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Journal of Clinical Medicine Sep 2023Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are effective treatments for severe knee and hip osteoarthritis. Historically, TKA has been associated...
Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are effective treatments for severe knee and hip osteoarthritis. Historically, TKA has been associated with lower satisfaction than THA, but recent advances in knee surgery have led to lower dissatisfaction rates. This study aimed to compare the satisfaction and self-reported improvement in the quality of life of two cohorts of patients who underwent TKA and THA, respectively. This observational study compared two previously published cohorts of patients who underwent THA and TKA in a single university center. The Goodman scale was used to assess satisfaction and self-perception of improved quality of life after TKA and THA at a minimum one-year follow-up. Propensity score matching was used to balance age, gender, and follow-up between groups. Significance was set at 0.05. The study included a total of 105 THAs and 131 TKAs. Both groups had high levels of satisfaction with pain relief, ability to do house/yard work, and overall satisfaction, with above 90% satisfaction rates. Regarding improvement in quality of life, both groups had 86% of patients reporting improvement as "much better." After propensity score matching, no significant difference was found between THA and TKA for any of the comparisons made using the Goodman scale. The study showed that both TKA and THA resulted in high levels of satisfaction and improvement in quality of life. There was no significant difference in satisfaction rates between TKA and THA, contrary to the historical trend of lower satisfaction rates for TKA.
PubMed: 37763035
DOI: 10.3390/jcm12186096 -
Antimicrobial Agents and Chemotherapy Nov 2023AmpC β-lactamases are associated with development of ceftriaxone resistance despite initial susceptibility, but the risk of AmpC derepression is not equal among...
AmpC β-lactamases are associated with development of ceftriaxone resistance despite initial susceptibility, but the risk of AmpC derepression is not equal among Enterobacterales. The purpose of this study was to evaluate the impact of an AmpC stewardship intervention on the definitive treatment of low- and no-risk Enterobacterales. This was an IRB-approved, single pre-test, post-test quasi-experiment at a 5-hospital system. An AmpC stewardship intervention was implemented in July 2022 and included prescriber education, the removal of microbiology comments indicating potential for ceftriaxone resistance on therapy, and the modification of a blood PCR comment for to recommend ceftriaxone. Adults ≥18 years pre-intervention (July 2021 to December 2021) and post-intervention (July 2022 to December 2022) who received ≥72 hours of inpatient definitive therapy and had non-urine cultures growing low- and no-risk organisms (, spp., , , or ) were included. The primary endpoint was definitive treatment with ceftriaxone. A total of 224 patients were included; 115 (51%) in pre-intervention and 109 (49%) in post-intervention. Definitive ceftriaxone therapy was prescribed more frequently after intervention [6 (5%) vs 72 (66%), < 0.001]. After adjustment for critical illness, patients in the post-group were more likely to receive definitive ceftriaxone (adjOR, 34.7; 95% CI, 13.9-86.6). The proportion of patients requiring retreatment was 18 (15%) and 11 (10%) for pre- and post-intervention patients ( = 0.22), and ceftriaxone resistance within 30 days occurred in 5 (4%) and 2 (2%) patients in the pre- and post-group ( = 0.45). An antimicrobial stewardship intervention was associated with increased ceftriaxone prescribing and similar patient outcomes for low- and no-risk AmpC Enterobacterales.
Topics: Adult; Humans; Anti-Bacterial Agents; Ceftriaxone; Enterobacteriaceae; Enterobacteriaceae Infections; beta-Lactamases; Bacterial Proteins; Gammaproteobacteria; Serratia marcescens; Microbial Sensitivity Tests
PubMed: 37882541
DOI: 10.1128/aac.00826-23 -
Journal of Translational Medicine Feb 2024Tumor mutational burden (TMB) has been demonstrated to predict the response to immune checkpoint inhibitors (ICIs) in various cancers. However, the role of TMB in head... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Tumor mutational burden (TMB) has been demonstrated to predict the response to immune checkpoint inhibitors (ICIs) in various cancers. However, the role of TMB in head and neck squamous cell carcinoma (HNSCC) has not yet been specifically addressed. Since HNSCC patients exhibit a rather limited response to ICIs, there is an unmet need to develop predictive biomarkers to improve patient selection criteria and the clinical benefit of ICI treatment.
METHODS
We conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. HNSCC cohort studies were selected when TMB prior to ICI treatment was evaluated, TMB cutoff value was available, and the prognostic value of TMB was evaluated by time-to-event survival analysis. A total of 11 out of 1960 articles were analyzed, including 1200 HNSCC patients.
RESULTS
The results showed that those patients harboring high TMB exhibited a significantly superior overall response rate (OR = 2.62; 95% CI 1.74-3.94; p < 0.0001) and a survival advantage (HR = 0.53; 95% CI 0.39-0.71; p < 0.0001) after ICI treatment.
CONCLUSION
This is the first meta-analysis to demonstrate a higher response and clinical benefit from ICI therapy in HNSCC patients with high TMB.
Topics: Humans; Squamous Cell Carcinoma of Head and Neck; Prognosis; Immunotherapy; Survival Analysis; Biomarkers, Tumor; Head and Neck Neoplasms; Mutation
PubMed: 38311741
DOI: 10.1186/s12967-024-04937-x -
Environmental Science and Pollution... Feb 2024We here report of a conference about "Pesticides in Soil, Groundwater and Food in Latin America as part of One Health" that took place at the "IV Seminario Internacional...
We here report of a conference about "Pesticides in Soil, Groundwater and Food in Latin America as part of One Health" that took place at the "IV Seminario Internacional de Sanidad Agropecuaria (SISA)" in Varadero, Cuba, 8-12 May 2023. Researchers of Latin America (Argentina, Brazil, Chile, Costa Rica, Colombia, Cuba, Mexico) and Switzerland (workshop initiator) held presentations about occurrence and effects of pesticides on the environment, human health, the replacement of highly hazardous pesticides (HHP) by agroecological alternatives and the agri-food value chain. In a subsequent round table discussion, the presenters identified deficits, needs, interests and opportunities. According to them, the lack of awareness of pesticide use affects the health and safety of workers applying the chemicals. Despite Latin America representing the main agricultural area in the world with a very intense pesticide use, monitoring data of pesticides in soil, surface and groundwaters, food, as well as in humans are missing. Risks of pesticides to humans should be assessed so that authorities can withdraw or limit within "short time" the access to corresponding formulations on the market. Also, communication is not state of the art and should be improved as, e.g. the teaching of workers and farmers, how to correctly use and apply pesticides or the briefing of decision makers. Pollinators suffer from multiple stressors not the least due to pesticides, and alternatives are badly needed. On the technical side, the different analytical methods to determine residues of active ingredients and transformation products in matrices of concern should be harmonized among laboratories.Seven future actions and goals were identified to overcome the above deficits. Next steps after the publishing of this conference report are to harmonize and complete the information status of the presenters by exchanging the results/data already present. Therefore, a platform of interaction to address issues described above and to enhance collaboration shall be created. Samples of different matrices shall be exchanged to harmonize the chemical analysis and establish interlaboratory comparisons. Such activities might be facilitated by joining international associations or organizations, where researchers can offer their expertise, or by forming a new pesticide network for Central and South America that could present tailored projects to national and international organizations and funding agencies.
Topics: Humans; Latin America; Pesticides; Soil; One Health; Groundwater; Brazil
PubMed: 38329663
DOI: 10.1007/s11356-024-32036-3 -
Cancers Oct 2023The latest technical development in the field of positron emission tomography/computed tomography (PET/CT) imaging has been the extension of the PET axial field-of-view.... (Review)
Review
The latest technical development in the field of positron emission tomography/computed tomography (PET/CT) imaging has been the extension of the PET axial field-of-view. As a result of the increased number of detectors, the long axial field-of-view (LAFOV) PET systems are not only characterized by a larger anatomical coverage but also by a substantially improved sensitivity, compared with conventional short axial field-of-view PET systems. In clinical practice, this innovation has led to the following optimization: (1) improved overall image quality, (2) decreased duration of PET examinations, (3) decreased amount of radioactivity administered to the patient, or (4) a combination of any of the above. In this review, novel applications of LAFOV PET in oncology are highlighted and future directions are discussed.
PubMed: 37958347
DOI: 10.3390/cancers15215173 -
Insects Mar 2024The blowfly, (Diptera: Calliphoridae), is a well-known forensically important insect. Basic data related to have been well documented; but despite the pivotal role of...
The blowfly, (Diptera: Calliphoridae), is a well-known forensically important insect. Basic data related to have been well documented; but despite the pivotal role of gut microbes in various facets of insect biology, little is known about its gut microbiome. To investigate the gut bacterial community of and explore its stability, diet and developmental stage were selected as the two variables. Larvae were reared on bovine liver, swine manure, and chicken manure, and high-throughput sequencing of the 1st, 2nd, and 3rd instar larvae and the newly emerged adults was performed. According to our results, the alpha diversity of the gut bacterial community did not significantly vary among different diets and developmental stages. Principal coordinate analysis revealed that the gut microbiome of clustered together among different diets and developmental stages. The main phyla in the gut microbial community of were Firmicutes and Proteobacteria, and the dominant genera were , , , and . These findings characterized the gut microbiome of and demonstrated that the gut bacterial community is fairly stable. The dominant genera , , , and have the potential to serve as core microbiomes within the gut microbial community of .
PubMed: 38535376
DOI: 10.3390/insects15030181 -
Clinical Reviews in Allergy & Immunology Apr 2024Secondary prevention with penicillin aims to prevent further episodes of acute rheumatic fever and subsequent development of rheumatic heart disease (RHD). Penicillin... (Meta-Analysis)
Meta-Analysis Review
Secondary prevention with penicillin aims to prevent further episodes of acute rheumatic fever and subsequent development of rheumatic heart disease (RHD). Penicillin allergy, self-reported by 10% of the population, can affect secondary prevention programs. We aimed to assess the role for (i) routine penicillin allergy testing and the (ii) safety of penicillin allergy delabeling approaches in this context. We searched MEDLINE, Embase, CENTRAL, ClinicalTrials.gov, WHO ICTRP, ISRCTN, and CPCI-S to identify the relevant reports. We found 2419 records, but no studies addressed our initial question. Following advice from the WHO-Guideline committee and experts, we identified 6 manuscripts on allergy testing focusing on other populations showing that the prevalence of allergy confirmed by testing was low and the incidence of life-threatening reactions to BPG was very low (< 1-3/1000 individuals treated). A subsequent search addressed penicillin allergy delabeling. This found 516 records, and 5 studies addressing the safety of direct oral drug challenge vs. skin testing followed by drug administration in patients with suspected penicillin allergy. Immediate allergic reactions of minor severity were observed for a minority of patients and occurred less frequently in the direct drug challenge group: 2.3% vs. 11.5%; RR = 0.25, 95%CI 0.15-0.45, P < 0.00001, I = 0%. No anaphylaxis or deaths were observed. Severe allergic reactions to penicillin are extremely rare and can be recognized and dealt by trained healthcare workers. Confirmation of penicillin allergy diagnosis or delabeling using direct oral drug challenge or penicillin skin testing seems to be safe and is associated with a low rate of adverse reactions.
Topics: Humans; Drug Hypersensitivity; Penicillins; Skin Tests; Practice Guidelines as Topic; World Health Organization; Anti-Bacterial Agents
PubMed: 38696031
DOI: 10.1007/s12016-024-08988-2 -
Pathogens (Basel, Switzerland) Nov 2023is a common uropathogen and a leading cause of catheter-associated urinary tract infections (CAUTIs), which are often polymicrobial. Through a genome-wide screen, we...
is a common uropathogen and a leading cause of catheter-associated urinary tract infections (CAUTIs), which are often polymicrobial. Through a genome-wide screen, we previously identified two [NiFe] hydrogenases as candidate fitness factors for CAUTI: a Hyb-type Group 1c H-uptake hydrogenase and a Hyf-type Group 4a H-producing hydrogenase. In this study, we disrupted one gene of each system ( and ) and also generated a double mutant to examine the contribution of flexible H metabolism to growth and fitness in vitro and during experimental CAUTI. Since is typically present as part of a polymicrobial community in the urinary tract, we also examined the impact of two common co-colonization partners, and , on the expression and contribution of each hydrogenase to fitness. Our data demonstrate that neither system alone is critical for growth in vitro or fitness during experimental CAUTI. However, perturbation of flexible H metabolism in the ∆∆ double mutant decreased fitness in vitro and during infection. The Hyf system alone contributed to the generation of proton motive force and swarming motility, but only during anaerobic conditions. Unexpectedly, both systems contributed to benzyl viologen reduction in TYET medium, and disruption of either system increased expression of the other. We further demonstrate that polymicrobial interactions with and alter the expression of Hyb and Hyf in vitro as well as the contribution of each system to fitness during CAUTI.
PubMed: 38133262
DOI: 10.3390/pathogens12121377 -
BMC Public Health Dec 2023The current study aimed to explore the association of individual characteristics, social and environmental factors - school and region - in the intention to be...
OBJECTIVE
The current study aimed to explore the association of individual characteristics, social and environmental factors - school and region - in the intention to be physically active in Brazilian adolescents.
METHODS
This is a cross sectional study based on the third edition of the National School Health Survey. The study included a total of 53,937 adolescents. To assess the intention to be physically active, only who engaged in less than 300 min of physical activity per week were included. Participants were asked: "If you had the opportunity to practice physical activity most days of the week, what would your attitude be?" Individual characteristics, physical activity domains, social factors, school, and regional environments were used as exposures. Network analysis was utilized to evaluate the associations.
RESULTS
We observed that boys had higher intentions to be physically active compared to their peers, as did adolescents who perceived themselves as fat. In addition, students from private schools show a higher intention to regularly engage in physical activities, and in general, private schools offer more extracurricular physical activities.
CONCLUSION
In conclusion, individual factors such as sex and body image perception, and environmental factors such as school administrative dependency and availability of extracurricular activities had a significant contribution to the intention to be physically active among Brazilian adolescents.
Topics: Male; Humans; Adolescent; Intention; Brazil; Cross-Sectional Studies; Exercise; Sports
PubMed: 38066468
DOI: 10.1186/s12889-023-17291-2 -
Polymers Aug 2023The only biotic factor that can satisfy the needs of human species are plants. In order to minimize plastic usage and spread an immediate require of environmental...
The only biotic factor that can satisfy the needs of human species are plants. In order to minimize plastic usage and spread an immediate require of environmental awareness, the globe urges for the development of green composite materials. Natural fibers show good renewability and sustainability and are hence utilized as reinforcements in polymer matrix composites. The present work concerns on the usage of Butea parviflora fiber (BP), a green material, for high end applications. The study throws light upon the characterization of raw and potassium hydroxide (KOH)-treated Butea Parviflora plant, where its physical, structural, morphological, mechanical, and thermal properties are analyzed using the powder XRD, FTIR spectroscopy, FESEM micrographs, tensile testing, Tg-DTA, Thermal conductivity, Chemical composition, and CHNS analysis. The density values of untreated and KOH-treated fibers are 1.238 g/cc and 1.340 g/cc, respectively. The crystallinity index of the treated fiber has significantly increased from 83.63% to 86.03%. The cellulose content of the treated fiber also experienced a substantial increase from 58.50% to 60.72%. Treated fibers exhibited a reduction in both hemicelluloses and wax content. Spectroscopic studies registered varying vibrations of functional groups residing on the fibers. SEM images distinguished specific changes on the raw and treated fiber surfaces. The Availability of elements Carbon, Nitrogen, and Hydrogen were analyzed using the CHNS studies. The tensile strength and modulus of treated fibers has risen to 192.97 MPa and 3.46 Gpa, respectively. Thermal conductivity (K) using Lee's disc showed a decrement in the K values of alkalized BP. The activation energy E lies between 55.95 and 73.15 kJ/mol. The fibers can withstand a good temperature of up to 240 °C, presenting that it can be tuned in for making sustainable composites.
PubMed: 37688148
DOI: 10.3390/polym15173522