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Major Emergency

Hans R Gelderblom, Dick Madeley
Diagnostic electron microscopy (DEM) was an essential component of viral diagnosis until the development of highly sensitive nucleic acid amplification techniques (NAT). The simple negative staining technique of DEM was applied widely to smallpox diagnosis until the world-wide eradication of the human-specific pathogen in 1980. Since then, the threat of smallpox re-emerging through laboratory escape, molecular manipulation, synthetic biology or bioterrorism has not totally disappeared and would be a major problem in an unvaccinated population...
March 22, 2018: Viruses
Siavash Piran, Caroline Gabriel, Sam Schulman
Direct oral factor Xa (FXa) inhibitors are widely used for anticoagulation but a targeted antidote is not available. Four-factor prothrombin complex concentrate (4FPCC) has been shown in observational studies to support hemostasis in most patients with major bleeding related to FXa inhibitors with an acceptable rate of thromboembolic events. However, the effectiveness of 4FPCC for reversal of FXa inhibitors prior to emergency surgery or invasive procedures is unclear. A retrospective chart review was performed in patients that received 4FPCC at Hamilton General Hospital from 2015 to 2017...
March 21, 2018: Journal of Thrombosis and Thrombolysis
Beverley Kok, Erica L W Lester, William M Lee, A James Hanje, R Todd Stravitz, Safwat Girgis, Vaishali Patel, Joshua R Peck, Christopher Esber, Constantine J Karvellas
BACKGROUND: Tumor necrosis factor-α antagonists (anti-TNF-α) have been associated with drug-induced liver injury. However, cases of anti-TNF-α-associated acute liver failure have only been rarely reported. AIMS: To identify cases of anti-TNF-α-associated acute liver failure and evaluate patterns of liver injury and common characteristics to the cases. METHODS: The United States Acute Liver Failure Study Group database was searched from 1998 to 2014...
March 21, 2018: Digestive Diseases and Sciences
João Cruz, Vasco Mascarenhas
Muscle injuries are one of the major problems facing elite athletes, representing a significant source of time lost from competition, with substantial consequences for teams and athletes. There are considerable pressures for a rapid return, but players who return to competition too soon have an increased risk of recurrent muscle injuries, which are associated with longer lay-offs. Imaging plays a key role in achieving the correct diagnosis, and magnetic resonance imaging (MRI) has emerged as the method of choice for skeletal muscle imaging...
March 21, 2018: Skeletal Radiology
Xuan Qin, Chuan Zhou, Danielle M Zerr, Amanda Adler, Amin Addetia, Shuhua Yuan, Alexander L Greninger
Clinical isolates of Pseudomonas aeruginosa from patients with cystic fibrosis (CF) are known to differ from those associated with non-CF hosts by colony morphology, drug susceptibility patterns, and genomic hypermutability. Pseudomonas aeruginosa isolates from CF patients have long been recognized for their overall reduced rate of antimicrobial susceptibility, but their intraclonal MIC heterogeneity has long been overlooked. Using two distinct cohorts of clinical strains ( n = 224 from 56 CF patients, n = 130 from 68 non-CF patients) isolated in 2013, we demonstrated profound Etest MIC heterogeneity in CF P...
March 2018: MSphere
Sophia Lazar, Lawrence E Goldfinger
Platelet-derived microparticles (PMPs) have long been known to increase in circulation in the presence of cancer, and have been considered to be cancer promoting by multiple mechanisms including shrouding of circulating tumor cells allowing immune evasion, inducing a procoagulant state associated with increased risk for venous thromboembolic events in cancer patients, and supporting metastatic dissemination by establishment of niches for anchorage of circulating tumor cells. These modes of PMP-enhanced progression of late stage cancer are generally based on the adhesive and procoagulant surfaces of PMPs...
2018: Frontiers in Cardiovascular Medicine
Nischala Ammannagari, Ajlan Atasoy
Gastroesophageal (GE) cancers continue to be a significant cause of mortality globally. Despite therapeutic advances in oncology, the prognosis of advanced GE cancer remains exceedingly poor. Immunotherapy has caused a major paradigm shift in the field of oncology. Not all patients benefit from these agents and several studies are trying to identify predictive and prognostic biomarkers to better inform and guide treatment decisions. The potential role of immunotherapy in GE cancers is emerging. These cancer types are molecularly and immunologically heterogeneous, and this heterogeneity influences the tumor microenvironment posing a significant challenge to studying biomarkers of response to immunotherapy...
February 2018: Journal of Gastrointestinal Oncology
Stephanie M Topp, Anjali Sharma, Clement N Moonga, Chisele Chileshe, George Magwende, German Henostroza
Introduction: In 2013, the Zambian Correctional Service (ZCS) partnered with the Centre for Infectious Disease Research in Zambia on the Zambian Prisons Health System Strengthening project, seeking to tackle structural, organisational and cultural weaknesses within the prison health system. We present findings from a nested evaluation of the project impact on high, mid-level and facility-level health governance and health service arrangements in the Zambian Correctional Service. Methods: Mixed methods were used, including document review, indepth interviews with ministry (11) and prison facility (6) officials, focus group discussions (12) with male and female inmates in six of the eleven intervention prisons, and participant observation during project workshops and meetings...
2018: BMJ Global Health
Federico Coccolini, Yoram Kluger, Luca Ansaloni, Ernest E Moore, Raul Coimbra, Gustavo P Fraga, Andrew Kirkpatrick, Andrew Peitzman, Ron Maier, Gianluca Baiocchi, Vanni Agnoletti, Emiliano Gamberini, Ari Leppaniemi, Rao Ivatury, Michael Sugrue, Massimo Sartelli, Salomone Di Saverio, Walt Biffl, Fausto Catena
Optimal management of emergency surgical patients represents one of the major health challenges worldwide. Emergency general surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and non-traumatic acute conditions during the same admission in the hospital. EGS represents the easiest viable way to provide affordable and high-quality level of care to emergency surgical and trauma patients. It may result from the association of different physicians with other specialties in a cooperative model...
2018: World Journal of Emergency Surgery: WJES
Yari Gvion, Yossi Levi-Belz
Background: One of the main obstacles in studying suicide risk factors is the difference between cases in which the individual died by suicide and those in which the individual engaged in suicidal behavior. A promising strategy that overcomes this obstacle is the study of survivors of serious suicide attempt (SSA), i.e., an attempt that would have been lethal had it not been for the provision of rapid and effective emergency treatment. Serious suicide attempters are epidemiologically very much like those who died by suicide, and thus may serve as valid proxies for studying suicides...
2018: Frontiers in Psychiatry
Kornelius Zeth, Ulrich Zachariae
Mitochondria are evolutionarily related to Gram-negative bacteria and both comprise two membrane systems with strongly differing protein composition. The major protein in the outer membrane of mitochondria is the voltage-dependent anion channel (VDAC), which mediates signal transmission across the outer membrane but also the exchange of metabolites, most importantly ADP and ATP. More than 30 years after its discovery three identical high-resolution structures were determined in 2008. These structures show a 19-stranded anti-parallel beta-barrel with an N-terminal helix located inside...
2018: Frontiers in Physiology
Sari A Mahasneh, Adel M Mahasneh
Probiotics have a role in maintaining oral health through interaction with oral microbiome, thus contributing to healthy microbial equilibrium. The nature and composition of any individual microbiome impacts the general health, being a major contributor to oral health. The emergence of drug resistance and the side effects of available antimicrobials have restricted their use in an array of prophylactic options. Indeed, some new strategies to prevent oral diseases are based on manipulating oral microbiota, which is provided by probiotics...
September 27, 2017: Dent J (Basel)
Ting-Chao Lin, Tse-Min Lu, Feng-Chyn Huang, Pai-Feng Hsu, Chun-Che Shih, Shing-Jong Lin, Chiao-Po Hsu
Percutaneous coronary intervention (PCI) has emerged as an alternative treatment to coronary artery bypass grafting (CABG) in patients with unprotected left main coronary artery disease (ULMCAD). However, the optimal treatment for ULMCAD concomitant with chronic kidney disease (CKD) was rarely addressed. Herein, we compare the long-term outcomes of these patients treated with CABG or PCI.From January 2004 to December 2010, 185 patients with ULMCAD and CKD undergoing PCI (n = 84) or CABG (n = 101) were matched for the selection criteria...
March 20, 2018: International Heart Journal
Tao Yang, David F Meoli, Javid Moslehi, Dan M Roden
While inhibition of phosphoinositide 3-kinase (PI3K) is an emerging strategy in cancer therapy, we and others have reported that this action can also contribute to drug-induced Q-T prolongation and arrhythmias by increasing cardiac late sodium current (INaL). Previous studies in mice implicate the PI3K-α isoform as the major effector of the INaL action. Here, we have determined the effects of new anticancer drugs targeting specific PI3K isoforms on INaL and action potentials (APs) in mouse cardiomyocytes and CHO cells...
March 21, 2018: Journal of Pharmacology and Experimental Therapeutics
Chuansong Quan, Weifeng Shi, Yang Yang, Yongchun Yang, Xiaoqing Liu, Wen Xu, Hong Li, Juan Li, Qianli Wang, Zhou Tong, Gary Wong, Cheng Zhang, Sufang Ma, Zhenghai Ma, Guanghua Fu, Zewu Zhang, Yu Huang, Houhui Song, Liuqing Yang, William J Liu, Yingxia Liu, Wenjun Liu, George F Gao, Yuhai Bi
H7N9 virus has caused five infection waves since it emerged in 2013. The highest number of human cases was seen in Wave Five; however, the underlying reasons have not been thoroughly elucidated. In this study, the geographical distribution, phylogeny and genetic evolution of 240 H7N9 viruses in Wave Five, including 35 new isolates from patients and poultry in nine provinces, were comprehensively analyzed together with strains from first four waves. Geographical distribution analysis displayed the newly-emerging highly pathogenic (HP) and low pathogenic (LP) H7N9 viruses were co-circulating, causing human and poultry infections across China...
March 21, 2018: Journal of Virology
Shao-Hua Wang, Ao Wang, Pan-Pan Liu, Wen-Yan Zhang, Juan Du, Shuang Xu, Guan-Chen Liu, Bai-Song Zheng, Chen Huan, Ke Zhao, Xiao-Fang Yu
Coxsackievirus A6 (CV-A6) is an emerging pathogen associated with hand, foot, and mouth disease (HFMD). Its genetic characterization and pathogenic properties are largely unknown. Here, we report 39 circulating CV-A6 strains isolated in 2013 from HFMD patients in Northeast China. Three major clusters of CV-A6 were identified and related to CV-A6 mostly from Shanghai, indicating that domestic CV-A6 strains were responsible for HFMD emerging in Northeast China. Four full-length CV-A6 genomes representing each cluster were sequenced and analyzed further...
March 21, 2018: Journal of Virology
Almudena Cascajero, Alberto Rastrojo, Francisco Díez-Fuertes, Beatriz Hernández-Novoa, Begoña Aguado, Santiago Moreno, José Alcami, Mayte Pérez-Olmeda
In this study we have characterized quasispecies dynamics and the evolution of viral tropism in naive HIV-1-infected patients treated with a short-course of maraviroc monotherapy (NCT01060618) independently of their tropism. We randomly selected 20 patients displaying different basal tropism -10 R5 and 10 DMX4- at recruitment as determined by phenotypic tests (Trofile® ). Evolution of viral quasiespecies at the end of treatment was determined by ultra-deep sequencing of the V3 region using a 454 Life Sciences Platform and geno2pheno (g2p) algorithm for viral tropism prediction...
March 21, 2018: Journal of Virology
William M Vanderheyden, Miranda M Lim, Erik S Musiek, Jason R Gerstner
Sleep-wake abnormalities are common in patients with Alzheimer's disease, and can be a major reason for institutionalization. However, an emerging concept is that these sleep-wake disturbances are part of the causal pathway accelerating the neurodegenerative process. Recently, new findings have provided intriguing evidence for a positive feedback loop between sleep-wake dysfunction and β-amyloid (Aβ) aggregation. Studies in both humans and animal models have shown that extended periods of wakefulness increase Aβ levels and aggregation, and accumulation of Aβ causes fragmentation of sleep...
March 21, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Terdsak Yano, Somphorn Phornwisetsirikun, Patipat Susumpow, Surasing Visrutaratna, Karoon Chanachai, Polawat Phetra, Warangkhana Chaisowwong, Pairat Trakarnsirinont, Phonpat Hemwan, Boontuan Kaewpinta, Charuk Singhapreecha, Khwanchai Kreausukon, Arisara Charoenpanyanet, Chongchit Sripun Robert, Lamar Robert, Pranee Rodtian, Suteerat Mahasing, Ekkachai Laiya, Sakulrat Pattamakaew, Taweesart Tankitiyanon, Chalutwan Sansamur, Lertrak Srikitjakarn
BACKGROUND: Aiming for early disease detection and prompt outbreak control, digital technology with a participatory One Health approach was used to create a novel disease surveillance system called Participatory One Health Disease Detection (PODD). PODD is a community-owned surveillance system that collects data from volunteer reporters; identifies disease outbreak automatically; and notifies the local governments (LGs), surrounding villages, and relevant authorities. This system provides a direct and immediate benefit to the communities by empowering them to protect themselves...
March 21, 2018: JMIR Public Health and Surveillance
Daniel Hormaechea-Agulla, Youngjo Kim, Min Sup Song, Su Jung Song
Intracellular communication via ubiquitin (Ub) signaling impacts all aspects of cell biology and regulates pathways critical to human development and viability; therefore aberrations or defects in Ub signaling can contribute to the pathogenesis of human diseases. Ubiquitination consists of the addition of Ub to a substrate protein via coordinated action of E1-activating, E2-conjugating and E3-ligating enzymes. Approximately 40 E2s have been identified in humans, and most are thought to be involved in Ub transfer; although little information is available regarding the majority of them, emerging evidence has highlighted their importance to human health and disease...
March 20, 2018: Molecules and Cells
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