A Lower Global Lung Ultrasound Score Is Associated with Higher Likelihood of Successful Extubation in Invasively Ventilated COVID-19 Patients.

Lung ultrasound (LUS) can be used to assess loss of aeration, which is associated with outcome in patients with coronavirus disease 2019 (COVID-19) presenting to the emergency department. We hypothesized that LUS scores are associated with outcome in critically ill COVID-19 patients receiving invasive ventilation. This retrospective international multicenter study evaluated patients with COVID-19-related acute respiratory distress syndrome (ARDS) with at least one LUS study within 5 days after invasive mechanical ventilation initiation. The global LUS score was calculated by summing the 12 regional scores (range 0-36). Pleural line abnormalities and subpleural consolidations were also scored. The outcomes were successful liberation from the ventilator and intensive care mortality within 28 days, analyzed with multistate, competing risk proportional hazard models. One hundred thirty-seven patients with COVID-19-related ARDS were included in our study. The global LUS score was associated with successful liberation from mechanical ventilation (hazard ratio [HR]: 0.91 95% confidence interval [CI] 0.87-0.96; P = 0.0007) independently of the ARDS severity, but not with 28 days mortality (HR: 1.03; 95% CI 0.97-1.08; P = 0.36). Subpleural consolidation and pleural line abnormalities did not add to the prognostic value of the global LUS score. Examinations within 24 hours of intubation showed no prognostic value. To conclude, a lower global LUS score 24 hours after invasive ventilation initiation is associated with increased probability of liberation from the mechanical ventilator COVID-19 ARDS patients, independently of the ARDS severity.

Occurrence of Brettanomyces bruxellensis on Grape Berries and in Related Winemaking Cellar.

The spoilage yeasts belonging to the genus Dekkera (anamorph Brettanomyces) are associated with the fermentation process and can be responsible for off-flavors in wine. Brettanomyces bruxellensis is difficult to isolate from natural environments because of its low diffusion, low presence on the grape surface and low competition capacity, slow growth, and VBNC (viable but not culturable) state, even when selective media are used. In this study, to investigate the origins and occurrence of B. bruxellensis in winemaking, a total of 62 samples from grapes, winery environment, and fermenting musts were taken through direct isolation with a selective medium. B. bruxellensis was not directly detected in the grape samples but was instead widely isolated from the winery environment samples. However, using a combination of enrichment and selective media, eight of fifteen grape samples were positive for B. bruxellensis. Analysis of the genetic traits of the isolates indicated a strict relationship among the strains from the vineyard and the winery. Isolates from the vineyard and the winery were both part of the more common and dominant biotypes suggesting that the vineyard may be the contamination source of B. bruxellensis in the winery environment. For this, grapes may represent the possible primary origin source from which a flow toward the winery environment originates. On the other hand, the wide occurrence of B. bruxellensis in winery indicates that this environment can be considered as the favorable ecological niche for colonization and diffusion of these yeast.

Anterior discolored teeth restored with procera all-ceramic restorations: a clinical evaluation of the esthetic outcome based on the thickness of the core selected.

UNLABELLED: The most common esthetic challenge associated with endodontics is the discoloration of natural tooth structure. Also in fixed prosthesis, discolorations represent an esthetic limit, particularly in the case of all-ceramic restorations. In fact, the final esthetic result can be compromised by the grey radiated through the coping and soft tissue. PURPOSE: The aim of the study was to evaluate the masking ability of Procera alumina restorations. MATERIALS AND METHODS: Clinical evaluation was investigated by using tests of discolored teeth. Each abutment, classified with Natural Die Material (Ivoclar Vivadent), were manufactured three alumina copings with thickness of 0.4, 0.6, and 0.8 mm, respectively. Masking ability for each coping was evaluated in relation to the degree of discoloration. On the basis of the results obtained, seventeen discolored teeth, treated with Procera alumina restorations, were evaluated. Color match, porcelain surface, marginal discoloration, and marginal integrity were clinically examined following modified CDA/Ryge criteria. CONCLUSION: The Procera AllCeram alumina system seems to be a reliable and excellent technology for the prosthetic treatment of moderate and serious discolored anterior teeth with an exceptionally natural look.