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Bouza E, de Alarcón A, Fariñas MC, Gálvez J, Goenaga MÁ, Gutiérrez-Díez F, Hortal J, Lasso J, Mestres CA, Miró JM, Navas E, Nieto M, Parra A, Pérez de la Sota E, Rodríguez-Abella H, Rodríguez-Créixems M, Rodríguez-Roda J, Sánchez Espín G, Sousa D, Velasco García de Sierra C, Muñoz P, Kestler M. Prevention, Diagnosis and Management of Post-Surgical Mediastinitis in Adults Consensus Guidelines of the Spanish Society of Cardiovascular Infections ( SEICAV), the Spanish Society of Thoracic and Cardiovascular Surgery ( SECTCV) and the Biomedical Research Centre Network for Respiratory Diseases ( CIBERES). J Clin Med 2021; 10:5566. [PMID: 34884268 PMCID: PMC8658224 DOI: 10.3390/jcm10235566] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 01/04/2023] Open
Abstract
This is a consensus document of the Spanish Society of Cardiovascular Infections (SEICAV), the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) and the Biomedical Research Centre Network for Respiratory Diseases (CIBERES). These three entities have brought together a multidisciplinary group of experts that includes anaesthesiologists, cardiac and cardiothoracic surgeons, clinical microbiologists, infectious diseases and intensive care specialists, internal medicine doctors and radiologists. Despite the clinical and economic consequences of sternal wound infections, to date, there are no specific guidelines for the prevention, diagnosis and management of mediastinitis based on a multidisciplinary consensus. The purpose of the present document is to provide evidence-based guidance on the most effective diagnosis and management of patients who have experienced or are at risk of developing a post-surgical mediastinitis infection in order to optimise patient outcomes and the process of care. The intended users of the document are health care providers who help patients make decisions regarding their treatment, aiming to optimise the benefits and minimise any harm as well as the workload.
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Affiliation(s)
- Emilio Bouza
- Clinical Microbiology and Infectious Diseases Department, Gregorio Marañon University Hospital, Gregorio Marañon Health Research Institute, Complutense University of Madrid, CIBER of Respiratory Diseases—CIBERES, 28007 Madrid, Spain; (E.B.); (M.R.-C.); (P.M.)
| | | | | | - Juan Gálvez
- Virgen Macarena University Hospital, 41009 Seville, Spain;
| | | | - Francisco Gutiérrez-Díez
- Cardiovascular Surgery Department, Marques de Valdecilla University Hospital, 39008 Santander, Cantabria, Spain;
| | - Javier Hortal
- Anesthesia and Intensive Care Department, Gregorio Marañon University Hospital, 28007 Madrid, Spain;
| | - José Lasso
- Plastic Surgery Department, Gregorio Marañon University Hospital, 28007 Madrid, Spain;
| | - Carlos A. Mestres
- Department of Cardiac Surgery, University Hospital Zurich, 8091 Zurich, Switzerland;
| | - José M. Miró
- Infectious Diseases Services, Hospital Clinic-IDIBAPS, University of Barcelona, 08036 Barcelona, Spain;
| | - Enrique Navas
- Infectious Diseases Department, Ramón y Cajal University Hospital, 28034 Madrid, Spain;
| | - Mercedes Nieto
- Cardiovascular Unit, Intensive Care Department, San Carlos Clinical Hospital, 28040 Madrid, Spain;
| | - Antonio Parra
- Department of Radiology, Marquez de Valdecilla University Hospital, 39008 Santander, Cantabria, Spain;
| | | | - Hugo Rodríguez-Abella
- Cardiac Surgery Department, Gregorio Marañon University Hospital, 28007 Madrid, Spain;
| | - Marta Rodríguez-Créixems
- Clinical Microbiology and Infectious Diseases Department, Gregorio Marañon University Hospital, Gregorio Marañon Health Research Institute, Complutense University of Madrid, CIBER of Respiratory Diseases—CIBERES, 28007 Madrid, Spain; (E.B.); (M.R.-C.); (P.M.)
| | | | - Gemma Sánchez Espín
- Heart Clinical Management Unit, Virgen de la Victoria University Hospital, 29006 Malaga, Spain;
| | - Dolores Sousa
- Infectious Diseases Department, A Coruña Hospital Complex, 15006 A Coruña, Spain;
| | | | - Patricia Muñoz
- Clinical Microbiology and Infectious Diseases Department, Gregorio Marañon University Hospital, Gregorio Marañon Health Research Institute, Complutense University of Madrid, CIBER of Respiratory Diseases—CIBERES, 28007 Madrid, Spain; (E.B.); (M.R.-C.); (P.M.)
| | - Martha Kestler
- Clinical Microbiology and Infectious Diseases Department, Gregorio Marañon University Hospital, Gregorio Marañon Health Research Institute, Complutense University of Madrid, CIBER of Respiratory Diseases—CIBERES, 28007 Madrid, Spain; (E.B.); (M.R.-C.); (P.M.)
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Pettigrew JE. Essential role for simulation models in animal research and application. ANIMAL PRODUCTION SCIENCE 2018. [DOI: 10.1071/an15794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Simulation models have been used productively to aid understanding of animal biology and production systems. Emphasis here is on pig growth models, but the principles apply also to other species and other outcomes. Main applications for such models are direct use within a production system, indirect use across production systems and guidance of research. Most useful models are dynamic and mechanistic; most are deterministic but some gain added utility from stochasticity. Several pig growth models have predicted growth rate, feed efficiency and body and carcass composition from inputs, including protein accretion capacity and diet composition and intake. They have been so successful that now attention can be applied elsewhere. Pigs in commercial production fail to achieve their potential growth, presumably because of various stressors, including disease, and the gap between actual and potential growth is a rich target for future simulation models. Models should address activation of the innate immune system separately from clinical disease. They can provide special benefits from prediction of the impacts of several health-promoting technologies, including those in feed.
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Pujols J, Segalés J, Polo J, Rodríguez C, Campbell J, Crenshaw J. Influence of spray dried porcine plasma in starter diets associated with a conventional vaccination program on wean to finish performance. Porcine Health Manag 2016; 2:4. [PMID: 28405430 PMCID: PMC5382401 DOI: 10.1186/s40813-016-0021-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 01/20/2016] [Indexed: 12/03/2022] Open
Abstract
Background Conventional vaccination programs using a single injection of a combined vaccine against porcine circovirus type 2 (PCV2) and Mycoplasma hyopneumoniae (MHYO) can promote a strong immune response that reduces feed intake for 24 to 48 h post injection. Often such vaccines are given around the time of weaning during a critical stress period in which feed intake is already compromised. Spray dried porcine plasma (SDPP) is a protein source used in starter diets that increases post-weaning feed intake of pigs. The objectives of this study were to determine the effects of a conventional vaccination program along with feeding SDPP in a starter diet on antibody development and wean to finish performance of pigs. Results Pigs fed the starter diet with SDPP had improved body weight, average daily weight gain and average daily feed intake during the initial 14 d after weaning along with improved feed efficiency during the initial 7 d after weaning and these responses were independent of vaccination. Vaccination at 3 d after weaning had no significant effect on performance during the initial 14 d after weaning. Cumulative mortality was reduced for pigs fed the starter diet with SDPP, while vaccinated pigs had reduced mortality from d 48 to 145. Both vaccinated pigs and those fed the starter diet with SDPP had heavier carcass weight. One pig per pen was challenged with PCV2 at d 63. A higher percentage of vaccinated pigs were sero-positive for antibodies against PCV2 and MHYO at d 35, 63 and 78. Antibody values against PCV2 were higher for vaccinated pigs at d 35 and 63, but lower at d 146. Percentage of positive samples for PCV2 genome in serum was reduced for vaccinated pigs at d 117 and 146. Antibody values against MHYO were increased for vaccinated pigs at d 35, 63 and 78. Conclusions Vaccination supported a long term antibody response against PCV2 and a moderate but weaker antibody response against MHYO for early finishing pigs challenged with PCV2. Using SDPP in the starter diet along with vaccination supported the best long-term beneficial effects on survival to market and carcass weight.
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Affiliation(s)
- Joan Pujols
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain
| | - Joaquim Segalés
- UAB, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain.,Departament de Sanitat i Anatomia Animals, Universitat Autònoma de Barcelona (UAB), 08193 Bellaterra, Barcelona, Spain
| | - Javier Polo
- APC EUROPE, S.A. Avda, Sant Julià 246-258, Pol. Ind. El Congost, E-08403 Granollers, Spain
| | - Carmen Rodríguez
- APC EUROPE, S.A. Avda, Sant Julià 246-258, Pol. Ind. El Congost, E-08403 Granollers, Spain
| | - Joy Campbell
- APC Inc., 2425 SE Oak Tree Court, Ankeny, IA 50021 USA
| | - Joe Crenshaw
- APC Inc., 2425 SE Oak Tree Court, Ankeny, IA 50021 USA
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