, imposing companies to change the colorant production process. The inkjet application requires micronized particles in the ultrafine particle size range (smaller than 1 μm). Particles size reduction of ceramic colorants is performed by a high-energy comminution process in wet-operated bead mills, affecting colorants properties. Since a deep knowledge of milling-induced microstructural changes is still lacking, the micronization effects on a set of five industrial ceramic colorants are thoughtfully investigated in this work by simulating the industrial process at a pilot plant. Particle size distribution and energy consumption are monitored during the comminution process. The compositional (including crystallite size and microstrain analysis of the main phases) and morphological variation of four ceramic pigments (yellow zircon, brown spinel, pink malayaite, and green eskolaite) and one dye (blue olivine) is investigated by XRPD (Rietveld method) and SEM analyses. The analytical approach combined with a physical/semiempirical modelling of the colorants elastic features versus the energy demand for particle reduction has yielded details on the nature of the micronizationinduced microstructural changes in ceramic colorants. Specifically, the comminution efficiency as well as the crystalline phase stability are related to the intrinsic properties of each colorant. Brittle breakage rather than plastic deformation on comminution are also system dependent. When an euhedral to subhedral crystal habit is maintained a brittle fracture is preserved throughout the comminution progress, while the formation of flake-like particles and particle agglomeration are strong evidences of plastic deformation. The last evidence deals with the material elastic features. Materials with high bulk modulus convert the grinding energy to lattice defects that lead to particle breakage by brittle fractures, while materials with lower bulk modulus convert/dissipate part of the supplied energy in plastic deformations, drastically decreasing the comminution process efficiency

17q12 Microduplications: A Challenge for Clinicians

In the recent years, some cases of 17q12 deletions and duplications have been reported, but the clinical impact of these imbalances is still to be fully elucidated. In particular, 17q12 duplications elude syndrome classification, since they are associated with a wide phenotypic spectrum, ranging from very mild to quite severe phenotypes. Here, two unrelated patients with the same 1.2 Mb microduplication of 17q12 are reported. Comparing these patients' phenotype with those previously published, it emerges that the more patients reported, the more difficult is finding common characteristics, even in presence of exactly the same genetic anomaly. The role of the genes duplicated in this region and the impact of this chromosomal imbalance are discussed

Effect of micronisation on colour and optical properties of ceramic colourants for inkjet printing

The advent of inkjet printing (IJP) as the main used decoration technique for ceramic products has changed the technological requirements for pigments and the way they are obtained. To meet IJP and durability requirements, it is necessary to micronise the colourants to achieve particles smaller than 1 μm (median particle diameter d50 ∼300 nm). The high-energy milling process induces microstructural changes that affect the colour properties. In order to understand the effect of particle size reduction on chromatic properties, an in-depth study was carried out by simulating the industrial milling process on a pilot scale. The effect of micronisation was investigated for four ceramic pigments (yellow zircon, brown spinel, pink malayaite, and green eskolaite) and one dye (blue olivine) by UV–vis–NIR optical spectroscopy (DRS), chromatic coordinates and XRPD analyses (Rietveld method). This study was carried out on the colourants both as they were and mixed with glass, reproducing the industrial firing process. The results obtained led to the definition of the main aspects responsible for the colour evolution derived from the milling process