Serotypes and Clonal Composition of Streptococcus pneumoniae Isolates Causing IPD in Children and Adults in Catalonia before 2013 to 2015 and after 2017 to 2019 Systematic Introduction of PCV13.

The goal of this study was to investigate the distribution of serotypes and clonal composition of Streptococcus pneumoniae isolates causing invasive pneumococcal disease (IPD) in Catalonia, before and after systematic introduction of PCV13. Pneumococcal strains isolated from normally sterile sites obtained from patients of all ages with IPD received between 2013 and 2019 from 25 health centers of Catalonia were included. Two study periods were defined: presystematic vaccination period (2013 and 2015) and systematic vaccination period (SVP) (2017 to 2019). A total of 2,303 isolates were analyzed. In the SVP, there was a significant decrease in the incidence of IPD cases in children 5 to 17 years old (relative risk [RR] 0.61; 95% confidence interval [CI] 0.38 to 0.99), while there was a significant increase in the incidence of IPD cases in 18- to 64-year-old adults (RR 1.33; 95% CI 1.16 to 1.52) and adults over 65 years old (RR 1.23; 95% CI 1.09 to 1.38). Serotype 8 was the major emerging serotype in all age groups except in 5- to 17-year-old children. In children younger than 5 years old, the main serotypes in SVP were 24F, 15A, and 3, while in adults older than 65 years they were serotypes 3, 8, and 12F. A significant decrease in the proportions of clonal complexes CC156, CC191, and ST306 and an increase in those of CC180, CC53, and CC404 were observed. A steady decrease in the incidence of IPD caused by PCV13 serotypes indicates the importance and impact of systematic vaccination. The increase of non-PCV13 serotypes highlights the need to expand serotype coverage in future vaccines and rethink vaccination programs for older adults. IMPORTANCE We found that with the incorporation of the PCV13 vaccine, the numbers of IPD cases caused by serotypes included in this vaccine decreased in all of the age groups. Still, there was an unforeseen increase of the serotypes not included in this vaccine causing IPD, especially in the >65-year-old group. Moreover, a significant increase of serotype 3 included in the vaccine has been observed; this event has been reported by other researchers. These facts call for the incorporation of more serotypes in future vaccines and a more thorough surveillance of the dynamics of this microorganism.

Pneumococcal serotypes in children, clinical presentation and antimicrobial susceptibility in the PCV13 era.

The aim was to analyse invasive pneumococcal disease (IPD) serotypes in children aged ⩽17 years according to clinical presentation and antimicrobial susceptibility. We conducted a prospective study (January 2012-June 2016). IPD cases were diagnosed by culture and/or real-time polymerase chain reaction (PCR). Demographic, microbiological and clinical data were analysed. Associations were assessed using the odds ratio (OR) and 95% confidence intervals (CI). Of the 253 cases, 34.4% were aged <2 years, 38.7% 2-4 years and 26.9% 5-17 years. Over 64% were 13-valent pneumococcal conjugate vaccine (PCV13) serotypes. 48% of the cases were diagnosed only by real-time PCR. Serotypes 3 and 1 were associated with complicated pneumonia (P < 0.05) and non-PCV13 serotypes with meningitis (OR 7.32, 95% CI 2.33-22.99) and occult bacteraemia (OR 3.6, 95% CI 1.56-8.76). Serotype 19A was more frequent in children aged <2 years and serotypes 3 and 1 in children aged 2-4 years and 5-17 years, respectively. 36.1% of cases were not susceptible to penicillin and 16.4% were also non-susceptible to cefotaxime. Serotypes 14, 24F and 23B were associated with non-susceptibility to penicillin (P < 0.05) and serotypes 11, 14 and 19A to cefotaxime (P < 0.05). Serotype 19A showed resistance to penicillin (P = 0.002). In conclusion, PCV13 serotypes were most frequent in children aged ⩽17 years, mainly serotypes 3, 1 and 19A. Non-PCV13 serotypes were associated with meningitis and occult bacteraemia and PCV13 serotypes with pneumonia. Non-susceptibility to antibiotics of non-PCV13 serotypes should be monitored.

The effect of protease and Bacillus licheniformis on nutritional value of pea, faba bean, yellow lupin and narrow-leaved lupin in broiler chicken diets.

1. This study investigated the nutritional value (digestibility of ileal crude protein and amino acids (AAs)) and the AMEN value of legumes (pea, faba bean, yellow lupin, and narrow-leaved lupin) with or without protease. 2. Two hundred, one-day-old, male Ross 308 broiler chickens were randomly allocated to ten groups. Each group received one of five different protein raw materials - either peas, faba beans, yellow lupins or narrow-leaved lupins, with or without protease produced from Bacillus licheniformis. The birds were kept in individual cages. Nutrient digestibility was calculated using the difference method. The total duration of the study was 23 d, and the study involved two phases - accommodation phase (d 1-18) and experimental phase (d 18-23). 3. The effect of protease on response traits was not consistent between the legumes. The enzyme increased the digestibility of some AAs in the pea (arginine, leucine, phenylalanine, histidine, tyrosine, alanine, and proline), faba bean (lysine, arginine, glycine, and asparagine), and yellow lupin diets (lysine, valine, and serine), but this effect was not observed in the narrow-leaved lupin diet. The change in AMEN values due to protease addition was only statistically significant for the pea diet (P < 0.05), whereas in the case of other legume species, the difference was insignificant (P > 0.05). 4. Exogenous protease increased the digestibility of AAs present in pea, faba bean, and yellow lupin seeds but not in narrow-leaved lupin diets. The AMEN value of peas increased with protease supplementation, but no effect of protease was found for the AMEN values of faba bean and both the lupin diets.

Brachytherapy organ dose estimation using Monte Carlo simulations of realistic patient models.

Radiation Therapy Planning Systems (RTPS) currently used in hospitals contain algorithms based on deterministic simplifications that do not properly consider electrons lateral transport in the areas where there are changes of density, and as a result, erroneous dose predictions could be produced. According to this, the present work proposes the use of Monte Carlo method in brachytherapy planning systems, which could affect positively on the radiotherapy treatment planning, since it provides results that are more accurate and takes into account the in homogeneities density variations. This paper presents a Monte Carlo (MC) simulation of a brachytherapy prostate treatment with I-125 seeds, using the latest version of MCNP, v.6.1.1. To that, a 3D model of the anatomy of a real anonymized patient is created from the segmentation of Computed Tomography (CT) images. Treatment over this 3D model is simulated and the dose given to each organ is obtained. These doses are compared with those calculated by deterministic planning system used in hospital demonstrating the effectiveness of MC method in the planning of brachytherapy treatments, because of not only the results precision but also regarding the affordable computing times.

Encapsulated benzoic acid supplementation in broiler diets influences gut bacterial composition and activity.

1. The present study investigated the effects of encapsulated benzoic acid (BA) supplementation in broiler feed on performance and gastrointestinal microbiota. 2. Eighty broilers were randomly divided into two groups. Birds in the control group were fed on maize-soybean-based diets. Birds in the treatment group were provided the same diet supplemented with 2 g/kg BA encapsulated in a vegetable oil matrix. 3. At the end of the trial (d 35), pH, bacterial composition and metabolites were determined in the crop, jejunum, ileum and caecum. 4. Growth performance variables and pH were not significantly different. 5. BA concentration decreased rapidly in the proximal gut. However, the treatment diet showed higher BA in the crop, jejunum, ileum and caecum. 6. Total lactate in the crop and D-lactate in the jejunum was higher in the BA treated group. Caecal total and branched chain fatty acids were decreased due to the treatment. 7. Lactobacilli populations were significantly altered by BA supplementation. A trend for increased lactobacilli was observed in the crop, while it became significant in the jejunum and ileum. Lactobacillus species responded differently to the treatment. Four of 5 measured Lactobacillus species, particularly in the ileum, followed the course observed for total lactobacilli; only Lactobacillus salivarius was not modified. 8. Correlation analysis showed that BA modified the intestinal microbiota. Lactobacilli correlated negatively to all studied clostridial clusters and enterobacteria. Clostridial clusters IV and XIVa were significantly increased in the jejunum, whereas only clostridial cluster XIVa was increased in the caecum. 9. Encapsulated BA modified the intestinal microbiota which can lead to the conclusion, that the main beneficial mode of action of BA in the gut appears to be the enhancement of lactic acid bacteria, which in turn may act as a vanguard against pathogens.

Enfermedad invasora por meningococo del serogrupo 29E / Invasive meningitis due to serogroup 29E meningococci

No disponible

Empleo del modelo animal en la formación enendoscopia diagnóstica y terapéutica de la vía biliar / Animal model training in diagnostic and therapeutic biliary tract endoscopy teaching

Objetivo. Mostrar nuestra experiencia en la formación en endoscopia terapéutica de la vía biliar en modelo animal. Materiales y métodos. Esta actividad formativa tiene una duración de 13 horas y comienza iniciando al alumno en las diferencias anatómicas de las especies que se emplean, la porcina y la canina, con respecto a la anatomía humana. Las prácticas consisten en habituar al endoscopista a la visión lateral del duodenoscopio; se realizan en un modelo porcino debido a que es más sencillo atravesar el esfínter pilórico, aunque no suele ser muy adecuado para la canulación de la papila duodenal. Tras superar la primera fase se utiliza el modelo canino, que permite adquirir las habilidades y destrezas propias de esta técnica. La evaluación de los resultados se realiza mediante una encuesta anónima. Resultados. El 76% de los alumnos confirma que ha avanzado mucho con este entrenamiento, un 18% regular y un 6% poco. El 75% considera que, tras realizar esta actividad de formación, se encontraría capacitado para llevar a cabo la técnica en su hospital. El 94% de los alumnos recomendaría esta actividad a sus compañeros. Conclusiones. El empleo del modelo animal en la formación en colangio pancreatografía retrógada endoscópica (CPRE)permite la adquisición de habilidades básicas necesarias para la práctica, ya que posibilita la repetición de las maniobras y la tutela continuada. Consideramos que con esta metodología mixta se podría acortar la curva de aprendizaje de la CPRE y disminuiría la iatrogenia en las primeras fases (AU)

Aim. To show our experience in training in therapeutic endoscopy of the biliary tract in animal model. Materials and methods. This training activity has duration of 13 hours and starts initiating the trainee in anatomical differences with regard to human anatomy that occur between species that are used, the swine and canine. The practices consist of endoscopist to habituate the lateral view of duodenoscope, performing on pig model because it is easier to pass through the pyloricsphincter, although this is not very suitable for cannulation of the duodenal papilla. After passing the first stage, we used the canine model to acquire the skills and abilities specific to this technique. The performance evaluation is done through an anonymous survey. Results. 76% of students confirmed that they have made good progress with this training, 18% regular and 6% that shortly. 75% believed that after making this training would be found competent to carry out the technique in their hospitals. About 94% of students would recommend this activity. Conclusions. The use of animal model in training in endoscopic retrograde cholangiopancreatography (ERCP)permits the acquisition of basic skills needed for practice, a sit enables the repetition of the maneuvers and continuing care. We believe that this mixed methodology could shorten the learning curve for ERCP and reduce iatrogenic in the early stages (AU)

Risk of introduction of H5N1 HPAI from Europe to Spain by wild water birds in autumn.

Highly pathogenic avian influenza (HPAI) subtype H5N1 continues to circulate across Eurasia and Africa since its unprecedented rapid spread in 2005. Diffusion by wild bird movements has been evidenced in the European Union in 2006 and 2007. Spain is an important wintering quarter for aquatic birds from northern latitudes, so identifying the critical areas and species where an outbreak is prone to happen is necessary. This work presents an assessment of the risk of introduction of H5N1 HPAI in Spain by aquatic wild birds estimating a relative risk value per province. For this purpose, an assessment of the release and exposure to the risk of infection with H5N1 HPAI of 25 selected water bird species has been carried out. Parameters considered in the assessment include H5N1 HPAI notifications from 2006 to 2008 and factors that favour the occurrence or persistence of H5N1 HPAI (wetlands' surface, low temperatures), together with aquatic wild birds' movements parameters (departure, destination, stop-overs, abundance) and parameters relative to the susceptible population in Spain: poultry density and wild aquatic abundance. Results show the relative risk for each Spanish province of experiencing H5N1 HPAI introduced by wild aquatic birds helping to identify higher risk areas.

Changes in cisternal udder compartment induced by milking interval in dairy goats milked once or twice daily.

Fourteen Murciano-Granadina dairy goats were used to evaluate udder compartments (cisternal and alveolar) and cisternal recoil after an oxytocin (OT) challenge at different milking intervals (8, 16, and 24 h) during wk 7 of lactation. Goats were milked once (1x; n = 7) or twice (2x; n = 7) daily from wk 2 of lactation. Average milk yields for wk 4 and 8 were 1.76 and 2.24 L/d, for goats milked 1x and 2x, respectively. For each half udder, cisternal area was measured by ultrasonography and cisternal milk was measured by machine milking after i.v. injection of an OT receptor blocking agent. Alveolar milk was then obtained after i.v. injection of OT. Regardless of milking frequency, alveolar milk increased from 8 to 16 h after milking, but did not change thereafter. Cisternal area and cisternal milk increased linearly (R2 = 0.96 to 0.99) up to 24 h, indicating continuous milk storage in the cistern at any alveoli filling degree. Cisternal to alveolar ratio increased with milking interval (from 57:43 to 75:25), but differences between milking intervals were significant at 8 h only, at which time goats milked 2x showed a greater ratio (1x = 51:49; 2x = 62:38). Despite extended milking intervals, cisterns of goats milked 1x did not become larger than cisterns of goats milked 2x after 5 wk of treatment. The highest correlation between cisternal area and cisternal milk was detected at 8 h after milking (r = 0.74). Primiparous goats had smaller cisternal areas and less cisternal milk than multiparous goats at all milking intervals. Cisternal recoil was studied in a sample of multiparous goats milked 1x (n = 4) and 2x (n = 4) by scanning cisterns by ultrasonography at 0, 5, 15, and 30 min after an OT challenge for each milking interval. Cisternal area increased after OT injection for the 8- and 16-h milking intervals, but no differences were observed for the 24-h interval. Unlike cows, no changes in cisternal area were observed after OT injection, indicating the absence of cisternal recoil in goats. We conclude that goats show a large cisternal compartment that increases linearly after milking. Nevertheless, cisternal size did not increased after 1x milking, probably because of lesser milk yield. Multiparous goats had larger cisterns than primiparous goats and were able to store more milk in their cisterns at all milking intervals. Because of the high capacity of goat cisterns, no milk return from cistern to alveoli is expected if milking is delayed after milk letdown.

Tests of Large N(c) QCD from Hadronic tau Decay.

We use the ALEPH Collaboration data on vector and axial-vector spectral functions to test simple duality properties of QCD in the large N(c) limit, which emerge in the approximation of a minimal hadronic ansatz of a spectrum of narrow states. These duality properties relate the short- and long-distance behaviors of specific correlation functions, which are order parameters of spontaneous chiral symmetry breaking, in a way that we find well supported by the data.

Ring chromosome 7 and sacral agenesis.

A ring chromosome 7 was found in a 19-month-old girl with microcephaly, growth and developmental delay, multiple angiomas, and partial sacral agenesis. Absent sacrum is a frequent finding in patients with 7q terminal deletions; in fact, genes involved in the sacral agenesis are localized in 7q36. However, this anomaly was not described previously in patients with a ring chromosome 7. High resolution G-banding chromosome and fluorescence in situ hybridization (FISH) demonstrated that our patient lost this region during ring formation.

Ion-mediated resistance to osmotic changes of ram spermatozoa: the role of amiloride and ouabain.

The aim of this study was to evaluate whether the Na+/K+ and Na+/H+ exchange can maintain the function of fresh ram spermatozoa. We analyzed the quality parameters of spermatozoa from fresh ram ejaculates incubated in iso- (about 300 mOsm), hypo- (about 100 mOsm) and hyperosmotic (about 900 mOsm) media in the presence of ouabain a specific inhibitor of the Na+/K+ ATP-ase or amiloride, a specific inhibitor of the Na+/H+ antiporter. Ouabain increased the percentage of morphologically altered acrosomes in isoosmotic media (from about 10% to 15% in control to about 30% with 10(-4) M ouabain) and decreased the percentage of total motility (from about 80% in control to about 50% to 55% with 10(-4) M ouabain). Ouabain decreased the mean linearity component of motility and decreased the frequency of head displacement. The addition of ouabain increased the percentage of altered acrosomes in the hypo- and hyperosmotic media, although it did not modify viability in either media. Ouabain also increased the percentage of swollen tails in the hypoosmotic medium at higher concentrations of the inhibitor. Amiloride increased the percentage of altered acrosomes in all media although its effect was less intense than that of ouabain. In isoosmotic media, total motility was decreased from about 80% in control to about 65% with 10(-4) M amiloride. Motile spermatozoa incubated with amiloride showed a clear decrease of mean velocity and mean linearity and increased frequency of head displacement. In the hyperosmotic medium, adding amiloride decreased the percentage of viability and altered tails at concentrations as low as 10(-6) to 10(-5) M. Our results indicate that the active mechanisms which control Na+ transport play a significant role in the maintenance of function in ram spermatozoa subjected to different osmotic environments. These mechanisms may be important in maintaining ram sperm function both "in vivo" and "in vitro".

Influence of kid rearing systems on milk composition and yield of Murciano-Granadina dairy goats.

One-hundred eight lactations of Murciano-Granadina goats from different years were used to compare two kid rearing systems. Goats were separated into two groups: suckling and milking. Dams in the suckling group were milked once daily until kids were weaned (wk 0 to 7) and then were milked twice daily. Dams in the milking group were separated from their kids at 48 h after birth; then, kids were raised artificially, and goats were milked twice daily. Total milk yield was estimated according to the oxytocin method during suckling. Stage of lactation, parity, prolificacy, and year effects on milk yield and composition were also studied. As expected, during the first 7 wk of lactation, marketable milk was higher for dams that were milked than for dams that were suckled. Neither milk yield nor milk composition throughout the entire lactation was affected by group or prolificacy with the exception of the percentage of milk CP. The lactation curve peaked at wk 4 or 5 and declined slowly afterward. First parity goats had the lowest milk yield but the highest fat and protein percentages. Third parity goats had the highest milk yield. The separation of kids from their dams after birth did not affect total lactation performance because of the minimal importance of the neuroendocrine milk ejection reflex in goats compared with that of other ruminants.

Milkability of Murciano-Granadina dairy goats. Milk partitioning and flow rate during machine milking according to parity, prolificacy and mode of suckling.

A total of 78 lactations (25 primiparous and 53 multiparous) in a herd of Murciano-Granadina dairy goats were studied over 3 years. Animals were allocated to two experimental groups: suckling (S) goats were milked once daily until weaning (week 7) and thereafter twice daily; milking (M) goats were milked twice daily from 2 d after parturition. Milk partitioning during milking (machine and machine stripping milk fractions) was recorded every week and the residual milk every 2 weeks. Milk flow rate was studied in 63 lactations on three consecutive days during week 12 or 13. Average machine and machine stripping milk fractions over 210 d were 1.09 and 0.23 l/d for the S and 1.23 and 0.28 l/d for the M group respectively. Machine milk volume and percentage were smaller in the S group during the first 7 weeks of lactation, while the machine stripping fraction was unaffected by group, indicating that this fraction was constant. The average residual milk was 11.1 and 9.2% of total milk in the S and M groups. Goats in their third lactation had the least residual milk (8.9%). Milk flow and total machine milk volume (but not milking time) were affected by parity, second and third lactation goats having higher values. Positive correlations were found between daily milk yield and milk flow characteristics. Residual milk was positively correlated with the machine stripping but not with the machine milk fraction. The results indicated that Murciano-Granadina goats can readily be machine milked, since > 80% of the milk can be obtained without massage or stripping.