An Authentication Survey on Retail Seafood Products Sold on the Bulgarian Market Underlines the Need for Upgrading the Traceability System

Economically motivated or accidental species substitutions lead to economic and potential health damage to consumers with a loss of confidence in the fishery supply chain. In the present study, a three-year survey on 199 retail seafood products sold on the Bulgarian market was addressed to assess: (1) product authenticity by molecular identification; (2) trade name compliance to the list of official trade names accepted in the territory; (3) adherence of the list in force to the market supply. DNA barcoding on mitochondrial and nuclear genes was applied for the identification of whitefish (WF), crustaceans (C) and mollusks (cephalopods-MC; gastropods-MG; bivalves-MB) except for Mytilus sp. products for which the analysis was conducted with a previously validated RFLP PCR protocol. Identification at the species level was obtained for 94.5% of the products. Failures in species allocation were reconducted due to low resolution and reliability or the absence of reference sequences. The study highlighted an overall mislabeling rate of 11%. WF showed the highest mislabeling rate (14%), followed by MB (12.5%), MC (10%) and C (7.9%). This evidence emphasized the use of DNA-based methods as tools for seafood authentication. The presence of non-compliant trade names and the ineffectiveness of the list to describe the market species varieties attested to the need to improve seafood labeling and traceability at the national level

The Dutch Working Party on Antibiotic Policy (SWAB) Recommendations for the Diagnosis and Management of Febrile Neutropenia in Patients with Cancer

Introduction This guideline was written by a multidisciplinary committee with mandated members of the Dutch Society for Infectious Diseases, Dutch Society for Hematology, Dutch Society for Medical Oncology, Dutch Association of Hospital Pharmacists, Dutch Society for Medical Microbiology, and Dutch Society for Pediatrics. The guideline is written for adults and pediatric patients. Method The recommendations are based on the answers to nine questions formulated by the guideline committee. To provide evidence-based recommendations we used all relevant clinical guidelines published since 2010 as a source, supplemented with systematic searches and evaluation of the recent literature (2010-2020) and, where necessary, supplemented by expert-based advice. Results For adults the guideline distinguishes between high- and standard-risk neutropenia based on expected duration of neutropenia (> 7 days versus 7 days) and in children with neutropenia, ceftazidime, cefepime, and piperacillin-tazobactam are all first-choice options for empirical antibiotic therapy in case of fever. In adults with standard-risk neutropenia (duration of neutropenia <= 7 days) the MASCC score can be used to assess the individual risk of infectious complications. For patients with a low risk of infectious complications (high MASCC score) oral antibiotic therapy in an outpatient setting is recommended. For patients with a high risk of infectious complications (low MASCC score) antibiotic therapy per protocol sepsis of unknown origin is recommended.Immunogenetics and cellular immunology of bacterial infectious disease

Targeting of Antithrombin in Hemophilia A or B with RNAi Therapy.

BACKGROUND: Current hemophilia treatment involves frequent intravenous infusions of clotting factors, which is associated with variable hemostatic protection, a high treatment burden, and a risk of the development of inhibitory alloantibodies. Fitusiran, an investigational RNA interference (RNAi) therapy that targets antithrombin (encoded by SERPINC1), is in development to address these and other limitations. METHODS: In this phase 1 dose-escalation study, we enrolled 4 healthy volunteers and 25 participants with moderate or severe hemophilia A or B who did not have inhibitory alloantibodies. Healthy volunteers received a single subcutaneous injection of fitusiran (at a dose of 0.03 mg per kilogram of body weight) or placebo. The participants with hemophilia received three injections of fitusiran administered either once weekly (at a dose of 0.015, 0.045, or 0.075 mg per kilogram) or once monthly (at a dose of 0.225, 0.45, 0.9, or 1.8 mg per kilogram or a fixed dose of 80 mg). The study objectives were to assess the pharmacokinetic and pharmacodynamic characteristics and safety of fitusiran. RESULTS: No thromboembolic events were observed during the study. The most common adverse events were mild injection-site reactions. Plasma levels of fitusiran increased in a dose-dependent manner and showed no accumulation with repeated administration. The monthly regimen induced a dose-dependent mean maximum antithrombin reduction of 70 to 89% from baseline. A reduction in the antithrombin level of more than 75% from baseline resulted in median peak thrombin values at the lower end of the range observed in healthy participants. CONCLUSIONS: Once-monthly subcutaneous administration of fitusiran resulted in dose-dependent lowering of the antithrombin level and increased thrombin generation in participants with hemophilia A or B who did not have inhibitory alloantibodies. (Funded by Alnylam Pharmaceuticals; ClinicalTrials.gov number, NCT02035605 .)

Application of Functional Endoscopic Sinus Surgery with Navigation system in Medical University - Pleven: Pilot results

Background: Functional Endoscopic Sinus Surgery (FESS), supported by a navigation system, is a modern minimally invasive method for diagnosis and surgical treatment of nasal polyposis, acute and chronic sinusitis, benign and malignant tumors of the nasal cavities and skull base, congenital anomalies, severe epistaxis, and a number of other pathological processes in these anatomical areas. Advantages of the method are the improved orientation through navigation, reduced blood loss, sparing of neighboring tissues and structures, optimization of postoperative results, reduction of recovery period and pain as well as the optimized quality of life of the patient.Aim: Presentation of pilot results from the first surgical interventions under Work Package 3 “Endoscopic sinus surgery, supported by a navigation system, in ENT practice”, performed in the “Integrated Interdisciplinary Operating Unit with Navigation and Telesurgery Systems” built under the project BG05M2OP001–1.002–0010 “Center of Competence in Personalized Medicine, 3D and Telemedicine, Robot-assisted and Minimally Invasive Surgery” funded by the“Science and education for smart growth” Operational Program and the European Regional Development Fund.Results: The surgical interventions were performed without intraoperative and early postoperative complications; the recovery period was smooth. During the follow-up examinations, we observed good local postoperative status, optimal period of healing and absence of subjective complaints reported by the patients.Conclusion: Our pilot results support the advantages of navigated FESS for safer, more precise and sparing radical treatment of diseases of the nose and nasal cavities. Extended multidisciplinary studies are forthcoming within the project for overall assessment of the significance and applicability of the introduced method in different groups of patients

New official Bulgarian list of seafood trade names: coping with EU labelling requirements and market trends to enhance consumers’ informed choice

The present study aimed at assessing the validity and accuracy of the new official Bulgarian list of seafood trade names in compliance with EU requirements, and the list evolution and adherence to the Bulgarian market trends. The new list consists of 88 commercial designations (CD) associated with 81 scientific names (SN) provided as 72 species, 8 genera and 1 family&nbsp;mostly&nbsp;belonging to the fish category (86.4%, SN&nbsp;=&nbsp;70). The list&nbsp;analysis highlighted the presence of&nbsp;14 invalid SN (17.3%), with an obsolete classification.&nbsp;In terms of adherence to the Bulgarian market’s trend&nbsp;the inclusion of 51 new SN reflecting fishing data in total, both from inland waters and along the Black Sea coast&nbsp;was pointed out. However, 44 SN relating to commercially relevant species and currently available at purchase were deleted. In terms of accuracy, the introduction of SN as family, the significant reduction of CDs and the use of vague CDs lead the list to distance itself from the one name-one fish conception, proposed at international level, as ideal approach for unambiguous product identification by the consumer. To conclude, the analysis shows a clear will of the national Bulgarian Legislator to enhance local fisheries and aquaculture trade. Nevertheless, major issues related to the SN validity and the non-adherence to seafood market trends are highlighting the ineffectiveness of the current list in describing retail seafood products. This emphasizes the urgency to provide a further substantial list revision

Requirement of Signal Peptidase ComC and Thiol-Disulfide Oxidoreductase DsbA for Optimal Cell Surface Display of Pseudopilin ComGC in Staphylococcus aureus

Staphylococcus aureus is an important Gram-positive bacterial pathogen producing many secreted and cell surface-localized virulence factors. Here we report that the staphylococcal thiol-disulfide oxidoreductase DsbA is essential for stable biogenesis of the ComGC pseudopilin. The signal peptidase ComC is indispensable for ComGC maturation and optimal cell surface exposure

High genetic diversity of Staphylococcus aureus strains colonizing patients with epidermolysis bullosa

Patients with the blistering disease, epidermolysis bullosa (EB), frequently suffer from chronic wounds that become colonized by pathogenic bacteria, such as Staphylococcus aureus. To determine S.similar to aureus colonization rates in patients with EB, swabs were collected from the anterior nares, throats and wounds of 52 Dutch patients with EB. Swabs were also collected from nares and throats of 13 healthcare workers who occasionally meet the sampled patients with EB. All EB patients with chronic wounds and 75% of the patients without chronic wounds were colonized with S.similar to aureus. In contrast, 39% of the sampled healthcare workers were colonized with S.similar to aureus. Typing revealed a high degree of genetic diversity of 184 collected S.similar to aureus isolates. Autoinoculation of S.similar to aureus in individual patients with EB was shown to occur frequently, whereas transmission of S.similar to aureus between patients with EB is apparently rare. There was no evidence for S.similar to aureus transmission between patients with EB and healthcare workers