Effectiveness of Saccharomyces Boulardii CNCM I-745 probiotic in acute inflammatory viral diarrhoea in adults: results from a single-centre randomized trial.

BACKGROUND: Probiotics are effective for treating acute infectious diarrhoea caused by bacteria, but there are inconsistent results for the effectiveness of probiotics for diarrhoea caused by viruses. In this article we want to determine whether Sb supplementation has an effect on acute inflammatory viral diarrhoea diagnosed with the multiplex panel PCR test. The aim of this study was to evaluate the efficacy of Saccharomyces boulardii (Sb) as a treatment in patients diagnosed with viral acute diarrhoea. METHODS: From February 2021 to December 2021, 46 patients with a confirmed diagnosis of viral acute diarrhoea diagnosed with the polymerase chain reaction multiplex assay were enrolled in a double-blind, randomized placebo-controlled trial. Patients received paracetamol 500 mg as a standard analgesic and 200 mg of Trimebutine as an antispasmodic treatment plus 600 mg of Sb (n = 23, 1 × 109/100 mL Colony forming unit) or a placebo (n = 23) orally once daily for eight days. The improvement in and severity of symptoms were measured using a symptom diary, the Patient Global Impression and the Patient Global Impression of Change scales (days 4 and 8), both answered and recorded by the patient. RESULTS: Of the 46 patients who completed treatment, 24 (52%) were men and 22 (48%) were women. The average age was 35.6 ± 12.28 years (range 18 to 61 years). The average duration of the evolution of illness at the time of diagnosis was 0.85 ± 0.73 days (maximum 2 days). On day 4 after the diagnosis, 20% reported pain and 2% reported fever, but on day 8, no patient reported pain or fever. On day 4, 70% of patients in the Sb group and 26% in the placebo group reported improvement (P = 0.03), based on the Patients' Global Impression of Change scale, which assesses patient's rating of overall improvement. These findings suggest that 3 to 4 days of treatment with Sb helped to improve symptoms of diarrhoea caused by a virus. CONCLUSION: Treatment with Sb on acute inflammatory diarrhoea of viral aetiology shows no changes regarding the severity of the symptoms; nevertheless, it seems to impact improvement positively. TRIAL REGISTRATION: 22CEI00320171130 dated on 16/12/2020, NCT05226052 dated on 07/02/2022.

Microwave background temperature at a redshift of 6.34 from H2O absorption.

Distortions of the observed cosmic microwave background provide a direct measurement of the microwave background temperature at redshifts from 0 to 1 (refs. 1,2). Some additional background temperature estimates exist at redshifts from 1.8 to 3.3 based on molecular and atomic line-excitation temperatures in quasar absorption-line systems, but are model dependent3. No deviations from the expected (1 + z) scaling behaviour of the microwave background temperature have been seen4, but the measurements have not extended deeply into the matter-dominated era of the Universe at redshifts z > 3.3. Here we report observations of submillimetre line absorption from the water molecule against the cosmic microwave background at z = 6.34 in a massive starburst galaxy, corresponding to a lookback time of 12.8 billion years (ref. 5). Radiative pumping of the upper level of the ground-state ortho-H2O(110-101) line due to starburst activity in the dusty galaxy HFLS3 results in a cooling to below the redshifted microwave background temperature, after the transition is initially excited by the microwave background. This implies a microwave background temperature of 16.4-30.2 K (1σ range) at z = 6.34, which is consistent with a background temperature increase with redshift as expected from the standard ΛCDM cosmology4.

Gender Differences in Postoperative Pain, Nausea and Vomiting After Elective Laparoscopic Cholecystectomy.

BACKGROUND: Although reports suggest that pain and postoperative nausea and vomiting (PONV) may be more frequent in women, the evidence is inconsistent. The objective of this study was to investigate whether women are more sensitive to pain and PONV after laparoscopic cholecystectomy (LC). METHODS: A total of 370 women and 275 men were included in a retrospective cohort study. All underwent LC under standardized general anesthesia. The variables analyzed included clinical and anthropometric parameters. End points were the incidence of nausea, vomiting, pain, and the requirement for additional pain relievers and antiemetics to control these. RESULTS: The women were younger and had lower body weight than the men (p < 0.001). Body mass index was within the normal range for 50% of women and 30% of men (p < 0.001). Pain was more common in women at 1, 6, 12 and 24 h after surgery (p < 0.02). Narcotics in addition to the doses used to lessen pain intensity (p = 0.01) were required in 60 women and 19 men (p < 0.001). PONV was more frequent in women at 1 and 6 h after surgery (p < 0.01). Rescue antiemetics were required in 35 women and 11 men (p = 0.008). Hospital stay was shorter for men (p < 0.001). Four patients in each group developed postoperative complications (p = 0.14). There was no mortality. CONCLUSIONS: Early postoperative pain, nausea and vomiting after LC were more common in women, who more frequently required analgesic and antiemetic rescue medication.

Gas Accretion within the Dust Cavity in AB Aur.

AB Aur is a Herbig Ae star hosting a well-known transitional disk. Because of its proximity and low inclination angle, it is an excellent object to study planet formation. Our goal is to investigate the chemistry and dynamics of the molecular gas component in the AB Aur disk, and its relation with the prominent horseshoe shape observed in continuum mm emission. We used the NOEMA interferometer to map with high angular resolution the J = 3-2 lines of HCO+ and HCN. By combining both, we can gain insight into the AB Aur disk structure. Chemical segregation is observed in the AB Aur disk: HCO+ shows intense emission toward the star position, at least one bright molecular bridge within the dust cavity, and ring-like emission at larger radii, while HCN is only detected in an annular ring that is coincident with the dust ring and presents an intense peak close to the dust trap. We use HCO+ to investigate the gas dynamics inside the cavity. The observed bright HCO+ bridge connects the compact central source with the outer dusty ring. This bridge can be interpreted as an accretion flow from the outer ring to the inner disk/jet system proving gas accretion through the cavity.

Probing the Cold Dust Emission in the AB Aur Disk: A Dust Trap in a Decaying Vortex?

One serious challenge for planet formation is the rapid inward drift of pebble-sized dust particles in protoplanetary disks. Dust trapping at local maxima in the disk gas pressure has received much theoretical attention but still lacks observational support. The cold dust emission in the AB Aur disk forms an asymmetric ring at a radius of about 120 au, which is suggestive of dust trapping in a gas vortex. We present high spatial resolution (0".58×0".78 ≈ 80×110 au) NOEMA observations of the 1.12 mm and 2.22 mm dust continuum emission from the AB Aur disk. Significant azimuthal variations of the flux ratio at both wavelengths indicate a size segregation of the large dust particles along the ring. Our continuum images also show that the intensity variations along the ring are smaller at 2.22 mm than at 1.12 mm, contrary to what dust trapping models with a gas vortex have predicted. Our two-fluid (gas+dust) hydrodynamical simulations demonstrate that this feature is well explained if the gas vortex has started to decay due to turbulent diffusion, and dust particles are thus losing the azimuthal trapping on different timescales depending on their size. The comparison between our observations and simulations allows us to constrain the size distribution and the total mass of solid particles in the ring, which we find to be of the order of 30 Earth masses, enough to form future rocky planets.

Complex Organic Molecules tracing shocks along the outflow cavity in the high-mass protostar IRAS 20126+4104.

We report on subarcsecond observations of complex organic molecules (COMs) in the high-mass protostar IRAS 20126+4104 with the Plateau de Bure Interferometer in its most extended configurations. In addition to the simple molecules SO, HNCO and H213CO, we detect emission from CH3CN, CH3OH, HCOOH, HCOOCH3, CH3OCH3, CH3CH2CN, CH3COCH3, NH2CN, and (CH2OH)2. SO and HNCO present a X-shaped morphology consistent with tracing the outflow cavity walls. Most of the COMs have their peak emission at the putative position of the protostar, but also show an extension towards the south(east), coinciding with an H2 knot from the jet at about 800-1000 au from the protostar. This is especially clear in the case of H213CO and CH3OCH3. We fitted the spectra at representative positions for the disc and the outflow, and found that the abundances of most COMs are comparable at both positions, suggesting that COMs are enhanced in shocks as a result of the passage of the outflow. By coupling a parametric shock model to a large gas-grain chemical network including COMs, we find that the observed COMs should survive in the gas phase for ∼ 2000 yr, comparable to the shock lifetime estimated from the water masers at the outflow position. Overall, our data indicate that COMs in IRAS 20126+4104 may arise not only from the disc, but also from dense and hot regions associated with the outflow.

The intense starburst HDF 850.1 in a galaxy overdensity at z ≈ 5.2 in the Hubble Deep Field.

The Hubble Deep Field provides one of the deepest multiwavelength views of the distant Universe and has led to the detection of thousands of galaxies seen throughout cosmic time. An early map of the Hubble Deep Field at a wavelength of 850 micrometres, which is sensitive to dust emission powered by star formation, revealed the brightest source in the field, dubbed HDF 850.1 (ref. 2). For more than a decade, and despite significant efforts, no counterpart was found at shorter wavelengths, and it was not possible to determine its redshift, size or mass. Here we report a redshift of z = 5.183 for HDF 850.1, from a millimetre-wave molecular line scan. This places HDF 850.1 in a galaxy overdensity at z ≈ 5.2, corresponding to a cosmic age of only 1.1 billion years after the Big Bang. This redshift is significantly higher than earlier estimates and higher than those of most of the hundreds of submillimetre-bright galaxies identified so far. The source has a star-formation rate of 850 solar masses per year and is spatially resolved on scales of 5 kiloparsecs, with an implied dynamical mass of about 1.3 × 10(11) solar masses, a significant fraction of which is present in the form of molecular gas. Despite our accurate determination of redshift and position, a counterpart emitting starlight remains elusive.

A massive protocluster of galaxies at a redshift of z ≈ 5.3.

Massive clusters of galaxies have been found that date from as early as 3.9 billion years (3.9 Gyr; z = 1.62) after the Big Bang, containing stars that formed at even earlier epochs. Cosmological simulations using the current cold dark matter model predict that these systems should descend from 'protoclusters'-early overdensities of massive galaxies that merge hierarchically to form a cluster. These protocluster regions themselves are built up hierarchically and so are expected to contain extremely massive galaxies that can be observed as luminous quasars and starbursts. Observational evidence for this picture, however, is sparse because high-redshift protoclusters are rare and difficult to observe. Here we report a protocluster region that dates from 1 Gyr (z = 5.3) after the Big Bang. This cluster of massive galaxies extends over more than 13 megaparsecs and contains a luminous quasar as well as a system rich in molecular gas. These massive galaxies place a lower limit of more than 4 × 10(11) solar masses of dark and luminous matter in this region, consistent with that expected from cosmological simulations for the earliest galaxy clusters.

A kiloparsec-scale hyper-starburst in a quasar host less than 1 gigayear after the Big Bang.

The host galaxy of the quasar SDSS J114816.64+525150.3 (at redshift z = 6.42, when the Universe was less than a billion years old) has an infrared luminosity of 2.2 x 10(13) times that of the Sun, presumably significantly powered by a massive burst of star formation. In local examples of extremely luminous galaxies, such as Arp 220, the burst of star formation is concentrated in a relatively small central region of <100 pc radius. It is not known on which scales stars are forming in active galaxies in the early Universe, at a time when they are probably undergoing their initial burst of star formation. We do know that at some early time, structures comparable to the spheroidal bulge of the Milky Way must have formed. Here we report a spatially resolved image of [C ii] emission of the host galaxy of J114816.64+525150.3 that demonstrates that its star-forming gas is distributed over a radius of about 750 pc around the centre. The surface density of the star formation rate averaged over this region is approximately 1,000 year(-1) kpc(-2). This surface density is comparable to the peak in Arp 220, although about two orders of magnitude larger in area. This vigorous star-forming event is likely to give rise to a massive spheroidal component in this system.

Adverse haematological outcome and environmental lead poisoning.

The South-eastern Area (SA) of the Municipality of La Spezia (Liguria Region, Italy) is characterised by a heavy environmental lead (Pb) contamination, chiefly due to the emissions of a Pb-processing plant in operation since 1930. In order to assess the risk of Pb poisoning of residents of SA, and to estimate the degree of association between the blood Pb level (BLL) and haematocrit % (HCT), intended as a biomarker of early haematological dysfunction, we reanalysed data of 785 individuals collected in 1992 as a part of a larger national biological monitoring project. Multiple normal regression modelling was applied to estimate the role of residence on log-transformed BLL, and Median Ratio (MR) was used as an index of effect. The same statistical modelling was also applied to reveal the relationship between HCT and BLL. Allowing for several confounders (including occupational exposure to Pb), residents of SA showed a 14% increase (MR=1.14, 95% IC=1.06-1.23%) in the median BLL value compared to people living outside SA. The excess reached 27% (MR=1.27, 95% IC=1.14-1.41%) after 30 years of residence. Parallel results were also obtained in a subgroup composed only of pupils (<18 years, non-smokers, non-drinkers). Finally, regression analysis highlighted a statistically significant parabolic trend in HCT in relation to BLL. The non-linear dose-response relationship, which attests to an adverse effect on the erythrocytic function of BLLs at least over 17.00 microg/dl, is in agreement with the findings of other authors and consistent with the results of an excess occurrence of self-reported anaemia obtained from a previous comparative survey carried out on the same population.

Permanent pacing lead insertion through the cephalic vein using an hydrophilic guidewire.

The cephalic vein (CV) should be preferred to the subclavian vein for the insertion of permanent pacing leads because of better results. Unfortunately, the direct lead introduction using the standard CV cutdown is often unsuccessful. This study evaluated the efficacy and safety of a steerable hydrophilic guidewire (HGW) for lead insertion through the CV. An HGW was successfully introduced through the cephalic vein and into the subclavian vein. Over a 6-month period, 115 consecutive patients underwent pacemaker implantation. In nine (7.8%) patients, the cephalic vein did not allow lead or guidewire introduction. The direct introduction of the leads through the CV was successful in 55 (51.9%) of 106 patients. In 14 (12.2%) additional patients, a lead was inserted through the CV using a standard guidewire. The use of an HGW and of a split introducer allowed successful insertion of at least one lead in 35 (30.4%) additional patients. Overall, the HGW was successful in 35 (94.6%) of 37 of patients in which the technique was attempted. The CV approach was successful in 104 (90.4%) of 115 patients. In conclusion, the use of an HGW allows the insertion of a pacing lead through the CV in the great majority of patients in whom direct introduction and the use of a standard guidewire had failed. The technique significantly improves the success rate of the CV approach and may help to improve the acute and long-term results of permanent cardiac pacing.

Molecular gas in the host galaxy of a quasar at redshift z = 6.42.

Observations of molecular hydrogen in quasar host galaxies at high redshifts provide fundamental constraints on galaxy evolution, because it is out of this molecular gas that stars form. Molecular hydrogen is traced by emission from the carbon monoxide molecule, CO; cold H2 itself is generally not observable. Carbon monoxide has been detected in about ten quasar host galaxies with redshifts z > 2; the record-holder is at z = 4.69 (refs 1-3). Here we report CO emission from the quasar SDSS J114816.64 + 525150.3 (refs 5, 6) at z = 6.42. At that redshift, the Universe was only 1/16 of its present age, and the era of cosmic reionization was just ending. The presence of about 2 x 1010 M\circ of H2 in an object at this time demonstrates that molecular gas enriched with heavy elements can be generated rapidly in the youngest galaxies.

[Lead pollution and hematologic effects in the city of La Spezia]. / Inquinamento da piombo ed effetti ematologici nel Comune di La Spezia.

During 1998-1999 a survey assessed the health impact of living in an area (Zona D) of the city of La Spezia (Liguria Region, Italy) characterised by industrial plants, urban waste disposal sites and incinerators, a coal-fired power-station and a heavily trafficked thoroughfare. One of the main results was an excess prevalence and incidence of self-reported anaemia among residents in area D compared to those of the control area (Zone C). Given the environmental lead pollution in Zone D due to the emissions of a lead processing plant active since 1930, and in order to confirm the validity of previous findings, was investieable the association between residence and blood lead levels, as well as the relationship between the latter and an anaemia-specific biomarker. We re-analysed personal, occupational and haematological data of 785 residents of La Spezia Province collected by the Liguria Environmental Protection Agency (ARPAL) during 1992 as part of a biological monitoring survey of the general population about the risk of lead intoxication. Subjects were geo-referenced by the 1992 residence address, and the haematocrit value was used as the anaemia-specific biomarker. Multiple regression analysis estimated the effect of residence on log-transformed lead blood levels, and to assess the relationship between the latter and haematocrit values. After adjusting for several potential confounding factors, residents from Zone D showed a 14% increase (95% IC = 6%-23%) in the blood lead median value estimated via the log-normal regression model compared to people living elsewhere. The excess became 27% (95% IC = 14%-41%) after 30 years of residence in the study area. Similar results were obtained by focusing analyses on students (n = 89, < 18 years, non-smokers, non-drinkers). The same modelling highlighted a significant non-linear (parabolic) dose-response relationship between lead blood and haematocrit values. This trend is consistent with the findings of other Authors and might reveal an adverse haematological effect of lead values over 170, 0 microgram/l. In conclusion, The results of this investigation strengthen the epidemiological evidence of the 1998-1999 survey.

Percutaneous reperfusion of left main coronary disease complicated by acute myocardial infarction.

Previous studies have shown a benefit of a strategy of direct angioplasty and stenting in patients with acute myocardial infarction (AMI) complicated by early cardiogenic shock. However, few data exist for the subset of patients with left main trunk disease complicated by AMI and cardiogenic shock. We performed an analysis of patients with AMI who underwent mechanical intervention between January 1995 and December 2000. Out of 1,433 patients with ST segment elevation AMI treated with primary coronary angioplasty (PTCA), 22 patients (1.5%) had left main disease (LMD) as the culprit lesion. Baseline characteristics were age, 66 +/- 11 years; female gender, 9%; diabetes, 14%; previous myocardial infarction, 14%; mean systolic blood pressure, 77 +/- 24 mm Hg; time to treatment, 4.8 +/- 2.2 hr; TIMI 0-1, 77%; collateral flow (Rentrop grade >or= 2) 9%. The primary success rate was 91%. Primary stenting was performed in 17 patients (77%). The in-hospital mortality rate was 50%. All deaths were due to refractory shock. The 6-month survival rate was 41% +/- 1%, while the event-free survival rate was 27% +/- 10%. At 6-month follow-up, the mortality rate increased to 59%; the target vessel revascularization rate was 14%. A percutaneous mechanical intervention strategy in patients with left main disease complicated by AMI is feasible and effective, and patients discharged alive have a good mid-term prognosis.