251 research outputs found
Is blood-brain-barrier disruption associated with cognitive deficits in first-episode psychosis? Findings from a retrospective chart analysis [Abstract]
Common laboratory tests and their correlation with the clinical presentation and prognosis of lemierre syndrome
INTRODUCTION
Lemierre syndrome is a thromboembolic complication following an acute bacterial infection of the head/neck area, often due to anaerobes. Data on the prognostic role of laboratory parameters is lacking.
METHODS
We analyzed individual-patient level data from a multinational cohort of patients with Lemierre-syndrome. Patients had an infection in the head/neck area, and contiguous vein thrombosis or septic embolism, irrespective of the causal pathogen. We studied the patterns of white blood cell count, platelet count, and C-reactive protein concentration investigating their association with baseline characteristics and in-hospital clinical outcomes (septic embolism, major bleeding, all-cause death).
RESULTS
A total of 447 (63%) patients had complete data for analysis. White blood cells were elevated across all subgroups (median 17Â ĂÂ 10/ÎŒL; Q1-Q3:12-21). Median platelet count was 61Â ĂÂ 10/ÎŒL (Q1-Q3:30-108) with decreasing levels with increasing age. Males, patients with renal failure or cardiopulmonary impairment, and those with typical Lemierre syndrome (tonsillitis, septic thromboembolism, positivity for Fusobacterium spp.) had the lowest platelet count. Median C-reactive protein was 122 (Q1-Q3:27-248) mg/L with higher values in patients who also had more severe thrombocytopenia. The overall risk of complications was similar across subgroups of patients stratified according to white blood cell and C-reactive protein levels. Patients in the lowest third of platelet count (<42Â ĂÂ 10/ÎŒL) had the highest rate of complications (26%), as opposed to those in the highest third (11%), notably septic embolic events.
CONCLUSIONS
Common laboratory tests correlate with the clinical presentation of Lemierre syndrome. However, extreme values did not appear to be prognostically relevant for in-hospital complications and potentially able to improve clinical management
Novel Organism Verification and Analysis (NOVA) study: identification of 35 clinical isolates representing potentially novel bacterial taxa using a pipeline based on whole genome sequencing
BACKGROUND
Reliable species identification of cultured isolates is essential in clinical bacteriology. We established a new study algorithm named NOVA - Novel Organism Verification and Analysis to systematically analyze bacterial isolates that cannot be characterized by conventional identification procedures MALDI-TOF MS and partial 16Â S rRNA gene sequencing using Whole Genome Sequencing (WGS).
RESULTS
We identified a total of 35 bacterial strains that represent potentially novel species. Corynebacterium sp. (nâ=â6) and Schaalia sp. (nâ=â5) were the predominant genera. Two strains each were identified within the genera Anaerococcus, Clostridium, Desulfovibrio, and Peptoniphilus, and one new species was detected within Citrobacter, Dermabacter, Helcococcus, Lancefieldella, Neisseria, Ochrobactrum (Brucella), Paenibacillus, Pantoea, Porphyromonas, Pseudoclavibacter, Pseudomonas, Psychrobacter, Pusillimonas, Rothia, Sneathia, and Tessaracoccus. Twenty-seven of 35 strains were isolated from deep tissue specimens or blood cultures. Seven out of 35 isolated strains identified were clinically relevant. In addition, 26 bacterial strains that could only be identified at the species level using WGS analysis, were mainly organisms that have been identified/classified very recently.
CONCLUSION
Our new algorithm proved to be a powerful tool for detection and identification of novel bacterial organisms. Publicly available clinical and genomic data may help to better understand their clinical and ecological role. Our identification of 35 novel strains, 7 of which appear to be clinically relevant, shows the wide range of undescribed pathogens yet to define
Validation of a proxyâreported SARCâF questionnaire for current and retrospective screening of sarcopeniaârelated functional impairments
BACKGROUND: The strength, assistance walking, rise from a chair, climb stairs, and falls (SARCâF) questionnaire is a wellâestablished instrument for screening of sarcopenia and sarcopeniaârelated functional impairments. As it is based on selfâreporting, its use precludes patients who are unable to answer the questionnaire as a consequence of severe acute diseases or cognitive impairment. Therefore, we aimed to validate a proxyâreported version of the SARCâF for both adâhoc as well as retrospective screening for severe sarcopeniaârelated functional impairments. METHODS: Patients aged â„60 years completed the SARCâF and performed the short physical performance battery (SPPB) at baseline (T1). Proxies in Cohort A gave a simultaneous assessment of the patients' functional status with the proxyâreported SARCâF at T1 and again, retrospectively, after 3 months (T2). Proxies in Cohort B only completed the SARCâF retrospectively at T2. The questionnaires' performances were assessed through sensitivity/specificity analyses and receiver operating characteristic (ROC) curves. For nonâinferiority analyses, results of both the patientâreported and proxyâreported SARCâF were correlated with the SPPB total score as well as the results of the chairârise test subcategory; the respective correlation coefficients were tested against each other. RESULTS: One hundred and four patients and 135 proxies participated. Using a SPPB score < 9 points as the reference standard, the proxyâreported SARCâF identified patients at high risk for sarcopeniaârelated functional impairment with a sensitivity of 0.81 (adâhoc), 0.88 (retrospective Cohort A), and 0.87 (retrospective Cohort B) as well as a specificity of 0.89 (adâhoc), 0.78 (retrospective Cohort A), and 0.64 (retrospective Cohort B). Areas under the ROC curves were â„ 0.9 for the adâhoc proxyâreported SARCâF and the retrospective proxyâreported SARCâF in both cohorts. The proxyâreported SARCâF showed a nonâinferior correlation with the SPPB compared with the patientâreported SARCâF for adâhoc (P = <0.001) as well as retrospective screening for severe sarcopeniaârelated functional impairment in both Cohorts A (P = 0.007) and B (P = 0.026). CONCLUSIONS: Proxyâreported SARCâF is a valid instrument for both adâhoc as well as retrospective screening for sarcopeniaârelated functional impairment and could become the standard tool for evaluating this risk in older adults with severe acute disease, for example, in patients with quickly evolving haematological conditions
Associations between aerobic fitness and brain structure in schizophrenia with a focus on hippocampal formation subfield volume [Abstract]
The interaction studied via femtoscopy in p + Nb reactions at
We report on the first measurement of and correlations via
the femtoscopy method in p+Nb reactions at , studied with the High Acceptance Di-Electron Spectrometer
(HADES). By comparing the experimental correlation function to model
calculations, a source size for pairs of and a slightly
smaller value for of is extracted.
Using the geometrical extent of the particle emitting region, determined
experimentally with correlations as reference together with a source
function from a transport model, it is possible to study different sets of
scattering parameters. The correlation is proven sensitive to
predicted scattering length values from chiral effective field theory. We
demonstrate that the femtoscopy technique can be used as valid alternative to
the analysis of scattering data to study the hyperon-nucleon interaction.Comment: 12 pages, 11 figure
Exploring effects of exercise on the functional connectome in patients with schizophrenia [Abstract]
ZIC1 Is Downregulated through Promoter Hypermethylation, and Functions as a Tumor Suppressor Gene in Colorectal Cancer
The transcription factor, Zinc finger of the cerebellum (ZIC1), plays a crucial role in vertebrate development. Recently, ZIC1 has also been found to participate in the progression of human cancers, including medulloblastomas, endometrial cancers, and mesenchymal neoplasms. However, the function of ZIC1 in colon cancer progression has not been defined. In this study, we demonstrate ZIC1 to be silenced or significantly downregulated in colon cancer cell lines. These effects were reversed by demethylation treatment with 5-aza-2âČ-deoxycytidine (Aza). ZIC1 expression is also significantly downregulated in primary colorectal cancer tissues relative to adjacent non-tumor tissues (pâ=â0.0001). Furthermore, methylation of ZIC1 gene promoter is frequently detected in primary tumor tissues (85%, 34/40), but not in adjacent non-tumor tissues. Ectopic expression of ZIC1 suppresses cell proliferation and induces apoptosis, which is associated with MAPK and PI3K/Akt pathways, as well as the Bcl-xl/Bad/Caspase3 cascade. To identify target candidates of ZIC1, we employed cDNA microarray and found that 337 genes are downregulated and 95 genes upregulated by ectopic expression of ZIC1, which were verified by 10 selected gene expressions by qRT-PCR. Taken together, our results suggest that ZIC1 may potentially function as a tumor suppressor gene, which is downregulated through promoter hypermethylation in colorectal cancers
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