Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Effect of supplying four copepod densities (Acartia sp. and Calanus pacificus) onthe productive response of Litopenaeus vannamei pregrown intensively at microcosm level

A seven-week experiment was performed to evaluate the effect of supplying copepods (Acartia sp. and Calanus pacificus), as exogenous feed during the intensive pre-growout phase of white shrimp (Litopenaeus vannamei), on the productive parameters and water quality. Five treatments were tested in which shrimp were fed formulated feed and the addition of 0 (control), 1, 2, 4, or 8 copepods mL–1. Treatments with 1 and 4 copepods mL–1 had higher ammonia nitrogen levels than the rest of the treatments (>4 mg L–1). Nitrite levels were significantly higher in the treatment with 8 copepods mL–1, whereas nitrate levels were higher in all treatments relative to the control. Phosphate concentration was higher in the treatments with 4 and 8 copepods mL–1. Shrimp from the treatments with 2, 4, and 8 copepods mL–1 showed a higher survival (>93%), weight (>3.1 g), and final biomass (>77 g). The treatment with 2 copepods mL–1 had the best feed conversion ratio (1.19) compared with the rest (>1.7). The results suggest that the additional supply of copepods as exogenous feed during the intensive pre-growout phase of shrimp culture can have a negative effect on the water quality, although survival was not affected; however, the effect on the production parameters was positive, indicating that the use of copepods as exogenous live feed is feasible in the culture of white shrimp.

Frequency of Cefazolin Inoculum Effect among Bacteremic Methicillin-Susceptible Staphylococcus aureus, is it a cause of concern?

Background: Recent studies suggest that cefazolin (Cz) has clinical efficacy similar to isoxazolyl penicillins for the treatment of methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia with a lower rate of adverse events and greater ease of administration. However, the Cz inoculum effect (CzIE), mediated by staphylococcal beta-lactamases, could limit the therapeutic efficacy of Cz. In this study the presence of CzIE was analyzed in 55 bloodstream MSSA isolates recovered consecutively from 55 patients in a Spanish hospital during 2020-2021. Methods: The identification of the isolates was performed by MALDI-TOF. Cz MICs were determined at standard (105 CFU/mL) and high (107 CFU/mL) inoculum by broth microdilution. The CzIE was defined as an increase of MIC to 16 mg/L when tested at high inoculum. S. aureus ATCC 29213, a producer of BlaZ type A beta-lactamase lacking the CzIE, was used as control strain.The characterization of the blaZ gene was performed in all isolates by PCR (using new designed primers to amplify the complete gene) and sequencing; BlaZ variants and allotypes were stablished according to Carvajal et al (AAC 2020; 64:e02511-19). Results: The Cz MIC90 for all isolates when tested at standard inoculum was 1 mg/L. The overall prevalence of the CzIE was 20% (11/55). Among the 55 BlaZ sequences, type B was the most predominant beta-lactamase (n=32; 58%), followed by type A (n=11; 25%), and type C (n=9; 16%). Most isolates with type A (10/14; 71.4%) showed CzIE; however, none of the type B isolates, and only one isolate with type C beta-lactamase showed CzIE. We found 10 allotypes in BlaZ, being BlaZ-1, -2, -3 and -7 predominants (83%). A single allotype, designated BlaZ-2, was present in 72.7% (8/11) of isolates showing CzIE. All BlaZ-2 isolates presented three critical amino acid substitutions (A9V, E112A, and G145E). Two other allotypes (BlaZ-3 and BlaZ-7) were associated with a lack of the CzIE. Conclusion: Among recent bloodstream MSSA isolates, the prevalence of the CzIE was 20% and was mostly associated with type A beta-lactamase. The presence of type A beta-lactamase could predict the CzIE among MSSA clinical isolates

Effect of alternative mediums on production and proximate composition of the microalgae Chaetoceros muelleri as food in culture of the copepod Acartia sp. Efecto de medios alternativos sobre la producción y composición proximal de la microalga Chaetoceros muelleri como alimento en cultivo del copépodo Acartia sp.

Microalgae Chaetoceros muelleri was cultured in three different mediums consisting on an agricultural fertilizer (Agr-F), aquacultural fertilizer (Aq-F) and a conventional medium (F/2, control). These microalgae were later used as natural food to culture the copepod Acartia sp. The productive response and chemical proximate composition of microalgae and copepods were monitored. Growth rate and final cell concentration were higher in microalgae cultured in Agr-F compared to the control. In addition, the final biomass and cellular concentration were also the highest in Agr-F. Microalgae from Agr-F and Aq-F had higher carbohydrate and lower protein contents than those in the control. No differences in lipid and ash contents were observed. Regarding copepod production, higher densities and fecundity indexes were observed for those fed with microalgae previously cultured in Agr-F and Aq-F, compared to the control. The adult-nauplii ratio was also higher in copepods fed on microalgae from Agr-F compared to Aq-F and control. Copepods fed on Agr-F and Aq-F microalgae, had higher protein content compared to those fed on control microalgae; carbohydrates were higher in copepods fed on Agr-F as compared to Aq-F microalgae. No differences in lipid and ash contents were registered. Agr-F and Aq-F were adequate alternative mediums to produce C. muelleri, which produced higher quality microalgae that increased the copepod production.La microalga Chaetoceros muelleri fue cultivada en tres medios diferentes basados en un fertilizante agrícola (Agr-F), un fertilizante acuícola (Aq-F) y un medio convencional (F/2, control). Éstas microalgas fueron posteriormente utilizadas como alimento natural para cultivar el copépodo Acartia sp. La respuesta productiva y la composición proximal de las microalgas y copépodos fueron monitoreadas. La tasa de crecimiento y concentración final de células fueron mayores en la microalga cultivada en Agr-F, comparada con el control. La biomasa y concentración celular finales también fueron más altas en Agr-F. Las microalgas de Agr-F y Aq-F tuvieron mayor contenido de carbohidratos y menor contenido de proteína en comparación con el control. No se observaron diferencias en los contenidos de lípidos y cenizas. Respecto a la producción de copépodos, las mayores densidades e índices de fecundidad se observaron en los organismos alimentados con microalgas producidas en Agr-F y Aq-F, en comparación con el control. La proporción adulto-nauplio también fue mayor en copépodos alimentados con microalga de Agr-F comparada con Aq-F y el control. Los copépodos alimentados con microalgas del Agr-F y Aq-F, tuvieron un mayor contenido de proteínas que el control; la cantidad de carbohidratos fue mayor en copépodos alimentados con microalga del Agr-F comparada con Aq-F. No se observaron diferencias en los contenidos de lípidos y cenizas. Agr-F y Aq-F fueron medios alternativos adecuados para producir C. muelleri, los cuales produjeron microalgas de alta calidad que incrementaron la producción de copépodos

Kinin B₁ Receptor in Adipocytes Regulates Glucose Tolerance and Predisposition to Obesity

<div><h3>Background</h3><p>Kinins participate in the pathophysiology of obesity and type 2 diabetes by mechanisms which are not fully understood. Kinin B₁ receptor knockout mice (B₁^−/−) are leaner and exhibit improved insulin sensitivity.</p> <h3>Methodology/Principal Findings</h3><p>Here we show that kinin B₁ receptors in adipocytes play a role in controlling whole body insulin action and glucose homeostasis. Adipocytes isolated from mouse white adipose tissue (WAT) constitutively express kinin B₁ receptors. In these cells, treatment with the B₁ receptor agonist des-Arg⁹-bradykinin improved insulin signaling, GLUT4 translocation, and glucose uptake. Adipocytes from B₁^−/− mice showed reduced GLUT4 expression and impaired glucose uptake at both basal and insulin-stimulated states. To investigate the consequences of these phenomena to whole body metabolism, we generated mice where the expression of the kinin B₁ receptor was limited to cells of the adipose tissue (aP2-B₁/B₁^−/−). Similarly to B₁^−/− mice, aP2-B₁/B₁^−/− mice were leaner than wild type controls. However, exclusive expression of the kinin B₁ receptor in adipose tissue completely rescued the improved systemic insulin sensitivity phenotype of B₁^−/− mice. Adipose tissue gene expression analysis also revealed that genes involved in insulin signaling were significantly affected by the presence of the kinin B₁ receptor in adipose tissue. In agreement, GLUT4 expression and glucose uptake were increased in fat tissue of aP2-B₁/B₁^−/− when compared to B₁^−/− mice. When subjected to high fat diet, aP2-B₁/B₁^−/− mice gained more weight than B₁^−/− littermates, becoming as obese as the wild types.</p> <h3>Conclusions/Significance</h3><p>Thus, kinin B₁ receptor participates in the modulation of insulin action in adipocytes, contributing to systemic insulin sensitivity and predisposition to obesity.</p> </div

The kinin B₁R is constitutively expressed in WAT and downregulated with obesity.

<p>A: Kinin B₁R mRNA expression was quantified in different organs of male C57Bl/6 mice (<i>n</i> = 5) using TaqMan real-time PCR. Data are expressed as mean±SEM of the 2^−ΔCt parameter, which represents the relative expression of B₁R mRNA in relation to β-actin mRNA. WAT, white adipose tissue; ND, non-detectable; a.u., arbitrary units. B: Effects of acute treatment with the B₁R agonist des-Arg⁹-bradykinin (DBK), the B₂ receptor agonist bradykinin (BK) or DBK in the presence of the B₁R antagonist [Leu⁸]-DBK on the extracellular acidification rate of isolated adipocytes from wild type (WT) and B₁ knockout (B₁^−/−) mice (<i>n</i> = 5 animals per group) measured using the <i>Cytosensor</i> system. C: Representative RT-PCR showing expression of components of the kallikrein kinin system kallikrein in WAT, lung, and heart of C57Bl/6 male (<i>n</i> = 3). KK, tissue kallikrein; CPM, carboxypeptidase M; B₂, kinin B₂ receptor. C-, negative control. D: C57BL/6 mice were submitted to HFD for 9 weeks (<i>n</i> = 5 per group). Kinin B₁R expression was quantified in WAT by real time PCR. Results are mean ± SEM. *, <i>P</i><0.05.</p