Prevention of fish photobacteriosis. Comparison of the efficacy of intraperitoneally administered commercial and experimental vaccines

Two commercial multivalent vaccines against vibriosis, caused by Vibrio anguillarum serotype(s) and photobacteriosis, caused by Photobacterium damsela subsp. piscicida, one with oil adjuvant (AJ) and the other,being an aqueous solution (AV), and an experimental monovalent (Ph. damselae subsp. piscicida) vaccine inactivated with formalin or heat, namely EVF and EVH, were tested in laboratory trials on sea bass (Dicentrarchus labrax) in respect to their efficacy against experimentally induced photobacteriosis. The first trial aiming at high bacterial pressure was carried out 34 days post-vaccination and resulted in 90% mortalities in the control. The relative per cent survival (RPS) of vaccinated fish was calculated at 24, 3.7, 0 and 0 for the AJ, AV, EVF and EVH formulations, respectively. The second trial aiming at medium bacterial pressure was carried out 49 days post-vaccination and resulted in 45% mortalities in the control. The relative per cent survival (RPS) of vaccinated fish was calculated at 100, 92.7, 77.8 and 66.7 for the AJ, EVF, EVH and AV, formulations, respectively. Apparently, under both these high and medium bacterial pressure conditions, the commercial vaccine AJ performed better than the commercial vaccine AV, while under medium pressure there was no statistical difference between the performance of EVF and AJ. The measurement of specific antibody titers in sera collected from all fish groups 49 days post-vaccination, showed high levels in the fish vaccinated with the AJ vaccine, almost three times lower levels for the AV and EVF vaccines and even lower levels for the EVH vaccine. Results are discussed in respect to the choices mariculture companies have in selecting a commercial vaccine against photobacteriosis and possible alternatives, which, if commercially developed, may reduce vaccine cost

Surgical Management of Cervical Spondyloarthropathy in Hemodialysis Patients

Dialysis-related spondyloarthropathy is a rare cause of spinal deformity and cervical myelopathy. Optimal management of cervical spine spondyloarthropathy often requires circumferential reconstructive surgery, because affected patients typically have both the anterior column and the facet joints compromised. The occasional presence of noncontiguous or "skip lesions" adds an additional level of complexity to surgical management, because decompression and fusion in an isolated segment of neural compression can worsen spine deformity by applying increased stress to adjacent cervical spine segments. We report two cases of hemodialysis patients who presented with cervical myelopathy and initially had anterior cervical discectomy or corpectomy. Because symptoms recurred due to hardware failure, both patients required posterior spine fusion as well. In retrospect, because of the hardware failure, both of these patients might have benefited from a circumferential (combined anterior and posterior) cervical spine reconstruction as their initial treatment

Exploring the views of infection consultants in England on a novel delinked funding model for antimicrobials: the SMASH study

OBJECTIVES: A novel 'subscription-type' funding model was launched in England in July 2022 for ceftazidime/avibactam and cefiderocol. We explored the views of infection consultants on important aspects of the delinked antimicrobial funding model. METHODS: An online survey was sent to all infection consultants in NHS acute hospitals in England. RESULTS: The response rate was 31.2% (235/753). Most consultants agreed the model is a welcome development (69.8%, 164/235), will improve treatment of drug-resistant infections (68.5%, 161/235) and will stimulate research and development of new antimicrobials (57.9%, 136/235). Consultants disagreed that the model would lead to reduced carbapenem use and reported increased use of cefiderocol post-implementation. The presence of an antimicrobial pharmacy team, requirement for preauthorization by infection specialists, antimicrobial stewardship ward rounds and education of infection specialists were considered the most effective antimicrobial stewardship interventions. Under the new model, 42.1% (99/235) of consultants would use these antimicrobials empirically, if risk factors for antimicrobial resistance were present (previous infection, colonization, treatment failure with carbapenems, ward outbreak, recent admission to a high-prevalence setting).Significantly higher insurance and diversity values were given to model antimicrobials compared with established treatments for carbapenem-resistant infections, while meropenem recorded the highest enablement value. Use of both 'subscription-type' model drugs for a wide range of infection sites was reported. Respondents prioritized ceftazidime/avibactam for infections by bacteria producing OXA-48 and KPC and cefiderocol for those producing MBLs and infections with Stenotrophomonas maltophilia, Acinetobacter spp. and Burkholderia cepacia. CONCLUSIONS: The 'subscription-type' model was viewed favourably by infection consultants in England

Exploring the views of infection consultants in England on a novel delinked funding model for antimicrobials: the SMASH study

OBJECTIVES: A novel ‘subscription-type’ funding model was launched in England in July 2022 for ceftazidime/avibactam and cefiderocol. We explored the views of infection consultants on important aspects of the delinked antimicrobial funding model. METHODS: An online survey was sent to all infection consultants in NHS acute hospitals in England. RESULTS: The response rate was 31.2% (235/753). Most consultants agreed the model is a welcome development (69.8%, 164/235), will improve treatment of drug-resistant infections (68.5%, 161/235) and will stimulate research and development of new antimicrobials (57.9%, 136/235). Consultants disagreed that the model would lead to reduced carbapenem use and reported increased use of cefiderocol post-implementation. The presence of an antimicrobial pharmacy team, requirement for preauthorization by infection specialists, antimicrobial stewardship ward rounds and education of infection specialists were considered the most effective antimicrobial stewardship interventions. Under the new model, 42.1% (99/235) of consultants would use these antimicrobials empirically, if risk factors for antimicrobial resistance were present (previous infection, colonization, treatment failure with carbapenems, ward outbreak, recent admission to a high-prevalence setting). Significantly higher insurance and diversity values were given to model antimicrobials compared with established treatments for carbapenem-resistant infections, while meropenem recorded the highest enablement value. Use of both ‘subscription-type’ model drugs for a wide range of infection sites was reported. Respondents prioritized ceftazidime/avibactam for infections by bacteria producing OXA-48 and KPC and cefiderocol for those producing MBLs and infections with Stenotrophomonas maltophilia, Acinetobacter spp. and Burkholderia cepacia. CONCLUSIONS: The ‘subscription-type’ model was viewed favourably by infection consultants in England

Defining the optimal dietary approach for safe, effective and sustainable weight loss in overweight and obese adults

Various dietary approaches with different caloric content and macronutrient composition have been recommended to treat obesity in adults. Although their safety and efficacy profile has been assessed in numerous randomized clinical trials, reviews and meta-analyses, the characteristics of the optimal dietary weight loss strategy remain controversial. This mini-review will provide general principles and practical recommendations for the dietary management of obesity and will further explore the components of the optimal dietary intervention. To this end, various dietary plans are critically discussed, including low-fat diets, low-carbohydrate diets, high-protein diets, very low-calorie diets with meal replacements, Mediterranean diet, and diets with intermittent energy restriction. As a general principle, the optimal diet to treat obesity should be safe, efficacious, healthy and nutritionally adequate, culturally acceptable and economically affordable, and should ensure long-term compliance and maintenance of weight loss. Setting realistic goals for weight loss and pursuing a balanced dietary plan tailored to individual needs, preferences, and medical conditions, are the key principles to facilitate weight loss in obese patients and most importantly reduce their overall cardiometabolic risk and other obesity-related comorbidities. © 2018 by the authors. Licensee MDPI, Basel, Switzerland

Orthodontic journals with impact factors in perspective: trends in the types of articles and authorship characteristics

The purposes of this study were to analyze the types of articles and their authorship characteristics in the 3 orthodontic journals with impact factors--American Journal of Orthodontics and Dentofacial Orthopedics (AJODO), Angle Orthodontist (AO), and European Journal of Orthodontics (EJO)--during 2 intervals of 5 years each (1993-1997 and 1998-2002) and to assess the changes in their contents during these periods.; The results of 3004 article entries were analyzed with the Pearson chi-square test, and the examination of the variability of the parameters studied among journals and across the 2 time intervals was performed at the 0.05 level of significance.; Significant differences were found between the journals with respect to the research component of articles (higher in the EJO) and case reports (higher in the AJODO and the AO). For each journal, differences were also identified between the 2 time intervals, with multi-authored papers and multiple affiliations appearing more frequently in the second interval. The contributions of articles from the United States and Canada to the AJODO and the AO were statistically higher than to the EJO. A similar trend was found for articles from Europe, which comprise more than 70% of the content of the EJO. An increased contribution of articles from East Asia and Oceania was noted in the second time interval, which reached almost 100% of the previous time frame. The potential sources of variation in the studied parameters are discussed