Biological Therapies and Tuberculosis Infection in Dermatology

After contact with a case of transmissible tuberculosis (TB), some of the exposed individuals may be infected and develop an immune reaction against Mycobacterium tuberculosis (Mtb), the causative agent of the disease. The replication of mycobacteria is usually stopped within cellular structures called granulomas, whose integrity relies on a complex interplay between cells and cytokines, the most prominent of them being TNF. In case of deficiency or inhibition of the activity of TNF, the granulomas may disrupt and release the surviving mycobacteria which may multiply, disseminate and lead to active TB disease. Several immune-mediated inflammatory diseases, among which rheumatoid arthritis, Crohn’s disease, ankylosing spondylitis and psoriasis can be treated by biological therapies acting by the inhibition of TNF or cytokines like IL-17 and IL-23. If these therapies, in particular TNF-inhibitors, are administered to people infected by Mtb, there is a risk of decreasing the integrity of granulomas and increasing the probability of mutiplication of mycobacteria and TB reactivation. Therefore, in persons with rheumatological, gastro-enterological and dermatological diseases candidate to biological therapies there is a general recommendation of screening for TB infection (TBI) at baseline. The screening should include also a search for history of prior TB or contact with TB, a test for the presence of TBI, and if scored positive, a chest X-Ray

Writing a Psychological Blitz Literature Review with Nothing but a Browser

The ways so far of writing literature reviews represent valid, but not sufficient, landmarks, connected to the current technological context. In this sense, this article proposes a research method called blitz literature review, as a way to quickly, transparently, and repeatably consult key references in a particular area of interest, seen as a network composed of elements that are indispensable to such a process. The tutorial consists of six steps explained in detail, easy to follow and reproduce, accompanied by publicly available supplementary material. Finally, the possible implications of this research method are discussed, being brought to the fore a general recommendation regarding the optimization of the citizens’ involvement in the efforts and approaches of open scientific research.

Antibiotics in the Medical and Surgical Treatment of Necrotizing Enterocolitis. What Regimen is the Best? - A Systematic Review

Background: The aim of this review was to identify relevant randomized controlled trials (RCTs) and non-RCTs to evaluate the existing knowledge on antibiotic treatment effect for infants with Necrotizing Enterocolitis (NEC). Objective: Identifying 1) the best antibiotic regimen to avoid progression or surgery in infants with NEC 2) the best antibiotic regimen for infants operated for stage III NEC. Methods: Embase, MEDLINE and Cochrane were searched systematically for human studies using antibiotics for patients with NEC. Eligible studies had patients with NEC Bells stage II and III. Study selection, data extraction, and quality assessment were performed independently by two authors. RoB2 and ROBINS-I were used where appropriate. Results: 5 studies were included, 2 RCT and 3 n-RCT. Four regimens were investigated. Three used a combination of ampicillin + gentamycin (or similar) with an addition of 1) clindamycin 2) metronidazole or 3) enteral gentamycin. One studied investigated cefotaxime + vancomycin. None of the included studies had a specific regimen for stage III infants undergoing surgery. Conclusions: A GRADE evaluation was not possible because of large heterogeneity. For now, there is not sufficient evidence to make a general recommendation on which antibiotic regimen is the most effective for infants with NEC stage II and III.

Baby-Led Weaning: What Role Does It Play in Obesity Risk during the First Years? A Systematic Review

Childhood is a window of opportunity for the prevention of the obesity pandemic. Since “the first 1000 days of life” is a period in which healthy eating habits must be acquired, it should be the target for preventive strategies. Baby-led weaning (BLW) is an emergent way of weaning that could influence children’s health. The nutrition committees of the main pediatric societies affirm there is not enough evidence to support which is the best method of weaning. The aim was to determinate the influence of BLW on the infant’s weight gain compared to the traditional spoon-feeding, and to assess if it could decrease the risk of obesity in children. A systematic review was conducted, following the PRISMA method. Pubmed, Web of Science, Embase, and Cochrane Library were searched. Out of 747 articles, eight studies (2875 total infants) were included (two randomized control trials, 6 observational studies). Results were indecisive, while some studies seem to demonstrate lower weight gain in infants that apply BLW, others show inconclusive results. The risk of bias in all included studies was moderate or high. In conclusion, more clinical trials and prospective studies should be done prior to providing a general recommendation about the best method of weaning to reduce the risk of obesity.

Long peripheral catheters and midline catheters: Insights from a survey of vascular access specialists

Background: Peripheral intravenous access is no longer limited to the standard intravenous catheter (cannula). Devices varying in length, material and insertion technique, are increasingly accessible. There is substantial variability surrounding the nomenclature and use of these devices in the literature. We wished to understand the attitude of vascular access specialists towards the nomenclature and use of peripheral intravenous catheters (PIVCs), long peripheral catheters (LPCs) and midline catheters (MCs). Methods: A 15-question electronic survey was sent to members of the Association of Vascular Access (AVA) regarding the nomenclature and use of PIVCs, LPCs and MCs. Results: A total of 228 participants completed the survey. Approximately two-thirds of respondents use LPCs (65.8%) and MCs (71.9%) in their clinical practice. The most common indication for LPCs was difficult venous access (56.5%), while the most common indication for MCs was medium-term (1–4 weeks) intravenous therapy (62.7%). The majority of participants (57.9%) agreed with the following classification of peripheral intravenous devices: PIVCs: 2 to 6 cm in length, terminating distal to the axilla; LPCs: 6 to 15 cm in length, terminating distal to the axilla; MCs: 15–25 cm in length, terminating in the axilla. Participants suggested that the length of the catheter should be considered a general recommendation, as LPCs and MCs should be primarily differentiated by tip location. Conclusions: The majority of vascular access specialists from AVA have incorporated LPCs and MCs into their repertoire of peripheral venous access tools. We envisage that their use will increase as the clinical community becomes more familiar with these devices.

Development of an algorithm for optimizing nitrogen fertilization in wheat using GreenSeeker proximal optical sensor

Proximal plant sensing with active canopy sensors offers a leap in the non-destructive assessment of crop agronomic information. For managing fertilizer nitrogen (N), sensor readings must be translated using functional models or algorithms to fertilizer amounts. Six field experiments were conducted in three wheat seasons in the West Nile Delta in Egypt to develop and validate an algorithm based on GreenSeeker canopy reflectance sensor for field-specific fertilizer N management in wheat, which takes into account both spatial and temporal variability of N during the crop growth season. The proposed algorithm is based on the prediction of total N uptake and response index of N uptake determined from normalized difference vegetation index measured by the sensor from plots differing in yield potential as established by applying a range of fertilizer N levels in the four experiments conducted in the first two wheat seasons. The treatments in the two experiments conducted in the third wheat season were designed to define appropriate fertilizer N management prior to applying a sensor-based dose at Feekes 6 stage (jointing stage). The application of 40 and 60 kg N ha−1 at 10 and 30 days after sowing of wheat and a sensor-guided dose of N estimated by using the algorithm developed in this study resulted in yields similar to those obtained by following the general recommendation, but with an average of 66 kg N ha−1 less fertilizer N. These results were also reflected in a substantial increase in N recovery (21.9%) and agronomic (7.7 kg grain kg−1 N) efficiencies compared with the general recommendation, thereby proving the usefulness of the sensor-based algorithm in optimizing fertilizer N management in wheat.

Success Rate of Individual Pollinizers for the Pear Cultivars “Ingeborg” and “Celina” in a Nordic Climate

Norwegian pear production is low due to climatic limitations, a lack of well-adapted cultivars and suitable pollinizers. However, nowadays it is increasing as a result of newly introduced and bred pear cultivars. Since cross pollination is necessary for high yields and good fruit quality, the aim of this investigation was to find the most suitable pollinizers for the pear cultivars “Ingeborg” (“Conference” × “Bonne Louise”) and “Celina” (“Colorée de Juillet” × “Williams”). Self-pollination of “Ingeborg” and “Celina”, together with “Conference”, “Belle Lucrative”, “Anna”, “Clara Frijs”, “Herzogin Elsa”, “Kristina” and “Fritjof” as potential pollinizers, were studied in this experiment during the 2017 and 2018 seasons in Norway. The success rate of each pollinizer was tested under field conditions, while the monitoring of pollen tube growth was done using the fluorescence microscopy method. All reproductive parameters (pollen germination, number of pollen tubes in the upper part of the style, pollen tube number in the locule of the ovary, number of fertilized ovules, initial fruit set, and final fruit set) in all crossing combinations were higher in 2018 due to much warmer weather. Based on the flowering overlap and success rate of each individual pollinizer and fruit set, the cultivars “Anna” and “Clara Frijs” can be suggested as pollinizers for the cultivar “Ingeborg”, while “Fritjof”, “Anna”, “Kristina” and “Herzogin Elsa” for the cultivar “Celina”. An even distribution of two compatible pollinizers having overlapping flowering times with the main commercial pear cultivar is a general recommendation for commercial pear production.