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BACKGROUND Carbapenemase-producing Enterobacterales (CPE) represents a serious threat to public health. Clinical microbiology laboratories (CML) need effective protocols for screening and confirmation of CPE. AIM To prospectively evaluate an algorithm for the screening of carbapenemase-producing Klebsiella pneumoniae in an OXA-48 endemic hospital. METHODS The algorithm was based on a disc diffusion assay using ertapenem and temocillin, which also served as a purity check for routine automated antimicrobial susceptibility testing. All isolates with minimal inhibitory concentrations >0.5 mg/L or zone inhibition diameters less then 25 mm for ertapenem (criteria 1) and less then 12 mm for temocillin (criteria 2) were tested sequentially by a OXA-48 lateral-flow immunochromatographic assay, a multiplex PCR which targets VIM, KPC and OXA-48 and, if neither of them were positive, by the modified Hodge or CARBA NP tests. FINDINGS Over two years, 2,487 K. pneumoniae were assessed by the algorithm proposed, and 378 (15.20%) complied both criteria. Of these, 98.68% (373/378) were either confirmed as OXA-48 producers or originated from patients with a previous CPE-isolate that maintained the same resistance phenotype over time; the remaining three were VIM producers. Only two out of the 378 isolates (0.53%) did not produce carbapenemase, despite meeting criteria 1 and 2. CONCLUSION The algorithm here described combined the most sensitive carbapenem for CPE detection with a cut-off of temocillin highly specific for OXA-48 detection. It is reliable and easy to apply in the routine work-flow of CML, allowing rapid detection of CPE isolates, and hence prompt implementation of infection control measures and targeted antimicrobial regimens. BACKGROUND Transforaminal lumbar interbody fusion (TLIF) via a fusion cage is widely carried out to treat degenerative lumbar spinal disease, and cage implantation plays a pivotal role in buttressing the vertebrate and promoting fusion. Clinically, the cage implantation is commonly placed in two different orientations oblique and traverse. Therefore, this study aimed to explore the effects of different orientations of cage implantation on lumbar interbody fusion. METHODS From January 2016 to January 2018, a retrospective study of 98 patients with lumbar degenerative disease who were treated with lumbar interbody fusion with at least 2-year follow-up was performed. According to the different positions of cage implantation, the patients were divided into two groups oblique group (OG) and traverse group (TG). The clinical and radiographic outcomes were compared preoperatively, postoperatively, and at the last follow-up evaluation. Radiographic measurements included the height of intervertebral (HOI), segment loratients achieved grade I fusion at the final evaluation. CONCLUSION The traverse cage implantation in TLIF had the same clinical effect as oblique cage implantation, while that is superior in improving sagittal alignment. Therefore, we advise that the cage should be placed in traverse orientation in TLIF. OBJECTIVE To determine the location of kinesthetic cell clusters within the subthalamic nucleus (STN) on MRI, adjusted for interindividual anatomical variability by employing the medial STN border as a reference point. METHODS We retrospectively localized microelectrode recording (MER)-defined kinesthetic cells on 3-Tesla T2-weighted and susceptibility-weighted images (SWI) in patients that underwent STN Deep Brain Stimulation (DBS) for Parkinson’s Disease (PD), and averaged the stereotactic coordinates. These locations were calculated relative to the non-individualized midcommissural point (MCP) and, in order to account for interindividual anatomical variability, also calculated relative to the patient-specific intersection of Bejjani’s line with the medial STN border. Two example patients were selected in order to visualize the discrepancies between the adjusted and non-adjusted theoretic kinesthetic cell clusters on MRI. RESULTS Relative to the MCP, average kinesthetic cell coordinates were 12.3±1.2 mm lateral, 1.7±1.4 mm posterior, and 2.3±1.5 mm inferior. Relative to the medial STN border, mean coordinates were 3.4±1.0 mm lateral, 1.0±1.4 mm anterior, and 1.7±1.5 mm superior on T2-sequences, and on SWI mean coordinates were 3.2±1.1 mm lateral, 0.8±1.5 mm anterior, and 2.1±1.5 mm superior. The theoretic kinesthetic cell clusters may appear outside the sensorimotor STN when using the MCP, whereas these clusters fall well within the sensorimotor STN when employing the medial STN border as a reference point. CONCLUSION By using the medial STN border as a patient-specific anatomical reference point in STN DBS for PD, we accounted for interindividual anatomical variability and provided accurate insight in the clustering of kinesthetic cells within the dorsolateral STN. learn more BACKGROUND Mechanical thrombectomy (MT) is the standard of care for the treatment of acute ischemic stroke (AIS) due to anterior circulation large vessel occlusion. However, the true safety and efficacy of MT in medium size vessel occlusions like the M2 segment of middle cerebral artery has yet to be completely defined. In this study, we analyze the safety and efficacy of MT in M2 occlusions when compared to M1 occlusions. METHODS A restrospective analysis was performed on patients with AIS secondary to M1 and M2 occlusions between 2011 and 2018. The inclusion criterias were 1) AIS secondary to M1 or M2 occlusion, 2) MT performed by stent retrieval technique alone, aspiration technique, or combined stent retrieval-aspiration techniques. Basic patient characteristics, number of passages, first passage recanalization success (≥TICI 2b), total recanalization success, hemorrhagic complications, (including intracerebral hemorrhage[ICH] and subarachnoid hemorrhage [SAH]), and clinical outcomes were compared between both groups. RESULTS Two hundred and sixty patients met inclusion criteria. 171 patients had M1 occlusion versus 89 patients with M2 occlusion. First passage recanalization success rate was significantly higher in the M2 group(55.1% versus 39.2%, p=0.015). Total recanalization success rate was higher in the M2 group but did not reach significance(83% versus 75%, p=0.128). Subarachnoid hemorrhage rate was significantly higher in the M2 group(25% versus 12%, p=0.010) but there was no difference for ICH complications (14.6% versus 16.4%, p=0.711). CONCLUSION MT for M2 occlusions has similar overall efficacy as M1 occlusions, but with higher first pass successful recanalization rates. MT for M2 occlusions has a higher risk of associated SAH.