Experimental Legionella longbeachae infection in intratracheally inoculated mice

This study established an experimental model of replicative Legionella longbeachae infection in A/J mice. The animals were infected by intratracheal inoculation of 10 3 –10 9 c.f.u. L. longbeachae serogroup 1 (USA clinical isolates D4968, D4969 and D4973). The inocula of 10 9 ,10 8 ,10 7 and 10 6 c.f.u. of all tested L. longbeachae serogroup 1 isolates were lethal for A/J mice. Inoculation of 10 5 c.f.u. L. longbeachae caused death in 90% of the animals within 5 days, whilst inoculation of 10 4 c.f.u. caused sporadic death of mice. All animals that received 10 3 c.f.u. bacteria developed acute lower respiratory disease, but were able to clear Legionella from the lungs within 3 weeks. The kinetics of bacterial growth in the lungs was independent of inoculum size and reached a growth peak about 3 logarithms above the initial inoculum at 72 h after inoculation. The most prominent histological changes in the lungs were observed at 48–72 h after inoculation in the form of a focal, neutrophil-dominant, peribronchiolar infiltration. The inflammatory process did not progress towards the interstitial or alveolar spaces. Immunohistological analyses revealed L. longbeachae serogroup 1 during the early phase of infection near the bronchiolar epithelia and later co-localized with inflammatory cells. BALB/c and C57BL/6 mice strains were also susceptible to infection with all L. longbeachae serogroup 1 strains tested and very similar changes were observed in the lungs of infected animals. These results underline the infection potential of L. longbeachae serogroup 1, which is associated with high morbidity and lethality in mic

Clinical profile of patients with no-reperfusion therapy in Bosnia and Herzegovina and Serbia

There is little information about coronary reperfusion therapy patterns in patients with ST-elevation myocardial infarction (STEMI) in the former federal states of Yugoslavia. The objective of this study was to evaluate the clinical profile and mortality of patients who were hospitalized with a diagnosis of STEMI, but did not receive reperfusion therapy in Bosnia and Herzegovina and Serbia. This was an observational study using registry data from the International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS-TC; ClinicalTrials.gov, NCT01218776) on 633 STEMI patients admitted to 14 hospitals in Bosnia and Herzegovina (both Republic Srpska and Federation of Bosnia and Herzegovina) and Serbia from October 2012 to September 2013. Of these, 61 (9.6%) received fibrinolytic therapy (Group A), almost exclusively with streptokinase (79.3%), 402 (63.5%) underwent primary percutaneous coronary intervention (PCI; Group B), and 170 (26.9%) received no-reperfusion therapy (Group C). In Groups A, B, and C, mean age was 60.3, 60.5, and 69.1 years, respectively. Patients in Group C were more likely to present after 12 h from symptoms onset (61.3 vs. 13.6% in Group A, and 13.4% in Group B). After adjustment for risk factors and clinical presentation, female sex, age, diabetes, prior MI, and symptom onset-to-presentation time after 12 h were all independent variables associated with no-reperfusion therapy. There was a significantly reduced in-hospital mortality in patients who received reperfusion therapy with fibrinolysis or primary PCI (odds ratio: 0.27, 95% confidence interval: 0.09\u20130.76, P = 0.01). The majority of STEMI patients from Bosnia and Herzegovina and Serbia undergo reperfusion therapy with fibrinolysis or primary PCI. More than one-fourth of the patients do not received any reperfusion therapy. Reperfusion therapies are applied to relatively lower risk patients. More elderly and diabetics should be considered for such strategies

Clinical profile of patients with no-reperfusion therapy in Bosnia and Herzegovina and Serbia

There is little information about coronary reperfusion therapy patterns in patients with ST-elevation myocardial infarction (STEMI) in the former federal states of Yugoslavia. The objective of this study was to evaluate the clinical profile and mortality of patients who were hospitalized with a diagnosis of STEMI, but did not receive reperfusion therapy in Bosnia and Herzegovina and Serbia. This was an observational study using registry data from the International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS-TC; ClinicalTrials.gov, NCT01218776) on 633 STEMI patients admitted to 14 hospitals in Bosnia and Herzegovina (both Republic Srpska and Federation of Bosnia and Herzegovina) and Serbia from October 2012 to September 2013. Of these, 61 (9.6%) received fibrinolytic therapy (Group A), almost exclusively with streptokinase (79.3%), 402 (63.5%) underwent primary percutaneous coronary intervention (PCI; Group B), and 170 (26.9%) received no-reperfusion therapy (Group C). In Groups A, B, and C, mean age was 60.3, 60.5, and 69.1 years, respectively. Patients in Group C were more likely to present after 12 h from symptoms onset (61.3 vs. 13.6% in Group A, and 13.4% in Group B). After adjustment for risk factors and clinical presentation, female sex, age, diabetes, prior MI, and symptom onset-to-presentation time after 12 h were all independent variables associated with no-reperfusion therapy. There was a significantly reduced in-hospital mortality in patients who received reperfusion therapy with fibrinolysis or primary PCI (odds ratio: 0.27, 95% confidence interval: 0.09-0.76, P = 0.01). The majority of STEMI patients from Bosnia and Herzegovina and Serbia undergo reperfusion therapy with fibrinolysis or primary PCI. More than one-fourth of the patients do not received any reperfusion therapy. Reperfusion therapies are applied to relatively lower risk patients. More elderly and diabetics should be considered for such strategies. © 2013 Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2013