Assessment of physicians’ and senior medical students’ knowledge in treatment of patients with community acquired pneumonia: Current results of the KNOCAP project

Introduction. Community-acquired pneumonia (CAP) remains one of the most acute problems of bronchopulmonary pathology being the 4th in the mortality structure (after cardiovascular, cerebrovascular diseases and malignant neoplasms) and the 1st among all fatalities from infectious diseases. Thanks to the scientific progress achieved in the antibiotic therapy and vaccine prophylaxis, the death toll has decreased four times compared to its rate during the “pre-antibiotic era“. However, nowadays there is a steadily increasing trend in the pneumonia mortality rate in Russia. The only possible way to increase efficacy of CAP treatment is timely initiated rational antibiotic therapy, considering the possible etiologies, risk factors and the severity of the patient’s condition. Materials and methods. The article represents the results of anonymous prospective surveys within the framework of the KNOCAP multi-centered research project aimed at accessing the knowledge on the fundamental issues in diagnosis and treatment of community-acquired pneumonia. The survey involved 222 students in their fifth- and sixth years in medical institute from Belgorod, Dnepr (Dnipro), Voronezh, Kiev (Kyiv) and Saratov and 110 physicians from Krasnodar, Saratov, Belgorod and Dnepr.Results and discussion. According to the results of the survey, such levels of correct answers were given by doctors and students, respectively: the inadmissibility of antimicrobial therapy (AMT) delay in CAP - 82% and 59%; the main criterion for withholding AMT - 56% and 37%; “sequential therapy” - 61% and 59%. At the same time, only 24% of the students and 23% of the physicians surveyed correctly reported typical mistakes in the treatment of a non-severe CAP with 50% or more accuracy; and in case of initial treatment, the number of correct responses was less than 28% for students and 45% for doctors. Conclusion. The survey showed that both senior medical students majoring in Medical Care and general practitioners had a low level of knowledge in CAP treatment. Hence, curricula need to be adjusted both in medical universities and in health institutions for practitioners in order to inform them and, thus, improve the quality of their knowledge in this field

Assessment of physicians’ and senior medical students’ knowledge in treatment of patients with community-acquired pneumonia: Current results of the KNOCAP project

Community-acquired pneumonia (CAP) remains one of the most acute problems of bronchopulmonary pathology being the 4th in the mortality structure (after cardiovascular, cerebrovascular diseases and malignant neoplasms) and the 1st among all fatalities from infectious diseases. Thanks to the scientific progress achieved in the antibiotic therapy and vaccine prophylaxis, the death toll has decreased four times compared to its rate during the “pre-antibiotic era“. However, nowadays there is a steadily increasing trend in the pneumonia mortality rate in Russia. The only possible way to increase efficacy of CAP treatment is timely initiated rational antibiotic therapy, considering the possible etiologies, risk factors and the severity of the patient’s condition

Association of residential dampness and mold with respiratory tract infections and bronchitis: a meta-analysis

<p>Abstract</p> <p>Background</p> <p>Dampness and mold have been shown in qualitative reviews to be associated with a variety of adverse respiratory health effects, including respiratory tract infections. Several published meta-analyses have provided quantitative summaries for some of these associations, but not for respiratory infections. Demonstrating a causal relationship between dampness-related agents, which are preventable exposures, and respiratory tract infections would suggest important new public health strategies. We report the results of quantitative meta-analyses of published studies that examined the association of dampness or mold in homes with respiratory infections and bronchitis.</p> <p>Methods</p> <p>For primary studies meeting eligibility criteria, we transformed reported odds ratios (ORs) and confidence intervals (CIs) to the log scale. Both fixed and random effects models were applied to the log ORs and their variances. Most studies contained multiple estimated ORs. Models accounted for the correlation between multiple results within the studies analyzed. One set of analyses was performed with all eligible studies, and another set restricted to studies that controlled for age, gender, smoking, and socioeconomic status. Subgroups of studies were assessed to explore heterogeneity. Funnel plots were used to assess publication bias.</p> <p>Results</p> <p>The resulting summary estimates of ORs from random effects models based on all studies ranged from 1.38 to 1.50, with 95% CIs excluding the null in all cases. Use of different analysis models and restricting analyses based on control of multiple confounding variables changed findings only slightly. ORs (95% CIs) from random effects models using studies adjusting for major confounding variables were, for bronchitis, 1.45 (1.32-1.59); for respiratory infections, 1.44 (1.31-1.59); for respiratory infections excluding nonspecific upper respiratory infections, 1.50 (1.32-1.70), and for respiratory infections in children or infants, 1.48 (1.33-1.65). Little effect of publication bias was evident. Estimated attributable risk proportions ranged from 8% to 20%.</p> <p>Conclusions</p> <p>Residential dampness and mold are associated with substantial and statistically significant increases in both respiratory infections and bronchitis. If these associations were confirmed as causal, effective control of dampness and mold in buildings would prevent a substantial proportion of respiratory infections.</p

Association of residential dampness and mold with respiratory tract infections and bronchitis: a meta-analysis

Dampness and mold have been shown in qualitative reviews to be associated with a variety of adverse respiratory health effects, including respiratory tract infections. Several published meta-analyses have provided quantitative summaries for some of these associations, but not for respiratory infections. Demonstrating a causal relationship between dampness-related agents, which are preventable exposures, and respiratory tract infections would suggest important new public health strategies. We report the results of quantitative meta-analyses of published studies that examined the association of dampness or mold in homes with respiratory infections and bronchitis. For primary studies meeting eligibility criteria, we transformed reported odds ratios (ORs) and confidence intervals (CIs) to the log scale. Both fixed and random effects models were applied to the log ORs and their variances. Most studies contained multiple estimated ORs. Models accounted for the correlation between multiple results within the studies analyzed. One set of analyses was performed with all eligible studies, and another set restricted to studies that controlled for age, gender, smoking, and socioeconomic status. Subgroups of studies were assessed to explore heterogeneity. Funnel plots were used to assess publication bias. The resulting summary estimates of ORs from random effects models based on all studies ranged from 1.38 to 1.50, with 95% CIs excluding the null in all cases. Use of different analysis models and restricting analyses based on control of multiple confounding variables changed findings only slightly. ORs (95% CIs) from random effects models using studies adjusting for major confounding variables were, for bronchitis, 1.45 (1.32-1.59); for respiratory infections, 1.44 (1.31-1.59); for respiratory infections excluding nonspecific upper respiratory infections, 1.50 (1.32-1.70), and for respiratory infections in children or infants, 1.48 (1.33-1.65). Little effect of publication bias was evident. Estimated attributable risk proportions ranged from 8% to 20%. Residential dampness and mold are associated with substantial and statistically significant increases in both respiratory infections and bronchitis. If these associations were confirmed as causal, effective control of dampness and mold in buildings would prevent a substantial proportion of respiratory infections

YB-1 Phosphorylation at Serine 209 Inhibits Its Nuclear Translocation

YB-1 is a multifunctional DNA- and RNA-binding protein involved in cell proliferation, differentiation, and migration. YB-1 is a predominantly cytoplasmic protein that is transported to the nucleus in certain conditions, including DNA-damaging stress, transcription inhibition, and viral infection. In tumors, YB-1 nuclear localization correlates with high aggressiveness, multidrug resistance, and a poor prognosis. It is known that posttranslational modifications can regulate the nuclear translocation of YB-1. In particular, well-studied phosphorylation at serine 102 (S102) activates YB-1 nuclear import. Here, we report that Akt kinase phosphorylates YB-1 in vitro at serine 209 (S209), which is located in the vicinity of the YB-1 nuclear localization signal. Using phosphomimetic substitutions, we showed that S209 phosphorylation inhibits YB-1 nuclear translocation and prevents p-S102-mediated YB-1 nuclear import

Taxonomic Reassessment of Freshwater Mussels from the Western Balkans Reveals an Overlooked but Critical Refugium and Defines Conservation Priorities

Freshwater mussels are an endangered group of animals, especially in the water bodies of Central and Western Europe. Conservation priorities were established for many endangered freshwater mussel species in the last decade. Here, we present new data on a cryptic refugium of freshwater mussels in the Western Balkans. Two species, Anodonta exulcerata Porro, 1838 and Unio elongatulus Pfeiffer, 1825, were discovered in Montenegro for the first time. The phylogenetic position and taxonomic status of freshwater mussel species from Montenegro were studied by means of an integrative approach, combining morphological data and COI gene sequences. Unio carneus K&uuml;ster, 1854 stat. rev. represents a species with a restricted range, which is endemic to the Western Balkans. A viable population of Microcondylaea&nbsp;bonellii (F&eacute;russac, 1827) was discovered in the Zeta River. This species was not mentioned in Montenegro since the 1900s. A significant level of genetic diversity was revealed for the studied species. In the Skadar Lake basin, freshwater mussels from diverse ecological groups were discovered. Rheophilic species of freshwater mussels may represent ancient lineages, which need special conservation planning. Conservation priorities should be aimed at the protection of freshwater mussel habitats on the Balkan Peninsula

Taxonomic Reassessment of Freshwater Mussels from the Western Balkans Reveals an Overlooked but Critical Refugium and Defines Conservation Priorities

Freshwater mussels are an endangered group of animals, especially in the water bodies of Central and Western Europe. Conservation priorities were established for many endangered freshwater mussel species in the last decade. Here, we present new data on a cryptic refugium of freshwater mussels in the Western Balkans. Two species, Anodonta exulcerata Porro, 1838 and Unio elongatulus Pfeiffer, 1825, were discovered in Montenegro for the first time. The phylogenetic position and taxonomic status of freshwater mussel species from Montenegro were studied by means of an integrative approach, combining morphological data and COI gene sequences. Unio carneus Küster, 1854 stat. rev. represents a species with a restricted range, which is endemic to the Western Balkans. A viable population of Microcondylaea bonellii (Férussac, 1827) was discovered in the Zeta River. This species was not mentioned in Montenegro since the 1900s. A significant level of genetic diversity was revealed for the studied species. In the Skadar Lake basin, freshwater mussels from diverse ecological groups were discovered. Rheophilic species of freshwater mussels may represent ancient lineages, which need special conservation planning. Conservation priorities should be aimed at the protection of freshwater mussel habitats on the Balkan Peninsula

Host Range and Phylogenetic Position of Acipenserobdella volgensis (Zykoff, 1904) (Hirudinea: Piscicolidae) with a Global Checklist of Bivalve-Associated Fish Leeches

The fish leech Acipenserobdella volgensis (Hirudinea: Piscicolidae) is a rare and poorly known freshwater species, which is thought to be an obligate parasite of sturgeons. This leech has a disjunctive range in Europe and Eastern Siberia. Here, we estimate the phylogenetic affinities and host range of A. volgensis using a set of DNA sequences (COI and 18S rRNA gene fragments), field observation data, and a review of the body of literature. Based on a time-calibrated Bayesian phylogeny, we show that the European and Siberian lineages of A. volgensis have been separated since the latest Pliocene (mean age = 2.7 Ma). The analysis of available host records indicates that this leech is characterized by a broader host range as it was collected from fish belonging to four families (Acipenseridae, Cyprinidae, Salmonidae, and Esocidae). Conversely, only a few suitable primary hosts (six sturgeons, one cyprinid, and one salmonid fish) were confirmed by earlier research. Moreover, this leech could be considered a facultative mussel-associated species that uses bivalves (duck mussel Anodonta anatina; Unionidae) as shelter. Globally, three other piscicolid leeches have been recorded from the mantle cavity of bivalve molluscs, that is, the freshwater taxa Caspiobdella fadejewi and Alexandrobdella makhrovi, and the marine species Austrobdella coliumicus