Cost of care and antibiotic prescribing attitudes for community-acquired complicated intra-abdominal infections in Italy: a retrospective study.

INTRODUCTION: Complicated intra-abdominal infections (cIAIs) are a common cause of morbidity worldwide, and in spite of improvements in patient care, therapeutic failure still occurs, impacting in-hospital resource consumption. This study aimed to assess the costs associated with the treatment of community-acquired cIAIs, from the Italian National Health Service perspective. METHODS: This retrospective study analyzed the charts of patients who were discharged from four Italian university hospitals between January 1 and December 31, 2009 with a primary diagnosis of community-acquired cIAIs. Patient characteristics, diagnosis, surgical procedure, antibiotic therapy, and length of hospital stay were all recorded and the cost of total hospital care was estimated. Costs were calculated in Euros at 2009 values. RESULTS: The records of 260 patients (mean age 48.9 years; 57% males) were analyzed. The average cost of care for a patient hospitalized due to cIAI was €4385 (95% CI 3650–5120), with an average daily cost of €419 (95% CI 378–440). Antibiotic therapy represented just under half (44.3%) of hospitalization costs. The strongest predictor of the increase in hospital costs was clinical failure: patients who clinically failed received an average of 8.2 additional days of antibiotic therapy and spent 11 more days in hospital compared with patients who responded to first-line therapy (both p < 0.05 vs. patients who were successfully treated). Furthermore, they incurred €5592 in additional hospitalization costs (2.88 times the cost associated with clinical success) with 53% (€2973) of the additional costs attributable to antibiotic therapy. Overall, antibiotic appropriateness rate was 78.8% (n = 205), and was significantly higher in patients receiving combination therapy compared with those treated with monotherapy (97.3% vs. 64.6%). CONCLUSION: The results of this study suggest that hospitals need to be aware of the clinical and economic consequences of antibiotic therapy of cIAIs and to reduce overall resource use and costs by improving the rate of success with appropriate initial empiric therapy

Oxidative DNA damage bypass in Arabidopsis thaliana requires DNA polymerase λ and proliferating cell nuclear antigen 2

The oxidized base 7,8-oxoguanine (8-oxo-G) is the most common DNA lesion generated by reactive oxygen species. This lesion is highly mutagenic due to the frequent misincorporation of A opposite 8-oxo-G during DNA replication. In mammalian cells, the DNA polymerase (pol) family X enzyme DNA pol l catalyzes the correct incorporation of C opposite 8-oxo-G, together with the auxiliary factor proliferating cell nuclear antigen (PCNA). Here, we show that Arabidopsis thaliana DNA pol l, the only member of the X family in plants, is as efficient in performing error-free translesion synthesis past 8-oxo-G as its mammalian homolog. Arabidopsis, in contrast with animal cells, possesses two genes for PCNA. Using in vitro and in vivo approaches, we observed that PCNA2, but not PCNA1, physically interacts with DNA pol l, enhancing its fidelity and efficiency in translesion synthesis. The levels of DNA pol l in transgenic plantlets characterized by overexpression or silencing of Arabidopsis POLL correlate with the ability of cell extracts to perform error-free translesion synthesis. The important role of DNA pol l is corroborated by the observation that the promoter of POLL is activated by UV and that both overexpressing and silenced plants show altered growth phenotypes

World Caf&#233; at Summer School of WHO Collaborating Centre for Epidemiology and Community Dentistry

This study is a qualitative evaluation of a teaching method. The 2015 Summer School organized by the WHO Collaborating Centre for Epidemiology and Community Dentistry of Milan took place in Sardinia. The educational objectives of the first day included: make an informal conversation with other members of the summer school; create an interesting exchange of ideas and experiences also between new, \u201chabitu\ue9\u201d and beginners with senior professionals of this event; make a group for the works in the next days. Considering the different professional roles, age and context of origin, the purpose of the Pedagogists was to create a positive, relaxed but intimate atmosphere using the pleasure of \u201cinformal\u201d conversation, through a creative and practical method: The World Caf\ue8. Materials & methods: The Pedagogists\u2019 first task focused on: caring of the location and the physical setup of the table, creating relevant questions to the concerns of the group, establishing the rules, managing the process to encourage participants to have a non- formal learning experience consequently improving thinking, speaking and listening skills. Finally the participants answered self-administered questionnaire to write about their emotions and cognitive processes that went out during the World Caf\ue8. Results: The analysis of the questionnaires was carried out with Interpretative Phenomenological Analysis (IPA), The interpretative steps identified two emerging themes: \u201cdifferent vs peer\u201d and \u201cdiscovering vs practicing\u201d. Conclusions: The World Caf\ue9 experience improves learning by connection; thinking and learning become dynamic processes instead of learning outcomes

Arabidopsis S2Lb links AtCOMPASS-like and SDG2 activity in H3K4me3 independently from histone H2B monoubiquitination.

The functional determinants of H3K4me3, their potential dependency on histone H2B monoubiquitination, and their contribution to defining transcriptional regimes are poorly defined in plant systems. Unlike in Saccharomyces cerevisiae, where a single SET1 protein catalyzes H3K4me3 as part of COMPlex of proteins ASsociated with Set1 (COMPASS), in Arabidopsis thaliana, this activity involves multiple histone methyltransferases. Among these, the plant-specific SET DOMAIN GROUP 2 (SDG2) has a prominent role. We report that SDG2 co-regulates hundreds of genes with SWD2-like b (S2Lb), a plant ortholog of the Swd2 axillary subunit of yeast COMPASS. We show that S2Lb co-purifies with the AtCOMPASS core subunit WDR5, and both S2Lb and SDG2 directly influence H3K4me3 enrichment over highly transcribed genes. S2Lb knockout triggers pleiotropic developmental phenotypes at the vegetative and reproductive stages, including reduced fertility and seed dormancy. However, s2lb seedlings display little transcriptomic defects as compared to the large repertoire of genes targeted by S2Lb, SDG2, or H3K4me3, suggesting that H3K4me3 enrichment is important for optimal gene induction during cellular transitions rather than for determining on/off transcriptional status. Moreover, unlike in budding yeast, most of the S2Lb and H3K4me3 genomic distribution does not rely on a trans-histone crosstalk with histone H2B monoubiquitination. Collectively, this study unveils that the evolutionarily conserved COMPASS-like complex has been co-opted by the plant-specific SDG2 histone methyltransferase and mediates H3K4me3 deposition through an H2B monoubiquitination-independent pathway in Arabidopsis

Speech Communication

Contains reports on two research projects.National Institutes of Health (Grant 2 ROl1 NS04332)National Institutes of Health (Training Grant 5 T32 NS07040)C.J. LeBel FellowshipsNational Science Foundation (Grant BNS77-26871

The transcriptional landscape of polyploid wheat

Ramirez-Gonzalez RH, Borrill P, Lang D, et al. The transcriptional landscape of polyploid wheat. SCIENCE. 2018;361(6403): eaar6089

Caracterización de la variedad de pimiento tradicional ´Voghera´, rescatada en el norte de Italia

A traditional Italian sweet pepper landrace, ‘Peperone di Voghera’, which faced the risk of extinction, was analyzed for its genetic, phenological, morphological, agronomic and biochemical traits. An extant population was compared with cultivars ‘Quadrato d’Asti’, ‘Cuneo’, and ‘Giallo d’Asti’, cultivated in the same area, in order to evaluate the chance of the landrace recovery. Amplified fragment length polymorphism (AFLP) analysis demonstrated that Voghera landrace is distinct with respect to reference cultivars, thus excluding extensive genetic contamination and providing a molecular basis of both phenological and biochemical differences. Leaf chlorophyll content is lower, fruits start ripening earlier than controls, and yield (1100-1300 g plant-1) does not significantly differ. Sensitivity to root pathogens, the main factor that led to the decline in the past, does not seem to compromise the future chance of recovery. Vitamin C concentration is high (200-240 mg/100 g) and preserved by cold storage; more than 25% of vitamin C is also kept in pickled fruits. ‘Voghera’ landrace has nutritional and gastronomic properties that can be appreciated by consumers. The high internal genetic variability shown by AFLP analysis indicates that future selection work is necessary to fully maintain the original traits of the landrace and to improve it.En este trabajo se han analizado las características genéticas, morfológicas, fenológicas, agronómicas y bioquímicas de una variedad tradicional italiana de pimiento dulce, 'Peperone di Voghera', en peligro de extinción. Se comparó una población existente con cultivares de la misma zona, 'Quadrato d´Asti', 'Cuneo', y 'Giallo d'Asti', a fin de evaluar la posibilidad de recuperarla. Análisis AFLPs (polimorfismos en la longitud de fragmentos amplificados) demostraron que ´Voghera´ es distinta con respecto a los cultivares de referencia, lo que excluye que haya una amplia contaminación genética y proporciona una base molecular de las diferencias, tanto fenológicas como bioquímicas. Su contenido en clorofila es menor y los frutos comienzan a madurar antes que los controles, pero el rendimiento (1100-1300 g planta-1) no es significativamente diferente. Su sensibilidad a patógenos de la raíz, el principal factor que llevó a su declive en el pasado, no parece poner en peligro la posibilidad de una futura recuperación. La concentración en vitamina C es alta (200-240 mg/100 g) y se preserva en el fruto conservado en cámara frigorífica; también se detecta una buena cantidad (más del 25%) de vitamina C en las frutas encurtidas. 'Voghera' tiene propiedades nutritivas y gastronómicas que pueden ser apreciadas por los consumidores. La alta variabilidad genética interna detectada en los análisis AFLP indica que el trabajo de selección es necesario para mantener plenamente los caracteres originales de la variedad y mejorarla

Ophthalmia neonatorum da chlamydia

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Colecistite alitiasica e colangite intraepatica associate a citomegalovirus in un paziente con AIDS

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