Lung sealant and morbidity after pleural decortication: a prospective randomized, blinded study

<p>Abstract</p> <p>Objectives</p> <p>Prolonged postoperative air leaks (AL) are a major cause of morbidity. Aim of this work was evaluating use of a Lung Sealant System (Pleuraseal™, Covidien, Mansfield, MA, U.S.A.) in pleural decortications for empyema thoracis.</p> <p>Methods</p> <p>From January 2008 to December 2008, 46 consecutive patients received pleural decortications for empyema thoracis. Post-procedural and malignancy-related empyemas were excluded. After hydro-pneumatic test and surgical correction of AL (until satisfaction), patients were assigned (23 per group) to Control or Sealant group. Control group underwent no additional interventions. In Sealant group, lung sealant was applied over AL areas. Following variables were measured daily: patients with AL; time to chest drainage (CD) removal; CD drainage volume at removal, postoperative length of hospital stay, postoperative C-reactive protein (CRP), and leukocyte counts. Personnel recording parameters were blinded to intervention. Two-tailed t-tests (normally distributed data) or Mann - Whitney U-test (not-normally distributed data) were used for evaluating significance of differences between group means or medians. Significance of any proportional differences in attributes were evaluated using Fisher's Exact Test. Statistical analysis was carried out using R-software (version 2.8.1).</p> <p>Results</p> <p>Groups were similar regarding demographic and baseline characteristics. No patients were withdrawn from study; no adverse effects were recorded. There were no significative differences on CRP and leukocyte levels between two groups. Compared with the Control group, in Sealant group significantly fewer patients had AL (30 versus 78%, <it>p = 0.012</it>), and drains were inserted for a shorter time (medians, 3 versus 5 days, <it>p = 0.05</it>). Postoperative hospitalization time was shorter in Sealant group than in control group, but difference was not significant (0.7 days, <it>p = 0.121</it>).</p> <p>Conclusions</p> <p>Pleuraseal™ Lung Sealant System significantly reduces AL following pleural decortications for empyema and, despite of not-increased infectious indexes, is suitable for routinely use, even in procedures with contaminated pleura.</p

BNT162B2 mRNA COVID-19 vaccine in heart and lung transplanted young adults: is an alternative SARS-CoV-2 immune response surveillance needed?

[no abstract available

Ultrastructural evaluation of human metaphase II oocytes after vitrification: closed versus open devices

Objective: To compare the ultrastructural appearance of oocytes after vitrification and warming with two different devices. Design: Oocytes were examined by ultrastructural analysis after vitrification and warming with use of closed (CryoTip; Irvine Scientific, Santa Ana, CA) or open (Cryotop; Kitazato BioPharma Co., Ltd., Shizuoka, Japan) devices. Setting: Pordenone Hospital IVF Unit and Medical Morphological Research Department, University of Udine. Patient(s): Surplus oocytes from 10 patients (aged 31-39 years) undergoing assisted reproductive technologies at the Pathophysiology Unit of Human Reproduction and Sperm Bank between 2006 and 2008. Intervention(s): Oocytes with normal invertoscopic appearance underwent vitrification and warming with closed (CryoTip) or open (Cryotop) devices and were processed for transmission electron microscopy. Main Outcome Measure(s): Cryodamage extent and cell alterations in oocytes after open or closed vitrification and warming procedures and their rehydration rate. Result(s): A higher rate of complete oocyte rehydration and less-severe ultrastructural alterations were observed after vitrification and warming with the open Cryotop device. Conclusion(s): These preliminary data suggest that oocyte ultrastructure is better preserved with an open rather than closed vitrification and warming protocol

Multicentre Italian study of SARS-CoV-2 infection in children and adolescents, preliminary data as at 10 April 2020

Data on features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children and adolescents are scarce. We report preliminary results of an Italian multicentre study comprising 168 laboratory-confirmed paediatric cases (median: 2.3 years, range: 1 day-17.7 years, 55.9% males), of which 67.9% were hospitalised and 19.6% had comorbidities. Fever was the most common symptom, gastrointestinal manifestations were frequent; two children required intensive care, five had seizures, 49 received experimental treatments and all recovered

Reduced Poliovirus vaccine neutralising-antibody titres in infants with maternal HIV-exposure.

BACKGROUND: Maternally HIV-exposed (mHIV-EU) infants have poor health even without HIV-1 infection. The responses to vaccination are less well defined. Immunity to oral Poliovirus vaccine (OPV) was studied in Zambian infants participating in a randomised controlled trial of micronutrient fortification to improve child health. METHOD: Maternally HIV-unexposed and mHIV-EU infants were recruited at 6 months age and randomised to basal or enriched micronutrient-fortified diets for 12 months. HIV-exposed mother-infant pairs had received perinatal nevirapine to prevent mother-to-child-transmission. In the cohort of 597 infants, neutralising-antibody titres to OPV were analysed at 18 months with respect to micronutrient fortification, maternal or infant HIV-1 infection, and human cytomegalovirus (HCMV) infection detected by antibodies and viraemia (serum DNA). Vaccine protection was defined as log2 titre>3. RESULTS: Compared to uninfected children, HIV-1-infected children had reduced neutralising antibody titres to OPV, irrespective of diet: log2 titre difference (95% confidence interval) -3.44 (-2.41; -4.46), P<0.01. OPV antibody titres were lower in HIV-infected children with HCMV viraemia compared to those without viraemia at 18 months, but did not reach significance: difference -2.55 (-6.10; 1.01), P=0.14. Breast-feeding duration was independently associated with increasing OPV titre (P-value<0.01). In mHIV-EU children there were reduced neutralising antibody titres to Poliovirus compared with maternally HIV-unexposed, irrespective of diet, maternal education and socioeconomic status: log2 titre difference (95% confidence interval) -0.56 (-0.98; -0.15), P<0.01. This difference was noticeably decreased after adjusting for breast-feeding duration, suggesting that in our study population less breast-feeding by HIV-positive mothers could explain the reduced OPV titres in mHIV-EU infants. CONCLUSION: The mHIV-EU infants had reduced polio vaccine antibody titres which were associated with reduced breast-feeding duration. This has important implications for polio eradication and control of vaccine-preventable diseases, in countries where childhood HIV-1 infection and maternal exposure are public health threats

Evaluación de lodos de purines de la cuenca porcina unión Marcos Juárez-Córdoba-Argentina

El encarecimiento de importaciones y la demanda interna acrecentó la producción de porcinos en Argentina. Concentrándose en la zona núcleo agrícola del país, coincidiendo con la disponibilidad de granos, centros de faena y consumo. La cuenca bajo posee un elevado potencial bioenergético (5861 tep/año). Este crecimiento, generó un incremento de los efluentes. En la mayor parte de los establecimientos, se realizan mediante lagunas de estabilización. Estos lodos estabilizados, se pueden utilizar como enmienda en suelo o como inóculo para las DA, porque contiene los microorganismos y composición química adecuada. El objetivo de este trabajo fue evaluar los lodos provenientes de lagunas de tratamiento de purines de la región, comprendiendo la caracterización y determinación del potencial de producción de biogás y metano (PPB y PPM), biodegradabilidad y actividad, mediante ensayos por Bach triplicados a escala laboratorio y piloto. Además, se determinó la calidad del biogás y la composición del inóculo luego de desgasificarlo. Los resultados muestran una baja concentración de sólidos correspondiente con la modalidad de trabajo y presento macro y micronutrientes necesarios para la DA. Luego del proceso de inanición, PM1 no presento patógenos, indicando que un correcto proceso de DA reduciría o eliminaría los patógenos en PM0, adicionalmente presenta características salino-sódicas, reduciendo su aplicación directa como enmienda en suelo. El biogás obtenido del proceso de desgasificación mostró baja calidad (baja concentración de CH4 y elevada de CO2 e H2/N2).The increase in the price of imports and domestic demand increased the production of pigs in Argentina. It is concentrated in the agricultural core zone of the country, coinciding with the availability of grains, slaughter and consumption centers. The lower basin has a high bioenergy potential (5861 tep/year). This growth generated an increase in effluents. In most of the establishments, they are carried out by means of stabilization lagoons. This stabilized sludge can be used as a soil amendment or as inoculum for AD, because it contains the appropriate microorganisms and chemical composition. The objective of this work was to evaluate sludge from slurry treatment lagoons in the region, including the characterization and determination of biogas and methane production potential (PPB and PPM), biodegradability and activity, by means of triplicate Bach tests at laboratory and pilot scale. In addition, biogas quality and inoculum composition after degassing were determined. The results show a low concentration of solids corresponding to the working mode and present macro and micronutrients necessary for AD. After the starvation process, PM1 did not present pathogens, indicating that a correct AD process would reduce or eliminate pathogens in PM0, additionally it presents saline-sodium characteristics, reducing its direct application as a soil amendment. The biogas obtained from the degassing process showed low quality (low concentration of CH4 and high concentration of CO2 and H2/N2).Instituto de Ingeniería RuralFil: Galván, María José. Universidad Nacional de Villa María. Centro de Investigaciones y Transferencia de Villa María (CIT-VM); ArgentinaFil: Cagnolo, Mara. Universidad Nacional de Villa María. Centro de Investigaciones y Transferencia de Villa María (CIT-VM); ArgentinaFil: Degano, Salvador. Universidad Nacional de Villa María. Centro de Investigaciones y Transferencia de Villa María (CIT-VM); ArgentinaFil: Badin, Francisco. Universidad Nacional de Villa María (UNVM). Instituto Académico Pedagógico de Ciencias Básicas y Aplicadas; ArgentinaFil: Becker, Analía. Universidad Nacional de Villa María (UNVM). Instituto Académico Pedagógico de Ciencias Básicas y Aplicadas; ArgentinaFil: Manno, Roberto. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas Físico Química y Naturales; ArgentinaFil: Acevedo, Diego. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas Físico Química y Naturales; ArgentinaFil: Hilbert, Jorge Antonio. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Ingeniería Rural; ArgentinaFil: Fuentes, Mauren. Universidad Tecnológica Nacional. Facultad Regional Santa Fe. Instituto de Desarrollo y Diseño (INGAR); Argentin

Humoral and cellular response following vaccination with the BNT162b2 mRNA COVID-19 vaccine in patients affected by primary immunodeficiencies

Mass SARS-Cov-2 vaccination campaign represents the only strategy to defeat the global pandemic we are facing. Immunocompromised patients represent a vulnerable population at high risk of developing severe COVID-19 and thus should be prioritized in the vaccination programs and in the study of the vaccine efficacy. Nevertheless, most data on efficacy and safety of the available vaccines derive from trials conducted on healthy individuals; hence, studies on immunogenicity of SARS-CoV2 vaccines in such populations are deeply needed. Here, we perform an observational longitudinal study analyzing the humoral and cellular response following the BNT162b2 mRNA COVID-19 vaccine in a cohort of patients affected by inborn errors of immunity (IEI) compared to healthy controls (HC). We show that both IEI and HC groups experienced a significant increase in anti-SARS-CoV-2 Abs 1 week after the second scheduled dose as well as an overall statistically significant expansion of the Ag-specific CD4+CD40L+ T cells in both HC and IEI. Five IEI patients did not develop any specific CD4+CD40L+ T cellular response, with one of these patients unable to also mount any humoral response. These data raise immunologic concerns about using Ab response as a sole metric of protective immunity following vaccination for SARS-CoV-2. Taken together, these findings suggest that evaluation of vaccine-induced immunity in this subpopulation should also include quantification of Ag-specific T cells

In response to “missed opportunities and potentially misleading results in maternal mortality study

non not