scholarly journals Influence of LncRNA NKILA on Bloodstream Infection of Hypervirulent Klebsiella pneumoniae and Its Ability to Induce Delayed Neutrophil Apoptosis

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Yang Li ◽  
Weijia Wang ◽  
Kang Chen ◽  
Suzhen Ma ◽  
Juan Wang

Objective. Pneumonia due to hypervirulent Klebsiella pneumoniae (hvKP) is a high-risk subtype of pneumonia with high mortality and disability rates. An in-depth understanding of hvKP’s pathogenic process and mechanism of action is the focus of achieving early disease diagnosis and early symptomatic treatment. This study conducted a preliminary analysis on the influence of lncRNA NKILA (NKILA) on hvKP, aiming at providing a new approach to the diagnosis and treatment of hvKP and laying a reliable foundation for subsequent NKILA-related studies. Methods. Selected from our hospital from October 2016 to February 2018, 67 patients who were examined for the pathogenic microorganisms of alveolar lavage fluid were selected as the research subjects. Among them, 29 were diagnosed as hvKP (research group), and the other 38 had no pathogenic bacteria (control group). Serum and bronchoalveolar lavage fluid (BALF) NKILA and inflammatory factors were detected, and the clinical significance of NKILA was analyzed. In addition, neutrophils from research group were extracted and NKILA expression was increased to observe the alterations in cell apoptosis, respiratory burst intensity, and NF-kappa B inhibitor alpha (NF-κB) p65 protein. Results. Serum and BALF levels of NKILA and inflammatory factors were higher in research group than in control group, and NKILA decreased in both cohorts after treatment ( P < 0.05 ). NKILA had an excellent predictive effect on the occurrence of hvKP ( P < 0.001 ) and was positively correlated with inflammatory factors ( P < 0.05 ). Prognostic follow-up revealed that NKILA also had a good predictive value for death in hvKP patients ( P < 0.05 ), and increased posttreatment levels predicted an increased risk of death ( P < 0.05 ). In vitro, increased NKILA hindered the delayed apoptosis rate, decreased respiratory burst intensity of hvKP neutrophils, and activated NF-κB p65 protein ( P < 0.05 ). Conclusion. With an elevated expression profile in hvKP, NKILA can induce the delayed apoptosis of neutrophils, enhance the ability of releasing inflammatory mediators, and promote the progression of hvKP via activating NF-κB p65.


2009 ◽  
Vol 194 (2) ◽  
pp. 165-167 ◽  
Author(s):  
David M. Taylor ◽  
Petrina Douglas-Hall ◽  
Banke Olofinjana ◽  
Eromona Whiskey ◽  
Arwel Thomas

BackgroundClozapine has a range of serious adverse effects that may give rise to an increased risk of death.AimsTo compare reasons for discontinuation of clozapine with reasons for discontinuation of risperidone long-acting injection in age-matched individuals treated in the same clinical environment.MethodComparison of patients receiving clozapine and an age-matched control group receiving risperidone injection.ResultsWe established outcome for 529 consecutive patients receiving clozapine and 250 receiving risperidone (161 discontinuers from each group were compared). Adverse effects (odds ratio OR=2.19, 95% CI 1.31–3.67) and death (OR=7.0, 95% CI 2.09–23.5) were more commonly observed as reasons for discontinuation of clozapine than of risperidone. Clozapine was less likely to be withdrawn because of ineffectiveness than was risperidone (OR=0.034, 95% CI 0.01–0.14). Standardised mortality ratio (SMR) was significantly raised for patients receiving clozapine (SMR=4.17, 95% CI 2.78–6.26). Pneumonia was the most common single cause of death.ConclusionsClozapine use in patients with severe mental illness was associated with a significantly increased risk of death compared with that for the general population. Causation could not be established. Adverse effects and death are common causes of clozapine discontinuation.



Hematology ◽  
2014 ◽  
Vol 2014 (1) ◽  
pp. 425-431 ◽  
Author(s):  
Kenneth I. Ataga ◽  
Elizabeth S. Klings

Abstract The increased survival of patients with sickle cell disease (SCD) into adulthood is associated with an increased incidence of multiorgan dysfunction and a progressive systemic and pulmonary vasculopathy. The high prevalence of an elevated tricuspid regurgitant jet velocity and its association with an increased risk of death in adult patients is well established. However, there has been controversy regarding the prevalence of pulmonary hypertension (PH) and its association with mortality in SCD. Multiple recently published reports demonstrate that PH as diagnosed by right heart catheterization is common in adult SCD patients, with a prevalence of 6%–11%. Furthermore, PH is associated with an increased risk of death in SCD patients. In this chapter, we provide evidence for the high prevalence of PH in SCD and its association with mortality and make recommendations for its evaluation and management. Finally, we provide the rationale for screening for this life-threatening complication in adult patients with SCD.



Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 1677-1677
Author(s):  
Louise De Swart ◽  
Tom Johnston ◽  
Alexandra Smith ◽  
Pierre Fenaux ◽  
Argiris Symeonidis ◽  
...  

Abstract Background The outcome of lower-risk MDS patients with red blood cell transfusions (RBCT) dependency is inferior to that of RBCT independent patients, but whether the intensity of RBCT is important for prognosis is unknown. The EUMDS Registry is a non-interventional, observational longitudinal study enrolling patients with lower-risk MDS from 142 sites in 17 countries as described elsewhere (1). The EUMDS registry has accrued 1,902 patients as of July 21, 2015. We hypothesized that RBCT intensity is an independent prognostic factor for survival. Methods We first assessed the impact of RBCT intensity in the first year post-diagnosis (1yrPD) on progression-free survival among the 1034 patients who survived at least 1yrPD and had potential for a further year of follow-up. Secondly, we developed a longitudinal model of platelet counts throughout follow-up for 1660 patients in the registry with potential for at least one year follow-up. Results Among the 1034 patients, 323 patients had died: 67 after progression to higher-risk MDS/AML and 256 without progression. A further 41 surviving patients had progressed to AML. The overall 5-year survival was 52%. In a proportional hazards regression model (Table), the risk of death or progression increased in a non-linear fashion with age at diagnosis (p<0.001). The risk of death was increased in the intermediate IPSS-R risk group compared to low risk. Patients with RARS and 5q- syndrome had a better outcome compared to RCMD. Increased RBCT intensity in 1yrPD (Table, Figure) was strongly associated with an increased risk of death (p<0.001). In the 1660 patients no significant decline in platelet counts was observed (0.16x109 platelets/l average monthly decline, p=0.16) among patients who were not RBC transfused at any time during follow-up. However platelet counts of patients receiving RBCT declined more quickly (p<0.0001) at an average rate of 1.14x109 platelets/l/month. Among the 920 RBCT dependent patients, lower platelet counts were associated with receiving more RBCT units in the preceding six months. 185 Patients had at least 2 observations both before and after becoming RBCT dependent, defined as 1st RBCT. 50% of these patients had a decreasing trend of platelets prior to their 1st RBCT and 67% had a decreasing slope of platelets after their 1st RBCT. In the control group of RBC untransfused patients, decreasing slopes of platelets occurred in around 50% of the patients throughout the whole observation period of 4 visits. Logistic regression of the risk of having a post-1st RBCT decreasing trend in platelets showed that transfused patients were at a greater risk (OR=1.7, 95% CI: 1.1-2.7) of having a post-1st RBCT decreasing trend in platelets than untransfused patients. Conclusion These multivariate regression models including age, sex, country, IPSS and WHO classification showed that more intensive RBCT treatment is associated with poor prognosis and a more rapid decline of platelets. This indicates that the intensity of RBCT should be incorporated in the regular prognostic scoring systems and the choice of therapeutic interventions. (1): De Swart L et al. Br J Haematol 2015; 170: 372-83. Disclosures Fenaux: NOVARTIS: Honoraria, Research Funding; CELGENE: Honoraria, Research Funding; JANSSEN: Honoraria, Research Funding; AMGEN: Honoraria, Research Funding. Hellström-Lindberg:Celgene Corporation: Research Funding. Sanz:JANSSEN CILAG: Honoraria, Research Funding, Speakers Bureau. Mittelman:Roche: Research Funding; Novartis Pharmaceuticals Corporation: Research Funding; GlaxoSmithKline: Research Funding; Johnson & Johnson: Research Funding, Speakers Bureau; Celgene: Research Funding, Speakers Bureau; Amgen: Research Funding. Almeida:Bristol Meyer Squibb: Speakers Bureau; Shire: Speakers Bureau; Celgene: Consultancy; Novartis: Consultancy. Park:Hospira: Research Funding; Novartis: Membership on an entity's Board of Directors or advisory committees, Research Funding; Celgene: Research Funding. Itzykson:Oncoethix: Research Funding. de Witte:Novartis: Research Funding.



2011 ◽  
Vol 26 (S2) ◽  
pp. 133-133
Author(s):  
N. Aghakhani

IntroductionAbout 65 percent of patients with myocardial infarction experience mental and emotional problems like depression and anxiety that causes delay in the return to work, decreased quality of life and increased risk of death.The purpose of this study was to determine the effect of education on anxiety and depression in patients with myocardial infarction in Urmia hospitals in 2009.MethodsThis study was a quasi-experimental study that compares the effect of education on anxiety and depression in patients with myocardial infarction in the Urmia University of medical science hospitals. 124 patients were selected randomly and divided into two groups. The experimental group was educated through face to face training and educational booklet. Control group did not receive any intervention.Level of anxiety and depression was evaluated by using HADS questionnaire at 3 intervals after 48 hours of admission, discharge day and 2 months after discharge.ResultsThere was no significant difference between control and experimental groups before the intervention, But after the intervention, anxiety and depression in the experimental group was significantly less than controls, p < 0.05.ConclusionConsidering the beneficial results obtained from education on reducing anxiety and depression in patients with myocardial infarction, it should be one of the health care goals.



2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Ying Lu ◽  
Ning Wu ◽  
Bin Ma ◽  
Feng Qin

Objective. To explore the clinical effect of root canal therapy combined with full crown restoration in patients with cracked teeth and chronic pulpitis. Methods. From May 2018 to June 2020, 87 patients with cracked teeth and chronic pulpitis in our hospital were selected; the patients were randomly divided into the control group and the research group by random number method. The control group only used root canal therapy; the research group used root canal therapy combined with full crown restoration. The therapeutic effect, levels of inflammatory factors, chewing function, periodontal index, complications, and quality of life were compared between the two groups. Results. The total effective rate of the research group (97.78%) was better than the total effective rate of the control group (85.71%) ( P < 0.05 ). Compared with before treatment, the serum levels of interleukin-1β (IL-1β), IL-6, and C-reactive protein (CRP) of the two groups of patients decreased after treatment. After treatment, compared with the control group, the serum levels of IL-1β, IL-6, and CRP in the research group decreased ( P < 0.05 ). Compared with before treatment, the bite force of teeth and chewing efficiency of the two groups of patients increased after treatment. After treatment, compared with the control group, the bite force of teeth and chewing efficiency of the research group increased ( P < 0.05 ). Compared with before treatment, the plaque index (PLI), probing depth (PD), gingival sulcus bleeding index (BI), and gingival index (GI) of the two groups of patients decreased after treatment. After treatment, compared with the control group, the PLI, PD, BI, and GI of the research group decreased ( P < 0.05 ). The total incidence of complications in the research group was (11.11%), and the total incidence of complications in the control group was (16.67%); there was no significant difference between the two groups ( P > 0.05 ). After treatment, compared with the control group, the quality of life scores of the patients in the research group were reduced ( P < 0.05 ). Conclusion. Root canal therapy and full crown restoration have a definite curative effect in patients with cracked teeth and chronic pulpitis, which can improve the inflammatory response, restore chewing function, maintain periodontal health, improve the quality of life, and do not increase the incidence of complications, so it has good application value.



2021 ◽  
pp. injuryprev-2021-044224
Author(s):  
Mikkel Jacobi Thomsen ◽  
Matthew Liston ◽  
Merete Grothe Christensen ◽  
Peter Vestergaard ◽  
Rogerio Pessoto Hirata

BackgroundUnintentional falls among older adults are of primary importance due to their impact on quality of life. Falling accounts for 95% of hip fractures, leading to an approximately six times increased risk of death within the first 3 months. Furthermore, physical and cognitive parameters are risk factors for falls. The purpose of this study is to examine the effect of a 6-month salsa dance training intervention, compared with regular fitness circuit training and a control group.MethodsThis study will include 180 older adults: 90 healthy patients and 90 patients with osteoporosis. Participants will be allocated randomly in either of the groups, stratified according to age. Training groups will receive 2 weekly 1-hour training sessions, continuously through 6 months. Participants will be tested at baseline and 6 and 18 months post baseline. Primary outcome will be number of falls and secondary outcomes include bone mineral density, body composition, pain evaluation, weekly physical activity, single-task and dual-task gait patterns, balance, Fullerton Functional Fitness Test and assessment of the mini-BESTest.DiscussionThis study will investigate the effects of a specially designed dance training programme (Dancing Against falls iN Community-dwElling older adults (DANCE)) to reduce the risk of falling among older adults. The study will investigate the effect against an active and passive comparator, resulting in the possibility to state, if DANCE training should be an alternative to traditional training.Trial registration numberNCT03683849.



Critical Care ◽  
2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Elizabeth C. George ◽  
Sarah Kiguli ◽  
Peter Olupot Olupot ◽  
Robert O. Opoka ◽  
Charles Engoru ◽  
...  

Abstract Background African children hospitalised with severe febrile illness have a high risk of mortality. The Fluid Expansion As Supportive Therapy (FEAST) trial (ISCRTN 69856593) demonstrated increased mortality risk associated with fluid boluses, but the temporal relationship to bolus therapy and underlying mechanism remains unclear. Methods In a post hoc retrospective analysis, flexible parametric models were used to compare change in mortality risk post-randomisation in children allocated to bolus therapy with 20–40 ml/kg 5% albumin or 0.9% saline over 1–2 h or no bolus (control, 4 ml/kg/hour maintenance), overall and for different terminal clinical events (cardiogenic, neurological, respiratory, or unknown/other). Results Two thousand ninety-seven and 1041 children were randomised to bolus vs no bolus, of whom 254 (12%) and 91 (9%) respectively died within 28 days. Median (IQR) bolus fluid in the bolus groups received by 4 h was 20 (20, 40) ml/kg and was the same at 8 h; total fluids received in bolus groups at 4 h and 8 h were 38 (28, 43) ml/kg and 40 (30, 50) ml/kg, respectively. Total fluid volumes received in the control group by 4 h and 8 h were median (IQR) 10 (6, 15) ml/kg and 10 (10, 26) ml/kg, respectively. Mortality risk was greatest 30 min post-randomisation in both groups, declining sharply to 4 h and then more slowly to 28 days. Maximum mortality risk was similar in bolus and no bolus groups; however, the risk declined more slowly in the bolus group, with significantly higher mortality risk compared to the no bolus group from 1.6 to 101 h (4 days) post-randomisation. The delay in decline in mortality risk in the bolus groups was most pronounced for cardiogenic modes of death. Conclusions The increased risk from bolus therapy was not due to a mechanism occurring immediately after bolus administration. Excess mortality risk in the bolus group resulted from slower decrease in mortality risk over the ensuing 4 days. Thus, administration of modest bolus volumes appeared to prevent mortality risk declining at the same rate that it would have done without a bolus, rather than harm associated with bolus resulting from a concurrent increased risk of death peri-bolus administration. Trial registration ISRCTN69856593. Date of registration 15 December 2008.



2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Bo Liu ◽  
Yongxiang Zhang ◽  
Jun Li ◽  
Weihong Zhang

AbstractEpidemiological studies have demonstrated an increased risk of non-Hodgkin lymphoma (NHL) in patients with chronic hepatitis C virus (HCV) infection. Therefore, we investigated the risk of extrahepatic malignancies associated with HCV infection. Inpatients diagnosed with lymphoma, breast, thyroid, kidney, or pancreatic cancer (research group, n = 17,925) as well as inpatients with no malignancies (control group, n = 16,580) matched by gender and age were enrolled from The First Affiliated Hospital of Nanjing Medical University between January 2008 and December 2016. A case-control study was conducted by retrospective analysis. The difference in HCV prevalence was analyzed between the research group and the control group. Also, the research group was compared to the 2006 National Hepatitis C sero-survey in China. A total of 86 cases were positive for anti-HCV in the research group. Compared with the control group (103 cases were anti-HCV positive), no significant associations between extrahepatic malignancies and HCV infection were observed. Meanwhile, compared to the 2006 National Hepatitis C sero-survey, we observed a significant association between the chronic lymphoma leukemia/small lymphocytic lymphoma (CLL/SLL) and HCV seropositivity in females in the research group aged 1–59 years old (OR = 14.69; 95% CI, 1.94–111.01). HCV infection had a potential association with CLL/SLL in females aged 1–59 years old. Our study did not confirm an association between HCV infection and the risk of extrahepatic malignancies. In regions with a low HCV prevalence, the association between HCV infection and extrahepatic malignancies needs further investigation.



2021 ◽  
Vol 11 ◽  
Author(s):  
Martin Maripuu ◽  
Marie Bendix ◽  
Louise Öhlund ◽  
Micael Widerström ◽  
Ursula Werneke

Background: Individuals with severe mental disorder (SMD) have a higher risk of somatic comorbidity and mortality than the rest of the population. We set up a population-based study to assess whether individuals with SMD had a higher risk of death associated with a COVID-19 infection (COVID-19 associated death) than individuals without SMD.Methods: Exploratory analysis with a cross-sectional design in the framework of a population-based register study covering the entire Swedish population. The Swedish Board for Health and Welfare (Socialstyrelsen) provided anonymized tabulated summary data for further analysis. We compared numbers of COVID-19 associated death in individuals with SMD (cases) and without SMD (controls). We calculated the odds ratio (OR) for the whole sample and by age group and four comorbidities, namely diabetes, cardiovascular disease, hypertension, chronic lung disease.Results: The sample comprised of 7,923,859 individuals, 103,999 with SMD and 7,819,860 controls. There were 130 (0.1%) COVID-19 associated deaths in the SMD group and 4,945 (0.06%) in the control group, corresponding to an OR of 1.98 (CI 1.66-2.35; p &lt; 0.001). The odds were 4-fold for the age groups between 60 and 79 years and 1.5-fold for cardiovascular diseases. Individuals with SMD without any of the risk factors under study had 3-fold odds of COVID-19 associated death.Conclusion: Our preliminary results identify individuals with SMD as a further group at increased risk of COVID-19 associated death. In regard to comorbidities, future studies should explore the potential confounding or mediation role in the relationship between SMD and COVID-19 associated deaths.



Author(s):  
Xue Luan ◽  
Chunai Cui ◽  
Jingzhi Jiang ◽  
Chongyang Wang ◽  
Li Li ◽  
...  

<b><i>Introduction:</i></b> This study aimed to explore the effects and mechanisms of salidroside (SAL) in airway inflammation in asthmatic mice. <b><i>Methods:</i></b> Mice were sensitized with ovalbumin (OVA) to establish an asthma model. They were divided into the control group, OVA group, SAL low-dose group (SAL-L), SAL high-dose group (SAL-H), and dexamethasone (DXM) group. The airway reactivity of the mice was measured, and the total cells, neutrophils, eosinophils, and lymphocytes were counted, respectively. The levels of IL-4, IL-5, IL-13, and IFN-γ in bronchoalveolar lavage fluid (BALF) were detected by ELISA. Immunohistochemistry was used to detect the expression levels of p-AMPK, p-Akt, and p-GSK3β. Western blot was used to detect cytokine levels in lung tissue and p-AMPK, p-Akt, and p-GSK3β levels in LPS-induced 16HBE cells. <b><i>Results:</i></b> The airway hyperresponsiveness of asthmatic mice in the SAL-H group decreased (<i>p</i> &#x3c; 0.05), and the total number of cells, neutrophils, eosinophils, and lymphocytes decreased significantly (<i>p</i> &#x3c; 0.05). In addition, the airways of mice showed airway inflammatory infiltration and goblet cell proliferation, and the corresponding cellular inflammatory factors IL-4, IL-5, and IL-13 were significantly decreased. However, the expression of IFN-γ in BALF and lung tissues was increased (<i>p</i> &#x3c; 0.05). Moreover, after the mice were treated with SAL, the phosphorylation level of AMPK was significantly increased, which further reduced the phosphorylation levels of Akt and GSK3β (<i>p</i> &#x3c; 0.05). Both SAL and AMPK inhibitors exerted effects on LPS-induced 16HBE cells, consistent with in vivo results. <b><i>Conclusion:</i></b> SAL can inhibit bronchial hyperresponsiveness and reduce tracheal inflammation by increasing AMPK phosphorylation and inhibiting Akt and GSK3β signaling pathways.



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