The prophylactic use of negative-pressure wound therapy after cardiac surgery: a meta-analysis.

Surgical site infections (SSIs) pose a frequent complication in cardiac surgery patients and lead to increased patient discomfort and extended hospitalization. This meta-analysis aimed to evaluate the protective role of single-use negative-pressure wound therapy (sNPWT) devices on closed surgical wounds after cardiac surgery, and explored their potential preventive application across all cardiac surgery patients. A comprehensive literature search was conducted on ScienceDirect, focusing on studies related to "negative pressure wound therapy" or "PICO negative pressure wound therapy" combined with "cardiac surgery" or "sternotomy," published between 2000 and 2022. Inclusion criteria encompassed case-control studies comparing sNPWT with traditional dressings on closed cardiac surgical incisions in adult patients undergoing median sternotomy without immediate postoperative infective complications, with available details on SSIs. A retrospective analysis of cases treated with sNPWT in our centre was also performed. The meta-analysis revealed a protective role of sNPWT, indicating a 44% risk reduction in overall SSIs (odds ratio 0.56) and a 40% risk reduction in deep wound infections (odds ratio 0.60). Superficial wound infections, however, showed non-significant protective effects. A single-centre study aligned with the meta-analysis findings, confirming the efficacy of sNPWT and was included in the meta-analysis. In conclusion, the meta-analysis and the single-centre study collectively support the protective role of negative pressure wound therapy against overall and deep SSIs, suggesting its potential prophylactic use on all cardiac surgery populations.

White blood cells, TNF-α, and interleukin-6 in subjects with infantile colic treated with Lacticaseibacillus rhamnosus GG (ATCC 53103): a randomised prospective study.

Recent metanalysis reported that certain probiotic strains, such as Limosilactobacillus reuteri and Lacticaseibacillus rhamnosus (LGG), seem effective for treatment of infantile colic of exclusively breastfed infants; some reports have also linked probiotics to have an immunological effect, however further investigation are needed to fully understand the exact mechanism. The objective of this study was to assay white blood cells, tumour necrosis factor (TNF)-α and interleukin (IL)-6 values in peripheral blood in subjects treated in a randomised, double-blind, placebo-controlled trial for infantile colic with LGG. Fifty-eight infants were enrolled and followed for a study period of 28 days. Parent were asked to record daily crying time using a structured cry diary. Peripheral white blood cells was assessed and RNA (mRNA) expression of TNF-α and IL-6 was measured using TaqMan real-time PCR-maternal amplification. Infants with colic treated with LGG showed a reduction in daily crying duration after 28 days of treatment and a reduction in values of IL-6 ( P < 0.005) and TNF-α ( P < 0.05); we observe also a significantly decreasing of IL-6 in the placebo group while decrease of TNF-α was not significant in this group. A significant decreased values of monocytes ( P < 0.05) was observed in infants treated with LGG. Our data therefore showed, in addition to crying time reduction, a significant decrease of TNF-α and a significant reduction of monocytes cells in colicky infants treated with LGG, compared to placebo group. This observation supports the hypothesis that probiotics may have anti-inflammatory properties. Further studies are needed to better understand the influence of probiotic on immunity cells.

Clinal variation in colony breeding structure and level of inbreeding in the subterranean termites Reticulitermes flavipes and R. grassei.

Social insects exhibit remarkable variation in their colony breeding structures, both within and among species. Ecological factors are believed to be important in shaping reproductive traits of social insect colonies, yet there is little information linking specific environmental variables with differences in breeding structure. Subterranean termites (Rhinotermitidae) show exceptional variation in colony breeding structure, differing in the number of reproductives and degree of inbreeding; colonies can be simple families headed by a single pair of monogamous reproductives (king and queen) or they can be extended families headed by multiple inbreeding neotenic reproductives (wingless individuals). Using microsatellite markers, we characterized colony breeding structure and levels of inbreeding in populations over large parts of the range of the subterranean termites Reticulitermes flavipes in the USA and R. grassei in Europe. Combining these new data with previous results on populations of both species, we found that latitude had a strong effect on the proportion of extended-family colonies in R. flavipes and on levels of inbreeding in both species. We examined the effect of several environmental variables that vary latitudinally; while the degree of inbreeding was greatest in cool, moist habitats in both species, seasonality affected the species differently. Inbreeding in R. flavipes was most strongly associated with climatic variables (mean annual temperature and seasonality), whereas nonclimatic variables, including the availability of wood substrate and soil composition, were important predictors of inbreeding in R. grassei. These results are the first showing that termite breeding structure is shaped by local environmental factors and that species can vary in their responses to these factors.

The Efficacy of a Pyrethroid-impregnated Mattress Liner on Multiple International Strains of Cimex lectularius (Hemiptera: Cimicidae) and Cimex hemipterus (Hemiptera: Cimicidae).

Modern bed bugs are resistant to multiple insecticide classes, particularly the pyrethroids. The efficacy of pyrethroid-impregnated mattress liners marketed for bed bug management has been variable. This study evaluated the efficacy of a permethrin-impregnated mattress liner, ActiveGuard, against 24 bed bug strains, consisting of both Cimex hemipterus (F.) and Cimex lectularius L. A 'mat assay', employing an allethrin-impregnated mat, was used to establish the pyrethroid resistance profile of all strains. Three experiments were conducted to evaluate the effect of ActiveGuard exposure on bed bug knockdown: 1) exposing the bed bugs continuously on the liner for up to 24 d, 2) holding the bed bugs on the liner for either 4 or 6 h, and 3) placing a noninsecticide treated fabric above the liner with the bed bugs held continuously on top. Our results indicated that all modern strains (collected within the last 15 years during the current resurgence) were pyrethroid-resistant, although the magnitude of resistance was highly variable between strains. In the continuous exposure study, an incomplete knockdown was recorded for most modern bed bug strains, with some having no knockdown even up to 7 d of constant exposure. In the 4 or 6 h exposure study, the level of knockdown was reduced even further, and very few bed bugs were knocked down in the double fabric study. The results of this study indicate that pyrethroid-impregnated mattress liners are not likely to be effective in the management of most modern bed bug infestations involving either C. hemipterus or C. lectularius.

Quantification of Fecal Spot Production as a Measure of Environmental Contamination Based on Common Bed Bug (Hemiptera: Cimicidae: Cimex lectularius L.) Population Size.

The presence of fecal spots has often been used to verify the existence of a bed bug (Cimex lectularius) infestation. However, no research has been conducted to determine how much fecal material that a bed bug population produces over time. In this study, the number of fecal spots that each nymphal life stage was capable of producing after a bloodmeal was quantified. Adult fecal spots were also quantified to determine if there was consistent production between feedings. During this study, it was discovered that bed bugs produced visible fecal spots and clear spots that were only visible under ultraviolet light. Therefore, three types of fecal spots were quantified: dark feces, light feces, and clear spots. Clear spots were produced in greater amounts (38.5-55.5%) than either dark spots (27.3-40.7%) or light spots (17.3-21.9%). For example, 5th instar bed bugs were thought to produce an average of 21 spots (dark and light) after a single bloodmeal. However, using the ultraviolet light, it was found that the 5th instars actually produced an average of 44.7 spots. Using the total fecal spot data collected during this study, researchers could project contamination potential for an infestation starting with a single gravid female over 30, 60, and 90 d. In addition, the amount of area covered by these spots was projected to be over 12 m2 in just 3 mo, which could greatly reduce the environmental and aesthetic quality of a home.

Computational Evaluation of Combined Cerebellar and Frontal Transcranial Direct Current Stimulation for Treatment-Resistant Depression.

This work aimed to estimate the distribution of the electric field generated by a combined cerebellar and frontal transcranial direct current stimulation (tDCS) for treatment-resistant depression using electromagnetics computational techniques applied to a realistic head human model. Results showed that the stronger electric fields occur mainly in the cerebellum and in DLPFC areas, where the two pairs of electrodes were applied. Furthermore, the study demonstrated that the simultaneous use of the two pairs of electrodes did not imply a lower effectiveness of the tDCS technique, in fact the electric field distributions in the primarily targets of the anatomical regions (i.e., cerebellum and DLPFC) were very similar to when the pairs of electrodes were applied separately.

Quantifying the Efficacy of an Assessment-Based Pest Management (APM) Program for German Cockroach (L.) (Blattodea: Blattellidae) Control in Low-Income Public Housing Units.

Over the last several decades, low-income public housing facilities have been known to be infested with particularly large German cockroach populations. These populations persist even though the housing pest control contracts often require, and pay for, IPM practices to be used in their facilities. When Virginia Tech researchers began reviewing public housing contracts in Virginia and North Carolina, it was easy to see why these 'IPM programs' were not successful. Many of these 'low-bidder' contracts do not allow the technician enough time in each apartment to assess the size of the pest population. In addition, these pest management contracts did not require German cockroach population monitoring, even though all IPM programs are based on assessments of the pest population. There was a clear need for an effective, easy to apply cockroach management program in U.S. public housing authorities. This study determined the long-term efficacy of an Assessment-based Pest Management (APM) program for German cockroach control in U.S. public housing facilities. Specifically, we evaluated an APM program where the residents were not asked to clean or prepare for treatment, and where overnight cockroach trap counts were used to determine the volume of gel bait that would be applied. The APM baiting program was conducted for 15 mo in three housing authorities. In all three housing authorities, cockroach populations in test units were typically reduced by >90%. German cockroach infestations were even eliminated from 49 of the 65 (75%) test units during this study.

Field evaluations of insecticide treatment regimens for control of the common bed bug, Cimex lectularius (L.).

BACKGROUND: Because bedbugs, Cimex lectularius L., have not been a problem in the USA for over 40 years, few insecticide products are labeled for their control. Most products that are labeled for bedbugs are pyrethroids. However, recent studies indicate that field-collected bedbugs may be resistant to pyrethroids. There are also non-pyrethroid products labeled for bedbugs, but, like the pyrethroids, none of these products has been evaluated for field efficacy. This study evaluated the efficacy of two insecticide treatment regimens for bedbugs in multi-unit housing. Both of the treatments included multiple products currently being used by the pest management industry. RESULTS: The 'traditional' treatment consisted of applications of pyrethroid products and an insect growth regulator. The 'novel' treatment consisted of applications of non-pyrethroid products. The traditional treatment significantly reduced the number of bedbugs from 39.8 +/- 10.1 per unit prior to treatment to 2.2 +/- 1.0 at the end of the test period (P = 0.02; 95% reduction). The number of live bedbugs in the 'novel' treatment was also significantly reduced from 71.4 +/- 25.3 bedbugs per unit to 10.2 +/- 4.4 after 8 weeks (86% population reduction). CONCLUSIONS: Although both treatment regimens reduced bedbug numbers, the fact that bedbugs were not eliminated after multiple applications suggests that the insecticides, applied at the current label rates, were inadequate. These results suggest that a more integrated approach to bedbug control is necessary in multi-unit housing situations.

[Association between causes of lNPS compensated disability and occupational category (Veneto Region, 1994-2002): a surveillance method for occupational diseases?]. / Associazione tra causa di invalidita pensionabile INPS e comparto lavorativo (Veneto, 1994-2002): un metodo di sorveglianza delle malattie professionali?

BACKGROUND: According to Italian law, workers are insured against disability through the National Social Security Institute (INPS), whose records contain information on diseases causing disability and occupational histories. OBJECTIVES: Using the INPS data, our objective was to identify any excess risk of disabling diseases in relation to the occupational categories. METHODS: Insurance covers all private sector employees, a small proportion of public sector employees, agricultural labourers, domestic workers, self-employed workers (craftsmen, commercial dealers,farmers), and few other occupational categories. For each insured worker, a database was created containing registry data, occupational history and, for compensated workers, the disease code, for each year from 1994 to 2002. A cohort study design was adopted, in which references were self-employed workers (with mixed exposure) to whom different categories of employees in agriculture, industry, crafts, and services were compared. Data were analyzed by means of Poisson regression, estimating the Incidence Rate Ratio (IRR) and confidence interval (CI) at 99.99%, instead of 95%, in order to set the threshold of error for the entire study at 0.05. RESULTS: In the construction industry there were significantly high risks of disability in both industry and crafts for tumours (industry: IRR = 2.07; IC = 1. 67-2.57; crafts: 2.57; 1.89-3.18), circulatory disorders (industry: IRR = 2.24; IC = 1.65-3.04; crafts.: 3.06; 2.16-4.32), and bone and joint diseases (industry. IRR = 5.0; IC = 3.15-7.94; crafts: 6.58; 5.04-8.59). CONCLUSIONS: The advantage of this approach is to recruit a large number of subjects at limited cost. The procedure here proposed is a mainly exploratory approach aimed at establishing new study hypotheses: disability, in fact, is acknowledged by INPS when its cause is not occupational according to the current literature.

[Safety and health in workers employed in industry. Data from Industrial Accidents Compensation Board (INAIL) and National Social Security Institute (INPS), Veneto Region, 1994-2002]. / Sicurezza e salute dei lavoratori dell'Industria attraverso i dati INAIL e INPS, Veneto, 1994-2002.

BACKGROUND: A decreasing time trend for occupational injuries and sickness absence would be the effect of the new legislation (D.Lgs. 626/94 and successive laws) on prevention in occupational settings. Conversely, the reduction of INPS disability would reflect a health improvement due to non-occupational causes. OBJECTIVES: The aim of the study was to investigate the efficacy of the new legislation among employees in industry (where the law was mainly applied), via the time trend of three standardized rates in the Veneto Region. METHODS: The numerator for the rate of occupational accidents (cases occurring in industry workers in the Veneto Region, broken down for sex, age and calendar years) was supplied by INAIL. The denominator for the above rate, as well as numerators and denominators for disability and sickness absence were supplied by INPS. Data were available from 1994 to 2002 for accidents and disability, and from 1997 to 2002 for sickness absence. In every year from 1994 to 2002, the rates were standardized for age and sex with the direct method, using an internal "standard" population. The time trend of year-specific standardized rates was analyzed by Joinpoint regression software. RESULTS: Among industrial workers in the Veneto Region, occupational accidents increased by 0.4% yearly, while disability decreased by 2.56% from 1994 to 2002. Sick absence increased up to 1999, then decreased. CONCLUSIONS: This epidemiological pattern is difficult to explain. The increase in accidents could be due to the increase of non-European Union workers and/or to the fact that accidents on the way to or from work were recognized as occupational accidents by INAIL starting from 2000. Both these phenomena could have contributed to increase the rate that was otherwise diminishing. On the other hand, this same situation could be due to insufficient efficacy of the legislation (D.Lgs. 626/94 and successive laws) for preventing occupational accidents and diseases.

A Method for Evaluating Insecticide Efficacy against Bed Bug, Cimex lectularius, Eggs and First Instars.

Standard toxicity evaluations of insecticides against insect pests are primarily conducted on adult insects. Evaluations are based on a dose-response or concentration-response curve, where mortality increases as the dose or concentration of an insecticide is increased. Standard lethal concentration (LC50) and lethal dose (LD50) tests that result in 50% mortality of a test population can be challenging for evaluating toxicity of insecticides against non-adult insect life stages, such as eggs and early instar or nymphal stages. However, this information is essential for understanding insecticide efficacy in all bed bug life stages, which affects control and treatment efforts. This protocol uses a standard dipping bioassay modified for bed bug eggs and a contact insecticidal assay for treating nymphal first instars. These assays produce a concentration-response curve to further quantify LC50 values for insecticide evaluations.

Laboratory evaluations of insecticide product efficacy for control of Cimex lectularius.

A susceptible, laboratory strain of bed bug, Cimex lectularius L., was used to determine the efficacy of insecticide products labeled or possessing a site label for bed bug control. Field strain bed bugs also were used to evaluate one insecticide product. The lethal time (LT),, values calculated for the laboratory strain bed bugs indicated that all of the pyrethroid products killed significantly faster than chlorfenapyr (0.5% [AIl; Phantom: BASF; LT50 = 10 d and 9 h). lamda-Cyhalothrin (0.03%; Demand CS; Syngenta) was the fastest acting insecticide (LT50 = 20 min), followed by bifenthrin (0.02% [AI]; Talstar One, FMC; LT50 = 53 min), deltamethrin (0.06% [AI]; Suspend SC; Bayer; LT50 = 61 min), and permethrin (0.05%; Dragnet SFR; FMC; LT50 = 88 min). The field strain bed bugs exposed to deltamethrin had an LT50 value of 14 day 8 h, indicating that the field strain was significantly less susceptible to deltamethrin than the laboratory strain. Chlorfenapyr exposure did not prevent the laboratory strain bed bugs from mating and laying eggs, nor did it prevent the eggs from hatching during the 2-wk exposure period. Surprisingly, none of the insecticides tested, including the pyrethroids, were repellent to laboratory strain bed bugs. Bed bugs rested on pyrethroid-treated panels and remained in contact with the panels until they died (2 h). Chlorfenapyr was also not repellent to bed bugs, but it caused no mortality during the 2-h test period. This study suggests that although pyrethroids were effective for controlling laboratory strain bed bugs, there is the potential for significant resistance in field strains. This study also determined that pyrethroid products were not repellent to bed bugs and would not cause bed bug aggregations to scatter or avoid treated surfaces.

Insecticide Resistance in Eggs and First Instars of the Bed Bug, Cimex lectularius (Hemiptera: Cimicidae).

Two strains of the common bed bug, Cimex lectularius L., eggs and first instars collected from pyrethroid-resistant adults were evaluated for insecticide resistance and compared to a susceptible strain. Dose-response bioassays were conducted using two insecticide formulations (Temprid: imidacloprid/ß-cyfluthrin, and Transport: acetamiprid/ bifenthrin). The lethal concentration (LC50) for the two resistant egg strains exposed to imidacloprid/ß-cyfluthrin ranged from 3 to 5-fold higher than susceptible strain eggs. Resistant strain eggs dipped into formulations of acetamiprid/bifenthrin had LC50 values which were significantly greater (39 to 1,080-fold) than susceptible strain eggs. Similar to eggs, resistant strain first instars exposed to residual applications of imidacloprid/ß-cyfluthrin had LC50 values ranging from 121 to 493-fold greater than susceptible strain first instars. When resistant strain first instars were treated with acetamiprid/bifenthrin, they had LC50 values that were 99 to >1,900-fold greater than susceptible strain first instars. To determine differences between egg and first instar resistance, stage resistance ratios (SRR) were compared between the two stages. There was little difference between the egg and first instar stages, indicated by small SRR values ranging from 1.1 to 10.0. This study suggests that insecticide resistance is expressed early during bed bug development.

Binding of the benzodiazepine ligand [3H]-Ro 15-1788 to brain membrane of the saltwater fish Mullus surmuletus.

The distribution and the pharmacological properties of the binding of the benzodiazepine receptor antagonist [3H]-Ro 15-1788 (8-fluoro-3-carboethoxy-5,6-dihydro-5-methyl-6-oxo-4H imidazol [1,5-a] 1,4 benzodiazepine) were compared in some brain membranes of the saltwater teleost fish, Mullus surmuletus: only a single population of [3H]-Ro 15-1788 binding sites was detected. The binding was saturable and reversible with a high affinity, revealing a significant population of binding sites (Kd value of 2.1 +/- 0.2 nM and Bmax value of 1400-900 fmol mg-1 of protein, depending on fish length). The highest concentration of benzodiazepine recognition sites labelled with [3H]-Ro 15-1788 was present in the optic lobe and the olfactory bulb and the lowest concentration was found in the medulla oblongata, cerebellum and spinal cord. In order to explore behavioural selectivity as a consequence of multiple receptor subtypes, six benzodiazepine receptor ligands, flunitrazepam (5-(2-fluoro-phenyl)-1,3-dihydro-1-methyl-7-nitro-2H-1, 4-benzodiazepin-2-one), alpidem, (N,N-dipropyl-6-chloro-2-(4-chlorophenyl)imidazo [1,2-a] pyridine-3- acetamide) zolpidem {N,N,6, trimethyl-2-(4-methyl-phenyl) imidazo [1,2-a] pyridine-3-acetamide hemitartrate}, methyl beta carboline-3-carboxylate (beta CCM), Ro 15-1788 and Ro 5-4864 (4'-chlorodiazepam), were tested in vitro by binding of [3H]-Ro 15-1788 to membrane preparations from various brain areas of Mullus surmuletus, Displacement studies showed a similar rank order of efficacy of various unlabelled ligands. In all regions of the brain and in the spinal cord. GABA potentiate [3H]-flunitrazepam binding in a similar order, suggesting that the BDZ recognition sites are part of the GABAA receptor structure. These results suggest that central-type benzodiazepine receptors are present in one class of benzodiazepine binding sites in the saltwater teleost fish brain of Mullus surmuletus (type I-like). Here we report initial evidence of homogeneity of subtypes of central benzodiazepine receptors in the spinal cord of the saltwater teleost fish. Mullus surmuletus.

Cell-mediated cytotoxicity in preinvasive and invasive squamous cell carcinoma of the cervix.

Cell-mediated immunity was tested by coincubation of target cell line (2043) of human squamous cell carcinoma and peripheral blood leukocytes (PBL) of 22 patients with squamous cell neoplasia of the uterine cervix, 9 patients with other tumors, and 9 normal females. The percentage of cell reduction in mild dysplasia was 90.1 +/- 6.8% (.001 less than P less than .005), in moderate dysplasia was 91.1 +/- 6.4% (.001 less than P less than .005), in severe dysplasia was 91.6 +/- 15.6% (P less than .001), in carcinoma in situ was 85.0 +/ 2.6% (P less than .001), and in invasive squamous cell carcinoma of the cervix was 85.0 +/- 6.9% (P less than .001). Peripheral blood leukocytes of patients with squamous neoplasia did not show any significant cytocoxicity against cell line SKOV-3, developed from an ovarian adenocarcinoma, nor did the PBL of patients with "other tumors" show any significant cytotoxicity against cell line 2043. This study shows that even in early stages of preinvasive squamous cell carcinoma of the cervix, the PBL are sensitized against the neoplastic process, confirming that different stages of cervical intraepithelial neoplasia and invasive squamous cell carcinoma are different intensities of the same biologic process.

So-called nasal glioma: case report with immunohistochemical study.

The so-called nasal gliomas (nasal cerebral heterotopias) are rare, congenital, benign masses of neurogenic origin with intra or extranasal location, or both. An intranasal case is reported in a 7-month-old infant who successfully underwent surgery with the intranasal approach. The tumor had no intracranial extension and the child is free of disease after a three-year follow-up. Immunohistochemical study confirmed the glial (GFAP+) and neuronal (NSE+) nature of the cells composing the mass. In addition to the clinical behavior, the benign nature of the tumor is also indicated by the negativity of Ki67 (MIB-1) and p53 proliferation markers as well as by CD44 negativity. As far as we know, this is the first reported case of nasal glioma subjected to immunohistochemical investigation of proliferation activity.

Oxyphil cell adenoma (oncocytoma) of the lacrimal caruncle: a case report.

The onset of oncocytic neoplasms in the ocular area is exceptional. A rare case of oxyphil cell adenoma of the lacrimal caruncle in an 81-year-old woman is presented. The anatomo-clinical profile of this benign small tumor is drawn up: a slowly growing tumor, generally occurring in the caruncle of elderly women, which is characterized by a uniform population of epithelial cells with eosinophilic finely-granular cytoplasm containing large numbers of mitochondria. The histogenetic problem of this tumor is briefly discussed.

Endometrial cancer in a double uterus. A report of two cases.

Two cases of double uteri associated with endometrial adenocarcinoma are presented. A correct diagnosis in this situation may be difficult to make due to anatomic difficulties or the unrecognized presence of a second uterine cavity. Ultrasound imaging should be considered to look for a second uterine cavity after a negative endometrial biopsy when clinically suspecting endometrial cancer.

Management of intraepithelial neoplasia of the uterine cervix in the black population.

The records of 2,277 patients referred to the Colposcopy Clinic at Cook County Hospital were reviewed, and those of 1,328 black patients who had a histological diagnosis of dysplasia or carcinoma in situ of the cervix were chosen for this study.Treatment modalities of intraepithelial cervical neoplasia are discussed and the conservative management of young patients is emphasized. Because of the effectiveness of outpatient management in cervical preinvasive lesions, health providers should make every attempt to motivate people particularly those at high risk, ie, black women, to undertake preventive measures.