Daptomycin-Impregnated PMMA Cement against Vancomycin-Resistant Germs: Dosage, Handling, Elution, Mechanical Stability, and Effectiveness.

BACKGROUND: The number of periprosthetic joint infections caused by vancomycin-resistant pathogens is increasing. Currently, no PMMA cement is commercially available to cover VRE. Daptomycin shows promising results in treating infection, offering a good safety profile and a reduced risk of developing resistance. The purpose of this in vitro study was to investigate the mechanical stability, handling properties, elution behavior, and antimicrobial effectiveness of PMMA cement loaded with three different daptomycin concentrations in comparison to commercially available antibiotic-loaded bone cement (ALBC). METHODS: Mechanical properties and handling characteristics (ISO 5833, DIN 53435), HPLC elution, antimicrobial effectiveness with proliferation assay (DIN 17025), and inhibition zone testing were investigated. RESULTS: All tested daptomycin concentrations met the ISO and DIN standards for mechanical strength. Loading of 40 g of PMMA cement with 0.5 g of daptomycin did not show any antimicrobial effectiveness, in contrast to 1.0 g and 1.5 g. PMMA cement with 1.5 g of daptomycin was the best in terms of elution and effectiveness, and it showed good ISO mechanical strength; ISO doughing was sticky for a little longer and setting was faster compared to the vancomycin-containing reference cement. CONCLUSION: PMMA cement containing 0.5 g of gentamicin and 1.5 g of daptomycin could be a good alternative to the already established COPAL® (Wehrheim, Germany) G+V for the treatment of PJIs caused by VRE.

Algunas especificidades concernientes a las complicaciones quirúrgicas infecciosas en adultos mayores tras cirugía abdominal de urgencia / Specificities Concerning Infectious Surgical Complications in Older Adults after Emergency Abdominal Surgery

Introducción: El manejo del paciente geriátrico en cirugía siempre ha representado un gran desafío por considerarse de "alto riesgo". Objetivo: Describir las características clínicas, terapéuticas y epidemiológicas concernientes a las complicaciones quirúrgicas infecciosas en adultos mayores tras cirugía abdominal de urgencia. Métodos: Se realizó un estudio observacional analítico de casos y controles en pacientes adultos mayores que presentaron complicaciones quirúrgicas tras cirugía abdominal de urgencia en el período comprendido de 2019 hasta 2021 en el Servicio de Cirugía General del Hospital Provincial Saturnino Lora de Santiago de Cuba. Se trabajó con una muestra de casos complicados y otra de controles, representada por aquellos que no sufrieron complicaciones. Las variables analizadas fueron: edad, sexo, comorbilidades gérmenes aislados y tratamiento requerido. Resultados: Las complicaciones quirúrgicas en la cirugía abdominal urgente afectan fundamentalmente a pacientes adultos mayores en edades tempranas de ambos sexos con antecedentes de enfermedades endocrinas y/o cardiovasculares. La infección superficial y profunda del sitio quirúrgico es la complicación predominante. Los gérmenes más frecuentemente aislados fueron: Escherichia coli, Pseudomona aureoginosa y Klebsiella. El tratamiento farmacológico seguido del quirúrgico se utilizó en la mayoría de los enfermos para la solución de sus complicaciones. Conclusiones: Las comorbilidades constituyen el factor de riesgo principal para la aparición de complicaciones quirúrgicas infecciosas en adultos mayores, tras cirugía abdominal de urgencia con primacía de la infección superficial y profunda del sitio quirúrgico. Los gérmenes causales están en relación con la microbiota de la piel, donde se realiza la incisión, y la microbiota de los órganos donde se efectúa la intervención quirúrgica(AU)

Introduction: The surgical management of the geriatric patient has always represented a great challenge because such is considered as "high risk." Objective: To describe the clinical, therapeutic and epidemiological characteristics concerning infectious surgical complications in older adults after emergency abdominal surgery. Methods: An analytical observational study of cases and controls was carried out with older adult patients who presented surgical complications after emergency abdominal surgery, in the period from 2019 to 2021, at the general surgery service of Hospital Provincial Saturnino Lora, of Santiago de Cuba. The study work was conducted with a sample of complicated cases and another sample of controls, the latter represented by those who did not suffer complications. The analyzed variables were age, sex, comorbidity, isolated germs and required treatment. Results: Surgical complications in emergency abdominal surgery affect mainly older adult patients at early ages, from both sexes and with a history of endocrine or cardiovascular diseases. Superficial and deep surgical-site infection is the predominant complication. The most frequently isolated germs were Escherichia coli, Pseudomona aureoginosa and Klebsiella. Pharmacological treatment followed by surgical treatment was used in most of the patients, with the aim of giving a solution to their complications. Conclusions: Comorbidity is the main risk factor for the appearance of infectious surgical complications in older adults after emergency abdominal surgery, primarily for superficial and deep surgical-site infection. The causal germs are related to the skin microbiota, according to the site where the incision is made, as well as the microbiota of the organs where the surgical intervention is performed(AU)

Role of CPNE1 in Odontoblastic Differentiation of Rat Stem Cells from Apical Papilla.

CPNE1 is a calcium-dependent, phospholipid-binding protein that is ubiquitously expressed in various tissues and organs. This study investigates the expression and localization of CPNE1 in tooth germ development and the role of CPNE1 in odontoblastic differentiation. In rat tooth germs, CPNE1 is expressed in the odontoblasts and ameloblasts since the late bell stage. The depletion of CPNE1 in the stem cells from apical papilla (SCAPs) clearly inhibits the expression of odontoblastic-related genes and the formation of mineralized nodules during differentiation, while CPNE1 overexpression promotes this process. In addition, CPNE1 overexpression increases AKT phosphorylation during the odontoblastic differentiation of SCAPs. Furthermore, treatment with AKT inhibitor (MK2206) reduces the expression of odontoblastic-related genes in CPNE1 over-expressed SCAPs, and Alizarin Red staining shows reduced mineralization. These results suggest that CPNE1 plays a role in the tooth germ development as well as the odontblastic differentiation of SCAPs in vitro that is related to the AKT signaling pathway.

Egg-Associated Germs Induce Salicylate Defenses but Not Render Plant Against a Global Invasive Fruit Fly Effectively.

Germs associated with insect eggs can profoundly mediate interactions between host plants and herbivores, with the potential to coordinate plant physiological reactions with cascading effects on insect fitness. An experimental system was established including the oriental fruit fly (OFF, Bactrocera dorsalis) and tomato to examine the functions of egg-associated germs in mediating plant-herbivore interactions. OFF feeding resulted in significantly increased tannins, flavonoids, amino acids, and salicylic acid in the host tomato. These defensive responses of tomato were induced by the egg-associated germs, including Lactococcus sp., Brevundimonas sp., and Vagococcus sp. Tannins and flavonoids had no significant feedback effects on the pupal weight of OFF, while pupal biomass was significantly decreased by tannins and flavonoids in the germ-free treatment. Metabolome analysis showed that OFF mainly induced metabolic changes in carboxylic acid derivatives. Phenylalanine significantly induced downstream metabolic changes associated with phenylpropanoid accumulation. Finally, we conclude that the effects of egg-associated germs played an important role in facilitating OFF population adaptation and growth by mediating plant defenses, which provides a new paradigm for exploring the interaction of plant-pest and implementing effective pest biocontrol.

Incidencia y comportamiento clínico de la endoftalmitis poscirugía de catarata / Incidence and clinical behavior of endophthalmitis post cataract surgery

Introducción: La endoftalmitis posquirúrgica es la complicación más temida de la cirugía de catarata. Resulta potencialmente devastadora, puede amenazar seriamente la visión y tiene una incidencia estimada de entre 0,02 y 0,71 por ciento. Objetivo: Determinar la incidencia de endoftalmitis poscirugía de catarata y su comportamiento clínico. Métodos: Se realizó un estudio observacional, descriptivo y de corte transversal. Se revisaron 13 850 cirugías consecutivas de catarata realizadas en el Centro Oftalmológico del Hospital Universitario Clínico Quirúrgico "Arnaldo Milián Castro" de Villa Clara, Cuba. Resultados: La incidencia de endoftalmitis poscirugía de catarata en esta serie fue de 0,17 por ciento (IC 95 por ciento: 0,10-0,24 por ciento); 0,18 por ciento (IC 95 por ciento 0,11-0,25 por ciento) para extracción extracapsular del cristalino y sin incidencia en la facoemulsificación. La forma de presentación aguda fue más frecuente que la crónica; 0,13 por ciento (IC 95 por ciento: 0,07-0,19 por ciento) y 0,04 por ciento (IC 95 por ciento: 0,01-0,07 por ciento), respectivamente. Los hombres fueron más afectados que las mujeres y la edad media fue de 71,8 años. La forma aguda se presentó con una media de 5,1 días entre la cirugía y el inicio de los síntomas y la crónica con una media de 21,2 semanas. El 39,1 por ciento de los pacientes tuvo agudeza visual de percepción luminosa al momento del diagnóstico. Se reportó un crecimiento bacteriano en el 44,7 por ciento de las muestras, con una positividad en humor acuoso y vítreo del 42,1 por ciento y 47,4 por ciento, respectivamente. El Staphylococcus coagulasa negativo fue el germen más frecuente. Los antibióticos intravítreos más vitrectomía plana precoz fue la conducta terapéutica más empleada. Conclusiones: La incidencia de endoftalmitis poscirugía de catarata en esta serie está en el rango de lo reportado a nivel mundial. Se presenta comúnmente de forma aguda y con pobre agudeza visual. El agente etiológico aislado con más frecuencia fue el Staphylococcus coagulasa negativa(AU)

Introduction: Postoperative endophthalmitis is the most feared complication of cataract surgery. It is potentially devastating, can seriously threaten vision and has an estimated incidence of between 0.02 and 0.71 percent. Objective: To determine the incidence of endophthalmitis after cataract surgery and its clinical behavior. Methods: An observational, descriptive, cross-sectional, descriptive study was performed. Thirteen 850 consecutive cataract surgeries performed at the Ophthalmologic Center of the Clinical Surgical University Hospital "Arnaldo Milián Castro" of Villa Clara were reviewed. Results: The incidence of endophthalmitis after cataract surgery in this series was 0.17 percent (95 percent CI: 0.10-0.24 percent); 0.18 percent (95 percent CI: 0.11-0.25 percent) for extracapsular extraction of the crystalline lens and no incidence in phacoemulsification. The acute form of presentation was more frequent than the chronic form; 0.13 percent (95 percent CI: 0.07-0.19 percent) and 0.04 percent (95 percent CI: 0.01-0.07 percent), respectively. Males were more affected than females and the mean age was 71.8 years. The acute form occurred with a mean of 5.1 days between surgery and symptom onset and the chronic form with a mean of 21.2 weeks. Thirty-nine.1 percent of patients had visual acuity of light perception at the time of diagnosis. Bacterial growth was reported in 44.7 percent of the specimens, with positivity in aqueous and vitreous humor of 42.1 percent and 47.4 percent, respectively. Coagulase-negative Staphylococcus was the most frequent germ. Intravitreal antibiotics plus remission for early flat vitrectomy was the most commonly employed therapeutic behavior. Conclusions: The incidence of post cataract surgery endophthalmitis in this series is in the range of that reported worldwide. It commonly presents acutely and with poor visual acuity. The most frequently isolated etiologic agent was coagulase-negative Staphylococcus(AU)

Process optimisation of defatted wheat germ protein extraction in a novel alkaline-based deep eutectic solvent (DES) via Box-Behnken experimental design (BBD).

This is the first study to provide a preliminary investigation into the recovery of protein from wheat germ and the prediction of their extraction conditions in microwave cavity using a novel DES solvent. The response surface methodology was used to predict the microwaved protein extraction conditions of the DWG. The effects of DES buffer-concentration (X1: 0.01-1.00 g/mL), microwave power (X2: 50-250 W), irradiation time (X3: 1-5 min) and sample-to-buffer ratio (X4: 1:10-1:50) were tested using a single factor and Box-Behnken experimental design. Under the optimized conditions (X1 = 0.52 g/mL, X2 = 186 W, X3 = 3.28 min, and X4 = 1:39) protein yield and absorbed microwave were obtained at the optimal value of 33.00 % and 677 J/min, respectively with no denaturation of the protein as validated from the SDS-PAGE gel electrophoresis profile. Consequently, this investigation provides a practical approach for the extraction of bioactive protein from DWG using a novel deep eutectic solvent.

Knowledge, germs, and output.

This paper studies the equilibrium and the social optimum in an economy where knowledge diffusion interacts with disease transmission. Knowledge increases productivity and is diffused through learning. A learner chooses the intensities in normal learning, isolated learning and production. Normal learning is more effective than isolated learning but requires a learner to contact a teacher. A higher intensity in normal learning increases a learner's contact rate with a teacher, thereby speeding up both knowledge diffusion and the transmission of an infectious pathogen. An infection reduces productivity and possibly results in death. Calibrating the pathogen to Covid-19, the model shows that the unexpected arrival of the pathogen induces a susceptible learner to adjust the normal learning intensity in a V-shaped pattern over time. Aggregate output also follows V-shaped adjustments. Switching from the equilibrium to the social optimum reduces infections and deaths substantially and increases social welfare. I also examine temporary lockdowns in the equilibrium.

Complicaciones quirúrgicas infecciosas en adultos mayores tras cirugía abdominal de urgencia

Introducción: En la actualidad el aumento de la población envejecida, asociado al desarrollo de la anestesiología, la cirugía y los cuidados intensivos ha generado un incremento del número de adultos mayores con abdomen agudo, que requieren tratamiento quirúrgico con urgencia, no exentos de complicaciones. Se realizó una revisión en bases de datos bibliográficas y se seleccionaron 25 documentos en idioma inglés y español. Objetivo: Analizar las características esenciales que identifican a los pacientes adultos mayores con complicaciones quirúrgicas infecciosas tras cirugía abdominal de urgencia. Desarrollo: En el plano biológico suceden cambios por reducción de la reserva fisiológica del adulto mayor: respiratorios, cardiovasculares, genitourinarios, digestivos, endocrino-metabólicos y del equilibrio ácido-base, que los hacen vulnerables al estrés quirúrgico. Las complicaciones posoperatorias constituyen un importante indicador de calidad: retardan la evolución de la enfermedad, prolongan la estadía hospitalaria e incrementan los índices de morbilidad y mortalidad de modo significativo en enfermos de este grupo etario. Conclusiones: A pesar del aumento del número de adultos mayores con abdomen agudo que requieren tratamiento quirúrgico con urgencia, la edad no debe considerarse como una limitante para efectuar la operación. Además del tratamiento específico y preventivo de las complicaciones tras cirugía abdominal de urgencia, las comorbilidades y la fragilidad presentes en estos pacientes requieren adecuada compensación preoperatoria, operatoria y posoperatoria, a fin de garantizar la evolución satisfactoria de estos enfermos.

Introduction: Currently, the increase in the aging population associated with the development of anesthesiology, surgery and intensive care has generated an increase in the number of older adults with acute abdomen requiring urgent surgical treatment. A review was carried out in bibliographic databases, and 25 documents were selected in English and Spanish. Objective: To analyze the clinical, epidemiological and therapeutic characteristics that identify older adult patients with infectious surgical complications after emergency abdominal surgery. Development: At the biological level, changes occur due to the reduction of the physiological reserve of the elderly: respiratory, cardiovascular, genitourinary, digestive, endocrine-metabolic and acid-base balance that makes them vulnerable to surgical stress. Postoperative complications are an important indicator of quality: they delay the evolution of the disease, prolong hospital stay and significantly increase morbidity and mortality rates in patients of this age group. Conclusions: Despite the increase in the number of older adults with acute abdomen who require urgent surgical treatment, age should not be considered as a limitation to perform the operation. In addition to the specific and preventive treatment of complications after emergency abdominal surgery, the comorbidities and frailty present in these patients require adequate preoperative, operative and postoperative compensation, in order to guarantee the satisfactory evolution of these patients.

Incidencia de infecciones relacionadas a la bula de filtración en pacientes con trabeculectomía / Incidence of Filtration Bullae-related Infections in Trabeculectomy Patients

Objetivo: Determinar la incidencia de infecciones relacionadas a la bula de filtración en pacientes sometidos a trabeculectomía; así como su comportamiento clínico. Métodos: Se realizó un estudio descriptivo longitudinal y retrospectivo. El universo estuvo comprendido por 1320 ojos con trabeculectomía y muestra conformada por 7 ojos con diagnóstico de infección relacionada a la bula de filtración operados en el Centro Oftalmológico de Villa Clara desde enero del 2012 hasta diciembre del 2021. Resultados: La incidencia global de infección en la bula de filtración fue de 0,53 por ciento. La incidencia de blebitis y de blebitis-endoftalmitis fue 0,15 por ciento y 0,38 por ciento, respectivamente. Los hombres fueron los más afectados y la edad media fue de 64,7 años. En todos los casos, la infección se presentó de forma tardía con una media de 4,1 años. El 57,1 por ciento tuvo una agudeza visual mejor corregida al inicio de la infección de movimiento de manos. Se reportó crecimiento bacteriano en un 57,1 por ciento, el estafilococo coagulasa negativo fue el germen más frecuente. El control de la infección se logró en 6 pacientes mientras 2/3 de ellos no tuvo mejoría de la agudeza visual mejor corregida a la resolución de la infección, todos con blebitis-endoftalmitis. Conclusiones: Las infecciones relacionadas a la bula de filtración son poco comunes. Se presentan con frecuencia años después de la cirugía filtrante y con mala agudeza visual. Los ojos con blebitis-endoftalmitis tienen una pobre recuperación visual a pesar del tratamiento(AU)

Purpose: To determine the incidence of filtration bullae-related infections in patients undergoing trabeculectomy; as well as their clinical behavior. Methods: A longitudinal and retrospective descriptive study was performed. The universe was comprised of 1320 eyes with trabeculectomy and the sample consisted of 7 eyes with a diagnosis of infection related to the filtration bulla operated at the Villa Clara Ophthalmologic Center between January 2012 and December 2021. Results: The overall incidence of infection in the filtration bullae was 0.53 percent. The incidence of blebitis and blebitis-endophthalmitis was 0.15 percent and 0.38 percent, respectively. Males were the most affected and the average age was 64.7 years. In all cases, the infection presented late with a average age of 4.1 years. Fifty-seven point one percent had best corrected visual acuity at the onset of hand motion infection. Bacterial growth was reported in 57.1 percent, coagulase negative staphylococcus was the most frequent germ. Infection control was achieved in 6 patients while 2/3 of them had no improvement of best corrected visual acuity at resolution of infection, all with blebitis-endophthalmitis. Conclusions: Infections related to filtration bullae are uncommon. They occur frequently years after filtering surgery and with poor visual acuity. Eyes with blebitis-endophthalmitis have poor visual recovery despite treatment(AU)

Mobility of trace metals and microbiological pollution from dredged sediments to the Gulf of Gabes, Tunisia.

Sediments are periodically dredged from the major ports in the Gulf of Gabes (GG) during maintenance operations. These sediments are dumped near the coats of Sfax and Gabes cities. In the present study, 6 trace metals (Cd, Cu, Cr, Ni, Pb, and Zn) concentrations were assessed in both sediments and column water taken from the different basins of Sfax port. This study is the first to focus on the microbial and microalgae contaminations of Sfax port sediments. The spatial distributions of trace metals in dredged sediments from the different basins of Sfax port show that the maximum concentrations of Cd (13.75 µg/g), Cu (892.5 µg/g), and Zn (1447 µg/g) exceeded the Geode standard thresholds. The same elements, also detected in the water column, exceeded the toxicity thresholds for phytoplankton, shellfish, and algae (Cd 0.095 µg/l, Cu 4.52 µg/l, and Zn 37 µg/l). The presence of coliforms, indicators of sewage pollution, as pathogenic germs (Pseudomonas), was shown through microbiological examinations of the sediments and water column. The microalgae enumeration showed the abundance of dinoflagellate cysts (stressed form) which attests to the presence of severe conditions in Sfax port. Different toxic species were identified as Prorocentrum lima and Alexandrium minutum. The same trace metal sources and abundance in Sfax port and GG sediments suggest the hypothesis of their transfer from their disposal sites in coastal areas to deeper depths in the GG and until Boughrara lagoon (BL). As trace metals, microalgae species were also transferred by hydrodynamic currents inside the GG where they found suitable conditions to their proliferation causing the seawater coloration phenomenon, eutrophication, and degradation of the aquatic system.

COVID-19 Vaccines and Potential Implications for COVID-19-Specific Obsessive-Compulsive Disorder Presentations.

Public health crises, including the ongoing COVID-19 pandemic, have wide reaching implications on mental health, and have resulted in unique OCD presentations specific to respective crises. The distribution of highly efficacious and effective vaccines for COVID-19 present a crossroads for the COVID-19-specific OCD presentation, including the potential for COVID-19 presentation perpetuation or remission in the face of vaccinations. Individual differences may play a unique role in who does and does not see a reduction of OCD symptoms specific to this virus as a function of vaccination status. Here, we discuss prior health crises that have resulted in unique OCD presentations, review relevant assessment and intervention guidelines, discuss potential implications that vaccines may have on this COVID-19-specifc presentation, and provide case presentations and future recommendations for treatment providers and researchers.

Peripheral Pathways to Neurovascular Unit Dysfunction, Cognitive Impairment, and Alzheimer's Disease.

Alzheimer's disease (AD) is the most common form of dementia. It was first described more than a century ago, and scientists are acquiring new data and learning novel information about the disease every day. Although there are nuances and details continuously being unraveled, many key players were identified in the early 1900's by Dr. Oskar Fischer and Dr. Alois Alzheimer, including amyloid-beta (Aß), tau, vascular abnormalities, gliosis, and a possible role of infections. More recently, there has been growing interest in and appreciation for neurovascular unit dysfunction that occurs early in mild cognitive impairment (MCI) before and independent of Aß and tau brain accumulation. In the last decade, evidence that Aß and tau oligomers are antimicrobial peptides generated in response to infection has expanded our knowledge and challenged preconceived notions. The concept that pathogenic germs cause infections generating an innate immune response (e.g., Aß and tau produced by peripheral organs) that is associated with incident dementia is worthwhile considering in the context of sporadic AD with an unknown root cause. Therefore, the peripheral amyloid hypothesis to cognitive impairment and AD is proposed and remains to be vetted by future research. Meanwhile, humans remain complex variable organisms with individual risk factors that define their immune status, neurovascular function, and neuronal plasticity. In this focused review, the idea that infections and organ dysfunction contribute to Alzheimer's disease, through the generation of peripheral amyloids and/or neurovascular unit dysfunction will be explored and discussed. Ultimately, many questions remain to be answered and critical areas of future exploration are highlighted.

Neuroendoscopic lavage for the treatment of pyogenic ventriculitis in children: personal series and review of the literature.

INTRODUCTION: Pyogenic ventriculitis is a severe infection of the central nervous system with serious and often irreversible consequences in the quality of life of patients. Its treatment is difficult due to the impossibility of achieving sterility of cerebrospinal fluid (CSF) and the physiological characteristics promptly. Several treatment options have been described, from prolonged antibiotic treatments to placement of ventricular drains with continuous irrigation and puncture reservoirs. We propose an aggressive and minimally invasive treatment with neuroendoscopic lavage (NEL). METHODS: Retrospective and descriptive study. We analyzed the NEL performed in our hospital for pyogenic ventriculitis between 2011 and 2020. A total of 16 patients were found; 2 of them lost follow-up, so they were not included. All patients had a diagnosis of pyogenic ventriculitis, either due to the macroscopic characteristics of the CSF or due to imaging criteria. Between 1 and 3 NEL were performed per patient until obtaining sterility and normalization of protein and cell counts of CSF. RESULTS: The average age was 38 months (2 months to 16 years). Ten patients were female and 4 were male. Sixty-four percent of germs in cultures corresponded to gram-negative and polymicrobial flora. The average number of days until the first sterile CSF post-NEL was 3.8 days (0 to 10 days). The NEL produced a significant improvement in the characteristics of the CSF compared to the pre-NEL. The mean pre-NEL of CSF protein levels was 907 mg/dl (123-4510 mg/dl) compared with the post-NEL of 292 mg/dl (38-892 mg/dl) with a p-value = 0.0076. Regarding cellularity, statistically significant results were also achieved (p-value = 0.0011) with a pre-surgical cellularity of 665 elements/mm3 (4-3090 elements/mm3) compared with 57 elements/mm3 (0-390 elements/mm3) post-NEL. Of the patients, 85.7% had a shunt prior to the onset of ventriculitis and the average number of days until the new shunt was 36.56 days (17-79 days), with a total hospitalization days ranging from 22 to 170. CONCLUSIONS: NEL allows rapid sterilization of CSF, decreasing the deleterious effect of infection in the CNS more rapidly compared to other types of conventional treatment.

Deciduous teeth development in fetuses using postmortem computed tomography image analysis.

Fetal age is estimated widely by body length and weight and skeletal or dental development and maturation. Regarding dental development, dental development charts reported by Schour and Massler and Ubelaker are well known. We tried to calculate the calcification rate of the deciduous teeth, mandibular cortical bone, and clavicle in fetuses utilizing postmortem computed tomography (CT) image analysis. The CT values within the circumferential area of the region of interest were automatically calculated using a software, and the calcification rate was calculated by performing single regression analysis. Our results showed that deciduous tooth calcification could be detected in over 19-week-old fetuses using CT images. The calcification of bones (mandibular cortical bone and clavicle) started earlier than the calcification of deciduous teeth. However, the calcification rate of the bones was slower compared to that of the deciduous teeth. The calcification rate of the deciduous teeth in fetuses using CT value may be effective to estimate fetal age and evaluate deciduous teeth development, suggesting that our established method is effective for age estimation in forensic dentistry.

Características microbiológicas de los pacientes con úlcera del pie diabético / Microbiologic characteristics of patients with diabetic foot ulceration

RESUMEN Introducción: Las infecciones de las úlceras del pie diabético son comunes, complejas, de alto costo y constituyen la principal causa de amputación no traumática de las extremidades inferiores. Objetivo: Identificar los microorganismos aislados para estimar tanto la sensibilidad a los antibióticos como la coincidencia entre el tratamiento empírico y los resultados microbiológicos en pacientes con úlceras del pie diabético. Métodos: Se realizó una investigación descriptiva-retrospectiva. La población de estudio estuvo constituida por 210 pacientes ingresados en el Hospital Universitario Clínico Quirúrgico "Comandante Faustino Pérez Hernández" de Matanzas entre junio de 2017 y junio de 2020. Las variables de salida fueron la frecuencia y el tipo de germen, la cantidad de gérmenes por úlcera, la sensibilidad para cada tipo de antibiótico, y el porcentaje de coincidencia entre el tratamiento empírico y el resultado microbiológico. Resultados: Se identificaron 259 gérmenes y se observaron 1,23 gérmenes por úlcera. El 62,5 por ciento de los gérmenes encontrados fueron Gram negativos, pero el germen más representado fue el Staphylococcus aureus. El 58,8 por ciento de los Staphylococcus aureus se mostraron resistentes a la meticillin. La vancomicina y el linezolid resultaron efectivos en el 100 por ciento de los Gram positivos. La amikacina fue el antibiótico más efectivo para los Gram negativos. Se observó coincidencia entre el tratamiento empírico y el resultado del antibiograma en el 27,6 por ciento de los pacientes. Conclusiones: Resulta necesario un apropiado diagnóstico microbiológico de las úlceras del pie diabético para identificar los gérmenes presentes en las lesiones y diseñar algoritmos de terapia antimicrobiana adecuados(AU)

ABSTRACT Introduction: Diabetic foot ulcer infections are common, complex, high cost and are the leading cause of non-traumatic lower extremity amputation. Objective: To identify the microorganisms isolated to estimate both the sensitivity to antibiotics and the coincidence between empirical treatment and microbiological results in patients with diabetic foot ulcers. Methods: A descriptive-retrospective investigation was performed. The study population consisted of 210 patients admitted to the University Hospital "Comandante Faustino Pérez Hernández" of Matanzas between June 2017 and June 2020. The output variables were the frequency and type of germ, the number of germs per ulcer, the sensitivity for each type of antibiotic, and the percentage of coincidence between the empirical treatment and the microbiological result. Results: A total of 259 germs were identified and 1.23 germs per ulcer were observed. The 62.5 percent of the germs found were Gram negative, but the most represented germ was Staphylococcus aureus. Of the Staphylococcus aureus, 58.8 percentwere resistant to methicillin. Vancomycin and linezolid were effective in 100 percent of Gram positives. Amikacin was the most effective antibiotic for Gram-negatives. Agreement between empirical treatment and antibiogram result was observed in 27.6 percent of patients. Conclusions: An appropriate microbiological diagnosis of diabetic foot ulcers is necessary to identify the germs present in the lesions and to design adequate antimicrobial therapy algorithms(AU)

Dos décadas de análisis de las peritonitis en diálisis peritoneal en Andalucía: aspectos epidemiológicos, clínicos, microbiológicos y evolutivos / Two decades of analysis of peritonitis in peritoneal dialysis in Andalusia: Epidemiological, clinical, microbiological and progression aspects

Antecedentes: Este estudio se centra en la principal complicación asociada a diálisis peritoneal, la peritonitis. Su relevancia deriva de su elevada morbilidad, el efecto negativo que provoca en el peritoneo como membrana de diálisis y de coste económico que ocasiona. Métodos: Estudio observacional de cohortes, analítico, no intervencionista, cuyo objetivo principal es el análisis de las peritonitis en pacientes en diálisis peritoneal, en Andalucía en el periodo: 1 de enero de 1999 a 31 de diciembre de 2017, con un total de 2.904 peritonitis. La base de datos utilizada es la del Sistema de Información de la Coordinación Autonómica de Trasplantes de Andalucía (SICATA). Objetivos: Conocer la evolución de la tasa de peritonitis en nuestra comunidad, analizar datos descriptivos relacionados con los pacientes y las peritonitis, conocer la evolución de estas complicaciones infecciosas y analizar los factores que influyen en estas peritonitis y en su evolución: germen, hospitalización y fecha. Resultados: La tasa de peritonitis ha disminuido progresivamente durante el periodo de estudio desde 0,7 peritonitis por paciente en 1999 hasta 0,33 al final del periodo. La mayoría de las infecciones se tratan de manera ambulatoria (72,5%). Los gérmenes más frecuentes fueron los grampositivos (55,9%), y entre ellos, los estafilococos coagulasa negativos (28,1%). La mayoría de las peritonitis evolucionan a la curación (77,8%). Los factores que influyen de manera significativa en la necesidad de hospitalización y en la evolución de la peritonitis son el germen causal y la presencia de infección del orificio de salida asociado. Conclusiones: En nuestra población, la tasa de peritonitis ha disminuido progresivamente durante el periodo de estudio, alcanzando las recomendaciones de las guías. (AU)

Background: This study focuses on the main complication associated with peritoneal dialysis, peritonitis. Its relevance derives from its high morbidity, the negative effect it has on the peritoneum as a dialysis membrane and its financial cost. Methods: Analytical, non-interventional, observational cohort study, whose main objective is the analysis of peritonitis in patients on peritoneal dialysis in Andalusia from 1 January 1999 to 31 December 2017, with a total of 2,904 peritonitis cases. The database used is the Andalusian Autonomous Transplant Coordination Information System (SICATA). Objectives: To ascertain how the rate of peritonitis is evolving in our community, analyse descriptive data pertaining to patients and peritonitis, ascertain the course of these infectious complications and analyse the factors that influence these cases of peritonitis and their outcomes: germ, hospitalisation and date. Results: The rate of peritonitis decreased progressively during the study period, from 0.7 peritonitis per patient in 1999 to 0.33 at the end of the period. Most infections were treated on an outpatient basis (72.5%). The most common germs were Gram-positive (55.9%), including coagulase-negative staphylococci (28.1%). Most cases of peritonitis progressed to healing (77.8%). The factors that significantly influence the need for hospitalisation and peritonitis progression were the causative germ and associated exit site infection. Conclusions: In our population, the rate of peritonitis decreased progressively during the study period, meeting guideline recommendations. (AU)

What Do We See in Spectra?: Assignment of High-Intensity Peaks of Cutibacterium and Staphylococcus Spectra of MALDI-TOF Mass Spectrometry by Interspecies Comparative Proteogenomics.

Matrix-assisted laser-desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry is a widely used and reliable technology to identify microbial species and subspecies. The current methodology is based on spectral fingerprinting, analyzing protein peaks, most of which are yet to be characterized. In order to deepen the understanding of these peaks and to develop a more reasonable identification workflow, we applied proteogenomic approaches to assign the high-intensity peaks of MALDI-TOF spectra of two bacterial genera. First, the 3-22 kD proteomes of 5 Cutibacterium strains were profiled by UPLC-MS/MS, and the amino acid sequences were refined by referring to their genome in the public database. Then, the sequences were converted to m/z (x-axis) values based on their molecular masses. When the interspecies comparison of calculated m/z values was well-fitted to the observed peaks, the peak assignments for the five Cutibacterium species were confirmed. Second, the peak assignments for six Staphylococcus species were performed by using the above result for Cutibacterium and referring to ribosomal subunit proteins coded on the S10-spc-alpha operon (the S10-GERMS method), a previous proteomics report by Becher et al., and comprehensive genome analysis. We successfully assigned 13 out of 15 peaks for the Cutibacterium species and 11 out of 13 peaks for the Staphylococcus species. DNA-binding protein HU, the CsbD-like protein, and 50S ribosomal protein L7/L12 were observed in common. The commonality suggests they consist of high-intensity peaks in the MALDI spectra of other bacterial species. Our workflow may lead to the development of a more accurate species identification database of MALDI-TOF mass spectrometry based on genome data.

Concepts of God and Germs: Social Mechanisms and Cognitive Heuristics.

Previous research has shown that the more individuals view observable entities as animate, the more those entities are associated with having psychological and physiological experiences. This study examined the relationship between children's animistic and anthropomorphic reasoning for concepts of unobservable scientific (i.e., germ) and religious (i.e., God) entities. This study further explored how children's conceptions vary according to the social learning opportunities (i.e., discourse, rituals) parents reportedly create. Parent-child dyads with young children from diverse ethnic and religious backgrounds participated. Three central findings emerged. First, children readily associated God with psychobiological characteristics but did not do so to the same extent for germs. Second, children applied more psychobiological properties to both entity types when they believed that the entity was animate. Third, engaging in rituals and discourse with parents was indirectly related to children's concepts of God but not related to their concepts of germs. Overall, this study presented support for a connection between children's animistic and anthropomorphic reasoning for unobservable entities, and an indirect effect of cultural input on this reasoning. The implications of these findings will be discussed.

Gérmenes bacterianos aislados con frecuencia en úlceras flebostáticas de pacientes ingresados / Bacterial germs frequently isolated in phlebostatic ulcers of admitted patients

Introducción: Las úlceras flebostáticas constituyen una patología importante en la práctica médica diaria en todos los niveles de asistenciales; después del dolor y del edema, las úlceras de los miembros inferiores representan el tercer problema más común en las consulta de angiología. Objetivo: Caracterizar los gérmenes bacterianos aislados con frecuencia en las úlceras flebostáticas de los pacientes ingresados. Métodos: Se realizó un estudio descriptivo retrospectivo de corte transversal en 60 pacientes ingresados por diagnóstico de úlceras flebostáticas entre julio de 2016 y junio de 2017. A todos se les hizo cultivo microbiológico de la lesión con el respectivo antibiograma. Se tuvieron en cuenta las variables: tipo de úlcera flebostática, gérmenes bacterianos aislados, antibióticos analizados in vitro y patrón de sensibilidad antibiótica. Se calcularon las frecuencias absolutas y relativas. Resultados: Se encontró un predominio de úlceras varicosas (67 por ciento). El germen bacteriano que más se aisló fue Pseudomas spp. (41,7 por ciento), con más frecuencia en las úlceras varicosas que en las postrombóticas (47,5 por ciento vs. 30 por ciento). Los mejores porcentajes de sensibilidad in vitro se mostraron ante los siguientes antibióticos: Clindamicina (100 por ciento), Tobramicina (79,2 por ciento), Ciprofloxacino (78,4 por ciento), Amikacina (68,4 por ciento), Cotrimoxazol (68,2 por ciento), Cefepime (67,6 por ciento), Doxiciclina (66,7 por ciento), Cloranfenicol (60 por ciento), Meropenem (62,1 por ciento), Penicilina G (57 por ciento) y Aztreonam (55,9 por ciento). Conclusiones: Pseudomas spp. fue el germen bacteriano que más se aisló en los pacientes con úlceras varicosas y postrombóticas; además, se manifestó sensibilidad a 11 de los 23 antibióticos que se probaron in vitro en más del 50 por ciento de los aislados a los que se enfrentaron(AU)

Introduction: Phlebostatic ulcers are an important pathology in daily medical practice at all levels of care; after pain and edema, lower limb ulcers are the third most common problem in angiology consultations. Objective: Characterize frequently isolated bacterial germs in the phlebostatic ulcers of admitted patients. Methods: A descriptive, cross-sectional, retrospective study was conducted in 60 patients admitted due to a diagnosis of phlebostatic ulcers from July 2016 to June 2017. It was made a microbiological cultivation of the lesion with the respective antibiogram to all the patients. Variables were taken into account, like: type of phlebostatic ulcer, isolated bacterial germs, antibiotics tested in vitro and antibiotic sensitivity pattern. The absolute and relative frequencies were calculated. Results: A predominance of varicose ulcers (67 percent) was found. The most isolated bacterial germ was Pseudomasspp. (41.7 percent), and it was more often in varicose ulcers than in post-thrombotic ulcers (47.5 percent vs. 30 percent). The best percentages of in vitro sensitivity were shown against the following antibiotics: Clindamycin (100 percent), Tobramycin (79.2 percent), Ciprofloxacin (78.4 percent), Amikacin (68.4 percent), Cotrimoxazol (68.2 percent), Cefepime (67.6 percent), Doxycycline (66.7 percent), Chloramphenicol (60 percent), Meropenem (62.1 percent), Penicillin G (57 percent), Aztreonam (55.9 percent). Conclusions: Pseudomasspp. was the most isolated bacterial germ in patients with varicose and post-thrombotic ulcers; in addition, sensitivity was present in 11 of the 23 antibiotics that were tested in vitro in more than 50 percent of the isolates they faced(AU)

Impact of adipose-derived stem cells on engineering hair follicle germ-like tissue grafts for hair regenerative medicine.

Hair regenerative medicine has emerged as a promising treatment strategy for severe hair loss, such as end-stage androgenetic alopecia. Various approaches to engineering three-dimensional tissue grafts have been explored since they drive the ability to regenerate hair follicles when transplanted. In the present study, we demonstrated the assembly of human adipose-derived stem cells (hASCs) into hair follicle germ (HFG)-like aggregates for de novo hair regeneration. We mixed human dermal papilla cells (hDPCs), murine embryonic epithelial cells, and hASCs in suspension, and allowed them to form aggregates. During three days of culture, cells initially formed a single aggregate with a random distribution of the three cell types, but the epithelial and dermal papilla cells subsequently separated from each other and formed a dumbbell-shaped HFG, with hASCs localized on the hDPC aggregate side. The involvement of hASCs significantly increased gene expression associated with hair morphogenesis compared to HFGs without hASCs. The self-organization of the three cell types was observed in our scalable lab-made chip device. HFGs containing hASCs efficiently generated hair shafts upon transplantation to nude mice, while only a few shafts were generated with HFGs without hASCs. This approach may be a promising strategy for fabricating tissue grafts for hair regenerative medicine.