Association of Cutibacterium avidum Colonization in the Groin With Obesity: A Potential Risk Factor for Hip Periprosthetic Joint Infection

Background An increase in the incidence of hip periprosthetic joint infections (PJIs) caused by Cutibacterium avidum has recently been detected after implantation of hip arthroplasties with an anterior surgical approach. We raised the question of whether skin colonization with C. avidum differs between the anterior and the lateral thigh as areas of surgical incision fields. Methods Between February and June 2017, we analyzed skin scrapings from the groin and the anterior and lateral thigh in all patients undergoing a primary hip arthroplasty. We anaerobically cultured plated swabs for Cutibacterium spp. for at least 7 days. Univariate logistic regression analysis was used to explore associations between body mass index (BMI) and colonization rate at different sites. Results Twenty-one of 65 patients (32.3%) were colonized with C. avidum at any side, mainly at the groin (n=16, 24.6%), which was significantly higher than at the anterior (n=5, 7.7%, P= 0.009) or lateral (n=6, 9.2%) thigh (P=0.019). Patients colonized with C. avidum did not differ in age or sex compared to non-colonized patients, but BMI was significantly higher (30.1 kg/m2 and 25.6 kg/m2, respectively, P=0.019). Furthermore, increased BMI was associated with colonization at the groin (odds ratio per unit BMI increase: 1.15, 95% confidence interval: 1.03-1.29, P=0.014). Conclusions The groin, rather than the anterior thigh, showed colonization for C. avidum in obese patients. Further studies are needed to evaluate current skin disinfection and draping protocols for hip arthroplasty surgeries, in particular in obese patients

Age-related striatal BOLD changes without changes in behavioral loss aversion

Loss aversion (LA), the idea that negative valuations have a higher psychological impact than positive ones, is considered an important variable in consumer research. The literature on aging and behavior suggests older individuals may show more LA, although it is not clear if this is an effect of aging in general (as in the continuum from age 20 and 50 years), or of the state of older age (e.g., past age 65 years). We also have not yet identified the potential biological effects of aging on the neural processing of LA. In the current study we used a cohort of subjects with a 30 year range of ages, and performed whole brain functional MRI (fMRI) to examine the ventral striatum/nucleus accumbens (VS/NAc) response during a passive viewing of affective faces with model-based fMRI analysis incorporating behavioral data from a validated approach/avoidance task with the same stimuli. Our a priori focus on the VS/NAc was based on (1) the VS/NAc being a central region for reward/aversion processing; (2) its activation to both positive and negative stimuli; (3) its reported involvement with tracking LA. LA from approach/avoidance to affective faces showed excellent fidelity to published measures of LA. Imaging results were then compared to the behavioral measure of LA using the same affective faces. Although there was no relationship between age and LA, we observed increasing neural differential sensitivity (NDS) of the VS/NAc to avoidance responses (negative valuations) relative to approach responses (positive valuations) with increasing age. These findings suggest that a central region for reward/aversion processing changes with age, and may require more activation to produce the same LA behavior as in younger individuals, consistent with the idea of neural efficiency observed with high IQ individuals showing less brain activation to complete the same task

CAST constraints on the axion-electron coupling

In non-hadronic axion models, which have a tree-level axion-electron interaction, the Sun produces a strong axion flux by bremsstrahlung, Compton scattering, and axiorecombination, the "BCA processes." Based on a new calculation of this flux, including for the first time axio-recombination, we derive limits on the axion-electron Yukawa coupling gae and axion-photon interaction strength ga using the CAST phase-I data (vacuum phase). For ma <~ 10 meV/c2 we find ga gae < 8.1 × 10−23 GeV−1 at 95% CL. We stress that a next-generation axion helioscope such as the proposed IAXO could push this sensitivity into a range beyond stellar energy-loss limits and test the hypothesis that white-dwarf cooling is dominated by axion emission

Sistema de réguas milimetradas para análise da proporção áurea dentária (RMAPAD) no planejamento e execução de fechamento de diastemas: Millimeter rulers system for dental golden ratio analysis (RMAPAD) in the planning and execution of diastema closure

Diastema é a denominação dada ao espaço presente entre os elementos dentais, que pode ocorrer tanto na arcada superior como na inferior. O planejamento para fechamento de diastema, envolve muitos fatores, entre eles a proporção áurea dentária. O presente trabalho tem como objetivo relatar o planejamento e execução de um caso de fechamento de diastemas, utilizando um inovador sistema de réguas disponível no mercado. Paciente feminino, 21 anos de idade, procurou atendimento na Residência de Dentística da Universidade Estadual de Londrina com queixa principal dos amplos espaços presentes entre seus dentes. Após exame clínico associado aos complementares foi realizado o planejamento com o auxílio do sistema de Réguas Milimetradas para Análise da Proporção Áurea Dentária (RMAPAD) e assim proposto o fechamento dos espaços por meio de facetas diretas com resina composta. Após a execução do caso clínico, planejado com o sistema RMAPAD, concluimos que foi possível a reanatomização e fechamento dos diastemas de forma harmônica

Piotórax felino por Klebisiella spp. – Relato de caso: Feline pyothorax by Klebisiella spp. - Case report

Piotórax ou empiema torácico, é definido como o acúmulo de exsudato purulento no espaço pleural. Estima-se que 80% dos casos de piotórax em felinos sejam causados por infecções por bactérias anaeróbias obrigatórias e ou aeróbias. Disseminação hematogênica ou linfática, inoculação direta através de uma ferida de mordida penetrante, migração parasitária, disseminação parapneumônica e migração de corpo estranho são as possíveis condições nas quais os felinos desenvolvem a doença. Assim, o objetivo deste estudo foi descrever as características clínicas, radiográficas e citológicas de um caso de piotórax felino. Foi atendido um felino, macho, PCB, de 5 anos de idade, com queixa principal de prostração e anorexia. No exame físico o animal apresentava-se dispneico. Foi realizado análise hematológica que revelou leucocitose com neutrofilia e desvio a esquerda regenerativo. No raio X observou-se aumento da radiopacidade homogênea da porção cranial e média da cavidade torácica com conteúdo de radiopacidade de água no espaço pleural e obliteração dos limites da silhueta cardíaca. Foi realizada toracocentese e no exame citológico da amostra havia grande quantidade de neutrófilos degenerados, com macrófagos e bactérias fagocitadas. O diagnóstico de piotórax nesse caso baseou-se nas alterações radiográficas, que indicaram efusão pleural; no exame citológico e na cultura do fluido obtido na toracocentese. O diagnóstico de piotórax em pequenos animais é geralmente direto e deve ser considerado em qualquer paciente que apresente exame clínico indicativo de doença do espaço pleural. Os exames de imagem torácicos podem ser utilizados para dar suporte ao diagnóstico de derrame pleural; porém, o exame citológico ou cultura do líquido pleural são necessários para o diagnóstico definitivo da doença

Bibliometric analysis of academic journal recommendations and requirements for surgical and anesthesiologic adverse events reporting.

BACKGROUND Standards for reporting surgical adverse events vary widely within the scientific literature. Failure to adequately capture adverse events hinders efforts to measure the safety of healthcare delivery and improve the quality of care. The aim of the present study is to assess the prevalence and typology of perioperative adverse event reporting guidelines among surgery and anesthesiology journals. MATERIALS AND METHODS In November 2021, three independent reviewers queried journal lists from the SCImago Journal & Country Rank (SJR) portal (www.scimagojr.com), a bibliometric indicator database for surgery and anesthesiology academic journals. Journal characteristics were summarized using SCImago, a bibliometric indicator database extracted from Scopus journal data. Quartile 1 (Q1) was considered the top quartile and Q4 bottom quartile based on the journal impact factor. Journal author guidelines were collected to determine whether adverse event reporting recommendations were included and, if so, the preferred reporting procedures. RESULTS Of 1,409 journals queried, 655 (46.5%) recommended surgical adverse event reporting. Journals most likely to recommend adverse event reporting were: 1) by category surgery (59.1%), urology (53.3%), and anesthesia (52.3%); 2) in top SJR quartiles (i.e. more influential); 3) by region, based in Western Europe (49.8%), North America (49.3%), and the Middle East (48.3%). CONCLUSIONS Surgery and anesthesiology journals do not consistently require or provide recommendations on perioperative adverse event reporting. Journal guidelines regarding adverse event reporting should be standardized and are needed to improve the quality of surgical adverse event reporting with the ultimate goal of improving patient morbidity and mortality

Respiratory Virus Infection and Risk of Invasive Meningococcal Disease in Central Ontario, Canada

BACKGROUND: In temperate climates, invasive meningococcal disease (IMD) incidence tends to coincide with or closely follow peak incidence of influenza virus infection; at a seasonal level, increased influenza activity frequently correlates with increased seasonal risk of IMD. METHODS: We evaluated 240 cases of IMD reported in central Ontario, Canada, from 2000 to 2006. Associations between environmental and virological (influenza A, influenza B and respiratory syncytial virus (RSV)) exposures and IMD incidence were evaluated using negative binomial regression models controlling for seasonal oscillation. Acute effects of weekly respiratory virus activity on IMD risk were evaluated using a matched-period case-crossover design with random directionality of control selection. Effects were estimated using conditional logistic regression. RESULTS: Multivariable negative binomial regression identified elevated IMD risk with increasing influenza A activity (per 100 case increase, incidence rate ratio = 1.18, 95% confidence interval (CI): 1.06, 1.31). In case-crossover models, increasing weekly influenza A activity was associated with an acute increase in the risk of IMD (per 100 case increase, odds ratio (OR)  = 2.03, 95% CI: 1.28 to 3.23). Increasing weekly RSV activity was associated with increased risk of IMD after adjusting for RSV activity in the previous 3 weeks (per 100 case increase, OR = 4.31, 95% CI: 1.14, 16.32). No change in disease risk was seen with increasing influenza B activity. CONCLUSIONS: We have identified an acute effect of influenza A and RSV activity on IMD risk. If confirmed, these finding suggest that influenza vaccination may have the indirect benefit of reducing IMD risk

Effectiveness and safety of tocilizumab in patients with systemic sclerosis : a propensity score matched controlled observational study of the EUSTAR cohort

Objectives Tocilizumab showed trends for improving skin fibrosis and prevented progression of lung fibrosis in systemic sclerosis (SSc) in randomised controlled clinical trials. We aimed to assess safety and effectiveness of tocilizumab in a real-life setting using the European Scleroderma Trial and Research (EUSTAR) database. Methods Patients with SSc fulfilling the American College of Rheumatology (ACR)/EULAR 2013 classification criteria, with baseline and follow-up visits at 12±3 months, receiving tocilizumab or standard of care as the control group, were selected. Propensity score matching was applied. Primary endpoints were the modified Rodnan skin score (mRSS) and FVC at 12±3 months compared between the groups. Secondary endpoints were the percentage of progressive/regressive patients for skin and lung at 12±3 months. Results Ninety-three patients with SSc treated with tocilizumab and 3180 patients with SSc with standard of care fulfilled the inclusion criteria. Comparison between groups did not show significant differences, but favoured tocilizumab across all predefined primary and secondary endpoints: mRSS was lower in the tocilizumab group (difference -1.0, 95% CI -3.7 to 1.8, p=0.48). Similarly, FVC % predicted was higher in the tocilizumab group (difference 1.5 (-6.1 to 9.1), p=0.70). The percentage of progressive/regressive patients favoured tocilizumab over controls. These results were robust regarding the sensitivity analyses. Safety analysis confirmed previously reported adverse event profiles. Conclusion Although this large, observational, controlled, real-life EUSTAR study did not show significant effectiveness of tocilizumab on skin and lung fibrosis, the consistency of direction of all predefined endpoints generates hypothesis for potential effectiveness in a broader SSc population

Sorption of steroidal hormones by electrodialysis membranes

Article in Press (Corrected Proof) - first available online 21 September 2010.The mechanisms of sorption of four steroidal hormones – estradiol, estrone, progesterone and testosterone – to electrodialysis (ED) membranes were investigated as a function of solution pH and presence of humic acid (HA). Hormone-membrane partition coefficients (log KAEM/CEM) determined through sorption isotherm experiments suggested that hormone sorption was due to hydrogen bonding and cation–π interactions between hormone and membrane functional groups. Progesterone sorption at pH 7 (922 μg/cm3) during ED was greater than estrone sorption (591 μg/cm3) due to its greater cation-exchange membrane (CEM) bonding affinity. Estrone sorption at pH 11 (487 μg/cm3) was reduced due to estrone dissociation and electrostatic repulsion with negatively charged CEMs. Permeation of estrone (30–100 ng/cm2 h) through the anion-exchange membranes (AEMs) was observed. At pH 11, charge repulsion between estrone and HA coupled with AEM electrostatic attraction resulted in increased sorption. Partial membrane desorption was noted in isotherm (20–30%) and ED desorption (3.8%) experiments and was dependent on the initial mass sorbed, solution pH and resultant electrostatic interactions