Evaluation of photobiomodulation therapy associated with guided bone regeneration in critical size defects. In vivo study

The repair of bone defects raises the interest of investigators in several health specialties. Grafting techniques with bone substitutes and laser therapies have been investigated to replace autogenous bone and accelerate the bone healing process. Objective: To evaluate the effect of photobiomodulation therapy (PBMT) associated with guided bone regeneration (GBR) in critical size defects. Material and Methods: The study was conducted on 80 male rats (Rattus norvegicus albinus, Wistar) submitted to surgical creation of a critical size defect on the calvaria, divided into eight study groups: group C (control - only blood clot); group M (collagen membrane); group PBMT (photobiomodulation therapy); group AB (autogenous bone); group AB+PBMT; group AB+M; group PBMT+M; group AB+PBMT+M. The animals were killed 30 days postoperatively. After tissue processing, bone regeneration was evaluated by histomorphometric analysis and statistical analyses were performed (Tukey test, p<0.05). Results: All groups had greater area of newly formed bone compared to group C (9.96±4.49%). The group PBMT+M (achieved the greater quantity of new bone (64.09±7.62%), followed by groups PBMT (47.67±8.66%), M (47.43±15.73%), AB+PBMT (39.15±16.72%) and AB+PBMT+M (35.82±7.68%). After group C, the groups AB (25.10±16.59%) and AB+M (22.72±13.83%) had the smallest quantities of newly formed bone. The area of remaining particles did not have statistically significant difference between groups AB+M (14.93±8.92%) and AB+PBMT+M (14.76±6.58%). Conclusion: The PBMT utilization may be effective for bone repair, when associated with bone regeneration techniques

A multi-center validation study on the discrimination of Legionella pneumophila sg.1, Legionella pneumophila sg. 2-15 and Legionella non-pneumophila isolates from water by FT-IR spectroscopy

This study developed and validated a method, based on the coupling of Fourier-transform infrared spectroscopy (FT-IR) and machine learning, for the automated serotyping of Legionella pneumophila serogroup 1, Legionella pneumophila serogroups 2-15 as well as their successful discrimination from Legionella non-pneumophila. As Legionella presents significant intra- and inter-species heterogeneities, careful data validation strategies were applied to minimize late-stage performance variations of the method across a large microbial population. A total of 244 isolates were analyzed. In details, the method was validated with a multi-centric approach with isolates from Italian thermal and drinking water (n = 82) as well as with samples from German, Italian, French, and British collections (n = 162). Specifically, robustness of the method was verified over the time-span of 1 year with multiple operators and two different FT-IR instruments located in Italy and Germany. Moreover, different production procedures for the solid culture medium (in-house or commercial) and different culture conditions (with and without 2.5% CO2) were tested. The method achieved an overall accuracy of 100, 98.5, and 93.9% on the Italian test set of Legionella, an independent batch of Legionella from multiple European culture collections, and an extra set of rare Legionella non-pneumophila, respectively

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Foodborne transmission of Toxoplasma gondii: a laboratory and literature based assessment

Toxoplasma gondii is a zoonotic parasite with a wide diffusion, a high human seroprevalence and the potential for causing severe harm when infection occurs in at-risk individuals such as pregnant women, HIV-positive individuals, recipients of organ transplants or other immunocompromised subjects. The consumption of contaminated food is estimated to account for about half of all infections worldwide, with variations across years and countries. Among food, meat is of high concern, as it is consumed in large amounts, not always well cooked, by a large part of the population. The aim of the present project was to gain insight into the role of food as a source of human toxoplasmosis. The first step in this path was to assess the prevalence of T. gondii in livestock species commonly used as sources of meat for human consumption. To obtain relevant scientific evidence, a double-sided approach was applied. Firstly, a systematic review of all published studies dealing with the direct detection of T. gondii in meat belonging to relevant livestock species was carried out. This work allowed the estimation of the worldwide T. gondii prevalence in each species (cattle, pigs and sheep), and also the evaluation of differences due to the geographical origins and to the laboratory methods applied for diagnostic purposes. Two species were selected for a biomolecular investigation of prevalence at local level: cattle and pigs. Different reasons supported the choice to focus on these species, such as the wide consumption, the inconsistent epidemiological evidence (cattle) or the primary importance as a source of meatborne toxoplasmosis (pigs). Samples were collected from retail or ready to retail processing stages. To support the outcomes of different activities, both from the systematic review and from experimental results, the best available epidemiological evidence about the role of different food consumption habits in human infection was systematically collected. Finally, a quantitative risk assessment model was built, thanks to all the previously collected information, to estimate the yearly probability of infection due to bovine meat and pork consumption, in Italy. The investigations carried out within the present research project allowed us to conclude that T. gondii prevalence in meat animals worldwide, as well as in Europe and Italy, is not negligible. Sheep meat displayed the highest prevalence rate, followed by pork and beef. However, our survey confirmed that meat preparation habits make beef a relevant risk factor for T. gondii infection in humans, as confirmed by the epidemiological evidence from the literature. In addition, the model allowed us to observe that, In Italy, bovine meat contributes more to the annual toxoplasmosis incidence than does pork.Toxoplasma gondii è un parassita di interesse zoonosico con una notevole diffusione su scala mondiale, un’elevata sieroprevalenza nell’uomo ed è in grado di causare sintomatologia grave in soggetti a rischio come le donne in gravidanza e tutti i soggetti immunocompromessi. Si stima che il consumo di alimenti contaminati sia responsabile di circa la metà dei casi totali di infezione nell’uomo, con alcune differenze tra paesi. La carne, in particolare, è di notevole interesse epidemiologico in quanto viene consumata in grandi quantità dalla maggior parte della popolazione e non sempre viene cotta adeguatamente prima del consumo. L’obiettivo di questo progetto era quello di approfondire le conoscenze circa il ruolo degli alimenti come causa di toxoplasmosi umana tenendo in considerazione l’intera filiera alimentare. Il primo passo è stato quello di stimare la prevalenza di T. gondii negli animali da reddito più comunemente utilizzati per la produzione di carne utilizzando un duplice approccio. In primis, sono stati sistematicamente raccolti gli studi pubblicati nella letteratura scientifica e riguardanti la ricerca di T. gondii nella carne di specie animali da reddito comunemente consumate. Questi studi hanno consentito di ottenere una stima di prevalenza per ogni specie selezionata (bovini, maiali e pecore) e di valutare le differenze dovute alla diversa origine geografica e al metodo diagnostico applicato. Successivamente sono state selezionate due specie (bovini, maiali) per un’indagine molecolare in grado di stimare la prevalenza su carni locali. Le specie sono state selezionate per ragioni diverse: la grande diffusione del loro consumo, evidenze epidemiologiche contrastanti (bovini), o il ruolo epidemiologico riconosciuto nella trasmissione di T. gondii (maiali). I campioni analizzati erano tutti idonei alla vendita. Per sostenere i risultati ottenuti dalle diverse attività di questo progetto, sia sul fronte della sintesi delle ricerche già pubblicate sia per quanto riguarda le attività sperimentali, una seconda systematic review è stata realizzata. In questo caso sono stati raccolti tutti gli studi epidemiologici (caso-controllo) pubblicati, indirizzati all’identificazione degli alimenti responsabili delle infezioni alimentare da T. gondii. Infine, è stato realizzato un modello di valutazione del rischio quantitativo, in grado di considerare tutti i dati e le evidenze precedentemente ottenute, con l’obiettivo di stimare la probabilità annua di contrarre toxoplasmosi a seguito del consumo di carne bovina o suina, in Italia. Le analisi effettuate nel contesto di questo progetto di ricerca consentono di concludere che la prevalenza di T. gondii in specie animali comunemente consumate, nel mondo e in Europa, non è trascurabile. La carne di pecora ha la prevalenza più elevata, seguita dalla carne suina e bovina. Tuttavia l’abitudine di consumare la carne bovina cruda o poco cotta aumenta il rischio derivante da essa. Tale osservazione è confermata dagli studi epidemiologici ottenuti con la ricerca sistematica della letteratura cosi come dal modello statistico realizzato, che identifica il consumo di carne bovina come più probabile causa di toxoplasmosi nella popolazione italiana rispetto al consumo di carne suina

Insetti per uso alimentare umano: aspetti nutrizionali e igienico sanitari.

The need of new food sources in relation to the continuous increase in human population, especially in developing countries, bring us to consider insects as an alternative protein source. Entomophagy is not a novelty but it exists alla along in human habits and is a popular practice among several populations