Comparative study of virulence potential, phylogenetic origin, CRISPR-Cas regions and drug resistance of Escherichia coli isolates from urine and other clinical materials

IntroductionUrinary tract infections (UTI), among which the main etiological factor is uropathogenic Escherichia coli (UPEC, E. coli), remain an important issue for clinicians. The aim of the study was to demonstrate clear differences in the pathogenic properties of urine-derived E. coli compared to other extraintestinal E. coli clinical isolates (derived from: blood, lower respiratory tracts, sputum, reproductive tract, body fluids, perianal pus, other pus, wound, postoperative wound and other sources).MethodsThe collection of 784 E. coli isolates was collected from various materials of hospitalized patients. They were analyzed in terms of virulence-associated genes (papC, sfaD/sfaE, cnf1, usp., fimG/H, hlyA), belonging to phylogenetic groups and the presence of CRISPR-Cas regions using PCR. In addition, the epidemiological data and the antibiotic resistance profiles provided by the hospital’s microbiology department were included for statistical analyses.ResultsUrine-derived E. coli showed significantly greater virulence potential compared to other isolates, but they were generally unremarkable in terms of drug resistance. The isolates most often belonged to phylogenetic group B2. Drug resistance was negatively correlated with CRISPR 2 presence and high average virulence score, but positively correlated with CRISPR 4 presence. To the best of our knowledge, we are the first to report significant differences in sputum-derived isolates—they revealed the lowest virulence potential and, at the same time, the highest drug resistance.DiscussionIn conclusion, we demonstrated significant differences of urinary-derived E. coli compared to other clinical E. coli isolates. We would like to suggest excluding penicillins from use in E. coli infection at this time and monitoring strains with a high pathogenicity potential

Troska o zdrowie w aspekcie społecznym. Cz. 2

Praca recenzowana / peer-reviewed pape

The money will be well spent: Even uninformative arguments boost prosocial and prevent from antisocial behavior

Although the majority of people value the idea of helping others, they often take no particular action. In two field studies we investigated the impact of differently justified requests for spontaneous charity donations and for antisocial behavior like stealing. In the experiments, unwatched stands with cookies and money jars were placed on a crowded city square with one of three different notes: (1) detailed prosocial justification, (2) general justification or (3) no justification. After testing almost 500 participants, we show that mere general arguments can both increase prosocial behavior and decrease antisocial behavior. Additionally, detailed prosocial justification augments generosity, causing people voluntarily to pay more than required. We conclude that prosocial (compliance with request) and antisocial (stealing) behavior is guided by automatic processes that track that there is any reason for the request, while generosity is guided by reflective assessment of the justification of the request

Radialna fala uderzeniowa i ultradźwięki w leczeniu entezopatii nadkłykcia bocznego kości ramiennej – doniesienie wstępne

Introduction: Lateral epicondylitis can be resistant to treatment that usually involves the use of conservative therapies, including physical modalities such as radial shockwave and ultrasound. Studies show that both modalities are efficacious but their results are inconsistent. The optimal parameters for applying them are also yet to be determined. This trial was designed to analyse and compare the efficacy of radial shock wave and ultrasound as therapies for treating patients with lateral epicondylitis. Material and methods: The trial was conducted with 26 patients with lateral epicondylitis divided into two comparative groups (A and B), each consisting of 13 patients. The groups were treated with radial shockwave and ultrasound, respectively. In both of them, changes in patients’ rest pain, night pain, pain during activity, and hand grip strength were evaluated, as well as the efficacy of both therapies. Results: The intensity of all types of pain decreased over the course of the study in both groups and patients’ grip strength gradually improved. The groups were comparable in terms of percentage change in the analysed parameters and the distribution of patients’ self-assessments of treatment efficacy. Conclusions: Radial shockwave and ultrasound show comparable efficacy in treating lateral epicondylitis. They are particularly effective in reducing pain intensity and increasing the hand grip strength of the affected extremity.Wstęp: Leczenie entezopatii nadkłykcia bocznego kości ramiennej bywa trudne. W terapii tego schorzenia wykorzystuje się przede wszystkim metody zachowawcze. Wśród stosowanych czynników fizykalnych zastosowanie znajdują między innymi radialna fala uderzeniowa i ultradźwięki. Wyniki badań, w których w leczeniu entezopatii nadkłykcia bocznego stosowano wspomniane bodźce wskazują na dobrą skuteczność omawianych zabiegów choć nie są jednoznaczne. Ponadto do tej pory nie ustalono optymalnych parametrów aplikacyjnych tych zabiegów. Celem pracy jest analiza skuteczności terapii za pomocą radialnej fali uderzeniowej i ultradźwięków w leczeniu entezopatii nadkłykcia bocznego kości ramiennej oraz porównanie efektywności terapeutycznej tych zabiegów we wspomnianej jednostce chorobowej. Materiał i metody: Do badań zakwalifikowano 26 pacjentów z entezopatią nadkłykcia bocznego kości ramiennej, których podzielono na dwie grupy porównawcze (A i B). Do grupy A i do grupy B zakwalifikowano po 13 pacjentów. W grupie A podczas terapii stosowano radialną falę uderzeniową, w grupie B natomiast ultradźwięki. W obu grupach analizowano zmiany wielkości bólu spoczynkowego, bólu nocnego oraz bólu występującego podczas aktywności, zmiany siły ścisku ręki, a także oceniano skuteczność terapii. Wyniki: W całym okresie obserwacji w obu grupach obserwowano redukcję wszystkich rodzajów analizowanego bólu. Ponadto, w obu grupach dochodziło również do stopniowego wzrostu siły chwytu chorej kończyny. Zmiany procentowe wszystkich analizowanych parametrów były zbliżone w obu porównywanych grupach. Rozkład wyników subiektywnej oceny efektów terapii w grupach A i B jest porównywalny. Wnioski: Zarówno radialna fala uderzeniowa, jak i ultradźwięki są skutecznymi metodami leczenia entezopatii nadkłykcia bocznego kości ramiennej, dając przede wszystkim dobry efekt przeciwbólowy oraz poprawę siły chwytu objętej patologią kończyny. Skuteczność obu metod fizykalnych w przypadku entezopatii nadkłykcia bocznego kości ramiennej jest porównywalna

Prediction of Wastewater Quality at a Wastewater Treatment Plant Inlet Using a System Based on Machine Learning Methods

One of the important factors determining the biochemical processes in bioreactors is the quality of the wastewater inflow to the wastewater treatment plant (WWTP). Information on the quality of wastewater, sufficiently in advance, makes it possible to properly select bioreactor settings to obtain optimal process conditions. This paper presents the use of classification models to predict the variability of wastewater quality at the inflow to wastewater treatment plants, the values of which depend only on the amount of inflowing wastewater. The methodology of an expert system to predict selected indicators of wastewater quality at the inflow to the treatment plant (biochemical oxygen demand, chemical oxygen demand, total suspended solids, and ammonium nitrogen) on the example of a selected WWTP—Sitkówka Nowiny, was presented. In the considered system concept, a division of the values of measured wastewater quality indices into lower (reduced values of indicators in relation to average), average (typical and most common values), and upper (increased values) were adopted. On the basis of the calculations performed, it was found that the values of the selected wastewater quality indicators can be identified with sufficient accuracy by means of the determined statistical models based on the support vector machines and boosted trees methods

Esophageal Impedance-pH Monitoring and Pharyngeal pH Monitoring in the Diagnosis of Extraesophageal Reflux in Children

Various clinical symptoms are attributed to extraesophageal reflux disease (EERD). Multichannel intraluminal impedance-pH monitoring (MII-pH) is considered to correlate symptoms with acid and nonacid gastroesophageal reflux (GER) events. Pharyngeal pH monitoring (Dx-pH) is considered to correlate the decrease in the pH level in the oropharynx with reported symptoms and to diagnose supraesophageal reflux. We aimed to assess the correlation between acid reflux episodes recorded by Dx-pH and GER detected via MII-pH in children with suspected EERD. The study enrolled 23 consecutive children (15 boys and 8 girls; median age 8.25 [range 3-16.5] years) with suspected EERD. MII-pH and Dx-pH were conducted concurrently in all patients. A total of 1228 reflux episodes were recorded by MII-pH. With the antimonic sensor placed inside the impedance probe, 1272 pH-only reflux episodes were recorded. Of these, 977 (76.81%) were associated with a retrograde bolus transit. Regarding GER, 630 full-column episodes extended to the most proximal pair of impedance sensors; 500 (83.33%) demonstrated an acidic character. The following acid reflux numbers were determined by the Dx-pH system: for pH10% relative to the baseline, n=324. There was no significant correlation between the number of pharyngeal reflux episodes detected by Dx-pH and that of GERs identified by MII-pH. The proportion of oropharyngeal pH events that were temporally related to a GER episode increased with the extended pH criteria. The highest proportion was observed for a pH decrease of ≥10% from the baseline and did not exceed 5.2%. The application of the extended pH criteria in the Dx-pH system resulted in an increase in the number of diagnosed laryngopharyngeal refluxes; most were not temporally associated with GER episodes confirmed by MII-pH. Thus, the efficacy of the exclusive application of Dx-pH for supraesophageal gastric reflux diagnosis is uncertain

Non-Invasive Biomarkers in the Diagnosis of Upper Urinary Tract Urothelial Carcinoma—A Systematic Review

Beyond laboratory, imaging and endoscopic procedures, new diagnostic tools are increasingly being sought for the diagnosis of upper urinary tract urothelial carcinoma (UTUC), especially those that are non-invasive. In this systematic review, we aimed to determine the effectiveness of non-invasive tests in the diagnosis of UTUC. PubMed and Embase electronic databases were searched to identify studies assessing effectiveness of non-invasive tests in the primary diagnosis of UTUC. The study protocol was registered with PROSPERO (CRD42020216480). Among 10,084 screened publications, 25 were eligible and included in the analysis. Most of them were conducted on small samples of patients and the control groups were heterogenous. The test used in the largest number of studies was voided urinary cytology, which has poor sensitivity (11–71.1%) with favorable specificity (54–100%). Fluorescence in situ hybridization in diagnostic cytology showed higher sensitivity (35–85.7%) with equally good specificity (80–100%). There were also studies on the use of tests known to diagnose bladder cancer such as NMP22, uCYT or BTA test. Other urine or blood tests have been the subject of only isolated studies, with varying results. To conclude, currently there is a lack of high-quality data that could confirm good effectiveness of non-invasive tests used in the diagnosis of UTUC