VAC Group Research Articles

Role of COVID-19 Vaccine in the Management of Gynecologic Oncology Lymphadenopathies.

This study aimed to evaluate the incidence of lymphadenopathies after COVID-19 vaccination and their impact on the clinical management of gynecologic oncology patients. A retrospective observational study was conducted involving patients who underwent abdominopelvic or thoracoabdominopelvic CT scans during diagnosis or follow-up. Patients were classified into a vaccinated group (Vac group) and a non-vaccinated group (NoVac group). The radiological appearance of lymphadenopathies was categorized as low or high risk of malignancy, and management strategies were recorded as standard management or additional assessment. 75 patients were included, with 44 in the Vac group and 31 in the NoVac group. The incidence of lymphadenopathies was similar between the groups: 34.1% in the Vac group and 32.3% in the NoVac group (p = 0.868). High-risk lymphadenopathies were observed in 20.4% of the Vac group and 22.6% of the NoVac group, while low-risk lymphadenopathies were seen in 13.6% of the Vac group and 9.7% of the NoVac group (p = 0.691). Standard management was the most common approach, used in 80.0% of the Vac group and 100.0% of the NoVac group (p = 0.25). COVID-19 vaccine does not increase the incidence of lymphadenopathies in imaging tests of gynecological cancer patients.

Duration of Protection and Humoral Immune Response in Nile Tilapia (Oreochromis niloticus L.) Vaccinated against Streptococcus agalactiae.

Streptococcosis caused by Streptococcus agalactiae (S. agalactiae) is a major bacterial disease affecting the production of Nile tilapia (Oreochromis niloticus L.), causing significant economic losses due to mortality in the growing phase. Vaccination is the most effective method for preventing streptococcosis on Nile tilapia farms. In Brazil, the major tilapia-producing regions have long production cycles (6-10 months) and harvest tilapias weighing over 900 g for fillet production. Thus, data on the duration of the humoral immune response and protection in farmed tilapia have not been reported or are poorly described. Furthermore, the efficiency of serological testing for the long-term monitoring of immune responses induced by vaccination against S. agalactiae has never been addressed. This study evaluated the duration of protection and humoral immune response induced in Nile tilapia vaccinated against S. agalactiae until 300 days post-vaccination (dpv). The immunization trial was composed of two groups: vaccinated (Vac), vaccinated intraperitoneally with a commercial vaccine, and unvaccinated (NonVac) group, injected fish with sterile saline solution. At 15, 30, 150, 180, 210, and 300 dpv, blood sampling was conducted to detect anti-S. agalactiae IgM antibodies using indirect Enzyme-Linked Immunosorbent Assay (ELISA), and the fish were challenged with pathogenic S. agalactiae to determine the duration of vaccine protection through relative percentage survival (RPS). Spearman's rank correlation was performed between the ELISA optical density (OD) of vaccinated tilapia and the duration of vaccine protection (RPS). The mean cumulative mortality in NonVac and Vac groups ranged from 65 to 90% and less than 35%, respectively. The average RPS was 71, 93, 94, 70, 86, and 67% at 15, 30, 150, 180, 210, and 300 dpv, respectively. RPS revealed that the vaccine provided protection from 15 to 300 dpv. The specific anti-S. agalactiae IgM antibody levels were significantly higher in the Vac group than that non-Vac group up to 180 dpv. The vaccinated fish exhibited significant protection for up to 10 months after vaccination. There was a positive correlation between the antibody response and RPS. This study revealed that a single dose of commercial vaccine administered to Nile tilapia can confer long-term protection against S. agalactiae and that indirect ELISA can monitor the duration of the humoral immune response for up to six months following vaccination. Finally, vaccine protection over six months can be associated with other components of the fish immune system beyond the humoral immune response by IgM antibodies.

Effect of Concomitant Use of Polaprezinc and Vonoprazan-Based Triple Therapy for Helicobacter pylori Eradication

Background: Vonoprazan-based triple therapy has recently been reported as being more effective than proton pump inhibitors for the eradication of Helicobacter pylori (H. pylori), but it is apparent that the eradication rate could be further improved. Methods: We investigated the effect of the concomitant use of polaprezinc, a therapeutic agent for gastric ulcers, and vonoprazan-based seven-day triple therapy in patients with gastric ulcers compared to standard vonoprazan-based seven-day triple therapy in patients with atrophic gastritis. The regimen for the treatment of atrophic gastritis contained vonoprazan 20 mg, amoxicillin 750 mg, and clarithromycin 200 mg b.d. (VAC group) for seven days; and that for gastric ulcers contained VAC and polaprezinc 75 mg b.d. (VACP group) for seven days. Results: Between October 2021 and January 2023, 201 subjects were examined (VAC group, n = 165; VACP group, n = 36). In per-protocol (PP) analysis, the eradication rate was significantly higher in the VACP group (100%) than in the VAC group (88.2%) (p = 0.025). In patients with severe atrophic gastritis, eradication rates were significantly higher in the VACP group (100%) than in the VAC group (84.4%) in PP analysis. (p = 0.024). Conclusions: The concomitant use of polaprezinc and standard vonoprazan-based first-line eradication therapy is effective for H. pylori.

Timeline kinetics of protective immunity to SARS-CoV-2 upon primary vaccination and humoral response to variants after booster dose

New variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have emerged, imposing the need for periodic booster doses. However, whether booster doses should be applied to the entire population or groups, and the booster doses interval, remains unclear. In this study, we evaluated humoral reactivity kinetics from before the first dose to 180 days after the third booster dose in different schedules in a well-controlled health worker cohort. Among the 2,506 employees, the first 500 vaccinated health workers were invited to participate. The third booster dose was administered 8 months after the first dose. Among the invited participants, 470 were included in the study; 258 received inactivated vaccine CoronaVac (VAC group) and 212 received viral vector vaccine ChAdOx1 (AZV group). The groups were homogeneous in terms of age and sex. 347 participants were followed up after the booster dose with AZV or BNT162b2 (Pfizer, BNT group): 63 with VAC/AZV, 117 with VAC/BNT, 72 with the AZV/AZV and 95 with AZV/BNT schedules. Blood samples were collected immediately before, 28 days after each dose and 180 days after the primary vaccination and booster dose. Anti-SARS-CoV-2 antibodies were measured by chemiluminescence and plaque reduction neutralization test (PRNT). Plasma immune mediators were quantified using a multiplex immunoassay. Geometric mean of antibodies increased 28 days after the second dose with 100 % seroconversion rate in both groups and decreased 180 days after the first dose. In the baseline-seropositive VAC group, the levels of plasma immune mediators increased after the second dose. Booster dose was applied at 4–6 months after the primary vaccination. Heterologous booster in VAC or AZV primary vaccinees were effective maintaining the titers of anti-SARS-CoV-2 antibodies even after 6 months of follow-up. The heterologous schedule induced higher and stable antibody reactivity, even after 180 days, protecting to ancestral (Wuhan), Delta, and Omicron variants.

Brucella abortus antigen omp25 vaccines: Development and targeting based on Lactococcus lactis.

Most Brucella infections take place on mucosal membranes. Therefore, creating vaccinations delivered through the mucosa may be crucial for managing brucellosis. Consequently, we assessed the efficacy of a recombinant oral antigen delivery system based on Lactococcus lactis for Brucella abortus omp25 antigen. Oral vaccinations with L. lactis transformed with pNZ8148 variants encoding for omp25 (pNZ8148:omp25) and free-pNZ8148 were administered to mice. On day 30, following immunization in animal groups, anti-omp25-specific IgG1 antibodies were assessed by the ELISA test. Additionally, nasal and bronchoalveolar lavages containing omp25-specific secretory IgA (sIgA) were analysed by ELISA. ELISA test and real-time PCR were also used to analyse cytokine responses up to 28 days following the last boost. In addition, the protective potential of L. lactis pNZ8148:omp25 vaccines was assessed in BALB/c mice by exposing them to the B. abortus strain. Based on the initial screening results, the omp25 protein was identified for immunogenicity because it had the maximum solubility and flexibility and antigenic values of 0.75. The produced plasmid was digested using KpnI and XbaI. By electrophoretic isolation of the digestion fragments at 786bp, the omp25 gene, the successful production of the recombinant plasmid, was confirmed. Antigen expression at the protein level revealed that the target group generated the 25kDa-sized omp25 protein, but there was no protein expression in the control group. Fourteen days after priming, there was a considerable amount of omp25-specific IgG1 in the sera of mice vaccinated with pNZ8148-Usp45-omp25-L. lactis (p<0.001 in target groups compared to the phosphate-buffered saline control group). IFN-γ and TNF-α levels were more significant in samples from mice that had been given the pNZ8148-Usp45-omp25-L. lactis and IRBA vaccinations, in samples taken on days 14 and 28, respectively (p<0.001). The pNZ8148-Usp45-omp25-L. lactis and IRBA immunization groups had significantly greater IL-4 and IL-10 transcription levels than the other groups. The spleen portions from the pNZ8148-Usp45-omp25-L. lactis and IRIBA vac group had less extensive spleen injuries, alveolar oedema, lymphocyte infiltration and morphological damage due to the inflammatory process. Our study offers a novel method for using the food-grade, non-pathogenic and noncommercial bacterium L. lactis as a protein cell factory to produce the novel immunogenic fusion candidate romp25. This method offers an appealing new approach to assessing the cost-effective, safe, sustainable, simple pilot development of pharmaceutical products.

Influence of VAC Therapy on Perfusion and Edema of Gracilis Flaps: Prospective Case-control Study

In total, 26 patients with soft tissue defects of lower extremity underwent gracilis muscle flap reconstruction. The study group (VAC, n = 13) was supplied with postoperative negative pressure therapy as a dressing; the control group (NVAC, n = 13) was supplied with conventional fat gauze dressing. Postoperative measurements of micro- and macroperfusion were performed intraoperatively, on postoperative day (POD) 3 and POD 5. Flap edema measurement was performed intraoperatively, on POD 5 and 2 weeks after operation. The VAC group showed significantly better macroflow during intraoperative VAC treatment, as well on POD 3 and POD 5. Venous outflow was also better with lower hemoglobin levels. Microflow was better in the NVAC group with higher measured oxygen levels. All gracilis muscle flaps of the VAC group showed significantly less flap edema compared with the control group. VAC application on free gracilis muscle flaps leads to significantly less postoperative flap edema, improved arterial macroflow, and improved venous outflow. VAC therapy can be used without any danger for patient's safety, as flap survival is not endangered, and presents an easy to handle and pleasant dressing regimen for nursing staff and patients.

Efficacy of prepartum vaccination against neonatal calf diarrhea in Nelore dams as a prevention measure

BackgroundNeonatal calf diarrhea (NCD) is the leading cause of calf morbidity and mortality in beef cattle. Cow’s vaccination in last stage of pregnancy is one of the most important measures to mitigate the risk of NCD outbreaks. The aim of this study was to evaluate the efficacy of prepartum single dose vaccination against NCD, especially Bovine Rotavirus type A (BoRVA) and Bovine Coronavirus (BCoV), in Nelore dams and offspring. A total of 117 pregnant cows (n = 81) and heifers (n = 36) were distributed in two groups, vaccinated (VAC: cows = 40; heifers = 19) and non-vaccinated (NVAC: cows = 41; heifers = 17). Vaccination occurred between 60 to 50 days before the expected calving date with a single dose of a water-in-oil (W/O) vaccine, and NVAC group received a dose of saline solution 0.9%. Blood samples were collected before vaccination and 30 days after to evaluate the antibody (Ab) response. Specific IgG1 Abs against BoRVA and BCoV were measured by using an Enzyme Linked Immuno Sorbent Assay (ELISA). Calves’ births were monitored, and the transference of passive immunity was evaluated. Diarrhea was monitored in the first 30 days of age, and fecal samples were collected for identification of the etiological agent.ResultsHigher titers of IgG1 Ab against BoRVA and BCoV was observed in the VAC group than NVAC group in the cow (P < 0.0001) and total dams categories (P < 0.0001). The titer of specific IgG1 Abs in the calves’ serum reflected the dams response, observing higher IgG1 Ab titers for BoRVA (P < 0.0016) and BCoV (P < 0.0095) in the offspring born to VAC cows and higher IgG1 Ab titers for BoRVA(P < 0.0171) and BCoV (P < 0.0200) in the offspring born to VAC total dams. The general incidence of diarrhea observed was 18.6% (11/59) and 29.3% (17/58) in the calves born to the VAC and NVAC group, respectively.ConclusionsPrepartum vaccination with a single dose of the vaccine tested increased the titers of IgG1 Ab against BCoV and BoRVA, and it could be used as a preventive strategy to decrease the NCD occurrence in Nelore calves.

One-Stage Coverage of Leg Region Defects with STSG Combined with VAC Dressing Improves Early Patient Mobilisation and Graft Take: A Comparative Study.

Lower limb skin defects are very common and can result from a wide range of aetiologies. Split thickness skin graft (STSG) is a widely used method to address these problems. The role of postoperative dressing is primary as it permits one to apply a uniform pressure over the grafted area and promote adherence. Focusing on lower limb reconstruction, our clinical study compares the application of V.A.C. (Vacuum Assisted Closure) Therapy vs. conventional dressing in the immediate postoperative period following skin grafting. We included in the study all patients who received skin grafts on the leg region between January 2015 and December 2018, despite the aetiology of the defect. Only reconstructions with complete preoperative and postoperative follow-up data were included in the study. Patients were divided into two groups depending on if they received a traditional compressive dressing or a VAC dressing in the immediate postoperative period. We could retain 92 patients, 23 in the No VAC group and 69 in the VAC group. The patients included in the VAC group showed a statistically significant higher rate of graft take together with a lower immobilisation time (p < 0.05). Moreover, a lower rate of postoperative infection was recorded in the VAC group. This study represents the largest in the literature to report in detail surgical outcomes comparing the use of VAC therapy vs. conventional dressing after STSG in the postoperative management of lower limb reconstruction using skin grafts. VAC therapy was used to secure the grafts in the leg region, increasing the early graft take rate while at the same time improving patient mobilisation.

Vascular access complications in patients undergoing veno-arterial ecmo and their impact on survival in patients with refractory cardiogenic shock: A retrospective 8-year study.

Introduction:Veno-arterial extracorporeal membrane oxygenation (ECMO) is well-recognized treatment modality for patients with refractory cardiogenic shock. Uncomplicated cannulation is a prerequisite and basis for achieving a successful outcome in ECMO. Vascular access is obtained either by surgical cut-down. Common vascular access complications are bleeding and limb ischemia.Objective:To evaluate cannulation technique, the incidence of vascular complications, and their impact on the outcome.Methods:A retrospective data analysis conducted on 95 patients receiving ECMO from 2013 to 2020 was done. The patients were divided into two groups: no vascular access complications (non-VAC group) and vascular access complications (VAC group). The groups were compared related to the hospital and ICU stays and blood transfusion.Results:The patients in both groups were demographically and clinically comparable. The Non-VAC group had 75 patients, whereas the VAC group had a total of 20 patients. The main complication observed in the VAC group was bleeding from the cannulation site which required more blood transfusion than the non-VAC group (6.8 ± 1.02 vs 4.2 ± 1.26). Limb ischemia was another complication seen in the VAC group (4.2%, n = 4). Two patients had delayed bleeding after decannulation. The overall average length of stay in the hospital was statistically similar in both the groups (22 days in the VAC group vs 18 days in the non-VAC group), but the average ICU stay was more in the VAC group compared to the non-VAC group (18 days vs 12.06 days).Conclusion:Bleeding and limb ischemia are the important vascular access site complications, which increase blood transfusion requirements, ICU stay, and overall hospital stay.

A Comparative Study between the Use of Negative Pressure Wound Therapy and Silver-Releasing Foam Dressings in the Management of Diabetic Ulcers

AbstractIntroduction Diabetic foot ulcers are one among the most commonly encountered complication of diabetes mellitus tackled by the surgical department worldwide. Negative pressure wound therapy (NPWT) and silver-releasing foam dressings are effective modalities for the treatment of ulcers. This study compares the two treatment modalities.Methods Sixty adult patients admitted with diabetic foot ulcers undergoing NPWT (vacuum-assisted closure [VAC]) or silver-releasing foam dressing (Biatain Ag) treatment were included in the study. Patients undergoing either of the treatment modalities were observed and followed up on a weekly basis prospectively. Wounds were routinely examined for the size of ulcer in area (cm2) and time taken for wound healing. Patients were also assessed qualitatively by means of a questionnaire to find out patient satisfaction and compliance.Results Time taken for wound healing among Biatain Ag group was found to be 24±9.483 days compared with only 19.73±7.575 days in the VAC group. Decrease in size ulcer measured in area was found to be 38.79% in Biatain Ag group, whereas in the VAC group it was found to be 26.56%. Patients were satisfied with both modalities of treatment; however, patient compliance was better for the Biatain Ag Group due to decrease in restriction of mobility and decrease in cost.Conclusion Overall, both modalities of treatment were found to be comparable and can be used with similar efficacy. It can be concluded that silver-releasing foam dressing can act as a beneficial alternative to NPWT in the treatment of diabetic ulcers.

COMPARATIVE STUDY OF ROLE OF WOUND OUTCOME IN VACUUM ASSISTED CLOSURE OF WOUNDS TO CLASSICAL (MOIST) WOUND CLOSURES

Background &amp; Method: This study is conducted at General Surgery department of Index Medical College Hospital and Research Centre, Indore (M.P.) To Analysis of wound outcome in Vacuum assisted closure of wounds in comparison to classical (moist) wound closure in terms of rate of granulation tissue formation, culture at presentation, complications and recommendations. The wound of the patient was assessed by measuring the maximum length and maximum width of the wound. Then on day 7th, 14th and day 21st, the maximum length and maximum width of the granulation tissue covering the same wound was measured.&#x0D; Result: In Group I Mean age of patients is 39 ± 13 years and in Group II it is 42 ± 14 years. In Group I and Group II there is no difference in the gender wise distribution. The most common disease in both the groups I and II is bed sore followed by compound fractures. The most common organism on culture in group I is S. aureus (9) followed by polymicrobial growth (7), and in group II is S. aureus (10) followed by E.coli (7). The average rate of granulation in group I on day 7th is 27.63 ± 23.23, on day 14th it increased to 35.92 ± 25.75, and on day 21st it further increased to 65.6 ± 15.20. The average rate of granulation in group II on day 7th is 31.34 ± 18.22, on day 14th it is increased to 57.4 ± 17.55, and on day 21st it further increased to 75.16 ± 6.732. Group I had higher number of complications (8) in comparison to group II (6). There is no complication in 44 patients of group II and 42 patients of group I.&#x0D; Conclusion: In our present study it was concluded that the rate of granulation tissue formation was better in the VAC group in comparison to the conventional dressing group. Vacuum assisted closure dressing was found to be totally safe, although technically demanding. Thus, we conclude that the surgeon’s discretion is very much needed in VAC being the choice of dressings in certain wounds and where there is much difficulty in performing VAC dressings, the conventional dressings should be the choice.&#x0D; Keywords: wound, vacuum, moist &amp; outcome.

Comparison of flagellin and an oil-emulsion adjuvant in inactivated Newcastle disease vaccine in stimulation of immunogenic parameters

The present study was designed to investigate the potential application of native (N) and recombinant (truncated modified [tmFliC] and full-length [flFliC]) flagellin proteins along with inactivated Newcastle disease virus (NDV). Fifty six SPF chickens were immunized twice with PBS (control), inactivated NDV (Ag), inactivated NDV/flFliC (AgF), inactivated NDV/tmFliC (AgT), inactivated NDV/N (AgN), commercial vaccine containing Montanide (Vac) and Vac/N (VacN), with a two-week interval. Blood was collected weekly and spleens were harvested after chickens were sacrificed. Interleukin-6 (IL-6) and tumor necrotic factor-α (TNF-α) gene expression in peripheral blood mononuclear cells were analyzed by Real-Time PCR. Antibody response was assessed by haemagglutination inhibition (HI). Cellular activity was quantified by MTT assay. Results showed that the most IL-6 and TNF-α gene expression was observed in AgF group (P < 0.01). The lowest gene expression among vaccinated groups was observed in Ag group for IL-6 and Ag and Vac group for TNF-α. The highest HI titer was observed in Vac, VacN, AgF and AgT groups. The AgF group showed the highest cellular activity (P < 0.01). In conclusion, flagellin-adjuvanted groups showed a pro-inflammatory effect and acted similarly to or better than the Vac group. Hence, flagellin can be proposed as a potential adjuvant for ND vaccine.

Vacuum assistance therapy as compared to early reconstructive treatment in deep sternal wound infection.

Background and Aims:Deep sternal wound infection is a major concern after cardiac surgery. This study describes the incidence of postoperative deep sternal wound infections after cardiac surgery and compares two available treatment modalities.Materials and Methods:In Tampere University Hospital, 7973 open heart operations were performed between 2007 and 2016. Patients treated for a postoperative deep sternal wound infection were categorized in two groups based on treatment: revision surgery with early reconstruction (revision group; 74 patients) or vacuum-assisted closure treatment (VAC group; 55 patients). The end points in comparisons were overall mortality and hospitalization time.Results:A total of 129 patients (1.6%) developed a postoperative deep sternal wound infection. The 30-day mortality rates were 8.1% and 3.6%, the 90-day mortality rates were 15.5% and 18.2%, and the 1-year mortality rates were 17.6% and 23.6% for the revision and VAC group, respectively. There was no statistically significant difference in mortality rates. The hospital stay was 18 days in the revision group and 38 days in the VAC group (p < 0.001). The secondary intensive care unit stay was longer in the VAC group (median 1 vs 4, p = 0.011). The most common pathogens isolated in the first reoperation were coagulase-negative staphylococci (33.8% and 41.8%, respectively; p = 0.366), and positive candida findings were more common in the VAC group (4.1% vs 37.0 %, p < 0.001).Conclusion:Vacuum-assisted closure treatment induces an inferior outcome in terms of fungal infections, treatment times, and the number of reoperations.

Estradiol benzoate priming during induction of estrus with Vitex-castus extract in dogs

This study compared two methods of estrus induction between dogs (using vitagnus and vitagnus-estradiol). A total of 10 adult cyclic female Shih tzu Terrier mix breed dogs at anestrus stage were selected and divided into two groups. The first group (VAC) received vitagnus for five weeks (90 mg daily, PO). The second group (VAC-E2) was treated with vitagnus and estradiol benzoate. Estradiol benzoate was injected at the beginning of each week (0.01 mg/kg, IM). Blood sampling for evaluation of steroid hormones and vaginal smears were taken weekly. The sings and return to the estrus with the number of puppies were recorded. In the VAC group, 60%, and in the VAC-E2 group, 80% of dogs returned to the follicular phase after five weeks. In the VAC-E2 group, signs of estrus appeared 7 to 10 days and a mating process started 4 to 6 days earlier than those in the VAC group. The average number of delivered puppies was 4. These symptoms were confirmed by the cytology of the vagina. There was no significant difference in the estradiol and progesterone levels between groups. The mean concentration of estradiol significantly changed between weeks 1 and 4, 1 and 5, and 2 and 5 (p < 0.05). The progesterone level in the VAC-E2 group on week five was higher than that in other weeks. In conclusion, the administration of estradiol benzoate before vitagnus improved induction of estrus in dogs.

Vacuum-assisted closure device in the postoperative wound care for Fournier's gangrene: a systematic review.

To determine the effectiveness of Vacuum-Assisted Closure Device in the postoperative wound care for Fournier's gangrene METHODS: We performed a systematic review in the following databases: Medline (Ovid), EMBASE, and The Cochrane Central Register of Controlled Trials (CENTRAL), from inception to nowadays. We included RCTs and analytical observational studies. Meta-analysis was not possible given the clinical and methodological heterogeneity of the studies. We included six studies that compared VAC treated patients and a control group. The length of stay of the VAC treated vs. the conventional dressing treated patients was higher for the VAC treated patients in all but one of the included studies. The VAC group had the highest number of surgical debridements requiring anesthesia. The conventionally treated patients had a higher number of daily dressings, and the need for additional dressing changes, without anesthesia. Two studies found significantly higher mean scores for VAS, requiring a higher need for daily analgesics for the control group patients. VAC therapy is an effective method, but it is not better than conventional dressing treatment. VAC carries fewer dressing changes, less pain, and less need for analgesics, but it comes with a higher need for surgical interventions requiring anesthesia.

Effect of Parenteral Vaccination of Newborn Holstein Calves against Viral Agents Involved in Bovine Respiratory Disease (BRD)

Background: Newborn calves are born immunosuppressed, hypogammaglobulinemic, immunologically immature, and therefore more vulnerable to many infectious diseases. During pregnancy, the fetal-placental environment is regulated by Th2-type cytokines that neutralize Th1 responses, an important factor for immune defense against viral agents. The ingestion and absorption of colostral immunoglobulins enhance the immunity of the neonate. However, the presence of maternal antibodies might negatively affect the success of parental vaccination in the first two months of life. This study aimed to evaluate the effecacy of parenteral vaccination in newborn calves with high titers of maternal antibodies against respiratory viruses.Materials, Methods &amp; Results: Twenty-eight Holstein calves were allocated to the vaccinated group (VAC, n = 18) or an unvaccinated control group (NVAC, n = 10). The initial vaccination with 5 mL of a commercial vaccine occurred around the 14th day of life (D14) and the booster at D35. Respiratory and diarrhea symptoms were evaluated at D12, D14, D16, D20, D31, D36, D45, D53, and D60. Blood samples were taken for leukogram, haptoglobin, and seroneutralization of BVDV, BoHV-1, BRSV, and BPI3V, at the time of vaccination at D14 (T1), at booster (D35, T2), and 21 days after the booster (D56, T3). Despite the increased prevalence of BRD during the period of the study, no calves from either group exhibited respiratory disease at D12 or D14. In subsequent assessments, the frequency of BRD increased over time in the VAC group until it reached a maximum prevalence of 38.9% (7/18) at D31. In the NVAC group, the maximum prevalence observed was 40% at D45 and D60. A comparison of the frequencies for BRD cases showed a statistical trend at D36 (P = 0.07), with a higher prevalence for the NVAC group (30%) in relation to the VAC group (5.6%). For the NVAC group, a greater number of total leukocytes was observed at T3 (P = 0.038) and granulocytes (trend) at T2 (P = 0.066). Time analysis demonstrated a decrease in haptoglobin concentration in both groups (NVAC, P = 0.005 and VAC, P = 0.006), with a reduction in the values at T1 and T3 (NVAC = 0.005 and VAC = 0.024). Antibody titers were similar between groups for BVDV, BoHV-1, and BRSV. Higher titers for BPI3V were observed for the VAC group at D56 (P = 0.045).Discussion: The early-onset BRD was present in both groups between 30 and 60 days of age, based on the higher prevalence observed. These data reinforce the importance of early immunization programmes before infection. Factors such as management practices and facilities may have also contributed to the higher prevalence of BRD. The increased number of leukocytes and neutrophils at T2 (D35) and T3 (D56) in the NVAC group points to a stronger inflammatory response to various types of potential challenges. The inflammatory leukocyte profile explains the higher haptoglobin values observed in the NVAC group at T2 (D35). The similarity of titers of antibodies against BVDV, BoHV-1, and BRSV between groups may indicate that vaccinating the calves at 14 days of age did not induce a humoral immune response to these viruses, likely due to interference from the maternal antibodies. Early vaccination prevented a drop in specific viral antibodies and promoted partial protection for vaccinated calves around 14 days of age, with a decrease in the intensity of the inflammatory response at the peak of the disease and a higher concentration of antibodies against BPI3V after the booster.

To study the effectiveness of vacuum assisted closure in reducing the dimension of wound

Method: Informed consent taken in the vernacular language. Wounds of the patients rectangularied while doing debridement for the purpose of measurement. Maximum transverse diameter is taken and a line parallel to the perpendicular line dissecting it through midpoint is taken. Sample collection (As per microbiological parameters) for the purpose of bacterial load done after debridement of wound under aseptic precaution. VAC will be applied as per the norms and setting noted. Measurement of wound dimension and wound assessment score done at the time of application of VAC /Dressing & after removal of VAC / Dressing after 8 days. Sample for bacterial load and type of bacteria send prior and after application of VAC / Conventional dressing. Bacterial load and type of bacteria, noted as per microbiological report.Result: The above table shows the comparison of Mean age of patients of two groups. The student T test applied to determine the difference between the mean age of patients of two groups which was found to be non significant (P>0.05). The mean age of Dressing group (40.90) is higher than mean age of VAC group (39.50) but no significant difference was found between their mean age.The above table shows the comparison of Mean reduction in wound area of patients of two groups. The student T test applied to determine the difference between two Groups at Pre and Post time interval which was found to be statistically significant (P

Treatment of postoperative sternomediastinitis in infants

Aim. To evaluate the results of vacuum therapy and closed irrigation drainage (CID) technique for the treatment of postoperative sternomediastinitis in infantsMethods. This single-institution retrospective study included 69 patients diagnosed with sternomediastinitis from 2008 to 2018. Patients were divided into two groups: those treated using vacuum-assisted closure therapy (VAC; n = 29) and those treated using CID (n = 40). After propensity score matching, a total of 25 infants were included in each group.Results. Age, gender, weight, body surface area, Risk Adjustment for Congenital Heart Surgery score, cardiopulmonary bypass time and the frequency of open chest management were comparable between the two groups after propensity score matching. During hospital stay, no deaths were noted in the VAC group, whereas eight patients died in the CID group (32%; P = 0.004). The median durations of mechanical ventilation were 79 (28; 176) and 154 (24; 356) hours in the VAC and CID groups, respectively (P = 0.38). Moreover, eight patients in the VAC group (32%) were extubated early (P = 0.028). Re-mediastinitis occurred in 1 (4%) and 8 (32%) patients from the VAC and CID groups, respectively (P = 0.01). The multivariable regression analysis revealed that the CID technique was the only risk factor for re-mediastinitis (odds ratio, 13.9; 95% confidence interval, 1.2–152.5; P = 0.031). The median durations of hospital stay were 14 (10; 30) and 23 (18; 33) days in the VAC and CID groups, respectively (P = 0.045).Conclusion. VAC therapy in patients with mediastinitis showed better outcomes than CID technique such as lower hospital mortality and re-mediastinitis rates.Received 14 August 2019. Revised 8 December 2019. Accepted 10 December 2019.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.

Donor-site morbidity after harvesting of radial forearm free flaps—comparison of vacuum-assisted closure with conventional wound care: A randomized controlled trial

IntroductionRadial forearm free flaps (RFFF) are often used to replace tissue removed in head and neck surgery. In recent years, many attempts have been made to reduce donor-site morbidity and to prevent common complications such as infection, skin-graft necrosis, tendon exposure and subsequent impairment of hand function. One promising option is the use of vacuum-assisted-closure wound therapy (VAC). The objective of this study was to evaluate the effectiveness of VAC compared with a conventional bolster dressing (CBD). Material and methodsA randomized controlled trial was enrolled. Our study was prospective in design and included patients with a skin-grafted forearm defect after harvesting of RFFF. Patients who met the inclusion criteria were randomly assigned into two study arms. The predictor variable was the type of wound therapy (VAC therapy compared with CBD) and the outcome variables were (1) the size of the wound area, (2) wrist movement and (3) grip strength. Outcome variables were assessed 12 days, three weeks and eight weeks after surgery. ResultsFifty patients (33 males, mean age 61.7 years [SD 15.5]; 17 females, mean age 54.7 years [SD 10.5]) were included consecutively in the study. Patients in the VAC group experienced a faster postsurgical reduction of wound area and had better wrist movement; nonetheless, the differences between the VAC group and CBD group did not reach statistical significance. In contrast, the recovery of postsurgical grip strength was significantly faster in the VAC group. ConclusionsOur study failed to prove that VAC therapy is significantly superior to CBD for all the variable studied. Because VAC therapy has some positive effects, however, we recommend further development of this negative-pressure wound treatment, rather than the termination of its use.

Vacuum-assisted closure versus closed irrigation for deep sternal wound infection treatment in infants: a propensity score-matched study.

This study aimed to compare vacuum-assisted closure therapy (VAC) and closed irrigation drainage therapy (CID) for deep sternal wound infection treatment in infants. From January 2008 to March 2018, 69 patients (1.73%) had deep sternal wound infection. They were divided into 2 groups: patients treated with VAC therapy (VAC group, 29 patients) and those treated with CID therapy (CID group, 40 patients). After performing a propensity score analysis (1:1) for the entire sample, 16 patients receiving VAC therapy were matched with 16 patients receiving CID therapy. No significant difference was noted between both groups regarding age [d = 0.045; 95% confidence interval (CI) 0.99-1.07], gender (d = 0.001; 95% CI 0.22-4.45), weight (d = 0.011; 95% CI 0.73-1.35), body surface area (d = -0.023; 95% CI 0.01-5733.08), cardiopulmonary bypass (d = 0; 95% CI 0.16-5.90) and open chest duration (d = -0.112; 95% CI 0.31-5.16). Five patients died in the CID group (31.25%) during hospital stay, and there were no deaths in the VAC group (P = 0.024). Recurrence of mediastinitis occurred in 1 patient (6.25%) from the VAC group and in 6 patients (37.5%) from the CID group (P = 0.037). The multivariable regression analysis revealed that the CID method was the only risk factor for remediastinitis (odds ratio 17.3; 95% CI 1.04-286.75; P = 0.046). Use of VAC therapy in infants with deep sternal wound infection was associated with a substantial decrease in the mortality rate and duration of therapy compared with CID technique. The CID technique was an independent risk factor for recurrence of mediastinitis.