31 research outputs found

    Viral entry and translation in brain endothelia provoke influenza-associated encephalopathy

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    The version of record of this article, first published in Acta Neuropathologica, is available online at Publisher’s website: https://doi.org/10.1007/s00401-024-02723-z.Influenza-associated encephalopathy (IAE) is extremely acute in onset, with high lethality and morbidity within a few days, while the direct pathogenesis by influenza virus in this acute phase in the brain is largely unknown. Here we show that influenza virus enters into the cerebral endothelium and thereby induces IAE. Three-weeks-old young mice were inoculated with influenza A virus (IAV). Physical and neurological scores were recorded and temporal-spatial analyses of histopathology and viral studies were performed up to 72 h post inoculation. Histopathological examinations were also performed using IAE human autopsy brains. Viral infection, proliferation and pathogenesis were analyzed in cell lines of endothelium and astrocyte. The effects of anti-influenza viral drugs were tested in the cell lines and animal models. Upon intravenous inoculation of IAV in mice, the mice developed encephalopathy with brain edema and pathological lesions represented by micro bleeding and injured astrocytic process (clasmatodendrosis) within 72 h. Histologically, massive deposits of viral nucleoprotein were observed as early as 24 h post infection in the brain endothelial cells of mouse models and the IAE patients. IAV inoculated endothelial cell lines showed deposition of viral proteins and provoked cell death, while IAV scarcely amplified. Inhibition of viral transcription and translation suppressed the endothelial cell death and the lethality of mouse models. These data suggest that the onset of encephalopathy should be induced by cerebral endothelial infection with IAV. Thus, IAV entry into the endothelium, and transcription and/or translation of viral RNA, but not viral proliferation, should be the key pathogenesis of IAE

    Efficacy of Antimicrobial Catheters for Prevention of Catheter-Associated Urinary Tract Infection in Acute Cerebral Infarction

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    Background: Catheter-associated urinary tract infection (CAUTI) is a common nosocomial infection. However, the effectiveness of antimicrobial catheters in reducing CAUTI in cerebral infarction patients is unknown. The purpose of this study was to determine whether antimicrobial catheters protect against CAUTI in cerebral infarction patients. Methods: We identified 27,548 patients from the Japanese Diagnosis Procedure Combination Database who had been admitted from April 1, 2012 through March 31, 2014 for acute management of cerebral infarction and had used at least an indwelling urethral catheter. We extracted data on patient sex, age, comorbidity, length of stay, activities of daily living (ADL), surgery, hospital case volume, and catheter type. We defined CAUTI as a urinary tract infection arising during admission. We performed multi-level logistic regression analysis to analyze the reduction in CAUTI using antimicrobial catheters. Results: The rate of CAUTI was 8.8% and 8.3% in the control and antimicrobial catheter groups, respectively. Significant risk factors for CAUTI were age, diabetes requiring insulin therapy, low ADL score, and long hospitalization. Incidence rate was significantly lower in operated cases and those treated with tissue plasminogen activator. For all cases overall, the use of an antimicrobial catheter was not associated with a lower CAUTI rate. However, use was associated with a lower rate of CAUTI in diabetic patients on insulin. Conclusions: Antimicrobial catheter use was not associated with a lower incidence rate of CAUTI in acute cerebral infarction patients. However, stratified analysis suggested that use was associated with a lower incidence in diabetic patients on insulin

    Mechanical and oral antibiotics bowel preparation for elective rectal cancer surgery: A propensity score matching analysis using a nationwide inpatient database in Japan

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    Abstract Aim The best bowel preparation method for rectal surgery remains controversial. In this study we compared the efficacy and safety of mechanical bowel preparation (MBP) alone and MOABP (MBP combined with oral antibiotic bowel preparation [OABP]) for rectal cancer surgery. Methods In this retrospective study we analyzed data from the Japanese Diagnosis Procedure Combination (DPC) database on 37 291 patients who had undergone low anterior resection for rectal cancer from 2014 to 2017. Propensity score matching analysis was used to compare postoperative outcomes between MBP alone and MOABP. Results A total of 37 291 patients were divided into four groups: MBP alone: 77.7%, no bowel preparation (NBP): 16.9%, MOABP: 4.7%, and OABP alone: 0.7%. In propensity score matching analysis with 1756 pairs, anastomotic leakage (4.84% vs 7.86%, P < 0.001), small bowel obstruction (1.54% vs 3.08%, P = 0.002) and reoperation (3.76% vs 5.98%, P = 0.002) were less in the MOABP group than in the MBP group. The mean duration of postoperative antibiotics medication was shorter in the MOABP group (5.2 d vs 7.5 d, P < 0.001) than in the MBP group. There was no significant difference between the two groups in the incidence of Clostridium difficile (CD) colitis (0.40% vs 0.68%, P = 0.250) and methicillin‐resistant Staphylococcus aureus (MRSA) colitis (0.11% vs 0.17%, P = 0.654). There was no significant difference in in‐hospital mortality between the two groups (0.00% vs 0.11% respectively, P = 0.157). Conclusion MOABP for rectal surgery is associated with a decreased incidence of postoperative complications without increasing the incidence of CD colitis and MRSA colitis

    An outbreak of H7N6 low pathogenic avian influenza in quails in Japan

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    In February and March 2009, a total of seven quail farms in the Aichi Prefecture in Japan were found to be infected with an avian influenza (AI) virus. Low pathogenic AI viruses, subtype H7N6, were isolated from three of these farms. The infection was eliminated through the destruction of susceptible birds on the infected premises, movement controls of quail and other poultry in areas around infected premises, accompanied by intensive clinical, serological and virological surveillance. Sentinel quails were used to verify that the infected farms were free from AI virus before they were restocked. An epidemiological study revealed that the virus was likely to have been introduced into the infected area some time ago. Economic losses amounted to 874 million yen (US$9.75 million), mainly accounting for costs incurred by control and eradication measures and financial support for the infected farms and farms in the movement control areas
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