Enteral versus parenteral nutrition in critically ill patients: an updated systematic review and meta-analysis of randomized controlled trials

Subgroup analysis comparing the effect of enteral versus parenteral nutrition on infectious complications in higher versus lower quality trials (with the median methodological score 7 as cutoff). CI confidence interval, EN enteral nutrition, M-H Mantel-Haenszel test, PN parenteral nutrition. (PDF 87 kb

Adaptation and diagnostic potential of a commercial cat interferon gamma release assay for the detection of Mycobacterium bovis infection in African lions (Panthera leo)

CITATION: Gumbo, R. et al. 2022. Adaptation and diagnostic potential of a commercial cat interferon gamma release assay for the detection of Mycobacterium bovis infection in African lions (Panthera leo). Pathogens, 11:765, doi:10.3390/pathogens11070765.The original publication is available at https://www.mdpi.comMycobacterium bovis (M. bovis) infection in wildlife, including lions (Panthera leo), has implications for individual and population health. Tools for the detection of infected lions are needed for diagnosis and disease surveillance. This study aimed to evaluate the Mabtech Cat interferon gamma (IFN-γ) ELISABasic kit for detection of native lion IFN-γ in whole blood samples stimulated using the QuantiFERON® TB Gold Plus (QFT) platform as a potential diagnostic assay. The ELISA was able to detect lion IFN-γ in mitogen-stimulated samples, with good parallelism, linearity, and a working range of 15.6–500 pg/mL. Minimal matrix interference was observed in the recovery of domestic cat rIFN-γ in lion plasma. Both intra- and inter-assay reproducibility had a coefficient of variation less than 10%, while the limit of detection and quantification were 7.8 pg/mL and 31.2 pg/mL, respectively. The diagnostic performance of the QFT Mabtech Cat interferon gamma release assay (IGRA) was determined using mycobacterial antigen-stimulated samples from M. bovis culture-confirmed infected (n = 8) and uninfected (n = 4) lions. A lion-specific cut-off value (33 pg/mL) was calculated, and the sensitivity and specificity were determined to be 87.5% and 100%, respectively. Although additional samples should be tested, the QFT Mabtech Cat IGRA could identify M. bovisinfected African lions.https://www.mdpi.com/2076-0817/11/7/765Publisher's versio

A clinical review of the treatment of catatonia

Catatonia is a severe motor syndrome with an estimated prevalence among psychiatric inpatients of about 10%. At times, it is life-threatening especially in its malignant form when complicated by fever and autonomic disturbances. Catatonia can accompany many different psychiatric illnesses and somatic diseases. In order to recognize the catatonic syndrome, apart from thorough and repeated observation, a clinical examination is needed. A screening instrument, such as the Bush-Francis Catatonia Rating Scale, can guide the clinician through the neuropsychiatric examination. Although severe and life-threatening, catatonia has a good prognosis. Research on the treatment of catatonia is scarce, but there is overwhelming clinical evidence of the efficacy of benzodiazepines, such as lorazepam, and electroconvulsive therapy

Integrated genomic characterization of oesophageal carcinoma

Oesophageal cancers are prominent worldwide; however, there are few targeted therapies and survival rates for these cancers remain dismal. Here we performed a comprehensive molecular analysis of 164 carcinomas of the oesophagus derived from Western and Eastern populations. Beyond known histopathological and epidemiologic distinctions, molecular features differentiated oesophageal squamous cell carcinomas from oesophageal adenocarcinomas. Oesophageal squamous cell carcinomas resembled squamous carcinomas of other organs more than they did oesophageal adenocarcinomas. Our analyses identified three molecular subclasses of oesophageal squamous cell carcinomas, but none showed evidence for an aetiological role of human papillomavirus. Squamous cell carcinomas showed frequent genomic amplifications of CCND1 and SOX2 and/or TP63, whereas ERBB2, VEGFA and GATA4 and GATA6 were more commonly amplified in adenocarcinomas. Oesophageal adenocarcinomas strongly resembled the chromosomally unstable variant of gastric adenocarcinoma, suggesting that these cancers could be considered a single disease entity. However, some molecular features, including DNA hypermethylation, occurred disproportionally in oesophageal adenocarcinomas. These data provide a framework to facilitate more rational categorization of these tumours and a foundation for new therapies

Energy expenditure and protein catabolism in ventilated trauma patients, the effect of head injury and neuromuscular blockade

grantor: University of TorontoEnergy expenditure (EE) and nitrogen excretion (NE) were compared in trauma patients with and without severe head injury. Indirect calorimetry was used to measure energy expenditure (MEE) in 18 head injured (HI), (GCS $\leq$ 8), and 14 multiple trauma patients (TR), (ISS of 17-59), while ventilated, on and off pancuronium within the first 13 days of injury. Urinary nitrogen losses from urea and creatinine were measured daily. Average EE (off pancuronium) was 28.7 $\pm$ 4.6 vs. 24.5 $\pm$ 4.5 kcal/kg/day in HI vs TR patients (NS). With pancuronium, EE in the HI group was 22.8 $\pm$ 3.7 kcal/kg/day (p = 0.006). Comparison of average NE and nitrogen balance respectively, between HI and TR groups were not significant, 200 $\pm$ 53 vs. 208 $\pm$ 60 mg/kg/day (t = 0.23), and $-$91 $\pm$ 6 vs. $-$137 $\pm$ 6 mg/kg/day (p = 0.061). We conclude that there were no significant differences in EE or NE between HI and TR patients. Pancuronium use significantly lowers EE to basal levels in HI patients.M.Sc

A Novel Synthesis of p-Nitrobenzylphosphonic Acid and Its Action on Alkaline Phosphatase

p-Nitrobenzylphosphonic acid was obtained via a nucleophilic substitution of nitrobenzyl bromide with trimethyl phosphite as opposed to nitration of benzylphosphonic acid. This compound is a competitive inhibitor of alkaline phosphatase (KI ∼ 125 μM) and has potential to inhibit a wide range of other phosphatases including serine/threonine phosphatases and tyrosine phosphatases

Wolbachia and its influence on the pathology and immunology of Dirofilaria immitis infection

Since the definitive identification in 1995 of the bacterial endosymbiont Wolbachia that resides in different tissues of the filarial worm Dirofilaria immitis, there has been increasing interest to understand whether and what role it plays in the pathogenesis of and immune response to heartworm infection. The present study evaluated the effects of treatments on lung pathology in 20 beagle dogs experimentally infected with D. immitis. Dogs in Group 1 were treated with doxycycline (10 mg/kg/day) orally from weeks 0–6, 10–12, 16–18, 22–26, and 28–34. Dogs in Group 2 served as infected, non-treated controls. Dogs in Group 3 were given doxycycline as described for Group 1 combined with weekly oral doses of ivermectin (6 mcg/kg) for 34 weeks and intramuscular (IM) melarsomine (2.5 mg/kg) at week 24, followed by two additional melarsomine injections 24 h apart 1 month later. Group 4 received only melarsomine as described for Group 3. Lung lesion criteria, scored by two independent blinded pathologists, included perivascular inflammation and endothelial proliferation. Doxycycline treatment alone had no effect on lesion scores, whereas the combination of doxycycline and ivermectin resulted in less severe perivascular inflammation. All lungs were evaluated for positive immunostaining for the Wolbachia surface protein (WSP). Control dogs showed numerous thrombi, intense perivascular and interstitial inflammation and, occasionally, positive staining for WSP. Interestingly, dogs receiving doxycycline/ivermectin/melarsomine showed significantly less severe arterial lesions and the virtual absence of thrombi