03).

Microvascular free tissue transfer is a reliable, safe and gold standard modality in surgical reconstruction and can be replicated in non-institutional settings.

Microvascular free tissue transfer is a reliable, safe and gold standard modality in surgical reconstruction and can be replicated in non-institutional settings.

Hyponatraemia has a prevalence of up to 30% after orthopaedic surgery and is associated with poor outcomes, including around 20% mortality and longer hospital stays. This study assessed the prevalence of hyponatraemia following total hip and knee replacement, the causes, further tests, management, effect on length of stay, intensive care admissions and the impact of an endocrinology hyponatraemia protocol.

Day one postoperative urea and electrolyte results for patients undergoing elective total hip and knee replacements were reviewed. Retrospective data was gathered through the web-based requesting and reporting system ICE. Parameters included demographics, procedure, sodium pre- and postoperatively, endocrine input, high-dependency admissions and length of hospital stay. Next, a hyponatraemia protocol based on NICE guidance was developed with the endocrinology department and a second audit cycle was initiated. SPSS software was used to analyse the data.

Hyponatraemia occurred in 12% of patients, resultntly. The main limitation in this project was the fact that it was carried out in a single unit, although this process could be easily replicated should other units wish to adopt it and compare results over a wider cohort.

This endocrine pathway is easily reproducible for other departments. It may help reduce waiting times and improve outcomes for total hip and knee replacements within the NHS.

This endocrine pathway is easily reproducible for other departments. It may help reduce waiting times and improve outcomes for total hip and knee replacements within the NHS.A small renal mass is defined as a tumour less then 4cm. The standard treatment of choice for small renal masses is partial or radical nephrectomy, depending on the tumour anatomy, and has good overall and cancer-specific survival. Its association with lymph node metastasis and inferior vena cava (IVC) thrombus is very uncommon. We describe a case of a right small renal mass with a large metastatic paracaval lymph node with IVC level I thrombus who was treated with right radical nephrectomy with thrombus removal and lymph node excision.Nowadays, there is a lack of information on the mosquito’s fauna and DNA barcoding sequence reference library from many areas in Mexico, including the Volcanoes of Central America physiographic subprovince in the state of Chiapas. Consequently, a survey was undertaken to delineate the mosquito (Diptera Culicidae) fauna in this region across different seasons using different collecting techniques. All species were identified by morphology and DNA barcoding, and their ecological features were also defined. In total, 62 taxa were morphologically examined, 60 of these were successfully identified based on morphological characteristics, but two were unable to be identified at the species level. The genera Aedes, Anopheles, Culex, and Wyeomyia are the most diverse among mosquito genera collected and include several species of medical and veterinary importance. Ecological characteristics of the immature habitats indicated that they were grouped into four categories namely, (1) large water bodies at ground level, (2) small and shady phytotelmata (e.g., tree holes and bamboo internodes), (3) large phytotelmata (e.g., plant leaves and axis bromeliad), and (4) artificial containers. The cytochrome c oxidase subunit I (COI) DNA barcoding sequences successfully separated the majority of these species, although specific species showed >2% intraspecific genetic divergences.Introduction Trypanosomiasis is a parasitic infection caused by the protozoa Trypanosoma. It is exclusively associated with Glossina species habitats and, therefore, restricted to specific geographical settings. It affects a wide range of hosts, including humans. Animals may carry different Trypanosoma spp. while being asymptomatic. They are, therefore, potentially important in unpremeditated disease transmission. Aim The aim of this study was to study the potential impact of the government tsetse fly control program, and to elucidate the role of pigs in the Trypanosoma epidemiology in the West Nile region in Uganda. Methods A historically important human African trypanosomiasis (HAT) hotspot was selected, with sampling in sites with and without a government tsetse fly control program. Pigs were screened for infection with Trypanosoma and tsetse traps were deployed to monitor vector occurrence, followed by tsetse fly dissection and microscopy to establish infection rates with Trypanosoma. Pig blood samples were further analyzed to identify possible Trypanosoma infections using internal transcribed spacer (ITS)-PCR. Results Using microscopy, Trypanosoma was detected in 0.56% (7/1262) of the sampled pigs. Using ITS-PCR, 114 of 341 (33.4%) pig samples were shown to be Trypanosoma vivax positive. Of the 360 dissected tsetse flies, 13 (3.8%) were positive for Trypanosoma under the microscope. The difference in captured tsetse flies in the government intervention sites in comparison with the control sites was significant (p  0.05). Conclusion This study illustrated the impact of a government control program with low vector abundance in a historical HAT hotspot in Uganda. The study could not verify that pigs in the area were carriers for the causative agent for HAT, but showed a high prevalence of the animal infectious agent T. vivax.Chlamydia bovis is a widespread infection disease caused by the mixed infection of Chlamydia psittaci, Chlamydia pecorum, Chlamydia abortus, and Chlamydia suis in cattle. Although many studies have investigated Chlamydia infection in cattle, there is no nationwide study on the prevalence of Chlamydia infection in cattle of China. We constructed the first meta-analysis to assess the infection rate and infection risk factors of Chlamydia in cattle in China, and we searched PubMed, ScienceDirect, Chinese Web of Knowledge, Wanfang, and VIP Chinese journal database for studies reporting Chlamydia infection in cattle from April 29, 2020. We collected a total of 563 publications from 1989 to 2019, and finally, 78 studies were eligible, which included 152,364 cattle from 27 provinces across the country. We estimated the pooled prevalence of Chlamydia in cattle was 14.2% (95% confidence interval [CI] 12.2 to 16.4). The prevalence of bovine Chlamydia in China collected before 2000 (14.8%, 95% CI 5.6 to 27.3) showed the highest prevalence rate. The highest prevalence was found in Central China (22.6%, 95% CI 12.8 to 34.2). The prevalence of Chlamydia spp. between abortion cattle (39.1%, 95% CI 24.6 to 54.6) and healthy cattle (8.3%, 95% CI 3.1 to 15.2) showed significant variation (p 1 year (16.6%, 95% CI 12.6 to 20.9) was higher compared with age ≤1 year (9.8%, 95% CI 6.7 to 13.3). Yaks (17.8%, 95% CI 13.3 to 22.8) showed the highest Chlamydia prevalence among the varieties of bovine. We also estimated the potential risk factors such as feeding model, sample classification, sampling seasons, bovine gender, parity, and quality level of included studies. Our findings suggested that Chlamydia was prevalent in cattle in China. So we should pay attention to bovine Chlamydia and take necessary measures to prevent it.In pre-Hispanic Mexico, dogs were not identified as an important source of rabies. We know from codexes and chronicles of the conquerors that at that time, rabies cases in humans and domestic animals were caused by local wildlife species such as bats. Canine-rabies virus variant seems to have arrived with Europeans. The first documented case of canine rabies in the Americas is found in Mexico in the Annals of the Holy Inquisition (16th century). During Mexico’s independence, cases were frequently reported. In the 19th century the first attempts to control human rabies were made through sanitary measures such as elimination of rabid dogs and applying postexposure vaccination. During the first half of the 20th century, the efficacy of canine vaccination to prevent human rabies was established. However, in Mexico, despite reports of numerous human cases (>70/year), canine vaccination did not have enough coverage. It was only during the 1990s that Mexico made a serious commitment to eliminate dog-transmitted human rabies. Since the beginning, vaccination campaigns have been free and massive. Coverage increased from 7,100,000 doses in 1990 to more than 18,000,000 since 2017. This culminated in the elimination of dog-mediated human rabies cases since 2006. Subsequently, the epidemiology of rabies had changed. Nowadays, it is wildlife species (mainly bats and skunks) that are the source of human rabies. As a mega-biodiverse country Mexico has numerous wildlife species with potential to transmit rabies virus. Thus it is paramount to remain vigilant with respect to canine vaccination campaigns and to promote rabies research in wildlife.

To evaluate the refractive outcomes of small-incision lenticule extraction (SMILE) surgery in moderate to high myopic astigmatism.

Prospective interventional case series.

This study evaluated 111 eyes of 68 patients treated with femtosecond SMILE surgery for the correction of myopia and astigmatism. Inclusion criteria were myopia of - 0.5 D or more and astigmatism between - 1.0 D and -5.0 D. Refractive and visual measurements were obtained preoperatively, 1 and 12 month(s) postoperatively. Vector analysis was used to study the astigmatic outcomes at 12-month follow-up. Comparison of results in two groups of patients with astigmatism below and over 3.00 D was performed.

The preoperative mean spherical equivalent was -5.48 ± 2.17 D (range - 1.75 to - 10.00 D) and the mean cylinder was -2.02 ± 1.09 D (range - 1.00 to - 5.00 D). The mean postoperative cylinder value was -0.60 ± 0.52 D at 12-month visit. The 12-month safety and efficacy indices were 0.98 ± 0.07 and 0.97 ± 0.12, respectively. The high astigmatism group showed significantly lower safety and efficacy indices. The postoperative residual astigmatism was 0.5 D or less in 73% of the eyes. Higher amount of residual astigmatism was observed in the high astigmatism group. The angle of error was ± 5 degrees in 49% and ± 15 degrees in 87% of the eyes.

SMILE surgery is effective and safe method for correcting myopic astigmatism. Vector analysis indicated a tendency for the under correction of astigmatism in subjects with high astigmatism.

SMILE surgery is effective and safe method for correcting myopic astigmatism. Vector analysis indicated a tendency for the under correction of astigmatism in subjects with high astigmatism.Enterococcus faecium strain S6 is a newly identified bacteriocin producer isolated from raw camel milk. The draft genome sequence is composed of 2,617,971 bp, with 2,407 coding genes and a G+C content of 37.99%. The genome sequence analysis provided details into the antimicrobial properties of strain S6.