Sources of Dietary Protein in Relation to Blood Pressure in a General Dutch Population

Background - Little is known about the relation of different dietary protein types with blood pressure (BP). We examined whether intake of total, plant, animal, dairy, meat, and grain protein was related to BP in a cross sectional cohort of 20,820 Dutch adults, aged 20–65 y and not using antihypertensive medication. Design - Mean BP levels were calculated in quintiles of energy-adjusted protein with adjustment for age, sex, BMI, education, smoking, and intake of energy, alcohol, and other nutrients including protein from other sources. In addition, mean BP difference after substitution of 3 en% carbohydrates or MUFA with protein was calculated. Results - Total protein and animal protein were not associated with BP (ptrend = 0.62 and 0.71 respectively), both at the expense of carbohydrates and MUFA. Systolic BP was 1.8 mmHg lower (ptrend36 g/d) than in the lowest

Επισκόπηση ζιζανίων σε αμπελώνες Επαρχίας Λεμεσού

Από τα πιο σημαντικά, αν όχι το πιο σημαντικό πρόβλημα στη γεωργία σήμερα αποτελεί η παρουσία των ζιζανίων στις καλλιέργειες. Η εμφάνιση τους σε γεωργικές καλλιέργειες τα καθιστά ένα από τα πιο δυσεπίλυτα προβλήματα για τους παραγωγούς σήμερα. Η παρουσία τους οδηγεί σε άνισο ανταγωνισμό με τα καλλιεργούμενα φυτά σε θρεπτικά στοιχεία, φως, χώρο και νερό. Σ όλες τις χώρες τα ζιζάνια αποτελούν βασικό πρόβλημα στη γεωργία, έτσι και στη μικρή αλλά γεωργική Κύπρο, τα ζιζάνια δεν μπορούσαν να μην προκαλούν σοβαρές ζημιές. Σκοπός της παρούσας μελέτης ήταν η επιτόπια επισκόπηση καθώς και η καταγραφή σε αντιπροσωπευτικά εδαφοδείγματα από κάθε περιοχή των ζιζανίων σε αμπελώνες της επαρχίας Λεμεσού, σε πεδινές και ημιορεινές περιοχές. Πραγματοποιήθηκε επιτόπια επισκόπηση σε 4 διαφορετικές περιοχές ( δύο πεδινές και δύο ημιορεινές) σε δύο ή τρεις διαφορετικές εποχές. Από κάθε περιοχή, πάρθηκαν τυχαία δείγματα εδάφους, από 4-5 αγρούς της κάθε περιοχής, βάθους 0-30 οπι, σε 5 σημεία σε κάθε αγρό, σε απόσταση περίπου 100 πι μεταξύ τους. Τα μικτά δείγματα από κάθε αγρό μεταφέρθηκαν στο εργαστήριο, τοποθετήθηκαν σε φυτοδοχεία (30 χ 5 οπι) όπου έγινε βλάστηση και καταγραφή ζιζανίων για τρεις διαδοχικές περιόδους, διάρκειας ενός μήνα η κάθε μια. Μεταξύ των καταγραφών μεσολαβούσε διάστημα 15 ημερών και αναμόχλευση του εδάφους. Στην επιτόπια επισκόπηση των ζιζανίων στους πιο πάνω αμπελώνες καταγράφηκαν συνολικά 24 διαφορετικά είδη ζιζανίων από τα οποία τα 20 ήταν πλατύφυλλα και τα 4 αγρωστώδη. Στα εδαφοδείγματα στο εργαστήριο παρατηρήθηκαν συνολικά 22 είδη ζιζανίων εκ των οποίων τα 20 ήταν πλατύφυλλα και τα 2 αγρωστώδη. Τα ζιζάνια με τη μεγαλύτερη συχνότητα από τα πλατύφυλλα ήταν το πορφυρό λάμιο, η στελλάρια και η τσουκνίδα με συχνότητα 3/4 (αριθμός χωριών με παρουσία του ζιζανίου). Από τα αγρωστώδη τα ζιζάνια με την μεγαλύτερη συχνότητα ήταν η ήρα 4/4

National laboratory-based surveillance system for antimicrobial resistance: a successful tool to support the control of antimicrobial resistance in the Netherlands

An important cornerstone in the control of antimicrobial resistance (AMR) is a well-designed quantitative system for the surveillance of spread and temporal trends in AMR. Since 2008, the Dutch national AMR surveillance system, based on routine data from medical microbiological laboratories (MMLs), has developed into a successful tool to support the control of AMR in the Netherlands. It provides background information for policy making in public health and healthcare services, supports development of empirical antibiotic therapy guidelines and facilitates in-depth research. In addition, participation of the MMLs in the national AMR surveillance network has contributed to sharing of knowledge and quality improvement. A future improvement will be the implementation of a new semantic standard together with standardised data transfer, which will reduce errors in data handling and enable a more real-time surveillance. Furthermore, the

Dietary Protein and Blood Pressure: A Systematic Review

Background - Elevated blood pressure (BP), which is a major risk factor for cardiovascular disease, is highly prevalent worldwide. Recently, interest has grown in the role of dietary protein in human BP. We performed a systematic review of all published scientific literature on dietary protein, including protein from various sources, in relation to human BP. Methodology/Principal Findings - We performed a MEDLINE search and a manual search to identify English language studies on the association between protein and blood pressure, published before June 2010. A total of 46 papers met the inclusion criteria. Most observational studies showed no association or an inverse association between total dietary protein and BP or incident hypertension. Results of biomarker studies and randomized controlled trials indicated a beneficial effect of protein on BP. This beneficial effect may be mainly driven by plant protein, according to results in observational studies. Data on protein from specific sources (e.g. from fish, dairy, grain, soy, and nut) were scarce. There was some evidence that BP in people with elevated BP and/or older age could be more sensitive to dietary protein. Conclusions/Significance - In conclusion, evidence suggests a small beneficial effect of protein on BP, especially for plant protein. A blood pressure lowering effect of protein may have important public health implications. However, this warrants further investigation in randomized controlled trials. Furthermore, more data are needed on protein from specific sources in relation to BP, and on the protein-BP relation in population subgroup

Routinely available antimicrobial susceptibility information can be used to increase the efficiency of screening for carbapenemase-producing .

Introduction. Increased carbapenem resistance is often caused by carbapenemase production.Aim. The objective of our study was to assess which antibiotic susceptibility patterns, as tested by automated systems, are highly associated with the absence of carbapenemase production in Enterobacteriaceae isolates, and could therefore be used as a screening tool.Methodology. Routine antibiotic susceptibility testing data from 42 medical microbiology laboratories in the Netherlands in the period between January 2011 and June 2017 were obtained from the national antimicrobial resistance surveillance programme. Data on Enterobacteriaceae isolates that had an elevated minimum inhibitory concentration (MIC) for carbapenems (meropenem >0.25 mg l-1 or imipenem >1.0 mg l-1) were selected and subjected to phenotypic or genotypic carbapenemase production testing. Routinely available amoxicillin/clavulanic acid, piperacillin/tazobactam, cefuroxime and ceftriaxone/cefotaxime susceptibilities were studied in relation to carbapenemase production by calculating the negative predictive value.Results. No evidence for carbapenemase-producing Enterobacteriaceae (CPE) was found in 767 of 1007 (76 %) isolates. The negative predictive value was highest for amoxicillin/clavulanic acid (99.6 %) and piperacillin/tazobactam (98.8 %).Conclusion.Enterobacteriaceae isolates with elevated carbapenem MICs that are susceptible to amoxicillin/clavulanic acid or piperacillin/tazobactam are unlikely to be carbapenemase producers. Preselection based on this susceptibility pattern may lead to increased laboratory efficiency and reduction of costs. Whether this is also true for countries with a different distribution of CPE species and types or a higher prevalence of CPE needs to be studied

New methodology to assess the excess burden of antibiotic resistance using country-specific parameters: a case study regarding E. coli urinary tract infections

Objectives Antimicrobial resistant (AMR) infections are a major public health problem and the burden on population level is not yet clear. We developed a method to calculate the excess burden of resistance which uses country-specific parameter estimates and surveillance data to compare the mortality and morbidity due to resistant infection against a counterfactual (the expected burden if infection was antimicrobial susceptible). We illustrate this approach by estimating the excess burden for AMR (defined as having tested positive for extended-spectrum beta-lactamases) urinary tract infections (UTIs) caused by E. coli in the Netherlands in 2018, which has a relatively low prevalence of AMR E. coli, and in Italy in 2016, which has a relatively high prevalence.Design Excess burden was estimated using the incidence-based disability-adjusted life-years (DALYs) measure. Incidence of AMR E. coli UTI in the Netherlands was derived from ISIS-AR, a national surveillance system that includes tested healthcare and community isolates, and the incidence in Italy was estimated using data reported in the literature. A systematic literature review was conducted to find country-specific parameter estimates for disability duration, risks of progression to bacteraemia and mortality.Results The annual excess burden of AMR E. coli UTI was estimated at 3.89 and 99.27 DALY/100 0000 population and 39 and 2786 excess deaths for the Netherlands and Italy, respectively.Conclusions For the first time, we use country-specific and pathogen-specific parameters to estimate the excess burden of resistant infections. Given the large difference in excess burden due to resistance estimated for Italy and for the Netherlands, we emphasise the importance of using country-specific parameters describing the incidence and disease progression following AMR and susceptible infections that are pathogen specific, and unfortunately currently difficult to locate