Biobanking for necrotizing enterocolitis: Needs and standards

Background Necrotizing enterocolitis (NEC) is a devastating gastrointestinal disease that primarily affects premature infants. Despite medical advances, mortality and morbidity from NEC are still unacceptably high. This is partly because of the lack of specific biomarkers and therapies for this disease. Availability of high-quality biological samples and the associated data from premature infants are key to advance our understanding of NEC, and for biomarker discovery and drug development. To that end, the NEC Society Biorepository was established with the goal of promoting studies in human infants through sharing specialized biospecimen and data procurement for NEC research. Objective In this review, we will discuss the required infrastructure for biobanks, discuss the importance of informatics management, and emphasize the logistical requirements for sharing specimens. Finally, we will discuss the mechanism for how tissues and material will be shared between the institutions. Conclusion We have developed a state-of-the-art biobank for human infants to advance the field of NEC research. With the NEC Society Biorepository, we seek to facilitate and accelerate the basic and translational studies on NEC to provide hope to the infants afflicted with NEC and their families

Studying the Psychological Impacts of the COVID-19 Pandemic on Frontline Healthcare Workers

Purpose: The purpose of this study was to determine the prevalence of psychological distress in frontline healthcare workers during the COVID 19 pandemic, and to identify if interventions and higher measures of resiliency helped to minimize the prevalence of symptoms.https://scholarlycommons.henryford.com/nursresconf2021/1002/thumbnail.jp

Think outside the box: Incorporating secondary cognitive tasks into return to sport testing after ACL reconstruction

The optimal set of return to sport (RTS) tests after anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) remains elusive. Many athletes fail to pass current RTS test batteries, fail to RTS, or sustain secondary ACL injuries if they do RTS. The purpose of this review is to summarize current literature regarding functional RTS testing after ACLR and to encourage clinicians to have patients “think” (add a secondary cognitive task) outside the “box” (in reference to the box used during the drop vertical jump task) when performing functional RTS tests. We review important criteria for functional tests in RTS testing, including task-specificity and measurability. Firstly, tests should replicate the sport-specific demands the athlete will encounter when they RTS. Many ACL injuries occur when the athlete is performing a dual cognitive-motor task (e.g., attending to an opponent while performing a cutting maneuver). However, most functional RTS tests do not incorporate a secondary cognitive load. Secondly, tests should be measurable, both through the athlete’s ability to complete the task safely (through biomechanical analyses) and efficiently (through measures of performance). We highlight and critically examine three examples of functional tests that are commonly used for RTS testing: the drop vertical jump, single-leg hop tests, and cutting tasks. We discuss how biomechanics and performance can be measured during these tasks, including the relationship these variables may have with injury. We then discuss how cognitive demands can be added to these tasks, and how these demands influence both biomechanics and performance. Lastly, we provide clinicians with practical recommendations on how to implement secondary cognitive tasks into functional testing and how to assess athletes’ biomechanics and performance

Kidney Recovery in Patients with Acute Kidney Injury Treated in Outpatient Hemodialysis or Rehabilitation Facilities

Rationale & Objective: Since January 2017, patients with acute kidney injury requiring dialysis (AKI-D) can be discharged to outpatient dialysis centers for continued hemodialysis (HD) support. We aimed to examine the rate of kidney recovery, time to recovery, and hospitalization-related clinical parameters associated with kidney recovery in patients with AKI-D. Study Design: Single-center prospective cohort study. Setting & Participants: 111 adult patients who were admitted to the University of Kentucky Hospital, experienced AKI-D, and were discharged with need of outpatient HD. Exposure: Hospitalization-related clinical parameters were evaluated. Outcome: Kidney recovery as a composite of being alive and no longer requiring HD or other form of kidney replacement therapy. Analytical Approach: Discrete-time survival analysis and logistic regression were used to determine adjusted probabilities of kidney recovery at prespecified time points and to evaluate clinical parameters associated with recovery. Results: 45 (41%) patients recovered kidney function, 25 (55.5%) within the first 30 days following discharge, 16 (35.5%) within 30 to 60 days, and 4 (9%) within 60 to 90 days. Adjusted probabilities of recovery were 36.7%, 27.4%, and 6.3%, respectively. Of the remaining patients, 49 (44%) developed kidney failure requiring chronic kidney replacement therapy and 17 (15%) died or went to hospice. Patients who did not recover kidney function were older, had more comorbid conditions, had lower estimated glomerular filtration rates at baseline, and received more blood transfusions during hospitalization when compared with those who recovered kidney function. Limitations: Selection bias given that patients included in the study were all eligible for AKI management with outpatient HD as part of Medicare/Medicaid services. Conclusions: At least one-third of AKI-D survivors discharged from an acute care hospital dependent on HD recovered kidney function within the first 90 days of discharge, more commonly in the first 30 days postdischarge. Future studies should elucidate clinical parameters that can inform risk classification and interventions to promote kidney recovery in this vulnerable and growing population

New directions in necrotizing enterocolitis with early-stage investigators

The 2019 Necrotizing Enterocolitis (NEC) Symposium expanded upon the NEC Society's goals of bringing stakeholders together to discuss cutting-edge science, potential therapeutics and preventative measures, as well as the patient-family perspectives of NEC. The Symposium facilitated discussions and shared knowledge with the overarching goal of creating "A World Without NEC." To accomplish this goal, new research to advance the state of the science is necessary. Over the last decade, several established investigators have significantly improved our understanding of the pathophysiology of NEC and they have paved the way for the next generation of clinician-scientists funded to perform NEC research. This article will serve to highlight the contributions of these young clinician-scientists that seek to elucidate how immune, microbial and nervous system dysregulation contributes to the pathophysiology of NEC

FITOTERAPIA NO CONTROLE DE PARASITOS GASTRINTESTINAIS DE RUMINANTES: ÊNFASE NO GÊNERO MENTHA E SEUS COMPONENTES BIOATIVOS

Essa revisão apresenta considerações acerca da relevância das infecções de parasitos gastrintestinais (PGI) em ruminantes, abordando a importância de fármacos antiparasitários no controle das helmintoses e demais alternativas. Foi realizada uma abordagem conceitual e histórica sobre o controle de PGI e o processo de desenvolvimento da resistência parasitária. Como alternativa da baixa eficácia de medicamentos, foi feita uma descrição detalhada sobre o uso de óleos essenciais (OE) e de componentes bioativos no controle das PGI em ruminantes. A produção de OE de plantas, passa pela composição química, técnicas de extração dos componentes, mecanismo de ação e ensaios para validação da sua atividade terapêutica, incluindo sua ação anti-helmíntica. Este artigo traz, na sua segunda parte, uma descrição detalhada de duas espécies do gênero Mentha, com foco em sua biologia, composição química e mecanismos de ação de seus OE. Dentro desse tópico, as espécies Mentha vilosa e M. piperita são as mais estudadas, bem como os seus componentes majoritários e bioativos; carvone e limoneno. Ao final do documento, discutimos sobre a técnica de cromatografia gasosa e espectrometria de massas, que se faz obrigatória para a identificação de compostos presentes em OE. Incluímos ainda, o detalhamento sobre tecnologias de nanoemulsão e suas vantagens na confecção de formulações mais estáveis, menos tóxicas aos hospedeiros e com potencial de aumentar a eficácia de fármacos contra as PGI, para o desenvolvimento de novos compostos fitoterápicos ecosustentáveis.This review presents considerations about the relevance of gastrointestinal parasite (GIP) infections in ruminants, covering also the importance of antiparasitic drugs in the control of helminth infections and some other alternatives. This document describes a conceptual and historical view of the development of routine GIP control and the process of development of drug resistance. As an alternative to the low efficacy of some products, a detailed description was made of the use of essential oils (EO) and their bioactive compounds in the control of GIP in ruminants. The production of EO from plants, goes through the chemical composition, techniques of extraction of components, mechanism of action and assays for the validation of their activity, including the anthelmintic activity. The present document brings, in its second part, a more detailed description of two species of the genus Mentha, focusing on their biology, chemical composition and the mechanism of action of their EO. Within this topic, the species of Mentha vilosa and M. piperita are better studied, as well as their chemical composition and bioactive components carvone and limonene. At the end, it is discussed the gas chromatography and mass spectrometry techniques that are useful to identify compounds present in EO. It was also included the details about nanoemulsion technologies and their advantages in obtaining a more stable formulation, less toxic to the host, with a great potential to increase anthelmintic efficacy against GIP, for the development of new herbal bioactive and ecofriendly compounds

Plasma Levels of Inter-α Inhibitor Proteins in Children with Acute Dengue Virus Infection

Background: Inter-α inhibitor proteins (IaIp) belong to a family of protease inhibitors that are involved in the haemostatic and the vascular system. Dengue viruses (DENV) infections are characterized by coagulopathy and increased vascular permeability. In this study we measured the concentration of IaIp during DENV infections and evaluated its potential as a biomarker. Methods and Findings: Concentrations of IaIp were measured in patients with acute DENV infections using a quantitative, competitive enzyme linked immunoassay. Concentrations of IaIp measured in pediatric patients suffering from severe DENV infections were significantly lower than in healthy controls. Conclusions: This is the first report to demonstrate changes in concentration of IaIp during viral infections. The data also highlight the potential of IaIp as a biological marker for severity of DENV infections