Epidural anaesthesia and analgesia in hepatic resections

Eпидуралната анестезия и аналгезия намират все по-широко приложение в съвременната чернодробна онкохирургия. Изследването обхваща 29 болни на средна възраст от 58,410,7 г., подложени на чернодробни резекции през 2013-2015 г. При болните с нормален коагулационен статус и съхранена хемодинамика са използвани висок епидурален блок с повърхностна обща инхалаторна или венозна анестезия и малки дози релаксант с ендотрахеална интубация. Анализирани са няколко показателя на коагулационния статус: INR/PТ, тромбоцити, аПТТ, фибриноген и Д-димер. Установяват се скъсяване на PТ, намаляване на броя на тромбоцитите, леко намаляване на фибриногена и повишаване на Д-димера. Тези изменения са изразени предимно при болните с трисегментектомия и хемихепатектомия до 5-ия следоперативен ден. Постига се намаляване на болката при всички оперирани болни. Необходимо е индивидуализирано приложение на епидуралната анестезия и аналгезия и непрекъснатото мониториране на статуса на кръвосъсирването на болните, избрани за чернодробни резекции.Epidural anaesthesia and analgesia are more widely applied in contemporary oncological liver surgery. The study covered 29 patients at a mean age of 58,410,7 years who underwent hepatic resections in 2013-2015. In the patients with a normal coagulation status and preserved haemodynamics, a high epidural block with superficial general inhalation or venous anaesthesia and small dosages of relaxant with endotracheal intubation were applied. Several parameters of the coagulation status such as INR/PТ, platelet count, aPTT, fibrinogen and D-dimer were analyzed. PT shortening, platelet count reduction, a slight fibtinogen diminution and D-dimer elevation were established. These changes were predominantly outlined among the patients with trisegmentectomy and hemihepatectomy until the fifth postoperative day. Pain reduction was achieved in all the patients operated. An individualized application of the epidural anaesthesia and analgesia as well as continuous monitoring of the coagulation status of the patients selected for liver resections

Photonic Hydrogel Sensors

Analyte-sensitive hydrogels that incorporate optical structures have emerged as sensing platforms for point-of-care diagnostics. The optical properties of the hydrogel sensors can be rationally designed and fabricated through self-assembly, microfabrication or laser writing. The advantages of photonic hydrogel sensors over conventional assay formats include label-free, quantitative, reusable, and continuous measurement capability that can be integrated with equipment-free text or image display. This Review explains the operation principles of photonic hydrogel sensors, presents syntheses of stimuli-responsive polymers, and provides an overview of qualitative and quantitative readout technologies. Applications in clinical samples are discussed, and potential future directions are identified

The 2.4 Å cryo-EM structure of a heptameric light-harvesting 2 complex reveals two carotenoid energy transfer pathways

We report the 2.4 Ångström resolution structure of the light-harvesting 2 (LH2) complex from Marichromatium (Mch.) purpuratum determined by cryogenic electron microscopy. The structure contains a heptameric ring that is unique among all known LH2 structures, explaining the unusual spectroscopic properties of this bacterial antenna complex. We identify two sets of distinct carotenoids in the structure and describe a network of energy transfer pathways from the carotenoids to bacteriochlorophyll a molecules. The geometry imposed by the heptameric ring controls the resonant coupling of the long-wavelength energy absorption band. Together, these details reveal key aspects of the assembly and oligomeric form of purple bacterial LH2 complexes that were previously inaccessible by any technique

Spin Caloritronics

This is a brief overview of the state of the art of spin caloritronics, the science and technology of controlling heat currents by the electron spin degree of freedom (and vice versa).Comment: To be published in "Spin Current", edited by S. Maekawa, E. Saitoh, S. Valenzuela and Y. Kimura, Oxford University Pres

Sharing of carbapenemase-encoding plasmids between Enterobacteriaceae in UK sewage uncovered by MinION sequencing

Dissemination of carbapenem resistance among pathogenic Gram-negative bacteria is a looming medical emergency. Efficient spread of resistance within and between bacterial species is facilitated by mobile genetic elements. We hypothesized that wastewater contributes to the dissemination of carbapenemase-producing Enterobacteriaceae (CPE), and studied this through a cross-sectional observational study of wastewater in the East of England. We isolated clinically relevant species of CPE in untreated and treated wastewater, confirming that waste treatment does not prevent release of CPE into the environment. We observed that CPE-positive plants were restricted to those in direct receipt of hospital waste, suggesting that hospital effluent may play a role in disseminating carbapenem resistance. We postulated that plasmids carrying carbapenemase genes were exchanged between bacterial hosts in sewage, and used short-read (Illumina) and long-read (MinION) technologies to characterize plasmids encoding resistance to antimicrobials and heavy metals. We demonstrated that different CPE species ($\textit{Enterobacter kobei}$ and $\textit{Raoultella ornithinolytica}$) isolated from wastewater from the same treatment plant shared two plasmids of 63 and 280 kb. The former plasmid conferred resistance to carbapenems ($bla_\text{OXA-48}$), and the latter to numerous drug classes and heavy metals. We also report the complete genome sequence for $\textit{Enterobacter kobei}$. Small, portable sequencing instruments such as the MinION have the potential to improve the quality of information gathered on antimicrobial resistance in the environment.This publication presents independent research supported by the Health Innovation Challenge Fund (WT098600, HICF-T5-342), a parallel funding partnership between the Department of Health, UK, and the Wellcome Trust. C. L. is a Wellcome Trust Sir Henry Postdoctoral Fellow (110243/Z/15/Z). T. G. is a Wellcome Trust Research Training Fellow (103387/Z/13/Z)

New data on the level of immune stratum against Q fever agent in population of the of Republic of Guinea

which is bacteria of the species Coxiella burnetii. One of the factors showing the possibility of pathogen circulation in a certain territory is assessed by the presence of an immune stratum in the inhabitants of the region. In the 1980s, the study of the immune structure of the population of the Republic of Guinea in relation to coxiellosis has begun. The present study, carried out in 2015—2019, has been aimed to obtain new information about the immune stratum of the population of the Republic of Guinea against the causative agent of Q fever and to compare it with previous studies. Specific IgG antibodies in the blood of the Guinea residents were detected by using enzyme-linked immunosorbent assay (ELISA) with a set of reagents manufactured at the St. Petersburg Pasteur Institute (St. Petersburg, Russian Federation). The serum samples were tested in at 1:100 dilution. Antibodies against C. burnetii were detected in 124/2346 (5.3% [CI 4.5-6.3]) samples. This study confirms the previously obtained data on the circulation of the causative agent of coxiellosis in all landscape and geographical zones of the Republic of Guinea. The natural and climatic conditions of the region, the variety of ixodic tick species currently inhabiting this territory being a reservoir and vector of infection, as well as a large amount of livestock are the factors for active circulation of the Q fever pathogen and the emergence of related disease outbreaks. The data obtained necessitate continuing further studies on distribution of C. burnetii in the territory of the Republic of Guinea. Taking into consideration the epidemiological significance of Q fever, a pressing task is to study a proportion of this infectious disease in the overall structure of diseases registered in the territory of the Republic of Guinea. It is also necessary to conduct regular epizootological monitoring in order to clarify the types of carriers and vectors of C. burnetii in different landscape and geographical zones of the Republic of Guinea as well as to assess the immune stratum against the pathogen in large and small cattle being the main sources of infection for humans. The data obtained will allow us to determine presence of a natural focus of this infection as well as its borders and develop a set of preventive (anti-epidemic) measures