Differences between predicted outer membrane proteins of Pasteurella multocida, Histophilus somni, and genotype 1 and 2 Mannheimia haemolytica strains isolated from cattle.

Common bacterial causes of bovine respiratory disease (BRD) include Histophilus somni, Mannheimia haemolytica, and Pasteurella multocida. Within M. haemolytica, two major genotypes are commonly found in cattle (1 and 2); however, genotype 2 strains are isolated from diseased lungs much more frequently than genotype 1 strains. Outer membrane proteins (OMPs) of H. somni, P. multocida, and genotype 2 M. haemolytica may be important factors for acquired host immunity. The predicted OMP differences between genotypes 1 and 2 M. haemolytica have been previously identified. In this study, we expanded the focus to include bovine-isolated strain genomes representing all three species and the two M. haemolytica genotypes. Reported here are the core genomes unique to each of them, core genomes shared between some or all combinations of the three species and two M. haemolytica genotypes, and predicted OMPs within these core genomes. The OMPs identified in this study are potential candidates for further studies and the development of interventions against BRD.

New Insight into the Measurements of Particle-Bound Metals in the Urban and Remote Atmospheres of the Sarajevo Canton and Modeled Impacts of Particulate Air Pollution in Bosnia and Herzegovina.

The Sarajevo Canton Winter Field Campaign 2018 (SAFICA) was a project that took place in winter 2017-2018 with an aim to characterize the chemical composition of aerosol in the Sarajevo Canton, Bosnia and Herzegovina (BiH), which has one of the worst air qualities in Europe. This paper presents the first characterization of the metals in PM10 (particulate matter aerodynamic diameters ≤10 µm) from continuous filter samples collected during an extended two-months winter period at the urban background Sarajevo and remote Ivan Sedlo sites. We report the results of 18 metals detected by inductively coupled plasma mass spectrometry (ICP-MS) and electrothermal atomic absorption spectrometry (ETAAS). The average mass concentrations of metals were higher at the Sarajevo site than at Ivan Sedlo and ranged from 0.050 ng/m3 (Co) to 188 ng/m3 (Fe) and from 0.021 ng/m3 (Co) to 61.8 ng/m3 (Fe), respectively. The BenMAP-CE model was used for estimating the annual BiH health (50% decrease in PM2.5 would save 4760+ lives) and economic benefits (costs of $2.29B) of improving the air quality. Additionally, the integrated energy and health assessment with the ExternE model provided an initial estimate of the additional health cost of BiH's energy system.

Patient-Reported Outcome and Experience Measures Administered by Dietitians in the Outpatient Setting: Systematic Review.

Understanding how patients perceive their health and the experience with the dietitian is fundamental to providing patient-centred care. The types of patient reported measures (PRMs) used by outpatient dietitians is unclear. Guidance about use of PRMs for dietitians is also lacking. The aim of this systematic review was to synthesise evidence regarding the use of PRMs by dietitians in the outpatient setting and evaluate the methodological quality of studies evaluating the psychometric properties of PRMs. Eight databases were searched systematically for studies of dietitians working in the outpatient setting and administering a PRM. Forty-four studies were evaluated and described 58 different PRMs. These included direct nutrition related (n = 12 studies), clinical (n = 21 studies), and health-related quality of life PRMs (n = 24 studies); 1 study documented use of a patient-reported experience measure. A large range of PRMs are used by outpatient dietitians. Of the most common PRMs, the majority are administered in similar populations to the original validation study. Dietitians should use a combination of 3 PRMs: a generic health-related quality of life tool, an experience measure, and at least 1 clinical or direct nutrition-related measure. This will enable dietitians to fully capture the impact of their care on patients.

Variant formation of left common iliac vein by the confluence of four veins.

Common iliac vein variations are relatively rare compared to the variations of external and internal iliac veins. A rare pattern of formation of common iliac vein by the confluence of four veins is being reported here. The left common iliac vein was formed by the union of left external iliac vein, internal iliac vein, iliolumbar vein and a common trunk formed by the obturator and vesical veins. External iliac vein and obturator veins were connected by a communicating vein. Both external and common iliac veins were respectively medial to the external and common iliac arteries. Knowledge of this variant formation of common iliac vein could be useful to radiologists, gynecologists and orthopedic surgeons.

Superficial temporal artery capillary perforator-based island flap for conchal bowl and external auditory canal reconstruction.

BACKGROUND: Reconstruction of the auricle is challenging to surgeons as a result of its complex anatomy. Defects including the conchal bowl and the external auditory canal (EAC) do not accept imperfection as functional consequences may add to aesthetic ones. Local flaps that are relying mainly on posteriorly based auricle flaps do not represent ideal solutions. This study aims to report the perforator modification of an anteriorly based pre-auricular flap that matches all requires goals of reconstruction. METHODS: From 2015 to 2019, three capillary perforator-based island flaps (c-PBIF), with the Superficial Temporal Artery (STA) as source pedicle, were performed to reconstruct a combined Conchal Bowl-External Auditory Canal (CB-EAC) defect, secondary to basal cell carcinoma resection. Free margins were obtained via the Tubigen micrographic approach. All three flaps were raised on the perforator originating from the superficial temporal pedicle. In 2 of the cases, the perforator was found at the level of the tragus while in the last case, it was found 1cm more distal. Capillary perforators were isolated and dissected down to their origin from the STA thereby increasing their arc of rotation and pliability. The median follow-up time was 4 years. RESULTS: All flaps survived. Aesthetic results were excellent leaving no distortion of the external ear and the hollow aspect of the conchal was well supported. The tragus mount was preserved, EAC lining was secured, and good audition was restored with no bulging of the flap into the canal in all the cases. CONCLUSION: Harvesting pre-auricular flaps as c-PBIFs are safe and acts as an excellent solution for the reconstruction of the challenging combined CB-EAC defect. It allows a one-stage reconstruction that does not need a secondary revision, it also gives excellent correction and functional results. We would recommend it as a useful option for the reconstruction of the conchal-EAC defects.

[Nursing care on an external fixator]. / Les soins infirmiers sur un fixateur externe.

The external fixator is one of the treatments for fractures. It is classically used for serious fractures, polytraumatized patients or when there is a large influx of patients. The resulting paramedical care, which is often unknown, must be rigorous in order to avoid minor and frequent, or serious but less frequent, complications. The stock of what the caregiver must master in this regard: local care, information, monitoring.

Inactivation of Cronobacter sakazakii by blue light illumination and the resulting oxidative damage to fatty acids.

Blue light (BL) exerts an antimicrobial effect on pathogenic bacteria. It has been hypothesized that its bactericidal activity depends upon the generation of reactive oxygen species (such as anion superoxides) and the resultant cellular damage. However, some aspects of this hypothesis needed to be tested and investigated. Thus, the work conducted herein examined the molecular impact of BL treatment on Cronobacter sakazakii, an emerging foodborne pathogen. The results showed that BL exhibited an efficient bactericidal effect against C. sakazakii. Under a sublethal BL dose, both intracellular anion superoxides and malondialdehyde (a marker of oxidative stress) contents were increased gradually. Moreover, permeability of the outer membrane was increased by approximately 50%, indicating membrane damage. Further investigation revealed alterations to cellular fatty acid profiles, with a decrease and disappearance of unsaturated fatty acids, including C18:2, C16:1, and C18:1. These data indicate that bacterial lipids, especially unsaturated fatty acids, are important molecular targets of BL photo-oxidation. The transcriptional response of bacteria to BL was also studied, and it was found that three genes were upregulated, including genes encoding antioxidants. The current study contributes towards an improved understanding of the bactericidal mechanisms of BL and highlights the importance of lipid and membrane damage.

[Special reduction instruments]. / Spezielle Repositionsinstrumente.

Special and specialized instruments help perform reduction more effectively and in a tissue-preserving manner. In addition to other articles, the application and advantages of the following instruments are presented: colinear reduction forceps, cerclage, cerclage passer, distal radius reduction clamp, modular external fixator, extension table, distraction frame, joystick, manipulators, distractor and assistance of reduction with elastic nails.

[Secondary surgery of the external ear]. / Chirurgie secondaire du pavillon de l'oreille.

Secondary surgeries of the external ear can be divided into two categories: secondary otoplasties and secondary ear reconstructions. The most frequent causes of secondary otoplasties are a recurrence, an over-corrected ear, an off-center ear, a prominent lobule, and finally chronic ear pain. Recurrence of the prominence can be treated by a new posterior stitch otoplasty, an Earfold clip, or a frame stitch. The over-corrected ear can be projected either by costal cartilage grafts or by hyaluronic acids. Patients who are unsatisfied of the aesthetic result of their prominent ear correction usually complain about an off-centered ear, because the ideal ear axis is parallel to the cheek. A prominent lobule can be corrected with a posterior stitch and a VY flap. Chronic ear pain can be significantly reduced by a protocol of physiotherapy with positive sensory feedback. In ear reconstruction, it is important preserve the retroauricular skin and the superficial temporal fascia, which are the workhorses of ear reconstruction. Secondary ear reconstructions are usually very complex procedures, which should be performed by specialists.

[Organophosphorus poisoning: Towards enzymatic treatments]. / Intoxication aux organophosphorés : vers des traitements enzymatiques.

Organophosphorus compounds (OP) are toxic molecules developed as insecticides and chemical warfare nerve agents (CWNAs). Most OP are neurotoxic and act as nervous system disruptors by blocking cholinergic transmission. They are therefore responsible for many poisonings worldwide. OP toxicity may result either from acute or chronic exposure, and their poisoning effect were evaluated using several animal models. These latter were also used for evaluating the efficacy of antidotes. Strategies based on enzymes that can trap (stoichiometric bioscavengers) or degrade (catalytic bioscavengers) OP, were particularly studied since they allow effective decontamination, without toxicity or environmental impact. This review summarizes the results obtained in vivo with enzymes through three levels: prophylaxis, treatment and external decontamination. The efficiency of enzymatic treatments in different animal models is presented and the relevance of these models is also discussed for a better extrapolation to humans.

[Toxicity of multimodal regimens in prostate cancer]. / Complications des traitements multimodaux.

Multimodal regimens consist en more than one treatment to treat localized prostate cancer. They are now proposed routinely for high-risk diseases. Different approaches could be defined: In conclusion, multimodal regimens increase the risk of side effects compared to surgery or radiotherapy alone. Indications of these approaches muste be discussed with the patients after a careful evaluation of the benefit/risk ratio.

En quête de financement pour la création d'une clinique externe et d'un service social comme parachèvement de la désinstitutionnalisation à l'Hôpital Saint-Michel-Archange de Beauport, 1961-72.

The release of the report of the Commission d'étude des hôpitaux psychiatriques (Bédard report) in 1962 was long considered a transformative moment in the history of Québec psychiatry. But recent historiography suggests that deinstitutionalization in Québec features initiatives dating back to the early 20th century. Following this line of argumentation, we suggest that the Bédard report was primarily a political tool to obtain funding in the wake of the 1961 Hospital Insurance Act, and that the report's recommendations built upon ongoing changes. This article proposes a new reading of the commission's report on Beauport's Hôpital Saint-Michel-Archange, and offers a new perspective on deinstitutionalization in Québec. Data gathered from medical records help illustrate the organizational changes that occurred between 1962 and 1972 through new public funding.

La parution du rapport de la Commission d'étude des hôpitaux psychiatriques (rapport Bédard) en 1962 fut longtemps considérée comme un point de rupture dans l'histoire de la psychiatrie québécoise. L'historiographie récente propose une nouvelle interprétation du phénomène de la désinstitutionnalisation au Québec en s'intéressant à des initiatives datant du début du 20e siècle. Dans cette perspective, nous proposons l'hypothèse que le rapport Bédard constitue un levier politique pour obtenir un financement après l'entrée en vigueur de la Loi de l'assurance-hospitalisation en 1961 et que ses recommandations s'appuient sur les changements en cours. Cet article offre une relecture du rapport de la commission en ce qui concerne l'Hôpital Saint-Michel-Archange de Beauport et jette un éclairage différent sur la désinstitutionnalisation au Québec. Pour illustrer les changements organisationnels qui se produisent entre 1962 et 1972, notamment grâce à un nouveau financement public, nous nous appuyons sur les informations contenues dans un dossier médical spécifique.

The "hole" story of predatory outer-membrane vesicles.

All Gram-negative bacteria release membrane vesicles. These vesicles contain a cargo of proteins and enzymes that include one or more autolysins. Autolysins are a group of enzymes with specificity for the different linkages within peptidoglycan sacculi that if uncontrolled cause bacteriolysis. This minireview, written in honor and memory of Terry Beveridge, presents an overview of autolytic activity and focuses on Beveridge's important original observations regarding predatory membrane vesicles and their associated autolysin cargo.

Effect of toluene on Pseudomonas stutzeri ST-9 morphology - plasmolysis, cell size, and formation of outer membrane vesicles.

Isolated toluene-degrading Pseudomonas stutzeri ST-9 bacteria were grown in a minimal medium containing toluene (100 mg·L(-1)) (MMT) or glucose (MMG) as the sole carbon source, with specific growth rates of 0.019 h(-1) and 0.042 h(-1), respectively. Scanning (SEM) as well as transmission (TEM) electron microscope analyses showed that the bacterial cells grown to mid-log phase in the presence of toluene possess a plasmolysis space. TEM analysis revealed that bacterial cells that were grown in MMT were surrounded by an additional "material" with small vesicles in between. Membrane integrity was analyzed by leakage of 260 nm absorbing material and demonstrated only 7% and 8% leakage from cultures grown in MMT compared with MMG. X-ray microanalysis showed a 4.3-fold increase in Mg and a 3-fold increase in P in cells grown in MMT compared with cells grown in MMG. Fluorescence-activated cell sorting (FACS) analysis indicated that the permeability of the membrane to propidium iodide was 12.6% and 19.6% when the cultures were grown in MMG and MMT, respectively. The bacterial cell length increased by 8.5% ± 0.1% and 17% ± 2%, as measured using SEM images and FACS analysis, respectively. The results obtained in this research show that the presence of toluene led to morphology changes, such as plasmolysis, cell size, and formation of outer membrane vesicles. However, it does not cause significant damage to membrane integrity.

[How may practitioners interpret the results of clinical trials?] / Comment le praticien doit-il interpréter les résultats d'un essai clinique ?

To correctly interpret the results of a randomised controlled trial (RCT), practitioners have to spot bias and other potential problems present in the trial. Internal as well as external validity of the trial are linked to the presence of such bias. The internal validity is ensured by a clear definition of the objectives of the trial. The number of patients to be included in the trial is calculated on the basis of the main objective of the trial and more precisely on the basis of the primary endpoint selected to assess the efficacy of treatment. This is the best way to ensure that the statistical significance of the result may have a clinical relevance. Internal validity depends also on the process of patients selection, the methods used to ensure comparability of groups and treatments, the criteria employed to assess efficacy, and the methods for the analysis of data. External validity refers to subjects that have been excluded from the trial, limitations of RCTs, as well as the coherence and clinical relevance of the trial. Internal validity has to be fueled by external validity.

Mucosal and systemic immune responses induced by a single time vaccination strategy in mice.

Vaccination is considered by the World Health Organization as the most cost-effective strategy for controlling infectious diseases. In spite of great successes with vaccines, many infectious diseases are still leading killers, because of the inadequate coverage of many vaccines. Several factors have been responsible: number of doses, high vaccine reactogenicity, vaccine costs, vaccination policy, among others. Contradictorily, few vaccines are of single dose and even less of mucosal administration. However, more common infections occur via mucosa, where secretory immunoglobulin A plays an essential role. As an alternative, we proposed a novel protocol of vaccination called Single Time Vaccination Strategy (SinTimVaS) by immunizing 2 priming doses at the same time: one by mucosal route and the other by parenteral route. Here, the mucosal and systemic responses induced by Finlay adjuvants (AF Proteoliposome 1 and AF Cochleate 1) implementing SinTimVaS in BALB/c mice were evaluated. One intranasal dose of AF Cochleate 1 and an intramuscular dose of AF Proteoliposome 1 adsorbed onto aluminum hydroxide, with bovine serum albumin or tetanus toxoid as model antigens, administrated at the same time, induced potent specific mucosal and systemic immune responses. Also, we demonstrated that SinTimVaS using other mucosal routes like oral and sublingual, in combination with the subcutaneous route elicits immune responses. SinTimVaS, as a new immunization strategy, could increase vaccination coverage and reduce time-cost vaccines campaigns, adding the benefits of immune response in mucosa.

[The mobile geriatric team of Bretonneau Hospital and nursing home professionals]. / Évaluation du dispositif d'équipe mobile de gériatrie et Ehpad.

In the wake of an experimental project, external mobile geriatric teams have been working in nursing homes in order to train the nursing teams in caring for geriatric pathologies. The mobile teams also give diagnostic and therapeutic recommendations in order to direct where necessary these dependent elderly people, often with multiple pathologies, towards geriatric care.

[The role of external mobile geriatric teams in nursing homes]. / Apport des équipes mobiles gériatriques externes en Ehpad.

Since 2000, the mobile team of Bretonneau Hospital in Paris has helped to improve the assessment and care management of the elderly at home by strengthening the link between community health professionals and hospital geriatric services. In January 2008, an external mobile geriatric team working with nursing homes was created for the whole of the Paris area in order to strengthen the link between care homes accommodating often highly dependent elderly people and the hospital.

Comparative Analysis of External Validity Reporting in Non-randomized Intervention Studies.

This article describes a comparative analysis of external validity reporting in non-randomized behavioural and public health intervention studies that used and did not use the TREND (Transparent Reporting of Evaluations with Non-randomized Designs) statement. The search resulted in 14 non-randomized intervention studies that were rated based on Green and Glasgow's criteria for external validity reporting. Studies that used the TREND statement demonstrated improved external validity reporting when compared with studies that did not use the TREND statement. The implication is that the TREND statement and Green and Glasgow's criteria can improve external validity reporting of non-randomized behavioural and public health interventions.

Cet article présente une analyse comparative d'établissements de rapports de validité externe dans le cadre d'études d'interventions non aléatoires en matière de comportements et de santé publique faisant usage et ne faisant pas usage de l'énoncé TREND (Transparent Reporting of Evaluations with Non-randomized Designs). La recherche a relevé 14 études d'interventions non aléatoires, lesquelles ont été évaluées selon les critères de Green et Glasgow quant à l'établissement de rapports de validité externe. Les études ayant utilisé l'énoncé TREND ont démontré la présence de rapports de validité externe améliorés, en comparaison avec les études n'ayant pas fait usage de l'énoncé TREND. En conclusion, l'énoncé TREND et les critères de Green et Glasgow peuvent améliorer les rapports de validité externe d'interventions non aléatoires en matière de comportements et de santé publique.

An overview of neurological and neuromuscular signs in mitochondrial diseases.

Mitochondrial disorders have a broad clinical spectrum and are genetically heterogeneous, involving two genomes. These disorders may be develop at any age, with isolated or multiple system involvement, and any pattern of inheritance. Neurological involvement is the most frequent, and concerns muscular, peripheral and central nervous system. Among these diverse signs, some are suggestive of mitochondrial disease, such as progressive external ophthalmoplegia, exercise intolerance, psychomotor regression, stroke-like episodes, refractory epilepsy and Epilepsia Partialis Continua. Others are less specific and mitochondrial hypothesis may be evocated because of either association of different neuromuscular signs or a multisystemic involvement. This review describes the wealth of this neurological and neuromuscular symptomatology through different syndromes reported in the literature, according to preponderant signs and to modes of inheritance, as key elements to guide genetics testing.