Zusammenhang zwischen kindlichem Geschlecht und Atemnotsyndrom bei Frühgeborenen

Das Atemnotsyndrom (ANS) ist die häufigste pulmonale Komplikation im Zusammenhang mit frühgeborenen Kindern. Die Inzidenz des ANS unterscheidet sich zwischen Knaben und Mädchen im Verhältnis von 1.7:1. Somit stellt sich die Frage, welche pathophysiologischen Ursachen diesen Zusammenhang von kindlichem Geschlecht und Morbidität des ANS bei frühgeborenen Kindern begründen. Mittels aktueller Literatur wird die Fragestellung dieser themengeleiteten Bachelorarbeit beantwortet. Anhand drei Hauptstudien wird über die Unterschiede in der Lungenstruktur, in der Natrium-Transportaktivität sowie über den Einfluss der Geschlechtshormone die Geschlechterdisparität untersucht. Dabei sind die Geschlechtshormone der Hauptfaktor. Sie haben Einfluss auf der genetischen, hormonellen und strukturellen Ebene. Östrogene beeinflussen den Natriumtransport stimulierend, während Androgene hemmend wirken. In den Lungen von weiblichen Feten ist die Natrium-Transportaktivität höher als bei männlichen. Durch die vermehrte Wirkung von Östrogen entsteht ein Unterschied in der Lungenstruktur. Mädchen haben im Vergleich zu Knaben mehrere und kleinere Alveolen und folglich eine grössere Gasaustausch-Oberfläche. Ebenfalls beeinflussen die Geschlechtshormone die Surfactantproduktion qualitativ und quantitativ. Weitere Forschungen sind nötig, um ein umfangreicheres Wissen über den Geschlechterunterschied in Bezug auf das ANS zu erlangen. In Zukunft soll ein Praxis-Transfer stattfinden, um die betroffenen Eltern evidenzbasiert beraten zu können. Durch therapeutische Massnahmen könnte die Benachteiligung der männlichen Feten verbessert werden

Using sociometers to quantify social interaction patterns

Research on human social interactions has traditionally relied on self-reports. Despite their widespread use, self-reported accounts of behaviour are prone to biases and necessarily reduce the range of behaviours, and the number of subjects, that may be studied simultaneously. The development of ever smaller sensors makes it possible to study group-level human behaviour in naturalistic settings outside research laboratories. We used such sensors, sociometers, to examine gender, talkativeness and interaction style in two different contexts. Here, we find that in the collaborative context, women were much more likely to be physically proximate to other women and were also significantly more talkative than men, especially in small groups. In contrast, there were no gender-based differences in the non-collaborative setting. Our results highlight the importance of objective measurement in the study of human behaviour, here enabling us to discern context specific, gender-based differences in interaction style

Higher risk for influenza-associated pulmonary aspergillosis (IAPA) in asthmatic patients: A Swiss multicenter cohort study on IAPA in critically ill influenza patients

Background: Influenza-associated pulmonary aspergillosis (IAPA) is an important complication of severe influenza with high morbidity and mortality. Methods: We conducted a retrospective multicenter study in tertiary hospitals in Switzerland during 2017/2018 and 2019/2020 influenza seasons. All adults with PCR-confirmed influenza infection and treatment on intensive-care unit (ICU) for >24 h were included. IAPA was diagnosed according to previously published clinical, radiological, and microbiological criteria. We assessed risk factors for IAPA and predictors for poor outcome, which was a composite of in-hospital mortality, ICU length of stay ≥7 days, mechanical ventilation ≥7 days, or extracorporeal membrane oxygenation. Results: One hundred fifty-eight patients (median age 64 years, 45% females) with influenza were included, of which 17 (10.8%) had IAPA. Asthma was more common in IAPA patients (17% vs. 4% in non-IAPA, P = 0.05). Asthma (OR 12.0 [95% CI 2.1-67.2]) and days of mechanical ventilation (OR 1.1 [1.1-1.2]) were associated with IAPA. IAPA patients frequently required organ supportive therapies including mechanical ventilation (88% in IAPA vs. 53% in non-IAPA, P = 0.001) and vasoactive support (75% vs. 45%, P = 0.03) and had more complications including ARDS (53% vs. 26%, P = 0.04), respiratory bacterial infections (65% vs. 37%, P = 0.04), and higher ICU-mortality (35% vs. 16.4%, P = 0.05). IAPA (OR 28.8 [3.3-253.4]), influenza A (OR 3.3 [1.4-7.8]), and higher SAPS II score (OR 1.07 [1.05-1.10]) were independent predictors of poor outcome. Interpretation: High clinical suspicion, early diagnostics, and therapy are indicated in IAPA because of high morbidity and mortality. Asthma is likely an underappreciated risk factor for IAPA. Keywords: asthma; influenza; influenza-associated aspergillosis; intensive care medicine; invasive aspergillosis

Higher risk for influenza-associated pulmonary aspergillosis (IAPA) in asthmatic patients: A Swiss multicenter cohort study on IAPA in critically ill influenza patients.

BACKGROUND Influenza-associated pulmonary aspergillosis (IAPA) is an important complication of severe influenza with high morbidity and mortality. METHODS We conducted a retrospective multicenter study in tertiary hospitals in Switzerland during 2017/2018 and 2019/2020 influenza seasons. All adults with PCR-confirmed influenza infection and treatment on intensive-care unit (ICU) for >24 h were included. IAPA was diagnosed according to previously published clinical, radiological, and microbiological criteria. We assessed risk factors for IAPA and predictors for poor outcome, which was a composite of in-hospital mortality, ICU length of stay ≥7 days, mechanical ventilation ≥7 days, or extracorporeal membrane oxygenation. RESULTS One hundred fifty-eight patients (median age 64 years, 45% females) with influenza were included, of which 17 (10.8%) had IAPA. Asthma was more common in IAPA patients (17% vs. 4% in non-IAPA, P = 0.05). Asthma (OR 12.0 [95% CI 2.1-67.2]) and days of mechanical ventilation (OR 1.1 [1.1-1.2]) were associated with IAPA. IAPA patients frequently required organ supportive therapies including mechanical ventilation (88% in IAPA vs. 53% in non-IAPA, P = 0.001) and vasoactive support (75% vs. 45%, P = 0.03) and had more complications including ARDS (53% vs. 26%, P = 0.04), respiratory bacterial infections (65% vs. 37%, P = 0.04), and higher ICU-mortality (35% vs. 16.4%, P = 0.05). IAPA (OR 28.8 [3.3-253.4]), influenza A (OR 3.3 [1.4-7.8]), and higher SAPS II score (OR 1.07 [1.05-1.10]) were independent predictors of poor outcome. INTERPRETATION High clinical suspicion, early diagnostics, and therapy are indicated in IAPA because of high morbidity and mortality. Asthma is likely an underappreciated risk factor for IAPA

Expression and characterization of the bacterial mechanosensitive channel MscS in Xenopus laevis oocytes

We have successfully expressed and characterized mechanosensitive channel of small conductance (MscS) from Escherichia coli in oocytes of the African clawed frog, Xenopus laevis. MscS expressed in oocytes has the same single-channel conductance and voltage dependence as the channel in its native environment. Two hallmarks of MscS activity, the presence of conducting substates at high potentials and reversible adaptation to a sustained stimulus, are also exhibited by oocyte-expressed MscS. In addition to its ease of use, the oocyte system allows the user to work with relatively large patches, which could be an advantage for the visualization of membrane deformation. Furthermore, MscS can now be compared directly to its eukaryotic homologues or to other mechanosensitive channels that are not easily studied in E. coli

On the Dark Side of Therapies with Immunoglobulin Concentrates: The Adverse Events

Therapy by human immunoglobulin G (IgG) concentrates is a success story ongoing for decades with an ever increasing demand for this plasma product. The success of IgG concentrates on a clinical level is documented by the slowly increasing number of registered indication and the more rapid increase of the off-label uses, a topic dealt with in another contribution to this special issue of Frontiers in Immunology. A part of the success is the adverse event (AE) profile of IgG concentrates which is, even at life-long need for therapy, excellent. Transmission of pathogens in the last decade could be entirely controlled through the antecedent introduction by authorities of a regulatory network and installing quality standards by the plasma fractionation industry. The cornerstone of the regulatory network is current good manufacturing practice. Non-infectious AEs occur rarely and mainly are mild to moderate. However, in recent times, the increase in frequency of hemolytic and thrombotic AEs raised worrying questions on the possible background for these AEs. Below, we review elements of non-infectious AEs, and particularly focus on hemolysis and thrombosis. We discuss how the introduction of plasma fractionation by ion-exchange chromatography and polishing by immunoaffinity chromatographic steps might alter repertoire of specificities and influence AE profiles and efficacy of IgG concentrates