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Background: Non-tuberculous mycobacteria (NTM) are generally free-living organism, widely distributed in the environment, with sporadic potential to infect. In recent years, there has been a significant increase in the global incidence of NTM-related disease, spanning across all continents and an increased mortality after the diagnosis has been reported. The decisions on whether to treat or not and which drugs to use are complex and require a multidisciplinary approach as well as patients' involvement in the decision process. Methods and Results: This review aims at describing the drugs used for treating NTM-associated diseases emphasizing the efficacy, tolerability, optimization strategies as well as possible drugs that might be used in case of intolerance or resistance. We also reviewed data on newer compounds highlighting the lack of randomised clinical trials for many drugs but also encouraging preliminary data for others. We also focused on non-pharmacological interventions that need to be adopted during care of individuals with NTM-associated diseases Conclusions: Despite insufficient efficacy and poor tolerability this review emphasizes the improvement in patients' care and the needs for future studies in the field of anti-NTM treatments. [ABSTRACT FROM AUTHOR]

Monica Tontodonati,1,2 Giovanni Cenderello,3 Benedetto Maurizio Celesia,4 Michele Trezzi,5 Tamara Ursini,2 Andrea Costantini,6 Domenico Marra,7 Ennio Polilli,8 Corrado Catalani,5 Luca Butini,6 Federica Sozio,8 Elena Mazzotta,9 Antonina Sciacca,8 Giuliano Rizzardini,10 Lamberto Manzoli,11 Alessandro Cozzi-Lepri,12 Giustino Parruti8 1Infectious Disease Unit, Pescara General Hospital, Pescara, 2Clinic of Infectious Diseases, G D'Annunzio University of Chieti-Pescara, Chieti, 3Division of Infectious Disease, Galliera General Hospital, Genoa, 4Infectious Diseases Unit, ARNAS Garibaldi, Catania, 5Infectious Diseases Unit, Pistoia General Hospital, Pistoia, 6Clinical Immunology Unit, Ancona Hospital, Ancona, 7Division of Oncology, Galliera General Hospital, Genoa, 8Infectious Diseases Unit, Pescara General Hospital, Pescara, 9Internal Medicine Department, G D'Annunzio University of Chieti-Pescara, Chieti, 10First Infectious Diseases Department, Luigi Sacco Hospital, Milan, 11Section of Hygiene, Epidemiology, Pharmacology and Legal Medicine, G D'Annunzio University of Chieti-Pescara, Chieti, Italy; 12Research Department of Infection and Population Health, University College London, London, UK Background: As HIV infection turned into a chronic treatable disease, now ranking as one of the most costly in medicine, long-term sustainability of highly active antiretroviral treatment (HAART) expenses became a major issue, especially in countries with universal access to care. Identification of determinants of higher HAART costs may therefore help in controlling costs of care, while keeping high levels of retention in care and viral suppression. Methods: With this aim, we enrolled a large multicentric sample of consecutive unselected human immunodeficiency virus (HIV) patients followed at five sites of care in Italy, and evaluated annual individual HAART costs in relation to a number of sociodemographic, clinical, and laboratory variables. Results: We enrolled 2,044 patients, including 1,902 on HAART. Mean HAART costs were €9,377±€3,501 (range 782–29,852) per year, with remarkable site-based differences, possibly related to the different composition of local assisted populations. Percentages of patients on viral suppression were homogeneously high across all study sites. The factors identified by cross-validation were line of HAART, diagnosis of acquired immune deficiency syndrome, current CD4 T-cell count, and detectable HIV viremia >50 copies/mL. In the final multivariable model, HAART costs were independently directly associated with more advanced HAART line (P

Conyza spp. have become a major weed around the world, mainly because of weed resistance issues. The objective of this work was to test the hypothesis that the soyabean crop yield is dependent on the density of Conyza bonariensis and on the timing of weed establishment in relation to the crop sowing date. It was also theorised that these variables affect soyabean crop yield components and the economic threshold of C. bonariensis on soyabean. Field experiments were conducted during 2010 and 2011 using a randomised complete block design. In each experiment, several densities (0, 3, 6, 12, 24, 48, 96 and 192 plants m−2) of C. bonariensis were established in soyabean fields. Conyza bonariensis establishment dates varied considerably between the experiments [81, 38 and 0 days before soyabean sowing ( DBSS)]. Conyza bonariensis plants were first cultivated in a glasshouse and then transplanted to the field at the three-leaf growth stage. At the lower densities, each C. bonariensis plant decreased soyabean yield by 36%, 12% and 1.0%, when established at 81, 38 and 0 DBSS respectively. The economic thresholds based on sensitivity analysis were below 0.5 plant m−2 when C. bonariensis was introduced at 81 and 38 DBSS; in contrast, they were between 2 and 4 plants m−2 when the weed was established at the crop sowing time. The results emphasise the importance of proper C. bonariensis management prior to soyabean sowing and highlight the need for residual herbicides to avoid grain yield losses. [ABSTRACT FROM AUTHOR]

An international technical committee of the CIE has proposed a formula to predict the subjective impression of an outdoor floodlighting installation. The formula is based on appraisals of glare in football stadia and on football training grounds. It has since been validated for use in lighting airport aprons and railway marshalling yards. This report describes tests made to check the suitability of the formula for tennis court lighting. Very good agreement with the formula has been found. [ABSTRACT FROM PUBLISHER]

The HeartMate 3 ventricular assist device (VAD) is a newer centrifugal continuous-flow VAD used for bridge-to-transplant and destination therapy in adults. However, there is limited experience regarding its use in children and adolescents. We examined the outcomes of pediatric patients undergoing HeartMate 3 implantation at our institution between January 2016 and September 2020. Indications were bridge-to-transplant and bridge-to-recovery. All patients were in INTERMACS 2 profile at the time of surgery. In the early postoperative period bivalirudin was used as a bridge to warfarin therapy in all patients. Seven HeartMate 3 were implanted in five patients, with a median age of 14.5 (9.0-16.5) years, median weight of 48 (40.0-75.0) kg, and median body surface area (BSA) of 1.43 (1.36-1.92) m 2. Of the cohort, all patients but one weighed <60 kg. Diagnoses included idiopathic dilated cardiomyopathy (n=2) and myocardial failure secondary to acute myocarditis (n = 3). With a median of 1.16 years of follow-up (range 0.36-4.79) mortality was nil. One patient was initially successfully weaned from the device after 334 days of support but then required re-implantation due progressive myocardial failure and he is currently listed for heart transplant. Another patient, along with a HeartMate 3 LVAD, required a HeartMate 3 as an RVAD for severe right ventricular dysfunction seven months after the initial implant. This patient, at the time of LVAD placement underwent two runs of temporary RVAD support through the ProtekDuo percutaneous cannula for a total of 41 days. Two patients were successfully transplanted. Median time on the device was 138 days (range, 5-334). There were no episodes of stroke, pump thrombosis or driveline infection. Patients with prolonged time on the device were more likely to experience right ventricular failure. Use of the HeartMate 3 in children and adolescents was associated with no mortality. All patients were successfully implanted and supported, some for several months, indicating that this device is appropriate for older children and adolescents. The HeartMate 3 device in a RVAD configuration was able to provide satisfactory hemodynamic support. The anticoagulation protocol with bivalirudin to warfarin transition proved excellent virtually eliminating bleeding and thromboembolic events. [ABSTRACT FROM AUTHOR]

Continuous flow intra-corporeal ventricular assist devices (CF-VAD) in children has becoming attractive for their potential benefit in pediatric population. End stage heart failure in children less than 20 kgs are still challenging population. We reported the effect of CF VAD in small children with dilated cardiomyopathy refractory to conventional pharmacological treatment. We implanted CF VAD type Infant Jarvik 2015 (Infant JarvikInfant Jarvik 2015 Jarvik Heart, Inc., New York, NY) in 3 patients affected by dilated cardiomyopathy with refractory symptoms of heart failure. All children were in PEDIMACS 2 The mean weight at implantation was 11 kgs. Causes of acute heart failure was dilated cardiomyopathies in all. In one patient we changed the VAD for pump thromboses. The mean time on VAD was 336,7± 105,4 days. All patients were treated with heart failure therapies. In all patient we obtain a significant recovery of LV function with significant reduction of SD LVEDD and increase of ejection fraction > 45%. In all 3 patients the VAD was removed and the mean follow up after removal was 172,3 ± 36,3 days. No acute episode of heart failure after three months post VAD removal were recorded. Infant Jarvik 2015 LVAD, the smallest pump available conceived for children, can be successfully implanted in children. The use of continuous flow intracorporeal is feasible in children and from these preliminary results seem to be effective to induce recovery in small children with dilated cardiomyopathy. These data should be validated in future trial. [ABSTRACT FROM AUTHOR]