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2% and 16.3%) than in group A (6.6% and 9.5%), P less then  0.01. On multivariate analysis, higher PDW values on admission predicted 90-day mortality and shortened survival (relative risks 1.58 and 1.26; 95% confidence intervals 0.89 - 2.78 and 0.97-1.64, respectively). Conclusion Higher PDW values on admission to internal medicine wards are associated with a more severe clinical profile and increased risk of 90-day mortality. © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center.Purpose Duplex scanning is a useful noninvasive screening tool for the detection of carotid bifurcation disease. Internal carotid artery (ICA) peak systolic velocity (PSV) and ICA/common carotid artery (CCA) PSV ratios are proven metrics determining 70%-99% ICA stenosis. A potential disadvantage of using dramatically increasing systolic velocity measurements in areas of critical arterial stenosis is flow aliasing. Diastolic velocity should be less influenced by this flow artifact. We evaluate ICA and CCA end diastolic velocity (EDV) metrics in predicting severe ICA stenosis and document the prevalence of an aliasing artifact in a population of patients with critical ICA stenosis. Methods Consecutive patients undergoing carotid duplex assessments and contrast angiography were compared (n = 140). ICA and CCA PSV and EDV were recorded as was evidence of the flow aliasing of ICA waveforms. ICA/CCA PSV and EDV ratios were calculated. Duplex parameters were compared with angiographic ICA measurements. Receiver-operator characteristic curve (ROC) analysis was used to determine optimal criteria to identify ICA stenosis of 70% to 99%. Results Of 256 carotid bifurcation duplex studies, critical angiographic stenosis was present in 105 arteries. Only four completed arterial duplex scans demonstrated flow aliasing. In three of these patients, systolic metrics were non-diagnostic versus ICA/CCA EDV ratios. An ICA/CCA EDV ratio of 2.3 provided the best combination of sensitivity 73.8% and specificity 75.18%. Conclusion ICA/CCA diastolic ratios reliably determine 70% or greater ICA stenosis. Flow aliasing infrequently complicates ICA PSV. © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center.Background and objectives Bradykinin-mediated angioedema (AE) induced by antihypertensive drugs primarily affect the head and neck region and may occur even after several years of uneventful treatment. Many facts about the clinical course remain unknown. Diagnosis is not easy, as the clinical appearance resembles allergic AE. No specific diagnostic markers are known and no officially approved treatment is currently available. Methods All patients who presented to the ORL department between 2010 and 2016 with acute AE were included. Those with a history of renin-angiotensin-aldosterone system (RAAS) blocker intake were defined as RAE and their pathophysiological characteristics and clinical course of the disease were analyzed. Results A total of 84 patients (median age of 71 years) with RAE was identified. The majority (80%) was on ACE inhibition. The oral cavity was most often affected. Nearly 60% were medicated for more than 1 year before AE occurred. RAE occurred more often during the morning hours. The necessity for emergency intubation and/or tracheostomy was nine times higher in patients with acute RAE compared to patients with AE due to other reasons. Conclusions Event-free, long-term therapy with an RAAS blocker before the first development of edema does not exclude RAE. RAE is associated with an increased risk for emergency airway management. Abbreviations ACE Angiotensin Converting Enzyme; ACEi AE ACE inhibitor-induced angioedema; AE Angioedema; ARB Angiotensin II receptor 1 blocker; C1 INH C1 Inhibitor; CI Confidence Interval; CRP C-reactive protein; DPP IV Dipeptidyl peptidase IV; ENT Ear, Nose and Throat; HAE Hereditary Angioedema; ICD 10 International Statistical Classification of Diseases and Related Health Problems, 10th Edition; OR Odds Ratio; ORL Otorhinolaryngology; RAAS Renin-Angiotensin-Aldosterone System; RAE RAAS-blocker-induced angioedema. © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center.Introduction Wild birds pose a potential threat to animal and human health by spreading infectious diseases. In the present study, we studied the occurrence of bacterial zoonotic pathogens as well as enterobacteria with transferrable antimicrobial resistance genes among Swedish corvids. Materials and methods Intestines from 66 jackdaws, crows, rooks and magpies from the vicinity of livestock farms at 14 locations in 7 counties were analysed by direct culture or PCR screening followed by culture. Isolates were investigated by whole-genome sequencing. Results and discussion Campylobacter jejuni were detected in 82% and Yersinia in 3% of the birds. ESBL-producing E. coli were found in one sample (2%) and carried bla CTX-M-55. No Enterobacteriaceae with transferable carbapenem resistance were identified. No Salmonella or E. coli O157H7 were found, but PCR analysis for enterohaemorrhagic E. coli virulence genes revealed 35% positive samples for intimin, 9% for verotoxin 1 and 17% for verotoxin 2. C. jejuni isolates from corvids were compared to previously published isolates from Swedish sources by multi-locus sequence typing based on genome sequences. All corvid C. jejuni isolates formed a cluster, intermingled with human and chicken isolates. Our results indicate that C. jejuni is ubiquitous among Swedish corvid birds, with sporadic transmission to poultry and humans. © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.For an analysis of the prevalence of influenza A viruses (IAVs) circulating in chickens and their farmers in the Ashanti region, Ghana, we examined 2,400 trachea and cloaca swabs (chickens) and 102 oropharyngeal swabs (farmers) by qRT-PCR. Sera from 1,200 (chickens) and 102 (farmers) were analysed for IAV antibodies by ELISA and haemagglutination inhibition (HI). Avian influenza virus (AIV) was detected in 0.2% (n = 5) of chickens but not farmers. Virus detection was more pronounced in the cloacal (n = 4, 0.3%) than in tracheal swabs (n = 1, 0.1%). AIV antibodies were not detected in chickens. Two farmers (2.0%) tested positive to human seasonal IAV H1N1pdm09. Sixteen (15.7%) farmers tested seropositive to IAV of which 68.8% (n = 11) were due to H1N1pdm09-specific antibodies. AIV H5- or H7-specific antibodies were not detected in the farmers. Questionnaire evaluation indicated the rare usage of basic personal protective equipment by farmers when handling poultry. In light of previous outbreaks of zoonotic AIV in poultry in Ghana the open human-animal interface raises concern from a OneHealth perspective and calls for continued targeted surveillance. © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.Livestock is common in Indian cities and contribute to food security as well as livelihoods. Urban livestock keeping has been neglected, and in India, little is known about the topic. Therefore, urban and peri-urban pig farms of Guwahati, Assam, India, were surveyed in order to understand more about the pig rearing systems and risks of diseases. A total of 34 urban and 66 peri-urbanpig farms were selected randomly. All reared cross-bred pigs. Free-range pig rearing was common in both urban (58.8%) and peri-urban (45.45%) farms. Artificial insemination was used by around half of the pig farmers. Disinfection in pig farms was practiced in 26.5% of urban and 28.8% of peri-urban farms. More urban pig farms were observed to be moderately clean in (82.4%) compared to peri-urban (69.7%). However, more urban (67.7%) than peri-urban farms (57.6%) reported ahighrodent burden. Pig sheds were mostly basic, with bricked floors in 18.2% farms in peri-urban areas, and more than 80% had corrugated iron roofing sheets. IACS-010759 mw In conclusion, free-roaming pigs in both urban and peri-urban areas of Guwahati can contribute to disease transmission, and the low standard of hygiene and buildings may further increase the risk of diseases. © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.Oral defense should be able to sense the burden of, and distinguish between fungal commensals and pathogens, so that an adequate inflammatory response can be set up. Recently, Ephrin type-A receptor 2 (EphA2) was identified on oral epithelial cells and neutrophils that recognizes Candida albicans and induces adaptive protective host responses against this organism. The studies have increased our knowledge of how epithelial cells and neutrophils contribute to host defense against oral yeast infection. © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.This review considers an integrated hypothesis of dental caries and periodontal diseases that builds on theoretical ecological principles. The backbone of the hypothesis is based on the dynamic stability stage of the oral microbiota, at which intrinsic (mainly saliva and gingival crevicular fluid) and bacterial (mainly metabolic) resilience factors maintain ecological dynamic stability, compatible with clinical health. However, loss of intrinsic resilience factors and/or prolonged changes in the availability of microbial metabolic substrates may shift the ecological balance of the microbiota into either saccharolytic (acidogenic) or amino acid-degrading/proteolytic (alkalinogenic) stages, depending on the nature of the predominant substrates, leading to clinical diseases. Therefore, to maintain and restore the dynamic stability of the oral microbiota, it is necessary to control the drivers of disease, such as salivary flow and influx of bacterial nutrients into the oral cavity. Contrary to conventional wisdom, excessive intake of fermentable carbohydrates may contribute to inflammation in periodontal tissues resulting from hyperglycaemia. An integrated hypothesis emphasizes that both dental caries and periodontal diseases originate in the dynamic stability stage and emerge in response to nutritional imbalances in the microbiota. Periodontal diseases may belong to the sugar driven inflammatory diseases, similar to diabetes, obesity, and cardiovascular diseases. © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.Streptococcus mutans is recognized as the main cause of dental caries, and the formation of a plaque biofilm is required for caries development. This study aimed to determine the inhibitory effect of Lactobacillus plantarum FB-T9 on S. mutans biofilm formation in vitro and on the prevention and treatment of dental caries in rats. During in vitro experiments, FB-T9 exhibited good bacteriostatic ability in a plate competition assay. This strain also significantly reduced the biomass and viability of S. mutans biofilms and induced structural damage during the early (6 h), middle (12 h) and late (24 h) stages of biofilm formation. In a 70-day in vivo experiment, FB-T9 significantly reduced the levels of S. mutans on the dental surfaces of rats by more than 2 orders of magnitude of the levels in the dental caries model group (p less then 0.05). Moreover, FB-T9 significantly reduced the caries scores (modified Keyes scoring method) in both the prevention and treatment groups (p less then 0.05) and had great colonization potential in the oral cavity.