To assess the potential relationship between preoperative nutritional status, including anthropometric parameters, and infection following total knee replacement surgery.
A total of 213 patients ...undergoing total knee replacement between December 2007 and May 2008 were prospectively studied. Patients with rheumatoid arthritis were excluded. For each patient we pre-operatively checked biochemical and anthropometric parameters of nutrition information about co-morbidities such as diabetes and high blood pressure, ASA score, age, and gender. Information about early infections, both superficial and deep, was collected. A descriptive statistical analysis and univariate/multivariate logistic regression model for risk factors were performed.
Eleven patients (5.16%) had an infection, 5 deep and 6 superficial. Neither co-morbidities nor preoperatively biochemical parameters were associated with infection. However, in the univariate logistic regression model there was an inversely proportional relationship between triceps skinfold (TSF) and infection. After adjusting for age, ASA score and gender (multivariate logistic regression), TSF remained significantly associated with infection.
There was a statistically significant association between TSF and post-operative infection risk after TKR.
Level I (Prospective prognostic study).
This study compared the efficacy of graft-versus-host disease (GVHD) prophylaxis with post-transplantation cyclophosphamide (PTCy) and tacrolimus (Tac) versus other regimens in 272 adults undergoing ...peripheral blood (PB) allogeneic hematopoietic cell transplantation (allo-HCT) from HLA-matched donors. Of these 272 patients, 95 (34.9%) received PTCy/Tac. The times to neutrophil and platelet engraftment were longer in the PTCy/Tac group (20 days versus 16 days for neutrophils and 19 days versus 12 days for platelets). The day +30 cumulative incidence (CuI) of bacterial bloodstream infection was higher in the PTCy/Tac group (43.2% versus 13.0%; P < .001). The CuIs of grade II-IV and grade III-IV acute GVHD (aGVHD) at day +180 were 14.7% and 4.2%, and the CuI of moderate/severe cGVHD at 2 years was 2.4% in the PTCy/Tac group and 41.8% (hazard ratio HR, .29; P < .001), 15.8%, (HR, .24; P = .007), and 47.0% (HR, .05; P < .001), respectively, in the no-PTCy group. The duration of immunosuppression was shorter in patients receiving PTCy/Tac (6.2 months versus 9.0 months; P < .001). PTCy/Tac patients had higher OS (2 years: 74.3% versus 60.9%; HR, .54; P = .012), lower NRM (2 years: 8.6% versus 15.8%; HR, .54; P = .11), comparable CuI of relapse (2 years: 26.0% versus 24.4%; HR, 1.03; P = .89), and higher GRFS (2 years: 59.1% versus 16.7%; HR, .32; P < .001). Using PTCy/Tac in HLA-matched PB allo-HCT improved transplantation outcomes at out institution compared with previous prophylactic regimens, including a higher probability of survival despite more delayed engraftment and a higher rate of bacterial infection.
•Using PTCY for GVHD prevention and TBI-based conditioning regimens increased the risk for early cardiac toxicity in adults undergoing allo-HCT.
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This study investigates early cardiac ...events (ECEs) occurring during the first 180 days after allogeneic hematopoietic cell transplant (allo-HCT) in 416 adults receiving posttransplant cyclophosphamide (PTCY) (n = 258) or not receiving PTCY (n = 158). Total body irradiation (TBI) was given to 133 (31.9%) patients, of whom 111 (83.4%) received TBI combined with PTCY. The day +180 cumulative incidence function (CIF) of ECEs was 8.4%, with heart failure (n = 13) and pericardial complications (n = 11) being the most prevalent complications. The incidence of ECEs was higher in patients receiving PTCY, and receiving TBI. ECEs were more prevalent in haploidentical HCTs than in matched sibling donor, 10/10 HLA-matched unrelated donor, and 9/10 HLA-mismatched unrelated donor allo-HCTs. As for the ECE risk from the combination of PTCY and TBI, the multivariate analysis reported that patients receiving PTCY without TBI, TBI without PTCY, and TBI with PTCY were at higher risk for ECEs compared with patients receiving neither PTCY nor TBI. Pre-existing cardiac morbidity predicted ECEs. However, using high-dose CY-containing preparative regimens did not increase the risk for cardiac toxicity at +180 days after allo-HCT. ECEs were associated with higher nonrelapse mortality and lower overall survival. Considering that PTCY and TBI were predictors for ECEs, and the impact of this complication on transplant mortality, the implementation of cardiac monitoring plans could be appropriate in patients receiving these medications.
Methods
The main objective of this study is to combine the environmental evaluation of a basic wood box used to store wine bottles by means of the integration of two environmental methodologies: a ...quantitative methodology known as life cycle assessment (LCA) and a qualitative methodology which is useful in integrating environmental aspects into design, that is, the design for the environment (DfE). The LCA study covers the life cycle of wood box production from a cradle-to-gate perspective. A wood processing company located in Galicia (NW, Spain) was analysed in detail, dividing the process chain into five stages: cogeneration unit, material assembling, painting, packaging and distribution to clients.
Results
Abiotic depletion (AD), acidification, eutrophication, global warming, ozone layer depletion (OD), photochemical oxidant formation (PO), human toxicity (HT) and toxicological impact categories (HT, fresh water aquatic ecotoxicity, marine aquatic ecotoxicity and terrestrial ecotoxicity) were the impact categories analysed in the LCA study. According to the environmental results, the assembling stage contributed more than 57% to all impact categories, followed by the cogeneration unit and packaging. Contributions from packaging are mainly due to transoceanic transport activities related to the rope distribution and wood-based materials production. In addition, it is interesting to remark that all energy requirements were produced by on-site cogeneration boilers using a non-renewable fossil fuel. Several processes were identified as hot spots in this study: medium density fibreboards (MDF) production (with large contribution to ecotoxicity categories), energy production (with contributions to AD, GW and OD) and finally, the transportation of jute fibres (the main contributor to all the impact categories). Concerning the results from the DfE, the proposed eco-design strategies were evaluated from a technological, economic and social point of view by an interdisciplinary team of researchers and enterprise’s workers. The results show that the strategies with more viability of improvement were: reduction of resources used, multifunctional design, substitution of MDF by plywood, substitution of jute fibres, alternatives to the ink, optimization of energy requirement, transport alternatives for the final product and inputs distribution and definition of a protocol for disassembling the product.
Conclusions
The results obtained in this work allow forecasting the importance of the chosen raw materials as well as their origin for the environmental burdens associated with the wood-based box manufacture. Future work will focus on the manufacturing of a prototype eco-designed wood-based box.
Antibiotic-dependent pathogenic bacteria are sporadically isolated from patients that received prolonged antibiotic treatments. Evolution of antibiotics dependence and its clinical implications are ...scarcely studied.
A linezolid-dependent
strain was isolated from a cystic fibrosis patient. A draft genome sequence was obtained and searched for known antibiotics resistance determinants and virulence factors.
The genome was assembled into 79 contigs for a total of 2.83 Mbp. This strain is a sequence type 5 methicillin-resistant
with a type I SCC
cassette also conserving the Panton-Valentine leukocidin. The G2576T substitution, conferring linezolid resistance, was harbored by all five copies of the 23S rRNA.
The linezolid-dependent strain is related to a strain circulating in Latin America that acquired a mutation conferring linezolid resistance.
BackgroundLeishmania (Viannia) species are the principal cause of mucosal leishmaniasis. The natural history and pathogenesis of mucosal disease are enigmatic. Parasitological evaluation of mucosal ...tissues has been constrained by the invasiveness of conventional sampling methods MethodsWe evaluated the presence ofLeishmania in the mucosa of 26 patients with cutaneous leishmaniasis and 2 patients with mucocutaneous leishmaniasis. Swab samples of the nasal mucosa, tonsils, and conjunctiva were analyzed using polymerase chain reaction with LV-B1 primers and Southern blot hybridization ResultsTwo patients with mucocutaneous leishmaniasis and 21 (81%) of 26 patients with cutaneous leishmaniasis had Leishmania kinetoplast minicircle DNA (kDNA) in mucosal tissues. kDNA was amplified from swab samples of nasal mucosa from 14 (58%) of 24 patients, tonsils from 13 (46%) of 28 patients, and conjunctiva from 6 (25%) of 24 patients. kDNA was detected in the mucosa of patients with cutaneous disease caused by Leishmania panamensis, Leishmania guyanensis and Leishmania braziliensis ConclusionThe asymptomatic presence of parasites in mucosal tissues may be common in patients with Leishmania (Viannia) infection
A new deep learning system is proposed for the rapid and accurate identification of anthropogenic elements of the Roman mining infrastructure in NW Iberia, providing a new approach for automatic ...recognition of different mining elements without the need for human intervention or implicit subjectivity. The recognition of archaeological and other abandoned mining elements provides an optimal test case for decision-making and management in a broad variety of research fields. A new image dataset was created by obtaining UAV images from different anthropic features. A convolutional neural network architecture was implemented, achieving recognition results of close to 95% accuracy. This methodological approach is suitable for the identification and accurate location of ancient mines and hydrologic infrastructure, providing new tools for accurate mapping of mining landforms. Additionally, this novel application of deep learning can be implemented to reduce potential risks caused by abandoned mines, which can cause significant annual human and economic losses worldwide.
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