Airborne particle dispersion around the feet of surgical staff while walking in and out of a bio-clean operating theatre.

BACKGROUND: Bacterial contamination by airborne particles is one of the most important factors in the pathogenesis of surgical-site infections. AIM: This study aimed to identify the generation and behaviour of airborne particles around the feet of surgical staff while walking in and out of an operating theatre. METHODS: Two physicians and two nurses walked in and out of a bio-clean theatre under laminar airflow, either individually or as a group. The generation and behaviour of airborne particles was filmed using a fine-particle visualization system, and the number of airborne particles per 2.83 m3 of air was counted using a laser particle counter. Each action was repeated five times, and particle counts were evaluated statistically. FINDINGS: Airborne particles were generated from the floor and by the shoes and gown hems of the participants, whether walking individually or as a group. Numerous airborne particles were generated by the group, and significantly more particles, especially those measuring 0.3-0.5 µm, were carried up to the level of the operating table by the group than by individuals (P<0.01). CONCLUSIONS: The results of this study provide a clearer picture of the dispersion and distribution of airborne particles around the feet of staff walking in and out of an operating theatre. The findings suggest that to reduce the incidence of bacterial contamination and risk of surgical site infections, surgical staff should walk calmly and independently, if possible, near sterile areas.

Applicability of hemodialysis clearance parameter for vancomycin therapeutic drug monitoring during continuous hemodiafiltration in an infant.

Cases requiring vancomycin administration planning in infants undergoing continuous hemodiafiltration (CHDF) are extremely rare. Here, we report a single case in which vancomycin therapeutic drug monitoring and administration planning were implemented for an infant requiring CHDF. The patient was diagnosed with wound infection after gastrostomy and enterotomy surgery and received vancomycin treatment for infection with methicillin-resistant Staphylococcus epidermidis. The vancomycin trough serum concentration was successfully controlled within the acceptable range. Additionally, we discuss the potential usefulness of applying the CHDF clearance parameter for the fine management of vancomycin serum concentration in a pediatric patient undergoing CHDF.

Functional implications of microbial and viral gut metagenome changes in early stage L-DOPA-naïve Parkinson's disease patients.

BACKGROUND: Parkinson's disease (PD) presently is conceptualized as a protein aggregation disease in which pathology involves both the enteric and the central nervous system, possibly spreading from one to another via the vagus nerves. As gastrointestinal dysfunction often precedes or parallels motor symptoms, the enteric system with its vast diversity of microorganisms may be involved in PD pathogenesis. Alterations in the enteric microbial taxonomic level of L-DOPA-naïve PD patients might also serve as a biomarker. METHODS: We performed metagenomic shotgun analyses and compared the fecal microbiomes of 31 early stage, L-DOPA-naïve PD patients to 28 age-matched controls. RESULTS: We found increased Verrucomicrobiaceae (Akkermansia muciniphila) and unclassified Firmicutes, whereas Prevotellaceae (Prevotella copri) and Erysipelotrichaceae (Eubacterium biforme) were markedly lowered in PD samples. The observed differences could reliably separate PD from control with a ROC-AUC of 0.84. Functional analyses of the metagenomes revealed differences in microbiota metabolism in PD involving the ẞ-glucuronate and tryptophan metabolism. While the abundances of prophages and plasmids did not differ between PD and controls, total virus abundance was decreased in PD participants. Based on our analyses, the intake of either a MAO inhibitor, amantadine, or a dopamine agonist (which in summary relates to 90% of PD patients) had no overall influence on taxa abundance or microbial functions. CONCLUSIONS: Our data revealed differences of colonic microbiota and of microbiota metabolism between PD patients and controls at an unprecedented detail not achievable through 16S sequencing. The findings point to a yet unappreciated aspect of PD, possibly involving the intestinal barrier function and immune function in PD patients. The influence of the parkinsonian medication should be further investigated in the future in larger cohorts.

Coral host transcriptomic states are correlated with Symbiodinium genotypes.

A mutualistic relationship between reef-building corals and endosymbiotic dinoflagellates (Symbiodinium spp.) forms the basis for the existence of coral reefs. Genotyping tools for Symbiodinium spp. have added a new level of complexity to studies concerning cnidarian growth, nutrient acquisition, and stress. For example, the response of the coral holobiont to thermal stress is connected to the host-Symbiodinium genotypic combination, as different partnerships can have different bleaching susceptibilities. In this study, we monitored Symbiodinium physiological parameters and profiled the coral host transcriptional responses in acclimated, thermally stressed, and recovered fragments of the coral Montastraea faveolata using a custom cDNA gene expression microarray. Interestingly, gene expression was more similar among samples with the same Symbiodinium content rather than the same experimental condition. In order to discount for host-genotypic effects, we sampled fragments from a single colony of M. faveolata containing different symbiont types, and found that the host transcriptomic states grouped according to Symbiodinium genotype rather than thermal stress. As the first study that links coral host transcriptomic patterns to the clade content of their Symbiodinium community, our results provide a critical step to elucidating the molecular basis of the apparent variability seen among different coral-Symbiodinium partnerships.

Differential gene expression during thermal stress and bleaching in the Caribbean coral Montastraea faveolata.

The declining health of coral reefs worldwide is likely to intensify in response to continued anthropogenic disturbance from coastal development, pollution, and climate change. In response to these stresses, reef-building corals may exhibit bleaching, which marks the breakdown in symbiosis between coral and zooxanthellae. Mass coral bleaching due to elevated water temperature can devastate coral reefs on a large geographical scale. In order to understand the molecular and cellular basis of bleaching in corals, we have measured gene expression changes associated with thermal stress and bleaching using a complementary DNA microarray containing 1310 genes of the Caribbean coral Montastraea faveolata. In a first experiment, we identified differentially expressed genes by comparing experimentally bleached M. faveolata fragments to control non-heat-stressed fragments. In a second experiment, we identified differentially expressed genes during a time course experiment with four time points across 9 days. Results suggest that thermal stress and bleaching in M. faveolata affect the following processes: oxidative stress, Ca(2+) homeostasis, cytoskeletal organization, cell death, calcification, metabolism, protein synthesis, heat shock protein activity, and transposon activity. These results represent the first medium-scale transcriptomic study focused on revealing the cellular foundation of thermal stress-induced coral bleaching. We postulate that oxidative stress in thermal-stressed corals causes a disruption of Ca(2+) homeostasis, which in turn leads to cytoskeletal and cell adhesion changes, decreased calcification, and the initiation of cell death via apoptosis and necrosis.

Hydrogen ion compartmentation during and following cerebral ischemia evaluated by 31P NMR spectroscopy.

Two peaks were observed in the inorganic phosphate region in 31P NMR spectra obtained during and shortly after incomplete forebrain ischemia induced in rats under normoglycemic conditions. Pre-ischemia, a single Pi peak was observed at a chemical shift of 2.5 ppm (pH 7.2). This peak shifted upfield to 1.6 ppm (pH 6.5) and, following reperfusion, returned to its pre-ischemia value. During ischemia and for a short time following reperfusion, a second, smaller peak was observed which we assigned to a second pool of inorganic phosphate. The data support the proposal by Kraig and coworkers of pH compartmentation between neurons and glia during and following transient forebrain ischemia.

[An experience of dissecting cerebral aneurysm of the anterior cerebral artery].

Intracranial dissecting aneurysms have been reported occasionally in recent years. However, excluding dissecting aneurysms which extend from the proximal intracranial carotid artery, dissecting aneurysms arising merely in ACA are found only rarely. We are reporting here a case of a 42 year-old gentleman who did not present any particular causative etiology such as trauma or other basic diseases causing arteritis. Our patient is the 8th case, as far as we could find in the literature, in which the dissection of the arterial wall originated at the ACA. The patient was thought to have a tiny saccular aneurysm at the A 1-2 junction of the right ACA associated with vasospasm in the distal ACA on the angiogram. The patient had motor weakness on the left side and headache as well as a low density area in the territory of the ACA on the CT scan. A craniotomy was performed verifying the aneurysm to be dissecting in type without any sign of recent subarachnoid hemorrhage in the surrounding structures. No aggressive surgical treatment such as trapping of the aneurysm was done because the collateral blood circulation in that territory of the distal right ACA seemed to be poor and the patient no longer had neurological deficit at the time of operation. The patient was treated successfully with antiplatelet therapy. On the follow-up angiogram performed 3.5 months after the onset of the illness, we noted the disappearance of the abnormal angiographical findings of the dissecting aneurysm and distal arterial narrowing (pearl and string sign).(ABSTRACT TRUNCATED AT 250 WORDS)