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Francesca Micoli, Paolo Costantino, Roberto Adamo
Cell surface carbohydrates have been proven optimal targets for vaccine development. Conjugation of polysaccharides to a carrier protein triggers a T-cell dependent immune response to the glycan moiety. Licensed glycoconjugate vaccines are produced by chemical conjugation of capsular polysaccharides to prevent meningitis caused by meningococcus, pneumococcus and Haemophilus influenzae type b. However, other classes of carbohydrates (O-antigens, exopolysaccharides, wall/teichoic acids) represent attractive targets for developing vaccines...
March 14, 2018: FEMS Microbiology Reviews
Xu Chen, Stefan Gustafsson, Thomas Whitington, Yan Borné, Erik Lorentzen, Jitong Sun, Peter Almgren, Jun Su, Robert Karlsson, Jie Song, Yi Lu, Yiqiang Zhan, Sara Hägg, Per Svensson, Karin E Smedby, Susan L Slager, Erik Ingelsson, Cecilia M Lindgren, Andrew P Morris, Olle Melander, Thomas Karlsson, Ulf de Faire, Kenneth Caidahl, Gunnar Engström, Lars Lind, Mikael C I Karlsson, Nancy L Pedersen, Johan Frostegård, Patrik K E Magnusson
Phosphorylcholine (PC) is an epitope on oxidized low-density lipoprotein (oxLDL), apoptotic cells and several pathogens like Streptococcus pneumoniae. Immunoglobulin M against PC (IgM anti-PC) has the ability to inhibit uptake of oxLDL by macrophages and increase clearance of apoptotic cells. From our genome-wide association studies (GWAS) in four European-ancestry cohorts, six SNPs in 11q24.1 were discovered (in 3002 individuals) and replicated (in 646 individuals) to be associated with serum level of IgM anti-PC (the leading SNP rs35923643-G, combined beta=0...
March 14, 2018: Human Molecular Genetics
Douglas P Beall, M R Chambers, Sam Thomas, John Amburgy, James R Webb, Bradly S Goodman, Devin K Datta, Richard W Easton, Douglas Linville, Sanjay Talati, John B Tillman
BACKGROUND: Osteoporotic and neoplastic vertebral compression fractures (VCF) are common and painful, threatening quality of life and increasing risk of morbidity and mortality. Balloon kyphoplasty is a percutaneous option for treating painful cancer- and osteoporosis-related VCFs, supported by 2 randomized trials demonstrating efficacy benefits of BKP over nonsurgical care. OBJECTIVE: To investigate 12-mo disability, quality of life, and safety outcomes specifically in a Medicare-eligible population, representing characteristic patients seen in routine clinical practice...
March 14, 2018: Neurosurgery
Konstadinos Plestis, Oleg Orlov, Vishal N Shah, Joshua Wong, Matthew Thomas, Alon Aharon, Cinthia Orlov, Georgia Panagopoulos, Scott Goldman
OBJECTIVES: Minimally invasive aortic valve replacement (MIAVR) can be technically demanding and may lead to prolonged operative time. We evaluated the intraoperative and postoperative patient outcomes following implementation of 2 facilitating technologies (FT) in MIAVR: the Cor-Knot titanium fastener and Custodiol-histidine-tryptophan-ketoglutarate solution. METHODS: A total of 299 patients underwent MIAVR from 2008 to 2016; 172 (57.5%) patients were included in the FT group and 127 (42...
March 14, 2018: Interactive Cardiovascular and Thoracic Surgery
Ashley Gionfriddo, Mika L Nonoyama, Peter C Laussen, Peter N Cox, Megan Clarke, Alejandro A Floh
OBJECTIVES: To promote standardization, the Centers for Disease Control and Prevention introduced a new ventilator-associated pneumonia classification, which was modified for pediatrics (pediatric ventilator-associated pneumonia according to proposed criteria [PVAP]). We evaluated the frequency of PVAP in a cohort of children diagnosed with ventilator-associated pneumonia according to traditional criteria and compared their strength of association with clinically relevant outcomes. DESIGN: Retrospective cohort study...
March 15, 2018: Pediatric Critical Care Medicine
Laura Tarancon-Diez, Rebeca S De Pablo-Bernal, José Luis Jiménez, Ana I Álvarez-Ríos, Miguel Genebat, Isaac Rosado-Sánchez, María-Ángeles Muñoz-Fernández, Ezequiel Ruiz-Mateos, Manuel Leal
OBJECTIVE: Cardiovascular diseases (CVDs) are one of the main causes of morbimortality in HIV-infected patients on suppressive antiretroviral therapy. The objective of this work was to evaluate the role of single nucleotide polymorphisms (SNPs) in lipopolysaccharide (LPS) Toll-like receptor 4 (TLR4) and CVDs occurrence in HIV-infected patients. Additionally, the functional consequences of carrying these SNPs were analyzed. METHODS: The association of TLR4 SNPs, Asp299Gly/Thr399Ile with CVDs occurrence was analyzed using multivariate logistic regression models...
March 15, 2018: AIDS
Martin A Bewley, Richard C Budd, Eilise Ryan, Joby Cole, Paul Collini, Jennifer Marshall, Umme Kolsum, Gussie Beech, Richard D Emes, Irina Tcherniaeva, Guy A M Berbers, Sarah R Walmsley, Gavin Donaldson, Jadwiga A Wedzicha, Iain Kilty, William Rumsey, Yolanda Sanchez, Christopher E Brightling, Louise E Donnelly, Peter J Barnes, Dave Singh, Moira K B Whyte, David H Dockrell
RATIONALE: Previous studies have identified defects in bacterial phagocytosis by alveolar macrophages (AM) in patients with chronic obstructive pulmonary disease (COPD) but the mechanisms and clinical consequences remain incompletely defined. OBJECTIVES: To examine the effect of COPD on AM phagocytic responses and identify the mechanisms, clinical consequences and potential for therapeutic manipulation of these defects. METHODS: We isolated alveolar macrophages (AM) and monocyte-derived macrophages (MDM) from a cohort of COPD patients and controls within the MRC COPD-MAP consortium and measured phagocytosis of bacteria in relation to opsonic conditions and clinical features...
March 16, 2018: American Journal of Respiratory and Critical Care Medicine
Charles S Dela Cruz, Richard G Wunderink, David C Christiani, Stephania A Cormier, Kristina Crothers, Claire M Doerschuk, Scott E Evans, Daniel R Goldstein, Purvesh Khatri, Lester Kobzik, Jay K Kolls, Bruce D Levy, Mark L Metersky, Michael S Niederman, Roomi Nusrat, Carlos J Orihuela, Paula Peyrani, Alice S Prince, Julio A Ramírez, Karen M Ridge, Sanjay Sethi, Benjamin T Suratt, Jacob I Sznajder, Ephraim L Tsalik, Allan J Walkey, Sachin Yende, Neil R Aggarwal, Elisabet V Caler, Joseph P Mizgerd
Pneumonia is a complex pulmonary disease in need of new clinical approaches. While triggered by a pathogen, pneumonia often results from dysregulations of host defense that likely precede infection. The coordinated activities of immune resistance and tissue resilience then dictate whether and how pneumonia progresses or resolves. Inadequate or inappropriate host responses lead to more severe outcomes such as ARDS and to organ dysfunction beyond the lungs and overextended time-frames after pathogen clearance, some of which increase the risk for subsequent pneumonias...
March 16, 2018: American Journal of Respiratory and Critical Care Medicine
Florencia Escarrá, Ana G Fedullo, Natalia Veliz, Julián Rosa, Rodrigo Oribe, Marisa Di Santo, Bqca Vanesa Reijtman, Lic Alejandra Mastroianni, Guadalupe Pérez
INTRODUCTION: the incidence of invasive infections caused by pneumococcus (Streptococcus pneumoniae) has declined since generalized vaccination with pneumococcal conjugated vaccine, but it is still a prevalent pathogen in children. Amongst pneumococcal invasive infections, IE (infectious endocarditis) is rare, with an incidence between 1 and 7%. CASE REPORT: We describe the case of a previously healthy 4 year old boy, who had received one dose of 10-valent pneumococcal conjugate vaccine who presents with fever, a new heart murmur and heart failure...
December 2017: Revista Chilena de Pediatría
Alberto Pilotto, Simone Dini, Nicola Veronese, Julia Daragjati, Manuela Miolo, Monica M Mion, Andrea Fontana, Mario Lo Storto, Martina Zaninotto, Giada Bragato, Alberto Cella, Paolo Carraro, Filomena Addante, Massimiliano Copetti, Mario Plebani
BACKGROUND: To evaluate the prognostic accuracy of pro-ADM (adrenomedullin) in comparison with and in addition to the Multidimensional Prognostic Index (MPI), a validated predictive tool for mortality derived from a Comprehensive Geriatric Assessment (CGA), to predict one-month mortality risk in older patients hospitalized with community-acquired pneumonia (CAP). METHODS: All patients aged 65 years and older, consecutively admitted to an acute geriatric ward with a diagnosis of CAP from February to July 2012...
March 15, 2018: Panminerva Medica
Zhen Li, Xinmei Zhou, Jing Cao, Zheng Li, Xia Wan, Jiaqian Li, Jing Jiao, Ge Liu, Ying Liu, Fangfang Li, Baoyun Song, Jingfen Jin, Liu Yilan, Xianxiu Wen, Shouzhen Cheng, Xinjuan Wu
AIMS AND OBJECTIVES: To gain insight into nurses' knowledge and attitudes regarding major immobility complications (pressure ulcers, pneumonia, deep vein thrombosis and urinary tract infections) and explore the correlation of nurses' knowledge and attitudes with the incidence of these complications. BACKGROUND: Immobility complications have adverse consequences, and effective management requires appropriate knowledge, attitudes and skills. Evidence about nurses' knowledge and attitudes regarding immobility complications is lacking...
March 15, 2018: Journal of Clinical Nursing
Mariya E Skube, Quinn Mallery, Elizabeth Lusczek, Joel Elterman, Mary A Spott, Greg J Beilman
Introduction: Although there are multiple studies regarding the management and outcomes of colonic injuries incurred in combat, the literature is limited with regard to small bowel injuries. This study seeks to provide the largest reported review of the characteristics of combat-associated small bowel injuries. Materials and Methods: The Department of Defense Trauma Registry was queried for U.S. Armed Forces members who sustained hollow viscus injuries in the years 2007-2012 during Operations Enduring Freedom, Iraqi Freedom, and New Dawn...
March 13, 2018: Military Medicine
Selcuk Kayir, Hulya Ulusoy, Guvenc Dogan
Background/aims Sedation is one of the most important components of intensive care unit (ICU) in patients who are mechanically ventilated at intensive care conditions. As a result of sedation and analgesia in the intensive care unit, the patient is to be awakened a comfortable and easy process. The aim of the study is to demonstrate the effects of day-time sedation interruptions in intensive care patients. Material and methods We made a retrospective review of 100 patients who were monitored, mechanically ventilated and treated at our intensive care unit between January 2008 and January 2013...
January 13, 2018: Curēus
Hassan Al Moussawi, Michael Krzyzak, Zainab Awada, Jean M Chalhoub
A brain abscess is defined as a focal intracerebral infection consisting of an encapsulated collection of pus, which can be a life-threatening complication of infections, trauma, or surgery. While immunocompromised patients can have a wide array of causative organisms, bacterial species represent the most common etiology in immunocompetent individuals. The incidence of brain abscesses ranges from 0.4 to 0.9 per 100,000, with a high predisposition among immunocompromised patients and in those with disruption of the blood-brain barrier...
January 13, 2018: Curēus
Shuhong Zhang, Guangzhu Yang, Qinghua Ye, Qingping Wu, Jumei Zhang, Yuanbin Huang
Klebsiella pneumoniae is not only a major hospital-acquired pathogen but also an important food-borne pathogen that can cause septicaemia, liver abscesses, and diarrhea in humans. The phenotypic and genotypic characteristics of K. pneumoniae in retail foods have not been thoroughly investigated in China. The objective of this study was to characterize K. pneumoniae isolates through biotyping, serotyping, determination of virulence factors, antibiotic resistance testing, enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR), and (GTG)5 -PCR molecular typing...
2018: Frontiers in Microbiology
Yusuke Chigira, Ikuri Miyazaki, Masataka Izumi, Takahiro Oda
[Purpose] The present study examined the effects of expiratory muscle training on elderly day care service users, who had been classified into Care Grades 1 and 2 based on Japan's long-term care insurance system. [Subjects and Methods] Intervention was provided for 29 Care Grade 1 or 2 day care service users. During intervention, expiratory muscle training was performed by slowly expiring using the abdominal muscles and a device after maximal inspiration. Each intervention session lasted for approximately 10 minutes, and 2 sessions were held weekly for 3 months to compare respiratory function test values before and after intervention...
February 2018: Journal of Physical Therapy Science
Justin S Merkow, Erik J Nelson
BACKGROUND Providing anesthesia to immunocompromised patients introduces unique challenges, including difficulty in detecting respiratory infections. Detailed preoperative evaluation and preparation for perioperative complications is crucial. Human metapneumovirus is a common but lesser known respiratory virus that can lead to pneumonia and respiratory compromise and is challenging to detect in the immunocompromised patient. CASE REPORT We present a case of an immunocompromised individual scheduled for umbilical hernia repair who developed severe bronchospasm and intraoperative respiratory failure after induction of general anesthesia...
March 16, 2018: American Journal of Case Reports
Catia Cilloniz, Miquel Ferrer, Adamanthia Liapikou, Carolina Garcia-Vidal, Albert Gabarrus, Adrian Ceccato, Jorge Puig de La Bellacasa, Francesco Blasi, Antoni Torres
Question: To assess the incidence, characteristics, aetiology, risk factors and mortality of acute respiratory distress syndrome (ARDS) in ICU patients with community-acquired pneumonia (CAP) using the Berlin definition. Methods: We prospectively enrolled consecutive mechanically-ventilated ICU adults with CAP over 20 years, compared with mechanically-ventilated patients without ARDS. The main outcome was 30-day mortality. Results: Among 5,334 patients hospitalized with CAP, 930 (17%) were admitted to the ICU, and 432 required mechanical ventilation; 125 (29%) cases met the Berlin ARDS criteria...
March 15, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Qin-Li Liang, Yang Zou, Yun-Hang Gao, Lan-Bi Nie, Xiao-Xuan Zhang, Gui-Xue Hu, Rui Du, Xing-Quan Zhu
Porcine enzootic pneumonia caused by Mycoplasma hyopneumoniae affects the global pig industry with significant economic losses. It is yet to know whether wild boars in China were infected with M. hyopneumoniae. The present study was conducted to examine the seroprevalence and to evaluate risk factors of M. hyopneumoniae infection in farmed wild boars in China. A total of 882 serum samples were collected from farmed wild boars in Jilin City, Siping City and Baishan City in Jilin Province, northeastern China from April 2015 to February 2016, and were examined by the double sandwich enzyme-linked immunosorbent assay (ELISA)...
March 12, 2018: Acta Tropica
Hua Gao, Xiaolong Sun, Wen Li, Qiong Gao, Jing Zhang, Yi Zhang, Yue Ma, Xiai Yang, Xiaogang Kang, Wen Jiang
Objective Stroke due to atrial fibrillation (AF) is common and frequently devastating. However, there is no specific tool to accurately estimate the risk of mortality. This study aims to develop and validate a comprehensive risk score for predicting 30-day mortality in the patients with AF-related stroke. Methods A retrospective multi-center clinical study was performed based on the data from the project of secondary prevention of stroke in patients with nonvalvular AF in Shaanxi province, China. A total of 1077 consecutive patients were randomly classified into derivation (66...
March 16, 2018: Neurological Research
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