scholarly journals Elevated Airway Eosinophils is Associated with Lower Airway Haemophilus

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Vyvian C. Borse ◽  
Sydney E. Ross, MS ◽  
Alexis A. McEntire, BS ◽  
James Slaven, MS ◽  
Kirsten M. Kloepfer, MD MS
Keyword(s):  
Pathogenic Bacteria ◽  
Demographic Data ◽  
Antibiotic Use ◽  
Lavage Fluid ◽  
Lower Airway ◽  
Chi Square ◽  
Children With Asthma ◽  
Airway Microbiome ◽  
Student’S T ◽  
The Impact

Background and Hypothesis: Early wheezing and persistent cough in young children can be a first indication of asthma. Studies show that infants later diagnosed with asthma commonly exhibit airway microbiome dysbiosis particularly with pathogenic bacteria. Two such bacteria, Moraxella catarrhalis and Haemophilus influenzae, can stimulate pro-inflammatory cytokines such as IL-5. Because IL-5 can signal eosinophil production, we hypothesize children with asthma and positive bronchoalveolar lavage fluid (BALF) culture will have elevated BALF eosinophils.  Project Methods: Children undergoing clinically indicated bronchoscopy in the Riley Hospital outpatient center were recruited. Chart review was conducted to examine associations between BALF culture, BALF differential cytology, diagnoses, antibiotic history, and demographic data from biobank participants. Exclusion criteria included: diagnosis of cystic fibrosis or pulmonary ciliary dyskinesia; BALF culture not performed; and/or hypocellular sample. Statistical analyses included Student’s t-test, Wilcoxon rank-sum tests, and Chi-Square tests (verified with Fisher’s Exact tests).  Results: 94 samples were analyzed (37% female, age: 1mos – 17 yrs). BALF was positive for the following bacteria: M. catarrhalis (26%), H. influenzae (28%), S. pneumoniae (27%), and S. aureus (17%). Haemophilus in BALF was associated with elevated eosinophils (p = .03) and neutrophils (p = .04) and decreased macrophages (p = .001). Asthma diagnosis and prior antibiotic use were not significantly associated with positive BALF culture.  Conclusion and Potential Impact: Haemophilus was associated with elevated eosinophils in the airway. The impact of this observation remains unclear. Further research is necessary to determine pathways that lead to these observed changes within the airway.

scholarly journals Exploring protocol bias in airway microbiome studies: one versus two PCR steps and 16S rRNA gene region V3 V4 versus V4

BMC Genomics ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Christine Drengenes ◽  
Tomas M. L. Eagan ◽  
Ingvild Haaland ◽  
Harald G. Wiker ◽  
Rune Nielsen
Keyword(s):  
16S Rrna ◽  
16S Rrna Gene ◽  
Bacterial Load ◽  
Marker Gene ◽  
Gene Region ◽  
Lower Airway ◽  
Rrna Gene ◽  
Wide Range ◽  
Airway Microbiome ◽  
The Impact

Abstract Background Studies on the airway microbiome have been performed using a wide range of laboratory protocols for high-throughput sequencing of the bacterial 16S ribosomal RNA (16S rRNA) gene. We sought to determine the impact of number of polymerase chain reaction (PCR) steps (1- or 2- steps) and choice of target marker gene region (V3 V4 and V4) on the presentation of the upper and lower airway microbiome. Our analyses included lllumina MiSeq sequencing following three setups: Setup 1 (2-step PCR; V3 V4 region), Setup 2 (2-step PCR; V4 region), Setup 3 (1-step PCR; V4 region). Samples included oral wash, protected specimen brushes and protected bronchoalveolar lavage (healthy and obstructive lung disease), and negative controls. Results The number of sequences and amplicon sequence variants (ASV) decreased in order setup1 > setup2 > setup3. This trend appeared to be associated with an increased taxonomic resolution when sequencing the V3 V4 region (setup 1) and an increased number of small ASVs in setups 1 and 2. The latter was considered a result of contamination in the two-step PCR protocols as well as sequencing across multiple runs (setup 1). Although genera Streptococcus, Prevotella, Veillonella and Rothia dominated, differences in relative abundance were observed across all setups. Analyses of beta-diversity revealed that while oral wash samples (high biomass) clustered together regardless of number of PCR steps, samples from the lungs (low biomass) separated. The removal of contaminants identified using the Decontam package in R, did not resolve differences in results between sequencing setups. Conclusions Differences in number of PCR steps will have an impact of final bacterial community descriptions, and more so for samples of low bacterial load. Our findings could not be explained by differences in contamination levels alone, and more research is needed to understand how variations in PCR-setups and reagents may be contributing to the observed protocol bias.

scholarly journals Lung microbiome and host immune tone in subjects with idiopathic pulmonary fibrosis treated with inhaled interferon-γ

2017 ◽  
Vol 3 (3) ◽  
pp. 00008-2017 ◽  
Author(s):  
Jing Wang ◽  
Melissa Lesko ◽  
Michelle H. Badri ◽  
Bianca C. Kapoor ◽  
Benjamin G. Wu ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lavage Fluid ◽  
Interferon Γ ◽  
Lower Airway ◽  
Novel Therapy ◽  
Lung Microbiome ◽  
Airway Microbiome ◽  
Ifn Γ ◽  
Cell Supernatant

Therapies targeting inflammation reveal inconsistent results in idiopathic pulmonary fibrosis (IPF). Aerosolised interferon (IFN)-γ has been proposed as a novel therapy. Changes in the host airway microbiome are associated with the inflammatory milieu and may be associated with disease progression. Here, we evaluate whether treatment with aerosolised IFN-γ in IPF impacts either the lower airway microbiome or the host immune phenotype.Patients with IPF who enrolled in an aerosolised IFN-γ trial underwent bronchoscopy at baseline and after 6 months. 16S rRNA sequencing of bronchoalveolar lavage fluid (BALF) was used to evaluate the lung microbiome. Biomarkers were measured by Luminex assay in plasma, BALF and BAL cell supernatant. The compPLS framework was used to evaluate associations between taxa and biomarkers.IFN-γ treatment did not change α or β diversity of the lung microbiome and few taxonomic changes occurred. While none of the biomarkers changed in plasma, there was an increase in IFN-γ and a decrease in Fit-3 ligand, IFN-α2 and interleukin-5 in BAL cell supernatant, and a decrease in tumour necrosis factor-β in BALF. Multiple correlations between microbial taxa common to the oral mucosa and host inflammatory biomarkers were found.These data suggest that the lung microbiome is independently associated with the host immune tone and may have a potential mechanistic role in IPF.

scholarly journals Competency framework as an instrument of support to the continued professional development of pharmacists

2020 ◽  
Vol 17 (2) ◽  
pp. 64-69
Author(s):  
Svetlana Stojkov ◽  
Dušanka Krajnović
Keyword(s):  
Professional Development ◽  
Demographic Data ◽  
Female Gender ◽  
Competency Framework ◽  
Future Application ◽  
Chi Square ◽  
Cross Sectional ◽  
Respective Field ◽  
Microsoft Office ◽  
The Impact

Objective. Continued Professional Development (CPD) is one of the most significant precursors to increased competency. Appropriate instruments and support are required for its implementation. This paper demonstrates the attitudes held by pharmacists on the impact of the competency framework on CPD, its acceptance among Serbian pharmacists and potential future application. Furthermore, the motivational impact of the competency framework on CPD as well as the relationship between certain demographic indicators and motivators of CPD are provided. Method. Research on the cross-sectional method throughout 2015-16 included pharmacists working in publicly-owned pharmacies. The survey was anonymous and voluntary. The questionnaires generated for this research contain demographic data on those surveyed and open-ended questions with multiple choice answers and applied a Likert-type scale. Statistical analysis was conducted by applying Microsoft Office 2003 and the Statistical Package for Social Sciences (SPSS) version 22. Results. Among the respondents, the female gender dominated, respondents who had not completed a speciality within their respective field, with an average age of 42 years, and an average of approx. 15 years of service. 26.12% of the respondents had prior experience with the competency framework. Most respondents were of the opinion that these instruments motivated them to actively manage their own PD, to set concrete PD objectives and to review their own competency. Over half intend to apply competency frameworks in future. The statistical Chi-square test indicates it is not possible to determine with certainty that there are differences in terms of motivation in managing PD and in PD goal setting between the groups of variables. Conclusion. The research indicates a positive attitude/opinion of pharmacists towards the competency framework and in recognising these instruments as supportive to CPD.

scholarly journals Does a previous surgical experience interfere on psychic stress in patients submitted to major surgery?

2014 ◽  
Vol 41 (1) ◽  
pp. 043-048 ◽  
Author(s):  
Luiz Ronaldo Alberti ◽  
Márcia Rodrigues Daian ◽  
Andy Petroianu
Keyword(s):  
Emotional Disorders ◽  
Psychological Symptoms ◽  
Major Surgery ◽  
Chi Square ◽  
Stress Symptoms ◽  
Chi Square Test ◽  
Group 2 ◽  
Postoperative Stress ◽  
Student’S T ◽  
The Impact

OBJECTIVE: to evaluate the impact of stress in patients undergoing major surgeries under general anesthesia, relating their physical and psychic reactions to the different stages of stress. METHODS: we studied 100 adult patients of both genders, who were divided into two groups: Group 1 - 22 patients without experience with surgery; Group 2 - 78 patients previously submitted to medium and major surgery. To investigate the stress, we used the Inventory of Stress Symptoms for Adults, developed by Lipp, the day before the procedure and two days and seven days after the operation. The comparison of groups with respect to gender, pain, and percentage of stress were performed using the Chi-square test, and for the age variable the Student's t test was used. Differences were considered significant at p<0.05. RESULTS: the groups were not homogeneous as for the overall percentage of stress on the three measurements. G1 had decreased postoperative stress, whilst in G2 it increased. Psychological symptoms of stress prevailed in both groups. CONCLUSION: previous surgery reduced preoperative stress but did not affect postoperative emotional disorders.

scholarly journals A Single-Institution Experience in the Use of Chest Radiographs for Hospitalized Children Labelled as Asthma Exacerbation

2021 ◽  
Author(s):  
Ela Beyyumi ◽  
Mohamed Tawil ◽  
Huda AlDhanhani ◽  
Sara Jameel ◽  
Manal Mouhssine ◽  
...  
Keyword(s):  
Asthma Exacerbation ◽  
Asthma Management ◽  
Antibiotic Use ◽  
Chest Radiographs ◽  
Eligibility Criteria ◽  
Tertiary Center ◽  
Lower Oxygen ◽  
Children With Asthma ◽  
Model Coefficient ◽  
The Impact

Background: Risks of cancer have become more notable lately, especially for young children with a chronic condition such as atopy. This study reports on cumulative radiation from chest radiographs in children with asthma. Its main aims were to consider our current practice, and suggest minimizing chest radiograph use in this vulnerable people. Methods: The study was retrospective and conducted at tertiary center. Eligibility criteria included children 2-15 y who were admitted between January-2017 and December-2018 for asthma management. Results: Of 643 children who were admitted as ‘asthma exacerbation’, 243 (40% females; age [mean±SD] 5.4±3.3 y) met the study criteria for inclusion. Ninety-two (38%) children had temperature 38.8±0.7oC on the day of admission. Antibiotics were prescribed for 148 (61%) children, mainly for presumed pneumonia. Chest radiographs were requested for 214 (88%) children, mainly on the day of admission. Only 38 (18%) chest radiographs showed focal/multifocal pneumonia justifying antibiotic use. Significant predictors for requesting chest radiographs were antibiotic use for presumed pneumonia, lower oxygen saturation at presentation, and requesting blood culture. Rate of chest radiographs per year was negatively related to child’s age; the younger the child the higher the rate (model coefficient -0.259, P<0.001). For children <5 y, rate of chest radiographs was 1.39±1.21/y and radiation dose 0.028±0.025 mSV/y. The corresponding rates for children ≥5 y were 0.78±0.72/y and 0.008±0.007 mSV/y, respectively (P<0.001). Conclusion: Chest radiographs were commonly requested for children with asthma, especially the young ones. Prospective studies are necessary to measure the impact of this practice on their health.

Admitting Service and Outcome for Small Bowel Obstruction

2021 ◽  
pp. 000313482110540
Author(s):  
Christopher Thacker ◽  
Claire Lauer ◽  
Kathleen Nealon ◽  
Charles Walker ◽  
Matthew Factor
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Multivariable Analysis ◽  
Admission Diagnosis ◽  
Chi Square ◽  
Surgical Services ◽  
Multivariable Regression ◽  
Student’S T ◽  
The Impact

Introduction Small bowel obstruction (SBO) is a common admission diagnosis. Prior research has shown improved length of stay and time to operation for SBO patients on surgical services (SS) compared to medical services (MS). This study evaluates the impact of admitting service on readmission and mortality. Methods A 12-year retrospective cohort study of patients ≥18 years old, admitted with SBO to either a MS or SS within one health care system was performed. Clinicodemographic characteristics and admission details were extracted and reviewed. Statistical analyses performed included the Student’s t-test, chi-square, and multivariable regression. Results The study included 7921 patients, of which 3862 (48.8%) were admitted to a SS. No significant clinicodemographic differences existed between the groups except SS patients were more likely to have cancer (23.3% vs 15.2%, P < .0001) and to be within a 30-day post-operative period (9.4% vs 1.8%, P < .0001). On multivariable analysis, admission to a SS was associated with a decreased admission mortality (OR .70), 30-day mortality (OR .42), and 180-day mortality (OR .42). 30-day readmissions (OR .54) and 180-day readmission (OR .43) were also significantly decreased for SS patients. In patients requiring a procedure during admission, there was significantly decreased admission mortality (OR .684), 30-day mortality (OR .470), 180-day mortality (OR .431), 30-day readmission (OR .63), and 180-day readmission (OR .50). Conclusion In patients with SBO, admission to a SS confers decreased odds of readmission and mortality compared to MS. Future studies are needed to understand the management decisions potentially underlying these differences. These findings may help better define admission pathways and improve outcomes.

scholarly journals A Single-Institution Experience in the Use of Chest Radiographs for Hospitalized Children Labeled as Asthma Exacerbation

2021 ◽  
Vol 9 ◽  
Author(s):  
Ela Beyyumi ◽  
Mohamed I. Tawil ◽  
Huda AlDhanhani ◽  
Sara Jameel ◽  
Manal Mouhssine ◽  
...  
Keyword(s):  
Asthma Exacerbation ◽  
Asthma Management ◽  
Antibiotic Use ◽  
Chest Radiographs ◽  
Eligibility Criteria ◽  
Tertiary Center ◽  
Lower Oxygen ◽  
Children With Asthma ◽  
Model Coefficient ◽  
The Impact

Background: Risks of diagnostic radiation have become more notable lately, particularly in young children with chronic medical conditions. This study reports on the cumulative radiation from chest radiographs in children with asthma. Its main purpose was to review our current practice and suggest minimizing the use of chest radiographs.Methods: The study was retrospective and conducted at a pediatric tertiary center. Eligibility criteria included children 2–15 y, admitted between January 2017 and December 2018 for asthma management.Results: Of the 643 children admitted as “asthma exacerbation,” 243 [40% females; age (mean ± SD) 5.4±3.3 y] met the study criteria for inclusion. Ninety-two (38%) children had a temperature of 38.8±0.7°C on the day of admission. Antibiotics were prescribed for 148 (61%) children, mainly for presumed pneumonia. Chest radiographs were requested for 214 (88%) children, mainly on the day of admission. Only 38 (18%) chest radiographs showed focal/multifocal pneumonia justifying antibiotic use. Significant predictors for requesting chest radiographs were antibiotic use for presumed pneumonia, lower oxygen saturation at presentation, and a requested blood culture. The rate of chest radiographs per year was negatively related to the child's age; the younger the child the higher the rate (model coefficient −0.259, P &lt; 0.001). For children &lt; 5 y, the rate of chest radiographs was 1.39 ± 1.21/y and radiation dose 0.028 ± 0.025 mSv/y. The corresponding rates for children ≥5 y were 0.78 ± 0.72/y and 0.008 ± 0.007 mSv/y, respectively (P &lt; 0.001).Conclusion: Chest radiographs were commonly requested for children with asthma, especially younger children. Prospective studies are necessary to measure the impact of this practice on the children's health.

scholarly journals Behavior and development of Tetranychus ludeni Zacher, 1913 (Acari: Tetranychidae) and physiological stress in genetically modified cotton expressing Cry1F and Cry1Ac proteins

2020 ◽  
Author(s):  
N. R. Valadares ◽  
M. A. Soares ◽  
E. A. Ferreira ◽  
V. G. Mendes-Sá ◽  
A. M. Azevedo ◽  
...  
Keyword(s):  
Physiological Stress ◽  
Genetically Modified ◽  
Oviposition Preference ◽  
Photosynthetic Parameters ◽  
Bt Cotton ◽  
Chi Square ◽  
Genetically Modified Cotton ◽  
Randomized Design ◽  
Student’S T ◽  
The Impact

Abstract Genetically modified plants are one of the tactics used in integrated pest management - IPM. There is great concern about the impact of these plants on non-target organisms. On the other hand, there is little information in the literature on the effects of transgenics (Bacillus thuringiensis) Bt on populations of phytophagous mites, and the physiological responses that this attack promotes on plants. The objective of this work was to evaluate the biology of the T. ludeni mite in Bt cotton, expressing the Cry1F and Cry1Ac proteins. To evaluate the behavior of food and oviposition preference of the T. ludeni with Bt cotton and isohybrid. Verify if the physiological stress caused by T. ludeni’s attack is differentiated in Bt cotton. The mites were reared in Bt cotton and isohybrid, in a total of 40 replicates in the completely randomized design and the biological cycle was evaluated. The food preference and oviposition analysis were done with 10 replicates, with choice. The physiological stress was evaluated through chlorophyll fluorescence, under greenhouse conditions. The data of the T. ludeni biology were analyzed by Student's t-test, for food and oviposition preference the chi-square test was performed. Regression models were fitted for the fluorescence parameters. The model identity test was used to evaluate the differences between Bt and isohybrid treatments. Cry1F and Cry1Ac proteins have not affected the biology of T. ludeni. The photosynthetic parameters in Bt cotton plants were less influenced by T. ludeni infestation.

scholarly journals Medical Interns and COVID-19: results of national research

2020 ◽  
Vol 66 (6) ◽  
pp. 812-817 ◽  
Author(s):  
Maria M. C. Carrascosa ◽  
Tercio de Campos ◽  
Jéssica E. Sampaio ◽  
Rafaella R. F. Souza ◽  
Vitória L. Ribeiro ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Demographic Data ◽  
Protective Equipment ◽  
Online Questionnaire ◽  
Chi Square ◽  
Cross Sectional ◽  
Public And Private ◽  
The Face ◽  
Ease Of Access ◽  
The Impact

SUMMARY OBJECTIVE Assess the impact of COVID-19 on medical students’ internships in public and private institutions in Brasil, in addition to estimating the quality of the measures taken by their respective Universities in the face of the problem and the availability of personal protective equipment (PPE). METHODS A descriptive cross-sectional quantitative analysis study carried out with 317 students undergoing medical internship from March 31, 2020, to April 12, 2020. The survey was conducted through an online questionnaire using the SurveyMonkey tool with 20 questions. Interns from the fourth to the sixth year of medical schools in the country were randomly included in the study through a survey sent by Whatsapp application. Statistical analysis was performed using the Chi-Square, considering p <0.05 as significant. RESULTS Four main topics were identified in the research: student demographic data; how classes and courses are being taught; the use and ease of access to personal protective equipment and the students’ fears and perspectives for the future. CONCLUSION The study clarified that although half of the students still have some degree of content and, in their majority, they are satisfied, there is still a lot of difficulty in obtaining personal protective equipment, which prevents students from returning safely to their internships.

Oral and maxillofacial outcomes in children with microcephaly associated with the congenital Zika syndrome

2020 ◽  
Author(s):  
Renato Araújo Ribeiro ◽  
Adriana Mattos ◽  
Marcelo de C Meneghim ◽  
Silvia A S Vedovello ◽  
Técia Mendes Daltro Borges ◽  
...  
Keyword(s):  
Demographic Data ◽  
Clinical Analysis ◽  
Tooth Eruption ◽  
Control Group ◽  
Chi Square ◽  
Cross Sectional ◽  
Significance Level ◽  
Face Width ◽  
Congenital Zika Syndrome ◽  
Student’S T

Summary Introduction The objective of this study is to assess the oral and maxillofacial characteristics of microcephalic children associated with congenital Zika syndrome (CZS). Methods A cross-sectional, observational study was carried out with 61 patients with microcephaly/CZS born between June 2015 and September 2017 (29 boys and 32 girls, average age of 22.8 months) and a control group with 58 non-CZS children born in the same period (25 boys and 33 girls, average age of 23.8 months). The functional clinical analysis considered the labial and lingual frena, tongue anterior projection, oral escape, palate form, and first tooth eruption. For the craniofacial analysis, facial anthropometric points and the cephalic perimeter at the time were measured. Demographic data were collected from medical records, and a clinical exam was performed in order to register the intrabuccal characteristics and craniofacial measures. The chi-square test and Student’s t-test were used with a significance level of 0.05. Results The narrow palate form, tongue anterior projection, oral escape, and late first tooth eruption were significantly more present in the group with microcephaly/CZS. As for the craniofacial analysis, face width (Bi-Zi), mandible width (Go-Go), height of face upper third (Tr-G), and monthly growth of cephalic perimeter were significantly smaller, whereas height of face lower third (Sn-Gn) was significantly bigger in the group with microcephaly/CZS (P &lt; 0.05). Conclusion Children with microcephaly resulting from a congenital Zika infection showed functional, oral, and maxillofacial changes and smaller facial development in comparison with non-CZS children in the same age group.

Sign in / Sign up

Export Citation Format

Share Document