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Journal of Clinical Microbiology Mar 2022The European Committee on Antimicrobial Susceptibility Testing (EUCAST) is an international susceptibility testing committee, organized by the European Society for... (Review)
Review
The European Committee on Antimicrobial Susceptibility Testing (EUCAST) is an international susceptibility testing committee, organized by the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) and functioning as the breakpoint advisory committee of the European Medicines Agency (EMA). The original remit of EUCAST was to harmonize European clinical breakpoints, but very soon, the activities expanded beyond the borders of Europe and included newly licensed agents in Europe. Among the milestones were the aggregating of large numbers of MIC distributions, creating software to display these distributions, the EUCAST concept of identifying epidemiological cutoff values (ECOFF), and the development of a EUCAST disk diffusion method. The EUCAST Development Laboratory has played a critical role in the development of antimicrobial susceptibility testing (AST) methodology, including development work for novel antimicrobial agents and for rapid AST directly from blood culture bottles. EUCAST has several standing subcommittees, including for AST in fungi (AFST) and mycobacteria (AMST) and for microorganisms of veterinary interest (VetCAST), and subcommittees on subjects such as anaerobic bacteria, MIC and zone diameter distributions and epidemiological cutoff values, the relationship between phenotypic and genotypic resistance, and expert rules and methods for the detection of resistance mechanisms. All EUCAST decisions are subjected to the EUCAST public consultation process, the only exception being breakpoints of novel antimicrobial agents where confidentiality agreements during the licensing process prevent public participation. EUCAST has recently revised the definitions of clinical susceptibility interpretive categories S, I, and R, acknowledging the intimate relationship between drug exposure and susceptibility reporting.
Topics: Anti-Bacterial Agents; Anti-Infective Agents; Europe; Fungi; Humans; Microbial Sensitivity Tests
PubMed: 34346716
DOI: 10.1128/JCM.00276-21 -
The Journal of Craniofacial Surgery Sep 2020The postauricular region (PR) is an anatomic area that has been neglected until now, due to the fact that the significant cosmetic changes and features of this region...
OBJECTIVE
The postauricular region (PR) is an anatomic area that has been neglected until now, due to the fact that the significant cosmetic changes and features of this region are often overlooked. There are limited and inconsistent data about postauricular masses in the literature and the definition of the PR and its borders remain unclear. The aim of the present study was to define the PR and evaluate benign and malignant masses that may arise in the PR.
METHODS
Fifty-two patients were enrolled in the study. The patients were evaluated retrospectively in terms of demographic data, including age, gender, operative method, lesion side and size, diagnostic tools, and histopathologic diagnosis of the masses.
RESULTS
The masses were categorized into 4 groups according to the etiology; neoplastic (n: 15, 28.8%), inflammatory (n: 13, 25%), congenital (n: 22, 42.3%) and traumatic (n: 2, 3.8%). Of the neoplastic masses, 6 (11.5%) were nonmelanoma skin cancer, comprising 4 (7.6%) basal cell carcinomas and 2 (3.8%) squamous cell carcinomas. A total of 9 (17.3%) neoplastic masses were benign, comprising 3 (5.7%) lipomas, 3 (5.7%) temporal bone osteomas, 2 (3.8%) nevi, and 1 (1.9%) plexiform neurofibroma. Of the 13 (25%) inflammatory masses, 12 (23%) were lymph nodes and 1 (1.9%) was pilonidal sinus. There were 22 (42.3%) congenital masses comprising 15 (28.8%) epidermal cysts, 4 (7.6%) dermoid cysts, and 3 (5.7%) hemangiomas. The 2 (3.8%) patients with traumatic lesion were both keloid patients.
CONCLUSION
The PR does not attract attention from the cosmetic point of view but many benign and malignant masses can be found in this region. Any masses detected in this area should be treated to prevent further growth.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Diagnosis, Differential; Ear, External; Epidermal Cyst; Female; Humans; Lymph Nodes; Male; Middle Aged; Neurofibroma, Plexiform; Retrospective Studies; Temporal Bone; Young Adult
PubMed: 32604279
DOI: 10.1097/SCS.0000000000006526 -
Journal of Hepato-biliary-pancreatic... Jan 2022The Brisbane 2000 Terminology for Liver Anatomy and Resections, based on Couinaud's segments, did not address how to identify segmental borders and anatomic territories...
BACKGROUND
The Brisbane 2000 Terminology for Liver Anatomy and Resections, based on Couinaud's segments, did not address how to identify segmental borders and anatomic territories of less than one segment. Smaller anatomic resections including segmentectomies and subsegmentectomies, have not been well defined. The advent of minimally invasive liver resection has enhanced the possibilities of more precise resection due to a magnified view and reduced bleeding, and minimally invasive anatomic liver resection (MIALR) is becoming popular gradually. Therefore, there is a need for updating the Brisbane 2000 system, including anatomic segmentectomy or less. An online "Expert Consensus Meeting: Precision Anatomy for Minimally Invasive HBP Surgery (PAM-HBP Surgery Consensus)" was hosted on February 23, 2021.
METHODS
The Steering Committee invited 34 international experts from around the world. The Expert Committee (EC) selected 12 questions and two future research topics in the terminology session. The EC created seven tentative definitions and five recommendations based on the experts' opinions and the literature review performed by the Research Committee. Two Delphi Rounds finalized those definitions and recommendations.
RESULTS
This paper presents seven definitions and five recommendations regarding anatomic segmentectomy or less. In addition, two future research topics are discussed.
CONCLUSIONS
The PAM-HBP Surgery Consensus has presented the Tokyo 2020 Terminology for Liver Anatomy and Resections. The terminology has added definitions of liver anatomy and resections that were not defined in the Brisbane 2000 system.
Topics: Hepatectomy; Humans; Liver Neoplasms; Minimally Invasive Surgical Procedures; Tokyo
PubMed: 34866349
DOI: 10.1002/jhbp.1091 -
Salud Publica de Mexico Dec 2023The growing cancer burden particularly among less developed countries requires local data to plan and evaluate cancer control measures. This article describes the...
The growing cancer burden particularly among less developed countries requires local data to plan and evaluate cancer control measures. This article describes the development of a population-based cancer registry network (PBCRN) in Mexico that took place between 2017 and 2020 and present related data. The PBCRN, led by the National Cancer Institute (Incan), included nine registries representing 11.3% of the Mexican population. Definitions, coding, and operative processes were based on international standards. All cities were visited to set up local structure; personnel were hired by Incan and trained in basic cancer registration in Merida. A specific software was developed. Regular virtual meetings took place for data verification and quality control. Data collection included institutions of the public and private health system. Personnel included 34 registrars, nine local leaders, and 12 staff members at the Incan. A total of 13 517 cases were recorded between 2017-2020, 64% percent of them were among females. Breast cancer was the more frequent malignancy (23.3%), followed by digestive organs with (18.4%) and female genital cancers (13.5%). Childhood (0-14 years) and adolescents cancer represented 4.4% of the total new cancer cases. The network was suspended in 2020. The present effort lacked sustainability and data were only partial. However, the experience provides valuable insights to be considered for the renewed cancer registration efforts that are currently ongoing in Mexico.
PubMed: 38065103
DOI: 10.21149/15258 -
Le Infezioni in Medicina 2022Monkeypox is a rare viral infection, endemic in many central and western African countries. The last international outbreak of monkeypox reported outside Africa occurred... (Review)
Review
Monkeypox is a rare viral infection, endemic in many central and western African countries. The last international outbreak of monkeypox reported outside Africa occurred back in 2003. However, monkeypox has reemerged at a global scale with numerous confirmed cases across the globe in 2022. The rapid spread of cases through different countries has raised serious concerns among public health officials worldwide prompting accelerated investigations aimed to identify the origins and cause of the rapid expansion of cases. The current situation is reminiscent of the very early stages of the still ongoing COVID-19 pandemic. Overlapping features between these, two seemingly alike viral entities include the possibility for airborne transmission and the currently unexplained and rapid spread across borders. Early recognition of cases and timely intervention of potential transmission chains are necessary to contain further outbreaks. Measures should include rapid and accurate diagnosis of cases meeting case definitions, active surveillance efforts, and appropriate containment of confirmed cases. Governments and health policymakers must apply lessons learned from previous outbreaks and start taking active steps toward limiting the recent global spread of monkeypox. Herein, we discuss the status of the current monkeypox outbreaks worldwide, the epidemiological and public health situation at a global scale and what can be done to keep at bay its further expansion and future global implications.
PubMed: 36148174
DOI: 10.53854/liim-3003-6 -
Obstetrics & Gynecology Science Sep 2021To describe the laterally extended parametrectomy (LEP) surgical technique, emphasizing the main challenges of the procedure.
OBJECTIVE
To describe the laterally extended parametrectomy (LEP) surgical technique, emphasizing the main challenges of the procedure.
METHODS
LEP was designed as a more radical surgical procedure aiming to remove the entire parametrial tissue from the pelvic sidewall. Its initial indications were for lymph node positive Stage Ib (current International Federation of Gynecology and Obstetrics 2018 Stage IIIc) and Stage IIb cervical cancer. Currently, with most guidelines recommending definitive radiochemotherapy for these cases, initial LEP indications have become debatable. LEP is now mainly indicated for removing tumors involving the soft structures of the pelvic sidewall during a pelvic exenteration, aiming to obtain lateral free margins. This expands the lateral borders of the dissection to not only the medial surface of internal iliac vessels, but also to the true limits of the pelvic sidewall.
RESULTS
During LEP, the parietal and visceral branches of the hypogastric vessels are divided at the entry and exit level of the pelvis. Consequently, the entire internal iliac system is excised, and no connective or lymphatic tissue remain on the pelvic sidewall. The main technical challenges of LEP are caused by the difficulty in ligating large caliber vessels (internal iliac artery and vein) and the variable anatomic distribution of pelvic sidewall veins.
CONCLUSION
LEP is a feasible technique for removing pelvic sidewall recurrences, aiming to obtain surgical free margins.
PubMed: 34030221
DOI: 10.5468/ogs.21103