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There are only few data on the persistence and transmission of methicillin resistant Staphylococcus aureus (MRSA) of the clonal complex (CC) 398 among veterinarians and their household members. We therefore investigated the long-term colonisation with MRSA CC398 among participants of veterinary conferences in Germany in 2008/2009 and their household members. Forty-five initially MRSA CC398 positive and 180 initially MRSA CC398 negative conference participants were included in a longitudinal study. These persons and their household members were tested for nasal colonisation in 2011, 2012 and 2014. Of 31 continuously tested and initially MRSA CC398 positive participants only 8 (26%) were colonized with MRSA CC398 at all 4 time points, 4 (13%) of them consistently with the same spa type. Among initially MRSA CC398 negative participants, 13 (7%) were tested MRSA CC398 positive at least once during the follow-up period. Data for household members at least at one time point were available for 185 households. Of these 21 (11%) households had one or more household member who tested positive for MRSA CC398 at least once. The odds of household members to be MRSA CC398 positive was 12 times higher (95% confidence interval 4–37) when the conference participant tested MRSA CC398 positive in 2008/2009. This association remained strong when household members working in veterinary medicine or livestock farms were excluded. In summary, these data suggest that colonisation with MRSA CC398 is partially transient and that household members of MRSA CC398 colonized persons are at an increased risk of colonisation with MRSA CC398. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Neurofibromatosis type 2 (NF2) is a common neurocutaneous disorder that exhibits an autosomal dominant inheritance, with a mutation at chromosome 22q12.2. Two forms can be distinguished: the Wishart-phenotype with an early and aggressive course and the Feiling–Gardner-phenotype with a less dramatic presentation. In general, patients present bilateral vestibular schwannomas, meningiomas and neurinomas of the central and peripheral nervous system as well as neurofibromas and gliomas. There is no reported case of pulmonary meningiomas and neurinomas associated with NF2 until now. Patient and methods: Here, we present a 16-year-old girl with NF-2 associated to CNS and pulmonary tumours and we discuss the case in the backlight of the literature. Results: The reported patient presented a de novo NF2 germline mutation (R341X) and displayed the Wishart-type of NF-2 since she is 11 years old, with a huge anaplastic biparietal falx meningioma and a tentorium meningioma and a tumour-associated parietal mass as well as hypacusis starting at the infant age of 3 years. Multiple cranial and spinal tumours with extra- and intramedullary localization were also found. Moreover, recurrent pulmonary tumours developed and were classified as benign meningiomas and a single neurinoma. No direct evidence concerning a relationship between the pulmonary and cerebral tumours could be drawn. Conclusion: This rare case extends our knowledge of NF2 and also raises interesting questions about the pathogenesis of meningiomas outside the CNS. [Copyright &y& Elsevier]

Intercontinental travel contributes to the spread of extended-spectrum beta-lactamase producing Enterobacterales (ESBL-PE). We assessed risk factors for intestinal ESBL-PE colonization in people travelling to low and middle income countries in the tropics and subtropics to better understand how travel affects ESBL-PE spread. This prospective cohort study in travellers attending a travel clinic in Leipzig, Germany was conducted in 2016–2017. Information on risk factors related to travel, symptoms, antibiotic use, health care usage, accommodation, destination, diet and hygiene was collected by questionnaire after travel. Stools were phenotypically tested for ESBL-PE before and after travel. Risk factors for ESBL-PE colonization were identified using logistic regression. Of the 230 travellers that were ESBL-PE negative before travelling, 23% (n = 53) travellers returned positive. Multivariable analyses showed that age, type of accommodation and travelling to Asia were associated with ESBL-PE colonization. Given that a considerable amount of travellers returned with ESBL-PE, we recommend raising awareness in returning high-risk travellers, e.g. those returning from high-risk areas. They should be aware that they may carry antimicrobial-resistant bacteria after travel, and how they can prevent its spread. The role of the type of accommodation as a factor favouring intestinal colonization with ESBL-PE requires further investigation. [ABSTRACT FROM AUTHOR]

For bone implants, β‑titanium alloy is promising mainly due to its low modulus of elasticity; the disadvantage may be the insufficient wear-resistant and corrosion-resistant properties. Bulk β-Ti39Nb alloy and magnetron sputtered β-Ti39Nb alloy were surface modified by micro-arc oxidation (MAO) technique in an alkaline solution. The aim was to define in detail the relationships between the chemical composition of the surfaces, their morphology, and the tribological and corrosion properties. The structural properties, phase and chemical composition of the coating, tribological and corrosion properties were studied in detail using SEM, EDX, XRD, XPS and EDX analysis. The particles released during tribological measurements were evaluated using SEM/EDX particle analysis followed by statistical treatment of the particle parameters (material, size, area) using multiple factor analysis and principal component analysis. The results show that increased wear resistance was achieved for both magnetron-sputtered layers and bulk materials. The friction coefficient for the MAO-Al 2 O 3 friction pair samples ranged from 0.5 to 0.6 in phosphate-buffered solution. For powder metallurgy-prepared bulk β-Ti39Nb, MAO represents an effective tool to reduce the high friction coefficient from 1.0 to 1.1 to values of 0.4–0.5. The results of the particle analysis confirm that with increasing MAO process time, there is an increase in the number of released particles with increased Si content, which correlates well with the results of tribological tests. The evaluated tribological parameters wear rate, track width, and the chemical elements Si and Ti have a significant weak positive correlation, confirming that the presence of these elements in MAO coatings affects the resulting tribological parameters. Multivariate analysis revealed the greatest correlation of the resulting particle composition with the tribological attributes and original material and, to a lesser extent, with the process time. • β-Ti39Nb alloy and magnetron sputtered Ti39Nb layer were modified by MAO technique. • Better abrasion and corrosion resistance were achieved after the application of MAO. • Particle analysis results were analysed by multivariate statistical methods. [ABSTRACT FROM AUTHOR]

Objective Google is the most popular search engine, with about 100 billion searches per month. Google Trends is an integrated tool that allows users to obtain Google's search popularity statistics from the last decade. Our aim was to evaluate whether Google Trends is a useful tool to assess the public's interest in specific neurosurgical topics. Methods We evaluated Google Trends statistics for the neurosurgical search topic areas “hydrocephalus,” “spinal stenosis,” “concussion,” “vestibular schwannoma,” and “cerebral arteriovenous malformation.” We compared these with bibliometric data from PubMed and epidemiologic data from the German Federal Monitoring Agency. In addition, we assessed Google users' search behavior for the search terms “glioblastoma” and “meningioma.” Results Over the last 10 years, there has been an increasing interest in the topic “concussion” from Internet users in general and scientists. “Spinal stenosis,” “concussion,” and “vestibular schwannoma” are topics that are of special interest in high-income countries (eg, Germany), whereas “hydrocephalus” is a popular topic in low- and middle-income countries. The Google-defined top searches within these topic areas revealed more detail about people's interests (eg, “normal pressure hydrocephalus” or “football concussion” ranked among the most popular search queries within the corresponding topics). There was a similar volume of queries for “glioblastoma” and “meningioma.” Conclusions Google Trends is a useful source to elicit information about general trends in peoples' health interests and the role of different diseases across the world. The Internet presence of neurosurgical units and surgeons can be guided by online users' interests to achieve high-quality, professional-endorsed patient education. [ABSTRACT FROM AUTHOR]

Abstract: To compare the association of smoking with age-related macular degeneration (AMD) in the Muenster Aging and Retina Study (MARS) cohort with current evidence. Adjusted risk ratios for incident AMD in MARS were compared with findings of a systematic review and meta-analysis of observational prospective studies. 9.6% of MARS participants progressed to AMD over a median of 30.9 months. In MARS the adjusted risk ratio in current versus never smokers was 3.25 (95% confidence interval [1.50–7.06]), and 1.28 [0.70–2.33] in former smokers versus never smokers. The meta-analysis of previous studies showed a pooled adjusted risk ratio of 2.51 [1.09–5.76] in current versus never smokers. Inclusion of the MARS findings removed between-study heterogeneity and accentuated the pooled adjusted risk ratio for current smokers to 2.75 [1.52–4.98]. Specific analyses in MARS revealed a protective effect for time since smoking cessation in former smokers with an adjusted risk ratio=0.50 [0.29–0.89] per log(year). Current smoking nearly triples AMD incidence, while smoking cessation lowers AMD incidence in a non-linear fashion even in the elderly. [Copyright &y& Elsevier]