Two Years after Coxiella burnetii Detection: Pathogen Shedding and Phase-Specific Antibody Response in Three Dairy Goat Herds.

The infection dynamics of Coxiella (C.) burnetii were investigated in three dairy goat herds (A, B, and C) 2 years after the first pathogen detection. A total of 28 and 29 goats from herds A and B, and 35 goats from herd C, were examined. Sera were analyzed on three sampling dates using phase-specific serology. Pathogen shedding was assessed using post-partum vaginal swabs and monthly bulk tank milk (BTM) samples. Dust samples from a barn and milking parlor were also collected monthly. These samples were analyzed with PCR (target IS1111). In herd A, individual animals tested seropositive, while vaginal swabs, BTM, and most dust samples tested negative. Herds B and C exhibited high IgG phase I activity, indicating a past infection. In herd B, approximately two-thirds of the goats shed C. burnetii with vaginal mucus, and irregular positive results were obtained from BTM. Herd C had two positive goats based on vaginal swabs, and BTM tested positive once. Dust samples from herds B and C contained C. burnetii DNA, with higher quantities typically found in samples from the milking parlor. This study highlights the different infection dynamics in three unvaccinated dairy goat herds and the potential use of dust samples as a supportive tool to detect C. burnetii at the herd level

Perfil de los factores de riesgo asociados a la aparición de la primera infección intrahospitalaria en pacientes con quemaduras de segundo y tercer grado atendidos en el pabellón de Quemados de la Unidad de Servicios de Salud U. S. S. Simón Bolívar desde 1 de Enero hasta 31 de Julio del año 2018

102 páginasEn los pacientes con quemaduras existen diversos factores de riesgo, que favorecen la aparición de infecciones intrahospitalarias, una complicación frecuente debido a la condición fisiológica provocada por la lesión. Actualmente esto representa un serio problema de salud pública, el cual conlleva aumento significativo en la morbimortalidad y costos en salud. Se realiza un análisis descriptivo, retrospectivo y univariado que tiene como fin caracterizar los factores de riesgo asociados a la aparición de la primera de infección intrahospitalaria en pacientes con quemaduras de segundo y tercer grado en la Unidad de Servicios de Salud U.S.S. Simón Bolívar desde el 1 de enero hasta el 31 de julio del año 2018. En primer lugar, se seleccionó la población de estudio mediante criterios de inclusión y exclusión previamente establecidos, permitiendo así la caracterización de la población objeto. Posterior a esto se desarrolló un formulario para la recolección de información suministrada por las historias clínicas del pabellón de quemaduras en la U.S.S. Simón Bolívar, luego se procede analizar los datos encontrados, mediante frecuencias para variables cualitativas y prueba shapiro wilk para establecer la normalidad de las variables cuantitativas. Dentro de los factores de riesgo encontrados en el presente estudio asociados a la aparición de IAAS en los pacientes quemados son: ser remitido de otra institución, pertenecer al grupo de adultez, sufrir quemadura por llama o electricidad, presentar quemadura grado II superficial y profunda, demoras en el primer acto quirúrgico, modulación inadecuada de la respuesta inmune y fisiológica de los pacientes con quemaduras, presentar dos o mas segmentos comprometidos por la quemadura, y estancia hospitalaria prolongada.In patients with burns there are several risk factors that favor the appearance of nosocomial infections, a frequent complication due to the physiological condition caused by the injury. Currently, this represents a serious public health problem, which entails a significant increase in morbidity and mortality and health costs. A descriptive, retrospective and univariate analysis is carried out with the purpose of characterizing the risk factors associated with the appearance of the first intrahospital infection in patients with second and third degree burns in the U.S.S. Simón Bolívar from January 1 to July 31 of the year 2018. First, the study population was selected through previously established inclusion and exclusion criteria, thus allowing the characterization of the target population. Among the risk factors associated with IAAS were: Be remitted after 24 hours, time of the first surgical act, burned body segments, depth of burn, unmodulated inflammatory response, microbiology of the hospital and nutritional status of the patient.Incluye bibliografíaPregradoMédico(a) Cirujan

Comparison of genetic risk prediction models to improve prediction of coronary heart disease in two large cohorts of the MONICA/KORA study

It is still unclear how genetic information, provided as single-nucleotide polymorphisms (SNPs), can be most effectively integrated into risk prediction models for coronary heart disease (CHD) to add significant predictive value beyond clinical risk models. For the present study, a population-based case-cohort was used as a trainingset (451 incident cases, 1488 noncases) and an independent cohort as testset (160 incident cases, 2749 noncases). The following strategies to quantify genetic information were compared: A weighted genetic risk score including Metabochip SNPs associated with CHD in the literature (GRSMetabo ); selection of the most predictive SNPs among these literature-confirmed variants using priority-Lasso (PLMetabo ); validation of two comprehensive polygenic risk scores: GRSGola based on Metabochip data, and GRSKhera (available in the testset only) based on cross-validated genome-wide genotyping data. We used Cox regression to assess associations with incident CHD. C-index, category-free net reclassification index (cfNRI) and relative integrated discrimination improvement (IDIrel ) were used to quantify the predictive performance of genetic information beyond Framingham risk score variables. In contrast to GRSMetabo and PLMetabo , GRSGola significantly improved the prediction (delta C-index [95% confidence interval]: 0.0087 [0.0044, 0.0130]; IDIrel : 0.0509 [0.0131, 0.0894]; cfNRI improved only in cases: 0.1761 [0.0253, 0.3219]). GRSKhera yielded slightly worse prediction results than GRSGola

Obesity and its associated factors in older nursing home residents in three European countries—Secondary data analyses from the “International Prevalence Measurement of Care Quality”

Background: The prevalence of obesity has risen in recent decades and reached epidemic proportions worldwide. The proportion of those living with obesity is also increasing in nursing homes. This could impact the nursing care required, equipment and facilities provided, and morbidity in these settings. Limited evidence exists on clinical consequences of obesity in nursing home residents and their care. Objective: Therefore, the aim was to examine the rate and associated factors of obesity (BMI ≥30; class I (BMI 30.0–34.9 kg/m2), class II (BMI 35.0–39.9 kg/m2), and class III (BMI >40.0 kg/m2)) amongst older nursing home residents in European countries. Methods: We analysed data from 21,836 people who reside in nursing homes in Austria, the Netherlands, and the United Kingdom. They participated in the “International Prevalence Measurement of Care Quality”, a cross sectional study between 2016 and 2019, where trained nurses interviewed the residents, reviewed care records, and conducted clinical examinations. A tested and standardised questionnaire comprised questions on demographic data, measured BMI, medical diagnosis according to ICD‐10, and care dependency. Descriptive and logistic regression analyses were performed. Results: Obesity rates were highest in Austria (17.1%) and lowest in the UK (13.0%) (p = .006). Residents with obesity were younger and less likely to be care dependent or living with dementia and had more often diabetes mellitus, endocrine, metabolic, and skin diseases compared to residents without obesity (p < .05). Most obese residents had obesity class I. Therefore, two subgroups were built (class I vs. class II + III). Residents with obesity class II + III were more frequently care dependent for mobility, getting dressed and undressed, and personal hygiene compared to residents with class I (p < .05). Conclusions: This study identified several factors that are associated with obesity amongst older nursing home residents in selected European countries. Implications for practice: The division into obesity classes is important for planning targeted care according to the individual needs of nursing home residents

Which factors influence the prevalence of institution‐acquired falls? Results from an international, multi‐center, cross‐sectional survey

Purpose: Falls are a highly prevalent problem in hospitals and nursing homes with serious negative consequences such as injuries, increased care dependency, or even death. The aim of this study was to provide a comprehensive insight into institution-acquired fall (IAF) prevalence and risk factors for IAF in a large sample of hospital patients and nursing home residents among five different countries. Design: This study reports the outcome of a secondary data analysis of cross-sectional data collected in Austria, Switzerland, the Netherlands, Turkey, and the United Kingdom in 2017 and 2018. These data include 58,319 datapoints from hospital patients and nursing home residents. Methods: Descriptive statistics, statistical tests, logistic regression and generalised estimating equation (GEE) models were used to analyse the data. Findings: IAF prevalence in hospitals and nursing homes differed significantly between the countries. Turkey (7·7 %) had the highest IAF prevalence rate for hospitals and Switzerland (15·8 %), for nursing homes. In hospitals, our model revealed that IAF prevalence was associated with country, age, care dependency, number of medical diagnoses, surgery in the last two weeks, and fall history factors. In nursing homes, care dependency, diseases of the nervous system, and fall history were identified as significant risk factors for IAF prevalence. Conclusions: This large-scale study reveals that the most important IAF risk factor is an existing history of falls, independent of the setting. Whether a previous fall has occurred within the last 12 months is a simple question that should be included on every (nursing) assessment at the time of patient or resident admission. Our results guide the development of tailored prevention programs for persons at risk of falling in hospitals and nursing homes

Neuropeptide S receptor gene - converging evidence for a role in panic disorder

Animal studies have suggested neuropeptide S (NPS) and its receptor (NPSR) to be involved in the pathogenesis of anxiety-related behavior. In this study, a multilevel approach was applied to further elucidate the role of NPS in the etiology of human anxiety. The functional NPSR A/T (Asn¹⁰⁷Ile) variant (rs324981) was investigated for association with (1) panic disorder with and without agoraphobia in two large, independent case-control studies, (2) dimensional anxiety traits, (3) autonomic arousal level during a behavioral avoidance test and (4) brain activation correlates of anxiety-related emotional processing in panic disorder. The more active NPSR rs324981 T allele was found to be associated with panic disorder in the female subgroup of patients in both samples as well as in a meta-analytic approach. The T risk allele was further related to elevated anxiety sensitivity, increased heart rate and higher symptom reports during a behavioral avoidance test as well as decreased activity in the dorsolateral prefrontal, lateral orbitofrontal and anterior cingulate cortex during processing of fearful faces in patients with panic disorder. The present results provide converging evidence for a female-dominant role of NPSR gene variation in panic disorder potentially through heightened autonomic arousal and distorted processing of anxiety-relevant emotional stimuli

Ocean current patterns drive the worldwide colonization of eelgrass (Zostera marina)

publishedVersio

Comparable cellular and humoral immunity upon homologous and heterologous COVID-19 vaccination regimens in kidney transplant recipients

BackgroundKidney transplant recipients (KTRs) are at high risk for a severe course of coronavirus disease 2019 (COVID-19); thus, effective vaccination is critical. However, the achievement of protective immunogenicity is hampered by immunosuppressive therapies. We assessed cellular and humoral immunity and breakthrough infection rates in KTRs vaccinated with homologous and heterologous COVID-19 vaccination regimens.MethodWe performed a comparative in-depth analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–specific T-cell responses using multiplex Fluorospot assays and SARS-CoV-2-specific neutralizing antibodies (NAbs) between three-times homologously (n = 18) and heterologously (n = 8) vaccinated KTRs.ResultsWe detected SARS-CoV-2-reactive T cells in 100% of KTRs upon third vaccination, with comparable frequencies, T-cell expression profiles, and relative interferon γ and interleukin 2 production per single cell between homologously and heterologously vaccinated KTRs. SARS-CoV-2-specific NAb positivity rates were significantly higher in heterologously (87.5%) compared to homologously vaccinated (50.0%) KTRs (P &lt; 0.0001), whereas the magnitudes of NAb titers were comparable between both subcohorts after third vaccination. SARS-CoV-2 breakthrough infections occurred in equal numbers in homologously (38.9%) and heterologously (37.5%) vaccinated KTRs with mild-to-moderate courses of COVID-19.ConclusionOur data support a more comprehensive assessment of not only humoral but also cellular SARS-CoV-2-specific immunity in KTRs to provide an in-depth understanding about the COVID-19 vaccine–induced immune response in a transplant setting