The 3.31-Mb genome sequence of the intracellular pathogen and potential bioterrorism agent, Brucella suis, was determined. Comparison of B. suis with Brucella melitensis has defined a finite set of ...differences that could be responsible for the differences in virulence and host preference between these organisms, and indicates that phage have played a significant role in their divergence. Analysis of the B. suis genome reveals transport and metabolic capabilities akin to soil/plant-associated bacteria. Extensive gene synteny between B. suis chromosome 1 and the genome of the plant symbiont Mesorhizobium loti emphasizes the similarity between this animal pathogen and plant pathogens and symbionts. A limited repertoire of genes homologous to known bacterial virulence factors were identified.
Pediatric patients with spina bifida often experience neurogenic bowel dysfunction. Although cecostomy tubes could improve bowel continence, their effectiveness is not well established in this ...population. The aims of this study were to better understand the effectiveness of cecostomy tubes relative to other management strategies (between-subject) and to explore their effectiveness among patients who received these placements (within-subject).
Retrospective analysis of data from pediatric patients enrolled in a national spina bifida patient registry (n = 297) at a single multidisciplinary clinic was performed, covering visits between January 2014 -December 2021. Linear and ordinal mixed effect models (fixed and random effects) tested the influence of cecostomy status (no placement vs placement) and time (visits) on bowel continence while controlling for demographic and condition-specific covariates.
Patients with cecostomy tubes had higher bowel continence compared to patients without placements (B = 0.695, 95% CI 0.333, 1.050; AOR = 2.043, p = .007). Patients with cecostomy tubes had higher bowel continence after their placements compared to before (B = 0.834, 95% CI 0.142, 1.540; AOR = 3.259, p = 0.011).
Results indicate cecostomy tubes are effective for improving bowel continence in this pediatric population. Future research is needed to conduct risk analyses and determine the clinical significance of these effects.
Why PLoS became a publisher Brown, Patrick O; Eisen, Michael B; Varmus, Harold E
PLoS biology,
10/2003, Letnik:
1, Številka:
1
Journal Article
Recenzirano
Odprti dostop
...any new journal, even one with the stringent standards and the extraordinary editorial team of PLoS Biology, must begin without the established "brand name" of the older journals, which, like a ...designer logo, elevates the perceived status of the articles that bear it. ...it's the contributions of these authors that will make PLoS Biology a success.
Yoga interventions are heterogeneous and vary along multiple dimensions. These dimensions may affect mental and physical health outcomes in different ways or through different mechanisms. However, ...most studies of the effects of yoga on health do not adequately describe or quantify the components of the interventions being implemented. This lack of detail prevents researchers from making comparisons across studies and limits our understanding of the relative effects of different aspects of yoga interventions. To address this problem, we developed the Essential Properties of Yoga Questionnaire (EPYQ), which allows researchers to objectively characterize their interventions. We present here the reliability and validity data from the final phases of this measure-development project. Analyses identified fourteen key dimensions of yoga interventions measured by the EPYQ: acceptance/compassion, bandhas, body awareness, breathwork, instructor mention of health benefits, individual attention, meditation and mindfulness, mental and emotional awareness, physicality, active postures, restorative postures, social aspects, spirituality, and yoga philosophy. The EPYQ demonstrated good reliability, as assessed by internal consistency and test-retest reliability analysis, and evidence suggests that the EPYQ is a valid measure of multiple dimensions of yoga. The measure is ready for use by clinicians and researchers. Results indicate that, currently, trained objective raters should score interventions to avoid reference frame errors and potential rating bias, but alternative approaches may be developed. The EPYQ will allow researchers to link specific yoga dimensions to identifiable health outcomes and optimize the design of yoga interventions for specific conditions.
The distribution of I. scapularis, the tick vector of the bacteria that cause Lyme disease, has been expanding over the last two decades in the north-central United States in parallel with increasing ...incidence of human cases of Lyme disease in that region. However, assessments of residential risk for exposure to ticks are lacking from this region. Here, we measured the density of host-seeking I. scapularis nymphs in two suburban and two rural public recreational sites located in Washington County, Minnesota as well as in nearby residential properties. We sought to compare tick densities across land use types and to identify environmental factors that might impact nymphal density. We also assessed the prevalence of infection in the collected ticks with Lyme disease spirochetes (Borrelia burgdorferi sensu stricto, B. mayonii), and other I. scapularis-borne pathogens including B. miyamotoi, Babesia microti and Anaplasma phagocytophilum. Similar to studies from the eastern United States, on residential properties, I. scapularis nymphal densities were highest in the ecotonal areas between the forest edge and the lawn. Residences with the highest densities of nymphs were more likely to have a higher percentage of forest cover, log piles, and signs of deer on their property. In recreational areas, we found the highest nymphal densities both in the wooded areas next to trails as well as on mowed trails. Among the 303 host-seeking I. scapularis nymphs tested for pathogens, B. burgdorferi sensu stricto, A. phagocytophilum and B. miyamotoi were detected in 42 (13.8%), 14 (4.6%), and 2 (0.6%) nymphs, respectively.
Both oxygen therapy and nasal continuous positive airway pressure (CPAP) therapy have independently been shown to be effective in the treatment of Cheyne-Stokes respiration (CSR) in patients with ...congestive heart failure (CHF). The purpose of this study was to compare the short-term effects of oxygen therapy and nasal CPAP therapy on CSR in a group of stable patients with severe CHF.
Prospective, randomized, controlled trial.
University hospital.
Twenty-five stable patients (mean ± SD age, 56 ± 9) with CHF and a mean left ventricular ejection fraction (LVEF) of 17 ± 0.8%.
All patients had a right heart catheterization prior to the study and an echocardiogram performed to measure LVEF. In addition, all patients had an initial sleep study to identify the presence of CSR. Sleep studies included continuous recordings of breathing pattern, pulse oximetry, and EEG. Those patients identified as having CSR were randomized to a night on oxygen therapy (2 L/min by nasal cannula) and another night on nasal CPAP therapy (9 ± 0.3 cm H2O).
Fourteen of the 25 patients (56%) studied had CSR (apnea hypopnea index AHI, 36 ± 7 events per hour) during their initial sleep study. Nine of the 14 patients with CSR completed the study. When compared with baseline measurements, both oxygen therapy and nasal CPAP therapy significantly decreased the AHI (from 44 ± 9 to 18 ± 5 and 15 ± 8 events per hour, respectively; p < 0.05), with no significant difference between the two modalities. The mean oxygen saturation increased significantly and to a similar extent with oxygen therapy and nasal CPAP therapy (from 93 ± 0.7% to 96 ± 0.8% and 95 ± 0.7%, respectively; p < 0.05), as did the lowest oxygen saturation during the night (from 80 ± 2% to 85 ± 3% and 88 ± 2%, respectively; p < 0.05). In addition, the mean percent time the oxygen saturation was < 90% also improved with both interventions (from a baseline of 17 ± 5 to 6 ± 3% with oxygen therapy and 5 ± 2% with nasal CPAP therapy; p < 0.05). When compared with baseline measurements, the apnea-hypopnea length, cycle length, circulation time, and heart rate did not significantly change with either oxygen therapy or nasal CPAP therapy. Total sleep time and sleep efficiency decreased only with nasal CPAP therapy (from 324 ± 20 to 257 ± 14 min, and from 82 ± 3 to 72 ± 2%, respectively; p < 0.05). The arousal index, when compared with baseline, remained unchanged with both oxygen therapy and nasal CPAP therapy.
CSR occurs frequently in stable patients with severe CHF. In addition, oxygen therapy and nasal CPAP therapy are equally effective in decreasing the AHI in those CHF patients with CSR.
The inhalation of beryllium causes a serious lung disease characterised by pronounced radiographic and functional impairments and occurs in workers engaged in the extraction and manufacture of the ...metal. This paper describes the beryllium exposure levels and refining processes in a large beryllium factory operating since the 1930s. Lifetime beryllium exposure histories were estimated for the 309 workers present at a health survey conducted in 1977. Beryllium exposure levels in the plant were high for many years, with some estimated exposure levels in excess of 100 micrograms/m3. As late as 1975, there were exposures to beryllium above 10 micrograms/m3 in some jobs. After about 1977, the plant was in compliance with the permissible exposure limit of 2.0 micrograms/m3. The median cumulative exposure in this cohort was 65 micrograms/m3-years and the median duration of exposure was 17 years. From these data a series of exposure parameters, functions of the exposure histories that characterise biologically important dimensions of exposure were calculated for each worker.
Human skin fibroblast cultures have been employed to study the effects of a variety of vitamin A analogues (retinoids) on the expression of two enzymes involved in collagen degradation in the skin, ...collagenase and a gelatinolytic protease. In normal and recessive dystrophic epidermolysis bullosa fibroblast cultures, retinoic acid compounds were effective inhibitors of the accumulation of both enzymes in the culture medium with half-maximal inhibitions occurring at 0.25–1 μM for collagenase and at 3–6 μM for the gelatinolytic protease. Various retinoids exhibited differing degrees of inhibitory actions, so that at a 1 μM concentration, relative inhibitions were: 13-cis-retinoic acid > all-trans-retinoic acid > aromatic retinoid (Ro 10-9359) >> retinol. The retinoic acid-mediated decrease in collagenase activity was accompanied by a parallel decrease in immunoreactive collagenase protein, suggesting that the retinoic acids were acting to inhibit synthesis of the enzyme. However, an additional effect of these agents was encountered. Although the retinoids themselves had no direct collagenase inhibitory action, medium derived from cultures maintained in these retinoids showed direct inhibitory capacity which was dependent both on the concentration of retinoic acid and on the length of time in culture. The results suggest that the retinoic acids modulate collagenase in vitro by two mechanisms: by decreasing the synthesis of enzyme protein and by modulating the expression of an inhibitory molecule.
Abstract
Background
Patients with prior myocardial infarction (MI) are at increased risk for recurrent cardiovascular events. Advances in treatment in the last decade has improved prognosis of ...patients with acute coronary syndrome (ACS), yet it is not known whether similar trends exist in patients with prior MI who are admitted with an ACS, a particularly high-risk group.
Methods
Patients admitted with ACS who were enrolled in the ACS Israeli Surveys (ACSIS). Patients were stratified by early (2000–2008) and late (2010–2016) time-periods and by prior MI status. Clinical outcomes included 30-d MACE (death, MI, stroke, unstable angina, stent thrombosis, urgent revascularization) and 1-year mortality.
Results
A total of 15,211 ACS patients were included, of whom 4627 (30%) had a prior MI. These patients were older (67y vs. 63y), more commonly male, had more prior comorbidities, and a higher proportion had a GRACE score>140 (38.4% vs 12.2%). Patients with prior MI received more prior medications such as aspirin, statins, antihypertensives and hypoglycemics. During time, utilization of guideline-recommended therapies such as P2Y12 inhibitors, statins, and PCI had significantly improved in patients with prior MI. However, compared with patients without prior MI, they were still treated less commonly by PCI (61% vs. 74%). Overall, patients with prior MI had a higher 30-d MACE (13.7% vs 17.2%, p<0.001) and 1-year mortality (8.2% vs. 13.1%, p<0.001). In patients with prior MI, during time, 30d MACE nearly halved (22.7% to 11.8%) and 1-year mortality also decreased (15.5% to 10.7%). Upon adjustment, prior MI was independently associated with 1-year mortality (HR 1.13, 95% CI 1.01–1.26, p=0.04) and the late time-period was associated with reduced 1-year mortality (HR 0.75, 95% CI 0.65–0.84, p<0.001).
Conclusion
Patients with prior MI have a worse prognosis after ACS despite being treated with prior medications and improvement in guideline-based therapies. Although still undertreated, their clinical outcome has significantly improved throughout the years.
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