Antimicrobial Prophylaxis in Neonates and Children Undergoing Dental, Maxillo-Facial or Ear-Nose-Throat (ENT) Surgery: A RAND/UCLA Appropriateness Method Consensus Study

Surgical site infections (SSIs) represent a potential complication in surgical procedures, mainly because clean/contaminated surgery involves organs that are normally colonized by bacteria. Dental, maxillo-facial and ear-nose-throat (ENT) surgeries are among those that carry a risk of SSIs because the mouth and the first respiratory tracts are normally colonized by a bacterial flora. The aim of this consensus document was to provide clinicians with recommendations on surgical antimicrobial prophylaxis in neonates (<28 days of chronological age) and pediatric patients (within the age range of 29 days–18 years) undergoing dental, maxillo-facial or ENT surgical procedures. These included: (1) dental surgery; (2) maxilla-facial surgery following trauma with fracture; (3) temporo-mandibular surgery; (4) cleft palate and cleft lip repair; (5) ear surgery; (6) endoscopic paranasal cavity surgery and septoplasty; (7) clean head and neck surgery; (8) clean/contaminated head and neck surgery and (9) tonsillectomy and adenoidectomy. Due to the lack of pediatric data for the majority of dental, maxillo-facial and ENT surgeries and the fact that the recommendations for adults are currently used, there is a need for ad hoc studies to be rapidly planned for the most deficient areas. This seems even more urgent for interventions such as those involving the first airways since the different composition of the respiratory microbiota in children compared to adults implies the possibility that surgical antibiotic prophylaxis schemes that are ideal for adults may not be equally effective in children

Lead-DBS v3.0: Mapping Deep Brain Stimulation Effects to Local Anatomy and Global Networks.

Following its introduction in 2014 and with support of a broad international community, the open-source toolbox Lead-DBS has evolved into a comprehensive neuroimaging platform dedicated to localizing, reconstructing, and visualizing electrodes implanted in the human brain, in the context of deep brain stimulation (DBS) and epilepsy monitoring. Expanding clinical indications for DBS, increasing availability of related research tools, and a growing community of clinician-scientist researchers, however, have led to an ongoing need to maintain, update, and standardize the codebase of Lead-DBS. Major development efforts of the platform in recent years have now yielded an end-to-end solution for DBS-based neuroimaging analysis allowing comprehensive image preprocessing, lead localization, stimulation volume modeling, and statistical analysis within a single tool. The aim of the present manuscript is to introduce fundamental additions to the Lead-DBS pipeline including a deformation warpfield editor and novel algorithms for electrode localization. Furthermore, we introduce a total of three comprehensive tools to map DBS effects to local, tract- and brain network-levels. These updates are demonstrated using a single patient example (for subject-level analysis), as well as a retrospective cohort of 51 Parkinson's disease patients who underwent DBS of the subthalamic nucleus (for group-level analysis). Their applicability is further demonstrated by comparing the various methodological choices and the amount of explained variance in clinical outcomes across analysis streams. Finally, based on an increasing need to standardize folder and file naming specifications across research groups in neuroscience, we introduce the brain imaging data structure (BIDS) derivative standard for Lead-DBS. Thus, this multi-institutional collaborative effort represents an important stage in the evolution of a comprehensive, open-source pipeline for DBS imaging and connectomics

Vaccinazioni tra vere e false informazioni

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Immune response to Hepatitis B vaccine in patients with celiac disease: A systematic review and meta-analysis

It is debated whether patients with celiac disease (CD) have non-protective antibody responses to HBV vaccination more frequently than non-affected subjects. To perform a literature review and meta-analysis on protective response to HBV vaccination in CD patients. RCTs and observational controlled studies were eligible. Outcome of interest was an anti-HBs (HBsAb) titer 6510 IU/L after last vaccine dose. Comparative index was rate ratio (RR). Heterogeneity between studies was addressed and funnel plots were analyzed. Meta-regression models were applied to investigate effect size due to study-specific variables. Twelve retrospective studies on a total of 1,447 participants and 4 prospective studies on 184 subjects were selected. The RR was 0.732 (95% C.I.: 0.664-0.808) and 0.777 (95% C.I.: 0.629-0.960) in the prospective and retrospective studies, respectively. The I(2), indicating heterogeneity, was 51.1% in retrospective, 39.8% in prospective studies. Non-protective antibody responses occurred more frequently in patients than controls. Due to limitations in the available studies, additional trials to evaluate post-vaccination HBsAb titer in CD patients are needed

Nervous System and psychiatric disorders with ketamine (ab)use: an analysis of the WHO global individual case reports database (VigiBase)

Ketamine is an anaesthetic drug with dissociative, analgesic and psychedelic properties. The dissociative experience is pleasurable to some and has led to ketamine gaining in popularity as a recreational drug. Like all medicines, ketamine may have adverse drug reactions (ADRs). These can be spontaneously reported and then collected in an international database. The aim of study is to analyze reports in WHO Global Individual Case Safety Reports (ICSR) database (VigiBase)to understand in which cases ketamine was non-medical used and was abused

Profilo di sicurezza dose-dipendente della ketamina: analisi del database dell'OMS.

La ketamina \ue8 un farmaco anestetico il cui uso ricreazionale \ue8 aumentato nel corso degli anni. Recenti ricerche hanno inoltre dimostrato che la singola somministrazione di ketamina a dosaggio sub-anestetico induce un rapido effetto antidepressivo. Lo scopo dello studio \ue8 stato quello di caratterizzare il profilo di sicurezza dose-dipendente della ketamina soprattutto relativamente al suo utilizzo a basso dosaggio in modo da avere un riferimento per i futuri farmaci ketamina-like

Hexavalent vaccine and strabismus: data from the Italian spontaneous reporting system

Strabismus is a visual problem in which the eyes are not aligned properly and point in different directions.It is a common condition among children since about 4% of them have strabismus.Single reports of strabismus associated to palsy of cranial nerves attributed to vaccines have been reported2, none of them related to hexavalent vaccine.Strabismus is not reported in the Summary Product Information (SPC) of hexavalent vaccine. Twenty-six cases of strabismus are present in the database, 17 of them related to hexavalent vaccine

Hexavalent vaccine and strabismus: data from the Italian spontaneous reporting system

Strabismus is a visual problem in which the eyes are not aligned properly and point in different directions.It is a common condition among children since about 4% of them have strabismus.Single reports of strabismus associated to palsy of cranial nerves attributed to vaccines have been reported2, none of them related to hexavalent vaccine.Strabismus is not reported in the Summary Product Information (SPC) of hexavalent vaccine. Twenty-six cases of strabismus are present in the database, 17 of them related to hexavalent vaccine