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Spontaneous ischaemic stroke lesions in a dog brain: neuropathological characterisation and comparison to human ischaemic stroke
No full textAbstract
Background
Dogs develop spontaneous ischaemic stroke with a clinical picture closely resembling human ischaemic stroke patients. Animal stroke models have been developed, but it has proved difficult to translate results obtained from such models into successful therapeutic strategies in human stroke patients. In order to face this apparent translational gap within stroke research, dogs with ischaemic stroke constitute an opportunity to study the neuropathology of ischaemic stroke in an animal species.
Case presentation
A 7\ua0years and 8\ua0months old female neutered Rottweiler dog suffered a middle cerebral artery infarct and was euthanized 3\ua0days after onset of neurological signs. The brain was subjected to histopathology and immunohistochemistry. Neuropathological changes were characterised by a pan-necrotic infarct surrounded by peri-infarct injured neurons and reactive microglia/macrophages and astrocytes.
Conclusions
The neuropathological changes reported in the present study were similar to findings in human patients with ischaemic stroke. The dog with spontaneous ischaemic stroke is of interest as a complementary spontaneous animal model for further neuropathological studies
Microbiota fingerprints lose individually identifying features over time
No full textAbstract
Background
Humans host individually unique skin microbiota, suggesting that microbiota traces transferred from skin to surfaces could serve as forensic markers analogous to fingerprints. While it is known that individuals leave identifiable microbiota traces on surfaces, it is not clear for how long these traces persist. Moreover, as skin and surface microbiota change with time, even persistent traces may lose their forensic potential as they would cease to resemble the microbiota of the person who left them. We followed skin and surface microbiota within households for four seasons to determine whether accurate microbiota-based matching of individuals to their households could be achieved across long time delays.
Results
While household surface microbiota traces could be matched to the correct occupant or occupants with 67% accuracy, accuracy decreased substantially when skin and surface samples were collected in different seasons, and particularly when surface samples were collected long after skin samples. Most OTUs persisted on skin or surfaces for less than one season, indicating that OTU loss was the major cause of decreased matching accuracy. OTUs that were more useful for individual identification persisted for less time and were less likely to be deposited from skin to surface, suggesting a trade-off between the longevity and identifying value of microbiota traces.
Conclusions
While microbiota traces have potential forensic value, unlike fingerprints they are not static and may degrade in a way that preferentially erases features useful in identifying individuals
Effects of passive integrated transponder (PIT) implantation on Pacific lamprey ammocoetes
No full textAbstract
Background
Little is known of the larval biology of Pacific lamprey ( Entosphenus tridentatus ), a species of conservation concern. With miniaturization of passive integrated transponder (PIT) tags, researchers now have the potential to individually mark larval lamprey. However, recent studies with sea lamprey ( Petromyzon marinus ) ammocoetes indicated that mortality was unacceptably high after surgical implantation of these tags. We examined survival, tag retention, growth, and swimming performance of Pacific lamprey ammocoetes tagged with uniquely coded 8.4-mm PIT tags and controls marked with visible implant elastomer (VIE).
Results
Ammocoetes as small as 71\ua0mm in length were PIT-tagged. Of the 99 PIT-tagged individuals, four died (4%) and two lost their tags (2%) within 2\ua0months of tagging. In this period, controls had 5% mortality and 15% VIE mark loss. Incisions were completely healed within 3\ua0months of tagging, and mean specific growth rate during this period did not significantly differ between treatment groups. Ammocoetes bearing a PIT tag did not exhibit significant reductions in swimming performance relative to controls.
Conclusions
We attribute the success of this tagging effort to changes in tag implantation technique, including use of a lateral incision and no sutures. The ability to individually mark wild larval lamprey will allow research on individual growth rates, environmental effects on growth and metamorphosis, timing and rates of movement, and, ultimately, stage-specific survival
Erratum to: Risk and safety requirements for diagnostic and therapeutic procedures in allergology: World Allergy Organization Statement
No full textNo abstract available
Comments to Role of upper airway ultrasound in airway management
No full textAbstract
Tracheal ultrasound can be an alternative diagnostic tool in airway management, besides traditional confirmatory methods such as capnography and auscultation. The standard image is a hyperechoic air\u2013mucosa (A\u2013M) interface with a reverberation artifact posteriorly (comet-tail artifact). If the second A\u2013M interface appears, which we call a \u201cdouble-tract sign,\u201d esophageal intubation is considered
Embryogenesis in the parasitic nematode Heterodera glycines is independent of host-derived hatching stimulation
No full textAbstract
Background
Many parasites regulate their development to synchronize their life cycle with a compatible host. The parasitic nematode Heterodera glycines displays incomplete host-mediated hatching behavior wherein some H. glycines individuals hatch only in the presence of a host-derived cue while others hatch in water alone. Furthermore, H. glycines shows variable hatching behavior based on oviposition location. The mechanisms regulating this hatching variability are unknown. In this study, we established a detailed timeline of the H. glycines pre-hatch development from early embryogenesis to the pre-hatched J2. These descriptive data were then used to test hypotheses regarding the effect of host stimulus and oviposition location on pre-hatch development.
Results
We found that H. glycines develops from a single-cell egg to a fully formed J2 in approximately 172\ua0hours. The stylet-based mouthpart, which is used to pierce the eggshell during hatching, is not completely formed until late in pre-hatch J2 development and is preceded by the formation of stylet protractor muscles. We also found that the primary motor nervous system of H. glycines did not complete development until late in pre-hatch J2 development. These data suggest possible structural requirements for H. glycines hatching. As expected, exposure of H. glycines eggs to host-derived cues increased the percentage of nematodes that hatched. However, exposure to hatching cues did not affect pre-hatch development. Similarly, we found no obvious differences in the pre-hatch developmental timeline between eggs laid in an egg sac or retained within the mother.
Conclusions
The pattern of early embryonic development in H. glycines was very similar to that recently described in the related parasitic nematode Meloidogyne incognita . However, the speed of H. glycines pre-hatch development was approximately three times faster than reported for M. incognita . Our results suggest that hatching stimulants do not affect embryogenesis itself but only influence the hatching decision once J2 development is complete. Similarly, the oviposition location does not alter the rate of embryogenesis. These results provide insight into the primary survival mechanism for this important parasite
Comparison of clinical features and prognostic factors in HIV-negative adults with cryptococcal meningitis and tuberculous meningitis: a retrospective study
No full textAbstract
Background
The incidence of cryptococcal meningitis (CM) and tuberculous meningitis (TBM) have gradually increased in recent years. These two types of meningitis are easily misdiagnosed which leads to a poor prognosis. In this study we compared differences of clinical features and prognostic factors in non-HIV adults with CM and TBM.
Methods
We retrospectively reviewed the medical records of CM and TBM patients from January 2008 to December 2015 in our university hospital in China. The data included demographic characteristics, laboratory results, imaging findings, clinical outcomes.
Results
A total of 126 CM and 105 TBM patients were included. CM patients were more likely to present with headache, abnormal vision and hearing, and they might be less prone to fever and cough than TBM patients ( P \u2009<\u20090.05). Higher percentage of CM patients presented with cerebral ischemia/infarction and demyelination in brain MRI than TBM patients ( P \u2009<\u20090.05). CM patients had lower counts of WBC in CSF, lower total protein in CSF and serum CD4/CD8 ratio than TBM patients ( P \u2009<\u20090.05). After three months of treatment, CM group have worse outcome than TBM group ( P \u2009<\u20090.05). Multivariate analysis showed that age more than 60y (OR\u2009=\u20094.981, 95% CI: 1.955\u201312.692, P \u2009=\u20090.001), altered mentation (OR\u2009=\u20095.054, 95% CI: 1.592\u201316.046, P \u2009=\u20090.006), CD4/CD8 ratios\u2009<\u20091 (OR\u2009=\u20098.782, 95% CI: 2.436\u201331.661, P \u2009=\u20090.001) and CSF CrAg\u2009\u2265\u20091:1024 (OR\u2009=\u20094.853, 95% CI: 1.377\u201317.098, P \u2009=\u20090.014) were independent risk factors for poor prognosis for CM patients. For TBM patients, hydrocephalus (OR\u2009=\u20097.290, 95% CI: 1.630\u201332.606, P \u2009=\u20090.009) and no less than three underlying diseases (OR\u2009=\u20096.899, 95% CI: 1.766\u201326.949, P \u2009=\u20090.005) were independent risk factors, headache was a protective factor of prognosis.
Conclusions
Our study provided some helpful clues in the differential diagnosis of non-HIV patients with CM or TBM and identified some risk factors for the poor prognosis of these two meningitis which could help to improve the treatment outcome. Further studies are worth to be done
Cost-effectiveness of antibiotic treatment strategies for community-acquired pneumonia: results from a cluster randomized cross-over trial
No full textAbstract
Background
To determine the cost-effectiveness of strategies of preferred antibiotic treatment with beta-lactam/macrolide combination or fluoroquinolone monotherapy compared to beta-lactam monotherapy.
Methods
Costs and effects were estimated using data from a cluster-randomized cross-over trial of antibiotic treatment strategies, primarily from the reduced third payer perspective (i.e. hospital admission costs). Cost-minimization analysis (CMA) and cost-effectiveness analysis (CEA) were performed using linear mixed models. CMA results were expressed as difference in costs per patient. CEA results were expressed as incremental cost-effectiveness ratios (ICER) showing additional costs per prevented death.
Results
A total of 2,283 patients were included. Crude average costs within 90\ua0days from the reduced third payer perspective were \u20ac4,294, \u20ac4,392, and \u20ac4,002 per patient for the beta-lactam monotherapy, beta-lactam/macrolide combination, and fluoroquinolone monotherapy strategy, respectively. CMA results were \u20ac106 (95% CI \u20ac-697 to \u20ac754) for the beta-lactam/macrolide combination strategy and \u20ac-278 (95%CI \u20ac-991 to \u20ac396) for the fluoroquinolone monotherapy strategy, both compared to the beta-lactam monotherapy strategy. The ICER was not statistically significantly different between the strategies. Other perspectives yielded similar results.
Conclusions
There were no significant differences in cost-effectiveness of strategies of preferred antibiotic treatment of CAP on non-ICU wards with either beta-lactam monotherapy, beta-lactam/macrolide combination therapy, or fluoroquinolone monotherapy.
Trial registration
The trial was registered with ClinicalTrials.gov, number NCT01660204 , on May 2nd, 2012
A comparative assessment of major international disasters: the need for exposure assessment, systematic emergency preparedness, and lifetime health care
No full textAbstract
Background
The disasters at Seveso, Three Mile Island, Bhopal, Chernobyl, the World Trade Center (WTC) and Fukushima had historic health and economic sequelae for large populations of workers, responders and community members.
Methods
Comparative data from these events were collected to derive indications for future preparedness. Information from the primary sources and a literature review addressed: i) exposure assessment; ii) exposed populations; iii) health surveillance; iv) follow-up and research outputs; v) observed physical and mental health effects; vi) treatment and benefits; and vii) outreach activities.
Results
Exposure assessment was conducted in Seveso, Chernobyl and Fukushima, although none benefited from a timely or systematic strategy, yielding immediate and sequential measurements after the disaster. Identification of exposed subjects was overall underestimated. Health surveillance, treatment and follow-up research were implemented in Seveso, Chernobyl, Fukushima, and at the WTC, mostly focusing on the workers and responders, and to a lesser extent on residents. Exposure-related physical and mental health consequences were identified, indicating the need for a long-term health care of the affected populations. Fukushima has generated the largest scientific output so far, followed by the WTCHP and Chernobyl. Benefits programs and active outreach figured prominently in only the WTC Health Program. The analysis of these programs yielded the following lessons: 1) Know who was there; 2) Have public health input to the disaster response; 3) Collect health and needs data rapidly; 4) Take care of the affected; 5) Emergency preparedness; 6) Data driven, needs assessment, advocacy.
Conclusions
Given the long-lasting health consequences of natural and man-made disasters, health ..
T cell exhaustion: from pathophysiological basics to tumor immunotherapy
No full textAbstract
The immune system is capable of distinguishing between danger- and non-danger signals, thus inducing either an appropriate immune response against pathogens and cancer or inducing self-tolerance to avoid autoimmunity and immunopathology. One of the mechanisms that have evolved to prevent destruction by the immune system, is to functionally silence effector T cells, termed T cell exhaustion, which is also exploited by viruses and cancers for immune escape In this review, we discuss some of the phenotypic markers associated with T cell exhaustion and we summarize current strategies to reinvigorate exhausted T cells by blocking these surface marker using monoclonal antibodies