A vanguard randomised feasibility trial comparing three regimens of peri-operative oxygen therapy on recovery after major surgery.

International recommendations encourage liberal administration of oxygen to patients having surgery under general anaesthesia, ostensibly to reduce surgical site infection. However, the optimal oxygen regimen to minimise postoperative complications and enhance recovery from surgery remains uncertain. The hospital operating theatre randomised oxygen (HOT-ROX) trial is a multicentre, patient- and assessor-blinded, parallel-group, randomised clinical trial designed to assess the effect of a restricted, standard care, or liberal peri-operative oxygen therapy regimen on days alive and at home after surgery in adults undergoing prolonged non-cardiac surgery under general anaesthesia. Here, we report the findings of the internal vanguard feasibility phase of the trial undertaken in four large metropolitan hospitals in Australia and New Zealand that included the first 210 patients of a planned overall 2640 trial sample, with eight pre-specified endpoints evaluating protocol implementation and safety. We screened a total of 956 participants between 1 September 2019 and 26 January 2021, with data from 210 participants included in the analysis. Median (IQR [range]) time-weighted average intra-operative Fi O2 was 0.30 (0.26-0.35 [0.20-0.59]) and 0.47 (0.44-0.51 [0.37-0.68]) for restricted and standard care, respectively (mean difference (95%CI) 0.17 (0.14-0.20), p < 0.001). Median time-weighted average intra-operative Fi O2 was 0.83 (0.80-0.85 [0.70-0.91]) for liberal oxygen therapy (mean difference (95%CI) compared with standard care 0.36 (0.33-0.39), p < 0.001). All feasibility endpoints were met. There were no significant patient adverse events. These data support the feasibility of proceeding with the HOT-ROX trial without major protocol modifications.

A systematic review and meta-analysis of prophylactic medication of vestibular migraine.

OBJECTIVE: Vestibular migraine is in the process of recognition as an individual clinical entity. At present, no guidelines exist for its management. This study aimed to conduct a systematic review and meta-analysis to determine the effectiveness of available prophylactic medication. METHOD: A literature search was performed using PubMed, Ovid and Embase databases. Qualitative and quantitative analysis were performed as well as risk of bias analysis. Meta-analysis for the mean differences for pre- and post-treatment impact based on Dizziness Handicap Inventory and Vertigo Symptom Scale were performed. Proportionate transformation meta-analysis for the successful event rate based on complete symptoms control was explored. RESULTS: Thirteen publications were identified: 3 were randomised, controlled trials and 10 were non-randomised, controlled trials. Propranolol and venlafaxine improved the Vertigo Symptom Scale score by -13.31 points and -4.16 points, respectively, and the Dizziness Handicap Inventory score by -32.24 and -21.24, respectively. Only propranolol achieved statistically significant impact with 60 per cent of patients achieving complete symptom control. CONCLUSION: Propranolol should be offered as the first-line treatment for vestibular migraine followed by venlafaxine. Amitriptyline, flunarizine and cinnarizine showed a trend for symptom improvement, but this was not statistically significant.

Comparison of transport crates contamination with Campylobacter spp. before and after the cleaning and disinfection procedure in broiler slaughterhouses.

Campylobacteriosis is one of the most common types of bacterial gastroenteritis affecting humans, and poultry is considered a major source of the causative organism, Campylobacter spp. Broilers may arrive contaminated at slaughterhouses, and transport crates could be considered a potential source of contamination. Thus, cleaning and disinfection procedures are crucial to avoid cross-contamination among flocks. Despite its public health importance in Latin American countries, virulence factors of Campylobacter jejuni remain poorly studied in this region. Thus, this study aimed to: 1) determine the occurrence of contaminated crates at a poultry slaughterhouse, 2) compare the contamination before and after the cleaning and disinfection procedures, and 3) detect virulence-associated genes in C. jejuni strains by PCR. Campylobacter spp. were recovered from 8 of the 10 flocks evaluated, and C. jejuni was detected as the main species. There was no significant difference in the Campylobacter detection or quantification between crates at the reception platform and crates after the cleaning/disinfection processes. However, crates after 24 h of natural drying, presented a significant (P < 0.05) lower amount of Campylobacter cells than before the cleaning and disinfection processes. A negative relationship (R2 = 0.210, P = 0.045) between environmental conditions and Campylobacter quantification was found for transport crates after 24 h of natural drying. There was no significant difference (P > 0.05) in the detection of two C. jejuni virulence genes, flaA (encode a major flagellin protein) and cadF (encode an adhesion and fibronectin-binding protein), among various stages of the cleaning and disinfection processes. Our results demonstrate the high contamination levels of Campylobacter strains in broiler flocks and the potential involvement of poultry transport crates in transmitting these bacteria. This study also suggests that ineffective cleaning and disinfection procedures can increase Campylobacter contamination and facilitate the spread of bacteria in poultry establishments.

Initial Specimen Diversion Device® reduces blood culture contamination and vancomycin use in academic medical centre.

BACKGROUND: In suspected bloodstream infections, accurate blood culture results are critical to timely diagnoses and appropriate antibiotic administration. AIM: An Initial Specimen Diversion Device®, Steripath® (Magnolia Medical Technologies, Seattle, WA, USA) was evaluated for efficacy in reducing blood culture contamination at Brooke Army Medical Center (6.8% six-month contamination rate prior to intervention) in a six-month quality improvement project. METHODS: Blood cultures in the emergency department were collected using either Steripath or the standard method. Blood samples of 20 mL were cultured into an aerobic and anaerobic medium and incubated for five days using an automated microbial detection system immediately after collection. Positive bottles were Gram-stained and plated. Rapid molecular polymerase chain reaction identification was performed on all first positive bottles within a blood culture set for each admission or ED visit. Speciation was deduced during antimicrobial sensitivity testing using the Vitek-2 instrument. FINDINGS: Seven out of 1016 (0.69%) contamination events occurred when using Steripath vs 53 out of 800 (6.6%) contamination events when using the standard method. Steripath use was associated with a 90% lower incidence of blood culture contamination vs the standard method. Post study, Steripath use was implemented as standard practice hospital-wide, and a retrospective data analysis attributed a 31.4% decrease in vancomycin days of therapy to Steripath adoption. CONCLUSION: Using Steripath significantly decreased blood culture contamination events for bacterial bloodstream infections compared to the standard method. Subsequent adoption of Steripath reduced overall vancomycin usage. With widescale implementation Steripath could bolster antibiotic stewardship, mitigating antibiotic resistance caused by unnecessary antibacterial treatments.

Antimicrobial and disinfectant resistance of Salmonella Heidelberg from Brazilian flocks did not increase for ten years (2006-2016)

ABSTRACT: Salmonella is a major cause of foodborne illness worldwide, and poultry and its derived products are the most common food products associated with salmonellosis outbreaks. Some countries, including Brazil, have experienced an increased prevalence of Salmonella Heidelberg among their poultry flocks. Some isolates have also presented high resistance to antimicrobial agents and persist in the poultry farm environment. This study aimed to compare the susceptibility of S. Heidelberg strains isolated in 2006 with those isolated in 2016 against disinfectants and antimicrobial agents. The results showed that all the strains were highly susceptible to sodium hypochlorite, regardless of the conditions and year of isolation. Resistance to benzalkonium chloride varied according to the conditions applied, but not to the year of isolation. Increased antimicrobial resistance from 2006-2016 was observed only for tetracycline. The results suggest that the antimicrobial and disinfectant resistance of S. Heidelberg did not increase for ten years (2006-2016). However, further analysis should include a larger number of S. Heidelberg isolates from poultry origin and additional antimicrobial agents for more precise conclusions about the increasing in antimicrobial resistance in the last years.

RESUMO: Salmonella é uma das principais causas das doenças transmitidas por alimento em todo o mundo, e a carne de frango e produtos derivados são os principais alimentos associados com surtos de salmonelose em humanos. Alguns países, incluindo o Brasil, têm observado um aumento da ocorrência de Salmonella Heidelberg nas suas granjas avícolas. Além disto, alguns isolados têm apresentado alta resistência aos antimicrobianos e têm persistido no ambiente de produção avícola. Neste contexto, o objetivo deste estudo foi comparar a susceptibilidade de cepas de S. Heidelberg isoladas em 2006 com aquelas isoladas em 2016 contra desinfetantes e agentes antimicrobianos. Os resultados demonstraram que as cepas foram altamente resistentes a hipoclorito de sódio, independentemente das condições e do ano de isolamento. A resistência ao cloreto de benzalcônio variou de acordo com as condições testadas, mas não com o ano de isolamento. Um aumento da resistência aos antimicrobianos de 2006 a 2016 foi observado apenas para tetraciclina. Os resultados sugerem que a resistência aos desinfetantes e aos antimicrobianos não aumentou em um período de dez anos (2006-2016). Entretanto, novas análises devem incluir um número maior de cepas de S. Heidelberg isoladas de fontes avícolas e outros agentes antimicrobianos para uma conclusão mais precisa sobre o aumento da resistência antimicrobiana nos últimos anos.

Antimicrobial and disinfectant resistance of Salmonella Heidelberg from Brazilian flocks did not increase for ten years (2006-2016) / A resistência a desinfetantes e a antimicrobianos não aumentou em um período de 10 anos (2006 a 2016) em Salmonella Heidelberg isoladas de granjas avícolas brasileiras

Salmonella is a major cause of foodborne illness worldwide, and poultry and its derived products are the most common food products associated with salmonellosis outbreaks. Some countries, including Brazil, have experienced an increased prevalence of Salmonella Heidelberg among their poultry flocks. Some isolates have also presented high resistance to antimicrobial agents and persist in the poultry farm environment. This study aimed to compare the susceptibility of S. Heidelberg strains isolated in 2006 with those isolated in 2016 against disinfectants and antimicrobial agents. The results showed that all the strains were highly susceptible to sodium hypochlorite, regardless of the conditions and year of isolation. Resistance to benzalkonium chloride varied according to the conditions applied, but not to the year of isolation. Increased antimicrobial resistance from 2006-2016 was observed only for tetracycline. The results suggest that the antimicrobial and disinfectant resistance of S. Heidelberg did not increase for ten years (2006-2016). However, further analysis should include a larger number of S. Heidelberg isolates from poultry origin and additional antimicrobial agents for more precise conclusions about the increasing in antimicrobial resistance in the last years.(AU)

Salmonella é uma das principais causas das doenças transmitidas por alimento em todo o mundo, e a carne de frango e produtos derivados são os principais alimentos associados com surtos de salmonelose em humanos. Alguns países, incluindo o Brasil, têm observado um aumento da ocorrência de Salmonella Heidelberg nas suas granjas avícolas. Além disto, alguns isolados têm apresentado alta resistência aos antimicrobianos e têm persistido no ambiente de produção avícola. Neste contexto, o objetivo deste estudo foi comparar a susceptibilidade de cepas de S. Heidelberg isoladas em 2006 com aquelas isoladas em 2016 contra desinfetantes e agentes antimicrobianos. Os resultados demonstraram que as cepas foram altamente resistentes a hipoclorito de sódio, independentemente das condições e do ano de isolamento. A resistência ao cloreto de benzalcônio variou de acordo com as condições testadas, mas não com o ano de isolamento. Um aumento da resistência aos antimicrobianos de 2006 a 2016 foi observado apenas para tetraciclina. Os resultados sugerem que a resistência aos desinfetantes e aos antimicrobianos não aumentou em um período de dez anos (2006-2016). Entretanto, novas análises devem incluir um número maior de cepas de S. Heidelberg isoladas de fontes avícolas e outros agentes antimicrobianos para uma conclusão mais precisa sobre o aumento da resistência antimicrobiana nos últimos anos.(AU)

Antimicrobial susceptibility, biofilm formation and genetic profiles of Escherichia coli isolated from retail chicken meat.

Brazil is the number one exporter of chicken meat, and this industry maintains constant microbiological vigilance. The objective of this study was to characterize the pathogenicity, antimicrobial resistance (AMR) and the profile of biofilm production of Escherchia coli strains isolated from raw refrigerated cuts of chicken meat sold in retail markets of the four largest poultry companies in Brazil. We collected 150 samples of chicken meat, in order to isolate E. coli and performed susceptibility tests (to amoxicillin associated with clavulanic acid, ceftiofur, enrofloxacin, gentamicin, and trimethoprim + sulfamethoxazole). In addition, the disc approximation test to detect extended spectrum beta-lactamases enzymes (ESBLs) producers was performed. E. coli ability to form biofilm was checked using polystyrene microplates. We also searched for ESBLs genes (blaCTY-M2, blaSHV-1, blaTEM-1, blaCTX-M2, blaOXA-1, blaPSE-1 and AmpC) and adhesion genes (sfa/foc, afa/draB, iha, hrla, fimC, tsh, papC, mat, cr1, felA, fimH and papG) in ESBL-E. coli producers and in those E. coli classified as strongly biofilm formers, respectively. The overall percentage of E. coli isolation was 58.66%, with brand A having the highest percentage (70%), followed by brands D, B and C (60, 53.3 and 50%, respectively). The highest resistance profile was observed for beta-lactams (39.5%), followed by sulfonamide associated to trimethoprim (36.9%) and polymyxin (33.4%). Of the isolates obtained, 77% were non-susceptible to at least one antimicrobial. Brand A showed the highest overall percentage of resistance with 95.23%, followed by brands C (80%), B (75%) and D (69.44%). Overall, 73.86% of the isolates were non susceptible to at least one antibiotic and 36.3% were multiresistants. A total of 17.04% of E. coli strains were identified as ESBLs producers and 70.44% were able to form biofilms (moderate-to-strong). The blaTEM-1 gene was the most prevalent (73.33%), followed by blaSHV-1 (46.66%) and blaCMY-2 (6%). Of the 31 strongly biofilm-forming strains, 26 (83.87%), 24 (77.41%) and 20 (64.51%) expressed fimC, papG and crl genes, respectively. Taken together, our results show that Brazilian chicken meat can be contaminated with E. coli that are non-susceptible to multiple antibiotics, able to form biofilm and showing a diverse repertoire of adhesins linked to pathogenicity depending on the brand evaluated.

Head and neck squamous cell cancer associated with lymphoproliferative malignancies is aggressive.

BACKGROUND: Patients with non-Hodgkin's lymphoma and chronic lymphocytic leukaemia are at an elevated risk of further malignancy. Head and neck squamous cell carcinoma often presents with cervical lymph node metastasis, and can pose a diagnostic challenge in patients with non-Hodgkin's lymphoma or chronic lymphocytic leukaemia who may have pre-existing palpable neck nodes. METHODS: A retrospective case review of a health board was conducted to identify patients with head and neck squamous cell carcinoma with a previous diagnosis of non-Hodgkin's lymphoma or chronic lymphocytic leukaemia. RESULTS: Four patients with head and neck squamous cell carcinoma that developed after non-Hodgkin's lymphoma or chronic lymphocytic leukaemia were identified. Two patients had a background of non-Hodgkin's lymphoma treated with chemotherapy. The remaining two patients had a background of chronic lymphocytic leukaemia under active surveillance. Three out of the four patients died within 30 months of diagnosis. CONCLUSION: Head and neck squamous cell carcinoma following non-Hodgkin's lymphoma or chronic lymphocytic leukaemia is aggressive. A heightened clinical suspicion is essential to facilitate early diagnosis and treatment of head and neck squamous cell carcinoma in patients with dual pathology.

The natural history of canine occult Grade II medial patellar luxation: an observational study.

OBJECTIVES: To determine the risk of lameness and the rate of subsequent medial patellar luxation surgery in dogs that present with occult Grade II medial patellar luxation. MATERIALS AND METHODS: Retrospective owner survey and review of clinical records of adult dogs diagnosed with Grade II medial patellar luxation that were initially asymptomatic and managed non-surgically that had a minimum of 4-year follow-up. Clinical notes and owner questionnaires identified dogs that subsequently developed lameness and required surgery on the previously asymptomatic stifle. RESULTS: Thirty-eight dogs were included with an average follow-up of 51 months. Seventeen dogs re-presented for unscheduled contralateral medial patellar luxation surgery at an average of 15 months after initial presentation. A further two dogs had chronic contralateral limb lameness after an average of 33 months after initial surgery and may have been potential surgical candidates. CLINICAL SIGNIFICANCE: Fifty percent of adult dogs presenting with occult Grade II medial patellar luxation subsequently developed chronic lameness or required surgery.

Persistence and compliance with osteoporosis therapies among postmenopausal women in the UK Clinical Practice Research Datalink.

Gaining full benefits from osteoporosis medications requires long-term treatment. Investigating the real-world persistence of women receiving osteoporosis medications in the UK, we found that most patients stop treatment within a year. To prevent osteoporotic fragility fractures, long-term treatment persistence must be improved. INTRODUCTION: Persistence with osteoporosis therapies has historically been poor. To treat this chronic and progressive disease, it is essential that patients receive the full benefit of these medications. We estimated persistence and compliance with osteoporosis therapies in a large sample of postmenopausal women in the UK. METHODS: Data were obtained from the Clinical Practice Research Datalink for all women aged 50 years and over or women with early menopause, who received at least one prescription in primary care for any licensed osteoporosis therapy between January 1, 2010 and December 31, 2015. Persistence and compliance at 24 months (primary objective) and at 5 years (exploratory objective) were estimated in three patient cohorts: "All Patients," "Naïve Patients," and "Drug-Specific." RESULTS: The All Patients cohort included 72,256 women. Persistence with any therapy was 56.1%, 43.6%, 36.4%, and 31.0% at 6, 12, 18, and 24 months, respectively, and 23.2% and 13.1% at 3 years and 5 years, respectively. Patients were generally more persistent and compliant if evaluated from their first exposure to osteoporosis therapy (Naïve Patients cohort). In the drug-specific analysis, 64% of patients receiving denosumab (administered subcutaneously every 6 months) were persistent at 24 months compared with 28% and 23% of those taking oral bisphosphonates and intravenous bisphosphonates, respectively. CONCLUSIONS: Only about one in three patients who received osteoporosis therapy continued to be on treatment after 2 years. There is a need to improve persistence with osteoporosis therapy, especially for high-risk patients.

Biofilm Formation by Avian Pathogenic Escherichia coli is Not Related to In Vivo Pathogenicity.

Avian pathogenic Escherichia coli (APEC) is one of the pathogens that most concerns the poultry industry worldwide due to the economic losses it can cause. APEC persistence and survival, both in the environment and in the host, may be a consequence of biofilm-producing capabilities. The aim of this study was to evaluate APEC strains' biofilm production and its relationship to in vivo pathogenicity. Two hundred thirty-eight APEC isolates from three different origins (broiler bedding material, cellulite lesions, and respiratory diseases) were selected. The in vivo pathogenicity index (PI) was determined. Biofilm formation was evaluated using a microplate assay with analysis of colony morphology in Congo Red agar in order to detect the phenotypic expression of curli fimbriae and cellulose. Regarding biofilm production, it was observed that 55.8% of the strains produced biofilms. In the morphological test, 88.2% of the isolates expressed one or both components at one of the temperatures at least, and 11.8% of the isolates did not express curli or cellulose. Cellulose production was significantly higher at 25 °C. On the other hand, curli production was significantly higher at 37 °C. The study data indicate that there is no association between biofilm production and in vivo pathogenicity.

Fluoroquinolone resistance in Campylobacter jejuni and Campylobacter coli from poultry and human samples assessed by PCR-restriction fragment length polymorphism assay.

The objective of this study was to determine fluoroquinolone resistance in Campylobacter spp from poultry and human isolates. Forty-one Campylobacter jejuni isolates (30 of poultry origin and 11 of human origin) and 11 Campylobacter coli isolates (10 of human origin and 1 of poultry origin) were examined for ciprofloxacin, norfloxacin, and nalidixic acid resistance using the minimal inhibitory concentration (MIC) method. Thereafter, the isolates were analyzed by PCR-Restriction Fragment Length Polymorphism (RFLP) assay for detection of Thr-86 mutation. Finally, DNA sequencing was performed for confirmation of gyrA gene mutation. A complete correlation was observed between MICs, PCR-RFLP assay, and sequencing. The results revealed high quinolone resistance rates for C. jejuni (100%) and C. coli (100%) isolates obtained from poultry and moderate resistance for C. jejuni (9.1%) and C. coli (40%) samples of human origin. A mutation in codon 86 of the gyrA gene with a Thr-to-Ile substitution is reported to be the main cause of high resistance to quinolones. This mutation can be analyzed by PCR-RFLP assay, which has been proven to be a simple and fast method for the detection of fluoroquinolone resistance in Campylobacter spp.

Biofilm formation capacity of Salmonella serotypes at different temperature conditions / Capacidade de produção de biofilme por cepas de diferentes sorovares de Salmonella em quatro temperaturas de incubação

Salmonella spp. are one of the most important agents of foodborne disease in several countries, including Brazil. Poultry-derived products are the most common food products, including meat and eggs, involved in outbreaks of human salmonellosis. Salmonella has the capacity to form biofilms on both biotic and abiotic surfaces. The biofilm formation process depends on an interaction among bacterial cells, the attachment surface and environmental conditions. These structures favor bacterial survival in hostile environments, such as slaughterhouses and food processing plants. Biofilms are also a major problem for public health because breakage of these structures can cause the release of pathogenic microorganisms and, consequently, product contamination. The aim of this study was to determine the biofilm production capacity of Salmonella serotypes at four different temperatures of incubation. Salmonella strains belonging to 11 different serotypes, isolated from poultry or from food involved in salmonellosis outbreaks, were selected for this study. Biofilm formation was investigated under different temperature conditions (37°, 28°, 12° and 3°C) using a microtiter plate assay. The tested temperatures are important for the Salmonella life cycle and to the poultry-products process. A total of 92.2% of the analyzed strains were able to produce biofilm on at least one of the tested temperatures. In the testing, 71.6% of the strains produced biofilm at 37°C, 63% at 28°C, 52.3% at 12°C and 39.5% at 3°C, regardless of the serotype. The results indicate that there is a strong influence of temperature on biofilm production, especially for some serotypes, such as S. Enteritidis, S. Hadar and S. Heidelberg. The production of these structures is partially associated with serotype. There were also significant differences within strains of the same serotype, indicating that biofilm production capacity may be strain-dependent.(AU)

Salmonella spp. são um dos mais importantes agentes causadores de doenças transmitidas por alimentos em vários países, inclusive no Brasil. Produtos avícolas e ovos são os principais alimentos envolvidos na transmissão dos sorovares de Salmonella que são responsáveis por surtos de salmonelose em humanos. Salmonella possui a capacidade de formar biofilmes em diversas superfícies. O processo de formação de biofilme depende da interação entre as células bacterianas, a superfície de adesão e as condições do ambiente onde a bactéria se encontra. Estas estruturas favorecem a sobrevivência bacteriana em ambientes hostis, como em matadouros-frigoríficos e em indústrias processadoras de alimentos. Biofilmes são um grande problema em saúde pública, pois a ruptura destas estruturas pode provocar a liberação de microrganismos patogênicos e, consequentemente, a contaminação dos produtos. O objetivo deste estudo foi avaliar a capacidade de produção de biofilme por diferentes sorovares de Salmonella submetidos a quatro temperaturas de incubação. Cepas de Salmonella de 11 sorovares foram selecionadas. A produção de biofilme foi avaliada através do método de incubação em microplacas de poliestireno incubadas a 37°, 28°, 12° e 3°C. Estas temperaturas são importantes durante o ciclo de vida de Salmonella e para o processamento de produtos avícolas. Do total de cepas avaliadas, 92,2% foram capazes de produzir biofilme em pelo menos uma das quatro temperaturas testadas. Neste estudo, 71,6% das cepas produziram biofilme a 37°C, 63% a 28°C, 52,3% a 12°C e 39,5% a 3°C, independentemente do sorovar. Os resultados indicam uma forte influência da temperatura na produção de biofilme, especialmente para os sorovares S. Enteritidis, S. Hadar e S. Heidelberg. A produção de biofilme está parcialmente associada com o sorovar da cepa. Também foi observado que existe variação quanto à produção destas estruturas dentro de um mesmo sorovar, indicando que possivelmente a produção de biofilme é cepa-dependente.(AU)

The lesser spotted pregnant surgeon.

With more women entering surgical training, it will become more commonplace to encounter pregnant surgeons. This paper discusses the evidence for work-related risk factors as well as outlining the rights of a pregnant doctor. There are, in fact, very few real risks to pregnancy encountered as a surgeon, with the main risks involving standing or sitting for long periods and fatigue, which can be managed with support from the department. It is important for women in surgery to know that it is possible to continue their training while pregnant so they do not feel pressured into changing to a less demanding specialty or even leaving medicine entirely. It is also important for other professionals to understand the risks and choices faced by pregnant surgeons so that they can better support them in the workplace.

Evaluation of the biofilm formation capacity of Pasteurella multocida strains isolated from cases of fowl cholera and swine lungs and its relationship with pathogenicity / Avaliação da capacidade de formação de biofilme por cepas de Pasteurella multocida isoladas de casos de cólera aviária e de pulmões de suínos e sua relação com a patogenicidade

Pasteurella multocida is a Gram-negative bacillus that causes economic losses due to the development of respiratory diseases in several animal species. Among the mechanisms of virulence, the formation of biofilms is an important factor for bacterial survival in hostile environments. Studies of biofilm formation by P. multocida are needed because P. multocida is an important pathogen involved in respiratory infections. However, in contrast to other microorganisms, few studies of biofilm formation have examined P. multocida. Studies comparing the pathogenicity of microbial strains as a function of their biofilm production capacity are also rare. Consequently, the aim of this study was to evaluate the biofilm formation capacity of 94 P. multocida strains isolated from cases of fowl cholera and from swine lungs on polystyrene plates. The associations of the biofilm formation capacity with the pathogenicity index (PI) in vivo and with the presence of four genes (screened by PCR) of the tad locus (tadB, tadD, tadE and tadG), described as adhesion markers, were also determined. Strains from both animal origins were able to form biofilms. However, most of the specimens (52.13%) were classified as weak producers, and more than 40% of the strains of P. multocida (40.42%) did not produce biofilms. There was no significant difference (p>0.05) in the degree of biofilm production between the two sources of isolation. Of the analyzed strains, 56.52% contained all four genes (tadB, tadD, tadE and tadG). The PI arithmetic mean of the strains classified as non-biofilm producers was significantly different (p<0.05) from the PI of moderate-producer strains. The PI of specimens classified as weak biofilm producers also differed significantly (p<0.05) from that of the moderate-producer strains. The results indicate that even though the P. multocida strains isolated from cases of fowl cholera and swine lungs formed biofilms on polystyrene surfaces, adhesion was usually weak. The genes tadB, tadD, tadE and tadG were not significantly associated (p>0.05) with the production of biofilms and with the origin of a given strain. Finally, low virulence strains may suggest a higher biofilm formation capacity on polystyrene plates.(AU)

Pasteurella multocida é um bacilo Gram negativo que ocasiona perdas econômicas, geralmente associadas a doenças respiratórias em diversas espécies animais. Entre os mecanismos de virulência existentes, a formação de biofilmes demonstra ser um importante fator para a proteção e para a sobrevivência bacteriana em ambientes hostis. Estudos relacionados à formação de biofilmes por P. multocida são necessários, uma vez que este é um importante patógeno envolvido em infecções respiratórias. Entretanto, ainda são poucos os estudos desenvolvidos nesta área, quando comparados com aqueles envolvendo outros microrganismos. Também são os raros os estudos que comparam a patogenicidade das cepas com a sua capacidade de produção de biofilme. Neste contexto, o objetivo deste estudo foi avaliar a capacidade de formação de biofilme em placas de poliestireno de 94 cepas de P. multocida isoladas de casos de cólera aviária e de pulmões de suínos, associando-se com o índice de patogenicidade (IP) in vivo e com a presença de quatro genes do locus tad (tadB, tadD, tadE e tadG), descritos como marcadores de adesão e pesquisados através de PCR. As cepas de ambas as origens foram capazes de formar biofilme. Contudo, a maioria dos exemplares (52,12%) foi classificada como fracamente produtora e mais de 40% das cepas de P. multocida (40,42%) não produziram biofilme. Não foi observada diferença estatística (p>0,05) quanto ao grau de produção de biofilme entre as duas origens de isolamento. 56,52% das cepas analisadas apresentaram os quatro genes (tadB, tadD, tadE e tadG) concomitantemente. O IP médio das cepas classificadas como não produtoras de biofilme apresentou diferença estatística (p˂0,05) em relação ao IP das cepas moderadamente produtoras. Os exemplares classificados como fracamente produtores de biofilme diferiram significativamente (p˂0,05) do grupo de cepas moderadamente produtoras. Os resultados obtidos indicaram que, apesar de as cepas de P. multocida isoladas de casos de cólera aviária e do pulmão de suínos apresentarem capacidade de formar biofilme em superfícies de poliestireno, a adesão ocorreu geralmente de forma fraca. Os genes tadB, tadD, tadE e tadG, pertencentes ao locus tad, não apresentaram associação significativa com a produção de biofilme e nem com a origem de isolamento da cepa. Por fim, observou-se que as cepas de menor patogenicidade apresentaram uma maior capacidade de formação de biofilme em placas de poliestireno.(AU)

Intonational speech prosody encoding in the human auditory cortex.

Speakers of all human languages regularly use intonational pitch to convey linguistic meaning, such as to emphasize a particular word. Listeners extract pitch movements from speech and evaluate the shape of intonation contours independent of each speaker's pitch range. We used high-density electrocorticography to record neural population activity directly from the brain surface while participants listened to sentences that varied in intonational pitch contour, phonetic content, and speaker. Cortical activity at single electrodes over the human superior temporal gyrus selectively represented intonation contours. These electrodes were intermixed with, yet functionally distinct from, sites that encoded different information about phonetic features or speaker identity. Furthermore, the representation of intonation contours directly reflected the encoding of speaker-normalized relative pitch but not absolute pitch.

Genomic evidence of hybridization between two independent invasions of European green crab (Carcinus maenas) in the Northwest Atlantic.

Invasive species have been associated with significant negative impacts in their introduced range often outcompeting native species, yet the long-term evolutionary dynamics of biological invasions are not well understood. Hybridization, either among waves of invasion or between native and introduced populations, could alter the ecological and evolutionary impacts of invasions yet has rarely been studied in marine invasive species. The European green crab (Carcinus maenas) invaded eastern North America twice from northern and southern locations in its native range. Here we examine the frequency of hybridization among these two distinct invasions at locations from New Jersey, USA to Newfoundland, Canada using restriction-site-associated DNA sequencing (RAD-seq), microsatellite loci and cytochrome c oxidase subunit I mitochondrial DNA (mtDNA) sequences. We used Bayesian clustering and hybrid assignment analyses to investigate hybridization between the northern and southern populations. Of the samples analyzed, six locations contained at least one hybrid individual, while two locations were characterized by extensive hybridization, with 95% of individuals collected from Placentia Bay, Newfoundland being hybrids (mostly F2) and 90% of individuals from Kejimkujik, Nova Scotia being classified as hybrids, mostly backcrosses to the northern ecotype. The presence of both F2 hybrids and backcrossed individuals suggests that these hybrids are viable and introgression is occurring between invasions. Our results provide insight into the demographic and evolutionary consequences of hybridization between independent invasions, and will inform the management of green crabs in eastern North America.

Contrast-enhanced spectral mammography improves diagnostic accuracy in the symptomatic setting.

AIM: To assess the diagnostic accuracy of contrast-enhanced spectral mammography (CESM), and gauge its "added value" in the symptomatic setting. MATERIALS AND METHODS: A retrospective multi-reader review of 100 consecutive CESM examinations was performed. Anonymised low-energy (LE) images were reviewed and given a score for malignancy. At least 3 weeks later, the entire examination (LE and recombined images) was reviewed. Histopathology data were obtained for all cases. Differences in performance were assessed using receiver operator characteristic (ROC) analysis. Sensitivity, specificity, and lesion size (versus MRI or histopathology) differences were calculated. RESULTS: Seventy-three percent of cases were malignant at final histology, 27% were benign following standard triple assessment. ROC analysis showed improved overall performance of CESM over LE alone, with area under the curve of 0.93 versus 0.83 (p<0.025). CESM showed increased sensitivity (95% versus 84%, p<0.025) and specificity (81% versus 63%, p<0.025) compared to LE alone, with all five readers showing improved accuracy. Tumour size estimation at CESM was significantly more accurate than LE alone, the latter tending to undersize lesions. In 75% of cases, CESM was deemed a useful or significant aid to diagnosis. CONCLUSION: CESM provides immediately available, clinically useful information in the symptomatic clinic in patients with suspicious palpable abnormalities. Radiologist sensitivity, specificity, and size accuracy for breast cancer detection and staging are all improved using CESM as the primary mammographic investigation.