Extended-spectrum ß-lactamase-producing Enterobacterales in diverse foodstuffs: a prospective, longitudinal study in the city of Basel, Switzerland.

Background: The involvement of non-human-to-human transmission of extended-spectrum ß-lactamase-producing Enterobacterales (ESBL-PE) remains elusive. Foodstuffs may serve as reservoirs for ESBL-PE and contribute to their spread. Aim: We aimed to systematically investigate the presence and spatiotemporal distribution of ESBL-PE in diverse unprocessed foodstuffs of different origin purchased in a central European city. Methods: Chicken and green (herbs, salad, sprouts, vegetables) samples were collected monthly for two consecutive years, from June 2017 to June 2019, from large supermarket chains and small local food retailers, representing all ten postcode areas of the City of Basel (Switzerland), and the kitchen of the University Hospital Basel (Basel, Switzerland). After enrichment, presumptive ESBL-PE were isolated by selective culture methods and identified by Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. ESBL production was confirmed by phenotypic testing. Results: Among 947 food samples, 14.8% were positive for ESBL-PE isolate/s belonging to eight different ESBL-producing bacterial species. Escherichia coli and Serratia fonticola were predominant across samples (9 and 2%, respectively). Higher ESBL-PE prevalence was observed in chicken (25.9%) than in green (3.8%) samples (p < 0.001). Among greens, ESBL-PE were most frequently isolated from sprouts (15.2%). High ESBL-PE species diversity was observed among chicken samples, with E. coli as predominant (17.6%). ESBL-producing Enterobacter cloacae was detected among different greens. Yet, ESBL-producing Klebsiella pneumoniae was predominant in sprouts (12.1%). In total, 20.5% of samples from organic farming and 14.2% of samples from conventionally raised animals harbored an ESBL-producing isolate. Detection of ESBL-PE across samples differed between organic and non-organic when stratified by food source (p < 0.001), particularly among greens (12.5% organic, 2.4% conventional). High proportion of organic chicken samples was positive for ESBL-E. coli (33.3%), while the detection of several species characterized the conventional chicken samples. No significant differences in ESBL-PE frequences were detected between national (13.4%) and international samples (8.0%) (p = 0.122). Instead, differences were observed between regions of food production and countries (p < 0.001). No significant differences were found when comparing the proportion of ESBL-PE positive samples across districts, shop sizes and the hospital kitchen. The percentage of ESBL-PE positive samples did not differ monthly across the two-year sampling period (p = 0.107). Conclusion: Our findings indicate moderate dissemination of ESBL-PE in foodstuffs, especially between chicken products and sprouts. Chicken meat represents a source for several ESBL-producing Enterobacterales, especially E. coli, while greens are more prone to carry ESBL-K. pneumoniae and E. cloacae. We disclose the importance of food type, food production system and production origin when assessing the risk of contamination with different ESBL-PE species.

Within-host genetic diversity of extended-spectrum beta-lactamase-producing Enterobacterales in long-term colonized patients.

Despite recognition of the immediate impact of infections caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales (ESBL-PE) on human health, essential aspects of their molecular epidemiology remain under-investigated. This includes knowledge on the potential of a particular strain to persist in a host, mutational events during colonization, and the genetic diversity in individual patients over time. To investigate long-term genetic diversity of colonizing and infecting ESBL-Klebsiella pneumoniae species complex and ESBL-Escherichia coli in individual patients over time, we performed a ten-year longitudinal retrospective study and extracted clinical and microbiological data from electronic health records. In this investigation, 76 ESBL-K. pneumoniae species complex and 284 ESBL-E. coli isolates were recovered from 19 and 61 patients. Strain persistence was detected in all patients colonized with ESBL-K. pneumoniae species complex, and 83.6% of patients colonized with ESBL-E. coli. We frequently observed isolates of the same strain recovered from different body sites associated with either colonization or infection. Antimicrobial resistance genes, plasmid replicons, and whole ESBL-plasmids were shared between isolates regardless of chromosomal relatedness. Our study suggests that patients colonized with ESBL-producers may act as durable reservoirs for ongoing transmission of ESBLs, and that they are at prolonged risk of recurrent infection with colonizing strains.

Spatiotemporal dissemination of ESBL-producing Enterobacterales in municipal sewer systems: a prospective, longitudinal study in the city of Basel, Switzerland.

Background: The contribution of community and hospital sources to the transmission of extended-spectrum ß-lactamase producing Enterobacterales (ESBL-PE) remains elusive. Aim: To investigate the extent of community dissemination and the contribution of hospitals to the spread of ESBL-PE by exploring their spatiotemporal distribution in municipal wastewater of the central European city of Basel. Methods: Wastewater samples were collected monthly for two consecutive years throughout Basel, Switzerland, including 21 sites across 10 postcode areas of the city collecting either community wastewater (urban sites, n = 17) or community and hospital wastewater (mixed sites, n = 4). Presumptive ESBL-PE were recovered by selective culture methods. Standard methodologies were applied for species identification, ESBL-confirmation, and quantification. Results: Ninety-five percent (477/504) of samples were positive for ESBL-PE. Among these isolates, Escherichia coli (85%, 1,140/1,334) and Klebsiella pneumoniae (11%, 153/1,334) were most common. They were recovered throughout the sampling period from all postcodes, with E. coli consistently predominating. The proportion of K. pneumoniae isolates was higher in wastewater samples from mixed sites as compared to samples from urban sites, while the proportion of E. coli was higher in samples from urban sites (p = 0.003). Higher numbers of colony forming units (CFUs) were recovered from mixed as compared to urban sites (median 3.2 × 102 vs. 1.6 × 102 CFU/mL). E. coli-counts showed moderate correlation with population size (rho = 0.44), while this correlation was weak for other ESBL-PE (rho = 0.21). Conclusion: ESBL-PE are widely spread in municipal wastewater supporting that community sources are important reservoirs entertaining the spread of ESBL-PE. Hospital-influenced abundance of ESBL-PE appears to be species dependent.

Treatment with natalizumab during pregnancy in multiple sclerosis: The experience of implementing a clinical practice protocol (NAP-30).

BACKGROUND: Pregnancy planning in women with highly active multiple sclerosis (HAMS) who need a high-efficacy disease-modifying therapy (heDMT) currently requires a careful risk-benefit evaluation. This includes minimizing fetal drug toxicity and preventing MS reactivation. We describe our experience with natalizumab in women with HAMS and unplanned pregnancy by implementing a clinical practice protocol (NAP-30) designed to maintain the effectiveness of natalizumab during pregnancy, reduce fetal exposure and prevent complications. METHODS: This was an observational retrospective study including women with HAMS on active treatment with natalizumab who became unexpectedly pregnant in the period 2018-2021 and continued this treatment during pregnancy according to the NAP-30 protocol. MS clinical and radiological variables were analyzed before and during pregnancy and in the postpartum period, along with maternal and fetal toxicity during pregnancy and safety findings in newborns. We also describe the NAP-30 protocol, which includes the use of a bridging dose to adjust and maintain natalizumab infusions every 6 weeks during pregnancy up to week 30 and scheduled delivery at week 40. RESULTS: Six women (one in her first gestation) with a median age of 31.5 years at the onset of pregnancy (min-max: 24-37 years) were included. All were negative for anti-John Cunningham virus (JCV) antibodies and were on treatment with intravenous natalizumab 300 mg every 4 weeks. At the time of conception, three patients had received 12, 17 and 53 infusions of natalizumab, respectively, while for the remaining three patients natalizumab was their first DMT (two patients had received 6 infusions and one patient had received 3 infusions of natalizumab). All six patients received 6 doses of natalizumab during pregnancy according to the NAP-30 protocol. After delivery, all six patients restarted natalizumab every 4 weeks (median: 3 days; range: 2-4 days). No patients had relapses during pregnancy or at 6 months postpartum, nor did they develop any general health or laboratory abnormalities. The MRI scan performed at 4-6 months postpartum showed no new T2 lesions or gadolinium-enhancing lesions. No miscarriages or threatened miscarriages were reported. One of the patients underwent elective preterm delivery at week 35 after mild-to-moderate anemia was detected by fetal Doppler scan. The newborn had low birth weight (2080 g) and mild anemia, which resolved within two months with oral iron supplementation. The other infants were born with normal birth weight and showed no blood count abnormalities. After a median follow-up of 10 months, all six babies showed normal development with no complications detected. CONCLUSIONS: Based on our experience, the implementation of the NAP-30 protocol in women with HAMS and unplanned pregnancy undergoing treatment with natalizumab allows the continuation of natalizumab during pregnancy, with a very favorable clinical and radiological effectiveness and maternal-fetal safety profile during pregnancy and postpartum. Both in pregnancy with HAMS and in general, and particularly for successful implementation of the NAP-30 protocol, obstetric support and monitoring is essential for adequate pregnancy management.

Complete Circular Genome Sequences of Brachyspira hyodysenteriae Isolates of the Four Different Sequence Types Causing Swine Dysentery in Switzerland.

The complete genomes of four Brachyspira hyodysenteriae isolates of the four different sequence types (STs) (ST6, ST66, ST196, and ST197) causing swine dysentery in Switzerland were generated by whole-genome sequencing and de novo hybrid assembly of reads obtained from second (Illumina) and third (Oxford Nanopore Technologies and Pacific Biosciences) generation high-throughput sequencing.

Behavioral sensitization and cellular responses to psychostimulants are reduced in D2R knockout mice.

Repeated cocaine exposure causes long-lasting neuroadaptations that involve alterations in cellular signaling and gene expression mediated by dopamine in different brain regions, such as the striatum. Previous studies have pointed out to the dopamine D1 receptor as one major player in psychostimulants-induced behavioral, cellular, and molecular changes. However, the role of other dopamine receptors has not been fully characterized. Here we used dopamine D2 receptor knockout (D2-/- ) mice to explore the role of D2 receptor (D2R) in behavioral sensitization and its associated gene expression after acute and chronic cocaine and amphetamine administration. We also studied the impact of D2R elimination in D1R-mediated responses. We found that cocaine- and amphetamine-induced behavioral sensitization is deficient in D2-/- mice. The expression of dynorphin, primarily regulated by D1R and a marker of direct-pathway striatal neurons, is attenuated in naïve- and in cocaine- or amphetamine-treated D2-/- mice. Moreover, c-Fos expression observed in D2-/- mice was reduced in acutely but not in chronically treated animals. Interestingly, inactivation of D2R increased c-Fos expression in neurons of the striatopallidal pathway. Finally, elimination of D2R blunted the locomotor and striatal c-Fos response to the full D1 agonist SKF81297. In conclusion, D2R is critical for the development of behavioral sensitization and the associated gene expression, after cocaine administration, and it is required for the locomotor responses promoted by D1R activation.

The tva(A) Gene from Brachyspira hyodysenteriae Confers Decreased Susceptibility to Pleuromutilins and Streptogramin A in Escherichia coli.

The tva(A) gene suspected to confer resistance to pleuromutilins in Brachyspira hyodysenteriae was tested for functionality in Escherichia coli AG100A and Staphylococcus aureus RN4220. Expression of the cloned tva(A) gene conferred decreased susceptibility to pleuromutilin (P) and streptogramin A (SA) antibiotics in E. coli and had a minor effect in S. aureus The finding provides evidence of the direct association of tva(A) with the PSA resistance phenotype.

VLA-4 mediated adhesion of melanoma cells on the blood-brain barrier is the critical cue for melanoma cell intercalation and barrier disruption.

Melanoma is the most aggressive skin cancer in humans. One severe complication is the formation of brain metastasis, which requires extravasation of melanoma cells across the tight blood-brain barrier (BBB). Previously, VLA-4 has been assigned a role for the adhesive interaction of melanoma cells with non-BBB endothelial cells. However, the role of melanoma VLA-4 for breaching the BBB remained unknown. In this study, we used a mouse in vitro BBB model and imaged the shear resistant arrest of melanoma cells on the BBB. Similar to effector T cells, inflammatory conditions of the BBB increased the arrest of melanoma cells followed by a unique post-arrest behavior lacking immediate crawling. However, over time, melanoma cells intercalated into the BBB and compromised its barrier properties. Most importantly, antibody ablation of VLA-4 abrogated melanoma shear resistant arrest on and intercalation into the BBB and protected the BBB from barrier breakdown. A tissue microarray established from human brain metastasis revealed that indeed a majority of 92% of all human melanoma brain metastases stained VLA-4 positive. We propose VLA-4 as a target for the inhibition of brain metastasis formation in the context of personalized medicine identifying metastasizing VLA-4 positive melanoma.

Predominance of a macrolide-lincosamide-resistant Brachyspira hyodysenteriae of sequence type 196 in Swiss pig herds.

Worldwide emergence of antimicrobial-resistant Brachyspira (B.) hyodysenteriae led us question whether specific clones are present in Switzerland. Fifty-one B. hyodysenteriae isolates originating from 27 different Swiss pig herds sampled between 2010 and 2017 were characterised. Multilocus sequence typing revealed the presence of four different sequence types (STs) ST6, ST66, ST196 and ST197 with ST196 being predominant. Antimicrobial susceptibility to six different antimicrobial agents was determined by measurement of the minimal inhibitory concentration by broth dilution. Isolates were examined for the presence of point mutations and genes known to be associated with antimicrobial resistance in B. hyodysenteriae by PCR and sequence analysis. Forty-one isolates belonging to ST6 (n = 1), ST66 (n = 4) and ST196 (n = 36) exhibited decreased susceptibility to macrolides and lincomycin associated with an A2058 T/G mutation in the 23S rRNA gene. One isolate of ST66 and five isolates of ST196 exhibited decreased susceptibility to doxycycline associated with a G1058C mutation in the 16S rRNA gene. The Swiss B. hyodysenteriae population is characterised by a low genetic diversity, with macrolide-lincosamide-resistant isolates of ST196 being predominant.

Seasonal and Sexual Differences in the Microbiota of the Hoopoe Uropygial Secretion.

The uropygial gland of hoopoe nestlings and nesting females hosts bacterial symbionts that cause changes in the characteristics of its secretion, including an increase of its antimicrobial activity. These changes occur only in nesting individuals during the breeding season, possibly associated with the high infection risk experienced during the stay in the hole-nests. However, the knowledge on hoopoes uropygial gland microbial community dynamics is quite limited and based so far on culture-dependent and molecular fingerprinting studies. In this work, we sampled wild and captive hoopoes of different sex, age, and reproductive status, and studied their microbiota using quantitative polymerase chain reaction (qPCR), fluorescence in situ hybridization (FISH) and pyrosequencing. Surprisingly, we found a complex bacterial community in all individuals (including non-nesting ones) during the breeding season. Nevertheless, dark secretions from nesting hoopoes harbored significantly higher bacterial density than white secretions from breeding males and both sexes in winter. We hypothesize that bacterial proliferation may be host-regulated in phases of high infection risk (i.e., nesting). We also highlight the importance of specific antimicrobial-producing bacteria present only in dark secretions that may be key in this defensive symbiosis. Finally, we discuss the possible role of environmental conditions in shaping the uropygial microbiota, based on differences found between wild and captive hoopoes.

Transposon-associated lincosamide resistance lnu(C) gene identified in Brachyspira hyodysenteriae ST83.

Treatment of Swine Dysentery (SD) caused by Brachyspira hyodysenteriae (B. hyodysenteriae) is carried out using antimicrobials such as macrolides, lincosamides and pleuromutilins leading to the selection of resistant strains. Whole genome sequencing of a multidrug-resistant B. hyodysenteriae strain called BH718 belonging to sequence type (ST) 83 revealed the presence of the lincosamide resistance gene lnu(C) on the small 1724-bp transposon MTnSag1. The strain also contains an A to T substitution at position 2058 (A2058T) in the 23S rRNA gene which is known to be associated with macrolide and lincosamide resistance in B. hyodysenteriae. Testing of additional strains showed that those containing lnu(C) exhibited a higher minimal inhibitory concentration (MIC) of lincomycin (MIC ≥ 64 mg/L) compared to strains lacking lnu(C), even if they also harbor the A2058T mutation. Resistance to pleuromutilins could not be explained by the presence of already reported mutations in the 23S rRNA gene and in the ribosomal protein L3. This study shows that B. hyodysenteriae has the ability to acquire mobile genetic elements conferring resistance to antibiotics.

ALCAM (CD166) is involved in extravasation of monocytes rather than T cells across the blood-brain barrier.

Activated leukocyte cell adhesion molecule (ALCAM) has been proposed to mediate leukocyte migration across the blood-brain barrier (BBB) in multiple sclerosis or experimental autoimmune encephalomyelitis (EAE). Here, we confirmed vascular ALCAM expression in human brain tissue samples in situ and on two different human in vitro BBB models. Antibody-mediated inhibition of ALCAM reduced diapedesis of human CD4+ Th1 but not of Th17 cells across the human BBB in vitro. In accordance to human Th1 cells, mouse Th1 cells showed reduced diapedesis across an ALCAM-/- in vitro BBB model under static but no longer under flow conditions. In contrast to the limited role of ALCAM in T cell extravasation across the BBB, we found a contribution of ALCAM to rolling, adhesion, and diapedesis of human CD14+ monocytes across the human BBB under flow and static conditions. Taken together, our study highlights the potential differences in the CNS expression of ALCAM in mouse and human and supports a prominent role for ALCAM in the multi-step extravasation of monocytes across the BBB.

Antisocial Behavior and Interpersonal Values in High School Students.

This article analyzes the characteristics of antisocial behavior and interpersonal values of high school students (Compulsory Secondary Education) (CSE), the profile of students with high levels of antisocial behavior with regard to interpersonal values, and possible protection from antisocial behavior that interpersonal values could provide. The Interpersonal Values Questionnaire was used to assess interpersonal values, and the Antisocial-Delinquent Behaviors Questionnaire was employed to assess antisocial behaviors. The sample was made up of 885 CSE students aged 14-17. The results revealed a greater prevalence of antisocial behaviors among males and fourth-year CSE students. Moreover, antisocial behaviors were more frequent among participants with high scores in Stimulation, Recognition, Independence, and Leadership and low scores in Conformity and Benevolence. Lastly, logistic regression analyses showed that low scores in Conformity and Benevolence and high scores in Independence predicted high scores in antisocial behavior. The possibility of identifying certain interpersonal values which could positively or negatively affect the appearance of antisocial behavior during adolescence is discussed.

System to Detect Racial-Based Bullying through Gamification.

Prevention and detection of bullying due to racial stigma was studied in school contexts using a system designed following "gamification" principles and integrating less usual elements, such as social interaction, augmented reality and cell phones in educational scenarios. "Grounded Theory" and "User Centered Design" were employed to explore coexistence inside and outside the classroom in terms of preferences and distrust in several areas of action and social frameworks of activity, and to direct the development of a cell phone app for early detection of school bullying scenarios. One hundred and fifty-one interviews were given at five schools selected for their high multiracial percentage and conflict. The most outstanding results were structural, that is the distribution of the classroom group by type of activity and subject being dealt with. Furthermore, in groups over 12 years of age, the relational structures in the classroom in the digital settings in which they participated with their cell phones did not reoccur, because face-to-face and virtual interaction between students with the supervision and involvement of the teacher combined to detect bullying caused by racial discrimination.

Instructional Changes Adopted for an Engineering Course: Cluster Analysis on Academic Failure.

As first year students come from diverse backgrounds, basic skills should be accessible to everyone as soon as possible. Transferring such skills to these students is challenging, especially in highly technical courses. Ensuring that essential knowledge is acquired quickly promotes the student's self-esteem and may positively influence failure rates. Metaphors can help do this. Metaphors are used to understand the unknown. This paper shows how we made a turn in student learning at the University of Almeria. Our hypothesis assumed that metaphors accelerate the acquisition of basic knowledge so that other skills built on that foundation are easily learned. With these goals in mind, we changed the way we teach by using metaphors and abstract concepts in a computer organization course, a technical course in the first year of an information technology engineering degree. Cluster analysis of the data on collective student performance after this methodological change clearly identified two distinct groups. These two groups perfectly matched the "before and after" scenarios of the use of metaphors. The study was conducted during 11 academic years (2002/2003 to 2012/2013). The 475 observations made during this period illustrate the usefulness of this change in teaching and learning, shifting from a propositional teaching/learning model to a more dynamic model based on metaphors and abstractions. Data covering the whole period showed favorable evolution of student achievement and reduced failure rates, not only in this course, but also in many of the following more advanced courses. The paper is structured in five sections. The first gives an introduction, the second describes the methodology. The third section describes the sample and the study carried out. The fourth section presents the results and, finally, the fifth section discusses the main conclusions.

Drug use in adolescents in relation to social support and reactive and proactive aggressive behavior / Consumo de drogas en adolescentes y su relación con el apoyo social y las conductas agresivas reactivas y proactiva

BACKGROUND: Aggressive behavior in adolescents, along with drug use, has become one of the great issues in education in recent years, among other things, due to its relationship with school failure and delinquency. The purpose of this paper was to find out whether social support fulfils a basic role in decision-making on drug use and the behavior of adolescents. METHOD: 822 high school students participated in the study (M = 14.84, SD = 0.87). Data were collected with the Peer Conflict Scale and the Multidimensional Scale of Perceived Social Support, and an ad hoc questionnaire on drug use. RESULTS: The results show that drug use is significantly related to reactive and proactive aggressive behavior. It was also observed that higher use is significantly related to perceived social support by the peer group, and less support by family. DISCUSSION: It was shown that substance use is related to perceived social support by the adolescent's peer group and to aggressive behavior. It is therefore necessary to intervene in both respects to avoid the presence of substance use in schools

ANTECEDENTES: la presencia de conductas agresivas en los adolescentes, unido al consumo de drogas, se ha situado en los últimos años como una de las grandes problemáticas dentro del ámbito educativo. El objetivo de este estudio fue analizar la relación de la agresividad y el apoyo social con el consumo de alcohol y tabaco, dos de las drogas más frecuentes entre los jóvenes. MÉTODO: en el estudio han participado 822 adolescentes de Educación Secundaria Obligatoria (M = 14,84; DT = 0,87). Para recoger los datos se ha utilizado el Peer Conflict Scale, la Escala Multidimensional de Apoyo Social Percibido y un cuestionario realizado ad hoc de consumo de drogas. RESULTADOS: los resultados mostraron que el consumo de drogas está relacionado con las conductas agresivas tanto reactivas como proactivas. Asimismo, se observó que a mayor consumo mayor es también el apoyo social percibido por parte del grupo de iguales, y menor apoyo por parte de la familia. DISCUSIÓN: los resultados obtenidos se discuten en relación a la necesidad de intervenir en estas áreas para evitar la presencia de consumo de sustancias en los centros educativos

Drug use in adolescents in relation to social support and reactive and proactive aggressive behavior.

BACKGROUND: Aggressive behavior in adolescents, along with drug use, has become one of the great issues in education in recent years, among other things, due to its relationship with school failure and delinquency. The purpose of this paper was to find out whether social support fulfils a basic role in decision-making on drug use and the behavior of adolescents. METHOD: 822 high school students participated in the study (M = 14.84, SD = 0.87). Data were collected with the Peer Conflict Scale and the Multidimensional Scale of Perceived Social Support, and an ad hoc questionnaire on drug use. RESULTS: The results show that drug use is significantly related to reactive and proactive aggressive behavior. It was also observed that higher use is significantly related to perceived social support by the peer group, and less support by family. DISCUSSION: It was shown that substance use is related to perceived social support by the adolescent’s peer group and to aggressive behavior. It is therefore necessary to intervene in both respects to avoid the presence of substance use in schools.

Minimally invasive therapy for epiphrenic diverticula: Systematic review of literature and report of six cases.

INTRODUCTION: Epiphrenic diverticula (ED) are infrequent and conventional surgical treatment entails aggressive open or transthoracic surgery. Minimally invasive treatment has changed the surgical approach but some surgical controversies are not resolved. OBJECTIVE: The objective of this study is to describe our experience in minimally invasive treatment of the ED and to perform a systematic review of the current literature in this subject. MATERIALS AND METHODS: We reviewed all data from the Hospital de Sant Pau, focusing on patients that underwent minimally invasive treatment for an ED since 1998 to date. Furthermore, we performed a systematic literature review focused on the minimally invasive approach for ED. RESULTS: A total of 6 patients have been treated (5 transhiatal and 1 with abdominal and thoracic approach). We found a predominance of males with a median age of 63. The diagnosis was made with an endoscopy, barium swallow and manometry. Half of the manometry results were pathologic. The surgical technique involved a diverticulectomy, myotomy and a Dor partial founduplication. Two patients that presented suture line leakage (SLL) were treated conservatively. No mortality was reported. The systematic review was carried out under the Preferred Reporting Items for Systematic Reviews and Meta-analyses scheme, with a total of 20 studies where 189 patients were found. No comparative or prospective randomised trials were found. Overall morbidity was 24%, with a SLL rate of 12%, hospital stay of 5 days and mortality of 1.5%. After a median follow-up of 42 months, 81.5% of the patients were asymptomatic. CONCLUSION: The minimally invasive approach for ED is a safe and feasible procedure.

Contributions to a better comprehension of redox-mediated decolouration and detoxification of azo dyes by a laccase produced by Streptomyces cyaneus CECT 3335.

The ability of a laccase (EC 1.10.3.2) produced by Streptomyces cyaneus CECT 3335 to decolourise and detoxify azo dyes was assessed. Results showed that a colour loss of 90% was achieved only in the presence of acetosyringone (0.1mM) acting as a redox mediator for the laccase. Toxicological analysis of the decolourised dyes revealed that there was no direct correlation between decolouration and detoxification; in fact, in the case of the dyes Methyl Orange and Orange II, a significant increase in toxicity was produced after the treatment. In contrast, a significant decrease in toxicity was observed after the decolouration of New Coccine and Chromotrope 2R. Finally, HPLC analysis of the dyes after treatment revealed the complete disappearance of both dyes and mediator and a concomitant appearance of new chromatographic peaks which could be responsible of the residual toxicity detected in some cases.