Seawater is a reservoir of multi-resistant Escherichia coli, including strains hosting plasmid-mediated quinolones resistance and extended-spectrum beta-lactamases genes

The aim of this study was to examine antibiotic resistance (AR) dissemination in coastal water, considering the contribution of different sources of fecal contamination. Samples were collected in Berlenga, an uninhabited island classified as Natural Reserve and visited by tourists for aquatic recreational activities. To achieve our aim, AR in Escherichia coli isolates from coastal water was compared to AR in isolates from two sources of fecal contamination: human-derived sewage and seagull feces. Isolation of E. coli was done on Chromocult agar. Based on genetic typing 414 strains were established. Distribution of E. coli phylogenetic groups was similar among isolates of all sources. Resistances to streptomycin, tetracycline, cephalothin, and amoxicillin were the most frequent. Higher rates of AR were found among seawater and feces isolates, except for last-line antibiotics used in human medicine. Multi-resistance rates in isolates from sewage and seagull feces (29 and 32%) were lower than in isolates from seawater (39%). Seawater AR profiles were similar to those from seagull feces and differed significantly from sewage AR profiles. Nucleotide sequences matching resistance genes bla TEM, sul1, sul2, tet(A), and tet(B), were present in isolates of all sources. Genes conferring resistance to 3rd generation cephalosporins were detected in seawater (bla CTX-M-1 and bla SHV-12) and seagull feces (bla CMY-2). Plasmid-mediated determinants of resistance to quinolones were found: qnrS1 in all sources and qnrB19 in seawater and seagull feces. Our results show that seawater is a relevant reservoir of AR and that seagulls are an efficient vehicle to spread human-associated bacteria and resistance genes. The E. coli resistome recaptured from Berlenga coastal water was mainly modulated by seagulls-derived fecal pollution. The repertoire of resistance genes covers antibiotics critically important for humans, a potential risk for human health

How appropriate is the use of rehabilitation facilities? Assessment by an evaluation tool based on the AEP protocol

Background. During the last few decades, an increasing attention has been drawn to public health expenditure and resource use. The increasing aging population has highlighted the need to deliver post-acute care and to assess its appropriateness. The ?PRUO rehab? (Protocollo di Revisione dell?Utilizzo dell?Ospedale riabilitativo) protocol was realized and validated to assess the appropriateness of use of rehabilitation units. The aims of this study were to test the validity of the PRUO-rehab tool and to analyse the causes for Inappropriate Hospital Stay (IPS) in rehabilitation units. Methods. The PRUO rehab tool was retrospectively applied to the medical records of 502 patients who stayed at least overnight in one of ten different rehabilitation units set in Northern Italy, during 2007. Results. The tool was valid and the inappropriate patient stay (IPS) score was 25.0%. Conclusion. Although reasonably low, the IPS indicates that the rehabilitation structures analysed could be used more efficiently

HERBAL THERAPIES USED BY HYPERTENSIVE PATIENTS IN TURKEY

The purpose of this study was to determine herbal therapies used by the patients for regulation of blood pressure. This descriptive study was conducted in three districts of Izmir, Turkey. The study group included 193 patients with hypertension diagnosis who admitted to a primary care center and accepted to participate in the study. Data were collected through an investigator-made questionnaire including questions about socio-demographic features and herbal therapies used for regulation of blood pressure. Percentiles and chi–square statistics tests were used to evaluate the data through SPSS 11.0 program. The subjects included in the study had suffered from hypertension for 8.28+7.92 years, and 95.9% of them received medication to treat their hypertension. Of all hypertensive patients, 51.3% used herbal therapies for the treatment of hypertension. The patients used herbal therapies most commonly when they felt ill. There were no statistically significant difference between the use of herbal therapies and gender, education, marital status, having health insurance and income level. Health professionals who provide primary health services, especially nurses, need to follow patients regularly and provide patient education on antihypertensive therapy. Nurses must plan the necessary training programs by evaluating the data about, whether the hypertension patients use herbal therapies that can affect their health negatively or not

Comparing Behaviour of Simulated Proton Synchrotron Radiation in the Arcs of the LHC with Measurements

In previous work it was shown that at high proton-beam energies, synchrotron radiation is an important source of beam-screen heating, of beam-related vacuum pressure increase, and of primary photoelectrons, which can contribute to electron cloud formation. We have used the Synrad3D code developed at Cornell to simulate the photon distributions in the arcs of the LHC, HL-LHC, and FCC-hh. Specifically, for the LHC we studied the effect of the sawtooth chamber. In this paper specific results of the Synrad3D simulations are compared with simulations in Synrad+, developed at CERN; and later on compared with experimental data for actual LHC vacuum-chamber samples