Determinación de plásmidos en cepas de Avibacterium paragallinarum multidrogo resistentes y su correlación con los serogrupos A, B y C

Publicación a texto completo no autorizada por el autorDetermina la susceptibilidad a los antimicrobianos utilizados en el tratamiento de la Coriza Infecciosa, se empleó el método de microdilución en caldo utilizando los siguientes antimicrobianos: ampicilina, cloranfenicol, estreptomicina, sulfametoxazol-trimetoprim, tetraciclina, kanamicina y eritromicina. El método de microdilución en caldo resultó ser confiable y reproducible para Av. paragallinarum. El 73.7 % (14 aislados) de las cepas aisladas fueron resistente a la tetraciclina y estreptomicina. El grupo de resistencia más común (8 cepas aisladas, 42.1 %) fue a la tetraciclina y estreptomicina. Además, el 89.5 % (17 aislados) fueron resistentes por lo menos a un antibiótico. No obstante, todas las cepas estudiadas fueron sensibles a la ampicilina. Para detectar la presencia de plásmidos en todas las cepas del estudio, se utilizó el kit de extracción QIAprep Spin Miniprep, obteniéndose que el 63.2 % (12 aislados) presentaban plásmidos, l1 y 1 cepa presentaron un plásmido de 10 000 pb y 6 000 pb respectivamente. Con ello se pudo determinar que el grupo de resistencia a la tetraciclina y estreptomicina, denominado MIC –b (Tet –Str), fue recurrente para los serovares A, C y una cepa No Tipificable; el 87.5% (7 aislados) de este grupo de resistencia presentaron plásmidos. De igual forma, se logró determinar que los serogrupos B y B variante presentaron de forma más común el MIC –a (Tet) y el MIC – c (Kan-Tet-Str), pero sólo el 50 % (4 aislados) de ellos presentaron plásmidos. La determinación de plásmidos en cepas resistentes a las drogas mencionadas permitió conocer y establecer la distribución de las serovariedades resistentes en el país, así como establecer el posible mecanismo de adquisición de resistencia, ya que ésta podría facilitar la propagación de genes de resistencia entre bacterias

Is Evar Feasible in Challenging Aortic Neck Anatomies? A Technical Review and Ethical Discussion

Abstract: Background: Endovascular aneurysm repair (EVAR) has become an accepted alternative to open repair (OR) for the treatment of abdominal aortic aneurysm (AAA) despite “hostile” anatomies thatmay reduce its effectiveness. Guidelines suggest refraining fromEVAR in such circumstances, but in clinical practice, up to 44% of EVAR procedures are performed using stent grafts outside their instruction for use (IFU), with acceptable outcomes. Starting from this “inconsistency” between clinical practice and guidelines, the aim of this contribution is to report the technical results of the use of EVAR in challenging anatomies as well as the ethical aspects to identify the criteria by which the “best interest” of the patient can be set. Materials and Methods: A literature review on currently available evidence on standard EVAR using commercially available endografts in patients with hostile aortic neck anatomies was conducted. Medline using the PubMed interface and The Cochrane Library databases were searched from 1 January 2000 to 6May 2021, considering the following outcomes: technical success; need for additional procedures; conversion to OR; reintervention; migration; the presence of type I endoleaks; AAA-related mortality rate. Results: A total of 52 publications were selected by the investigators for a detailed review. All studies were either prospective or retrospective observational studies reporting the immediate, 30-day, and/or follow-up outcomes of standard EVAR procedures in patients with challenging neck anatomies. No randomized trials were identified. Fourteen different endo-grafts systems were used in the selected studies. A total of 45 studies reported a technical success rate ranging from 93 to 100%, and 42 the need for additional procedures (mean value of 9.04%). Results at 30 days: the incidence rate of type Ia endoleak was reported by 37 studies with a mean value of 2.65%; 31 studies reported a null migration rate and 32 a null conversion rate to OR; in 31 of the 35 studies that reported AAA-related mortality, the incidence was null. Mid-term follow-up: the incidence rate of type Ia endoleak was reported by 48 studies with a mean value of 6.65%; 30 studies reported a null migration rate, 33 a null conversion rate to OR, and 28 of the 45 studies reported that the AAA-related mortality incidence was null. Conclusions: Based on the present analysis, EVAR appears to be a safe and effective procedure—and therefore recommendable—even in the presence of hostile anatomies, in patients deemed unfit for OR. However, in order to identify and pursue the patient’s best interest, particular attention must be paid to the management of the patient’s informed consent process, which— in addition to being an essential ethical-legal requirement to legitimize the medical act—ensures that clinical data can be integrated with the patient’s personal preferences and background, beyond the therapeutic potential of the proposed procedures and what is generically stated in the guidelines

Pathogenicity of avibacterium paragallinarum strains from Peru and the selection of candidate strains for an inactivated vaccine

Worldwide, Avibacterium paragallinarum is the aetiological agent of infectious coryza in poultry. Vaccines are the best means of control, helping reduce clinical signs and colonization of this bacterium. Most vaccines are based on international reference strains, or, lately, regional strains, but, generally, without any information regarding their virulence. The characterization of the pathogenicity of 24 Av. paragallinarum strains of the three Page serogroups, including four variant strains of serogroup B, all isolated from infectious coryza outbreaks in Peru, was performed. After experimental inoculation into the infraorbital sinuses, information regarding their capacity to induce infectious coryza typical clinical signs, spreading, and colonization was recorded. Furthermore, after intraperitoneal inoculation, septicaemia and death were registered. Differences among strains in these parameters were observed, even within strains from the same serogroup. Finally, the four most pathogenic strains, one from each serogroup, were chosen to formulate an experimental vaccine that was tested successfully against homologous challenges in reducing clinical signs and colonization in vaccinated birds compared to unvaccinated ones. This is the first time that Av. paragallinarum strains from Peru were studied thoroughly for their virulence in a search for improving vaccine formulation.EEA BalcarceFil: Caballero Garcia, Melanie. Quimtia. Research and Development; Perú.Fil: Mendoza Espinoza, Alfredo. Quimtia. Research and Development; Perú.Fil: Ascanio, Silvia. Quimtia. Research and Development; Perú.Fil: Chero, Paula. Quimtia. Research and Development; Perú.Fil: Rojas, Rober. Quimtia. Research and Development; Perú.Fil: Huberman, Yosef Daniel. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina

Insight from an Italian Delphi Consensus on EVAR feasibility outside the instruction for use: the SAFE EVAR Study

Background: The SAfety and FEasibility of standard EVAR outside the instruction for use (SAFE-EVAR) Study was designed to define the attitude of Italian vascular surgeons towards the use of standard endovascular repair (EVAR) for infrarenal abdominal aortic aneurysm (AAA) outside the instruction for use (IFU) through a Delphi consensus endorsed by the Italian Society of Vascular and Endovascular Surgery (Società Italiana di Chirurgia Vascolare ed Endovascolare - SICVE). Methods: A questionnaire consisting of 26 statements was developed, validated by an 18-member Advisory Board, and then sent to 600 Italian vascular surgeons. The Delphi process was structured in three subsequent rounds which took place between April and June 2023. In the first two rounds, respondents could indicate one of the following five degrees of agreement: 1) strongly agree; 2) partially agree; 3) neither agree nor disagree; 4) partially disagree; 5) strongly disagree; while in the third round only three different choices were proposed: 1) agree; 2) neither agree nor disagree; 3) disagree. We considered the consensus reached when ≥70% of respondents agreed on one of the options. After the conclusion of each round, a report describing the percentage distribution of the answers was sent to all the participants. Results: Two-hundred-forty-four (40.6%) Italian Vascular Surgeons agreed to participate the first round of the Delphi Consensus; the second and the third rounds of the Delphi collected 230 responders (94.3% of the first-round responders). Four statements (15.4%) reached a consensus in the first rounds. Among the 22 remaining statements, one more consensus (3.8%) was achieved in the second round. Finally, seven more statements (26.9%) reached a consensus in the simplified last round. Globally, a consensus was reached for almost half of the proposed statements (46.1%). Conclusions: The relatively low consensus rate obtained in this Delphi seems to confirm the discrepancy between Guideline recommendations and daily clinical practice. The data collected could represent the source for a possible guidelines' revision and the proposal of specific Good Practice Points in all those aspects with only little evidence available

DUAL-PHASE STEEL REINFORCING BARS FOR MRFS STRUCTURES IN SEISMIC PRONE AREAS

Reinforced concrete structures in seismic areas are designed according to the capacity design approach, aiming to achieve ductile global collapse mechanisms dissipating the seismic energy through high deformations in correspondence of the ends of beams and columns. The global dissipative capacity of the building is related to the rotational capacity of sections and to the ductile properties of reinforcing bars. TempCore steel is used for RC constructions, due to its optimal strength and ductility properties and to the satisfaction of Eurocode 8 requirements concerning Agt and Rm/Re. Several studies in the current scientific literature anyway highlighted durability problems of TempCore bars exposed to corrosion conditions, with loss of ductility and strength even below the standards requirements. Dual-Phase (DP) steels, characterized by excellent mechanical and durability properties due to their Ferrite-Martensite microstructure and commonly adopted in the automotive sector, can be a possible solution to the problem. The possibility to produce DP rebars for RC structures is deeply analyzed in the European research project NEWREBAR “New Dual-Phase steel reinforcing bars for enhancing capacity and durability of anti-seismic moment resisting frames”, actually ongoing. The elaboration of new technical models for the design of RC elements, to be implemented in design guidelines and standards, is needed. In the present paper, preliminary results are presented concerning the selection of DP steel bars and the definition of technical models for RC elements with DP reinforcements

From Picture to Movie: Twenty Years of Ground Deformation Recording Over Tuscany Region (Italy) With Satellite InSAR

Synthetic Aperture Radar Interferometry (InSAR) techniques have been long exploited for detecting and mapping slow-moving ground surface displacements due to their millimeter accuracy, non-invasiveness and wide area coverage. A review on different applications of Persistent Scatterers InSAR approaches, proposed and applied over Tuscany region (Italy) across time, is here presented. The study area is characterized by both subsidence of alluvial plains and landslides on hilly and mountainous reliefs. Tuscany has a leading role in Italy in the field of interferometric applications: the first InSAR analyses, which date back to 2003, were performed at local basin scale, by exploiting various PSI-based approaches for risk mapping. The first InSAR applications at regional scale date back to 2009, relying on historical SAR archives of ERS and ENVISAT satellites for updating subsidence and landslide inventory maps at a certain temporal date. Nowadays, the availability of Sentinel-1 SAR data with a regular and systematic 6-days acquisitions plan, allows near-real time monitoring of deformative scenario at regional scale rather than solely mapping of geo-hydrological phenomena. Most recent innovative InSAR applications over Tuscany region scan the territory, exploiting the regular repeat pass of Sentinel-1, and promptly highlight the sites affected by the highest ground movements with high temporal frequency. Such approaches permit us to pass from a static ‘picture’ of regional slope instability to a weekly updated ‘movie’ with improved detail, useful for civil protection practices. These last ongoing works significantly enhance the value of multi-temporal InSAR approaches for investigating and managing geo-hazards over the Region

The efficacy of a trivalent inactivated salmonella vaccine combined with the live s. gallinarum 9R vaccine in young layers after experimental infections with s. enteritidis, s. typhimurium, and s. infantis

Worldwide, poultry infections by Salmonella are the cause of significant economic losses, not only due to reduced production (due to fowl typhoid disease), but also considering the efforts and control measures that must be constantly applied, especially due to zoonotic serovars. Poultry is a common reservoir of Salmonella and its transmission into the food chain is a risk for humans. The vaccination of layers plays an important role in the overall efforts to prevent Salmonella infections. An inactivated trivalent vaccine was prepared with S. Enteritidis, S. Typhimurium, and S. Infantis strains. Infection trials were performed to evaluate the efficacy of three vaccination schedules using inactivated and live S. Gallinarum 9R vaccines. For this purpose, at week 5 of life, one subcutaneous dose of live S. Gallinarum 9R vaccine (1–5 × 107 CFU) was given to Groups 1 and 2. At weeks 8 and 11 of life, chickens were also vaccinated with one (Group 1) or two (Groups 2 and 3) intramuscular doses of the inactivated oil-adjuvant trivalent vaccine (1 × 108 CFU/dose of each antigen). Group 4 consisted of chickens that remained unvaccinated (control). At week 14 of life, the efficacy of the vaccination plans was evaluated in three separate inoculation trials with S. Enteritidis, S. Typhimurium, or S. Infantis. After vaccination with the inactivated vaccine, homologous antibody production was observed, and after challenge, a significant reduction in the faecal shedding, invasion, and colonization of S. Typhimurium and S. Infantis was achieved by all vaccination schedules, while the vaccination with at least one dose of the live S. Gallinarum 9R vaccine was necessary to obtain such a significant protection against S. Enteritidis infection.EEA BalcarceFil: Huberman, Yosef Daniel. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina.Fil: Caballero Garcia, Melanie. Quimtia. Research and Development; Perú.Fil: Rojas, Rober. Quimtia. Research and Development; Perú.Fil: Ascanio, Silvia. Quimtia. Research and Development; Perú.Fil: Olmos, Leandro Hipólito. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina.Fil: Malena, Rosana Claudia. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina.Fil: Lomónaco, Jorgelina. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina.Fil: Nievas, Paula Andrea. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina.Fil: Chero, Paula. Quimtia. Research and Development; Perú.Fil: Lévano Gracía, Julio. Quimtia. Research and Development; Perú.Fil: Mendoza Espinoza, Alfredo. Quimtia. Research and Development; Perú

Para-infectious brain injury in COVID-19 persists at follow-up despite attenuated cytokine and autoantibody responses

To understand neurological complications of COVID-19 better both acutely and for recovery, we measured markers of brain injury, inflammatory mediators, and autoantibodies in 203 hospitalised participants; 111 with acute sera (1–11 days post-admission) and 92 convalescent sera (56 with COVID-19-associated neurological diagnoses). Here we show that compared to 60 uninfected controls, tTau, GFAP, NfL, and UCH-L1 are increased with COVID-19 infection at acute timepoints and NfL and GFAP are significantly higher in participants with neurological complications. Inflammatory mediators (IL-6, IL-12p40, HGF, M-CSF, CCL2, and IL-1RA) are associated with both altered consciousness and markers of brain injury. Autoantibodies are more common in COVID-19 than controls and some (including against MYL7, UCH-L1, and GRIN3B) are more frequent with altered consciousness. Additionally, convalescent participants with neurological complications show elevated GFAP and NfL, unrelated to attenuated systemic inflammatory mediators and to autoantibody responses. Overall, neurological complications of COVID-19 are associated with evidence of neuroglial injury in both acute and late disease and these correlate with dysregulated innate and adaptive immune responses acutely

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat