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Prominosomes - A Particular Class of Extracellular Vesicles Containing Prominin-1/CD133?
No full textTo the Point: Substituting SOAP Notes for Vignettes in Preclinical Assessment Question Stems
No full textNephrology Research in Focus: Insights From Acute Kidney Injury in ICU Patients, Covid-19 in the Dialysis Population, and Chronic Kidney Disease From the NHANES Dataset
No full textBackground: Kidney diseases are a growing public health concern, often underdiagnosed and influenced by systemic and social factors. Timely recognition of acute kidney injury (AKI) in critical care remains challenging. Dialysis-dependent populations faced elevated risks during the COVID-19 pandemic, while non-traditional factors like poor sleep health are increasingly linked to chronic kidney disease (CKD). This dissertation includes three related studies examining diagnostic accuracy in AKI, disparities in COVID-19 outcomes among dialysis patients, and associations between sleep disturbances and CKD.
Methods: Study 1 is a retrospective cohort analysis comparing physician-diagnosed AKI to KDIGO-based diagnoses in ICU patients. Study 2 examines COVID-19 trends and mortality among urban and suburban outpatient dialysis populations in New York during two pandemic waves. Study 3 uses NHANES 2017–2020 data to assess associations between sleep disturbances (excessive daytime sleepiness, snoring, apnea-like symptoms) and CKD in U.S. adults.
Results:In Study 1, 54% of AKI cases meeting KDIGO criteria were missed by physicians, especially early-stage cases. Study 2 found ongoing mortality disparities, with COVID-positive status strongly linked to death, despite lower infection rates. In Study 3, excessive daytime sleepiness remained significantly associated with CKD (OR = 1.33; p = 0.018), while snoring and apnea-like symptoms showed weaker associations.
Conclusions:These studies highlights the need for standardized AKI diagnosis, targeted responses to dialysis disparities during emergencies, and recognition of sleep health as a CKD risk factor. Aligning clinical practice with public health policy can enhance kidney disease detection and car
Practical Experimental Microbiology: Laboratory Manual
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Microbiology, especially the laboratory component, is a highly practical and useful course for students pursuing many career options. While a number of excellent microbiology laboratory manuals are available, many are more suitable for a full-year course in microbiology or for more advanced studies.
Microbiology Experimental Laboratory Manual is comprehensive in teaching students basic microbiological techniques, i.e., how to grow and stain bacteria, how to identify bacteria and fungi, and means of identifying different species of bacteria microscopically. Further experiments enable students to identify the most effective soap/detergent from those readily available; to discover which spices have the most anti-bacterial activity; to identify which sources of milk provide \u27good\u27 vs. \u27bad\u27 bacteria; and grow common micro-organisms from samples of soil, raw meat, and milk products. In addition, the lab course is designed to help students think scientifically and develop independent thinking skills by designing their own microbiological experiments to carry out during the course of the semester. The present manual is suitable for students pursuing paramedical professions, and is adaptable for those in a distance-learning course with limited access to laboratory resources.https://touroscholar.touro.edu/opentextbooks/1011/thumbnail.jp
Code-ICH: Time Is Brain
No full textPurpose of reviewIntracerebral hemorrhage (ICH) is the most devastating type of stroke resulting in severe disability and mortality. This review summarizes the emerging body of evidence supporting a new paradigm for care of patients called Code-ICH. It highlights the need for the adoption of time-based care bundles based on recent evidence, akin to those used in the management of acute ischemic stroke.Recent findingsNumerous trials aimed at decreasing hematoma expansion through single interventions have historically failed to show significant effects on primary outcomes. Time-sensitive, multifaceted, bundled care approaches have emerged with substantial promise in improving functional outcomes in patients with ICH. These bundles include early aggressive control of blood pressure and reversal of anticoagulation, strict normalization of blood sugar and temperature, early surgical evaluation, and minimizing early withdrawal of care.SummaryThe paradigm of Code-ICH empowers acute care providers to continuously measure system performance, reflect on best practices, improve outcomes, and tackle disparities for patients with ICH
Antibodies to Anaplasma Phagocytophilum in Patients With Human Granulocytic Anaplasmosis Confirmed by Both Polymerase Chain Reaction and Culture
No full textBackground/Aims: Sera from patients from a single medical institution in New York State with human granulocytic anaplasmosis established by a positive polymerase chain reaction test (PCR) for Anaplasma phagocytophilum were used to assess the performance of serologic testing. All cases were also confirmed by culture in order to eliminate any false positive PCR samples. Methods: A nested PCR was performed targeting the heat shock operon of A. phagocytophilum. Culture was done using the HL-60 promyelocytic cell line. Serologic testing was performed to detect IgG/A/M using an indirect immunofluorescence assay that incorporated a human isolate of A. phagocytophilum as the source of the antigen. Results: From 1997 to 2009, 38 human granulocytic anaplasmosis patients were evaluated. On the baseline serum sample 21 (55.3%; 95% CI: 38.3%-71.4%) had a positive serologic test; 7 samples (33.1%) were positive at a titer of 80-320 and 14 samples (66.7%) at a titer of at least 640. Sixteen (94.1%) of the 17 with a negative baseline test had follow-up testing performed. All 16 tested positive on a convalescent phase serum sample obtained from 6 to 45 days later. Conclusion: PCR testing is the most commonly used direct diagnostic test to diagnose human granulocytic anaplasmosis. Our findings demonstrate that only approximately 55% of the PCR and culture positive cases were also seropositive on blood samples obtained at the same time point, indicating that serologic testing performed at the time of presentation has limited sensitivity. However, all of the 16 evaluable seronegative patients developed antibodies to A. phagocytophilum during convalescence
Cognitive Function at the Time of Focal Epilepsy Diagnosis Is Not Associated With Treatment Resistance
No full textObjective: Seizures can impact cognition both acutely and chronically. However, among those without significant comorbidities and broadly average cognition at epilepsy onset, the relationship between cognitive function at the time of diagnosis and long-term seizure control has been relatively unexplored. This analysis investigated associations between participant characteristics including specific aspects of cognitive performance at the time of focal epilepsy diagnosis and antiseizure medication (ASM) treatment resistance. Methods: This was a secondary analysis of Human Epilepsy Project (HEP) data, which enrolled people with newly diagnosed focal epilepsy and broadly average cognition (estimated IQ ≥ 70) from June 29, 2012, to September 1, 2019. Participants analyzed in this study were between 18 and 60 years old, and scored within an acceptable range (i.e., Standard Score of ≥80) on measures estimating premorbid cognitive ability were offered the Cogstate Brief Battery (CBB). Participant characteristics were analyzed, including the presence of any anxiety disorders or depression, and summary CBB scores. HEP participants who were classified by the study as treatment resistant if they had experienced failure to achieve seizure freedom after two adequate trials of ASMs. Treatment resistance was modeled using multiple logistic regression to assess for independent associations between attention and working memory after correcting for the presence of the other potentially explanatory variables. Results: 200 HEP participants had comprehensive enrollment records including CBB results and complete seizure outcome data for analysis in this study. After correcting for potentially confounding variables, there were no independent associations between cognitive measures on the CBB at the time of enrollment and subsequent development of ASM treatment resistance. Specifically, z-scores for reaction time on the CBB (an average of the CBB Identification and Detection tests) were not associated with treatment resistance (p = 0.51) and z-scores for memory performance (an average of the CBB One Card Learning test and One Back tests) were not associated with treatment resistance (p = 0.24). There were no significant independent associations between age or the presence of depression or anxiety disorders at the time of CBB testing and treatment resistance. However, there was an independent association between employment status and treatment resistance, with those who were employed or students (\u3e18 years old) at the time of enrollment and CBB testing having 0.35 times lower odds of treatment resistance (95 %CI 0.15–0.81, p = 0.01). Significance: The findings from this study suggest that in otherwise healthy people with new onset focal epilepsy who have broadly average intelligence, attention and working memory as measured by the CBB at the time of diagnosis is not associated with treatment resistance. Although performance on cognitive testing at epilepsy onset may not be predictive of risk of treatment resistance in this population, other individual characteristics such as employment status at the time of diagnosis may be indirect markers of long-term seizure outcomes and require further investigation