Background and Aims Intestinal microbiota dysbiosis is implicated in Crohn’s disease [CD] and may play an important role in triggering postoperative disease recurrence [POR]. We prospectively studied faecal and mucosal microbial recolonisation following ileocaecal resection to identify the predictive value of recurrence-related microbiota. Methods Mucosal and/or faecal samples from 121 CD patients undergoing ileocaecal resection were collected at predefined time points before and after surgery. Ileal biopsies were collected from 39 healthy controls. POR was defined by a Rutgeerts score ≥i2b. The microbiota was evaluated by 16S rRNA sequencing. Prediction analysis was performed using C5.0 and Random Forest algorithms. Results The mucosa-associated microbiota in CD patients was characterised by a depletion of butyrate-producing species (false discovery rate [FDR] <0.01) and enrichment of Proteobacteria [FDR = 0.009] and Akkermansia spp. [FDR = 0.02]. Following resection, a mucosal enrichment of Lachnospiraceae [FDR <0.001] was seen in all patients but in POR patients, also Fusobacteriaceae [FDR <0.001] increased compared with baseline. Patients without POR showed a decrease of Streptococcaceae [FDR = 0.003] and Actinomycineae [FDR = 0.06]. The mucosa-associated microbiota profile had good discriminative power to predict POR, and was superior to clinical risk factors. At Month 6, patients experiencing POR had a higher abundance of taxa belonging to Negativicutes [FDR = 0.04] and Fusobacteria [FDR = 0.04] compared with patients without POR. Conclusions Microbiota recolonisation after ileocaecal resection is different between recurrence and non-recurrence patients, with Fusobacteria as the most prominent player driving early POR. These bacteria involved in the early recolonisation and POR represent a promising therapeutic strategy in the prevention of disease recurrence.

In response to the coronavirus disease 2019 (COVID-19) pandemic, Swiss health authorities approved and ordered two mRNA vaccines in 2021. The canton of Zurich was the second in Switzerland to allow community pharmacists to administer the COVID-19 mRNA Vaccine Moderna to the adult population. We aimed to pilot a customer satisfaction questionnaire regarding COVID-19 vaccinations in Zurich pharmacies. Questions focused on satisfaction with different aspects of the service, motivation for getting the vaccination, and reasons for being vaccinated in a pharmacy. Zurich pharmacies administered 68,169 COVID-19 doses until June 2021, and 421 questionnaires were filled. Respondents’ mean age was 43.5 (±13.2) years, with 42.3% reporting being women and 46.1% being men. Of the 372 complete questionnaires, 98.7% of the respondents would have recommended the service to others. High levels of satisfaction were reported concerning pre-vaccination discussion (98.9%), pharmacies’ information level on COVID-19 vaccines (98.9%), general comfort with receiving the vaccination in a pharmacy (99.5%), injection technique (99.2%), and premises used (98.1%). Most respondents (57.3%) would have had the option of another vaccination provider, but the pharmacies were chosen for their opening hours, ease of access, and perceived trust. The availability of pharmacist-administered services may be an important contributor to a successful vaccination programme in Switzerland.

Purpose: To compare the healing and clinical outcomes of anterior cruciate ligament (ACL) reconstruction between patients with or without intraoperative administration of adipose-derived regenerative stem cells (ADRC). Methods: Between 2013 and 2014, the outcomes of 20 soccer players undergoing ACL reconstruction using bone–patellar tendon–bone autograft infiltrated with ADRC at the end of the procedure were compared to a historical, matched cohort of 19 soccer players undergoing the same procedure without ADRC. Outcomes were obtained at baseline, and 6 and 12 months postop for IKDC (International Knee Documentation Committee), Lysholm, and Lequesne, and at 2, 4, 6, and 12 months postop for VAS (visual analogue scale) for pain and graft maturation to evaluate the ligamentization process (magnetic resonance imaging (MRI)-based). Results: Both groups significantly improved the IKDC ( p < 0.001 in both groups), Lysholm ( p < 0.001 in both groups), Lequesne index ( p < 0.001 in both groups), VAS for pain ( p = 0.002 for the ADRC and p < 0.001 for the control group), and MRI scores ( p < 0.001 in both groups) in the 12 months postop compared to baseline scores. However, there were no significant differences in the improvement of the outcomes between groups across time ( p > 0.05). All patients returned to sports after surgery, but 8 (40%) patients in the ADRC and 13 (68.4%) patients in the control group had lower Tegner activity score at 12 months postop. Conclusions: Patients receiving ADRC at the time of ACL reconstruction significantly improved knee function and healing/maturation of the graft at 12 months. However, this improvement was not statistically significant compared to a control group undergoing ACL reconstruction alone.

BackgroundMuscle injuries are one of the main daily problems in sports medicine, football in particular. However, we do not have reliable means to predict the outcome, i.e. return to play (RTP) from severe injury. The aim of the present study was to evaluate the capability of the MLG-R classification system to grade hamstring muscle injuries by severity, offer a prognosis for the RTP, and identify injuries with higher risk of reinjury. And to assess the consistency of our proposed system by investigating its intra-and inter-observer reliability. MethodsAll male professional football players from FC Barcelona (FCB)-senior A and B and the two U-19 teams-with injuries occurred between February 2010 and February 2020 were reviewed. Only players with clinical presentation of hamstring muscle injury, with complete clinic information and magnetic resonance images (MRI), were included. Three different statistical and machine learning approaches (linear regression, random forest, and XGBoost) were used to assess the importance of each factor of the MLG-R classification system in determining the RTP as well as to offer a prediction of the expected RTP. We used the Cohen's kappa and the intraclass correlation coefficient (ICC) to assess the intra-and interobserver reliability. ResultsBetween 2010 and 2020, 76 hamstring injuries corresponding to 42 different players were identified, of which 50 (65.8%) were Grade 3 r , 54 (71.1%) affected the biceps femoris long head (BFlh), and 33 of the 76 (43.4%) were located at the proximal myotendinous junction (MTJ). The mean RTP for Grade 2, 3, and 3 r injuries were 14.3, 12.4, and 37 days, respectively. Injuries affecting the proximal MTJ had a mean RTP of 31.7 days while those affecting the distal part of the MTJ had a mean RTP of 23.9 days. The analysis of the grade 3r BFlh injuries located at the FT showed a median RTP time of 56 days while the injuries located at the central tendon had a shorter RTP of 24 days (p=0.038). The statistical analysis showed an excellent predictive power of the MLG-R classification system with a mean absolute error of 9.8 days and an R-squared of 0.48. The most important factors to determine the RTP were if the injury was at the free tendon (FT) of the BFlh or if it was a Grade 3 r injury. For all the items of the MLG-R classification the intra-and inter-observer reliability was excellent (k > 0.93) except for fibers blurring (κ = 0.68). ConclusionThe main determinant for long RTP after hamstring injury is the injury affecting the connective tissue structures of the hamstring.We developed a reliable hamstring muscle injury classification system based on MRI that showed excellent results in terms of reliability, prognosis capability and objectivity. It is easy to use in clinical 2 daily practice, and can be further adapted to future knowledge. The adoption of this system by the medical community would allow to uniform diagnosis leading to better injury management.

Background: Healthy plant-based diets rich in fermentable residues may induce gas-related symptoms. Our aim was to determine the potential of a fermented milk product with probiotics in improving digestive comfort with such diets. Methods: In an open design, a 3-day high-residue diet was administered to healthy subjects (n = 74 included, n = 63 completed) before and following 28 days consumption of a fermented milk product (FMP) containing Bifidobacterium animalis subsp. lactis CNCM I-2494 and lactic acid bacteria. Main outcomes: digestive sensations, number of daytime anal gas evacuations, and gas volume evacuated during 4 h after a probe meal. Results: As compared to the habitual diet, the high-residue diet induced gas-related symptoms (flatulence score 4.9 vs. 1.2; p ≤ 0.0001), increased the daily number of anal gas evacuations (20.7 vs. 8.7; p < 0.0001), and impaired digestive well-being (1.0 vs. 3.4; p < 0.05). FMP consumption reduced flatulence sensation (by −1.7 [−1.9; −1.6]; p < 0.0001), reduced the number of daily evacuations (by −5.8 [−6.5; −5.1]; p < 0.0001), and improved digestive well-being (by +0.6 [+0.4; +0.7]; p < 0.05). FMP consumption did not affect the gas volume evacuated after a probe meal. Conclusion: In healthy subjects, consumption of a FMP containing B. lactis CNCM I-2494 and lactic acid bacteria improves the tolerance of a flatulogenic diet by subjective and objective criteria (sensations and number of anal gas evacuations, respectively).