Remission of Kimura disease with carotid hypervascularization after cyclosporine treatment

No abstract available

Biofilm production and antibiotic resistance of human and veterinary Staphylococcus strains.

Staphylococcus spp. is widely distributed in medical and veterinary pathology and represents one of the most important causes of infection. Many strains are antibiotic-resistant even for the presence of an eso-polysaccharide matrix. The aim of this work was to individuate, among 396 different Staphylococci of human and animal origin, the slime producing strains and to correlate the presence of biofilm to the resistance to eight antibiotics. A total of 185 coagulase negative staphylococci (CNS) and 211 S. aureus isolated from different sources and identified with Sceptor System, were tested for antibiotic susceptibility (Kirby Bauer method) and for slime production (Polystyrene plates – stained with Alcian blue – Spectrophotometric reading at 450 nm). The strains were classified as weak, strong and no slime-producing on the basis of OD results. The results were submitted to statistical analysis using Student’s t-test and chi-square tests. Evaluating the differences of slime production among medical and veterinary strains, we found different statistical frequencies (P > 0.001). No statistical differences wereobtained between S. aureus and the other CNS. Instead, the statistical analysis on S. epidermidis vs. the other staphylococci has shown no statistical differences among average values using Student’s ttest (P < 0.052) and significant frequency differences using chi square tests (P < 0.02). Finally in the CNS, between S. epidermidis and the other strains, no statistical differences were found. The relation between slime production and the origin of strains was evaluated and no correlation was found. About the correlation between antibiotic-resistance and slime production a resistance increment of about 30% was obtained in strongly slime producing strains. Staphylococcus spp. is often involved in nosocomial infections as complication of post-surgery wounds, catheters and orthopaedic devices. The presence of antibiotic-resistant strains interferes in the therapy successes and seems to be strictly related to biofilm production beyond that genetically acquired. Human and veterinary strains have shown a similar behaviour towards biofilm production and antibiotic-resistance. The results confirm that S. epidermidis is one of the most slime-producer and introduce S. aureus as a new high slime-producer

Management of Acute Kidney Injury and Extracorporeal Blood Purification Therapies During the COVID-19 Pandemic: The Italian SIN-SIAARTI Joint Survey (and Recommendations for Clinical Practice)

Background and aim: The novel coronavirus disease 2019 remains challenging. A large number of hospitalized patients are at a high risk of developing AKI. For this reason, we conducted a nationwide survey to assess the incidence and management of AKI in critically ill patients affected by the SARS-CoV-2 infection. Methods: This is a multicenter, observational, nationwide online survey, involving the Italian Society of Nephrology and the critical care units in Italy, developed in partnership between the scientific societies such as SIN and SIAARTI. Invitations to participate were distributed through emails and social networks. Data were collected for a period of 1 week during the COVID-19 pandemic. Results: A total of 141 responses were collected in the SIN-SIAARTI survey: 54.6% from intensivists and 44.6% from nephrologists. About 19,000 cases of COVID-19 infection have been recorded in hospitalized patients; among these cases, 7.3% had a confirmed acute kidney injury (AKI), of which 82.2% were managed in ICUs. Only 43% of clinicians routinely used the international KDIGO criteria. Renal replacement therapy (RRT) was performed in 628 patients with continuous techniques used most frequently, and oliguria was the most common indication (74.05%). Early initiation was preferred, and RRT was contraindicated in the case of therapeutic withdrawal or in the presence of severe comorbidities or hemodynamic instability. Regional anticoagulation with citrate was the most common choice. About 41.04% of the interviewed physicians never used extracorporeal blood purification therapies (EBPTs) for inflammatory cytokine or endotoxin removal. Moreover, 4.33% of interviewed clinicians used these techniques only in the presence of AKI, whereas 24.63% adopted them even in the absence of AKI. Nephrologists made more use of EBPT, especially in the presence of AKI. HVHF was never used in 58.54% of respondents, but HCO membranes and adsorbents were used in more than 50% of cases. Conclusion: This joint SIN-SIAARTI survey at the Italian Society of Nephrology and the critical care units in Italy showed that, during the COVID-19 pandemic, there was an underestimation of AKI based on the "non-use" of common diagnostic criteria, especially by intensivists. Similarly, the use of specific types of RRT and, in particular, blood purification therapies for immune modulation and organ support strongly differed between centers, suggesting the need for the development of standardized clinical guidelines