Pilot study on the antibacterial activity of hydrogen peroxide and silver ions in the hospital environment

BACKGROUND: Nosocomial environmental contamination plays an important role in the transmission of several health care-associated pathogens. Control of surfaces contamination can reduce the risk of cross-infection in hospitals. The aim of our study is to evaluate the disinfectant effectiveness of hydrogen peroxide and silver ions, against nosocomial multidrug-resistant strains, when it's used directly on surfaces. METHODS: Staphylococcus aureus ATCC 6538, Pseudomonas aeruginosa ATCC 15442 and the same multidrug-resistant clinical isolates were selected to study the effectiveness of the disinfectant used in suspension or on the clean and dirty surface. RESULTS: Regarding the suspension activity test, the hydrogen peroxide and silver ions resulted effective after 5 min for ATCC strains and after 10 min for multidrug-resistant isolates; about the surface activity test, its action resulted after 10 min for ATCC strains and after 15 min for multidrug-resistant isolates. Moreover, it was more effective when used in the absence or in presence of a low concentration of biological materials. CONCLUSIONS: In a complex environment such as hospital wards, to have a disinfectant notoriously effective but more easy and quick to use would be an useful solution to treat small surfaces occasionally contaminated by biological materials

Retrieval of the gastric specimen following laparoscopic sleeve gastrectomy. Experience on 275 cases.

Severe obesity leads to a high incidence of complications and a decrease in life expectancy, especially among younger adults. Laparoscopic sleeve gastrectomy (LSG) first intended as the first step of biliopancreatic diversion with duodenal switch is gaining a per-se procedure role because of its effectiveness on weight loss and comorbidity resolution. Different techniques have been described for specimen extraction in LSG. In this article we report the technique adopted in 275 LSGs performed in our department. In the first 120 LSGs performed from 2007, the specimen was extracted through a mini laparotomy. In the following 155 cases the technique has been simplified: the grasped specimen has been withdrawn through the 15 mm trocar site. We registered in the fist group six cases of wound infection (5%), ten cases of hematoma (8.3%) and four cases of port site hernia (3.3%). In the second group only one case of hematoma (0.6%, p = 0.01) but no cases of wound infection (p = 0.01) or port site hernia, (p = 0.03) although we registered a specimen perforation during retrieval in 16 patients, were reported. The technique described in the 155 cases of the control group has shown to be more effective than the technique we used in the case group, allowing significantly lower operative time (112.9 ± 1.0 vs 74.9 ± 9.1 p < 0.001) and complications, and providing unchanged costs

Updatable Blockchains

Software updates for blockchain systems become a real challenge when they impact the underlying consensus mechanism. The activation of such changes might jeopardize the integrity of the blockchain by resulting in chain splits. Moreover, the software update process should be handed over to the community and this means that the blockchain should support updates without relying on a trusted party. In this paper, we introduce the notion of updatable blockchains and show how to construct blockchains that satisfy this definition. Informally, an updatable blockchain is a secure blockchain and in addition it allows to update its protocol preserving the history of the chain. In this work, we focus only on the processes that allow securely switching from one blockchain protocol to another assuming that the blockchain protocols are correct. That is, we do not aim at providing a mechanism that allows reaching consensus on what is the code of the new blockchain protocol. We just assume that such a mechanism exists (like the one proposed in NDSS 2019 by Zhang et. al), and show how to securely go from the old protocol to the new one. The contribution of this paper can be summarized as follows. We provide the first formal definition of updatable ledgers and propose the description of two compilers. These compilers take a blockchain and turn it into an updatable blockchain. The first compiler requires the structure of the current and the updated blockchain to be very similar (only the structure of the blocks can be different) but it allows for an update process more simple, efficient. The second compiler that we propose is very generic (i.e., makes few assumptions on the similarities between the structure of the current blockchain and the update blockchain). The drawback of this compiler is that it requires the new blockchain to be resilient against a specific adversarial behaviour and requires all the honest parties to be online during the update process. However, we show how to get rid of the latest requirement (the honest parties being online during the update) in the case of proof-of-work and proof-of-stake ledgers

Feasibility of inguinal hernioplasty under local anaesthesia in elderly patients.

BACKGROUND: The aim of this study is to evaluate the feasibility and the safety of hernioplasty under local anaesthesia in elderly patients with significant comorbidity. METHODS: A total of 218 patients underwent inguinal hernia repair with mesh between June 2009 and July 2012. Presence of comorbid conditions and complications were compared between patients younger and older than 70 years. RESULTS: Hernia repair in older patients were more likely associated with comorbid conditions than in their younger counterparts ( hypertension: 25% vs 8.16%; cardiovascular diseases: 50% vs 22%; benign prostatic hypertrophy 60% vs 30%). The most common postoperative complications in both groups were recurrence, wound infection, urinary retention. There was a slightly higher rate of complication in elderly group. CONCLUSIONS: Inguinal hernia repair with local anaesthesia is quite safe and results in a good success rate in elderly patients despite a higher rate of comorbidity typical of this kind of patient

Non-malleable codes for space-bounded tampering

Non-malleable codes—introduced by Dziembowski, Pietrzak and Wichs at ICS 2010—are key-less coding schemes in which mauling attempts to an encoding of a given message, w.r.t. some class of tampering adversaries, result in a decoded value that is either identical or unrelated to the original message. Such codes are very useful for protecting arbitrary cryptographic primitives against tampering attacks against the memory. Clearly, non-malleability is hopeless if the class of tampering adversaries includes the decoding and encoding algorithm. To circumvent this obstacle, the majority of past research focused on designing non-malleable codes for various tampering classes, albeit assuming that the adversary is unable to decode. Nonetheless, in many concrete settings, this assumption is not realistic

Peripheral blood mono-nuclear cells implantation in patients with Peripheral Arterial Disease: a pilot study for clinical and biochemical outcome of neoangiogenesis.

BACKGROUND: Substantial progresses in the management of peripheral arterial disease (PAD) have been made in the past two decades. Progress in the understanding of the endothelial-platelet interaction during health and disease state has resulted in better antiplatelet drugs that can prevent platelet aggregation, activation and thrombosis during angioplasty and stenting. A role in physiological and pathological angiogenesis in adults has been recently shown in bone marrow–derived circulating endothelial progenitors (BM-DCEPs) identified in the peripheral blood. These findings have paved the way for the development of therapeutic neovascularization techniques using endothelial progenitors. METHODS: This pilot study includes five patients, aged 60 to 75, with a history of claudication and recruited from September 2010 to February 2011 at the A.O.U. Federico II of Naples. PBMNCs have been implanted three times in the limb with the worst ABI value in all the patients included in the study. The clinical follow up was performed during the subsequent 12 months from the beginning of the treatment. RESULTS: In four patients there was a regression of ulcerative lesions. One patient’s condition improved after the first implantation but later did not respond to the further treatments. All patients achieved a pain relief as judged by the numeric pain scale. Pain relief remained satisfactory in three patients for one year. Pain gradually returned to the pre-treatment level in two patients. All patients referred an ameliorating in their quality of life expressed even by an improvement in claudication free walking distance. These improvements are reflected also by intra-arterial digital subtraction angiography (IADSA) that shows an improvement of arterial vascularization. CONCLUSIONS: The data from this study suggest an efficacy of BM-DCEPs implantation in terms of improvement of the vascularization and quality of life in patients affected by Peripheral Arterial Disease. Nevertheless a double-blind placebo-controlled study is needed to confirm our findings

Oral sodium butyrate supplementation ameliorates paclitaxel-induced behavioral and intestinal dysfunction

Paclitaxel (PTX) is one of the most broadly used chemotherapeutic agents for the treatment of several tumor types including ovarian, breast, and non-small cell lung cancer. However, its use is limited by debilitating side effects, involving both gastrointestinal and behavioral dysfunctions. Due to growing evidence showing a link between impaired gut function and chemotherapy-associated behavioral changes, the aim of this study was to identify a novel therapeutic approach to manage PTX-induced gut and brain comorbidities. Mice were pre-treated with sodium butyrate (BuNa) for 30 days before receiving PTX. After 14 days, mice underwent to behavioral analysis and biochemical investigations of gut barrier integrity and microbiota composition. Paired evaluations of gut functions revealed that the treatment with BuNa restored PTX-induced altered gut barrier integrity, microbiota composition and food intake suggesting a gut-to-brain communication. The treatment with BuNa also ameliorated depressive- and anxiety-like behaviors induced by PTX in mice, and these effects were associated with neuroprotective and anti-inflammatory outcomes. These results propose that diet supplementation with this safe postbiotic might be considered when managing PTX-induced central side effects during cancer therapy

Increased use of high-flow nasal cannulas after the pandemic in bronchiolitis: a more severe disease or a changed physician’s attitude?

After the SARS-CoV-2 pandemic, we noticed a marked increase in high-flow nasal cannula use for bronchiolitis. This study aims to report the percentage of children treated with high-flow nasal cannula (HFNC) in various seasons. The secondary outcomes were admissions for bronchiolitis, virological results, hospital burden, and NICU/PICU need. We conducted a retrospective study in four Italian hospitals, examining the medical records of all infants (< 12 months) hospitalized for bronchiolitis in the last four winter seasons (1 September–31 March 2018–2022). In the 2021–2022 winter season, 66% of admitted children received HFNC versus 23%, 38%, and 35% in the previous 3 years. A total of 876 patients were hospitalized in the study periods. In 2021–2022, 300 infants were hospitalized for bronchiolitis, 22 in 2020–2021, 259 in 2019–2020, and 295 in 2018–2019. The percentage of patients needing intensive care varied from 28.7% to 18%, 22%, and 15% in each of the four considered periods (p < 0.05). Seventy-seven percent of children received oxygen in the 2021–2022 winter; vs 50%, 63%, and 55% (p < 0.01) in the previous 3 years. NIV/CPAP was used in 23%, 9%, 16%, and 12%, respectively. In 2021–2020, 2% of patients were intubated; 0 in 2020–2021, 3% in 2019–2020, and 1% in 2018–2019. Conclusion: This study shows a marked increase in respiratory support and intensive care admissions this last winter. While these severity indexes were all driven by medical choices, more reliable indexes such as intubation rate and length of stay did not change. Therefore, we suggest that there is a more aggressive treatment attitude rather than a more severe disease.What is Known:• COVID-19 pandemic deeply impacted bronchiolitis epidemiology, reducing hospitalizations to onetenth. In the 2021-2022 winter, bronchiolitis resurged to pre-pandemic numbers in Europe.What is New:• Bronchiolitis hospitalization rose much faster in the 2021-2022 winter period, peaking at a higher level. Respiratory supports and high-flow nasal cannula increased significantly compared to the pre-pandemic era