Microbiological Hazards Associated with Archaeological Works, Illustrated with an Example of Fredro Crypt (Przemyśl, Poland)

The human remains and other materials found in crypts can be highly contaminated with microorganisms. Archaeologists are exposed to microorganisms in many ways (e.g by inhaling dust, contaminating scratches or cuts). We aimed at evaluating microbial hazards associated with human remains and bioaerosols formed during archaeological works in burial crypts. The samples of the human remains, bioaerosols and personal protective equipment (dust respirators, disposable coveralls) were collected during archaeological works in the vault of the Cathedral Basilica of St. John the Baptist and the Assumption of the Blessed Virgin Mary in Przemyśl (Fredro crypt). The microbiological examination involved determining the number of spores of aerobic and anaerobic bacteria, the number of mesophilic and hemolytic bacteria, and the number of xerophilic, non- xerophilic and keratinolytic fungi. The air as well as objects and materials found in crypts are highly contaminated with bacteria and fungi. The xerophilic fungi were the most numerous in all samples of human remains 1–230·103 cfu(colony forming units/g). The non-xerophilic fungi were predominant in bioaerosols (>104 cfu/m3 during archaeological works). The majority of bacterial strains (81.3%) belonged to the genus Bacillus. Fungi belonging to the genera Penicillium (65.2%) and Aspergillus (28.6%) dominated among the isolated fungi. Fogging sterilization of the crypt turned out to be ineffective. The high number of microorganisms both in the air and on human remains indicates that there is a need for particular caution during archaeological works which cause dust emission. In order to reduce exposure to harmful biological factors, the use of disposable personal protective equipment seems necessary

Microbiological Hazards Associated with Archaeological Works, Illustrated with an Example of Fredro Crypt (Przemyśl, Poland)

The human remains and other materials found in crypts can be highly contaminated with microorganisms. Archaeologists are exposed to microorganisms in many ways (e.g by inhaling dust, contaminating scratches or cuts). We aimed at evaluating microbial hazards associated with human remains and bioaerosols formed during archaeological works in burial crypts. The samples of the human remains, bioaerosols and personal protective equipment (dust respirators, disposable coveralls) were collected during archaeological works in the vault of the Cathedral Basilica of St. John the Baptist and the Assumption of the Blessed Virgin Mary in Przemyśl (Fredro crypt). The microbiological examination involved determining the number of spores of aerobic and anaerobic bacteria, the number of mesophilic and hemolytic bacteria, and the number of xerophilic, non- xerophilic and keratinolytic fungi. The air as well as objects and materials found in crypts are highly contaminated with bacteria and fungi. The xerophilic fungi were the most numerous in all samples of human remains 1–230·103 cfu(colony forming units/g). The non-xerophilic fungi were predominant in bioaerosols (>104 cfu/m3 during archaeological works). The majority of bacterial strains (81.3%) belonged to the genus Bacillus. Fungi belonging to the genera Penicillium (65.2%) and Aspergillus (28.6%) dominated among the isolated fungi. Fogging sterilization of the crypt turned out to be ineffective. The high number of microorganisms both in the air and on human remains indicates that there is a need for particular caution during archaeological works which cause dust emission. In order to reduce exposure to harmful biological factors, the use of disposable personal protective equipment seems necessary

Blood pressure pattern and variability in adult patients after successful repair of coarctation of the aorta in adults

Wstęp Zaburzony dobowy profil ciśnienia tętniczego, szczególnie często stwierdzany we wtórnych postaciach nadciśnienia tętniczego, determinuje nasilenie uszkodzeń narządowych u chorych z nadciśnieniem. Jedną z przyczyn narastających uszkodzeń narządowych u pacjentów po udanej operacji koarktacji aorty mogą być nieprawidłowości dobowego rytmu ciśnienia, spowodowane zmianami hemodynamicznymi związanymi z zabiegiem naprawczym koarktacji aorty lub pojawiające się w przebiegu choroby nadciśnieniowej. Celem pracy była ocena zachowania się zmienności i dobowego rytmu ciśnienia tętniczego u dorosłych pacjentów będących w odległej obserwacji po korekcji chirurgicznej koarktacji aorty z nadciśnieniem (grupa CoA NT) i bez nadciśnienia (grupa CoA CP) w porównaniu z pacjentami z nadciśnieniem tętniczym pierwotnym (grupa NTP). Materiał i metody Badaniami objęto 32 chorych ze zwężeniem cieśni aorty po udanej operacji korekcji wady. Grupę kontrolną stanowiło 20 pacjentów z grupy NTP. Wśród pacjentów z koarktacją aorty u 11 rozpoznano nadciśnienie (grupa CoA NT), a pozostałych 21 pacjentów bez nadciśnienia zaliczono do grupy CoA CP. U wszystkich badanych zmierzono ciśnienie tętnicze metodą tradycyjną oraz wykonano 24-godzinne monitorowanie ciśnienia tętniczego (ABPM). Na jego podstawie obliczano nocny spadek ciśnienia tętniczego oraz zmienność dobową ciśnienia (ZmD CT). Pacjentów klasyfikowano jako dippers lub jako non-dippers na podstawie nasilenia (wartość graniczna — 10%) nocnego spadku ciśnienia. Wyniki Częstość zjawiska non-dipper wynosiła 44% w grupie CoA CP, 73% w grupie CoA NT i 20% w grupie NTP. Nocny spadek ciśnienia tętniczego skurczowego był istotnie mniejszy w grupie CoA NT w porównaniu z grupami CoA CP i NTP. Natomiast nocny spadek ciśnienia tętniczego rozkurczowego był istotnie mniejszy w obydwu grupach CoA w porównaniu z pacjentami z grupy NTP. ZmD SCT wynosiła 7,8 ± 1,9 mm Hg w grupie CoA CP i była niższa niż w grupach CoA NT i NTP (odpowiednio 11,8 ± mm Hg i 12,3 ± 2,3 mm Hg). Natomiast ZmD RCT w grupie CoA CP (7,3 ± 1,6 mm Hg) była niższa tylko w porównaniu z grupą NTP (10,4 ± 2,3 mm Hg) i nieznamiennie w porównaniu z grupą CoA NT (9,2 ± 2,1 mm Hg). Wnioski 1. Pacjenci po udanym zabiegu chirurgicznym koarktacji aorty, szczególnie ci z towarzyszącym nadciśnieniem tętniczym, wykazywali istotnie mniejszy nocny spadek ciśnienia tętniczego i częściej byli klasyfikowani jako non-dippers w porównaniu z pacjentami z grupy NTP. 2. Zmienność dobowa ciśnienia była zwiększona u pacjentów z grupy CoA NT w porównaniu z pacjentami z grupy CoA CT, ale w tym samym stopniu co u pacjentów z grupy NTP. 3. Zaobserwowane nieprawidłowości dobowego profilu ciśnienia wiążą się zarówno z konsekwencjami koarktacji aorty, jak i obecnością nadciśnienia tętniczego.Background Abnormal 24-h blood pressure profile is a frequent finding in patients with secondary forms of hypertension. It correlates with severity of end-organ damage in hypertensive patients. One can make hypothesis that increased incidence of end-organ damage in patients after a successful operation of coarctation of the aorta is connected with abnormal 24-h blood pressure profile caused by hemodynamic abnormalities due to recurrent aortic obstruction or hypertensive disease. The aim of the study was to evaluate 24-h blood pressure pattern and variability in adult patients long after successful surgical, having normal (group CoA CP) or increased (group CoA NT) blood pressure in comparison with patients with primary hypertension (group NTP). Material and methods Thirty two patients after a successful operation of coarctation of the aorta were studied. Control group consisted of 20 NTP patient. We found 11 CoA NT patients and 21 CoA CP patients among those with coarctation of the aorta. Blood pressure was measured traditionally and 24-h ABPM was performed in all patients. Based on it nocturnal blood pressure fall (NBPF) and blood pressure variability (BPV) was calculated. Patients were classified as dippers and nondippers according to extend of NBPF (threshold - 10 %). Results Forty four % patients in CoA CP group, 73% patients in CoA NT group and 20% patients in NTP group were nondippers. Systolic NBPF was significantly impaired in CoA NT patients in comparison with CoA CP and NTP patients, while diastolic NBPF was significantly smaller in both CoA NT and CoA CP patients in comparison with NTP patients. Systolic BPV was 7.8 ± 1.9 mm Hg in CoA CP group and was significantly lower than in CoA NT and NTP groups (11.8 ± mm Hg and 12.3 ± 2.3 mm Hg respectively). Diastolic BPV in CoA CP group (7.3 ± 1.6 mm Hg) was significantly lower than in NTP group (10.4 ± 2.3 mm Hg) but insignificantly in comparison with CoA NT group (9.2 ± 2.1 mm Hg). Conclusions 1. Patients after successful surgical repair of coarctation of the aorta, especially those with hypertension, have blunted nocturnal blood pressere fall and are more frequently classified as non-dippers in comparison with patients with primary hypertension. 2. BPV is increased in CoA NT patients in comparison with CoA CP patients, but to the same extent as with NTP patients. 3. It seems that abnormalities of 24-h blood pressure in patients after operation of coarctation of the aorta are connected both with hemodynamic changes due recurrent aortic obstruction and presence of hypertension

Risk factors for cardiac arrhythmias in children with congenital heart disease after surgical intervention in the early postoperative period

ObjectiveEarly postoperative arrhythmias are a recognized complication of pediatric cardiac surgery.MethodsDiagnosis and treatment of early postoperative arrhythmias were prospectively analyzed in 402 consecutive patients aged 1 day to 18 years (mean 29.5 months) who underwent operation between January and December 2005 at our institute. All children were admitted to the intensive care unit, and continuous electrocardiogram monitoring was performed. Risk factors, such as age, weight, Aristotle Basic Score, cardiopulmonary bypass time, aortic crossclamp time, and use of deep hypothermia and circulatory arrest, were compared. Statistical analysis using the Student t test, Mann–Whitney U test, or Fisher exact test was performed. Multivariate stepwise logistic regression was used to assess the risk factors of postoperative arrhythmias.ResultsArrhythmias occurred in 57 of 402 patients (14.2%). The most common types of arrhythmia were junctional ectopic tachycardia (21), supraventricular tachycardia (15), and arteriovenous block (6). Risk factors for arrhythmias, such as lower age (P = .0041⁎), lower body weight (P = .000001⁎), higher Aristotle Basic Score (P = .000001⁎), longer cardiopulmonary bypass time (P = .000001⁎), aortic crossclamp time (P = .000001⁎), and use of deep hypothermia and circulatory arrest (P = .0188⁎), were identified in a univariate analysis. In the multivariate stepwise logistic regression, only higher Aristotle Basic Score was statistically significant (P = .000003⁎) compared with weight (P = .62) and age (P = .40); in the cardiopulmonary bypass group, only longer aortic crossclamp time was statistically significant (P = .007⁎).ConclusionLower age, lower body weight, higher Aristotle Basic Score, longer cardiopulmonary bypass time, aortic crossclamp time, and use of deep hypothermia and circulatory arrest are the risk factors for postoperative arrhythmias. Junctional ectopic tachycardia and supraventricular tachycardia were the most common postoperative arrhythmias

Are new models needed to optimize the utilization of new medicines to sustain healthcare systems?

Medicines have made an appreciable contribution to improving health. However, even high-income countries are struggling to fund new premium-priced medicines. This will grow necessitating the development of new models to optimize their use. The objective is to review case histories among health authorities to improve the utilization and expenditure on new medicines. Subsequently, use these to develop exemplar models and outline their implications. A number of issues and challenges were identified from the case histories. These included the low number of new medicines seen as innovative alongside increasing requested prices for their reimbursement, especially for oncology, orphan diseases, diabetes and HCV. Proposed models center on the three pillars of pre-, peri- and post-launch including critical drug evaluation, as well as multi-criteria models for valuing medicines for orphan diseases alongside potentially capping pharmaceutical expenditure. In conclusion, the proposed models involving all key stakeholder groups are critical for the sustainability of healthcare systems or enhancing universal access. The models should help stimulate debate as well as restore trust between key stakeholder groups

Current practice of care for adolescent and adult patients after Fontan surgery in Poland

Background: The growing number of adults patients after the Fontan operation requires regular surveillance tests in the specialized centers. Aims: Evaluation of current practice of care for Fontan patients in Poland based on a multicenter survey. Methods: Eight centers were included in the study-5 adult congenital heart disease (ACHD) and 3 pediatric centers for adolescents. To aim for a comparison between the centers and facilitate the interpretation of the results, the Fontan Surveillance Score (FSS) was developed. The higher score is consistent with better care, with a maximum of 19 points. Results: The number of 398 Fontan patients (243 adults and 155 adolescents [age 14-18 years]) was included in the study. The median FSS was 13 points with variability between the centers (interquartile range 7-14 points). Centers providing continuous care from the pediatric period until 18 years of age achieved a higher FSS compared to ACHD centers (median: 14 points vs 12 points, p< 0.001). Most of the patients, both in the ACHD (82.3%) and in pediatric centers (89%), were seen annually and had a physical examination, electrocardiogram, and echocardiogram performed at each visit. However, unsatisfactory utilization of tests identifying the early stages of Fontan circulation failure (cardiopulmonary exercise tests, cardiac magnetic resonance, liver biochemistry and imaging, detection of protein-losing enteropathy) was observed. Conclusions: The results of the study showed that there is no unified surveillance approach for Fontan patients in Poland. The practice of care for adults differs from that of adolescents

Biopsy and tracheobronchial aspirates as additional tools for the diagnosis of bovine tuberculosis in living European bison (bison bonasus)

CITATION: Didkowska, Anna et al. 2020. Biopsy and tracheobronchial aspirates as additional tools for the diagnosis of bovine tuberculosis in living European bison (bison bonasus). Animals, 10(11):2017, doi:10.3390/ani10112017.The original publication is available at: https://www.mdpi.comENGLISH ABSTRACT: The diagnosis of bovine tuberculosis (BTB) in living wildlife remains a complex problem, and one of particular importance in endangered species like European bison (Bison bonasus). To identify infection and avoid the unnecessary culling of such valuable individuals, current best practice requires the collection and culture of material from living animals, as mycobacteria isolation remains the gold standard in BTB diagnosis. However, such isolation is challenging due to the need for the immobilization and collection of appropriate clinical material, and because of the sporadic shedding of mycobacteria. In the present study, we evaluated the potential of sampling for the detection of BTB in a group of seven living European bison suspected of being infected with Mycobacterium caprae. The specimens were collected both as swabs from the nasal and pharyngeal cavities, tracheobronchial aspirates (TBA), ultrasound-guided biopsies from lateral retropharyngeal lymph nodes, and post mortem, from mandibular, retropharyngeal and mediastinal lymph nodes. Clinical samples were tested for mycobacterial species via mycobacteriological culture and PCR. M. caprae was isolated from collected material in two out of four living infected individuals (TBA, biopsy) and mycobacterialDNAwas detected in three out of four (TBA, pharyngeal swab) bison. This is the first report of isolation of M. caprae in living European bison. Our findings demonstrate the value of diagnostic tests based on both molecular testing and culture in European bison and confirm the respiratory shedding of viable M. caprae in this host species.Publisher's versio

Spór o średniowiecze. Z rozważań nad tożsamością kulturową Europy. Studium postaw: J. Le Goff, J. Kłoczowski, A. Guriewicz.

Cel niniejszej pracy stanowi historiograficzna analiza porównawcza dorobku Jacquesa Le Goffa, Arona Guriewicza i Jerzego Kłoczowskiego, prześledzenie z lokalnej perspektywy przemian metodologicznych zachodzących w polskiej, francuskiej i rosyjskiej historiografii w drugiej połowie XX wieku, pod wpływem materializmu historycznego, braudelowskiej historii globalnej, wreszcie antropologii historycznej. Owe modele badawcze szczególnie dynamicznie wyrażały się właśnie w studiach nad średniowieczem. Przykładem szczególnej wrażliwości metodologicznej było na tym polu pisarstwo historyczne Arona Guriewicza. Jacques Le Goff i Jerzy Kłoczowski, wpisując się w powyższy proces zachowali bardziej umiarkowane postawy. Stanowiące przedmiot badań bohaterów niniejszej pracy średniowiecze można rozpatrywać jako stwarzany przez historyków konstrukt kulturowy, według koncepcji substancji narracyjnej Franklina Ankersmita. Finalnie próbuję dostarczyć odpowiedzi nie tylko na pytanie o modele średniowiecza dostępne w pracach wymienionych wyżej badaczy, lecz również o kulturową kondycję historiografii, która owe modele wytworzyła