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https://www.readbyqxmd.com/read/29224355/structural-features-and-domain-movements-controlling-substrate-binding-and-cofactor-specificity-in-class-ii-hmg-coa-reductase
#1
Bradley R Miller, Yan Kung
The key mevalonate pathway enzyme 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase (HMGR) uses the cofactor NAD(P)H to reduce HMG-CoA to mevalonate in the production of countless metabolites and natural products. Although HMGR inhibition by statin drugs is well understood, several mechanistic details of HMGR catalysis remain unresolved, and the structural basis for the wide range in cofactor specificity for either NADH or NADPH among HMGRs from different organisms is also unknown. Here, we present crystal structures of HMGR from Streptococcus pneumoniae (SpHMGR) alongside kinetic data on the enzyme's cofactor preferences...
December 11, 2017: Biochemistry
https://www.readbyqxmd.com/read/29200209/-nursing-sensitive-outcomes-and-staffing-a-review-on-healthcare-associated-infection
#2
Matteo Seligardi, Erika Bassi, Maria Mongardi
. Nursing sensitive outcomes and staffing: a review on healthcare associated infection. INTRODUCTION: Healthcare associated infections (HAI) continue to be an unresolved problem in hospital settings. AIM: To assess the relationship between nurse staffing and healthcare associated infections in different settings. METHODS: From April to May 2015 a review of literature was conducted consulting PubMed, CINAHL and Cochrane Library. RESULTS: An increased amount of Registered Nurse Hours Per Patient Day (RNHPPD) and nurse-to-patient ratio was associated to a decreased occurrence of HAI...
October 2017: Assistenza Infermieristica e Ricerca: AIR
https://www.readbyqxmd.com/read/29164144/intensive-care-unit-patients-with-lower-respiratory-tract-nosocomial-infections-the-enirris-project
#3
Gennaro De Pascale, Otavio T Ranzani, Saad Nseir, Jean Chastre, Tobias Welte, Massimo Antonelli, Paolo Navalesi, Eugenio Garofalo, Andrea Bruni, Luis Miguel Coelho, Szymon Skoczynski, Federico Longhini, Fabio Silvio Taccone, David Grimaldi, Helmut J F Salzer, Christoph Lange, Filipe Froes, Antoni Artigas, Emili Díaz, Jordi Vallés, Alejandro Rodríguez, Mauro Panigada, Vittoria Comellini, Luca Fasano, Paolo M Soave, Giorgia Spinazzola, Charles-Edouard Luyt, Francisco Alvarez-Lerma, Judith Marin, Joan Ramon Masclans, Davide Chiumello, Angelo Pezzi, Marcus Schultz, Hafiz Mohamed, Menno Van Der Eerden, Roger A S Hoek, D A M P J Gommers, Marta Di Pasquale, Rok Civljak, Marko Kutleša, Matteo Bassetti, George Dimopoulos, Stefano Nava, Fernando Rios, Fernando G Zampieri, Pedro Povoa, Lieuwe D Bos, Stefano Aliberti, Antoni Torres, Ignacio Martín-Loeches
The clinical course of intensive care unit (ICU) patients may be complicated by a large spectrum of lower respiratory tract infections (LRTI), defined by specific epidemiological, clinical and microbiological aspects. A European network for ICU-related respiratory infections (ENIRRIs), supported by the European Respiratory Society, has been recently established, with the aim at studying all respiratory tract infective episodes except community-acquired ones. A multicentre, observational study is in progress, enrolling more than 1000 patients fulfilling the clinical, biochemical and radiological findings consistent with a LRTI...
October 2017: ERJ Open Research
https://www.readbyqxmd.com/read/29139564/incident-diuretic-drug-use-and-adverse-respiratory-events-among-older-adults-with-chronic-obstructive-pulmonary-disease
#4
Nicholas T Vozoris, Xuesong Wang, Peter C Austin, Denis E O'Donnell, Shawn D Aaron, Teresa M To, Andrea S Gershon
AIMS: Diuretic drugs may theoretically improve respiratory health outcomes in chronic obstructive pulmonary disease (COPD) through several possible mechanisms, but they might also lead to respiratory harm. We evaluated the association of incident oral diuretic drug use with respiratory-related morbidity and mortality among older adults with COPD. METHODS: This was a population-based, retrospective cohort study using health administrative data from Ontario, Canada, for the period 2008-2013...
November 15, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28960643/serial-chest-ct-in-cryptogenic-organizing-pneumonia-evolutional-changes-and-prognostic-determinants
#5
Man P Chung, Bo D Nam, Kyung S Lee, Joungho Han, Jai S Park, Jung H Hwang, Min J Cha, Tae J Kim
BACKGROUND AND OBJECTIVE: Cryptogenic organizing pneumonia (COP) is corticosteroid responsive but residual computed tomography (CT) chest changes are often noted. The present study examined clinical and HRCT features of COP in which there was incomplete resolution. METHODS: We studied 93 patients with histopathologically confirmed COP and serial HRCT imaging. Clinical features were assessed, and serial CT images were analysed. Uni- and multivariate analyses were performed to determine clinical or imaging factors related to incomplete resolution on CT...
September 27, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28889900/a-62-year-old-woman-with-wheezing-respiratory-failure-and-an-abnormal-ct%C3%A2-scan
#6
Peter Hountras, Hector Cajigas
A previously healthy 62-year-old woman was transferred to the ICU from the medical ward with acute bronchospastic respiratory failure requiring intubation and mechanical ventilation. Four weeks before, the patient was vacationing in Arizona and acquired a mildly productive cough as well as mild dyspnea. She presented to an urgent care facility and was diagnosed with community-acquired pneumonia. She received a 5-day course of azithromycin, with partial improvement of her symptoms. The patient returned home 1 week prior to admission, reporting worsening dyspnea, chest pressure, cough, and fever...
September 2017: Chest
https://www.readbyqxmd.com/read/28827507/presentation-coagulopathy-and-persistent-acidosis-predict-complications-in-orthopaedic-trauma-patients
#7
Benjamin R Childs, Daniel R Verhotz, Timothy A Moore, Heather A Vallier
OBJECTIVES: To evaluate the ability of measures of coagulopathy and acidosis to predict complications. We hypothesize that increased coagulopathy and acidosis over the first 60 hours of hospitalization will result in increased rates of infection and mortality. DESIGN: Prospective, observational. SETTING: Level 1 trauma center. PATIENTS: Three hundred and seventy-six skeletally mature patients with an Injury Severity Score (ISS) greater than 16 who were surgically treated for high energy fractures of the femur, pelvic ring, acetabulum, and/or spine...
August 15, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28746328/unresolving-pneumonia-with-pleural-effusion-pulmonary-paragonimiasis
#8
D Gaire, S Sharma, K Poudel, P Pant
Paragonimiasis is a zoonosis caused by many species of Paragonimus commonly P. westermani. Human get infected by eating raw, salted, pickled, smoked, partially cooked crustaceans (crayfish or crabs). Clinical manifestations ranges from non-specific symptoms like pain abdomen, diarrhea, urticarial rashes, fever to pleuropulmonary symptoms like cough, hemoptysis, chest pain and dyspnea. A 48 years, female presented at TUTH emergency with fever on and off for nine months, cough and shortness of breath for three months, lethargy, malaise and urticaria with history of raw crab intake one month prior to the onset of symptoms...
April 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28734523/laparoscopic-choledochoduodenostomy
#9
Adolfo Cuendis-Velázquez, Mario E Trejo-Ávila, Enrique Rosales-Castañeda, Eduardo Cárdenas-Lailson, Martin E Rojano-Rodríguez, Sujey Romero-Loera, Carlos A Sanjuan-Martínez, Mucio Moreno-Portillo
INTRODUCTION: Today's options for biliary bypass procedures, for difficult choledocholithiasis, range from open surgery to laparo-endoscopic hybrid procedures. The aim of this study was to analyze the outcomes of patients with difficult choledocholithiasis treated with laparoscopic choledochoduodenostomy. METHODS: We performed a prospective observational study from March 2011 to June 2016. We included patients with difficult common bile duct stones (recurrent or unresolved by ERCP) in which a biliary bypass procedure was required...
August 2017: Cirugía Española
https://www.readbyqxmd.com/read/28528060/pulmonary-mucormycosis-treated-with-lobectomy
#10
Oluwatobi Afolayan, Hannah Copeland, Salman Zaheer, Jason M Wallen
A 57 year old man was referred from an outside facility for an unresolving pneumonia. Imaging of the chest demonstrated a right lung mass with a consolidation in the middle lobe, pleural effusion, and mediastinal lymphadenopathy. Cytologic examination of cultures from the bronchoscopy and thoracentesis did not yield a definitive diagnosis. Video-assisted thoracoscopic surgery (VATS) was performed because of a retained hemothorax and a suggestive lesion. Biopsy specimens obtained during VATS were consistent with mucormycosis...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28484441/molecular-demonstration-of-a-pneumocystis-outbreak-in-stem-cell-transplant-patients-evidence-for-transmission-in-the-daycare-center
#11
Christine Robin, Alexandre Alanio, Maud Gits-Muselli, Giulia la Martire, Frédéric Schlemmer, Françoise Botterel, Cécile Angebault, Mathieu Leclerc, Florence Beckerich, Rabah Redjoul, Cécile Pautas, Andrea Toma, Sébastien Maury, Stéphane Bretagne, Catherine Cordonnier
Pneumocystis jirovecii pneumonia (PCP) is a life-threatening infection in hematology. Although occasionally reported, the role of interhuman transmission of P. jirovecii in PCP, compared to that of reactivation, remains an unresolved question; the recommendation to isolate PCP patients in the hematology ward are not well evidence-based. Following an unexpected increase in the number of febrile pneumonia patients with P. jirovecii DNA detected in respiratory samples in our hematology ward, we explored 12 consecutive patients from November 2015 to May 2016...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28031261/copper-is-a-host-effector-mobilized-to-urine-during-urinary-tract-infection-to-impair-bacterial-colonization
#12
Amanda N Hyre, Kylie Kavanagh, Nancy D Kock, George L Donati, Sargurunathan Subashchandrabose
Urinary tract infection (UTI) is a major global infectious disease affecting millions of people annually. Human urinary copper (Cu) content is elevated during UTI caused by uropathogenic Escherichia coli (UPEC). UPEC upregulates the expression of Cu efflux genes during clinical UTI in patients as an adaptive response to host-derived Cu. Whether Cu is mobilized to urine as a host response to UTI and its role in protection against UTI remain unresolved. To address these questions, we tested the hypothesis that Cu is a host effector mobilized to urine during UTI to limit bacterial growth...
March 2017: Infection and Immunity
https://www.readbyqxmd.com/read/27826777/impact-of-routine-recurrent-laryngeal-nerve-monitoring-in-prone-esophagectomy-with-mediastinal-lymph-node-dissection
#13
Makoto Hikage, Takashi Kamei, Toru Nakano, Shigeo Abe, Kazunori Katsura, Yusuke Taniyama, Tadashi Sakurai, Jin Teshima, Soichi Ito, Nobuchika Niizuma, Hiroshi Okamoto, Toshiaki Fukutomi, Masato Yamada, Shota Maruyama, Noriaki Ohuchi
BACKGROUND: The problem of recurrent laryngeal nerve (RLN) paralysis (RLNP) after radical esophagectomy remains unresolved. Several studies have confirmed that intraoperative nerve monitoring (IONM) of the RLN during thyroid surgery substantially decreases the incidence of RLN damage. This study tried to determine the feasibility and effectiveness of IONM of the RLN during thoracoscopic esophagectomy in the prone position for esophageal cancer. METHODS: All 108 patients who underwent prone esophagectomy at Tohoku University Hospital between July 2012 and March 2015 were included in this study...
July 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/27576553/clinical-impact-of-emphysema-evaluated-by-high-resolution-computed-tomography-on-idiopathic-pulmonary-fibrosis-diagnosed-by-surgical-lung-biopsy
#14
Yasuo Kohashi, Toru Arai, Chikatoshi Sugimoto, Kazunobu Tachibana, Masanori Akira, Masanori Kitaichi, Seiji Hayashi, Yoshikazu Inoue
BACKGROUND: The prognosis of combined cases of pulmonary fibrosis and emphysema is unresolved partially because radiological differentiation between usual interstitial pneumonia and nonspecific interstitial pneumonia is difficult in coexisting emphysema cases. OBJECTIVE: The purpose of this study was to clarify the clinical impact of emphysema on the survival of patients with idiopathic pulmonary fibrosis (IPF). METHODS: One hundred and seven patients with interstitial lung diseases were diagnosed by surgical lung biopsies between 2006 and 2012, and 47 patients were diagnosed with IPF through multidisciplinary discussion...
2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27520469/chronic-eosinophilic-pneumonia-presenting-with-ipsilateral-pleural-effusion-a-case-report
#15
Narin Sriratanaviriyakul, Hanh H La, Timothy E Albertson
BACKGROUND: Chronic eosinophilic pneumonia is a rare idiopathic interstitial lung disease. The nearly pathognomonic radiographic finding is the peripheral distribution of alveolar opacities. Pleural effusions are rarely seen. We report a case of chronic eosinophilic pneumonia with transudative eosinophilic pleural effusion. CASE PRESENTATION: A 57-year-old Hispanic woman, a nonsmoker with a history of controlled asthma, presented to the hospital with unresolving pneumonia despite three rounds of antibiotics over a 2-month period...
August 12, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27468045/acute-phase-proteins-as-a-marker-of-respiratory-inflammation-in-przewalski-s-horse-equus-ferus-przewalskii
#16
Samantha J Sander, Priscilla H Joyner, Carolyn Cray, David S Rotstein, Copper Aitken-Palmer
Acute phase proteins are sensitive markers of inflammation, which are highly conserved across taxa. Although the utility of these proteins are becoming well defined in human and domestic animal medical fields, their role in nondomestic species remains unclear. In this communication, a 20-yr-old Przewalski's horse was presented for unresolving aspiration pneumonia, which cultured a unique Actinomyces-like bacteria. Despite waxing and waning clinical signs and minimal changes on baseline hematologic analysis, protein electrophoresis, serum amyloid A, and surfactant protein D serum concentrations showed changes that more accurately reflected the clinical severity of this case...
June 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/27357333/safety-and-efficacy-of-cryoballoon-ablation-for-paroxysmal-atrial-fibrillation-in-japan%C3%A3-results-from-the-japanese-prospective-post-market-surveillance-study
#17
MULTICENTER STUDY
Ken Okumura, Kazuo Matsumoto, Yoshinori Kobayashi, Akihiko Nogami, Robert B Hokanson, Fred Kueffer
BACKGROUND: Outcomes of cryoballoon ablation for paroxysmal atrial fibrillation (PAF) have been reported in the Western countries but not in Japan. The CRYO-Japan PMS study was a single-arm, observational, multicenter, prospective study of the 2nd-generation cryoballoon Arctic Front Advance(TM). We evaluated device- and procedure-related complications and clinical outcomes at 6 months. METHODS AND RESULTS: The 616 patients (male, 72%; mean age, 63±11 years) were enrolled from 33 Japanese hospitals...
July 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27231868/connective-tissue-disease-associated-interstitial-lung-diseases-unresolved-issues
#18
Irene Jarana Aparicio, Joyce S Lee
Interstitial lung disease (ILD) complicating connective tissue disorders, such as scleroderma and rheumatoid arthritis, is associated with significant morbidity and mortality. Progress has been made in our understanding of these collective diseases; however, there are still many unanswered questions. In this review, we describe the current views on epidemiology, clinical presentation, treatment, and prognosis in patients with connective tissue disease (CTD)-associated ILD. We also highlight several areas that remain unresolved and in need of further investigation, including interstitial pneumonia with autoimmune features, histopathologic phenotype, and pharmacologic management...
June 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27005460/carbapenemase-producing-klebsiella-pneumoniae-bloodstream-infections-in-neutropenic-patients-with-haematological-malignancies-or-aplastic-anaemia-analysis-of-50-cases
#19
Polydoros Tofas, Anna Skiada, Maria Angelopoulou, Nikolaos Sipsas, Ioanna Pavlopoulou, Sofia Tsaousi, Maria Pagoni, Maria Kotsopoulou, Stavroula Perlorentzou, Anastasia Antoniadou, Maria Pirounaki, Athanasios Skoutelis, George L Daikos
Carbapenemase-producing Klebsiella pneumoniae (CP-Kp) are currently among the most important nosocomial pathogens in many geographic regions. A retrospective study was conducted between 2010 and 2014 in four hospitals located in a high-prevalence area (Athens, Greece) to describe the clinical features, treatment and outcomes of neutropenic patients with haematological diseases complicated with CP-Kp bloodstream infections. A total of 50 patients were identified, including 48 with haematological malignancies and 2 with aplastic anaemia...
April 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/26829988/pcpa-promotes-higher-levels-of-infection-and-modulates-recruitment-of-myeloid-derived-suppressor-cells-during-pneumococcal-pneumonia
#20
Melissa M Walker, Lea Novak, Rebecca Widener, James Aaron Grubbs, Janice King, Joanetha Y Hale, Martina M Ochs, Lisa E Myers, David E Briles, Jessy Deshane
We used two different infection models to investigate the kinetics of the PcpA-dependent pneumococcal disease in mice. In a bacteremic pneumonia model, we observed a PcpA-dependent increase in bacterial burden in the lungs, blood, liver, bronchoalveolar lavage, and spleens of mice at 24 h postinfection. This PcpA-dependent effect on bacterial burden appeared earlier (within 12 h) in the focal pneumonia model, which lacks bacteremia or sepsis. Histological changes show that the ability of pneumococci to make PcpA was associated with unresolved inflammation in both models of infection...
March 1, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
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