scholarly journals A local gentamicin-collagen sponge reduces cardiovascular implantable electronic device infections and pocket hematoma

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Monaco ◽  
L Barone ◽  
G Stifano ◽  
G Magliano ◽  
V Cammalleri ◽  
...  
Keyword(s):  
De Novo ◽  
Electronic Device ◽  
Aminoglycoside Antibiotic ◽  
Infectious Complications ◽  
Collagen Sponge ◽  
Group I ◽  
Group Ii ◽  
Systemic Antibiotics ◽  
Cardiovascular Implantable Electronic Device ◽  
Pocket Hematoma

Abstract Background Implantation or replacement of cardiovascular implantable electronic device (CIED) may be associated with complications such as pocket hematoma and infections. Purpose The aim of this study is to determine whether a lyophilized collagen impact impregnated with the aminoglycoside antibiotic gentamicin, applied according to the size of pocket into the surgical wound during implantation or replacement, reduces major CIED infections and pocket hematoma 12 months after the surgical intervention. Methods We conducted a retrospective study including 1189 patients (mean age 77.45±9.83 y.o.), who underwent implantation or replacement of CIED in our center between June 2007 and November 2018. We compared 475 patients treated with the local gentamicin-collage sponge (group I) with 714 patients who did not receive it (group II). The primary endpoints were the reduction of infectious complications and pocket hematoma through 12 months of follow-up post procedure. Results Complications occurred in 127 of 1189 patients (10.68%): 102 of 1189 patients (8.58%) developed pocket hematoma, 20 of 1189 patients (1.68%) infectious events and 5 of 1189 patients (0.42%) both. Specifically, the rate of complications was lower in group I: pocket hematoma 0.63% vs 13.86% (p<0.001), infections 0.21% vs 2.6% (p=0.02), both 0% vs 0.7% (p=0.17). The study also shows a statistically significant major incidence of infectious complications in subjects undergoing implantation or replacement of ICD, compared to subjects undergoing implantation or replacement of PPM (5.59% vs 1.5%; p<0.05%). Regarding the type of intervention and the incidence of complications within the subgroups, was demonstrated a statistically significant reduction in the incidence of infections in de novo implant-group I subgroup compared to de novo implant-group II subgroup (0.5% vs 3.5%; p<0.05); a statistically significant reduction in the incidence of infectious complications was also observed in replacement-group I subgroup (0%) compared to replacement-group II subgroup (0% vs 1.4%; p<0.05). Similar results were demonstrated for the incidence of pocket hematoma, with a statistically significant reduction in de novo implant-group I subgroup compared to de novo implant-group II subgroup (0.5% vs 14.13%; p<0.05) and in replacement-group I subgroup compared to replacement-group II subgroup (1.4% vs 12.5%; p<0.05). The association between therapy and development of hematoma was not statistically significant. The association between comorbidities and infectious complications in both groups was always statistically significant. Conclusion The local gentamicin-collagen sponge is a medical device which can be used in addition to local hemostasis and prophylactic doses of systemic antibiotics, with the aim of reducing infective complications and pocket hematoma after permanent CIED implantation or replacement. Funding Acknowledgement Type of funding source: None

Heterogeneity of the εγδβ Thalassemias: Characterization of 3 Novel English Deletions.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3609-3609
Author(s):  
Helen Rooks ◽  
Jean Bergounioux ◽  
Laurence Game ◽  
James P. Close ◽  
Steve Best ◽  
...  
Keyword(s):  
Gene Cluster ◽  
Olfactory Receptor ◽  
De Novo ◽  
Globin Gene ◽  
Inherited Disorders ◽  
Chromosome 11P15 ◽  
Globin Gene Cluster ◽  
Group I ◽  
Group Ii

Abstract The thalassemias are inherited disorders classified genetically into α, β, γ, δβ, δ and εγδβ varieties according to the type of globin(s) that are underproduced. At the molecular level, the εγδβ thalassemias fall into two categories; Group I removes all, or a greater part, of the β globin gene cluster which is embedded in an array of olfactory receptor genes on chromosome 11p15. Group II removes extensive upstream regions leaving the β globin gene itself intact despite which, its expression is silenced due to inactivation of the upstream locus control region (β LCR). Recently, two novel deletions causing εγδβ thalassemia have been reported; a 153 kb deletion removing the entire β globin cluster in a Chilean family (Game, L., et al., Br J Haematol2003, 123:154–9) and an upstream deletion of 112 kb in a Dutch family (Dutch III) (Harteveld, C.L., et al., Br J Haematol2003,122: 855–8). We describe here the characterization of another three novel εγδβ thalassemia deletions, in three English families, named English II, III and IV, to differentiate them from the previously reported English (I) deletion (Curtin, P., et al., J Clin Invest1985, 76: 1554–8). Deletion English II removed 98 kb extending 90 kb upstream of the ε gene to 8 kb upstream of the Gγ gene, and included 4 upstream olfactory receptor (HOR) genes. Deletion English III removed 114 kb extending 60 kb upstream of the ε gene to 9 kb downstream of the β globin gene, thus including the entire β globin gene cluster as well as two upstream HOR genes. English IV is the largest deletion (439 kb) reported so far; starting 326 kb upstream of the ε gene to 70 kb downstream of the β gene and included 13 upstream, and 3 downstream, HOR genes plus the intervening β globin gene cluster. Breakpoints of all the 3 deletions occurred within regions of L1 or Alu repeat elements and contained short regions of direct homology between the flanking sequences, a feature that is likely to have contributed to the illegitimate recombinations. Deletions English II and III appear to be de novo while English IV is not. The proband for the English IV deletion had neonatal hemolytic anemia and required blood transfusions while 3 other family members who were heterozygous for the same deletion, had uneventful post-natal periods. The English III proband also required a blood transfusion soon after birth while the English II proband did not. Although in later life, heterozygotes for εγδβ thalassemia are transfusion-independent, and have a blood picture typical of β thalassemia trait but with normal Hb A2 levels, our data suggest that heterozygotes for εγδβ thalassemias have more severe microcytosis and hypochromia than β thalassemia carriers. To date, a total of 15 deletions causing εγδβ thalassemia have been described - five upstream deletions (Group II) associated with intact β globin genes and ten (Group I) that include the entire β globin gene cluster. These deletions are all unique and illustrate the heterogeneity of the εγδβ thalassemias.

scholarly journals Creation and Characterization of Industrially Applicable de Novo Lager Yeast Hybrids with a Unique Genomic Architecture

2020 ◽  
Author(s):  
Zachari Turgeon ◽  
Thomas Sierocinski ◽  
Cedric A. Brimacombe ◽  
Yiqiong Jin ◽  
Brittany Goldhawke ◽  
...  
Keyword(s):  
De Novo ◽  
Phenotypic Diversity ◽  
Breeding Strategy ◽  
Lager Yeast ◽  
Genomic Architecture ◽  
Group I ◽  
Saccharomyces Pastorianus ◽  
Lager Beer ◽  
Group Ii ◽  
Beer Production

Lager beer is produced by Saccharomyces pastorianus, which is a natural allopolyploid hybrid between Saccharomyces cerevisiae and Saccharomyces eubayanus. Lager strains are classified into two major groups based largely on genomic composition: Group I and Group II. Group I strains are allotriploid, whereas Group II are allotetraploid. A lack of phenotypic diversity in commercial lager strains has led to substantial interest in the reconstitution of de novo allotetraploid lager strains by hybridization of S. cerevisiae and S. eubayanus strains. Such strategies rely on the hybridization of wild S. eubayanus isolates, which carry unacceptable traits for commercial lager beer such as phenolic off-flavours and incomplete utilization of carbohydrates. Using an alternative breeding strategy, we have created de novo lager hybrids containing the domesticated S. eubayanus subgenome from an industrial S. pastorianus strain by hybridizing diploid meiotic segregants of this strain to a variety of S. cerevisiae ale strains. Five de novo hybrids were isolated which had fermentation characteristics similar to those of prototypical commercial lager strains but with unique phenotypic variation due to the contributions of the S. cerevisiae parents. Genomic analysis of these de novo lager hybrids identified novel allotetraploid genomes carrying three copies of the S. cerevisiae genome and one copy of the S. eubayanus genome. Most importantly, these hybrids do not possess the negative traits which result from breeding wild S. eubayanus. The de novo lager strains produced using industrial S. pastorianus in this study are immediately suitable for industrial lager beer production. IMPORTANCE All lager beer is produced using two related lager yeast types: Group I and Group II, which are highly similar resulting in a lack of strain diversity for lager beer production. To date, approaches for generating new lager yeasts have generated strains possessing undesirable brewing characteristics which render them commercially inviable. We have used an alternative approach that circumvents this issue and created new lager strains that are directly suitable for lager beer production. These novel lager strains also possess a unique genomic architecture, which may lead to a better understanding of industrial yeast hybrids. We propose that strains created using our approach be classified as a third group of lager strains (Group III). We anticipate that these novel lager strains will be of great industrial relevance, and that this technique will be applicable to the creation of additional novel lager strains that will help broaden the diversity in commercial lager beer strains.

Impact of Gentamicin-Collagen Sponge (Collatamp) on the Incidence of Sternal Wound Infection in High-Risk Cardiac Surgery Patients: A Propensity Score Analysis

2012 ◽  
Vol 15 (5) ◽  
pp. 257 ◽  
Author(s):  
Shahzad G. Raja ◽  
Kareem Salhiyyah ◽  
Muhammed Umar Rafiq ◽  
Jeremy Felderhof ◽  
Mohamed Amrani
Keyword(s):  
Cardiac Surgery ◽  
High Risk ◽  
Propensity Score ◽  
Wound Infection ◽  
Wound Infection Rate ◽  
Collagen Sponge ◽  
Sternal Wound Infection ◽  
Postoperative Wound ◽  
Group I ◽  
Group Ii

<p>Objective: Local delivery of prophylactic antibiotic to the wound site with an implanted, reabsorbable, gentamicin-containing collagen sponge (Collatamp) is a strategy that has been claimed to prevent sternal wound infection after cardiac surgery. The purpose of this study was to review our experience with Collatamp in cardiac surgery patients deemed at high risk for sternal wound infection.</p><p>Methods: From January 2007 to December 2010, Collatamp was used in 107 patients deemed at high risk for sternal wound infection. Applying the propensity score, we matched 97 patients with Collatamp (group I) with 97 patients who did not receive Collatamp (group II). All individuals received routine intravenous antimicrobial prophylaxis. Postoperative wound-infection rates as well as routine outcomes were compared. Information for the study was obtained from the cardiac surgical Patients Analysis and Tracking System (PATS) database and from hospital records.</p><p>Results: The superficial sternal wound infection rate was 2.1% (2/97) in group I and 6.2% (6/97) in group II (<i>P</i> = .01). The rates of deep sternal wound infection rate were similar (2.1% versus 3.1%, <i>P</i> = .87). There was no mediastinitis in the study population. In addition, more patients in group II received an intra-aortic balloon pump (5.2% versus 2.1%, <i>P</i> = .04) and underwent hemofiltration (7.2% versus 3.1%, <i>P</i> = .02). No side effects were noted.</p><p>Conclusion: Gentamicin-containing collagen sponge (Collatamp) is a useful adjunct to meticulous surgical technique and postoperative wound care in reducing the incidence of sternal wound infection in high-risk cardiac surgery patients. An adequately powered study is needed, however, to validate the safety and efficacy of this strategy.</p>

Improving the molecular risk classification for younger (<60 years) de novo cytogenetically normal acute myeloid leukemia (CN AML) patients (pts)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 7002-7002
Author(s):  
G. Marcucci ◽  
K. Maharry ◽  
S. P. Whitman ◽  
P. Paschka ◽  
C. D. Baldus ◽  
...  
Keyword(s):  
High Risk ◽  
De Novo ◽  
Information Criterion ◽  
Risk Groups ◽  
Risk Classification ◽  
Low Risk ◽  
Treatment Protocols ◽  
Group I ◽  
Group Ii ◽  
Wt1 Mutation

7002 Background: CN AML pts are currently stratified into Low-risk [FLT3-ITD negative (neg)/NPM1 mutated (mut)] and High-risk [FLT3-ITD positive (pos) or NPM1 wild type (wt)] groups (FLT3-ITD/NPM1-only classification). We recently showed that low ERG expression and CEBPAmut identify pts with better outcome within, respectively, the Low- and High-risk groups, and that WT1mut confers poor outcome regardless of FLT3-ITD/NPM1 status. Here, we assess if adding CEBPA and WT1 mutation and ERG expression testing improves the currently used CN AML molecular risk classification. Methods: FLT3, NPM1, CEBPA and WT1 mutations and ERG and BAALC expression were tested at diagnosis in 143 CN AML adults enrolled on CALGB treatment protocols 9621 and 19808. Pts were divided into two molecular risk groups: i) CALGB Group I that included Low-risk pts with low ERG & High-risk pts with CEBPAmut and ii) CALGB Group II that included WT1mut pts & Low-risk pts with high ERG & High- risk pts with CEBPAwt. Results: CALGB Group I (n=56) v Group II (n=87) had more complete remissions (CRs) (P=.005; 96% v 79%), and longer disease-free (DFS; P<.0001; 5 year (y) 69% v 21%) and overall (OS; P<.0001; 5 y 70% v 31%) survival [median follow-up for pts alive 6 y]. In multivariable (MV) analyses, Group I predicted higher rate of CR (P=.02), and longer DFS (P<.0001) and OS (P=.0002), after correcting for other variables (Table). In contrast, for the same cohort of pts grouped by the FLT3-ITD/NPM1-only classification, CRs were 94% v 82% and 5 y DFS 59% v 32% and OS 67% v 36% in the Low- v High-risk groups. Based on the Akaike Information Criterion, MV models for DFS and OS using the CALGB risk Groups were better than those using the FLT3-ITD/NPM1-only risk groups. Conclusions: Prognostic classification of younger de novo CN AML pts is improved by adding CEBPA and WT1 mutation and ERG expression testing. While mutational analyses are ready for use in clinical trials, quantification of ERG expression is yet to be standardized. [Table: see text] No significant financial relationships to disclose.

Assessment of aerosolized Colistin and Gentamicin in mechanically ventilated patient

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Aya Mohamed Mohamed Abdel Dayem ◽  
Haitham Salah Eldin ◽  
Karim Mohamed Elhamy
Keyword(s):  
Mechanical Ventilation ◽  
Antibiotic Use ◽  
Control Group ◽  
Local Concentration ◽  
Mechanically Ventilated ◽  
Survival Status ◽  
Group I ◽  
Group Ii ◽  
And Control ◽  
Systemic Antibiotics

Abstract Background and Objectives ineffective parental antibiotic use in treatment of Ventilator associated pneumonia (VAP) open the window for using inhaled antibiotic formula to achieve higher local concentration of antibiotics and subsequently good recovery response, the aim of that work was evaluation of aerosolized antibiotics (Colistin and Gentamicin) efficacy in improving the mechanically ventilated patient as adjunctive to intravenous systemic antibiotics Methods 30 mechanically ventilated patients classified equally in to 3 groups; Group I 10 patients received aerosolized Colistin along with systematic antibiotics (SA). Group II: 10 patients received aerosolized Gentamicin along with systematic antibiotics (SA) and Group III (Control): 10 patients received only systematic antibiotics (SA). All patients were followed up for clinical response by bacteriological culture (after 5 days of aerosolized antibiotics), development of VAP, days of mechanical ventilation, length of stay in the ICU, and mortality. Results The incidence of VAP was 10%; in group I no cases had VAP, while in group II and control group, just (20%) and (10%) of cases had VAP respectively, with insignificant association of VAP with particular group, (P = 0.3). Clinically; only group I showed significant lower degree of temperature in comparison with control group, (P = 0.01). The mean days of MV and ICU in each groups were (6.8±2.15; 8.9±3.11, 5.9±2.23; 7.2±2.7, 5.1±1.1; 6.1±1.85) respectively, with insignificant statistical difference between the treatment groups, (P = 0.2 and 0.07) respectively. Finally, the survival rate in group I was 90%, and was slightly lower in group II and control group; 60% and 50% respectively, with insignificant association of survival status in particular group, (P = 0.1) Conclusion the empirical treatment by AA (Colistin) was effective as an adjuvant to systemic antibiotics for protection of VAP than aerosolized Gentamicin, it had rapid resolution of respiratory infection signs, and subsequently the mechanical ventilation days, ICU stay days, and probably the cost of ICU admission, but did not affect mortality.

Ultrastructural Lesions Produced by Alcohol and Sucrose in the Heart and Liver of C57BL Mice

1970 ◽  
Vol 28 ◽  
pp. 208-209
Author(s):  
K.K. SEKHRI ◽  
C.S. ALEXANDER ◽  
H.T. NAGASAWA
Keyword(s):  
Osmium Tetroxide ◽  
Male Mice ◽  
Alcohol Group ◽  
Group Iii ◽  
Group I ◽  
C57bl Mice ◽  
Group Ii

C57BL male mice (Jackson Lab., Bar Harbor, Maine) weighing about 18 gms were randomly divided into three groups: group I was fed sweetened liquid alcohol diet (modified Schenkl) in which 36% of the calories were derived from alcohol; group II was maintained on a similar diet but alcohol was isocalorically substituted by sucrose; group III was fed regular mouse chow ad lib for five months. Liver and heart tissues were fixed in 2.5% cacodylate buffered glutaraldehyde, post-fixed in 2% osmium tetroxide and embedded in Epon-araldite.

Heterogeneity and Immunochemical Properties of Anti-β2-glycoprotein I Autoantibodies

1998 ◽  
Vol 80 (09) ◽  
pp. 393-398 ◽  
Author(s):  
V. Regnault ◽  
E. Hachulla ◽  
L. Darnige ◽  
B. Roussel ◽  
J. C. Bensa ◽  
...  
Keyword(s):  
Fluid Phase ◽  
Anticardiolipin Antibodies ◽  
Dual Reactivity ◽  
Group Iii ◽  
Important Group ◽  
Epitope Specificity ◽  
Glycoprotein I ◽  
Group I ◽  
Group Ii ◽  
Sufficient Concentration

SummaryMost anticardiolipin antibodies (ACA) associated with antiphospholipid syndrome (APS) are directed against epitopes expressed on β2-glycoprotein I (β2GPI). Despite a good correlation between standard ACA assays and those using purified human β2GPI as the sole antigen, some sera from APS patients only react in the latter. This is indicative of heterogeneity in anti-β2GPI antibodies. To characterize their reactivity profiles, human and bovine β2GPI were immobilized on γ-irradiated plates (β2GPI-ELISA), plain polystyrene precoated with increasing cardiolipin concentrations (CL/β2GPI-ELISA), and affinity columns. Fluid-phase inhibition experiments were also carried out with both proteins. Of 56 selected sera, restricted recognition of bovine or human β2GPI occurred respectively in 10/29 IgA-positive and 9/22 IgM-positive samples, and most of the latter (8/9) were missed by the standard ACA assay, as expected from a previous study. Based on species specificity and ACA results, IgG-positive samples (53/56) were categorized into three groups: antibodies reactive to bovine β2GPI only (group I) or to bovine and human β2GPI, group II being ACA-negative, and group III being ACA-positive. The most important group, group III (n = 33) was characterized by (i) binding when β2GPI was immobilized on γ-irradiated polystyrene or cardiolipin at sufficient concentration (regardless of β2GPI density, as assessed using 125I-β2GPI); (ii) and low avidity binding to fluid-phase β2GPI (Kd in the range 10–5 M). In contrast, all six group II samples showed (i) ability to bind human and bovine β2GPI immobilized on non-irradiated plates; (ii) concentration-dependent blockade of binding by cardiolipin, suggesting epitope location in the vicinity of the phospholipid binding site on native β2GPI; (iii) and relative avidities approximately 100-fold higher than in group III. Group I patients were heterogeneous with respect to CL/β2GPI-ELISA and ACA results (6/14 scored negative), possibly reflecting antibody differences in terms of avidity and epitope specificity. Affinity fractionation of 23 sera showed the existence, in individual patients, of various combinations of antibody subsets solely reactive to human or bovine β2GPI, together with cross-species reactive subsets present in all samples with dual reactivity namely groups III and II, although the latter antibodies were poorly purified on either column. Therefore, the mode of presentation of β2GPI greatly influences its recognition by anti-β2GPI antibodies with marked inter-individual heterogeneity, in relation to ACA quantitation and, possibly, disease presentation and pathogenesis.

Treatment of venous leg ulcers with sulodexide

Phlebologie ◽  
2003 ◽  
Vol 32 (05) ◽  
pp. 115-120 ◽  
Author(s):  
A. Franek ◽  
H. Koziolek ◽  
M. Kucharzewski
Keyword(s):  
Pharmacological Treatment ◽  
Healing Process ◽  
Leg Ulcers ◽  
Venous Ulceration ◽  
Venous Leg Ulcers ◽  
Group I ◽  
Group Ii

SummaryAim: The study of the influence of sulodexide in the treatment of venous leg ulcers. Patients and method: 44 patients with chronic venous ulceration were randomly divided into two groups. Group I: 21 patients (ulceration area: 12.7-18.9 cm2), Group II: 23 patients (ulceration size: 12.1-20.3 cm2). Both groups were treated by using Unna’s boot. This dressing was changed every seven days until the ulcer had healed. Additionally, the patients in group II received the systemic pharmacological treatment with sulodexide. Results: After 7 weeks of treatment ulcers of seven patients (35%) from group I had healed, and 3 weeks later the ulceration of two more patients had healed completely. After further 7 weeks the ulcers of 12 patients had healed completely. Whereas in group II after 7 weeks of treatment ulceration of 16 (70%, p <0.05) patient had healed completely and after further 3 weeks the ulcers of the remaining 7 patients had healed, too. Conclusion: The use of sulodexide in patients with chronic venous leg ulcers accelerates the healing process.

Effects of Rest and Exercise on Cardiac Blood Volume Determinations

1997 ◽  
Vol 36 (08) ◽  
pp. 259-264
Author(s):  
N. Topuzović
Keyword(s):  
Radionuclide Ventriculography ◽  
Left Ventricular ◽  
Peak Exercise ◽  
Volume Determination ◽  
Group I ◽  
Lv Volumes ◽  
Group Ii ◽  
Lv Volume

Summary Aim: The purpose of this study was to investigate the changes in blood activity during rest, exercise and recovery, and to assess its influence on left ventricular (LV) volume determination using the count-based method requiring blood sampling. Methods: Forty-four patients underwent rest-stress radionuclide ventriculography; Tc-99m-human serum albumin was used in 13 patients (Group I), red blood cells was labeled using Tc-99m in 17 patients (Group II) in vivo, and in 14 patients (Group III) by modified in vivo/in vitro method. LV volumes were determined by a count-based method using corrected count rate in blood samples obtained during rest, peak exercise and after recovery. Results: In group I at stress, the blood activity decreased by 12.6 ± 5.4%, p <0.05, as compared to the rest level, and increased by 25.1 ± 6.4%, p <0.001, and 12.8 ± 4.5%, p <0.05, above the resting level in group II and III, respectively. This had profound effects on LV volume determinations if only one rest blood aliquot was used: during exercise, the LV volumes significantly decreased by 22.1 ± 9.6%, p <0.05, in group I, whereas in groups II and III it was significantly overestimated by 32.1 ± 10.3%, p <0.001, and 10.7 ± 6.4%, p <0.05, respectively. The changes in blood activity between stress and recovery were not significantly different for any of the groups. Conclusion: The use of only a single blood sample as volume aliquot at rest in rest-stress studies leads to erroneous estimation of cardiac volumes due to significant changes in blood radioactivity during exercise and recovery.

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