Bacteriophage Therapy in Companion and Farm Animals.

Bacteriophages, which are viruses with restricted tropism for bacteria, have been employed for over a century as antimicrobial agents; they have been largely abandoned in Western countries but are constantly used in Eastern European countries with the advent of antibiotics. In recent decades, the growing spread of multidrug-resistant bacteria, which pose a serious threat to worldwide public health, imposed an urgent demand for alternative therapeutic approaches to antibiotics in animal and human fields. Based on this requirement, numerous studies have been published on developing and testing bacteriophage-based therapy. Overall, the literature largely supports the potential of this perspective but also highlights the need for additional research as the current standards are inadequate to receive approval from regulatory authorities. This review aims to update and critically revise the current knowledge on the application of bacteriophages to treat bacterial-derived infectious diseases in animals in order to provide topical perspectives and innovative advances.

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with cisplatin and doxorubicin in patients with ovarian cancer: A systematic review.

BACKGROUND: PIPAC consists in delivering normothermic chemotherapy solution directly into the peritoneal cavity as an aerosol under pressure. Currently PIPAC is considered as a palliative treatment for patients suffering from non-resectable peritoneal carcinomatosis. We performed a SR to assess tolerance and response of this novel method among patient with OC. METHODS: We searched electronic database PubMed, Embase, Web of Science, Clinical Trials.gov. We only included clinical studies reporting PIPAC with cisplatin and doxorubicin in patients with ovarian cancer. RESULTS: This systematic review included 4 studies. In 3 studies all patients were pretreated with cytoreductive surgery, in 1 study surgery was performed in 8/34 (23 %) patients. Mean PCI at first PIPAC procedure ranged from 16.3 to 19.6. All studies reported the proportion of patients with ascites at the first PIPAC with a pooled rate of 48,3 %. Pooled rate of CTCAE Grade 3 toxicity calculated on the total number of PIPAC was 6 % and Grade 4 was 0.9 %. One study reported two cases of small bowel perforation related or potentially related to PIPAC. On study reported a cumulative survival after 400 days of 62 % and a mean actuarial survival time of all patients who underwent PIPAC of 442 days. In another study the mean time to progression was 144 days (95 % CI 122-168 days). CONCLUSION: This systematic review demonstrated that PIPAC with cisplatin and doxorubicin appear to have a good safety profile with low toxicity and encouraging trend in terms of overall survival.

Mapping the microbial diversity associated with different geochemical regimes in the shallow-water hydrothermal vents of the Aeolian archipelago, Italy.

Shallow-water hydrothermal vents are unique marine environments ubiquitous along the coast of volcanically active regions of the planet. In contrast to their deep-sea counterparts, primary production at shallow-water vents relies on both photoautotrophy and chemoautotrophy. Such processes are supported by a range of geochemical regimes driven by different geological settings. The Aeolian archipelago, located in the southern Tyrrhenian sea, is characterized by intense hydrothermal activity and harbors some of the best sampled shallow-water vents of the Mediterranean Sea. Despite this, the correlation between microbial diversity, geochemical regimes and geological settings of the different volcanic islands of the archipelago is largely unknown. Here, we report the microbial diversity associated with six distinct shallow-water hydrothermal vents of the Aeolian Islands using a combination of 16S rRNA amplicon sequencing along with physicochemical and geochemical measurements. Samples were collected from biofilms, fluids and sediments from shallow vents on the islands of Lipari, Panarea, Salina, and Vulcano. Two new shallow vent locations are described here for the first time. Our results show the presence of diverse microbial communities consistent in their composition with the local geochemical regimes. The shallow water vents of the Aeolian Islands harbor highly diverse microbial community and should be included in future conservation efforts.

Bloodstream infections in COVID-19 patients undergoing extracorporeal membrane oxygenation in ICU: An observational cohort study.

BACKGROUND: COVID-19 patients undergoing ECMO are at highly increased risk of nosocomial infections. OBJECTIVES: To study incidence, clinical outcomes and microbiological features of bloodstream infections (BSI) occurring during ECMO in COVID-19 patients. METHODS: Observational prospective cohort study enrolling consecutive COVID-19 patients undergoing veno-venous-ECMO in an Italian ICU from March 2020 to March 2022. RESULTS: In the study population of 68 patients (age 53 [49-60] years, 82% males), 30 (44%) developed bloodstream infections (BSI group) while 38 did not (N-BSI group) with an incidence of 32 events/1000 days of ECMO. In BSI group pre-ECMO respiratory support was shorter (6 [4-9] vs 9 [5-12] days, p = 0.02) and ECMO treatment was longer (18 [10-29] vs 11 [7-18] days, p = 0.03) than in N-BSI group. The overall ECMO and ICU mortality were 50% and 59%, respectively, without any inter-group difference (p = 1.00). A longer ECMO treatment was independently correlated with higher rate of BSI (p = 0.04, OR [95% CI] 1.06 [1.02-1.11]). Sixteen primary and 14 secondary infectious events were documented. Gram-positive pathogens were more common in primary than secondary BSI (88% vs 43%, p = 0.02) and Enterococcus faecalis (56%) was the most frequent one. Conversely, Gram-negative microorganisms were more often isolated in secondary rather than primary BSI (57% vs 13%, p = 0.02), with Acinetobacter baumannii (21%) and Pseudomonas aeruginosa (21%) as most represented species. The administration of Sars-CoV-2 antiviral drug showed independent correlation with a reduced rate of ICU mortality (p = 0.01, OR [95% CI] 0.22 [0.07-0.73]). CONCLUSIONS: Bloodstream infections represented a frequent complication without worsening clinical outcomes in our COVID-19 patients undergoing ECMO. Primary and secondary BSI events showed peculiar microbiological profiles.

Serous Cystic Neoplasms of the Pancreas Management in the Real-world: Still Operating on a Benign Entity.

OBJECTIVE: Our aim is to provide a real-life picture of serous cystic neoplasms (SCNs) management once a presumptive diagnosis is made. SUMMARY OF BACKGROUND DATA: SCNs of the pancreas are invariably benign entities. While consensus about their management is lacking, surgical resection still plays a role. METHODS: Presumed SCNs evaluated from 1990 to 2018 were included. Indications for surgery, predictors of resection, rate, and predictors of misdiagnosis in the surgical cohort and time trends of management strategies were the main outcomes. RESULTS: A total of 672 presumed SCNs were included. Presence of symptoms (37%) and large size (34.1%) were the most frequent indications for surgery. Symptoms (60.4% vs 19.0%, P < 0.001), size (45 vs 30 mm, P < 0.001), solid components (19.7% vs 6.2%, P < 0.001), thick walls (14.4 vs 5.6%, P = 0.001) and main pancreatic duct dilation (13.4% vs 5.6%, P = 0.004) were associated with upfront resection (n = 134, 19.9%). Upfront resection decreased over time and 15.4% of patients eventually crossed over to surgery. Increase in size (6.9 vs 1.3 mm/yr), development of symptoms (25.3% vs 3.4%, P < 0.001), solid component (6.0% vs 1.4%, P = 0.010) or jaundice (3.6% vs 0.7%, P = 0.028) were associated with crossing over to surgery. Major morbidity and mortality occurred in 17.1% and 1.7% of patients, respectively. Misdiagnosis occurred mostly in case of macrocystic/unilocular lesions of the body-tail. CONCLUSIONS: In the real-life scenario, SCNs still represent an indication for surgery particularly once large and symptomatic. During surveillance, resection occurs mostly in younger individuals for body/tail lesions. Evidence-based consensus on appropriate indications for surgery is urgently needed.

Teaching as a system: COVID-19 as a lens into teacher change.

In the spring of 2020, schools and universities around the world were closed because of the COVID-19 pandemic. The relative lockdown affected more than 1.5 billion learners as teachers and students sheltered at home for several weeks. As schooling moved online, teachers were forced to change how they taught. In the research presented here, we focus on university mathematics professors, and we analyze how their practice, knowledge, and beliefs intertwine and change under these circumstances. More specifically, the context of the pandemic and the relative lockdown provides us with the experimental basis to argue that the new practice affected both knowledge and beliefs of mathematics teachers and that practice, knowledge, and beliefs form a system. Being part of a system, the reactions to change in practice can be of two types, namely, the system as a whole tries to resist change, or the system as a whole changes - and it changes significantly. The research presented here proposes a model for describing and analyzing what we called a teaching system and examines three cases that help to better depict the systemic nature of teaching.

Chemical composition of microplastic in sediments and protected detritivores from different marine habitats (Salina Island).

This study estimates chemical composition of microplastic in sediments and benthic detritivores (sea cucumbers) collected from different marine rocky bottom habitat types (bank, landslide, cliff) of Salina Island (Aeolian Archipelago, Italy). Also, species richness and bottom coverings by benthic species were recorded at each sampling station. Correlations among chemical composition of microplastic in sediments and in detritivores were explored linking recorded variability to the factor "habitat type". Results evidence that the habitat types considered in this study are characterized by wide species richness and by high percentages of bottom coverage by protected species by international conventions. In spite of the high ecological value of habitats considered in this study, microplastics were recorded both in sediments (PVC, PET, PE, PS, PA, PP) and in stomach contents of sea cucumbers (PET, PA) collected in all sampling sites, confirming the exposure of benthic species to microplastic pollution.

Plastic litter transfer from sediments towards marine trophic webs: A case study on holothurians.

This study estimates for the very first time plastic litter levels in sea cucumbers (Echinodermata, Holothuroidea) sampled in situ and their intakes from sediments in three different rocky bottom habitats (slides, cliff, banks) settled in Salina Island (Aeolian Archipelago). Macroplastic were never recorded while meso- and microplastics were identified in all sediment (81-438 items/kg d.w.) and animal samples (1.8-22 items/ind.). Plastic intakes by sea cucumbers resulted frequently associated to the size range included within 100-2000 µm. Over than 70% of ingested plastic litter is represented by the size fraction >500 µm. Sediment/animals ratios % are included 2.7 ±â€¯2.0% in studied habitats with a selective intake of fragments occurring in slides. Furthermore, results support the occurrence of selective ingestion of plastic litter by holothurians in natural environments underlining the role of these species in microplastic transfer from abiotic towards biotic compartments of the marine trophic web.

Management of Transverse Vaginal Septum by Vaginoscopic Resection: Hymen Conservative Technique.

Transverse vaginal septum is a rare female genital tract anomaly, and little is described about its surgical treatment. We report the case of a patient who wished to preserve hymenal integrity due to social and cultural beliefs. We performed a vaginoscopic resection of the septum under laparoscopic view, followed by the introduction of a Foley catheter in the vagina, thus preserving the hymen. After 12 months of follow-up, no septal closure was present, and the menstrual flow was effective. Vaginoscopic hysteroscopy is an effective method of vaginal septum resection, even in cases in which hymenal integrity must be preserved due to social and cultural beliefs.

Septo vaginal transverso é uma anomalia rara do trato genital feminino, e pouco é descrito sobre o tratamento cirúrgico. Relatamos o caso de uma paciente que desejava preservar a integridade do hímen devido a crenças sociais e culturais. Realizamos ressecção vaginoscópica do septo sob visão laparoscópica, seguida da introdução de um cateter de Foley na vagina, preservando assim o hímen. Após 12 meses de acompanhamento, não havia fechamento do septo, e o fluxo menstrual era eficaz. A histeroscopia vaginoscópica é um método eficaz de ressecção dos septos vaginais, incluindo os casos em que a integridade do hímen deve ser mantida devido a crenças sociais e culturais.

Corrigendum to "Umbilical Cord Hematoma: A Case Report and Review of the Literature".

[This corrects the article DOI: 10.1155/2018/2610980.].

Umbilical Cord Hematoma: A Case Report and Review of the Literature.

Objectives: To deepen the knowledge in obstetrics on a very rare pregnancy complication: umbilical cord hematoma. Methods: A review of the case reports described in the last ten years in the literature was conducted in order to evaluate epidemiology, predisposing factors, potential outcomes, prenatal diagnosis, and clinical management. Results: Spontaneous umbilical cord hematoma is a rare complication of pregnancy which represents a serious cause of fetal morbidity and mortality. There are many risk factors such as morphologic anomalies, infections, vessel wall abnormalities, iatrogenic causes, and traction or torsion of the cord, but the exact etiology is still unknown. Conclusions: Due to the rarity of this condition, every new case of umbilical cord hematoma should be reported in order to improve the knowledge of predisposing factors, prenatal diagnosis, and clinical management.

Oxidative Stress and Endometriosis: A Systematic Review of the Literature.

Endometriosis is one of the most common gynaecologic diseases in women of reproductive age. It is characterized by the presence of endometrial tissue outside the uterine cavity. The women affected suffer from pelvic pain and infertility. The complex etiology is still unclear and it is based on three main theories: retrograde menstruation, coelomic metaplasia, and induction theory. Genetics and epigenetics also play a role in the development of endometriosis. Recent studies have put the attention on the role of oxidative stress, defined as an imbalance between reactive oxygen species (ROS) and antioxidants, which may be implicated in the pathophysiology of endometriosis causing a general inflammatory response in the peritoneal cavity. Reactive oxygen species are intermediaries produced by normal oxygen metabolism and are inflammatory mediators known to modulate cell proliferation and to have deleterious effects. A systematic review was performed in order to clarify the different roles of oxidative stress and its role in the development of endometriosis. Several issues have been investigated: iron metabolism, oxidative stress markers (in the serum, peritoneal fluid, follicular fluid, peritoneal environment, ovarian cortex, and eutopic and ectopic endometrial tissue), genes involved in oxidative stress, endometriosis-associated infertility, and cancer development.

Plastic litter in sediments from a marine area likely to become protected (Aeolian Archipelago's islands, Tyrrhenian sea).

This research aims to define for the first time levels and patterns of different litter groups (macro, meso and microplastics) in sediments from a marine area designed for the institution of a new marine protected area (Aeolian Archipelago, Italy). Microplastics resulted the principal group and found in all samples analyzed, with shape and colours variable between different sampling sites. MPs levels measured in this study are similar to values recorded in harbour sites and lower than reported in Adriatic Sea, while macroplastics levels are notably lower than in harbor sites. Sediment grain-size and island extent resulted not significant in determining levels and distribution of plastic debris among islands. In the future, following the establishment of the MPA in the study area, these basic data will be useful to check for potential protective effects on the levels and distribution of plastic debris.