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F S Santos, E C Sousa Junior, S F S Guerra, P S Lobo, E T Penha Junior, A B F Lima, C B G Vinente, E H N Chagas, M C A Justino, A C Linhares, J Matthijnssens, L S Soares, J D P Mascarenhas
Worldwide rotaviruses A (RVA) are responsible for approximately 215,000 deaths annually among children aged <5 years. RVA G1P[8] remains associated with >50% of gastroenteritis cases in this age group. The aim of this study was to assess the genetic variability of G1P[8] strains detected in children with severe diarrhea in Belém, Pará, Brazil, during the post-rotavirus vaccine introduction era. Phylogenetic analysis clustered the VP4 and VP7 genes of 40 samples selected between 2009 and 2011 into lineages found to be different from the Rotarix® vaccine strain...
February 11, 2019: Infection, Genetics and Evolution
Marta Olivé-Gadea, Manuel Requena, Elena Fonseca Hernández, Manuel Quintana, Estevo Santamarina, Laura Abraira Del Fresno, Jose Álvarez-Sabín, Xavier Salas-Puig, Manuel Toledo
Epileptic seizures are a common reason for emergency department (ED) admittance. We aimed to describe the etiological distribution of epileptic seizures and the relationships between etiology and semiology in patients admitted to the emergency room, and to identify early prognostic factors for recurrence and mortality. METHODS: A retrospective observational study was conducted in adult patients consecutively attended in the emergency room with epileptic seizures over a 2-year period. We recorded data on the etiological and syndromic classification of the seizure, and on recurrence and mortality at 1 year of follow-up...
February 11, 2019: Epilepsy & Behavior: E&B
Yao Xiong, Kenneth C Bedi, Simon Berritt, Thomas G Brooks, Bennette K Attipoe, Kevin Wang, Kenneth B Margulies, Jeffrey Field
About one-third of dilated cardiomyopathy (DCM) cases are caused by mutations in sarcomere or cytoskeletal proteins. Yet treating the cytoskeleton directly is not possible because drugs that bind to actin are not well tolerated. Mutations in the actin binding protein CAP2 can cause DCM and knockout mice, either whole body (CAP2 KO) or cardiomyocyte-specific knockouts (CAP2 CKO), develop DCM with cardiac conduction disease. RNA-seq analysis of CAP2 KO hearts and isolated cardiomyocytes revealed over-activation of fetal genes including serum response factor (SRF) regulated genes such as Myl9 and Acta2 prior to the emergence of cardiac disease...
February 14, 2019: JCI Insight
Roberto Fariña-Castro, Cristina Roque-Castellano, Manuel Artiles-Armas, Joaquín Marchena-Gómez
AIM: The number of nonagenarians undergoing surgery has increased considerably in recent decades as a result of population aging. Greater knowledge of the most influential factors affecting perioperative morbidity and mortality would improve the quality of care and provision of health resources for these patients. The objective of the present study was to analyze the perioperative mortality, and its most determinant factors, among nonagenarian patients who underwent a surgical procedure in the Department of General and Digestive Surgery...
February 13, 2019: Geriatrics & Gerontology International
Mohanad Soliman, William Fuller, Nida Usmani, Olalekan Akanbi
Hyponatremia is a serious health problem and can cause substantial morbidity and mortality as a result of osmotically induced cerebral edema if left untreated. Also, inappropriate rapid correction of chronic cases of hyponatremia can lead to osmotic demyelination with neurological impairment and death as consequences. It is defined as a serum sodium concentration less than 135 mmol/L. Herbal detox regimens are gaining popularity with their easy access over the counter and not well studied adverse effects. We hereby present a case of a 67-year-old man who developed severe hyponatremia after starting a five-day kidney detox regime...
December 6, 2018: Curēus
Tetsuo Tsukamoto
HIV-1 causes the loss of CD4+ T cells via depletion or impairment of their production. The latter involves infection of thymocytes, but the involvement of hematopoietic CD34+ cells remains unclear even though HIV-positive patients frequently manifest myelosuppression. In order to have a closer look at the impact of HIV-1 on T-lineage differentiation, this study utilized the OP9-DL1 coculture system, which supports in vitro T-lineage differentiation of human hematopoietic stem/progenitor cells. In the newly developed in vitro OP9-DL1/HIV-1 model, cord-derived CD34+ cells were infected with CXCR4-tropic HIV-1NL4-3 and cocultured...
2019: Frontiers in Immunology
Marita Chakhtoura, Robert W Chain, Priscila Y Sato, Connie C Qiu, Michael H Lee, Joseph J Meissler, Toby K Eisenstein, Walter J Koch, Roberto Caricchio, Stefania Gallucci
Attenuating the innate immunity activation could ameliorate inflammation and disease in settings such as transplant rejection or autoimmunity. Recently, a pivotal role for metabolic re-programming in TLR-induced dendritic cell (DC) activation has emerged. Ethyl pyruvate (EP), a pyruvate derivative, possesses anti-inflammatory properties in vitro and in animal models of disease. However, its effects on DCs remain elusive. We found that EP attenuated LPS-induced activation of murine GM-CSF bone marrow-derived dendritic cells (DCs) in vitro , reducing pro-inflammatory cytokine and IL-10 production, costimulatory molecule and MHC expression, the type I Interferon (IFN-I) response, the LPS-induced cell death, and the ability of DCs to stimulate allogeneic T cells...
2019: Frontiers in Immunology
Julian R Garneau, Claire Nour Abou Chakra, Louis-Charles Fortier, Annie-Claude Labbé, Andrew E Simor, Wayne Gold, Matthew Muller, Allison McGeer, Jeff Powis, Kevin Katz, Jacques Pépin, Louis Valiquette
The epidemiology of Clostridioides difficile infection (CDI) has drastically changed since the emergence of the epidemic strain BI/NAP1/027, also known as ribotype 027 (R027). However, the relationship between the infecting C. difficile strain and clinical outcomes is still debated. We hypothesized that certain subpopulations of R027 isolates could be associated with unfavorable outcomes. We applied high-resolution multilocus variable-number tandem-repeat analysis (MLVA) to characterize C. difficile R027 isolates collected from confirmed CDI patients recruited across 10 Canadian hospitals from 2005 to 2008...
February 13, 2019: Journal of Clinical Microbiology
Callum P Rakhit, Ricky M Trigg, John Le Quesne, Michael Kelly, Jacqueline A Shaw, Catrin Pritchard, L Miguel Martins
Lung cancer is the leading cause of cancer-related death. Two-thirds of cases are diagnosed at an advanced stage that is refractory to curative treatment. Therefore, strategies for the early detection of lung cancer are urgently sought. Total circulating free DNA (cfDNA) and tumour-derived circulating tumour DNA (ctDNA) are emerging as important biomarkers within a 'liquid biopsy' for monitoring human disease progression and response to therapy. Owing to the late clinical diagnosis of lung adenocarcinoma, the potential for cfDNA and ctDNA as early detection biomarkers remains unexplored...
February 12, 2019: Disease Models & Mechanisms
Harshada Ketkar, Daniella Herman, Penghua Wang
Mosquito-borne diseases constitute a large portion of infectious diseases, causing more than 700,000 deaths annually. Mosquito-transmitted viruses, such as yellow fever, dengue, West Nile, chikungunya, and Zika viruses, have re-emerged recently and remain a public health threat worldwide. Global climate change, rapid urbanization, burgeoning international travel, expansion of mosquito populations, vector competence, and host and viral genetics may all together contribute to the re-emergence of arboviruses. In this brief review, we summarize the host and viral genetic determinants that may enhance infectivity in the host, viral fitness in mosquitoes and viral transmission by mosquitoes...
February 12, 2019: Viruses
Stefan W Ryter, Ivan O Rosas, Caroline A Owen, Fernando J Martinez, Mary E Choi, Chun Geun Lee, Jack A Elias, Augustine M K Choi
The mechanisms underlying the pathogenesis of chronic lung diseases, including chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis, remain incompletely understood. Mitochondria are vital cellular organelles crucial for energy generation, the maintenance of cellular metabolism, calcium homeostasis, intracellular signaling, and the regulation of cell death programs. Emerging evidence suggests that mitochondrial dysfunction plays a cardinal role in the initiation and progression of many human diseases, including chronic lung diseases...
December 2018: Annals of the American Thoracic Society
Alessandro Aprato, Alessandro Casiraghi, Giovanni Pesenti, Marco Bechis, Alessandro Samuelly, Claudio Galante, Dario Capitani, Alessandro Massè
BACKGROUND: In the last 10 years, the rate of femur fractures treated within 48 h from trauma has been introduced as a performance index for hospital management in Italy. Literature showed a significant indirect correlation between early treatment and mortality/comorbidity. The aims of early treatment are pain management and reduction of time to ambulation. The purpose of this study is to evaluate whether early treatment has reduced time to ambulation in femur fracture. MATERIALS AND METHODS: All patients admitted to two level I trauma centers with proximal femoral fracture between 1/1/2017 and 31/12/2017 were included in this study...
February 13, 2019: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Katherine Anne Comtois, Amanda H Kerbrat, Christopher R DeCou, David C Atkins, Justine J Majeres, Justin C Baker, Richard K Ries
Importance: Accessible and cost-effective interventions for suicidality are needed to address high rates of suicidal behavior among military service members. Caring Contacts are brief periodic messages that express unconditional care and concern and have been previously shown to prevent suicide deaths, attempts, ideation, and hospitalizations. Objective: To test the effectiveness of augmenting standard military health care with Caring Contacts delivered via text message to reduce suicidal thoughts and behaviors over 12 months...
February 13, 2019: JAMA Psychiatry
Zoe Lysy, Kinwah Fung, Vasily Giannakeas, Hadas D Fischer, Chaim M Bell, Lorraine L Lipscombe
BACKGROUND: Starting insulin therapy in hospitalized patients may be associated with an increase in serious adverse events after discharge. OBJECTIVE: Determine whether post-discharge risks of death and rehospitalization are higher for older hospitalized patients prescribed new insulin therapy compared with oral hypoglycemic agents (OHAs). DESIGN: Retrospective population-based cohort study including hospital admissions in Ontario, Canada, between April 1, 2004, and Nov 30, 2013...
February 12, 2019: Journal of General Internal Medicine
M K Khan, M N Islam, J Ferdous, M M Alam
Tuberculosis (TB) is a progressive granulomatous infectious disease caused by the gram positive, acid fast bacilli classified under the genus Mycobacterium. Tuberculosis in human is mostly by Mycobacterium tuberculosis and primarily affects lungs causing pulmonary tuberculosis. It can also affect intestine, meninges, bones, joints, lymph nodes, skin and other tissues of the body causing extra-pulmonary tuberculosis. Human TB is transmitted mainly through droplet infection and droplet nuclei. Infection of human with M...
January 2019: Mymensingh Medical Journal: MMJ
Kelly Thompson, Balasubramanian Venkatesh, Simon Finfer
Sepsis, defined as life-threatening organ dysfunction due to a dysregulated host response to infection, is recognised by the World Health Organization as a global health priority. Each year, 5000 of the 18 000 adults with sepsis treated in Australian intensive care units die, with survivors suffering long-term physical, cognitive and psychological dysfunction, which is poorly recognised and frequently untreated. There are currently no effective pharmacological treatments for sepsis, making early recognition, resuscitation and immediate treatment with appropriate antibiotics the key to reducing the burden of resulting disease...
February 2019: Internal Medicine Journal
Venice Du Pont, Richard K Plemper, Matthias J Schnell
Rabies virus (RABV) constitutes a major social and economic burden associated with 60 000 deaths annually worldwide. Although pre-exposure and post-exposure treatment options are available, they are efficacious only when initiated before the onset of clinical symptoms. Aggravating the problem, the current RABV vaccine does not cross-protect against the emerging zoonotic phylogroup II lyssaviruses. A requirement for an uninterrupted cold chain and high cost of the immunoglobulin component of rabies prophylaxis generate an unmet need for the development of RABV-specific antivirals...
February 9, 2019: Current Opinion in Virology
Harel Gilutz, Sevatlana Shindel, Ilana Shoham-Vardi
BACKGROUND: Adherence to guidelines for the initial treatment of ST-Segment Elevation Myocardial Infarction has been thoroughly studied, whereas the study of emergency department (ED) adherence to guidelines for Non-ST-Segment Elevation Myocardial Infarction-Acute Coronary Syndrome (NSTEMI-ACS) has been much scarcer. The recommended guidelines for the initial prompt workup and treatment of NSTEMI-ACS remains a challenge. AIM: We studied adherence to guidelines for NSTEMI in the ED...
March 2019: Critical Pathways in Cardiology
Troy Madsen, Rachelle Perkins, Brennen Holt, Margaret Carlson, Jacob Steenblik, Philip Bossart, Stephen Hartsell
BACKGROUND: Although some emergency department observation units (EDOUs) may exclude patients over 65 years old, our EDOU accepts patients up to 79 years old. We assessed the utilization of our EDOU by older patients (those 65-79 years old). METHODS: We prospectively enrolled emergency department (ED) patients with chest pain. We gathered baseline data at the time of ED presentation and tracked outcomes related to the ED stay, EDOU, and/or inpatient admission. Our primary outcome included EDOU placement among older patients...
March 2019: Critical Pathways in Cardiology
Chadwick D Miller, Jason P Stopyra, Simon A Mahler, L Doug Case, Sujethra Vasu, Ronny A Bell, W Gregory Hundley
BACKGROUND: Patients from racial and ethnic minority groups presenting to the Emergency Department (ED) with chest pain experience lower odds of receiving stress testing compared with nonminorities. Studies have demonstrated that care pathways administered within the ED can reduce health disparities, but this has yet to be studied as a strategy to increase stress testing equity. METHODS: A secondary analysis from 3 randomized clinical trials involving ED patients with acute chest pain was performed to determine whether a care pathway, ACES (Accelerated Chest pain Evaluation with Stress imaging), reduces the racial disparity in index visit cardiac testing between African American (AA) and White patients...
March 2019: Critical Pathways in Cardiology
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