Gruppo Italiano di Studio sulle Infezioni Gravi – GISIG 3: controversial issues of severe bacterial infections due to multidrug-resistant Gram-positive bacteria: introduction by the National Coordinators

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Relationship in a Medium-risk Population

By means of an accurate immunoenzymatic assay, the prevalence was studied of antibodies to hepatitis C virus (HCV) in three different populations: 74 patients affected with hepatocellular carcinoma (HCC) on preexisting cirrhosis, 82 patients with liver cirrhosis but with no apparent neoplasm, and 70 control subjects, hospitalized for various conditions, of internal medicine or geriatric interest. 70.2% of HCC patients exhibited anti-HBC antibodies, versus 47.5% of cirrhotic subjects with no tumor and 7.1% of controls. Such results suggest the possible role of HCV in the etiopathogenesis of HCC, and its possible synergy with other agents-e.g., hepatitis B virus, alcohol--in causing chronically injured hepatocytes to become neoplastic

Consensus document on controversial issues in the diagnosis and treatment of bloodstream infections and endocarditis.

Summary Background The treatment of severe bloodstream infections (sepsis, endocarditis, and infections of vascular prostheses) caused by Gram-positive microorganisms is made even more difficult by the emergence of resistant strains. The introduction of new antibiotics with activity against these strains has created new opportunities, but many controversial issues remain. Controversial issues The aim of this GISIG (Gruppo Italiano di Studio sulle Infezioni Gravi) working group – a panel of multidisciplinary experts – was to define recommendations for some controversial issues using an evidence-based and analytical approach. The controversial issues concerned the duration of therapy and role of aminoglycosides and teicoplanin in the treatment of Gram-positive bacterial endocarditis, the optimal use of the new antibiotics in the treatment of bloodstream infections caused by resistant Gram-positive strains, and the use of microbiological techniques (i.e., bactericidal serum testing and synergy testing) and of pharmacokinetic data (e.g., monitoring of plasma levels of antibiotics) in the treatment of difficult-to-treat Gram-positive bloodstream infections. Methods A systematic literature search of randomized controlled trials and/or non-randomized studies was performed mainly using the MEDLINE database. A matrix was created to extract evidence from original studies using the CONSORT method to evaluate randomized clinical trials and the Newcastle–Ottawa Quality Assessment Scale for non-randomized studies. The GRADE method for grading the quality of evidence and strength of recommendation was applied

Factores de riesgo cardiometabólicos y su relación con el consumo de alimentos fuente de ácidos grasos omega 3 en humanos

Introducción: las enfermedades cardiometabólicas (ECM) presentan elevada prevalencia global. El consumo de alimentos fuente de ácidos grasos omega 3 (AG n3) ha sido asociado a mejoras en marcadores de riesgo de ECM. Objetivo: analizar la asociación entre el consumo de alimentos fuente de AG n3 y la presencia de factores de riesgo cardiometabólicos. Material y métodos: estudio descriptivo, correlacional y transversal. Participaron voluntarios mayores de 35 años asistentes al Servicio de Cardiología del Hospital Nacional de Clínicas, Córdoba. Se aplicó historia clínica, cuestionario de frecuencia de consumo alimentario validado, medidas antropométricas y determinaciones bioquímicas séricas. La información alimentario-nutricional se analizó utilizando el programa informático Interfood v.1.3. Los participantes se agruparon según alcanzaran/superaran (G1) o no (G2) la media de consumo de alimentos fuente de AG n3, para analizar los factores de riesgo aplicando los test de Wilcoxon o Kruskal Wallis. Resultados: El 47% de los participantes presentó sobrepeso y el 53% circunferencia de cintura con riesgo muy aumentado. El 59% presentó hiperglucemia en ayunas, el 11% hipercolesterolemia, el 56% HDL-c deseables y el 63% trigliceridemia normal. El 74% niveles de PCR bajos. El consumo promedio total de alimentos fuentes de AG n3 fue bajo, 6,59 ± 16,64 g/día. No se observaron diferencias estadísticamente significativas en los factores de riesgo de ECM entre G1 y G2. Conclusión: Se observa elevada prevalencia de sobrepeso y obesidad abdominal, con bajo consumo de alimentos cardioprotectores necesarios para la prevención y tratamiento de ECM

Individual Particle Characteristics, Optical Properties and Evolution of an Extreme Long‐Range Transported Biomass Burning Event in the European Arctic (Ny‐Ålesund, Svalbard Islands)

This paper reports an exceptional biomass burning (BB) advection event from Alaska registered at Ny‐Ålesund from 10 to 17 July 2015 with particular interest on the influence of the airborne particle characteristics on the optical properties of the aerosol during the event. To this purpose we considered two DEKATI 12‐stage aerosol samples spanning the entire advection and analyzed them by scanning electron microscopy techniques. Aerosol chemical data and microphysical properties were also evaluated in order to correlate any change of individual particle characteristics with the bulk properties of the aerosol. The results of individual particle analysis depict a complex event characterized by a first phase (P1) of massive input of BB carbonaceous particles (i.e., tar balls, popcorn refractory particles, and organic particles), and by a second phase (P2) dominated by inorganic salts. The peculiar feature of this BB event is the exceptionally large grain size of the subspherical organic particles at the beginning of the event with respect to the background. At these conditions a significant increase of the scattering efficiency may occur even for a small increase of the size parameter. Results of the simulation of the complex refractive indices (n‐ik) confirm this evaluation. Aerosol evolution during the event resulted from the combination of three distinct occurrences: (a) progressive rotation of air mass circulation toward non‐BB source areas, (b) development of a thick fog layer in the planetary boundary layer, and (c) sea salt spray direct advection of local/regional provenance

A multi-society position paper on the prevention and management of nosocomial and severe infections: the Italian Society for Infectious Diseases, the Italian Multidisciplinary Society of Hospital Infections, the Italian Society of Chemotherapy, the Italian Society of Respiratory Medicine, the Italian Society of Clinical Microbiology, the Italian Society of Microbiology, and GISIG (Italian Study Group on Severe Infections)

Amulti-society position paper on the prevention and management of nosocomial and severe infections: the Italian Society for Infectious Diseases, the Italian Multidisciplinary Society of Hospital Infections, the Italian Society of Chemotherapy, the Italian Society of Respiratory Medicine, the Italian Society of Clinical Microbiology, the Italian Society of Microbiology, and GISIG (Italian Study Group on Severe Infections

Consensus document on controversial issues for the treatment of infections of the central nervous system: bacterial brain abscesses

Summary Background Bacterial brain abscesses remain a serious central nervous system problem despite advances in neurosurgical, neuroimaging, and microbiological techniques and the availability of new antibiotics. The successful treatment of brain abscesses requires surgery, appropriate antibiotic therapy, and eradication of the primary source; nevertheless many controversial issues on the management of this serious infection remain unresolved. Controversial issues The aim of this GISIG (Gruppo Italiano di Studio sulle Infezioni Gravi) working group – a panel of multidisciplinary experts – was to define recommendations for some controversial issues using an evidence-based and analytical approach. The controversial issues were: (1) Which patients with bacterial brain abscesses can be managed safely using medical treatment alone? (1a) What is the efficacy in terms of outcome, tolerability, cost/efficacy, and quality of life of the different antibiotic regimens used to treat bacterial cerebral abscesses? (1b) Which antibiotics have the best pharmacokinetics and/or tissue penetration of brain and/or brain abscess? 2) What is the best surgical approach in terms of outcome in managing bacterial brain abscesses? Results are presented and discussed in detail. Methods A systematic literature search using the MEDLINE database for the period 1988 to 2008 of randomized controlled trials and/or non-randomized studies was performed. A matrix was created to extract evidence from original studies using the CONSORT method to evaluate randomized clinical trials and the Newcastle–Ottawa Quality Assessment Scale for case–control studies, longitudinal cohorts, and retrospective studies. The GRADE method for grading quality of evidence and strength of recommendation was applied