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Patients receiving hematopoietic stem cell transplants (HSCT) are at increased risk for Clostridioides difficile infection (CDI). The purpose of this study was to assess the effectiveness of oral vancomycin prophylaxis (OVP) for CDI in HSCT patients.
Design:
Single-center, retrospective cohort.
Setting:
Tertiary care academic medical center in New Jersey.
Patients:
Patients ≥18 years old during admission for the HSCT were included. Patients who were admitted <72 hours or who had an active CDI prior to HSCT day 0 were excluded.
Methods:
Medical records of patients admitted between January 2015 and August 2022 to undergo an allogeneic or autologous HSCT were reviewed. The primary end point was the incidence of in-hospital CDI. Secondary end points included the incidence of vancomycin-resistant enterococci (VRE) bloodstream infections, VRE isolated from any clinical culture, gram-negative bloodstream infections, hospital survival, and hospital length of stay. Exploratory end points, including 1-year survival, relapse, and incidence of graft-versus-host disease, were also collected.
Results:
A total of 156 HSCT patients were included. There was 1 case of CDI (1 of 81, 1.23%) in the OVP group compared to 8 CDI cases (8 of 75, 10.67%) in the no OVP group (P = .0147). There were no significant (P > .05) between-group differences in incidence of gram-negative bloodstream infections, hospital survival, and length of stay. There were zero clinical cultures positive for VRE.
Conclusions:
In-hospital incidence of CDI in HSCT patients was significantly decreased with OVP. Randomized controlled trials are needed in this high-risk population to assess the efficacy and risks of OVP for CDI.
This research paper aimed to examine the antibacterial activity of lactoferrin (LF) as a potential natural alternative in the dairy sector, by measuring its minimum inhibitory concentration (MIC) against a number of common food-borne pathogens as well as Pseudomonas aeruginosa, one of the major dairy product spoiling microorganisms. Additionally, a viability experiment was applied to laboratory-manufactured set yoghurt to assess its impact on the activity of starter culture, sensory properties and STEC survivability. The findings demonstrated that LF exhibited significant antimicrobial activity, particularly against E. coli and S. typhimurium with MIC values of 0.0001 and 0.01 mg/ml, respectively. However, P. aeruginosa and B. cereus were quite resistant to LF requiring higher concentrations for MIC (2.5 mg/ml). By the third day of storage, LF at 0.0001 and 0.001 mg/ml significantly reduced the survivability of Shiga toxin-producing E. coli STEC by 70 and 91.6%, respectively, in the lab-manufactured yoghurt. Furthermore, LF enhanced the sensory properties of fortified yoghurt with a statistically significant difference in comparison to the control yoghurt group. There was no interference with the activity of the starter culture throughout the manufacturing process and the storage period. In conclusion, the potent antimicrobial effect of LF opens a new avenue for the dairy industry's potential applications of LF as a natural preservative without negatively influencing the sensory properties and starter culture activity of fermented products.
Cyanotic CHD is one of many disorders in paediatrics that influence the health of children in different clinical aspects. One of the fundamental aspects that may be affected is bone mineral density.
Objectives:
The aim of our study is to assess bone mineral density in children with congenital cyanotic heart disease of different anatomical diagnoses.
Design/Methods:
Cross-sectional, observational study included 39 patients (20 males) with congenital cyanotic heart disease of different anatomical diagnoses following with the cardiology clinic in Mansoura University children’s hospital. All patients were subjected to anthropometric measures, oxygen saturation assessment, and lumber bone mineral density using dual-energy X-ray absorptiometry.
Results:
Six patients (15.4%) out of the 39 included patients showed bone mineral density reduction, 13 patients (33.3%) showed bone mineral density with Z-score between −1 and −2, while 20 patients (51.3%) showed bone mineral density with Z-score more than −1.
Conclusion:
Low bone mineral density can be found in children with cyanotic CHD, making it important to consider bone mineral density assessment and early treatment if needed to avoid further complications.
Patient reported outcomes (PROs), i.e. quality of life (QoL), psychosocial functioning and medication adherence are vital assessments of results in schizophrenia treatment.
Objectives
Quality of life, psychosocial functioning and adherence attitude were evaluated among adult patients with schizophrenia switched from current antipsychotics to lurasidone, using the Personal Evaluation of Transitions in Treatment (PETiT) scale, a PRO measure.
Aims
Evaluate PROs after switching to lurasidone.
Methods
Stable but symptomatic adult outpatients with schizophrenia were switched from their previous antipsychotics to lurasidone, in a 6-week, open-label trial. Subjective responses to antipsychotic therapy were evaluated at baseline and study endpoint using PETiT (Higher scores=better outcomes). Score change was obtained for all patients and those switched from “sedating” (olanzapine, quetiapine) or “non-sedating” (risperidone, aripriprazole, ziprasidone, others) agents. Change from baseline to endpoint in total (overall QoL) and subscale scores (psychosocial functioning, adherence attitude) were compared using ANCOVA.
Results
Of the 244 patients switched to lurasidone, 213 had available data. Changes from baseline in mean total PETiT score (3.2, P< 0.0001) and subscale scores of psychosocial functioning (2.5) and adherence attitude (0.7) were reported in all patient groups (p< 0.001). Improvement in mean total PETiT score was observed in patients switched from non-sedating (3.5, n=139) and sedating (2.7, n=74) antipsychotics and was statistically significant (P< 0.0001) in the non-sedating group. Differences in statistical significance (sedating vs non-sedating) may arise from smaller changes, not sample size.
Conclusions
In this study, patients switching to lurasidone experienced improvement in QoL, psychosocial functioning and adherence attitude.
Recent observations revealed that there is a difference in the spatial distribution of both nitrogen and oxygen bearing species towards massive star forming regions. These differences can be explained under different temperature regimes in hot cores. In this study, we attempt to model the chemistry of few nitrogen species; namely, vinyl cyanide (CH2CHCN), ethyl cyanide (CH3CH2CN), and formamide (NH2CHO), using gas-grain chemical models. A special attention is given to the role and efficiency of surface chemistry as it is suggested to play one of the main key roles in manufacturing these species.
We compared bedside polymerase chain reaction to culture for identifying Staphylococcus aureus in patients about to undergo surgery with hardware implantation. Patients were screened for S. aureus carrier status at the preoperative clinic and on the day of surgery. The sensitivity, specificity, positive and negative predictive values, and accuracy were calculated.
Infectious bronchitis virus (IBV) is one of the foremost causes of economic loss within the poultry industry. IBV is a commonly occurring, economically significant pathogen of commercial chicken. Economic consequences to the poultry industry comprise mortality, growth retardation and high condemnation rates in meat-type birds. In addition, decreased egg production, reduced internal and external egg quality, and reduced hatchability have been documented in layers and breeders affecting the performance of both meat-type and egg-laying birds. Apart from this some nephro-pathogenic strains cause kidney damage. Secondary pathogens can complicate the disease resulting in increased morbidity and mortality. Being a single stranded RNA virus, IBV has an enormous capacity to change both by spontaneous mutation and by genetic recombination resulting into the emergence of new variants. Since the first isolation of virus in 1937, it has been found almost all over the world. In addition, most countries are now known to have their own indigenous IBV variants. Despite the use of currently available live and inactivated vaccines, one of the most important difficulties to control IB is related to emergence of variant strains. The following paper reviews the current status of research into IBV.
Campylobacteriosis is the most frequent zoonotic disease in humans worldwide. Poultry meat contaminated by Campylobacter jejuni (C. jejuni) is an important source of this enteric zoonosis. Broiler chickens are the common natural host for this pathogen and infected birds carry a very high Campylobacter load in their gastrointestinal tract. Therefore, intervention at the farm level by reducing pathogen colonisation should be taken into consideration in any control policy. In addition, hygienic measures at the farm and control measures during carcass processing can reduce Campylobacter numbers on the retail product. It is important to differentiate between prevention and colonisation-reducing measures, which intervene at a different stage of the infection process. Several approaches have been conducted to reduce the number of Campylobacter in poultry, such as vaccination, passive immunisation, bacteriophages, bacteriocins, organic acids or their derivatives and medium chain of fatty acids, all with varying degrees of success. Nonetheless, to date there is no reliable and practical intervention measure available to reduce colonisation of the broiler gut with Campylobacter. A possible way to reduce Campylobacter contamination in poultry is to develop new strategies at the primary production level. As a consequence, it has become necessary to develop alternatives such as beneficial microorganisms (probiotics). The use of probiotics can help to improve the natural defence of animals against pathogenic bacteria and is an effective approach for livestock to reduce bacterial contamination. This review summarises current on-farm control options to reduce the prevalence and colonisation of Campylobacter in poultry. The interaction between poultry welfare and Campylobacter colonisation is also discussed.
Maternal infection is associated with oxidative stress (OS) and inflammatory responses. We have previously shown that maternal exposure to lipopolysaccharide (LPS) at E18 alters the subsequent offspring immune response. As immune responses are mediated, in part, by OS, we sought to determine if maternal inflammation during pregnancy programs offspring OS and C-reactive protein (CRP) levels. Pregnant Sprague-Dawley rats received intraperitoneal (i.p.) injections of saline or LPS at 18 days’ gestation (n = 4), and pups delivered spontaneously at term. At postnatal day 24, male and female offspring received i.p. injection of LPS. Serum lipid peroxides formation (PD) and CRP levels were determined before and at 4 h following the LPS injection. Pups of LPS-exposed dams had significantly higher basal OS (PD 29.4 ± 5.4 v. 10.1 ± 4.8 nmol/ml) compared with controls. In response to LPS, CRP levels (20.4 ± 2.8 v. 5.7 ± 1.0 ng/ml) were significantly higher among pups of LPS-exposed dams than controls. Prenatal maternal exposure to LPS increases baseline OS levels in neonates and CRP levels in response to LPS. These results suggest that maternal inflammation during the antenatal period may induce long-term sequelae in the offspring that may predispose to adult disease.
Topical medicaments used by patients with diseases of the skin were examined for microbial contamination. Ps. aeruginosa was isolated from stock pots of a diluted emulsifying ointment used as a soap substitute in the bath. Cross-con tamination between patients and medicament was subsequently shown to have occurred.
Topical medicaments used in the treatment and prevention of pressure sores in patients in three hospitals were examined for Pseudomonas aeruginosa and Staphylococcus aureus contamination. Contamination rates were found to vary between hospitals and were affected by differences in the packaging of the product and in the method of application used by the nursing staff.
Isoenzyme typing was used to study a number of oocyst isolates of Cryptosporidium parvum from different geographical locations and of human or animal origin. All isolates showed identical enzyme motility when glucose phosphate isomerase (GPI; 23 isolates tested) or lactate dehydrogenases (LDH; 20 isolates tested) was assayed. However, two isoenzyme forms were observed with phosphoglucomutase (PGM; 9 animal isolates showed one form, while 8/9 human isolates showed a second form) and hexokinase (HK; 4 human isolates showed one form and 6 animal isolates showed a second form). Thus, PGM and HK each exhibit 2 isoenzymes corresponding to 2 parasite populations associated with separate hosts. The data from this study, plus supportive evidence obtained by different methods and by independent researchers, lend support to the hypothesis that separate cycles of transmission of C. parvum may exist within human and animal hosts.
The polymerase chain reaction (PCR) was used to produce a 556 bp nucleotide stretch, employing primers based on the published sequence of the 18S rRNA genes in Cryptosporidium parvum and C. muris. This sequence was found to contain 3 Mae I endonuclease restriction sites, 1 of which was present only in C. parvum. Mae I restriction of PCR products from 2 C. parvum isolates (one of human origin and the other of bovine origin), 1 C. muris isolate, and 1 C. baileyi isolate, showed a specific and reproducible profile for C. parvum that was different from the one obtained for both C. muris and C. baileyi. From these data, new Mae I restriction maps were proposed for the three species. The system was then used to screen 6 C. parvum isolates (from human and bovine hosts), and the C. parvum-specific profile was obtained for all isolates examined. It should be possible to adapt this protocol to detect small numbers of C. parvum oocysts in environmental samples (e.g. in water supplies).
The optical and electrical properties of the as-prepared and annealed SnxSb20Se$_{80-x}$ (where x = 8, 10, 12, 13.5, 15, 16.5 and 18 at.%) thin films were studied. X-ray diffraction showed that all the as-prepared Sn-Sb-Se films were amorphous. Annealing the films at 473 K or above crystallized the films and the degree of crystallinity depended on the Sn content. The optical transmittance and reflectance were measured in the wavelength rang 200–2500 nm. The estimated optical band gap was found to decrease with increasing Sn content. A great difference in the optical constants values due to transformation from amorphous to crystalline phase structure of the films were found after annealing. This is advantageous for optical disk data storage applications. It was found that the resistivity decreases with increasing temperature for all the compositions indicating that these films have a semiconducting behavior with thermally activated conduction. The conduction in these films was suggested to be thermally assisted charge carrier movement in the extended states. Annealing the films caused a reduction in the room temperature resistivity by six order of magnitude. This was ascribed to the amorphous-crystalline transformation.
A phylogenetic tree, which distinguishes between the serovars and serogroups of leptospires common in Central Europe was constructed using an established RAPD procedure together with digital reading and evaluation (using different computer software programs) of the generated amplified DNA patterns. The application of this procedure has revealed a consistent correspondence between serogroup and genotype (position in constructed tree) in 69 cases, and serovar and genotype in 72 cases, of wild strains of leptospires. There was an agreement between serovar and genotype in cases of strains of Grippotyphosa, Pomona, Mozdok, Arborea and Sorexjalna as well as between serogroup and genotype in cases of Australis, Bataviae and Sejroe. With the procedure used in this study, it was not possible to distinguish between reference strains of serovars Jalna, Bratislava and Lora (all serogroup Australis) as well as between serovars Icterohaemorrhagiae and Copenhageni (both of serogroup Icterohaemorrhagiae). In contrast to this, wild strains belonging to serogroup Sejroe were distributed between Polonica, Istrica, Saxkoebing and Sejroe serovars. Endemic strains of leptospires tested, were also distinguishable.
Background and objective: Unplanned hospital admission is a measure of quality of care in the setting of day-case surgery. We set out to identify the incidence and causes of unplanned hospital admission in a paediatric day-case unit.
Methods: A retrospective survey to determine the incidence and causes of unplanned hospital admissions in children undergoing day-case surgery. The survey covered the period from January 1996 until December 1999 inclusive in a university affiliated children’s hospital. This hospital is the second largest paediatric referral centre in Ireland with total admissions across all specialities during the study period of 42 738.
Results: During the study period 10 772 children underwent day-case surgery, of whom 242 (2.2%) experienced unplanned hospital admission. The reasons for admission were surgical 146 (54%), anaesthetic 44 (16%), social 38 (14%), medical 31 (11%) and unclassified 10 (4%). Pain, surgical complications and/or further management, admission for observation, extensive surgery and oozing were the commonest surgical reasons. Postoperative nausea and vomiting, anaesthetic-related complication and somnolence were the commonest anaesthetic causes responsible for admission. Surgery performed after 15:00 h was an important factor associated with admission for social reasons. Orthopaedic surgery accounted for the largest absolute number of unplanned admissions with 61 (25%), followed by urology with 46 (19%) and general surgery with 46 (19%). However, measured as percentage of caseload, urology had the highest proportion of unplanned hospital admissions.
Conclusion: This study demonstrated that the incidence and causes of unplanned hospital admission following day-case surgery in children are similar to those for adults.
Background. The patients' ability to appraise their quality of life in schizophrenia was studied by examining the reliability and the validity of self-rated quality of life estimates.
Methods. Sixty-three symptomatically stable patients with schizophrenia (DSM-IV) receiving maintenance treatment were evaluated over a 4-week period. The subjects were asked to appraise their quality of life at weekly intervals on a single item global quality of life measure, as well as the self-administered sickness impact profile. The patients' quality of life was also rated by a clinician using the social performance schedule and the global assessment scale of functioning; and clinical aspects such as the severity of psychotic symptoms, neurocognitive deficits, dose of medications, and side effects were documented with standardized measures.
Results. The results indicated that the patients' self-reports were highly consistent over the 4 weeks, and the quality of life ratings correlated significantly with the clinician's estimates. The patients' quality of life was predictably influenced by the severity of their symptoms, side effects, cognitive deficits and the dose of their antipsychotic medication, but the reliability of their reports was not materially affected by these factors.
Conclusions. It is concluded that clinically compliant and stable patients with schizophrenia can evaluate and report their quality of life with a high degree of reliability and concurrent validity, implying that self-report measures are potentially useful tools in clinical trials and outcome studies.