19 research outputs found
Clinical care pathway program versus open-access system: a study on appropriateness, quality, and efficiency in the delivery of colonoscopy in the colorectal cancer
Open-access colonoscopy (OAC), whereby the colonoscopy is performed without a prior office visit with a gastroenterologist, is affected by inappropriateness which leads to overprescription and reduced availability of the procedure in case of alarming symptoms. The clinical care pathway (CCP) is a healthcare management tool promoted by national health systems to organize work-up of various morbidities. Recently, we started a CCP dedicated to colorectal cancer (CRC), including a colonoscopy session for CRC diagnosis and prevention. We aimed to evaluate the appropriateness, the quality, and the efficiency in the delivery of colonoscopy with the open-access system and a CCP program in the CRC. Quality indicators for colonoscopy in subjects in the CCP were compared to referrals by general practitioners (OAC) or by non-gastroenterologist physicians (non-gastroenterologist physician colonoscopy, NGPC). Attendance rate to colonoscopy was greater in the CCP group and NGPC group than in the OAC group (99%, 99%, and 86%, respectively). Waiting time in the CCP group was shorter than in the OAC group (3.88 ± 2.27 vs. 32 ± 22.31 weeks, respectively). Appropriateness of colonoscopy prescription was better in the CCP group than in the OAC group (92 vs. 50%, respectively). OAC is affected by the lack of timeliness and low appropriateness of prescription. A CCP reduces the number of inappropriate colonoscopies, especially for post-polypectomy surveillance, and improves the delivery of colonoscopy in patients requiring a fast-track examination. The high rate of inappropriate OAC suggests that this modality of healthcare should be widely reviewed
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
La técnica de la microgota como alternativa para el recuento de Azospirillum spp. dentro del protocolo de la Red de Control de Calidad de Inoculantes (REDCAI)
La evaluaciĂłn de la calidad de los inoculantes comerciales es fundamental para garantizar una adecuada respuesta de los cultivos a la inoculaciĂłn dentro de un marco de bioseguridad. En este sentido, el objetivo de este trabajo fue la estandarizaciĂłn y validaciĂłn de la tĂ©cnica de la microgota para la cuantificaciĂłn de Azospirillum como metodologĂa alternativa a la tĂ©cnica de siembra en superficie, propuesta actualmente en el protocolo consenso de la Red de Calidad de Inoculantes, REDCAI. Entre 14 y 25 laboratorios, tanto privados como pĂșblicos, participaron de tres ensayos independientes. A partir de ellos se obtuvieron resultados reproducibles y robustos que permiten confirmar que ambas tĂ©cnicas son equivalentes y concluir que la tĂ©cnica de recuento por la microgota es una alternativa adecuada para ser incluida dentro del mencionado protocolo consenso.Quality evaluation of commercial inoculants is essential to warrant an adequate crop response to inoculation within a biosecurity framework. In this sense, this work is aimed at standardizing and validating the drop plate method for the enumeration of Azospirillum viable cells as an alternative to the spread plate technique, which is currently proposed in the consensus protocol of the REDCAI network. Between 14 and 25 private and public laboratories participated in three independent trials. We obtained consistent and robust results that allowed to confirm that both techniques are equivalent, concluding that the drop plate method is an alternative enumeration technique that is adequate to be included in the abovementioned consensus protocol.Fil: Di Salvo, Luciana Paula. Universidad de Buenos Aires. Facultad de AgronomĂa. Departamento de BiologĂa Aplicada y Alimentos. CĂĄtedra de MicrobiologĂa AgrĂcola; Argentina. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas; ArgentinaFil: GarcĂa, Julia E.. Instituto Nacional de TecnologĂa Agropecuaria. Centro de InvestigaciĂłn en Ciencias Veterinarias y AgronĂłmicas. Instituto de MicrobiologĂa y ZoologĂa AgrĂcola; ArgentinaFil: Puente, Mariana Laura. Instituto Nacional de TecnologĂa Agropecuaria. Centro de InvestigaciĂłn en Ciencias Veterinarias y AgronĂłmicas. Instituto de MicrobiologĂa y ZoologĂa AgrĂcola; ArgentinaFil: Amigo, Josefina Alejandra. Universidad Nacional de TucumĂĄn. Facultad de AgronomĂa y Zootecnia. Departamento de EcologĂa. CĂĄtedra de MicrobiologĂa AgrĂcola; ArgentinaFil: Anriquez, Analia Liliana. Universidad Nacional de Santiago del Estero; Argentina. Universidad Nacional de Santiago del Estero. Facultad de AgronomĂa y Agroindustrias; ArgentinaFil: Barlocco, Claudia. Instituto Nacional de InvestigaciĂłn Agropecuaria; UruguayFil: Benintende, Silvia Mercedes. Universidad Nacional de Entre RĂos. Facultad de Ciencias Agropecuarias; ArgentinaFil: Bochatay, Tatiana. BASF Agricultural Specialities S.A.; ArgentinaFil: Bortolato, Marta Alejandra. Universidad Nacional de Rosario. Facultad de Ciencias Agrarias; ArgentinaFil: Cassan, Fabricio Dario. Universidad Nacional de RĂo Cuarto. Facultad de Ciencias Exactas FisicoquĂmicas y Naturales. Instituto de Investigaciones AgrobiotecnolĂłgicas. - Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Centro CientĂfico TecnolĂłgico Conicet - CĂłrdoba. Instituto de Investigaciones AgrobiotecnolĂłgicas; ArgentinaFil: Ramirez Castaño, Carolina. Universidad Nacional de La Pampa. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Catafesta, Melina. Bio Nova; ArgentinaFil: Coniglio, Nayla AnahĂ. Universidad Nacional de RĂo Cuarto. Facultad de Ciencias Exactas FisicoquĂmicas y Naturales. Instituto de Investigaciones AgrobiotecnolĂłgicas. - Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Centro CientĂfico TecnolĂłgico Conicet - CĂłrdoba. Instituto de Investigaciones AgrobiotecnolĂłgicas; ArgentinaFil: DĂaz, Marisa. Rizobacter Argentina; ArgentinaFil: Galian, Liliana Rosa. Universidad Nacional de Lomas de Zamora. Facultad de Ciencias Agrarias; ArgentinaFil: Gallace, MarĂa Eugenia. Universidad Nacional de La Pampa. Facultad de AgronomĂa. Recursos Naturales; Argentina. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Centro CientĂfico TecnolĂłgico Conicet - Patagonia Confluencia; ArgentinaFil: Garcia, Patricia Graciela. Universidad Nacional de La Pampa. Facultad de Ciencias Exactas y Naturales; Argentina. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Centro CientĂfico TecnolĂłgico Conicet - Patagonia Confluencia; ArgentinaFil: GarcĂa de Salamone, InĂ©s E.. Universidad de Buenos Aires. Facultad de AgronomĂa. Departamento de BiologĂa Aplicada y Alimentos. CĂĄtedra de MicrobiologĂa AgrĂcola; ArgentinaFil: Landa, Marianela. Ministerio de Agricultura, GanaderĂa, Pesca y Alimento. Servicio Nacional de Sanidad y Calidad Agroalimentaria; ArgentinaFil: Liernur, GermĂĄn. No especifĂca;Fil: Maneiro, MarĂa Laura. Rizobacter Argentina S.A.; ArgentinaFil: Massa, Rosana. Stoller Biociencias S.R.L.; ArgentinaFil: Malinverni, Julieta. Ministerio de Agricultura, GanaderĂa, Pesca y Alimento. Servicio Nacional de Sanidad y Calidad Agroalimentaria; ArgentinaFil: Marchessi, Nicolas Carlos. Universidad Nacional de Lomas de Zamora. Facultad de Ciencias Agrarias; ArgentinaFil: Monteleone, Emilia. Nitrasoil Argentina S.A.; ArgentinaFil: Oviedo, Silvina. Rizobacter Argentina S.A.; ArgentinaFil: Pobliti, Lucrecia. Barenbrug Argentina; ArgentinaFil: Portela, Gabriela Rut. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de AgronomĂa; ArgentinaFil: Radovancich, DĂ©bora. Laformed S.A.; ArgentinaFil: Righes, Silvia. Marketing AgrĂcola S.R.L.; Argentin
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.
Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.
Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05â2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001).
Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication
Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study
Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28â2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65â3·22], p\textless0·0001), American Society of Anesthesiologists grades 3â5 versus grades 1â2 (2·35 [1·57â3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01â2·39], p=0·046), emergency versus elective surgery (1·67 [1·06â2·63], p=0·026), and major versus minor surgery (1·52 [1·01â2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research
Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic
This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic
MDM4/HIPK2/p53 cytoplasmic assembly uncovers coordinated repression of molecules with anti-apoptotic activity during early DNA damage response
The p53 inhibitor, MDM4 (MDMX) is a cytoplasmic protein with p53-activating function under DNA damage conditions. Particularly, MDM4 promotes phosphorylation of p53 at Ser46, a modification that precedes different p53 activities. We investigated the mechanism by which MDM4 promotes this p53 modification and its consequences in untransformed mammary epithelial cells and tissues. In response to severe DNA damage, MDM4 stimulates p53Ser46P by binding and stabilizing serine-threonine kinase HIPK2. Under these conditions, the p53-inhibitory complex, MDM4/MDM2, dissociates and this allows MDM4 to promote p53/HIPK2 functional interaction. Comparative proteomic analysis of DNA damage-treated cells versus - untreated cells evidenced a diffuse downregulation of proteins with anti-apoptotic activity, some of which were targets of p53Ser46P/HIPK2 repressive activity. Importantly, MDM4 depletion abolishes the downregulation of these proteins indicating the requirement of MDM4 to promote p53-mediated transcriptional repression. Consistently, MDM4-mediated HIPK2/p53 activation precedes HIPK2/p53 nuclear translocation and activity. Noteworthy, repression of these proteins was evident also in mammary glands of mice subjected to.-irradiation and was significantly enhanced in transgenic mice overexpressing MDM4. This study evidences the flexibility of MDM2/MDM4 heterodimer, which allows the development of a positive activity of cytoplasmic MDM4 towards p53-mediated transcriptional function. Noteworthy, this activity uncovers coordinated repression of molecules with shared anti-apoptotic function which precedes active cell apoptosis and that are frequently overexpressed and/or markers of tumour phenotype in human cancer
Olanzapine therapy in anorexia nervosa: psychobiological effects
Dopamine impairments occur in anorexia nervosa. The aim of this study was to see whether treatment with the atypical dopamine antagonist antipsychotic olanzapine improves the disorder. Thirty anorexics, 18 restricted and 12 bingeing-purging, underwent a 3-month course of cognitive behavioral therapy, plus at random and double-blinded oral olanzapine (2.5 mg for 1 month, 5 mg for 2 months) in half and oral placebo in the other half of them. BMI, psychopathological aspects (eating disorder inventory, Hamilton Rating Scale, Buss-Durkee Rating Scale, Yale Brown Cornell for Eating Disorders Rating Scale, temperament-character inventory), and homovanillic acid blood concentrations for dopamine secretion, were monitored at baseline and then monthly during the trial. At the end of the trial BMI, total eating disorder inventory, total Yale Brown Cornell for Eating Disorders Rating Scale, Buss-Durkee Rating Scale, Hamilton Rating Scale scores and in olanzapine-treated patients the subitems of eating disorder inventory ineffectiveness and maturity fear, of Buss-Durkee Rating Scale direct aggressiveness, of temperament-characteristic inventory persistence had improved significantly. When stratified for anorexia nervosa subtype, BMI changes were significant among anorexia nervosa bingeing-purging patient, 'depression' (Hamilton Rating Scale) and 'direct aggressiveness' (Buss-Durkee Rating Scale) among anorexia nervosa bingeing-purging patients, 'persistence' (temprerament-characteristic inventory), among anorexics restricted patients, with a trend toward significance for obsessivity-compulsivity (Yale Brown Cornell for Eating Disorders Rating Scale). homovanilic acid blood levels increased significantly in the cognitive behavioral therapy+olanzapine group. No correlations were observed between homovanilic acid concentrations and psychopathological parameters. The pharmacological treatment can significantly improve specific aspects of anorexia nervosa
Multiparametric ultrasonography and ultrasound elastography in the differentiation of parathyroid lesions from ectopic thyroid lesions or lymphadenopathies
To evaluate the accuracy of ultrasound elastography with ElastoscanTM Core Index in the differential diagnosis of parathyroid lesions from ectopic thyroid nodules and lymph nodes. Seventy nine patients with repeatedly high levels of circulating intact parathyroid hormone, normal vitamin D and renal function tests, with an ultrasound scan showing a neck lesion, sharply demarcated from the thyroid lobules, were consecutively enrolled. Ultrasound with and without Color Doppler and ultrasound elastography were performed before histological examination. All ultrasound features, vascularization and ultrasound elastography diagnostic performance were assessed using ROC curves. Histological examination confirmed 47 parathyroid lesions, 18 thyroid ectopic nodules and 14 reactive lymph nodes. In distinguishing parathyroid from thyroid nodules, shape had a 100 % sensitivity (95 % CI 92.4â100) and 50 % specificity (95 % CI 37.2â64.7), cleavage had a 85.1 % sensitivity (95 % CI 72.3â92.6) and 77.8 % specificity (95 % CI 65.1â88) while peripheral vascularization had a sensitivity of 91.5 (95 % CI 79.6â97.6) and specificity of 72.2 (95 % CI 46.5â90.3). An ElastoscanTM Core Indexof 1.28 was 46 % sensitive (95 % CI 33.4â58.7) and 77 % specific (95 % CI 66.2â89.1) in discriminating parathyroid lesions from thyroid nodules. An ElastoscanTM Core Index of 1.0 was 78 % sensitive (95 % CI 65.1â88) and 71 % specific (95 % CI 56â81.3) in discriminating parathyroid lesions from lymph nodes (p = 0.045). An ElastoscanTM Core Index greater than 2.58 had a 100 % sensitivity (95 % CI 43.8â100) and 95.4 % specificity (95 % CI 38.3â99.7) in discriminating malignant from benign parathyroid nodules. ElastoscanTM Core Index was significantly higher in thyroid nodules than in reactive lymph nodes (1.18 ± 0.62, p = 0.008). The ultrasound features of cleavage and peripheral vascularization help to differentiate parathyroid from thyroid nodules. ElastoscanTM Core Index can improve ultrasound discrimination of parathyroid lesions from lymph nodes. The ElastoscanTM Core Index is significantly higher in malignant than in benign parathyroid lesionsTo evaluate the accuracy of ultrasound elastography with Elastoscan(TM) Core Index in the differential diagnosis of parathyroid lesions from ectopic thyroid nodules and lymph nodes. Seventy nine patients with repeatedly high levels of circulating intact parathyroid hormone, normal vitamin D and renal function tests, with an ultrasound scan showing a neck lesion, sharply demarcated from the thyroid lobules, were consecutively enrolled. Ultrasound with and without Color Doppler and ultrasound elastography were performed before histological examination. All ultrasound features, vascularization and ultrasound elastography diagnostic performance were assessed using ROC curves. Histological examination confirmed 47 parathyroid lesions, 18 thyroid ectopic nodules and 14 reactive lymph nodes. In distinguishing parathyroid from thyroid nodules, shape had a 100â% sensitivity (95â% CI 92.4-100) and 50â% specificity (95â% CI 37.2-64.7), cleavage had a 85.1â% sensitivity (95â% CI 72.3-92.6) and 77.8â% specificity (95â% CI 65.1-88) while peripheral vascularization had a sensitivity of 91.5 (95â% CI 79.6-97.6) and specificity of 72.2 (95â% CI 46.5-90.3). An Elastoscan(TM) Core Indexof 1.28 was 46â% sensitive (95â% CI 33.4-58.7) and 77â% specific (95â% CI 66.2-89.1) in discriminating parathyroid lesions from thyroid nodules. An Elastoscan(TM) Core Index of 1.0 was 78â% sensitive (95â% CI 65.1-88) and 71â% specific (95â% CI 56-81.3) in discriminating parathyroid lesions from lymph nodes (pâ=â0.045). An Elastoscan(TM) Core Index greater than 2.58 had a 100â% sensitivity (95â% CI 43.8-100) and 95.4â% specificity (95â% CI 38.3-99.7) in discriminating malignant from benign parathyroid nodules. Elastoscan(TM) Core Index was significantly higher in thyroid nodules than in reactive lymph nodes (1.18â±â0.62, pâ=â0.008). The ultrasound features of cleavage and peripheral vascularization help to differentiate parathyroid from thyroid nodules. Elastoscan(TM) Core Index can improve ultrasound discrimination of parathyroid lesions from lymph nodes. The Elastoscan(TM) Core Index is significantly higher in malignant than in benign parathyroid lesions
Protocol for the Quality Control of Azospirillum spp. Inoculants
Azospirillum has been one of the most studied genera of plant growth promoting rhizobacteria (PGPR) worldwide over the past 50 years. The use of these microorganisms in agriculture practices has been adopted due to their ability to associate in rhizospheric, epiphytic, or endophytic ways with roots and promote whole plant growth or crop productivity. The biological treatment of seeds (inoculation) in more than a hundred species of economic or ecological interest has become a common practice in many countries. In Argentina, the Az39 strain of Azospirillum brasilense, belonging to the Culture Collection of the Instituto de MicrobiologĂ-a y ZoologĂ-a AgrĂ-cola (IMYZA) of INTA Castelar, was selected in the 1980s after an intensive program to isolate and identify microorganisms for agriculture, according to their agronomic behavior. Since then, its ability to cover the premise for which it was selected has determined that Az39 is largely adopted by inoculant companies in Argentina with the aim of producing biological products for the treatment of several crops. In this chapter, those methods developed and standardized by the network Red de Control de Calidad de Inoculantes (REDCAI) of the AsociaciĂłn Argentina de MicrobiologĂ-a (AAM) have been adapted as a guide for the quantification of Azospirillum spp. and the detection of contaminating microorganisms in biological products, as two of the most basic and important quality control parameters of inoculants.Fil: Cassan, Fabricio Dario. Universidad Nacional de RĂo Cuarto; ArgentinaFil: Penna, Claudio. No especifĂca;Fil: Creus, Cecilia MĂłnica. Universidad Nacional de Mar del Plata; Argentina. Instituto Nacional de TecnologĂa Agropecuaria. Centro Regional Buenos Aires Sur. EstaciĂłn Experimental Agropecuaria Balcarce; ArgentinaFil: Radovanicich, DĂ©bora. No especifĂca;Fil: Monteleone, Emilia. No especifĂca;Fil: GarcĂa de Salamone, InĂ©s. Universidad de Buenos Aires. Facultad de AgronomĂa. Departamento de BiologĂa Aplicada y Alimentos. CĂĄtedra de MicrobiologĂa AgrĂcola; ArgentinaFil: Di Salvo, Luciana Paula. Universidad de Buenos Aires. Facultad de AgronomĂa. Departamento de BiologĂa Aplicada y Alimentos. CĂĄtedra de MicrobiologĂa AgrĂcola; Argentina. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas; ArgentinaFil: Mentel, Maria Isabel. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Centro CientĂfico TecnolĂłgico Conicet - TucumĂĄn. Planta Piloto de Procesos Industriales MicrobiolĂłgicos; ArgentinaFil: GarcĂa, Julia. Instituto Nacional de TecnologĂa Agropecuaria. Centro de InvestigaciĂłn en Ciencias Veterinarias y AgronĂłmicas. Instituto de MicrobiologĂa y ZoologĂa AgrĂcola; ArgentinaFil: Pasarello Mayans, MarĂa del Carmen. Ministerio de Agricultura GanaderĂa y Pesca de la NaciĂłn; ArgentinaFil: Lett, Lina AnalĂa Carola. Universidad Nacional del Centro de la Provincia de Buenos Aires; ArgentinaFil: Puente, Mariana Laura. Instituto Nacional de TecnologĂa Agropecuaria. Centro de InvestigaciĂłn en Ciencias Veterinarias y AgronĂłmicas. Instituto de MicrobiologĂa y ZoologĂa AgrĂcola; ArgentinaFil: Correa, Olga Susana. Universidad de Buenos Aires. Facultad de AgronomĂa. Departamento de BiologĂa Aplicada y Alimentos. CĂĄtedra de MicrobiologĂa AgrĂcola; ArgentinaFil: Punschke Valerio, Karina. Ministerio de Agricultura GanaderĂa y Pesca de la NaciĂłn; ArgentinaFil: Massa, Rosana. No especifĂca;Fil: Catafesta, Melina. No especifĂca;Fil: Rossi, Alejandro Marcelo. No especifĂca;Fil: DĂaz, Marisa. No especifĂca;Fil: Righes, SIlvia. No especifĂca;Fil: Carletti, Susana Margarita. Universidad Nacional de LujĂĄn; ArgentinaFil: RodrĂguez CĂĄceres, Enrique. No especifĂca