Prosthetic valve endocarditis: superiority of surgical valve replacement versus medical therapy only

The objective of our study was to assess the long-term outcome of patients with prosthetic valve endocarditis. We used a multicenter, prospective, observational study design. Six university teaching hospitals with high volume cardiothoracic surgery participated. Seventy-four patients with prosthetic valve endocarditis as defined by explicit, objective criteria were selected for participation. All patients were followed up prospectively for 1 year. Thirty-one percent and 69% had development of endocarditis within 60 days of valve insertion ("early") and after 60 days ("late"), respectively. The most common causes were Staphylococcus epidermidis (40%), Staphylococcus aureus (20%), streptococcal species (18%), and aerobic gram-negative bacilli (11%). Physical signs of endocarditis (new or changing murmur, stigmata, emboli) were seen in 58%. At 6 months and 12 months, mortality was 46% and 47%, respectively. Surgical replacement of the infected valve led to significantly lower mortality (23%) as compared with medical therapy alone (56%), as assessed by both univariate and multivariate analyses (p < 0.05). Improved outcome was seen for the surgical group even when controlling for severity of illness at time of diagnosis. From these findings we conclude that accurate assessment of outcome in prosthetic valve endocarditis requires long-term follow-up of at least 6 months following diagnosis. Surgical therapy warrants greater scrutiny; evaluation in controlled clinical trials is appropriate.     

Laparoscopic versus open appendectomy

BACKGROUND: Clinical manifestations and course of sickle-cell anemia are variable. Knowledge about the factors, possibly geographic, that influence prognosis are still scanty. POPULATION AND METHODS: Data of hospitalization and management of children with sickle-cell disease were studied during two years (1992-1993) in the Pediatric Unit of Libreville Hospital. They concerned 205 admissions of 171 children and 131 outpatients. RESULTS: The main causes of hospitalization were: acute anemia (36 cases before the age of 5 years); painful crisis whose frequency increased with age (23% before 5 years, 35% between 5 and 10, 42% after 10 years); infections, essentially pulmonary occurring early, and bone infections at any age. Eight children died (because a complication of their disease). Among the 131 outpatients, half were detected because pyrexia, anemia and/or more often "hand-foot syndrome". More than 60% had hepatomegaly, one third still had splenomegaly after five years of age and more than one third was icteric. More than half children older than ten years had growth disorders. Mean hemoglobin level was 7 g/dL. 21 of the 83 tested children for HBsAg were positive and only one out of 79 was positive for HIV. CONCLUSIONS: Clinical manifestations and course of sickle-cell anemia in our patients are similar to those reported in Congolese children. Genetic and environmental factors may be responsible for differences with children from other, in particular French, cohorts.     

Surface and electronic structure of Ga0.92In0.08N thin film investigated by photoelectron spectroscopy

The surface and electronic structure of Ga_0.92In_0.08N layers grown by metal organic chemical vapor deposition (MOCVD) have been investigated by means of photoemission. Stability of chemical composition of the surface subjected to Ar⁺ ion sputtering was proven by means of X-ray photoemission spectroscopy. The analysis of the relative intensities of In 3d, Ga 3p, and N 1s peaks showed that argon ion bombardment does not change significantly the relative contents of the layer constituents. Simultaneous efficient removal of the main contaminants (O and C) was observed during the sputtering procedure, proving that argon sputtering can be used as a method for preparation of clean Ga_1−xIn_xN surfaces.For a clean (0001)-(1×1) surface prepared by repeated cycles of Ar⁺ ion sputtering and annealing, electronic structure was investigated. The band structure was explored along the Γ-A direction of the Brillouin zone, measuring angle-resolved photoemission spectra along the surface normal. A similar set of data was also acquired for the same surface of GaN layer. Comparison of the collected data revealed an additional feature at the valence band edge, which can be ascribed to the presence of In in the layer.     

Growth Performance,Carcass Characteristics,Fatty Acid Composition,and Blood Biochemical Parameters of Lamb Fed Diet with the Addition of Lingonberry Leaves and Oak Bark

The aim of the study is to determine the effect of natural additives supplemented to the lamb diet on lamb performance, fatty acid (FA) composition of edible parts of lambs, and biochemical plasma indices. The study is carried out on 18 male lambs, allocated to three groups in a randomized complete block design. Control animals (CON) are fed a basic diet, while the experimental lambs additionally receive lingonberry leaves (VVI) or oak bark (QUE) (10 g d^?1), as a different source of tannins. Supplementing lambs with the VVI diet decreases fat content in the longissimus dorsi muscle (MLD). The VVI diet decreases monounsaturated fatty acid (MUFA) concentration (including C18:1 cis‐9) in the MLD, increases the proportion of C16:0, C16:1, C17:1, and C22:6 n‐3 in the semitendinosus muscle, as well as increases the n‐6/n‐3 ratio and thrombogenic index in the liver. The addition of QUE to lamb diets decreases C17:1 concentration and increases the content of C18:1 trans‐11 in the MLD. Tannins‐enriched diets increase low density lipoprotein concentrations in the blood plasma. The VVI diet increases the activity of alkaline phosphatase, while QUE supplementation decreases gamma‐glutamyl transferase activity in blood plasma. Modifications of FA composition in lamb tissues may suggest an indirect effect of tannins on FA ruminal biohydrogenation. Practical Applications: The use of VVI and QUE in lamb nutrition as natural resources is of a great interest to scientists. The present study shows that primarily VVI addition to lamb diets affects the quality of meat, due to higher proportion of catechin than QUE. Decreased concentration of fat, as well as increased proportion of C22:6 n‐3 and desirable fatty acids (including MUFA, polyunsaturated fatty acid, C18:0) after VVI supplementation increases health‐promoting properties of lamb meat and is related to humans. However, the presence of biologically active substances (tannins) in the examined additives makes it necessary to further research and discover their full potential in many areas.     

Analysis and mathematical modelling of the behaviour of Escherichia coli in the mascarpone cheese during cold storage

The aim of this work was to study the behaviour of E. coli in mascarpone cheese during storage at the temperatures ranging from 3 to 15 °C, as well as application of predictive microbiology to describe the experimental data. The Baranyi, Gompertz and logistic models were fitted at the stage of primary modelling. Although all applied primary models described the growth of micro‐organisms accurately, the most accurate goodness of fit was obtained for the Gompertz model and the growth rates generated by this model were used for secondary modelling. The polynomial model predicted accurately the influence of temperature on the growth rate of E. coli, reaching the adjusted coefficient of linear regression 0.99. Generated predictive model that describes the growth of E. coli in mascarpone cheese constitutes a valuable tool in assessing the microbiological stability of the food product with similar physicochemical properties.