Peripheral nerve blocks for acute trigeminal neuralgia involving maxillary and mandibular branches: a case report.

Trigeminal neuralgia (TN) is neuropathic pain that affects the trigeminal nerve branches. Facial pain experienced by patients with TN is typically intense and excruciating. The second and third branches (maxillary and mandibular) are commonly affected. This case report focuses on the potential treatment options for acute TN attacks involving these branches. The proposed approach involves extra-oral peripheral blocks using local anesthetics. Pain levels were measured using a visual numeric scale (VNS) with potential side effects and other relevant documented information. The patients showed responses from high pain levels to almost complete remission (from 8 to 2 and from 10 to 2 on the final VNS), with no significant side effects. This technique provides immediate pain relief and complements oral medications by offering comfort and confidence until the desired drug effect is achieved.

Could Cratylia argentea replace Tifton 85 hay on growing and finishing lamb diets in tropical areas?

Legumes shrubs such as Cratylia argentea have an ability to thrive in environments with low water availability and poor soil. On the other hand, forage grasses such as Tifton 85 have a greater demand for inputs to be productive. The objective of this study was to evaluate the performance of growing and finishing Lacaune lambs fed Cratylia argentea hay as an alternative to Tifton 85 (Cynodon spp). Twenty-four Lacaune lambs aged between five and six months (average body weight [BW] 21.50 ± 3.38 kg) were arranged in a split-plot randomized block design. The plots consisted of different Cratylia to Tifton 85 hay proportions (0, 20%, 40%, or 100%, dry matter [DM] basis) as a roughage replacement in the total diet. The subplots represented two evaluation times, entitled "initial period" and "final period", which consisted of the early seven days of total feces and urine collection, and the last seven days of the experiment, respectively. The lambs were blocked by weight with six replicates per treatment. The results show that the level of Tifton 85 replacement for Cratylia hay in the roughage portion of the lamb diet did not influence (P > 0.05) weight gain (WG), dry matter intake or dry matter digestibility; feed conversion, feed efficiency; and the evaluated nitrogen balance variables. The digestibility coefficient of neutral detergent fiber decreased linearly as Tifton 85 replacement for Cratylia level was increased, which probably happened due to the presence of highly lignified material within the Cratylia hay. However, the alternative legume maintained animal performance of Tifton 85. In conclusion, Cratylia hay can be recommended as a potential substitute for Tifton 85 hay, which requires greater inputs for the production. Cratylia may be considered a feeding strategy for livestock production, especially for smallholder livestock systems and regions with unfavorable soil and climate.

Surgery for ulnar nerve decompression and drainage of a caseous granuloma in a neural form of leprosy in children.

Key Clinical Message: The findings in the literature, as well as those described in this study, emphasize the need for systematic and longitudinal care for patients with neglected diseases during and after treatment, mainly in low-middle income countries. Abstract: Leprosy is a chronic, granulomatous, mycobacterial infection caused by mycobacterium leprae, affecting the skin and peripheral nervous system. We present a case of a 13-year-old child with leprosy for more than a year, indicating decompression of the ulnar nerve. During surgery, an intraneural large caseous granule was evidenced.

Spatial variability of chemical indicators of Amazon agricultural soils through geomultivariate statistics, Brazil.

This work focuses on evaluating the spatial variability of chemical attributes of soils under different agricultural use and native forest, indicating which are the possible indicator attributes of changes in environmental, through the use and management of the soil. The study was carried out in the southern region of the Amazonas state, in an Argissolo Vermelho-Amarelo (Ultisol). Sampling grids were established measuring: 90 m × 70 m with regular soil collection spacing of 10 m for the guarana and forest areas; 90 m × 56 m spaced at 10 m × 8 m for annatto area; and 54 m × 42 m with spacing between points of 6 m for the cupuaçu area, totaling 80 sampling points in each area, with soil samples collected at depths of 0.0-0.05; 0.05-0.10 m and 0.10-0.20 m. The following attributes were determined: pH, Al3+, K+, Ca2+, Mg2+, P, H + Al, CEC, V% and m%. Descriptive, geostatistical and multivariate statistical analyzes were performed. The results show that it is possible to state that the descriptive, geostatistical and multivariate statistical techniques were able to identify the difference between the spatial variability of the attributes according to each specific use of individual soils. The multivariate analysis made it possible to select the attributes that most contribute to the variability of these soils, and with that, it was found that the forest showed less spatial variability in the surface layer, with higher reach values by scaled semivariograms.

Patients with inflammatory myopathies overlapping with systemic sclerosis: A Brazilian-Japanese bicentric study.

Objectives: This study aims to describe and compare the demographic, clinical, and laboratory characteristics and follow-up of representative samples of patients with myopathies and systemic sclerosis overlap syndromes (Myo-SSc) from two tertiary centers. Patients and methods: This is a cross-sectional and retrospective study conducted between January 2000 and December 2020. Fourty-five patients were analyzed with Myo-SSc (6 males, 39 females; mean age: 50.2±15.4 years; range, 45 to 65 years) from two tertiary centers (n=30 from Brazil and n=15 from Japan). Results: The median follow-up was 98 (range, 37 to 168) months. Muscle impairment started simultaneously with the diagnosis of systemic sclerosis in 57.8% (26/45) of cases. Muscle involvement occurred before the onset of systemic sclerosis in 35.5% (16/45) of cases, and after in 6.7% (3/45). Polymyositis was observed in 55.6% (25/45) of cases, followed by dermatomyositis in 24.4% (11/45) and antisynthetase syndrome in 20.0% (9/45). Concerning systemic sclerosis, the diffuse and limited forms occurred in 64.4% (29/45) and 35.6% (16/45) of the cases, respectively. Comparing the subgroups, Myo or SSc onset was earlier in Brazilian patients, and they had a higher frequency of dysphagia (20/45, [66.7%]) and digital ulcers (27/45, [90%]), whereas Japanese patients had higher modified Rodnan skin scores (15 [9 to 23]) and prevalence of positive anti-centromere antibodies (4/15 [23.7%]). The current disease status and mortality were similar in both groups. Conclusion: In the present study, Myo-SSc affected middle-aged women, and its manifestation spectrum varied according to geographic distribution.

Priming of the murine mammary gland with Staphylococcus chromogenes IM reduces bacterial growth of Streptococcus uberis: a proof-of-concept study.

Streptococcus uberis is a major causative agent of bovine mastitis, an inflammation of the mammary gland with substantial economic consequences. To reduce antibiotic use in animal agriculture, alternative strategies to treat or prevent mastitis are being investigated. Bovine-associated non-aureus staphylococci are proposed in that respect due to their capacity to inhibit the in vitro growth of S. uberis. We demonstrate that priming the murine mammary gland with Staphylococcus chromogenes IM reduces S. uberis growth in comparison with non-primed glands. The innate immune system is activated by increasing IL-8 and LCN2, which may explain this decreased growth.

Carbon Nanostructure Embedded Novel Sensor Implementation for Detection of Aromatic Volatile Organic Compounds: An Organized Review.

For field-like environmental gas monitoring and noninvasive illness diagnostics, effective sensing materials with exceptional sensing capabilities of sensitive, quick detection of volatile organic compounds (VOCs) are required. Carbon-based nanomaterials (CNMs), like CNTs, graphene, carbon dots (Cdots), and others, have recently drawn a lot of interest for their future application as an elevated-performance sensor for the detection of VOCs. CNMs have a greater potential for developing selective sensors that target VOCs due to their tunable chemical and surface properties. Additionally, the mechanical versatility of CNMs enables the development of novel gas sensors and places them ahead of other sensing materials for wearable applications. An overview of the latest advancements in the study of CNM-based sensors is given in this comprehensive organized review.

Prenatal and perinatal risk factors for bipolar disorder: A systematic review and meta-analysis.

BACKGROUND: Perinatal and prenatal risk factors may be implicated in the development of bipolar disorder, but literature lacks a comprehensive account of possible associations. METHODS: We performed a systematic review and meta-analyses of observational studies detailing the association between prenatal and perinatal risk factors and bipolar disorder in adulthood by searching PubMed, Embase, Web of Science and Psycinfo for articles published in any language between January 1st, 1960 and September 20th, 2021. Meta-analyses were performed when risk factors were available in at least two studies. FINDINGS: Twenty seven studies were included with 18 prenatal or perinatal factors reported across the literature. Peripartum asphyxia (k = 5, OR = 1.46 [1.02; 2.11]), maternal stress during pregnancy (k = 2, OR = 12.00 [3.30; 43.59]), obstetric complications (k = 6, OR = 1.41 [1.18; 1.69]), and birth weight less than 2500 g (k = 5, OR = 1.28 [1.04; 1.56]) were associated with an increased risk for bipolar disorder. INTERPRETATION: Perinatal and prenatal risk factors are implicated in the pathogenesis of bipolar disorder, supporting a role of prenatal care in preventing the condition.

Clinical manifestations, outcomes, and antibody profile of Brazilian adult patients with dermatomyositis: a single-center longitudinal study.

BACKGROUND: Currently, only a few retrospective cohort or cross-sectional studies have described the general characteristics of Brazilian patients with classical dermatomyositis (DM). In contrast, we aimed to longitudinally assess a large sample of these patients, and several myositis autoantibodies. METHODS: This single-center longitudinal study included 91 Brazilian adults with defined DM (EULAR/ACR 2017) who underwent follow-up appointments in our tertiary center from 2012 to 2021. Myositis autoantibody analysis was performed using a commercial kit. RESULTS: The mean age of the patients was 47.3 ± 15.4 years, with a predominance of female (67.0%) and White (81.3%) patients. As an initial treatment, 76.9% of the patients received methylprednisolone pulse therapy, 59.3% received intravenous immunoglobulin, and 54.9% received both drugs. The median follow-up duration was 44 months (interquartile 17-67) months. There were 92 severe episodes of infection, and neoplasms were identified in 20 patients (22.0%). Hypertension was identified in 46.2% of patients, whereas diabetes mellitus and myocardial infarction occurred in 19.8% and 4.4%, respectively. Nine patients died during the follow-up. At the last visit, one-third of the patients had disease activity, half had a complete clinical response, and one-fifth were in disease remission. In a univariate logistic regression, anti-aminoacyl-tRNA synthetase antibodies (n = 13) were associated with interstitial lung disease, "mechanic's hands", and anti-Ro-52, and had an inverse association with "V"-neck and "shawl" signs. Anti-MDA-5 (n = 10) were associated with male gender, digital ulcers, vasculitis, arthritis, anti-Ro-52, and active disease. Anti-Ro-52 (n = 26) were associated with "mechanics' hands", arthritis, interstitial lung disease, anti-tRNA synthetases, and anti-MDA-5. No association was found for anti-Mi-2 (n = 10). CONCLUSIONS: This study shows the general profile of a significant sample of Brazilian patients with DM as well as the association of some antibodies with clinical and laboratory manifestations of this myositis.

Forest-Fruticulture Conversion Alters Soil Traits and Soil Organic Matter Compartments.

Fruticulture in the Amazonian Rainforest is one of the main causes of deforestation, biodiversity loss, and soil erosion. Fruticulture plays a key role in the soil traits and soil organic matter (SOM) compartments by altering the soil ecosystem. Our aim was to assess the influence of Forest-Fruticulture conversion on soil traits, and SOM fractions in Brazil's Legal Amazon. The experiment was carried out in field conditions using four land uses as main treatments: Bixa orellana, Theobroma grandiflorum, Paullinia cupana, and the Amazon Rainforest. The soil physicochemical traits were analyzed using samples that were collected from 0-5, 5-10, and 10-20 cm soil depth by using grids (10 × 10 m) with 36 sampling points. Our results showed that the Fruticulture promoted an increase in bulk density, GMD, aggregate diameter, soil porosity, gravimetric moisture, sand, clay, carbon associated with humic acid, and, the sum of bases (K+, Ca2+, and Mg2+), while the Amazon Rainforest showed the highest values of silt, soil P content, SOC, p-SOC, m-SOC, carbon associated with fulvic acid, humine, and soil C stock. Overall, the fruticulture farming systems have negative effects on SOM compartments. The results of our study highlight the importance of considering fruticulture with endemic plant species by promoting soil fertility and soil aggregation.

Ventilation asymmetry, diaphragmatic mobility and exercise capacity in men with traumatic brachial plexus injury.

OBJECTIVE: To investigate the repercussions of traumatic brachial plexus injury (TBPI) on diaphragmatic mobility and exercise capacity, compartmental volume changes, as well as volume contribution of each hemithorax and ventilation asymmetry during different respiratory maneuvers, and compare with healthy individuals. The velocity of shortening of the diaphragm, inspiratory, and expiratory muscles were also assessed. PARTICIPANTS: The cross-sectional study was conducted with 40 male individuals (20 with TBPI who have not undergone nerve transfer surgery [mean age 30.1 ± 5.3] and 20 healthy paired by age and body mass index). Only patients with C8-T1 root avulsion were studied. MAIN OUTCOME: Compartmental and hemithoracic volumes, as well as asymmetry between the affected and unaffected sides were assessed using optoelectronic plethysmography. The 6 minute walking test was performed to evaluate exercise capacity, while diaphragm mobility was assessed during quiet breathing (QB) using an ultrasound device. RESULTS: TBPI patients with mean lesion time of 174 ± 45.24 days showed a decreased pulmonary function, respiratory muscle strength, exercise capacity, and diaphragm mobility (all p < .001) compared with healthy. The pulmonary ribcage compartment of the affected side was the main contributor to the reduction in volume during inspiratory capacity, vital capacity, and inspiratory load imposition (all p < .05). This compartment also exhibited a higher ventilation asymmetry with reduced shortening velocity of the inspiratory ribcage muscles. CONCLUSION: Compared with healthy, TBPI patients who have not undergone nerve transfer surgery present low exercise capacity and diaphragmatic mobility, as well as reduced volume of the upper ribcage compartment on the affected side that leads to reduced shortening velocity and ventilation asymmetry.

Gathering patients and rheumatologists' perceptions to improve outcomes in idiopathic inflammatory myopathies.

OBJECTIVE: Therapeutic targets in Idiopathic Inflammatory Myopathies (IIM) are based on the opinions of physicians/specialists, which may not reflect the main concerns of patients. The authors, therefore, assessed the outcome concerns of patients with IIM and compared them with the concerns of rheumatologists in order to develop an IIM outcome standard set. METHODS: Ninety-three IIM patients, 51 rheumatologists, and one physiotherapist were invited to participate. An open questionnaire was initially applied. The top 10 answers were selected and applied in a multiple-choice questionnaire, inquiring about the top 3 major concerns. Answers were compared, and the agreement rate was calculated. Concerns were gathered in an IIM outcome standard set with validated measures. RESULTS: The top three outcome concerns raised by patients were medication side effects/muscle weakness/prevention functionality loss. The top three concerns among rheumatologists were to prevent loss of functionality/to ensure the quality of life/to achieve disease remission. Other's outcomes concerns only pointed out by patients were muscle pain/diffuse pain/skin lesions/fatigue. The agreement rate between both groups was 41%. Assessment of these parameters guided the development of an IIM standard set which included Myositis Disease Activity Assessment Visual Analogue Scale/Manual Muscle Testing/fatigue and pain Global Visual Analogue Scale/Health Assessment Questionnaire/level of physical activity. CONCLUSION: The authors propose a novel standard set to be pursued in IIM routine follow-up, which includes not only the main patients/rheumatologist outcome concerns but also additional important outcomes only indicated by patients. Future studies are necessary to confirm if this comprehensive approach will result in improved adherence and ultimately in better assistance.

Efficacy of two polishing systems in reestablishing the surface smoothness of posterior monolithic lithium disilicate restorations: One-year results of a split-mouth randomized controlled clinical trial.

STATEMENT OF PROBLEM: Selecting the optimal polishing procedure to reestablish surface smoothness after occlusal adjustment is essential for the long-term success of glass-ceramic restorations. While in vitro studies have shown different effective polishing protocols, clinical trials are lacking. PURPOSE: The purpose of this split-mouth controlled clinical trial was to evaluate the effectiveness of 2 polishing systems in reestablishing the surface smoothness of posterior monolithic lithium disilicate ceramic restorations. MATERIAL AND METHODS: Ninety-six restorations that required occlusal adjustment after bonding were randomized into 2 groups: Forty-eight restorations were polished by using the Exa Cerapol polishing kit, and the other 48 restorations were polished by using the Shofu polishing kit. The restorations were replicated with epoxy resin at 3 study times-after bonding (t1), after occlusal adjustment (t2), and after polishing (t3)-for quantitative roughness analysis (Ra). Representative specimens from each group were qualitatively analyzed by using a confocal laser microscope. Clinical analyses were performed after the polishing procedure and at 30, 180, and 365 days after the polishing procedure by following the United States Public Health Service (USPHS) criteria. ANOVA and the Tukey multiple comparisons parametric tests were computed (α=.05). The Kaplan-Meier test was used to analyze the survival rate of restorations. RESULTS: No statistically significant difference was found between the Exa Cerapol and Shofu groups (P=.086). A statistically significant difference was found between study times t1 and t2 and between t2 and t3 (both P<.001) in both experimental groups. No statistically significant difference was found between study times t1 and t3 (P=.181) in either experimental group. For the clinical criterion "integrity of restorations," all the elements analyzed indicated an alfa grade at all study times. The survival rate of the restorations was 100%. CONCLUSIONS: Both polishing kits were effective in reestablishing the surface smoothness of restorations after occlusal adjustment.

Physical therapeutic treatment for traumatic brachial plexus injury in adults: A scoping review.

Traumatic brachial plexus injury (BPI) is one of the most disabling injuries of the upper extremity, often requiring specialized treatment and a prolonged rehabilitation period. This scoping review was carried out to identify and describe the physical therapy modalities applied in the rehabilitation of adult individuals with BPI. Electronic databases, gray literature, and reference lists were searched, and studies meeting the following eligibility criteria were included: (a) interventions including any physical therapy modality; (b) individuals age ≥18 years old; and (c) a clinical diagnosis of BPI. The literature search yielded 681 articles of which 49 met the inclusion criteria and had their outcomes, treatment parameters, and the differences between conservative and pre- and postoperative treatment phases analyzed. The most commonly used physical therapy interventions were in the subfields of kinesiotherapy (ie, involving range of motion exercises, muscle stretching, and strengthening), electrothermal and phototherapy, manual therapy, and sensory re-education strategies. Although several physical therapy modalities were identified for the treatment of BPI in this scoping review, the combination of low levels of evidence and the identified gaps regarding the treatment parameters challenge the reproducibility of such treatments in clinical practice. Therefore, future controlled clinical trials with clearer treatment protocols for individuals with BPI are needed.

Systemic autoimmune myopathies: a prospective phase 4 controlled trial of an inactivated virus vaccine against SARS-CoV-2.

OBJECTIVES: To evaluate immunogenicity and safety of an inactivated SARS-CoV-2 vaccine in systemic autoimmune myopathies (SAMs) and the possible influence of baseline disease parameters, comorbidities and therapy on immune response. METHODS: This prospective controlled study included 53 patients with SAMs and 106 non-immunocompromised control group (CTRL). All participants received two doses of the Sinovac-CoronaVac vaccine (28-day interval). Immunogenicity was assessed by anti-SARS-CoV-2 S1/S2 IgG seroconversion (SC), anti-S1/S2 IgG geometric mean titre (GMT), factor increase GMT (FI-GMT), neutralizing antibodies (NAb) positivity, and median neutralizing activity after each vaccine dose (D0 and D28) and six weeks after the second dose (D69). Participants with pre-vaccination positive IgG serology and/or NAb and those with RT-PCR confirmed COVID-19 during the protocol were excluded from immunogenicity analysis. RESULTS: Patients and CTRL had comparable sex (P>0.99) and age (P=0.90). Immunogenicity of 37 patients and 79 CTRL-naïve participants revealed at D69, a moderate but significantly lower SC (64.9% vs 91.1%, P<0.001), GMT [7.9 (95%CI 4.7-13.2) vs 24.7 (95%CI 30.0-30.5) UA/ml, P<0.001] and frequency of NAb (51.4% vs 77.2%, P<0.001) in SAMs compared with CTRL. Median neutralizing activity was comparable in both groups [57.2% (interquartile range (IQR) 43.4-83.4) vs 63.0% (IQR 40.3-80.7), P=0.808]. Immunosuppressives were less frequently used among NAb+ patients vs NAb- patients (73.7% vs 100%, P=0.046). Type of SAMs, disease status, other drugs or comorbidities did not influence immunogenicity. Vaccine-related adverse events were mild with similar frequencies in patients and CTRL (P>0.05). CONCLUSION: Sinovac-CoronaVac is safe and has a moderate short-term immunogenicity in SAMs, but reduced compared with CTRL. We further identified that immunosuppression is associated with diminished NAb positivity. TRIAL REGISTRATION: COVID-19 CoronaVac in Patients With Autoimmune Rheumatic Diseases and HIV/AIDS (CoronavRheum), http://clinicaltrials.gov/ct2/show/NCT04754698.

Long-term effects of early pulse methylprednisolone and intravenous immunoglobulin in patients with dermatomyositis and polymyositis.

OBJECTIVE: To evaluate the long-term effects of pulse i.v. methylprednisolone (IVMP) or IVIG administered during the first year of diagnosis in DM and PM patients. METHODS: This is a retrospective single-centre cohort study of patients with PM/DM followed for up to 4 years from 2001 to 2017. We used Cox regression models to estimate hazard ratios (HRs) and assess the effects of early pulse IVMP or IVIG on three outcomes: complete clinical response, CS discontinuation, and survival. Analysis was adjusted for clinical, laboratory and treatment covariates. RESULTS: A total of 204 patients were included and categorized into four initial treatment groups: pulse IVMP (n = 46), pulse IVMP + IVIG (n = 55), IVIG (n = 10), and without IVMP or IVIG (n = 93). The groups of early pulse IVMP and pulse IVMP + IVIG had a higher HR for complete clinical response in the multivariate models (HR = 1.56, 95% CI: 1.05, 2.33, P = 0.029; and HR = 1.58, 95% CI: 1.02, 2.45, P = 0.041, respectively). Only the group of pulse IVMP + IVIG had a significant association with CS discontinuation in the multivariate analysis (HR = 1.65, 95% CI: 1.02, 2.68, P = 0.043). Early pulse IVMP or IVIG had no impact on mortality. CONCLUSION: Despite having a more severe disease profile, patients with PM/DM submitted to pulse IVMP or pulse IVMP + IVIG during the first year of diagnosis had a higher HR for complete clinical response, whereas the combination of pulse IVMP + IVIG had an association with CS discontinuation. Prospective long-term studies are warranted to confirm these benefits of early pulse IVMP and IVIG on patients with PM/DM.

Multimodality Molecular Imaging in Arthropathy Associated with Multiple Myeloma.

We report a patient with multiple myeloma (MM) and polyarthritis of large joints. During the staging of the disease, bone marrow diffusely involved by MM was clearly demonstrated by 99mTc-2-methoxy-isobutyl-isonitrile (MIBI) single-photon emission computed tomography/computed tomography (SPECT/CT) but not by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/CT images. On the other hand, a very intense uptake of 18F-FDG was detected in periarticular tissues of multiple joints, with nonabnormal 99mTc-MIBI accumulation. Rheumatology tests were negative. A subsequent bone scintigraphy demonstrated radiolabeled bisphosphonate accumulation in periarticular tissues, suggesting amyloid arthropathy.

Gathering patients and rheumatologists' perceptions to improve outcomes in idiopathic inflammatory myopathies

Abstract Objective Therapeutic targets in Idiopathic Inflammatory Myopathies (IIM) are based on the opinions of physicians/specialists, which may not reflect the main concerns of patients. The authors, therefore, assessed the outcome concerns of patients with IIM and compared them with the concerns of rheumatologists in order to develop an IIM outcome standard set. Methods Ninety-three IIM patients, 51 rheumatologists, and one physiotherapist were invited to participate. An open questionnaire was initially applied. The top 10 answers were selected and applied in a multiple-choice questionnaire, inquiring about the top 3 major concerns. Answers were compared, and the agreement rate was calculated. Concerns were gathered in an IIM outcome standard set with validated measures. Results The top three outcome concerns raised by patients were medication side effects/muscle weakness/prevention functionality loss. The top three concerns among rheumatologists were to prevent loss of functionality/to ensure the quality of life/to achieve disease remission. Other's outcomes concerns only pointed out by patients were muscle pain/diffuse pain/skin lesions/fatigue. The agreement rate between both groups was 41%. Assessment of these parameters guided the development of an IIM standard set which included Myositis Disease Activity Assessment Visual Analogue Scale/Manual Muscle Testing/fatigue and pain Global Visual Analogue Scale/Health Assessment Questionnaire/level of physical activity. Conclusion The authors propose a novel standard set to be pursued in IIM routine follow-up, which includes not only the main patients/rheumatologist outcome concerns but also additional important outcomes only indicated by patients. Future studies are necessary to confirm if this comprehensive approach will result in improved adherence and ultimately in better assistance.

Bovine-associated non-aureus staphylococci suppress Staphylococcus aureus biofilm dispersal in vitro yet not through agr regulation.

Biofilm formation is a significant virulence factor in Staphylococcus (S.) aureus strains causing subclinical mastitis in dairy cows. A role of environmental signals and communication systems in biofilm development, such as the agr system in S. aureus, is suggested. In the context of multispecies biofilm communities, the presence of non-aureus staphylococci (NAS) might influence S. aureus colonization of the bovine mammary gland, yet, such interspecies interactions have been poorly studied. We determined whether 34 S. chromogenes, 11 S. epidermidis, and 14 S. simulans isolates originating from bovine milk samples and teat apices (TA) were able to affect biofilm formation and dispersion of S. aureus, and if so, how isolate traits such as the capacity to regulate the S. aureus agr quorum sensing system are determinants in this process. The capacity of an agr-positive S. aureus strain to form biofilm was increased more in the presence of S. chromogenes than in the presence of S. simulans and S. epidermidis isolates and in the presence of NAS isolates that do not harbor biofilm related genes. On the other hand, biofilm dispersion of this particular S. aureus strain was suppressed by NAS as a group, an effect that was more pronounced by isolates from TA. Furthermore, the observed effects on biofilm formation and dispersion of the agr-positive S. aureus strain as well as of an agr-negative S. aureus strain did not depend on the capacity of NAS to repress the agr system.

Milk Macrophage Function in Bovine Leukemia Virus-Infected Dairy Cows.

The implications of bovine leukemia virus (BLV) on innate and adaptive immune responses have been widely investigated; however, the effects of BLV on mammary gland immunity require further investigation. The present study investigated the viability, phagocytic capacity, and intracellular production of reactive oxygen and nitrogen species (RONS) by macrophages in milk samples from dairy cows naturally infected with BLV with or without persistent lymphocytosis (PL). No effect of BLV infection in the overall number of macrophages per milliliter and in the percentage of viable macrophages among overall milk viable cells was found. Furthermore, BLV-infected dairy cows had a higher frequency of viable milk macrophages, while healthy animals had a tendency toward a higher percentage of apoptotic milk macrophages. The percentage of milk macrophages that phagocytosed Staphylococcus aureus in seronegative animals was higher than that in BLV-infected dairy cows. No effect of BLV infection on the intracellular RONS production and the intensity of phagocytosis by milk macrophages was observed. Thus, this study provides new insights into the implications of BLV infections in the bovine mammary gland.