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Hua T, Fan R, Fan Y, Chen F. Immune response of COVID-19 vaccines in solid cancer patients: A meta-analysis. Hum Vaccin Immunother 2024; 20:2357424. [PMID: 38785118 PMCID: PMC11135846 DOI: 10.1080/21645515.2024.2357424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024] Open
Abstract
Solid cancer patients, compared to their healthy counterparts, are at a greater risk of contracting and suffering from severe complications and poorer prognosis after COVID-19 infections. They also have different immune responses after doses of COVID-19 vaccination, but limited evidence is available to reveal the effectiveness and help to guide immunization programs for this subpopulation; MEDLINE, Embase, Web of Science, Cochrane Library databases, and clinicaltrials.gov were used to search literature. The pooled seroconversion rate was calculated using a random-effects model and reported with a 95% confidence interval (CI); The review includes 66 studies containing serological responses after COVID-19 vaccination in 13,050 solid cancer patients and 8550 healthy controls. The pooled seropositive rates after the first dose in patients with solid cancer and healthy controls are 55.2% (95% CI 45.9%-64.5% N = 18) and 90.2% (95% CI 80.9%-96.6% N = 13), respectively. The seropositive rates after the second dose in patients with solid cancer and healthy controls are 87.6% (95% CI 84.1%-90.7% N = 50) and 98.9% (95% CI 97.6%-99.7% N = 35), respectively. The seropositive rates after the third dose in patients with solid cancer and healthy controls are 91.4% (95% CI 85.4%-95.9% N = 21) and 99.8% (95% CI 98.1%-100.0% N = 4), respectively. Subgroup analysis finds that study sample size, timing of antibody testing, and vaccine type have influence on the results; Seroconversion rates after COVID-19 vaccination are significantly lower in patients with solid malignancies, especially after the first dose, then shrinking gradually after the following two vaccinations, indicating that subsequent doses or a booster dose should be considered for the effectiveness of this subpopulation.
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Affiliation(s)
- Tiantian Hua
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Ru Fan
- Medical Statistics and Analysis Center, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yang Fan
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Feng Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
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Khan T, Das RS, Jana M, Bhattacharya SD, Halder S, Ray S, Satpathi P, Ghosh T, Mukherjee K, Choudhury SP. Factors influencing vaccine acceptance in pregnancy during the COVID-19 pandemic: A multicenter study from West Bengal, India. Hum Vaccin Immunother 2024; 20:2383030. [PMID: 39082142 PMCID: PMC11296540 DOI: 10.1080/21645515.2024.2383030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 07/10/2024] [Accepted: 07/18/2024] [Indexed: 08/04/2024] Open
Abstract
Influenza, COVID-19, tetanus, pertussis and hepatitis B pose increased risk for pregnant women and infants and could be mitigated by maternal immunization. In India Tetanus-diphtheria (Td) and COVID-19 vaccines are recommended during pregnancy, while influenza and tetanus-acellular pertussis-diphtheria (Tdap) vaccines are not. We conducted a multicenter study from November 2021 to June 2022 among pregnant women (n = 172) attending antenatal clinics in three public hospitals in West Bengal, to understand the factors that influence women's decisions to get vaccinated during pregnancy. Questions assessed vaccination coverage, knowledge, intention and willingness to pay for influenza vaccine, and factors influencing decisions to get Td, influenza, and COVID-19 vaccines. 152/172 (88.4%) women were vaccinated with Td, 159/172 (93%) with COVID-19, 1/172 (0.6%) with influenza, and none with Tdap. 10/168 (6%) had received hepatitis B vaccine (HBV). Community health workers advice was crucial for Td uptake and, the belief of protection from COVID for COVID-19 vaccines. Most women were unaware about Tdap (96%), influenza (75%), and influenza severity during pregnancy and infancy (85%). None were advised for influenza vaccination by healthcare providers (HCP), albeit, 93% expressed willingness to take, and pay INR 100-300 (95% CI: ≤100 to 300-500) [$ 1.3-4.0 (95% CI: ≤1.3, 4-6.7)] for it. Vaccination on flexible dates and time, HCP's recommendation, proximity to vaccination center, and husband's support were most important for their vaccination decisions. Women were generally vaccine acceptors and had high uptake of vaccines included in the Universal Immunization Program (UIP). Inclusion of influenza, Tdap, and HBV into UIP may improve maternal vaccine uptake.
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Affiliation(s)
- Tila Khan
- School of Medical Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Ranjan Saurav Das
- School of Medical Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Mithu Jana
- School of Medical Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur, India
| | | | - Sayantan Halder
- School of Medical Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Sabyasachi Ray
- Department of Obstetrics & Gynaecology, Midnapore Medical College and Hospital, Midnapore, India
| | | | - Tarapada Ghosh
- Department of Paediatrics and Neonatology, Midnapore Medical College and Hospital, Midnapore, India
| | | | - Shubhendu Pal Choudhury
- Antenatal Clinic & Baby Clinic, South Eastern Railway Hospital, South Eastern Railway, Kharagpur, India
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Fousková M, Habartová L, Vališ J, Nahodilová M, Vaňková A, Synytsya A, Šestáková Z, Votruba J, Setnička V. Raman spectroscopy in lung cancer diagnostics: Can an in vivo setup compete with ex vivo applications? SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2024; 322:124770. [PMID: 38996761 DOI: 10.1016/j.saa.2024.124770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 06/08/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024]
Abstract
Lung carcinoma remains the leading cause of cancer death worldwide. The tactic to change this unfortunate rate may be a timely and rapid diagnostic, which may in many cases improve patient prognosis. In our study, we focus on the comparison of two novel methods of rapid lung carcinoma diagnostics, label-free in vivo and ex vivo Raman spectroscopy of the epithelial tissue, and assess their feasibility in clinical practice. As these techniques are sensitive not only to the basic molecular composition of the analyzed sample but also to the secondary structure of large biomolecules, such as tissue proteins, they represent suitable candidate methods for epithelial cancer diagnostics. During routine bronchoscopy, we collected 78 in vivo Raman spectra of normal and cancerous lung tissue and 37 samples of endobronchial pathologies, which were subsequently analyzed ex vivo. Using machine learning techniques, namely principal component analysis (PCA) and support vector machines (SVM), we were able to reach 87.2% (95% CI, 79.8-94.6%) and 100.0% (95% CI, 92.1-100.0%) of diagnostic accuracy for in vivo and ex vivo setup, respectively. Although the ex vivo approach provided superior results, the rapidity of in vivo Raman spectroscopy might become unmatchable in the acceleration of the diagnostic process.
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Affiliation(s)
- Markéta Fousková
- Department of Analytical Chemistry, University of Chemistry and Technology, Prague, Technická 5, 166 28, Prague 6, Czech Republic
| | - Lucie Habartová
- Department of Analytical Chemistry, University of Chemistry and Technology, Prague, Technická 5, 166 28, Prague 6, Czech Republic
| | - Jan Vališ
- Department of Analytical Chemistry, University of Chemistry and Technology, Prague, Technická 5, 166 28, Prague 6, Czech Republic
| | - Magdaléna Nahodilová
- Department of Analytical Chemistry, University of Chemistry and Technology, Prague, Technická 5, 166 28, Prague 6, Czech Republic
| | - Aneta Vaňková
- Department of Analytical Chemistry, University of Chemistry and Technology, Prague, Technická 5, 166 28, Prague 6, Czech Republic
| | - Alla Synytsya
- Department of Analytical Chemistry, University of Chemistry and Technology, Prague, Technická 5, 166 28, Prague 6, Czech Republic
| | - Zuzana Šestáková
- 1st Clinic of Tuberculosis and Respiratory Diseases, 1st Faculty of Medicine, Charles University Prague and General University Hospital in Prague, U Nemocnice 2, 128 08, Prague 2, Czech Republic
| | - Jiří Votruba
- 1st Clinic of Tuberculosis and Respiratory Diseases, 1st Faculty of Medicine, Charles University Prague and General University Hospital in Prague, U Nemocnice 2, 128 08, Prague 2, Czech Republic
| | - Vladimír Setnička
- Department of Analytical Chemistry, University of Chemistry and Technology, Prague, Technická 5, 166 28, Prague 6, Czech Republic.
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Afriyie-Mensah JS, Domoyeri P, Antwi-Boasiako C, Aryee R, Dankwah GB, Ntiamoah M, Dzudzor B, Kusi-Mensah Y, Hayfron-Benjamin CF. Relationship between fraction of exhaled nitric oxide and peripheral eosinophilia in asthma. Ann Med 2024; 56:2382377. [PMID: 39051101 PMCID: PMC11275527 DOI: 10.1080/07853890.2024.2382377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/01/2023] [Accepted: 05/17/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Achieving disease control is the goal of asthma management. Serum or sputum eosinophil counts have been known traditional means of assessing eosinophilic airway inflammation in asthma, which is vital in predicting response to corticosteroid therapy which ultimately promotes control of the disease. Evidence suggests that fraction of exhaled nitric oxide (FeNO) may be a more useful non-invasive surrogate biomarker for the assessment of eosinophilic airway inflammation and could help with the timely adjustment of inhaled corticosteroid therapy in the uncontrolled asthma patient. The relationship between FeNO and other markers of airway inflammation has been variable in literature, with limited data in sub-Saharan Africa where FeNO testing is very sparse. We sought to define the relationship between FeNO levels, serum eosinophil counts, spirometry measures and symptom control among asthma patients. MATERIALS AND METHODS The study was conducted at the Asthma Clinic of a large tertiary hospital. This study included 82 patients with physician-diagnosed asthma being regularly managed at the clinic. All participants were taken through the asthma control test (ACT), had FeNO and spirometry measurements taken according to the American Thoracic Society (ATS) guidelines. Blood samples were obtained from all participants for serum eosinophil counts. Correlation coefficient was used to ascertain the relationship between FeNO levels and serum eosinophil counts, ACT scores, and spirometry measurements. Logistic regression was used to examine the association between high FeNO and abnormal FEV1 percentage predicted (<80%) with adjustments for age, sex, and BMI. RESULTS A total of 82 patients with asthma were included in the study, with higher prevalence of females (72%). Majority (40.2%) of the patients were found in the 60 and above age category. The median FeNO level and ACT score was 42.00 (26.00-52.50) parts per billion (ppb) and 20.0 (18-23) respectively. The median serum eosinophil counts was 0.25(0.90-0.38) × 109/L. The median FeNO levels were significantly higher in patients with partly and very poorly controlled asthma than in the well-controlled group (p < 0.001). A total of 47(57%) of the patients were classified as having well controlled asthma and 35 (42%) uncontrolled. FeNO correlated with serum eosinophil counts (r = 0.450, p < 0.001), ACT (r = -0.648, p < 0.001), and FEV1 percentage predicted (r = -0.353, p = 0.001). High FeNO (>50 ppb) was associated with an over fivefold increased risk of having an abnormal FEV1 percentage predicted. CONCLUSION FeNO levels significantly correlated with the ACT scores, serum eosinophil counts and FEV1% predicted among the asthma patients who were on inhaled corticosteroid therapy. High FeNO was significantly associated with abnormal FEV1 percentage predicted. We suggest that the point of care assessment of FeNO is a reliable marker of eosinophilic inflammation in our cohort of patients and together with 'ACT scores' in our asthma clinics could increase asthma control rates.
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Affiliation(s)
- Jane S. Afriyie-Mensah
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Philemon Domoyeri
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Charles Antwi-Boasiako
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Robert Aryee
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Gifty B. Dankwah
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Mabel Ntiamoah
- College of Nursing, University of Cincinnati, Cincinnati, USA
| | - Bartholomew Dzudzor
- Department of Medical Biochemistry, University of Ghana Medical School, Accra, Ghana
| | - Yaw Kusi-Mensah
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
- Department of Anaesthesia, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Charles F. Hayfron-Benjamin
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
- Department of Anaesthesia, Korle-Bu Teaching Hospital, Accra, Ghana
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Sehgal IS, Kaur G, Gupta N, Dhooria S, Prasad KT, Bal A, Gupta P, Aggarwal AN, Muthu V, Agarwal R. A Randomized Control Trial Comparing the Yield of Bronchoalveolar Lavage Using Three Different Techniques in Patients Undergoing Flexible Bronchoscopy (BAL-3T). J Bronchology Interv Pulmonol 2024; 31:e0979. [PMID: 39086062 DOI: 10.1097/lbr.0000000000000979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 06/26/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Three techniques have been described for aspirating the bronchoalveolar lavage (BAL) fluid, namely the wall mount suction (WMS), manual suction (MS), and manual suction with tubing (MST). However, there is no direct comparison among the 3 methods. METHODS We randomized patients undergoing flexible bronchoscopy and BAL in a 1:1:1 ratio to one of the 3 arms. The primary outcome was to compare the optimal yield, defined as at least 30% return of volume instilled and <5% bronchial cells. The key secondary outcomes were the percentage of volume and total amount (in millimeters) return of BAL, as well as complications (hypoxemia, airway bleeding, and others). RESULTS We randomized 942 patients [MST (n = 314), MS (n = 314), WMS (n = 314)]. The mean age of the study population [58.7% (n = 553) males] was 46.9 years. The most common indication for BAL was suspected pulmonary infection. Right upper lobes and middle lobes were the commonest sampled lobes. The optimal yield was similar in all the groups [MST (35.6%) vs MS (42.2%) vs WMS (36.5%); P = 0.27]. A significantly higher proportion of patients had BALF return >30% (P = 0.005) in the WMS (54.2%) and MS (54%) than in the MST arm (42.9%). The absolute and the percentage volume of BALF was also higher in WMS and MS than in the MST arm. There was no difference in the complication rate or other secondary outcomes across the groups. CONCLUSION We found no difference in the optimal yield of BAL or complications using any one of the 3 methods for BAL fluid retrieval.
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Affiliation(s)
| | | | - Nalini Gupta
- Department of Cytology and Gynecologic Pathology
| | | | | | - Amanjit Bal
- Department of Histopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Tou C, Ma L. PD-1 inhibitor in the treatment of relapsed primary mediastinal large B-cell lymphoma follow up by 18F-FDG PET/CT: A case report and literature review. Radiol Case Rep 2024; 19:4497-4503. [PMID: 39188628 PMCID: PMC11345284 DOI: 10.1016/j.radcr.2024.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 07/05/2024] [Accepted: 07/11/2024] [Indexed: 08/28/2024] Open
Abstract
Primary mediastinal large B-cell lymphoma (PMBCL) is a specific subtype of diffuse large B-cell lymphoma (DLBCL), which occurs more frequently in young women. PMBCL is an uncommon kind of cancer. R-EPOCH is a common therapeutic regimen that is suitable for patients with PMBCL, and could get a relatively high complete remission rate. However, it may not be effective response in patients with relapsed PMBCL. Immunotherapy appears to be helpful in recent years. Therefore, in this case, a 31-year-old female patient with relapsed PMBCL. Progressive disease was identified after rechemotherapy and target therapy, complete remission can be achieved after switching to PD-1 inhibitor plus targeted therapy. These recurrence, progression, remission and follow-up are all displayed well on 18F-FDG PET/CT. This case with consecutive imaging monitor illustrates that PD-1 inhibitor may be used as a first-line treatment for recurrent PMBCL. In addition, 18F-FDG PET/CT is strongly recommended for monitoring PMBCL include baseline staging, interim response and follow-up study.
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Affiliation(s)
- ChiIeng Tou
- Department of Medical Imaging Center, Kiang Wu hospital, Macau, China
| | - LinFeng Ma
- Department of Medical Imaging Center, Kiang Wu hospital, Macau, China
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G A, K L N, M S AS. Improving sepsis classification performance with artificial intelligence algorithms: A comprehensive overview of healthcare applications. J Crit Care 2024; 83:154815. [PMID: 38723336 DOI: 10.1016/j.jcrc.2024.154815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 04/10/2024] [Accepted: 04/13/2024] [Indexed: 08/04/2024]
Abstract
PURPOSE This study investigates the potential of machine learning (ML) algorithms in improving sepsis diagnosis and prediction, focusing on their relevance in healthcare decision-making. The primary objective is to contribute to healthcare decision-making by evaluating the performance of various supervised and unsupervised models. MATERIALS AND METHODS Through an extensive literature review, optimal ML models used in sepsis research were identified. Diverse datasets from relevant sources were employed, and rigorous evaluation metrics, including accuracy, specificity, and sensitivity, were applied. Innovative techniques were introduced, such as a Stacked Blended Ensemble Model and Skopt Optimization with Blended Ensemble, incorporating Bayesian optimization for hyperparameter tuning. RESULTS ML algorithms demonstrate efficacy in sepsis diagnosis, presenting an improved balance between specificity and sensitivity, critical for effective clinical decision-making. Classifier ensemble models show enhanced accuracy and efficiency, with novel optimization techniques contributing to improved adaptability. CONCLUSION The study emphasizes the potential benefits of ML algorithms in sepsis management, advocating for ongoing research to optimize performance and ensure ethical utilization in healthcare decision-making. Ethical considerations, interpretability, and transparency are crucial factors in implementing these algorithms in clinical practice.
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Affiliation(s)
- Anjana G
- Department of Electronics and Communication Engineering, Amrita Vishwa Vidyapeetham, Amritapuri, Kerala, India
| | - Nisha K L
- Department of Electronics and Communication Engineering, Amrita Vishwa Vidyapeetham, Amritapuri, Kerala, India.
| | - Arun Sankar M S
- School of CS&IT, University College Cork, Cork, Ireland; Electronic and Communications Department, South East Technological University, Carlow, Ireland
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Szarvas Z, Fekete M, Szollosi GJ, Kup K, Horvath R, Shimizu M, Tsuhiya F, Choi HE, Wu HT, Fazekas-Pongor V, Pete KN, Cserjesi R, Bakos R, Gobel O, Gyongyosi K, Pinter R, Kolozsvari D, Kovats Z, Yabluchanskiy A, Owens CD, Ungvari Z, Tarantini S, Horvath G, Muller V, Varga JT. Optimizing cardiopulmonary rehabilitation duration for long COVID patients: an exercise physiology monitoring approach. GeroScience 2024; 46:4163-4183. [PMID: 38771423 PMCID: PMC11336035 DOI: 10.1007/s11357-024-01179-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 04/25/2024] [Indexed: 05/22/2024] Open
Abstract
The presence of prolonged symptoms after COVID infection worsens the workability and quality of life. 200 adults with long COVID syndrome were enrolled after medical, physical, and mental screening, and were divided into two groups based on their performance. The intervention group (n = 100) received supervised rehabilitation at Department of Pulmonology, Semmelweis University with the registration number 160/2021 between 01/APR/2021-31/DEC/2022, while an age-matched control group (n = 100) received a single check-up. To evaluate the long-term effects of the rehabilitation, the intervention group was involved in a 2- and 3-month follow-up, carrying out cardiopulmonary exercise test. Our study contributes understanding long COVID rehabilitation, emphasizing the potential benefits of structured cardiopulmonary rehabilitation in enhancing patient outcomes and well-being. Significant difference was found between intervention group and control group at baseline visit in pulmonary parameters, as forced vital capacity, forced expiratory volume, forced expiratory volume, transfer factor for carbon monoxide, transfer coefficient for carbon monoxide, and oxygen saturation (all p < 0.05). Our follow-up study proved that a 2-week long, patient-centered pulmonary rehabilitation program has a positive long-term effect on people with symptomatic long COVID syndrome. Our data showed significant improvement between two and three months in maximal oxygen consumption (p < 0.05). Multidisciplinary, individualized approach may be a key element of a successful cardiopulmonary rehabilitation in long COVID conditions, which improves workload, quality of life, respiratory function, and status of patients with long COVID syndrome.
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Affiliation(s)
- Zsofia Szarvas
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Monika Fekete
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Gergo Jozsef Szollosi
- Coordination Center for Research in Social Sciences, Faculty of Economics and Business, University of Debrecen, Debrecen, Hungary
| | - Katica Kup
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Rita Horvath
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Maya Shimizu
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Fuko Tsuhiya
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Ha Eun Choi
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Huang-Tzu Wu
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Vince Fazekas-Pongor
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Kinga Nedda Pete
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Renata Cserjesi
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Regina Bakos
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Orsolya Gobel
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Kata Gyongyosi
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Renata Pinter
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Dora Kolozsvari
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Zsuzsanna Kovats
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Andriy Yabluchanskiy
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Cameron D Owens
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Zoltan Ungvari
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Stefano Tarantini
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Gabor Horvath
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Veronika Muller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Janos Tamas Varga
- Department of Pulmonology, Semmelweis University, Budapest, Hungary.
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Khosla D, Singh PK, Chhabria BA, Kataria V, Singh N, Kapoor R. Malignant pleural mesothelioma: The disdained member of thoracic oncology! World J Exp Med 2024; 14:91739. [DOI: 10.5493/wjem.v14.i3.91739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 07/17/2024] [Accepted: 07/30/2024] [Indexed: 08/29/2024] Open
Abstract
Pleural mesothelioma is a very aggressive malignancy that arises from the pleural mesothelial cell lining and is linked strongly to prior asbestos exposure. The ban on asbestos has helped to lower the incidence, but in developing countries like India, it is expected to rise. It has an extended latency period usually progressing over decades and presents with nonspecific symptoms. It has a median survival ranging between 10-22 months. The diagnosis of malignant pleural mesothelioma is challenging and is done using computed tomography (CT), magnetic resonance imaging, or positron emission tomography-CT, with the last two predicting the resectability of the tumor better than CT alone. A pleural biopsy along with an array of immunohistochemical markers, such as p16, BRCA1 associated protein 1, and claudin-4, are required for a definitive diagnosis. Several genetic alterations have prognostic significance as well. The current histological subtype identification is indispensable for decision making because of the new therapeutic avenues being explored. The combination of nivolumab and ipilimumab-based immunotherapy outperformed platinum and pemetrexed-based chemotherapy in terms of survival benefit and improved quality of life especially for non-epithelioid subtypes. However, the latter continues to be a robust treatment option for patients with the epithelioid subtype. Surgery is recommended for resectable cases with radiotherapy being indicated in neoadjuvant, adjuvant, and palliative settings along with systemic treatment. This review article provides an overview of epidemiology, etiology, clinical manifestations, diagnostic approaches (including immunohistochemical and genetic markers), staging, and multidisciplinary approaches to current treatment for malignant pleural mesothelioma using surgery, chemotherapy, immunotherapy, and radiotherapy. It also sheds light on some recent studies (EMPHACIS, CALGB30901, Checkmate-743, etc.) that have led to significant developments in recent years with clinically meaningful results.
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Affiliation(s)
- Divya Khosla
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Pawan Kumar Singh
- Department of Pulmonary and Critical Care Medicine, Pandit Bhagwat Dayal Sharma Postgraduate Institute of Medical Sciences, Rohtak 124001, India
| | - Bharath A Chhabria
- Department of Pulmonary and Critical Care Medicine, Ramaiah Memorial Hospital, Bengaluru 560054, India
| | - Vaishali Kataria
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Navneet Singh
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Rakesh Kapoor
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
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Qu LL, Zhao WP, Li JP, Zhang W. Predictive value of diaphragm ultrasound for mechanical ventilation outcome in patients with acute exacerbation of chronic obstructive pulmonary disease. World J Clin Cases 2024; 12:5893-5900. [DOI: 10.12998/wjcc.v12.i26.5893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/07/2024] [Accepted: 07/01/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is often combined with respiratory failure, which increases the patient's morbidity and mortality. Diaphragm ultrasound (DUS) has developed rapidly in the field of critical care in recent years. Studies with DUS monitoring diaphragm-related rapid shallow breathing index have demonstrated important results in guiding intensive care unit patients out of the ventilator. Early prediction of the indications for withdrawal of non-invasive ventilator and early evaluation of patients to avoid or reduce disease progression are very important.
AIM To explore the predictive value of DUS indexes for non-invasive ventilation outcome in patients with AECOPD.
METHODS Ninety-four patients with AECOPD who received mechanical ventilation in our hospital from January 2022 to December 2023 were retrospectively analyzed, and they were divided into a successful ventilation group (68 cases) and a failed ventilation group (26 cases) according to the outcome of ventilation. The clinical data of patients with successful and failed noninvasive ventilation were compared, and the independent predictors of noninvasive ventilation outcomes in AECOPD patients were identified by multivariate logistic regression analysis.
RESULTS There were no significant differences in gender, age, body mass index, complications, systolic pressure, heart rate, mean arterial pressure, respiratory rate, oxygen saturation, partial pressure of oxygen, oxygenation index, or time of inspiration between patients with successful and failed mechanical ventilation (P > 0.05). The patients with successful noninvasive ventilation had shorter hospital stays and lower partial pressure of carbon dioxide (PaCO2) than those with failed treatment, while potential of hydrogen (pH), diaphragm thickening fraction (DTF), diaphragm activity, and diaphragm movement time were significantly higher than those with failed treatment (P < 0.05). pH [odds ratio (OR) = 0.005, P < 0.05], PaCO2 (OR = 0.430, P < 0.05), and DTF (OR = 0.570, P < 0.05) were identified to be independent factors influencing the outcome of mechanical ventilation in AECOPD patients.
CONCLUSION The DUS index DTF can better predict the outcome of non-invasive ventilation in AECOPD patients.
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Affiliation(s)
- Lei-Lei Qu
- The First Department of Respiratory and Critical Care Medical Center, The First People's Hospital of Baiyin City, Baiyin 730900, Gansu Province, China
| | - Wen-Ping Zhao
- Department of Nursing, The First People's Hospital of Baiyin City, Baiyin 730900, Gansu Province, China
| | - Ji-Ping Li
- The First Department of Respiratory and Critical Care Medical Center, The First People's Hospital of Baiyin City, Baiyin 730900, Gansu Province, China
| | - Wei Zhang
- The First Department of Respiratory and Critical Care Medical Center, The First People's Hospital of Baiyin City, Baiyin 730900, Gansu Province, China
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11
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Al-Beltagi M, Saeed NK, Bediwy AS, Elbeltagi R. Pulse oximetry in pediatric care: Balancing advantages and limitations. World J Clin Pediatr 2024; 13:96950. [DOI: 10.5409/wjcp.v13.i3.96950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 07/06/2024] [Accepted: 07/30/2024] [Indexed: 08/30/2024] Open
Abstract
BACKGROUND Pulse oximetry has become a cornerstone technology in healthcare, providing non-invasive monitoring of oxygen saturation levels and pulse rate. Despite its widespread use, the technology has inherent limitations and challenges that must be addressed to ensure accurate and reliable patient care.
AIM To comprehensively evaluate the advantages, limitations, and challenges of pulse oximetry in clinical practice, as well as to propose recommendations for optimizing its use.
METHODS A systematic literature review was conducted to identify studies related to pulse oximetry and its applications in various clinical settings. Relevant articles were selected based on predefined inclusion and exclusion criteria, and data were synthesized to provide a comprehensive overview of the topic.
RESULTS Pulse oximetry offers numerous advantages, including non-invasiveness, real-time feedback, portability, and cost-effectiveness. However, several limitations and challenges were identified, including motion artifacts, poor peripheral perfusion, ambient light interference, and patient-specific factors such as skin pigmentation and hemoglobin variants. Recommendations for optimizing pulse oximetry use include technological advancements, education and training initiatives, quality assurance protocols, and interdisciplinary collaboration.
CONCLUSION Pulse oximetry is crucial in modern healthcare, offering invaluable insights into patients’ oxygenation status. Despite its limitations, pulse oximetry remains an indispensable tool for monitoring patients in diverse clinical settings. By implementing the recommendations outlined in this review, healthcare providers can enhance the effectiveness, accessibility, and safety of pulse oximetry monitoring, ultimately improving patient outcomes and quality of care.
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Affiliation(s)
- Mohammed Al-Beltagi
- Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31511, Alghrabia, Egypt
- Department of Pediatrics, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
| | - Nermin Kamal Saeed
- Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, Ministry of Health, Kingdom of Bahrain, Manama 26671, Manama, Bahrain
- Medical Microbiology Section, Department of Pathology, Irish Royal College of Surgeon in Bahrain, Busaiteen 15503, Muharraq, Bahrain
| | - Adel Salah Bediwy
- Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt
- Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
| | - Reem Elbeltagi
- Department of Medicine, The Royal College of Surgeons in Ireland-Bahrain, Busiateen 15503, Muharraq, Bahrain
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12
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Schafauser NS, Sampaio LMM, Heubel AD, Kabbach EZ, Kawakami DMDO, Leonardi NT, Castello-Simões V, Borghi-Silva A, Mendes RG. Influence of heart failure (HF) comorbidity in chronic obstructive pulmonary disease (COPD) and isolated forms of HF and COPD on cardiovascular function during hospitalization. Respir Med 2024; 231:107731. [PMID: 38969026 DOI: 10.1016/j.rmed.2024.107731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 06/07/2024] [Accepted: 07/03/2024] [Indexed: 07/07/2024]
Abstract
INTRODUCTION Coexistence of chronic obstructive pulmonary disease(COPD) and heart failure(HF) is associated with systemic inflammation, myocardial injury, and arterial stiffening, impacting cardiovascular risk and prognosis in patients. Arterial stiffness, reduced nitric oxide synthesis, and altered cardiac autonomic control further link COPD and HF pathophysiology, emphasizing the need for comprehensive cardiovascular assessment. OBJECTIVE To investigate a cardiovascular profile in patients hospitalized with exacerbation COPD(ECOPD) in coexistence with HF compared with isolated diseases. METHODS A cross-sectional study including patients diagnosed with ECOPD and decompensated HF, approached between 24 and 48 h after hospital admission. Assessments included: endothelial function by brachial artery flow-mediated vasodilation(FMD); hemodynamic through analysis of pulse wave and arterial stiffness by carotid-femoral pulse wave velocity(cfPWV) and cardiac autonomic modulation(CAM) by heart rate variability(HRV). RESULTS The mean FMD was 4.45 %, indicating endothelial dysfunction in all patients. Date is present in mean(confidence interval) sequency COPD(n = 12), COPD-HF(n = 21) and HF(n = 21). FMD: 5.47(3.96-6.91); 2.66(0.09-3.48); 4.60(2.30-6.43) p < 0.01. However, COPD-HF had worse FMD. Arterial stiffens (AIx: 29.0(19.0-42.6); 34.6(24.3-43.2); 14.5(8.0-24.0)p < 0.01; cfPWV: (6.5(5.4-7.2); 7.7(7.0-8.5); 6.0(5.0-6.5)); COPD-HF also showed greater activation of the sympathetic nervous system compared to patients with isolated diseases (PNS: 1.32(-2.53 to -0.62); -2.33(-2.60 to -2.12); -1.32(-1.42 to -1.01) p < 0.01; SNS: 3.50(1.40-8.55); 7.11(5.70-8.29); 2.32(1.78-5.01) p < 0.01). In addition, rMSSD, NN50, pNN50, and TINN also indicate worse CAM in the COPD-HF group compared to isolated diseases. CONCLUSION During hospitalization, the worst impairment in vascular function and cardiac autonomic modulation were found in patients with COPD and HF comorbidity compared to the isolated diseases(HF or COPD).
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Affiliation(s)
- Nathany Souza Schafauser
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, São Paulo, Brazil.
| | | | - Alessandro Domingues Heubel
- University Hospital of Federal University of São Carlos, (HU-UFSCar) Brazilian Company of Hospital Services (EBSERH), SP, Brazil.
| | - Erika Zavaglia Kabbach
- University Hospital of Federal University of São Carlos, (HU-UFSCar) Brazilian Company of Hospital Services (EBSERH), SP, Brazil.
| | - Débora Mayumi de Oliveira Kawakami
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, São Paulo, Brazil.
| | - Naiara Tais Leonardi
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, São Paulo, Brazil.
| | - Viviane Castello-Simões
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, São Paulo, Brazil.
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, São Paulo, Brazil.
| | - Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, São Paulo, Brazil.
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Agraval H, Kandhari K, Yadav UCS. MMPs as potential molecular targets in epithelial-to-mesenchymal transition driven COPD progression. Life Sci 2024; 352:122874. [PMID: 38942362 DOI: 10.1016/j.lfs.2024.122874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/17/2024] [Accepted: 06/25/2024] [Indexed: 06/30/2024]
Abstract
Chronic obstructive pulmonary disease (COPD) is the third leading cause of mortality globally and the risk of developing lung cancer is six times greater in individuals with COPD who smoke compared to those who do not smoke. Matrix metalloproteinases (MMPs) play a crucial role in the pathophysiology of respiratory diseases by promoting inflammation and tissue degradation. Furthermore, MMPs are involved in key processes like epithelial-to-mesenchymal transition (EMT), metastasis, and invasion in lung cancer. While EMT has traditionally been associated with the progression of lung cancer, recent research highlights its active involvement in individuals with COPD. Current evidence underscores its role in orchestrating airway remodeling, fostering airway fibrosis, and contributing to the potential for malignant transformation in the complex pathophysiology of COPD. The precise regulatory roles of diverse MMPs in steering EMT during COPD progression needs to be elucidated. Additionally, the less-understood aspect involves how these MMPs bi-directionally activate or regulate various EMT-associated signaling cascades during COPD progression. This review article explores recent advancements in understanding MMPs' role in EMT during COPD progression and various pharmacological approaches to target MMPs. It also delves into the limitations of current MMP inhibitors and explores novel, advanced strategies for inhibiting MMPs, potentially offering new avenues for treating respiratory diseases.
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Affiliation(s)
- Hina Agraval
- Department of Medicine, National Jewish Health, Denver, CO 80206, USA
| | - Kushal Kandhari
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Umesh C S Yadav
- Special Center for Molecular Medicine, Jawaharlal Nehru University, New Delhi 110067, India.
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14
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Popiołek AK, Niznikiewicz MA, Borkowska A, Bieliński MK. Evaluation of Event-Related Potentials in Somatic Diseases - Systematic Review. Appl Psychophysiol Biofeedback 2024; 49:331-346. [PMID: 38564137 DOI: 10.1007/s10484-024-09642-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Many somatic illnesses (e.g. hypertension, diabetes, pulmonary and cardiac diseases, hepatitis C, kidney and heart failure, HIV infection, Sjogren's disease) may impact central nervous system functions resulting in emotional, sensory, cognitive or even personality impairments. Event-related potential (ERP) methodology allows for monitoring neurocognitive processes and thus can provide a valuable window into these cognitive processes that are influenced, or brought about, by somatic disorders. The current review aims to present published studies on the relationships between somatic illness and brain function as assessed with ERP methodology, with the goal to discuss where this field of study is right now and suggest future directions.
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Affiliation(s)
- Alicja K Popiołek
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Curie Sklodowskiej 9, 85-094, Bydgoszcz, Poland.
| | - Margaret A Niznikiewicz
- Medical Center, Harvard Medical School and Boston VA Healthcare System, Psychiatry 116a C/O R. McCarly 940 Belmont St, Brockton, MA, 02301, USA
| | - Alina Borkowska
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Curie Sklodowskiej 9, 85-094, Bydgoszcz, Poland
| | - Maciej K Bieliński
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Curie Sklodowskiej 9, 85-094, Bydgoszcz, Poland
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Chaogang X, Mengna A, Zhen W, Ying L, Xin G, Xin Z, Shengjie Z, Yuan Z, Qian L, Wenbin M, Weiyi F. Cost-effectiveness of mepolizumab for severe eosinophilic asthma in China. J Asthma 2024; 61:1068-1075. [PMID: 38470879 DOI: 10.1080/02770903.2024.2324855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/16/2024] [Accepted: 02/25/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVE To evaluate the economic value of mepolizumab as an add-on therapy to the standard of care (SoC) for patients with severe eosinophilic asthma in China. METHODS A Markov model with three health conditions was constructed to calculate the incremental cost per quality-adjusted life year (QALY) in mepolizumab with SoC and SoC only groups from the perspective of the Chinese healthcare system throughout an entire lifespan. The model was populated with local costs, while efficacy parameters were obtained from the global Phase III MENSA trial and mortality was derived from two surveys. One-way and probabilistic sensitivity analyses were conducted. Additional scenario analysis was used to estimate the cost-effectiveness impact of changes in the price of mepolizumab. RESULTS Over the lifetime treatment horizon, the incremental cost-effectiveness ratio (ICER) of mepolizumab plus SoC compared to SoC alone was $170 648.73 per QALY. Sensitivity analyses focused on these results. Scenario analysis showed that mepolizumab would require a price reduction of at least 82% to reach the current willingness-to-pay (WTP=$38 223.34/QALY) threshold. CONCLUSION Mepolizumab is not a cost-effective healthcare resource in China at its current pricing.
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Affiliation(s)
- Xiong Chaogang
- Department of Pharmacy, Xi'an Chest Hospital, Xi'an, Shaanxi Province, China
| | - An Mengna
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Wang Zhen
- Department of Pharmacy, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi Province, China
| | - Li Ying
- Department of Pharmacy, Xi'an Chest Hospital, Xi'an, Shaanxi Province, China
| | - Gu Xin
- Department of Pharmacy, Xi'an Chest Hospital, Xi'an, Shaanxi Province, China
| | - Zhang Xin
- Department of Pharmacy, Xi'an Chest Hospital, Xi'an, Shaanxi Province, China
| | - Zhang Shengjie
- Department of Pharmacy, Xi'an Chest Hospital, Xi'an, Shaanxi Province, China
| | - Zhao Yuan
- Department of Pharmacy, Xi'an Chest Hospital, Xi'an, Shaanxi Province, China
| | - Lei Qian
- Department of Pharmacy, Xi'an Chest Hospital, Xi'an, Shaanxi Province, China
| | - Ma Wenbin
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Feng Weiyi
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
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Murugan K, Sivakumar A. Signs and terminologies in cutaneous manifestations of substance abuse. Indian J Dermatol Venereol Leprol 2024; 90:682-686. [PMID: 38595000 DOI: 10.25259/ijdvl_821_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/22/2023] [Indexed: 04/11/2024]
Affiliation(s)
- Kalaiarasi Murugan
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Pondicherry, India
| | - Aravind Sivakumar
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Pondicherry, India
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Shaker K, Alomar K, Aldabea M, Zwaraa H, Alnwaijie N, Aldalati H. Recurrent pneumonia in a 2-year-old: A rare case of congenital lobar emphysema. Int J Surg Case Rep 2024; 122:110074. [PMID: 39059238 PMCID: PMC11327477 DOI: 10.1016/j.ijscr.2024.110074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Revised: 07/16/2024] [Accepted: 07/22/2024] [Indexed: 07/28/2024] Open
Abstract
INTRODUCTION AND SIGNIFICANCE Emphysema is an uncommon but important condition that often appears in the neonatal period. Diagnosis is based on CT, which identifies the affected lung lobe, which is treated with complete surgical resection. CASE PRESENTATION We present a case of a child who had been suffering for about a year from recurrent respiratory infections without arriving at a clear and correct diagnosis. He was evaluated by us and diagnosed correctly despite the difficulty of distinguishing it from pneumothorax. The final treatment was surgical removal. CLINICAL DISCUSSION Emphysema is considered one of the important conditions that should be considered as a differential diagnosis if there is clear hyperinflated in the pulmonary lobe. The evaluation is mainly done through CT to reach the correct diagnosis and treatment. CONCLUSION Congenital lobar emphysema is a rare condition that primarily affects children. The majority of children with CLE experience symptoms and necessitate surgery.
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Affiliation(s)
- Kamar Shaker
- Damascus University, University Pediatric Hospital, Syria.
| | - Khaled Alomar
- Damascus University, University Pediatric Hospital, Syria.
| | | | - Hanady Zwaraa
- Damascus University, University Pediatric Hospital, Syria
| | | | - Husam Aldalati
- Damascus University, University Pediatric Hospital, Syria
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18
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Kazemi K, Abiri A, Zhou Y, Rahmani A, Khayat RN, Liljeberg P, Khine M. Improved sleep stage predictions by deep learning of photoplethysmogram and respiration patterns. Comput Biol Med 2024; 179:108679. [PMID: 39033682 DOI: 10.1016/j.compbiomed.2024.108679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 07/23/2024]
Abstract
Sleep staging is a crucial tool for diagnosing and monitoring sleep disorders, but the standard clinical approach using polysomnography (PSG) in a sleep lab is time-consuming, expensive, uncomfortable, and limited to a single night. Advancements in sensor technology have enabled home sleep monitoring, but existing devices still lack sufficient accuracy to inform clinical decisions. To address this challenge, we propose a deep learning architecture that combines a convolutional neural network and bidirectional long short-term memory to accurately classify sleep stages. By supplementing photoplethysmography (PPG) signals with respiratory sensor inputs, we demonstrated significant improvements in prediction accuracy and Cohen's kappa (k) for 2- (92.7 %; k = 0.768), 3- (80.2 %; k = 0.714), 4- (76.8 %, k = 0.550), and 5-stage (76.7 %, k = 0.616) sleep classification using raw data. This relatively translatable approach, with a less intensive AI model and leveraging only a few, inexpensive sensors, shows promise in accurately staging sleep. This has potential for diagnosing and managing sleep disorders in a more accessible and practical manner, possibly even at home.
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Affiliation(s)
| | - Arash Abiri
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, United States
| | - Yongxiao Zhou
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, United States
| | - Amir Rahmani
- Department of Computer Science, University of California, Irvine, Irvine, CA, United States; School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Rami N Khayat
- Division of Pulmonary and Critical Care Medicine, The UCI Comprehensive Sleep Center, University of California. Irvine, Newport Beach, CA, United States
| | | | - Michelle Khine
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, United States.
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19
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Huang Y, Hu B, Chen S, Jiang Z, Dai Z, Jiang Z, Liu C, Xu Y, Chen X, Jin W, Yu B, Zhang X. The role of serum chloride ion in the prognosis of COPD. Am J Med Sci 2024; 368:235-241. [PMID: 38777153 DOI: 10.1016/j.amjms.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 04/21/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND As exacerbations of chronic obstructive pulmonary disease (COPD) are one of the leading causes of hospitalization and are associated with significant mortality, it is particularly important to accurately assess the risk of exacerbations in COPD. Most of the current clinical biomarkers are related to inflammation and few consider how ion levels affect COPD. Chloride ion, the second most abundant serum electrolyte, has been shown to be associated with poor prognoses in several diseases, but their relationship with COPD remains unclear. METHODS In total, 105 patients with acute exacerbations of COPD were recruited. Data on clinical characteristics, lung function, blood count, blood biochemistry, relevant scales including the Clinical COPD Questionnaire (CCQ), BODE (BMI, airflow obstruction, dyspnea, exercise capacity) index and the St. George's Respiratory Questionnaire (SGRQ) were collected from all patients for statistical analysis. RESULT There were significant differences in lung function indicators and disease severity in the low chloride ion subgroup compared with the high chloride ion subgroup. On multiple logistic regression analysis, chloride ion was an independent factor affecting lung function in COPD patients (OR=0.808, 95% CI: 0.708 - 0.922, p=0.002). The sensitivity of chloride ion in predicting COPD severity was 78%, the specificity was 63%, and the area under the curve was 0.734 (p<0.001). Subgroup analysis showed that chloride ion was a stronger predictor in male and smoking patients. CONCLUSIONS Chloride ion was a novel prognostic biomarker for COPD, and low levels of chloride ion were independently associated with exacerbations in COPD patients.
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Affiliation(s)
- Yiben Huang
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Binbin Hu
- The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
| | - Siyao Chen
- The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
| | - Zerui Jiang
- The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
| | - Zicong Dai
- The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
| | - Zihan Jiang
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chunyan Liu
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yage Xu
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xianjing Chen
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wanzhong Jin
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Beibei Yu
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaodiao Zhang
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
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Khan AA, Agrawal M, Ahuja S. Clinical and histopathological spectrum of congenital pulmonary airway malformations: A case series. Int J Surg Case Rep 2024; 122:110096. [PMID: 39088970 PMCID: PMC11342210 DOI: 10.1016/j.ijscr.2024.110096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/21/2024] [Accepted: 07/26/2024] [Indexed: 08/03/2024] Open
Abstract
BACKGROUND Congenital pulmonary airway malformations (CPAM) are a spectrum of cystic and non-cystic anomalies arising from abnormal airway development in utero, with an incidence of 1 in 25,000 to 35,000 births. CPAM can present prenatally or postnatally with respiratory distress, recurrent infections, or occasionally as an incidental finding. This case series aims to highlight the clinical, radiological, and histopathological characteristics of CPAM through three pediatric cases, which include types 1, 2, and 3 CPAM. CASE PRESENTATION Case 1: A four-month-old male presented with cough, cold, and respiratory distress. Imaging revealed hypoattenuation and overinflation of the left upper lobe with mediastinal shift. Left upper lobectomy confirmed CPAM type 2. Case 2: A one-month-old female presented with recurrent respiratory distress and infections. Imaging showed a large cystic lesion in the right middle lobe. Right middle lobectomy confirmed CPAM type 3. Case 3: A two-month-old male presented with dyspnea. Imaging showed a large bullae in the right chest with mediastinal shift. Right upper lobectomy confirmed CPAM type 1. CLINICAL DISCUSSION CPAM is a rare congenital lung malformation characterized by abnormal bronchial development and localized glandular overgrowth. Management involves surgical resection, with the timing of surgery dependent on symptomatology. Early identification and intervention are crucial for preventing complications such as pulmonary hypoplasia and recurrent infections. Histopathological examination post-resection is essential for accurate classification and management of CPAM. CONCLUSION This case series provides valuable insights into the clinical, radiological, and histopathological features of CPAM, including the types encountered in each case. It underscores the importance of early diagnosis and timely surgical intervention, advocating for routine prenatal and postnatal screenings to effectively identify and manage CPAM.
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Affiliation(s)
- Adil Aziz Khan
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Meetu Agrawal
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Sana Ahuja
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
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Park JB, Kang P, Ji SH, Jang YE, Lee JH, Kim JT, Kim HS, Kim EH. Atmospheric particulate matter and hypoxaemia in Korean children receiving general anaesthesia: A retrospective analysis. Eur J Anaesthesiol 2024; 41:641-648. [PMID: 38884417 DOI: 10.1097/eja.0000000000002027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
BACKGROUND The association between the concentration of atmospheric particulate matter on the day of surgery and the occurrence of intra-operative hypoxaemia in children receiving general anaesthesia is unclear. OBJECTIVE To investigate the association between the exposure to particulate matter on the day of surgery and the occurrence of intra-operative hypoxaemia, defined as a pulse oximetry oxygen saturation of less than 90% for more than 1 min, in children. DESIGN Retrospective study. SETTING Single-centre. PARTICIPANTS Children aged 18 years or younger who received general anaesthesia between January 2019 and October 2020. INTERVENTION Information on daily levels of particulate matter with a diameter 10 μm or less and 2.5 μm or less measured within a neighbourhood corresponding to the area defined by the hospital's zip code was obtained from publicly available air-quality data. MAIN OUTCOME MEASURES The primary outcome was intra-operative hypoxaemia, defined as a pulse oximetry oxygen saturation of less than 90% lasting for more than 1 min, manually verified by anaesthesiologists using vital sign registry data extracted at 2 s intervals. RESULTS Of the patients finally analysed, 3.85% (489/13 175) experienced intra-operative hypoxaemia. Higher levels of particulate matter 10 μm or less in diameter (≥81 μg m -3 , 17/275, 6.2%) were associated with an increased occurrence of intra-operative hypoxaemia compared with lower particulate matter concentrations [<81 μg m -3 , 472/12 900, 3.7%; adjusted odds ratio, 1.71; 95% confidence interval (CI), 1.04 to 2.83; P = 0.035]. CONCLUSION The level of particulate matter on the day of surgery pose a risk of intra-operative hypoxaemia in children receiving general anaesthesia. If the concentrations of particulate matter 10 μm or less in diameter on the day of surgery are high, children receiving general anaesthesia should be managed with increased caution.
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Affiliation(s)
- Jung-Bin Park
- From the Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea (J-BP, PK, S-HJ, Y-EJ, J-HL, J-TK, H-SK, E-HK)
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22
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Kamal YA, Elshorbgy AA, Orieby AA. Determinants of positive rigid bronchoscopy for suspected organic foreign body aspiration in children younger than five years. Indian J Thorac Cardiovasc Surg 2024; 40:564-569. [PMID: 39156052 PMCID: PMC11329447 DOI: 10.1007/s12055-024-01744-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 08/20/2024] Open
Abstract
Purpose Rigid bronchoscopy is widely used for diagnosis and treatment of foreign body aspiration (FBA) in children, but negative results can be reported, especially with radiolucent organic FBA. This study aimed to evaluate the clinical features and pre-procedure predictors of organic FBA in children under 5 years of age. Methods Children aged less than 5 years old who underwent rigid bronchoscopy for suspected organic FBA were retrospectively evaluated for demographics, history of aspiration, relevant clinical symptoms and signs, radiological findings, in addition to type and location of foreign body (FB). To determine the predictors of positive FBA, stepwise backward logistic regression was applied. Results A total of 228 children were included (69.7% boys). The mean age was 1.98 ± 1.07 years. Foreign bodies were found in 202 cases (88.59%). Age ≤ 3 years and history of witnessed choking had the highest sensitivity while diminished breath sounds had the highest specificity for diagnosing FBA. In multivariate analysis, witnessed choking, wheezy chest, diminished breath sounds, and respiratory distress were independently associated with increased risk of FBA. Conclusion Children under 5 years of age with suspected organic FBA have varied clinical and radiological findings. The history of choking, wheezy chest, diminished air entry, or respiratory distress increases the chance of positive rigid bronchoscopy in this age group.
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Affiliation(s)
- Yasser Ali Kamal
- Department of Cardiothoracic Surgery, Faculty of Medicine, Minia University, Al-Minya, 61519 Egypt
| | - Ashraf Ali Elshorbgy
- Department of Cardiothoracic Surgery, Faculty of Medicine, Minia University, Al-Minya, 61519 Egypt
| | - Ahmed Anwar Orieby
- Department of Cardiothoracic Surgery, Faculty of Medicine, Minia University, Al-Minya, 61519 Egypt
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23
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Carnero Canales CS, Marquez Cazorla JI, Marquez Cazorla RM, Roque-Borda CA, Polinário G, Figueroa Banda RA, Sábio RM, Chorilli M, Santos HA, Pavan FR. Breaking barriers: The potential of nanosystems in antituberculosis therapy. Bioact Mater 2024; 39:106-134. [PMID: 38783925 PMCID: PMC11112550 DOI: 10.1016/j.bioactmat.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/17/2024] [Accepted: 05/05/2024] [Indexed: 05/25/2024] Open
Abstract
Tuberculosis (TB), caused by Mycobacterium tuberculosis, continues to pose a significant threat to global health. The resilience of TB is amplified by a myriad of physical, biological, and biopharmaceutical barriers that challenge conventional therapeutic approaches. This review navigates the intricate landscape of TB treatment, from the stealth of latent infections and the strength of granuloma formations to the daunting specters of drug resistance and altered gene expression. Amidst these challenges, traditional therapies often fail, contending with inconsistent bioavailability, prolonged treatment regimens, and socioeconomic burdens. Nanoscale Drug Delivery Systems (NDDSs) emerge as a promising beacon, ready to overcome these barriers, offering better drug targeting and improved patient adherence. Through a critical approach, we evaluate a spectrum of nanosystems and their efficacy against MTB both in vitro and in vivo. This review advocates for the intensification of research in NDDSs, heralding their potential to reshape the contours of global TB treatment strategies.
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Affiliation(s)
| | | | | | - Cesar Augusto Roque-Borda
- Tuberculosis Research Laboratory, School of Pharmaceutical Science, Sao Paulo State University (UNESP), Araraquara, 14800-903, Brazil
| | - Giulia Polinário
- Tuberculosis Research Laboratory, School of Pharmaceutical Science, Sao Paulo State University (UNESP), Araraquara, 14800-903, Brazil
| | | | - Rafael Miguel Sábio
- School of Pharmaceutical Science, Sao Paulo State University (UNESP), Araraquara, 14800-903, Brazil
- Department of Biomaterials and Biomedical Technology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, 9713 AV, the Netherlands
| | - Marlus Chorilli
- School of Pharmaceutical Science, Sao Paulo State University (UNESP), Araraquara, 14800-903, Brazil
| | - Hélder A. Santos
- Department of Biomaterials and Biomedical Technology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, 9713 AV, the Netherlands
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, FI-00014, Finland
| | - Fernando Rogério Pavan
- Tuberculosis Research Laboratory, School of Pharmaceutical Science, Sao Paulo State University (UNESP), Araraquara, 14800-903, Brazil
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24
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Khan ZS, Saini SK, Chua WJ, (Jacky) Liao HT, Manikkam S. Kartagener syndrome with pectus excavatum and upper lobar bronchiectasis. Radiol Case Rep 2024; 19:3952-3958. [PMID: 39050650 PMCID: PMC11266874 DOI: 10.1016/j.radcr.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 05/28/2024] [Accepted: 06/03/2024] [Indexed: 07/27/2024] Open
Abstract
Primary Ciliary Dyskinesia (PCD) is a rare autosomal recessive disorder caused by impaired ciliary function. The incidence of PCD is 1 in 20,000 births. Kartagener's syndrome (KS), a subtype of PCD, is distinguished by the presence of situs inversus. KS occurs in about 1 in 32,000 to 40,000 births. Characterized by a triad of situs inversus totalis, sinusitis, and typically lower lobe bronchiectasis, Kartagener's syndrome presents with distinct radiological features, which are explored in this case study. We report on an adolescent male with Kartagener's syndrome, manifesting atypical bronchiectasis in the left upper lobe, leading to a bilateral lung transplant, and severe pectus excavatum requiring surgical correction. This case documents a male patient with concurrent Kartagener's syndrome and pectus excavatum, supporting a previously explored, albeit theoretical association between these conditions.
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Affiliation(s)
- Zain Saleem Khan
- Gold Coast University Hospital, 1 Hospital Blvd, Southport Queensland 4215, Australia
- Griffith University, 1 Parklands Dr, Southport Queensland 4215, Australia
| | - Saransh Kumar Saini
- Gold Coast University Hospital, 1 Hospital Blvd, Southport Queensland 4215, Australia
- Griffith University, 1 Parklands Dr, Southport Queensland 4215, Australia
| | - Weng Joe Chua
- Royal North Shore Hospital, Reserve Rd, St Leonards NSW 2065, Australia
| | - Hao Ting (Jacky) Liao
- Gold Coast University Hospital, 1 Hospital Blvd, Southport Queensland 4215, Australia
- Griffith University, 1 Parklands Dr, Southport Queensland 4215, Australia
| | - Samuel Manikkam
- Gold Coast University Hospital, 1 Hospital Blvd, Southport Queensland 4215, Australia
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25
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Gupta A, Saleena LM, Kannan P, Shivachandran A. The impact of oral diseases on respiratory health and the influence of respiratory infections on the oral microbiome. J Dent 2024; 148:105213. [PMID: 38936454 DOI: 10.1016/j.jdent.2024.105213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/20/2024] [Accepted: 06/24/2024] [Indexed: 06/29/2024] Open
Abstract
OBJECTIVE The objective of this review is to examine the relationship between oral diseases and respiratory health, investigating how oral microbiome disruptions contribute to respiratory tract infections. Additionally, it aims to explore the impact of respiratory disease symptoms and treatments on the oral microbiome. DATA SOURCES The literature utilized in this review was sourced from studies focusing on the correlation between oral health and respiratory infections, spanning a period of 40 years. Various databases and scholarly sources were likely consulted to gather relevant research articles, reviews, and clinical studies. STUDY SELECTION This review summarizes four decades-long research, providing insights into the intricate relationship between oral and respiratory health. It delves into how oral diseases influence respiratory tract conditions and vice versa. The selection process likely involved identifying studies that addressed the interaction between oral microbiome disruptions and respiratory complications. CONCLUSION Oral diseases or poor oral habits have been known to increase the risk of getting respiratory infections. Modern techniques have demonstrated the relationship between oral disease and respiratory tract infections like influenza, chronic obstructive pulmonary diseases, asthma, and Pneumonia. Apart from that, the medications used to treat respiratory diseases affect oral physiological factors like the pH of saliva, and saliva flow rate, which can cause significant changes in the oral microbiome. This review provides regular oral hygiene and care that can prevent respiratory health and respiratory infections. CLINICAL SIGNIFICANCE Understanding the intricate relationship between oral health and respiratory infections is crucial for healthcare providers. Implementing preventive measures and promoting good oral hygiene habits can reduce respiratory tract infections and improve overall respiratory health outcomes.
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Affiliation(s)
- Annapurna Gupta
- Department of Biotechnology, School of Bioengineering, College of Engineering and Technology, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Kanchipuram, Chennai, Tamil Nadu 603203, India
| | - Lilly M Saleena
- Department of Biotechnology, School of Bioengineering, College of Engineering and Technology, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Kanchipuram, Chennai, Tamil Nadu 603203, India.
| | - Priya Kannan
- Department of Biotechnology, School of Bioengineering, College of Engineering and Technology, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Kanchipuram, Chennai, Tamil Nadu 603203, India
| | - A Shivachandran
- Department of Oral Pathology, SRM Dental College and Hospital, SRM Institute of Science and Technology, SRM Nagar Kattankulathur, Kanchipuram, Chennai, Tamil Nadu 603203, India
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26
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Mohd Abas MD, Mohd Asri MF, Yusafawi NAS, Rosman NAZ, Baharudin NAZ, Taher M, Susanti D, Khotib J. Advancements of gene therapy in cancer treatment: A comprehensive review. Pathol Res Pract 2024; 261:155509. [PMID: 39121791 DOI: 10.1016/j.prp.2024.155509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 07/23/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024]
Abstract
Cancer is the main contributor for mortality in the world. Conventional therapy that available as the treatment options are chemotherapy, radiotherapy and surgery. However, these treatments are hardly cell-specific most of the time. Nowadays, extensive research and investigations are made to develop cell-specific approaches prior to cancer treatment. Some of them are photodynamic therapy, hyperthermia, immunotherapy, stem cell transplantation and targeted therapy. This review article will be focusing on the development of gene therapy in cancer. The objective of gene therapy is to correct specific mutant genes causing the excessive proliferation of the cell that leads to cancer. There are lots of explorations in the approach to modify the gene. The delivery of this therapy plays a big role in its success. If the inserted gene does not find its way to the target, the therapy is considered a failure. Hence, vectors are needed and the common vectors used are viral, non viral or synthetic, polymer based and lipid based vectors. The advancement of gene therapy in cancer treatment will be focussing on the top three cancer cases in the world which are breast, lung and colon cancer. In breast cancer, the discussed therapy are CRISPR/Cas9, siRNA and gene silencing whereas in colon cancer miRNA and suicide gene therapy and in lung cancer, replacement of tumor suppressor gene, CRISPR/Cas9 and miRNA.
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Affiliation(s)
- Muhammad Dhiyauddin Mohd Abas
- Department of Pharmaceutical Technology, Faculty of Pharmacy, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Kuantan, Pahang 25200, Malaysia
| | - Muhammad Fareez Mohd Asri
- Department of Pharmaceutical Technology, Faculty of Pharmacy, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Kuantan, Pahang 25200, Malaysia
| | - Nur Anis Suffiah Yusafawi
- Department of Pharmaceutical Technology, Faculty of Pharmacy, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Kuantan, Pahang 25200, Malaysia
| | - Nur Anis Zahra Rosman
- Department of Pharmaceutical Technology, Faculty of Pharmacy, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Kuantan, Pahang 25200, Malaysia
| | - Nur Arifah Zahidah Baharudin
- Department of Pharmaceutical Technology, Faculty of Pharmacy, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Kuantan, Pahang 25200, Malaysia
| | - Muhammad Taher
- Department of Pharmaceutical Technology, Faculty of Pharmacy, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Kuantan, Pahang 25200, Malaysia.
| | - Deny Susanti
- Department of Chemistry, Faculty of Science, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Kuantan, Pahang 25200, Malaysia.
| | - Junaidi Khotib
- Department of Pharmacy Practice, Faculty of Pharmacy, Airlangga University, Surabaya 60115, Indonesia.
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Xinliang Z, Achkasov EE, Gavrikov LK, Yuchen L, Zhang C, Dudnik EN, Rumyantseva O, Beeraka NM, Glazachev OS. Assessing the importance and safety of hypoxia conditioning for patients with occupational pulmonary diseases: A recent clinical perspective. Biomed Pharmacother 2024; 178:117275. [PMID: 39126774 DOI: 10.1016/j.biopha.2024.117275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 07/25/2024] [Accepted: 08/05/2024] [Indexed: 08/12/2024] Open
Abstract
Occupational pulmonary diseases (OPDs) pose a significant global health challenge, contributing to high mortality rates. This review delves into the pathophysiology of hypoxia and the safety of intermittent hypoxic conditioning (IHC) in OPD patients. By examining sources such as PubMed, Relemed, NLM, Scopus, and Google Scholar, the review evaluates the efficacy of IHC in clinical outcomes for OPD patients. It highlights the complexities of cardiovascular and respiratory regulation dysfunctions in OPDs, focusing on respiratory control abnormalities and the impact of intermittent hypoxic exposures. Key areas include the physiological effects of hypoxia, the role of hypoxia-inducible factor-1 alpha (HIF-1α) in occupational lung diseases, and the links between brain ischemia, stroke, and OPDs. The review also explores the interaction between intermittent hypoxic exposures, mitochondrial energetics, and lung physiology. The potential of IHE to improve clinical manifestations and underlying pathophysiology in OPD patients is thoroughly examined. This comprehensive analysis aims to benefit molecular pathologists, pulmonologists, clinicians, and physicians by enhancing understanding of IHE's clinical benefits, from research to patient care, and improving clinical outcomes for OPD patients.
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Affiliation(s)
- Zhang Xinliang
- Chair of Sports Medicine and Rehabilitation, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia; Co-Chair of Normal Physiology, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia.
| | - Eugeny E Achkasov
- Chair of Sports Medicine and Rehabilitation, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia.
| | - Leonid K Gavrikov
- Volgograd State Medical University, 1, Pavshikh Bortsov Sq., Volgograd 400131, Russia.
| | - Li Yuchen
- Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia.
| | - Chen Zhang
- Chair of Epidemiology and Modern Technologies of Vaccination, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia
| | - Elena N Dudnik
- Co-Chair of Normal Physiology, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia.
| | - Olga Rumyantseva
- Izmerov Research Institute of Occupational Health, 31 Budeynniy Avenye, Moscow 105275, Russia.
| | - Narasimha M Beeraka
- Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, 1044 W. Walnut Street, R4-168, Indianapolis, IN 46202, USA; Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia; Raghavendra Institute of Pharmaceutical Education and Research (RIPER), Chiyyedu, Anantapuramu, Andhra Pradesh 515721, India.
| | - Oleg S Glazachev
- Co-Chair of Normal Physiology, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia.
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Mathur P, Ningombam A, Soni KD, Aggrawal R, Singh KV, Samanta P, Gupta S, Srivastava S, Behera B, Tripathy S, Ray P, Biswal M, Rodrigues C, Bhattacharya S, Mukherjee S, Mukherjee S, Venkatesh V, Verma S, Arshad Z, Tak V, Bhatia PK, Nag V, Karuna T, Saigal S, Sharma JP, Singh S, Mukhopadhyay C, KE V, Varma M, Majumdar T, Deotale V, Attal R, Iravane J, Harbade M, Omkari A, Walia K. Surveillance of ventilator associated pneumonia in a network of indian hospitals using modified definitions: a pilot study. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 28:100450. [PMID: 39130755 PMCID: PMC11315213 DOI: 10.1016/j.lansea.2024.100450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 06/20/2024] [Accepted: 07/03/2024] [Indexed: 08/13/2024]
Abstract
Background Ventilator-associated pneumonia (VAP) is a major cause of morbidity and mortality in patients receiving mechanical ventilation in India. Surveillance of VAP is essential to implement data-based preventive measures. Implementation of ventilator-associated events (VAE) criteria for surveillance has major constraints for low resource settings, which can lead to significant underreporting. Surveillance of VAP using common protocols in a large network of hospitals would give meaningful estimates of the burden of VAP in low resource settings. This study leverages a previously established healthcare-associated infections (HAI) surveillance network to develop and test a modified VAP definition adjusted for Indian settings. Methods In this observational pilot study, thirteen hospitals from the existing HAI surveillance network were selected for developing and testing a modified VAP definition between February 2021 and April 2023. The criteria used for diagnosing VAP were adapted from the CDC's Pediatric VAP definition and modified to cater to the needs of Indian hospitals. Designated nurses recorded each VAP event in a case report form (CRF) and also collected denominator data. The data was entered into an indigenously developed database for validation and analysis. At the time of data analysis, a questionnaire was sent to sites to get feedback on the performance of the modified VAP definitions. Findings Out of 133,445 patient days and 40,533 ventilator days, 261 VAP events were recorded, with an overall VAP rate of 6.4 per 1000 ventilator days and a device utilization ratio (DUR) of 0.3. A total of 344 organisms were reported from the VAP events. Of these, Acinetobacter spp (29.6%, 102) was the most frequent, followed by Klebsiella spp (26.7%, 92). Isolates of Acinetobacter spp (98%) and Enterobacterales (85.5%) showed very high resistance against Carbapenem. Colistin resistance was observed in 6% of Enterobacterales and 3.2% of Acinetobacter spp. Interpretation Data from this pilot study needs to validated in the larger Indian HAI surveillance network so that it can help in wider implementation of this protocol in order to assess its applicability p VAP across India. Funding This work was supported by a grant received from the Indian Council of Medical Research (code I-1203).
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Affiliation(s)
- Purva Mathur
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Aparna Ningombam
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Kapil Dev Soni
- Department of Anaesthesia and Critical Care, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Richa Aggrawal
- Department of Anaesthesia and Critical Care, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Kumari Vandana Singh
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Projoyita Samanta
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Stuti Gupta
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Smriti Srivastava
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Bijayini Behera
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Swagata Tripathy
- Department of Anaesthesia and Intensive Care, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Pallab Ray
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manisha Biswal
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Camilla Rodrigues
- Department of Clinical Microbiology, PD Hinduja National Hospital and Medical Research Centre, India
| | - Sanjay Bhattacharya
- Department of Microbiology, Tata Medical Center, Kolkata, West Bengal, India
| | - Sudipta Mukherjee
- Department of Critical Care, Tata Medical Center, Kolkata, West Bengal, India
| | - Satyam Mukherjee
- Department of Microbiology, Tata Medical Center, Kolkata, West Bengal, India
| | - Vimala Venkatesh
- Department of Microbiology, King George’s Medical University, Lucknow, India
| | - Sheetal Verma
- Department of Microbiology, King George’s Medical University, Lucknow, India
| | - Zia Arshad
- Department of Anaesthesiology and Critical Care, King George’s Medical University, Lucknow, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Pradeep Kumar Bhatia
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Vijaylakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Tadepalli Karuna
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal, India
| | - Sourabh Saigal
- Department of Anaesthesiology, All India Institute of Medical Sciences, Bhopal, India
| | - Jai Prakash Sharma
- Department of Anaesthesiology, All India Institute of Medical Sciences, Bhopal, India
| | - Sanjeev Singh
- Department of Microbiology, Amrita Institute of Medical Sciences, Kochi, India
| | - Chiranjay Mukhopadhyay
- Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Vandana KE
- Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Muralidhar Varma
- Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Tapan Majumdar
- Department of Microbiology, Government Medical College, Agartala, India
| | - Vijayshree Deotale
- Department of Microbiology Mahatma Gandhi Institute of Medical Sciences, Sevagram, India
| | - Ruchita Attal
- Department of Microbiology Mahatma Gandhi Institute of Medical Sciences, Sevagram, India
| | - Jyoti Iravane
- Department of Microbiology, Government Medical College, Aurangabad, India
| | - Mangala Harbade
- Department of Microbiology, Government Medical College, Aurangabad, India
| | - Amruta Omkari
- Department of Microbiology, Government Medical College, Aurangabad, India
| | - Kamini Walia
- Indian Council of Medical Research, New Delhi, India
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Malkova K, Wilhelm AB, Uddin H, Okereke I, Muthukumarana V. Non-IgG4-Related Fibrosing Mediastinitis Diagnosed on Core Needle Biopsy and Treated with Steroids: A Case Study and Review of the Differential Diagnoses. Int J Surg Pathol 2024; 32:1215-1221. [PMID: 38234079 PMCID: PMC11337727 DOI: 10.1177/10668969231219646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/17/2023] [Accepted: 11/18/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVES This study aimed to investigate the histological characteristics and treatment efficacy of non-immunoglobulin G4-related fibrosing mediastinitis and discuss differential diagnoses for this rare entity. METHODS We present a case study of non-immunoglobulin G4-related fibrosing mediastinitis diagnosed on core biopsy and treated with steroids. A total of four 18-gauge core needle biopsy specimens were obtained for surgical pathology. Analysis of the patient's medical history, radiological characteristics of fibrosing mediastinitis, histological features, immunohistochemistry results, the differential diagnosis and treatment efficacy of different types of fibrosing mediastinitis was performed. RESULTS This report describes a unique presentation of fibrosing mediastinitis (syncope and weight loss) that was concerning for malignancy. Histological, laboratory and radiographical studies confirmed the diagnosis of non-immunoglobulin G4-related fibrosing mediastinitis. The patient received corticosteroid treatment which showed marked improvement after 1 month of treatment. CONCLUSIONS Fibrosing mediastinitis is an extremely uncommon entity with unknown pathogenesis, and it is more important to rule out malignancy and infection than to delineate between fibrosing mediastinitis and IgG4-related disease. In doing this, we may reasonably initiate a trial of corticosteroids which may prove beneficial, as in this patient. More studies on the pathogenesis of fibrosing mediastinitis are necessary to guide better directed treatments.
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Affiliation(s)
- Kseniia Malkova
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - Alyeesha B. Wilhelm
- Department of Pathology, University of Pittsburg Medical Center, Pittsburgh, PA, USA
| | - Hamza Uddin
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Ikenna Okereke
- Department of Surgery, Henry Ford Health System, Detroit, MI, USA
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Pan B, Wang Y, Zhu Z, Zhu X. Diagnostic Performance of 18 F-FDG Positron Emission Tomography/Computed Tomography and Blood Test Parameters for Pulmonary Inflammatory Pseudotumor. J Thorac Imaging 2024; 39:298-303. [PMID: 38639385 DOI: 10.1097/rti.0000000000000780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
PURPOSE Pulmonary inflammatory pseudotumor (PIP) is an inflammatory proliferative tumor-like lesion that frequently exhibits hypermetabolism on 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography imaging (PET/CT) and is readily misdiagnosed as a malignant tumor. The purpose of this study was to identify PIP by combining PET/computed tomography metabolic and blood test characteristics with machine learning. PATIENTS AND METHODS We recruited 27 patients with PIP and 28 patients with lung cancer (LC). The PET metabolic and blood test parameters were collected, and the differences between the groups were evaluated. In addition, we combined the support vector machine (SVM) classifier with the indicators that differed between the groups to classify PIP and LC. RESULTS For PET metabolic parameters, our findings showed that, as compared with the LC group, maximal standardized uptake value ( P < 0.001, t = -4.780), Mean standardized uptake value SUV mean , P < 0.001, t = -4.946), and SD40% ( P < 0.001, t = -4.893) were considerably reduced in the PIP group, whereas CV40% ( P = 0.004, t = 3.012) was significantly greater. For blood test parameters, the total white blood cell count ( P < 0.001, t = 6.457) and absolute neutrophil count ( P < 0.001, t = 6.992) were substantially higher in the PIP group than in the LC group. Furthermore, the performance of SVM trained solely on PET metabolic parameters (mean area under the curve [AUC] = 0.84) was comparable to that of SVM trained solely on blood test parameters (mean AUC = 0.86). Surprisingly, utilizing the combined parameters increased SVM performance significantly (mean AUC = 0.98). CONCLUSION PET metabolic and blood test parameters differed significantly between the PIP and LC groups, and the SVM paradigm using these significantly different features has the potential to be used to classify PIP and LC, which has important clinical implications.
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Affiliation(s)
- Bo Pan
- Department of Nuclear Medicine, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC
| | - Yanming Wang
- Center for Biomedical Imaging, University of Science and Technology of China, Hefei, China
| | - Zehua Zhu
- Department of Nuclear Medicine, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC
| | - Xingxing Zhu
- Department of Nuclear Medicine, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC
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Fantin A, Castaldo N, Crisafulli E, Sartori G, Aujayeb A, Vailati P, Morana G, Patrucco F, de Martino M, Isola M, Patruno V. The Role of Medical Thoracoscopy with Talc Poudrage in Spontaneous, Iatrogenic, and Traumatic Pneumothorax: A Prolonged Experience of a Tertiary Care Center. Pulm Ther 2024; 10:347-362. [PMID: 39126456 PMCID: PMC11339209 DOI: 10.1007/s41030-024-00268-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024] Open
Abstract
INTRODUCTION Medical thoracoscopy is a minimally invasive and safe procedure mostly performed for unexplained exudative pleural effusions but may be considered for pneumothorax (PNX). METHODS This retrospective study included participants affected by PNX who underwent medical thoracoscopy with talc poudrage at a single academic hospital from 2008 to 2021. The primary endpoint was the observation of complete radiographical lung re-expansion and absence of air supply from the chest drain within 7 days of medical thoracoscopy. The secondary endpoint was achieving no recurrence of ipsilateral PNX at 24 months post-discharge. RESULTS A total of 95 patients affected by primary spontaneous PNX (PSP), secondary spontaneous PNX (SSP), iatrogenic, and traumatic PNX were enrolled. An additional procedure was required by 17.89% of patients, and only one patient with SSP required subsequent surgery. Recurrence of PNX occurred on the same side within 24 months after discharge in 9.47% of patients, with a median time to recurrence of 13.5 months. The PSP group was significantly more likely to achieve the primary endpoint. Pleural morphology was significantly associated with reaching the primary endpoint, while receiving a cumulative dose of talc greater than or equal to 4 g during hospitalization was associated with a lower risk of meeting it. Receiving a cumulative dose of talc greater than or equal to 4 g led in all cases to the achievement of the secondary endpoint. Patients with iatrogenic and traumatic PNX had an excellent prognosis in both the short- and long-term evaluation. CONCLUSION Medical thoracoscopy is an effective procedure for treating PNX in the acute setting in selected cases while preventing long-term relapses. Large prospective clinical studies are needed to support and better define the role of medical thoracoscopy in current clinical practice.
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Affiliation(s)
- Alberto Fantin
- Department of Pulmonology, Santa Maria della Misericordia University Hospital, Via Colugna, 33100, Udine, Italy.
| | - Nadia Castaldo
- Department of Pulmonology, Santa Maria della Misericordia University Hospital, Via Colugna, 33100, Udine, Italy
| | - Ernesto Crisafulli
- Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Giulia Sartori
- Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Paolo Vailati
- Department of Pulmonology, Santa Maria della Misericordia University Hospital, Via Colugna, 33100, Udine, Italy
| | - Giuseppe Morana
- Department of Pulmonology, Santa Maria della Misericordia University Hospital, Via Colugna, 33100, Udine, Italy
| | - Filippo Patrucco
- Division of Respiratory Diseases, Department of Medicine, Maggiore della Carità University Hospital, Novara, Italy
| | - Maria de Martino
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Miriam Isola
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Vincenzo Patruno
- Department of Pulmonology, Santa Maria della Misericordia University Hospital, Via Colugna, 33100, Udine, Italy
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Martín-Biel L, Aguado-Agudo M, Carilla-Sanromán A. [Endobronchial leiomyoma in a patient of 19 years]. Med Clin (Barc) 2024; 163:214-215. [PMID: 38692988 DOI: 10.1016/j.medcli.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 05/03/2024]
Affiliation(s)
- Laura Martín-Biel
- Servicio de Neumología, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - María Aguado-Agudo
- Servicio de Neumología, Hospital Universitario Miguel Servet, Zaragoza, España
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33
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Cave C, Samano D, Sharma AM, Dickinson J, Salomon J, Mahapatra S. Acute respiratory distress syndrome: A review of ARDS across the life course. J Investig Med 2024:10815589241270612. [PMID: 39092841 DOI: 10.1177/10815589241270612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
Acute respiratory distress syndrome (ARDS) is a multifactorial, inflammatory lung disease with significant morbidity and mortality that predominantly requires supportive care in its management. Although initially described in adult patients, the diagnostic definitions for ARDS have evolved over time to accurately describe this disease process in pediatric and, more recently, neonatal patients. The management of ARDS in each age demographic has converged in the application of lung-protective ventilatory strategies to mitigate the primary disease process and prevent its exacerbation by limiting ventilator-induced lung injury. However, differences arise in the preferred ventilatory strategies or adjunctive pulmonary therapies used to mitigate each type of ARDS. In this review, we compare and contrast the epidemiology, common etiologies, pathophysiology, diagnostic criteria, and outcomes of ARDS across the lifespan. Additionally, we discuss in detail the different management strategies used for each subtype of ARDS and spotlight how these strategies were applied to mitigate poor outcomes during the COVID-19 pandemic. This review is geared toward both clinicians and clinician-scientists as it not only summarizes the latest information on disease pathogenesis and patient management in ARDS across the lifespan but also highlights knowledge gaps for further investigative efforts. We conclude by projecting how future studies can fill these gaps in research and what improvements may be envisioned in the management of NARDS and PARDS based on the current breadth of literature on adult ARDS treatment strategies.
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Affiliation(s)
- Caleb Cave
- Division of Neonatology, and Division of Pulmonology, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, University of Nebraska Medical Center, Omaha, NE, USA
| | - Dannielle Samano
- Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Abhineet M Sharma
- Division of Neonatology, and Division of Pulmonology, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, University of Nebraska Medical Center, Omaha, NE, USA
| | - John Dickinson
- Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Jeffrey Salomon
- Division of Critical Care Medicine, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sidharth Mahapatra
- Division of Critical Care Medicine, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, University of Nebraska Medical Center, Omaha, NE, USA
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Li X, Luo X, Wang B, Fu L, Chen X, Lu Y. Clofazimine inhibits innate immunity against Mycobacterium tuberculosis by NF-κB. mSphere 2024; 9:e0025424. [PMID: 39046230 PMCID: PMC11351037 DOI: 10.1128/msphere.00254-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/20/2024] [Indexed: 07/25/2024] Open
Abstract
Tuberculosis (TB) remains one of the infectious diseases with high incidence and high mortality. About a quarter of the population has been latently infected with Mycobacterium tuberculosis. At present, the available TB treatment strategies have the disadvantages of too long treatment duration and serious adverse reactions. The sustained inflammatory response leads to permanent tissue damage. Unfortunately, the current selection of treatment regimens does not consider the immunomodulatory effects of various drugs. In this study, we preliminarily evaluated the effects of commonly used anti-tuberculosis drugs on innate immunity at the cellular level. The results showed that clofazimine (CFZ) has a significant innate immunosuppressive effect. CFZ significantly inhibited cytokines and type I interferons (IFNα and IFNβ) expression under both lipopolysaccharide stimulation and CFZ-resistant strain infection. In further mechanistic studies, CFZ strongly inhibited the phosphorylation of nuclear factor kappa B (NF-κB) p65 and had no significant effect on the phosphorylation of p38. In conclusion, our study found that CFZ suppresses innate immunity against Mycobacterium tuberculosis by NF-κB, which should be considered in future regimen development. IMPORTANCE The complete elimination of Mycobacterium tuberculosis (Mtb), the etiologic agent of TB, from TB patients is a complicated process that takes a long time. The excessive immune inflammatory response of the host for a long time causes irreversible organic damage to the lungs and liver. Current antibiotic-based treatment options involve multiple complex drug combinations, often targeting different physiological processes of Mtb. Given the high incidence of post-tuberculosis lung disease, we should also consider the immunomodulatory properties of other drugs when selecting drug combinations.
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Affiliation(s)
- Xinda Li
- Department of Pharmacology, Beijing Chest Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Drug Resistance Tuberculosis Research, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Xiaoyi Luo
- Department of Pharmacology, Beijing Chest Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Drug Resistance Tuberculosis Research, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Bin Wang
- Department of Pharmacology, Beijing Chest Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Drug Resistance Tuberculosis Research, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Lei Fu
- Department of Pharmacology, Beijing Chest Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Drug Resistance Tuberculosis Research, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Xi Chen
- Department of Pharmacology, Beijing Chest Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Drug Resistance Tuberculosis Research, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Yu Lu
- Department of Pharmacology, Beijing Chest Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Drug Resistance Tuberculosis Research, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
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Santiago MJ, Chinnapaiyan S, Panda K, Rahman MS, Ghorai S, Lucas JH, Black SM, Rahman I, Unwalla HJ. MicroRNA mediated suppression of airway lactoperoxidase by TGF-β1 and cigarette smoke promotes airway inflammation. J Inflamm (Lond) 2024; 21:31. [PMID: 39192275 DOI: 10.1186/s12950-024-00405-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 08/21/2024] [Indexed: 08/29/2024] Open
Abstract
Transforming Growth Factor Beta1 (TGF-β1) signaling is upregulated in Chronic Obstructive Pulmonary disease (COPD), smokers, and people living with HIV. Cigarette smoking and HIV are also independent risk factors for COPD. Chronic inflammation is a hallmark of COPD. However, the underlying mechanisms remain unknown. Previous research has suggested that TGF-β1 alters the airway epithelial microRNAome and transcriptome, potentially contributing to lung inflammation. The Lactoperoxidase (LPO) system is an integral component of innate immunity within the airway. LPO plays a crucial role in host defense by catalyzing the oxidation of thiocyanate to hypothiocyanite in the presence of hydrogen peroxide (H2O2), generating a potent antibacterial and antiviral agent. Additionally, the LPO system potentially aids in maintaining cellular redox balance by reducing the levels of H2O2, thus mitigating oxidative stress within the airway epithelium. LPO dysfunction can impair immune responses and exacerbate inflammatory processes in respiratory diseases.In this study, primary bronchial epithelial cells and bronchial cell lines were treated with TGF-β1 and exposed to cigarette smoke to characterize the effect of these factors on LPO and their downstream effects. RT-qPCR and Western Blot were applied to quantify mRNA and proteins' expression. The levels of H2O2 were detected using the Amplex Red Assay. Magnetofection and transfection were applied to probe the effect of miR-449b-5p. Staining procedures using the MitoTracker Green and C12FDG dyes were used to establish mitochondria mass and senescence. The levels of pro-inflammatory cytokines were measured via Luminex assays.We found that TGF-β1 and cigarette smoke suppressed airway LPO expression, increasing H2O2 levels. This increase in H2O2 had downstream effects on mitochondrial homeostasis, epithelial cellular senescence, and the pro-inflammatory cytokine response. We demonstrate for the first time that airway LPO is regulated by TGF-β1-induced miRNA-mediated post-transcriptional silencing through miR-449b-5p in the lungs. Further, we identify and validate miR-449-5p as the candidate miRNA upregulated by TGF-β1, which is involved in LPO suppression. This paper demonstrates a new mechanism by which TGF-β1 can lead to altered redox status in the airway.
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Grants
- HL147715, HL158316, HL167655,HL60190, HL137282, HL134610, HL146369 and R03DA057162-02 NIH HHS
- HL147715, HL158316, HL167655,HL60190, HL137282, HL134610, HL146369 and R03DA057162-02 NIH HHS
- HL147715, HL158316, HL167655,HL60190, HL137282, HL134610, HL146369 and R03DA057162-02 NIH HHS
- HL147715, HL158316, HL167655,HL60190, HL137282, HL134610, HL146369 and R03DA057162-02 NIH HHS
- 21K09 Florida Department of Health
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Affiliation(s)
- Maria J Santiago
- Department of Cellular and Molecular Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
- Department of Chemistry and Biochemistry, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Srinivasan Chinnapaiyan
- Department of Cellular and Molecular Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Kingshuk Panda
- Department of Cellular and Molecular Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Md Sohanur Rahman
- Department of Cellular and Molecular Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Suvankar Ghorai
- Department of Cellular and Molecular Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Joseph H Lucas
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Stephen M Black
- Department of Cellular and Molecular Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
- Center for Translational Science, Florida International University, 11350 SW Village Parkway, Port St Lucie, FL, 34987, USA
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Hoshang J Unwalla
- Department of Cellular and Molecular Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA.
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McClure TS, Phillips J, Kernagis D, Coleman K, Chappe E, Cutter GR, Egan B, Norell T, Stubbs BJ, Bamman MM, Koutnik AP. Ketone monoester attenuates oxygen desaturation during weighted ruck exercise under acute hypoxic exposure but does not impact cognitive performance. Exp Physiol 2024. [PMID: 39190570 DOI: 10.1113/ep091789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 07/19/2024] [Indexed: 08/29/2024]
Abstract
Acute ingestion of exogenous ketone supplements in the form of a (R)-3-hydroxybutyl (R)-3-hydroxybutyrate (R-BD R-βHB) ketone monoester (KME) can attenuate declines in oxygen availability during hypoxic exposure and might impact cognitive performance at rest and in response to moderate-intensity exercise. In a single-blind randomized crossover design, 16 males performed assessments of cognitive performance before and during hypoxic exposure with moderate exercise [2 × 20 min weighted ruck (∼22 kg) at 3.2 km/h at 10% incline] in a normobaric altitude chamber (4572 m, 11.8% O2). The R-BD R-βHB KME (573 mg/kg) or a calorie- and taste-matched placebo (∼50 g maltodextrin) were co-ingested with 40 g of dextrose before exposure to hypoxia. The R-βHB concentrations were rapidly elevated and sustained (>3 mM; P < 0.001) by KME. The decline in oxygen saturation during hypoxic exposure was attenuated in KME conditions by 2.4%-4.2% (P < 0.05) compared with placebo. Outcomes of cognitive performance tasks, in the form of the Defense Automated Neurobehavioral Assessment (DANA) code substitution task, the Stroop color and word task, and a shooting simulation, did not differ between trials before and during hypoxic exposure. These data suggest that the acute exogenous ketosis induced by KME ingestion can attenuate declining blood oxygen saturation during acute hypoxic exposure both at rest and during moderate-intensity exercise, but this did not translate into differences in cognitive performance before or after exercise in the conditions investigated. HIGHLIGHTS: What is the central question of this study? Can exogenous ketosis act as a countermeasure to declines in blood oxygen saturation and cognitive performance during acute hypoxic exposure while performing a weighted ruck exercise? What is the main finding and its importance? Acute exogenous ketosis via ingestion of a drink containing the (R)-3-hydroxybutyl (R)-3-hydroxybutyrate ketone monoester prior to acute hypoxic exposure attenuated hypoxia-induced declines in blood oxygen saturation but had no effect on cognitive performance during exercise.
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Affiliation(s)
- Tyler S McClure
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Jeffrey Phillips
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Dawn Kernagis
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
- Department of Neurosurgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kody Coleman
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Ed Chappe
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Gary R Cutter
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Brendan Egan
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Todd Norell
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | | | - Marcas M Bamman
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Andrew P Koutnik
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
- Sansum Diabetes Research Institute, Santa Barbara, California, USA
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Gazi U, Beyhan YE, Tosun O, Karasartova D, Cobanoglu U, Taylan-Ozkan A. Evaluation of Th1/Th2/Th17 Balance in Pulmonary Cystic Echinococcosis Patients. Acta Parasitol 2024:10.1007/s11686-024-00907-x. [PMID: 39190279 DOI: 10.1007/s11686-024-00907-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 08/13/2024] [Indexed: 08/28/2024]
Abstract
PURPOSE Cystic echinococcosis (CE) is a neglected tropical disease prevalent worldwide, particularly in rural areas. Previous studies evaluated immune responses in patients with hepatic CE, however none had assessed Th1, Th2 and Th17 levels simultaneously in pulmonary CE patients. This study aimed to fill this gap in literature by using flow cytometry analysis. METHODS Peripheral blood mononuclear cells (PBMCs) were isolated from blood samples collected from healthy control (HC) volunteers and patients with active pulmonary CE cysts. The PBMCs were analysed to evaluate Th1, Th2, and Th17 cell levels within the CD3 + CD4 + T-cell population, using antibodies against interferon (IFN)-γ, interleukin (IL)-4, and IL-17, respectively. RESULTS Our analysis revealed elevated Th2 levels in CE patients, while Th1 and Th17 cell counts showed no significant difference between HC volunteers and patients with pulmonary CE. CONCLUSION The results indicate an imbalanced Th1/Th2/Th17 cell regulation in the pathogenesis of pulmonary CE. Future studies are recommended to compare immune responses between pulmonary and hepatic CE to confirm these findings and evaluate any potential difference in the immunopathology associated with the two clinical forms of CE.
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Affiliation(s)
- Umut Gazi
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus.
| | - Yunus Emre Beyhan
- Department of Parasitology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - Ozgur Tosun
- Department of Biostatistics, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Djursun Karasartova
- Department of Medical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Ufuk Cobanoglu
- Department of Thoracic Surgery, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Aysegul Taylan-Ozkan
- Department of Medical Microbiology, Faculty of Medicine, TOBB University of Economics and Technology, Ankara, Turkey
- Department of Medical Microbiology, Faculty of Medicine, Cyprus International University, Nicosia, Cyprus
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McClure TS, Phillips J, Koutnik AP, Coleman K, Chappe E, Cutter GR, Egan B, Norell T, Stubbs BJ, Bamman MM, Kernagis D. Ketone monoester attenuates declines in cognitive performance and oxygen saturation during acute severe hypoxic exposure under resting conditions. Exp Physiol 2024. [PMID: 39190580 DOI: 10.1113/ep091794] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 07/19/2024] [Indexed: 08/29/2024]
Abstract
Exogenous ketone supplements are a potential augmentation strategy for cognitive resilience during acute hypoxic exposure due to their capacity to attenuate the decline in oxygen (O2) availability, and by providing an alternative substrate for cerebral metabolism. Utilizing a single-blind randomized crossover design, 16 male military personnel (age, 25.3 ± 2.4 year, body mass, 86.2 ± 9.3 kg) performed tests of cognitive performance at rest in three environments: room air (baseline), normoxia (20 min; 0 m; 20.9% O2) and hypoxia (20 min; 6096 m, 9.7% O2) using a reduced O2 breathing device (ROBD). (R)-3-Hydroxybutyl (R)-3-hydroxybutyrate (R-BD R-βHB) ketone monoester (KME; 650 mg/kg, split dose given at 30 min prior to each exposure) or taste-matched placebo (PLA) was ingested prior to normoxia and hypoxic exposure. Blood R-βHB and glucose concentrations, cognitive performance and O2 saturation (S p O 2 ${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$ ) were collected throughout. KME ingestion increased blood R-βHB concentration, which was rapid and sustained (>4 mM 30 min post; P < 0.001) and accompanied by lower blood glucose concentration (∼20 mg/dL; P < 0.01) compared to PLA. Declines in cognitive performance during hypoxic exposure, assessed as cognitive efficiency during a Defense Automated Neurobehavioral Assessment (DANA) code substitution task, were attenuated with KME leading to 6.8 (95% CL: 1.0, 12.6) more correct responses per minute compared to PLA (P = 0.018). The decline inS p O 2 ${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$ during hypoxic exposure was attenuated (6.40%S p O 2 ${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$ ; 95% CL: 0.04, 12.75; P = 0.049) in KME compared to PLA (KME, 76.8 ± 6.4%S p O 2 ${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$ ; PLA, 70.4 ± 7.4%S p O 2 ${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$ ). Acute ingestion of KME attenuated the decline in cognitive performance during acute severe hypoxic exposure, which coincided with attenuation of declines in O2 saturation. HIGHLIGHTS: What is the central question of this study? Can exogenous ketosis act as a countermeasure to declines in blood oxygen saturation and cognitive performance during acute severe hypoxic exposure at rest? What is the main finding and its importance? Acute exogenous ketosis via ingestion of a drink containing the (R)-3-hydroxybutyl (R)-3-hydroxybutyrate ketone monoester prior to acute severe hypoxic exposure attenuated hypoxia-induced declines in blood oxygen saturation and cognitive performance at rest.
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Affiliation(s)
- Tyler S McClure
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Jeffrey Phillips
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Andrew P Koutnik
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
- Sansum Diabetes Research Institute, Santa Barbara, California, USA
| | - Kody Coleman
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Ed Chappe
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Gary R Cutter
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Brendan Egan
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Todd Norell
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | | | - Marcas M Bamman
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Dawn Kernagis
- Healthspan, Resilience and Performance Research, Florida Institute for Human and Machine Cognition, Pensacola, Florida, USA
- Department of Neurosurgery, University of North Carolina, Chapel Hill, North Carolina, USA
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Debelu D, Mengistu DA, Aschalew A, Mengistie B, Deriba W. Global Public Health Implications of Traffic Related Air Pollution: Systematic Review. ENVIRONMENTAL HEALTH INSIGHTS 2024; 18:11786302241272403. [PMID: 39192968 PMCID: PMC11348364 DOI: 10.1177/11786302241272403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Accepted: 07/16/2024] [Indexed: 08/29/2024]
Abstract
Background Traffic-related air pollution (TRAP) has significant public health implications and a wide range of adverse health effects, including cardiovascular, respiratory, pulmonary, and other health problems. This study aimed to determine the public health impacts of traffic-related air pollution across the world that can be used as an input for protecting human health. Methods This study considered studies conducted across the world and full-text articles written in English. The articles were searched using a combination of Boolean logic operators (AND, OR, and NOT), MeSH, and keywords from the included electronic databases (SCOPUS, PubMed, EMBASE, Web of Science, CINAHL, and Google Scholars). The quality assessment of the articles was done using JBI tools to determine the relevance of each included article to the study. Results In this study, 1 282 032 participants ranging from 19 to 452 735 were included in 30 articles published from 2010 to 2022. About 4 (13.3%), 9 (30.0%), 12 (40.0%), 8 (26.7%), 2 (6.7%), 15 (50.0%), 3 (10.0%), 3 (10.0%) 1 (3.3%), and 3 (10.0%) of articles reported the association between human health and exposure to CO, PM10, PM2.5, NOx, NO, NO2, black carbon, O3, PAH, and SO2, respectively. Respiratory diseases, cancer, cognitive function problems, preterm birth, blood pressure and hypertension, diabetes, allergies and sensitization, coronary heart disease, dementia incidence, and hemorrhagic stroke were associated with exposure to TRAP. Conclusions Exposure to nitrogen dioxide, nitrogen oxide, sulfur dioxide, and fine particulate matter was associated with various health effects. This revealed that there is a need for the concerned organizations to respond appropriately.
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Affiliation(s)
- Desi Debelu
- School of Environmental Health, College of Health and Science, Haramaya University, Harar, Ethiopia
| | - Dechasa Adare Mengistu
- School of Environmental Health, College of Health and Science, Haramaya University, Harar, Ethiopia
| | - Alemayehu Aschalew
- Institutional Development and Facility Management, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Bizatu Mengistie
- Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Wegene Deriba
- School of Environmental Health, College of Health and Science, Haramaya University, Harar, Ethiopia
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Tesema E, Biru M, Leta T, Kumsa A, Liaulseged A, Gizatie G, Bogale T, Million M, Datiko DG, Gebreyohannes A, Molla Y, Hiruy N, Mebnga M, Suarez PG, Dememew ZG, Jerene D. Drug-resistant tuberculosis care and treatment outcomes over the last 15 years in Ethiopia: Results from a mixed-method review of trends. PLoS One 2024; 19:e0306076. [PMID: 39186714 PMCID: PMC11346926 DOI: 10.1371/journal.pone.0306076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 06/11/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Drug resistant tuberculosis (DR-TB) remains a global challenge with about a third of the cases are not detected. With the recent advances in the diagnosis and treatment follow-up of DR-TB, there have been improvements with treatment success rates. However, there is limited evidence on the successful models of care that have consistently registered good outcomes. Our aim was to assess Ethiopia's experience in scaling up an ambulatory, decentralized model of care while managing multiple regimen transition processes and external shocks. METHODS This was a cross-sectional, mixed-method study. For the quantitative data, we reviewed routine surveillance data for the period 2009-2022 and collected additional data from publicly available reports. We then analyzed the data descriptively. Qualitative data were collected from program reports, quarterly presentations, minutes of technical working group meetings, and clinical review committee reports and analyzed thematically. RESULTS The number of DR-TB treatment initiating centers increased from 1 to 67, and enrollment increased from 88 in 2010 to 741 in 2019, but declined to 518 in 2022. A treatment success rate (TSR) of over 70% was sustained. The decentralized and ambulatory service delivery remained the core service delivery model. The country successfully navigated multiple regimen transitions, including the recently introduced six-month short oral regimen. Several challenges remain, including the lack of strong and sustainable specimen transportation system, lack of established systems for timely tracing and linking of missed DR-TB cases, and data quality issues. CONCLUSIONS Ethiopia scaled up a decentralized ambulatory model of care, kept up to date with recent developments in treatment regimens, and maintained a high TSR, despite the influence of multiple external challenges. The recent decline in case notification requires a deeper look into the underlying reasons. The feasibility of fully integrating DR-TB treatment and follow up at community level should be explored further.
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Affiliation(s)
- E. Tesema
- USAID Eliminate TB Project, KNCV Tuberculosis Foundation, Addis Ababa, Ethiopia
| | - M. Biru
- USAID Eliminate TB Project, KNCV Tuberculosis Foundation, Addis Ababa, Ethiopia
| | - T. Leta
- Ministry of Health, National TB, Leprosy and other Lung Disease Program, Addis Ababa, Ethiopia
| | - A. Kumsa
- Ministry of Health, National TB, Leprosy and other Lung Disease Program, Addis Ababa, Ethiopia
| | - A. Liaulseged
- Ministry of Health, National TB, Leprosy and other Lung Disease Program, Addis Ababa, Ethiopia
| | - G. Gizatie
- USAID Eliminate TB Project, KNCV Tuberculosis Foundation, Addis Ababa, Ethiopia
| | - T. Bogale
- USAID Eliminate TB Project, KNCV Tuberculosis Foundation, Addis Ababa, Ethiopia
| | - M. Million
- USAID Eliminate TB Project, KNCV Tuberculosis Foundation, Addis Ababa, Ethiopia
| | - D. G. Datiko
- USAID Eliminate TB Project, Management Sciences for Health, Addis Ababa, Ethiopia
| | - A. Gebreyohannes
- USAID Eliminate TB Project, KNCV Tuberculosis Foundation, Addis Ababa, Ethiopia
| | - Y. Molla
- USAID Eliminate TB Project, Management Sciences for Health, Addis Ababa, Ethiopia
| | - N. Hiruy
- USAID Eliminate TB Project, Management Sciences for Health, Addis Ababa, Ethiopia
| | - M. Mebnga
- KNCV Tuberculosis Foundation, Moscow, Russia
| | - P. G. Suarez
- Management Sciences for Health, Arlington, VA, United States of America
| | - Z. G. Dememew
- USAID Eliminate TB Project, Management Sciences for Health, Addis Ababa, Ethiopia
| | - D. Jerene
- KNCV Tuberculosis Foundation, The Hague, The Netherlands
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Chong LS, Yeo AJ, Lin B. Childhood Family Stress and Women's Health: Parasympathetic Activity as a Risk and Resiliency Factor. Appl Psychophysiol Biofeedback 2024:10.1007/s10484-024-09661-2. [PMID: 39179946 DOI: 10.1007/s10484-024-09661-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2024] [Indexed: 08/26/2024]
Abstract
Childhood family stress (CFS) exacerbates risk for physical health problems across the lifespan. Health risks associated with CFS are particularly relevant for women who tend to endorse more CFS than men. Importantly, some evidence suggests that individuals may vary in their susceptibility to CFS. Parasympathetic activity, which helps to regulate automatic bodily activity (e.g., breathing, digestion), has been proposed to represent a marker of plasticity to environmental exposure. However, no research to date has tested whether parasympathetic activity may modulate the impact of early adversity on health. We examined whether parasympathetic activity would moderate the link between CFS and health complaints in a sample of 68 undergraduate women (Mean age = 19.44). Participants self-reported CFS and health complaints. Parasympathetic activity was indexed using high-frequency heart rate variability (HF-HRV) and was evaluated by measuring changes in HF-HRV in response to and following a laboratory-based stress induction. Multiple regression analyses indicated that CFS was significantly associated with more health complaints. Further, HF-HRV in response to stress and during recovery relative to baseline significantly moderated relationship between CFS and health complaints. Specifically, more CFS was significantly associated with more health complaints among women who showed mean or greater decreases in HF-HRV in response to stress. Additionally, lower levels of CFS were associated with fewer health complaints among women who showed mean or greater HF-HRV during recovery relative to baseline. Findings highlight the importance of parasympathetic activity in modulating stress-health links.
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Affiliation(s)
- Li Shen Chong
- Department of Psychology, San Jose State University, San Jose, CA, 95192, USA.
| | - Anna J Yeo
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
- The Mirriam Hospital, Providence, RI, 02906, USA
| | - Betty Lin
- Department of Psychology, University at Albany, State University of New York, Albany, NY, 12222, USA
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Amiresmaili S, Rajizadeh MA, Jafari E, Bejeshk MA, Salimi F, Moslemizadeh A, Najafipour H. Myrtenol ameliorates inflammatory, oxidative, apoptotic, and hyperplasic effects of urethane-induced atypical adenomatous hyperplasia in the rat lung. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024:10.1007/s00210-024-03375-2. [PMID: 39177787 DOI: 10.1007/s00210-024-03375-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 08/12/2024] [Indexed: 08/24/2024]
Abstract
Lung atypical adenomatous hyperplasia (AAH) is a forerunner of pulmonary adenocarcinoma. The drugs being utilized in the remediation of this type of hyperplasia have some adverse impacts. The present research focused on the potential anti-hyperplasia effect of myrtenol, an herbal terpenoid, on urethane-induced lung AAH in rats. Rats were injected with urethane (1.5 g/kg) thrice at 48 h intervals, and 20 weeks later, the animals were treated with 50 mg/kg myrtenol intraperitoneally once a day for 1 week. The ELISA method was used to measure inflammatory cytokines and oxidative parameters in the lung tissue and bronchoalveolar lavage fluid (BALF). The expression of NFκB and apoptotic/antiapoptotic factors (P53/Bcl-2) was evaluated by western blot and immunohistochemistry, respectively. H&E staining was performed for histopathological investigation. Histopathology confirmed the anti-hyperplasia effect of myrtenol, which was evidenced by the reduction of bronchoalveolar wall thickness and inflammation score. It also decreased hyperplasia progression by reducing Bcl-2, IL-10, p53, and Ki67. Compared with the urethane group, myrtenol normalized the activity of the oxidative stress markers malondialdehyde (MDA), total antioxidant capacity (TAC), glutathione peroxidase (GPX), and superoxide dismutase (SOD). Moreover, it showed an anti-inflammatory effect by decreasing lung and BALF IL-1β levels and NFκB expression. Myrtenol may have a promising effect on lung cancer treatment by counteracting lung hyperplasia via modulation of inflammation, oxidative stress, and apoptosis.
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Affiliation(s)
| | - Mohammad Amin Rajizadeh
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Elham Jafari
- Department of Pathology, Pathology and Stem Cell Research Center, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Abbas Bejeshk
- Department of Physiology, Bam University of Medical Sciences, Bam, Iran
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Fouzieh Salimi
- Department of Clinical Biochemistry, Medical Faculty, and Endocrinology and Metabolism Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Amirhossein Moslemizadeh
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Najafipour
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
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Błaszczyk B, Waliszewska-Prosół M, Więckiewicz M, Poręba R, Niemiec P, Przegrałek J, Martynowicz H. Sleep bruxism (SB) may be not associated with obstructive sleep apnea (OSA): A comprehensive assessment employing a systematic review and meta-analysis. Sleep Med Rev 2024; 78:101994. [PMID: 39182463 DOI: 10.1016/j.smrv.2024.101994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 06/22/2024] [Accepted: 08/17/2024] [Indexed: 08/27/2024]
Abstract
Associations between obstructive sleep apnea (OSA) and sleep bruxism (SB) are the subject of discussion but have not been confirmed definitively. Therefore, the objective of this meta-analysis was to examine the relationship between OSA and SB. This systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Embase and Web of Science were screened up to February 2024. The risk of bias was assessed with the Joanna Briggs Institute tool. 2260 records were identified, but only 14 studies were included. The odds of SB presence in OSA did not differ from the control group (OR: 1.23, 95 % CI: 0.47-3.20). The chance of SB compared to controls also did not differ in mild OSA (OR: 1.56, 95 % CI: 0.76-3.18), in moderate OSA (OR: 1.51, 95 % CI: 0.77-2.94) and in severe OSA (OR: 1.50, 95 % CI: 0.68-3.29). Additionally, the odds of SB were not increased in moderate OSA in comparison to mild OSA (OR: 1.14, 95 % CI: 0.63-2.94), in severe OSA compared to moderate OSA (OR: 1.31, 95 % CI: 0.61-2.79) or in severe OSA compared to mild OSA (OR = 1.42, 95 % CI: 0.69-2.93). The presence of SB in OSA did not differ between genders (OR: 2.14, 95 % CI: 0.65-7.05). The quality of the major studies included is low; therefore, the noted lack of correlation between OSA and SB may require further research. The relationship between OSA and SB seems to be multi-faceted. Presented results should not exempt clinicians from exact diagnosis of concomitant sleep conditions in OSA subjects.
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Affiliation(s)
- Bartłomiej Błaszczyk
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | | | - Mieszko Więckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland
| | - Rafał Poręba
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Piotr Niemiec
- Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Jakub Przegrałek
- Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Helena Martynowicz
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
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Grasl MT, Agusti A, Azizzadeh M, Karimi A, Hartl S, Breyer MK, Breyer-Kohansal R. Prevalence and etiotypes of persistent airflow obstruction in the general population ACROSS THE LIFETIME. Respir Med 2024:107779. [PMID: 39179051 DOI: 10.1016/j.rmed.2024.107779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 07/20/2024] [Accepted: 08/21/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND AND OBJECTIVES Different factors (etiotypes) can lead to persistent airflow obstruction (PAO) across the lifetime, including genetic factors, abnormal lung development, cigarette smoking, traffic pollution exposure, respiratory infections and asthma. Here we explore the prevalence of PAO and associated etiotypes in the general population in different age bins. METHODS We studied 664 individuals with PAO (FEV1/FVC post bronchodilation (post-BD) below the lower limit of normal (LLN)) and 11,522 with normal lung function (FEV1/FVC, FEV1 and FVC ≥LLN and ≤ upper limit of normal (ULN) post BD) included in the LEAD Study (NCT01727518), a general population cohort in Vienna (Austria). For analysis, participants were stratified in three age bins (<25, 25-<50 and ≥50 years of age). RESULTS PAO occurred in 3.8% in females and 5.6% in males of the cohort, and it increased with age. Most participants with PAO (57.5%) reported respiratory symptoms, indicating a high burden of disease. PAO was associated with male sex (25-<50 years), ever smoking (>50 years), increased number of pack years (25-<50 years, >50 years), not being breastfed (<25 years) and ever diagnosis of asthma (in all age bins). Etiotypes varied by age bins with cigarette smoking being the most prevalent one, often in combination with traffic pollution exposure. CONCLUSION In the general population PAO occurs in about 5% of participants with a higher prevalence in older individuals. Etiotypes and associated factors for PAO accumulate with age.
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Affiliation(s)
- M T Grasl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Healthcare Group, Vienna, Austria.
| | - A Agusti
- Cátedra de Salud Respiratoria, University of Barcelona, Respiratory Institute Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Centro de Investigación Biomedica en Red de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - M Azizzadeh
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Sigmund Freud Private University, Faculty of Medicine, Vienna, Austria
| | - A Karimi
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Sigmund Freud Private University, Faculty of Medicine, Vienna, Austria
| | - S Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Sigmund Freud Private University, Faculty of Medicine, Vienna, Austria
| | - M-K Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Healthcare Group, Vienna, Austria
| | - R Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Pulmonary Diseases, Clinic Hietzing, Vienna Healthcare Group, Vienna, Austria
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Zandee van Rilland ED, Yao L, Stevens KJ, Chung LS, Fiorentino DF, Boutin RD. Myositis and Its Mimics: Guideline Updates, MRI Characteristics, and New Horizons. AJR Am J Roentgenol 2024:1-16. [PMID: 38838235 DOI: 10.2214/ajr.24.31359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Myositis is defined as inflammation within skeletal muscle and is a subcategory of myopathy, which is more broadly defined as any disorder affecting skeletal muscle. Myositis may be encountered as a component of autoimmune and connective tissue diseases, where it is described as idiopathic inflammatory myopathy (IIM). Myositis can also be caused by infections as well as toxins and drugs, including newer classes of medications. MRI plays an important role in the diagnosis and evaluation of patients with suspected myositis, but many entities may have imaging features similar to those of myositis and can be considered myositis mimics. These include muscular dystrophies, denervation, deep venous thrombosis, diabetic myonecrosis, muscle injury, heterotopic ossification, and even neoplasms. In patients with suspected myositis, definitive diagnosis may require integrated analysis of imaging findings with clinical, laboratory, and pathology data. The objectives of this article are to review the fundamental features of myositis, including recent updates in terminology and consensus guidelines for IIMs; the most important MRI differential diagnostic considerations for myositis (i.e., myositis mimics); and new horizons, including the potential importance of artificial intelligence and multimodal integrated diagnostics in the evaluation of patients with muscle disorders.
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Affiliation(s)
| | - Lawrence Yao
- Radiology and Imaging Sciences, NIH Clinical Center, Bethesda, MD
| | - Kathryn J Stevens
- Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305
| | - Lorinda S Chung
- Department of Medicine, Immunology and Rheumatology Division, Stanford University School of Medicine, Stanford, CA
- Department of Medicine, Palo Alto VA Health Care System, Palo Alto, CA
| | - David F Fiorentino
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA
| | - Robert D Boutin
- Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305
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Prasiska DI, Chapagain DD, Osei KM, Rajaguru V, Kang SJ, Kim TH, Lee SG, Han W. Non-communicable comorbidities in pulmonary tuberculosis and healthcare utilization: a cross-sectional study of 2021 Indonesian national health insurance data. Arch Public Health 2024; 82:127. [PMID: 39160626 PMCID: PMC11331679 DOI: 10.1186/s13690-024-01352-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 08/01/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Limited research exists on the comorbidity of pulmonary tuberculosis with non-communicable diseases (NCDs) and its implications for healthcare utilization in Indonesia. The lack of investigation into NCD comorbidity among pulmonary tuberculosis patients could adversely affect both the healthcare system and the national health insurance scheme. Understanding the NCD comorbidity among pulmonary tuberculosis patients, associated factors, and healthcare utilization is crucial for ensuring the effective and efficient delivery of health services. METHOD This study utilized an observational cross-sectional design based on anonymized sample data from tuberculosis cases covered by Indonesia's National Health Insurance in 2021. Chi-square tests were employed to analyze dependent and independent variables, while unadjusted and adjusted logistic regressions were used to explore further associations. RESULTS The prevalence of NCD comorbidity in tuberculosis patients was 11.81%. Aged over 60 (aOR 5.16; [CI] 4.23-6.3), married (aOR 1.19; [CI] 1.05-1.34), and unemployed (aOR 1.27; [CI] 1.08-1.49) were associated with the NCD comorbidity in pulmonary tuberculosis patients. Factors associated with increased inpatient service utilization among pulmonary tuberculosis patients included aged over 60 (aOR 5.69; [CI] 4.81-6.74), male (aOR 1.32; [CI] 1.23-1.40), self-employment (aOR 1.42; [CI] 1.29-1.56), having insurance subsidized by central government (aOR 1.89; [CI] 1.73-2.08) or local government funds (aOR 1.75; [CI] 1.58-1.93), and having comorbidity non-communicable diseases (aOR 1.80; [CI] 1.66-1.96). CONCLUSION Pulmonary tuberculosis patients exhibit a significant prevalence of NCD comorbidity, which substantially impacts healthcare utilization. Early detection and management of these conditions are critical to mitigate burdens on both the healthcare system and the financial sustainability of the national health insurance scheme. Integrating health services for tuberculosis and NCDs through bidirectional screening is essential for comprehensive patient care.
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Affiliation(s)
- Danik Iga Prasiska
- Global Health Security, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Durga Datta Chapagain
- Global Health Security, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Kennedy Mensah Osei
- Global Health Security, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Vasuki Rajaguru
- Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Sun Joo Kang
- Department of Global Health Security and Infectious Disease Control, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Tae Hyun Kim
- Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Sang Gyu Lee
- Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, South Korea
| | - Whiejong Han
- Department of Global Health Security and Infectious Disease Control, Graduate School of Public Health, Yonsei University, Seoul, South Korea.
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Khan A, Ammar Zahid M, Farrukh F, Salah Abdelsalam S, Mohammad A, Al-Zoubi RM, Shkoor M, Ait Hssain A, Wei DQ, Agouni A. Integrated structural proteomics and machine learning-guided mapping of a highly protective precision vaccine against mycoplasma pulmonis. Int Immunopharmacol 2024; 141:112833. [PMID: 39153303 DOI: 10.1016/j.intimp.2024.112833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/09/2024] [Accepted: 07/27/2024] [Indexed: 08/19/2024]
Abstract
Mycoplasma pulmonis (M. pulmonis) is an emerging respiratory infection commonly linked to prostate cancer, and it is classified under the group of mycoplasmas. Improved management of mycoplasma infections is essential due to the frequent ineffectiveness of current antibiotic treatments in completely eliminating these pathogens from the host. The objective of this study is to design and construct effective and protective vaccines guided by structural proteomics and machine learning algorithms to provide protection against the M. pulmonis infection. Through a thorough examination of the entire proteome of M. pulmonis, four specific targets Membrane protein P80, Lipoprotein, Uncharacterized protein and GGDEF domain-containing protein have been identified as appropriate for designing a vaccine. The proteins underwent mapping of cytotoxic T lymphocyte (CTL), helper T lymphocyte (HTL) (IFN)-γ ±, and B-cell epitopes using artificial and recurrent neural networks. The design involved the creation of mRNA and peptide-based vaccine, which consisted of 8 CTL epitopes associated by GGS linkers, 7 HTL (IFN-positive) epitopes, and 8 B-cell epitopes joined by GPGPG linkers. The vaccine designed exhibit antigenic behavior, non-allergenic qualities, and exceptional physicochemical attributes. Structural modeling revealed that correct folding is crucial for optimal functioning. The coupling of the MEVC and Toll-like Receptors (TLR)1, TLR2, and TLR6 was examined through molecular docking experiments. This was followed by molecular simulation investigations, which included binding free energy estimations. The results indicated that the dynamics of the interaction were stable, and the binding was strong. In silico cloning and optimization analysis revealed an optimized sequence with a GC content of 49.776 % and a CAI of 0.982. The immunological simulation results showed strong immune responses, with elevated levels of active and plasma B-cells, regulatory T-cells, HTL, and CTL in both IgM+IgG and secondary immune responses. The antigen was completely cleared by the 50th day. This study lays the foundation for creating a potent and secure vaccine candidate to combat the newly identified M. pulmonis infection in people.
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Affiliation(s)
- Abbas Khan
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Muhammad Ammar Zahid
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.
| | - Farheen Farrukh
- Gujranwala Medical College, 5 KM Alipur Chatha Rd, Gondlanwala Rd, Gujranwala, Pakistan
| | - Shahenda Salah Abdelsalam
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.
| | - Anwar Mohammad
- Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute, Dasman, Kuwait
| | - Raed M Al-Zoubi
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar; Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar; Department of Chemistry, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
| | - Mohanad Shkoor
- Department of Chemistry, College of Arts and Science, Qatar University, P.O. Box 2713, Doha, Qatar.
| | - Ali Ait Hssain
- Medical Intensive Care Unit, Hamad Medical Corporation, Doha, Qatar
| | - Dong-Qing Wei
- Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China.
| | - Abdelali Agouni
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.
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Chikhale RV, Pawar SP, Kolpe MS, Shinde OD, Dahlous KA, Mohammad S, Patil PC, Bhowmick S. Identification of mycobacterial Thymidylate kinase inhibitors: a comprehensive pharmacophore, machine learning, molecular docking, and molecular dynamics simulation studies. Mol Divers 2024:10.1007/s11030-024-10967-w. [PMID: 39152354 DOI: 10.1007/s11030-024-10967-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 08/08/2024] [Indexed: 08/19/2024]
Abstract
Thymidylate kinase (TMK) is a pivotal enzyme in Mycobacterium tuberculosis (Mtb), crucial for phosphorylating thymidine monophosphate (dTMP) to thymidine diphosphate (dTDP), thereby playing a critical role in DNA biosynthesis. Dysregulation or inhibition of TMK activity disrupts DNA replication and cell division, making it an attractive target for anti-tuberculosis drug development. In this study, the statistically validated pharmacophore mode was developed from a set of known TMK inhibitors. Further, the robust pharmacophore was considered for screening the Enamine database. The chemical space was reduced through multiple molecular docking approaches, pharmacokinetics, and absolute binding energy estimation. Two different molecular docking algorithms favor the strong binding affinity of the proposed molecules towards TMK. Machine learning-based absolute binding energy also showed the potentiality of the proposed molecules. The binding interactions analysis exposed the strong binding affinity between the proposed molecules and active site amino residues of TMK. Several statistical parameters from all atoms MD simulation explained the stability between proposed molecules and TMK in the dynamic states. The MM-GBSA approach also found a strong binding affinity for each proposed molecule. Therefore, the proposed molecules might be crucial TMK inhibitors for managing Mtb inhibition subjected to in vitro/in vivo validations.
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Affiliation(s)
- Rupesh V Chikhale
- Department of Pharmaceutical and Biological Chemistry, School of Pharmacy, University College London, London, UK.
| | - Surbhi Pravin Pawar
- SilicoScientia Private Limited, Nagananda Commercial Complex, No. 07/3, 15/1, 18th Main Road, Jayanagar 9th Block, Bengaluru, 560041, India
- Department of Bioinformatics, Rajiv Gandhi Institute of IT and Biotechnology, Bharati Vidyapeeth (Deemed to be University), Pune-Satara Road, Pune, India
| | - Mahima Sudhir Kolpe
- SilicoScientia Private Limited, Nagananda Commercial Complex, No. 07/3, 15/1, 18th Main Road, Jayanagar 9th Block, Bengaluru, 560041, India
| | - Omkar Dilip Shinde
- SilicoScientia Private Limited, Nagananda Commercial Complex, No. 07/3, 15/1, 18th Main Road, Jayanagar 9th Block, Bengaluru, 560041, India
- Department of Bioinformatics, Rajiv Gandhi Institute of IT and Biotechnology, Bharati Vidyapeeth (Deemed to be University), Pune-Satara Road, Pune, India
| | - Kholood A Dahlous
- Department of Chemistry, College of Science, King Saud University, 11451, Riyadh, Saudi Arabia
| | - Saikh Mohammad
- Department of Chemistry, College of Science, King Saud University, 11451, Riyadh, Saudi Arabia
| | - Pritee Chunarkar Patil
- Department of Bioinformatics, Rajiv Gandhi Institute of IT and Biotechnology, Bharati Vidyapeeth (Deemed to be University), Pune-Satara Road, Pune, India
| | - Shovonlal Bhowmick
- SilicoScientia Private Limited, Nagananda Commercial Complex, No. 07/3, 15/1, 18th Main Road, Jayanagar 9th Block, Bengaluru, 560041, India
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Hao YP. Evaluating the role of interleukin-2 and interleukin-12 in pediatric patients with concurrent Mycoplasma pneumoniae and Epstein-Barr virus infections. World J Clin Cases 2024; 12:5346-5353. [PMID: 39156096 PMCID: PMC11238690 DOI: 10.12998/wjcc.v12.i23.5346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/24/2024] [Accepted: 06/11/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Mycoplasma pneumoniae (MP) frequently causes respiratory infections in children, whereas Epstein-Barr virus (EBV) typically presents subclinical manifestations in immunocompetent pediatric populations. The incidence of MP and EBV co-infections is often overlooked clinically, with the contributory role of EBV in pulmonary infections alongside MP remaining unclear. AIM To evaluate the serum concentrations of interleukin-2 (IL-2) and interleukin-12 (IL-12) in pediatric patients with MP pneumonia co-infected with EBV and assess their prognostic implications. METHODS We retrospectively analyzed clinical data from patients diagnosed with MP and EBV co-infection, isolated MP infection, and a control group of healthy children, spanning from January 1, 2018 to December 31, 2021. Serum IL-2 and IL-12 levels were quantified using enzyme-linked immunosorbent assay. Logistic regression was employed to identify factors influencing poor prognosis, while receiver operating characteristic (ROC) curves evaluated the prognostic utility of serum IL-2 and IL-12 levels in co-infected patients. RESULTS The co-infection group exhibited elevated serum IL-2 and C-reactive protein (CRP) levels compared to both the MP-only and control groups, with a reverse trend observed for IL-12 (P < 0.05). In the poor prognosis cohort, elevated CRP and IL-2 levels, alongside prolonged fever duration, contrasted with reduced IL-12 levels (P < 0.05). Logistic regression identified elevated IL-2 as an independent risk factor and high IL-12 as a protective factor for adverse outcomes (P < 0.05). ROC analysis indicated that the area under the curves for IL-2, IL-12, and their combination in predicting poor prognosis were 0.815, 0.895, and 0.915, respectively. CONCLUSION Elevated serum IL-2 and diminished IL-12 levels in pediatric patients with MP and EBV co-infection correlate with poorer prognosis, with combined IL-2 and IL-12 levels offering enhanced predictive accuracy.
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Affiliation(s)
- Yan-Ping Hao
- Department of Pediatrics, Maternal and Child Health Hospital, Shaoxing 312400, Zhejiang Province, China
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50
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Saper VE, Tian L, Verstegen RHJ, Conrad CK, Cidon M, Hopper RK, Kuo CS, Osoegawa K, Baszis K, Bingham CA, Ferguson I, Hahn T, Horne A, Isupova EA, Jones JT, Kasapcopur Ö, Klein-Gitelman MS, Kostik MM, Ozen S, Phadke O, Prahalad S, Randell RL, Sener S, Stingl C, Abdul-Aziz R, Akoghlanian S, Al Julandani D, Alvarez MB, Bader-Meunier B, Balay-Dustrude EE, Balboni I, Baxter SK, Berard RA, Bhattad S, Bolaria R, Boneparth A, Cassidy EA, Co DO, Collins KP, Dancey P, Dickinson AM, Edelheit BS, Espada G, Flanagan ER, Imundo LF, Jindal AK, Kim HA, Klaus G, Lake C, Lapin WB, Lawson EF, Marmor I, Mombourquette J, Ogunjimi B, Olveda R, Ombrello MJ, Onel K, Poholek C, Ramanan AV, Ravelli A, Reinhardt A, Robinson AD, Rouster-Stevens K, Saad N, Schneider R, Selmanovic V, Sefic Pasic I, Shenoi S, Shilo NR, Soep JB, Sura A, Taber SF, Tesher M, Tibaldi J, Torok KS, Tsin CM, Vasquez-Canizares N, Villacis Nunez DS, Way EE, Whitehead B, Zemel LS, Sharma S, Fernández-Viña MA, Mellins ED. Interleukin (IL)-1/IL-6-Inhibitor-Associated Drug Reaction With Eosinophilia and Systemic Symptoms (DReSS) in Systemic Inflammatory Illnesses. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00692-5. [PMID: 39002722 DOI: 10.1016/j.jaip.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/30/2024] [Accepted: 07/02/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND After introducing IL-1/IL-6 inhibitors, some patients with Still and Still-like disease developed unusual, often fatal, pulmonary disease. This complication was associated with scoring as DReSS (drug reaction with eosinophilia and systemic symptoms) implicating these inhibitors, although DReSS can be difficult to recognize in the setting of systemic inflammatory disease. OBJECTIVE To facilitate recognition of IL-1/IL-6 inhibitor-DReSS in systemic inflammatory illnesses (Still/Still-like) by looking at timing and reaction-associated features. We evaluated outcomes of stopping or not stopping IL-1/IL-6 inhibitors after DReSS reaction began. METHODS In an international study collaborating primarily with pediatric specialists, we characterized features of 89 drug-reaction cases versus 773 drug-exposed controls and compared outcomes of 52 cases stopping IL-1/IL-6 inhibitors with 37 cases not stopping these drugs. RESULTS Before the reaction began, drug-reaction cases and controls were clinically comparable, except for younger disease-onset age for reaction cases with preexisting cardiothoracic comorbidities. After the reaction began, increased rates of pulmonary complications and macrophage activation syndrome differentiated drug-reaction cases from drug-tolerant controls (P = 4.7 × 10-35 and P = 1.1 × 10-24, respectively). The initial DReSS feature was typically reported 2 to 8 weeks after initiating IL-1/IL-6 inhibition. In drug-reaction cases stopping versus not stopping IL-1/IL-6-inhibitor treatment, reaction-related features were indistinguishable, including pulmonary complication rates (75% [39 of 52] vs 76% [28 of 37]). Those stopping subsequently required fewer medications for treatment of systemic inflammation, had decreased rates of macrophage activation syndrome, and improved survival (P = .005, multivariate regression). Resolution of pulmonary complications occurred in 67% (26 of 39) of drug-reaction cases who stopped and in none who continued inhibitors. CONCLUSIONS In systemic inflammatory illnesses, recognition of IL-1/IL-6-inhibitor-associated reactions followed by avoidance of IL-1/IL-6 inhibitors significantly improved outcomes.
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Affiliation(s)
- Vivian E Saper
- Department of Pediatrics, Stanford University School of Medicine, Stanford, Calif.
| | - Lu Tian
- Department of Biomedical Data Science, Stanford University, Stanford, Calif
| | - Ruud H J Verstegen
- Hospital for Sick Children, Division of Clinical Pharmacology and Toxicology, Toronto, Ontario, Canada
| | - Carol K Conrad
- Department of Pediatrics, Stanford University School of Medicine, Stanford, Calif
| | - Michal Cidon
- Department of Pediatrics, Children's Hospital of Los Angeles, Los Angeles, Calif
| | - Rachel K Hopper
- Department of Pediatrics, Stanford University School of Medicine, Stanford, Calif
| | - Christin S Kuo
- Department of Pediatrics, Stanford University School of Medicine, Stanford, Calif
| | - Kazutoyo Osoegawa
- Histocompatibility & Immunogenetics Laboratory, Stanford Blood Center, Palo Alto, Calif
| | - Kevin Baszis
- Department of Pediatrics, Washington University in Saint Louis School of Medicine, Saint Louis, Mo
| | | | - Ian Ferguson
- Department of Pediatrics, Yale University School of Medicine, New Haven, Conn
| | - Timothy Hahn
- Pennsylvania State University College of Medicine, Hershey, Pa
| | - Annacarin Horne
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Eugenia A Isupova
- Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
| | - Jordan T Jones
- Children's Mercy Hospital, Kansas City, Mo; University of Kansas School of Medicine, Kansas City, Mo
| | - Özgür Kasapcopur
- Department of Pediatrics, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Marisa S Klein-Gitelman
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill; Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Mikhail M Kostik
- Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
| | - Seza Ozen
- Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Omkar Phadke
- University Hospitals Rainbow Babies & Children's Hospital, Cleveland, Ohio
| | - Sampath Prahalad
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Ga; Children's Healthcare of Atlanta, Atlanta, Ga
| | - Rachel L Randell
- Department of Pediatrics, Duke University School of Medicine, Durham, NC
| | - Seher Sener
- Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | | | - Rabheh Abdul-Aziz
- University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY
| | - Shoghik Akoghlanian
- Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio
| | - Dalila Al Julandani
- Bristol Royal Hospital for Children Bristol, University of Bristol, Bristol, United Kingdom
| | | | - Brigitte Bader-Meunier
- Hopital Universitaire Necker-Enfants Malades, Department of Paediatric Hematology-Immunology and Rheumatology, Reference Center for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Imagine Institute, Inserm, Paris, France
| | - Erin E Balay-Dustrude
- Seattle Children's Hospital Research Center, Seattle, Wash; Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash
| | - Imelda Balboni
- Department of Pediatrics, Stanford University School of Medicine, Stanford, Calif
| | - Sarah K Baxter
- Seattle Children's Hospital Research Center, Seattle, Wash; Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash
| | - Roberta A Berard
- Children's Hospital, London Health Sciences Centre, London, Ontario, Canada
| | - Sagar Bhattad
- Pediatric Immunology and Rheumatology, Aster CMI Hospital, Bangalore, Karnataka, India
| | - Roxana Bolaria
- Department of Pediatrics, University of British Columbia, Victoria, British Columbia, Canada
| | - Alexis Boneparth
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY
| | - Elaine A Cassidy
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pa
| | - Dominic O Co
- Department of Pediatrics, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wis
| | - Kathleen P Collins
- The University of Tennessee Health Science Center, Memphis, Tenn; LeBonheur Children's Hospital, Memphis, Tenn
| | - Paul Dancey
- Janeway Children's Health and Rehabilitation Centre and Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Aileen M Dickinson
- Department of Pediatrics, University of California Los Angeles David Geffen School of Medicine, Los Angeles, Calif
| | - Barbara S Edelheit
- University of Connecticut School of Medicine, Farmington, Conn; Connecticut Children's Medical Center, Hartford, Conn
| | - Graciela Espada
- Hospital de Niños Dr Ricardo Gutierrez, Buenos Aires, Argentina
| | - Elaine R Flanagan
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Ga; Children's Healthcare of Atlanta, Atlanta, Ga
| | - Lisa F Imundo
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY
| | - Ankur K Jindal
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Hyoun-Ah Kim
- Department of Rheumatology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Günter Klaus
- Philipps-University of Marburg and KfH Pediatric Kidney Center, Marburg, Germany
| | - Carol Lake
- Translational Genetics and Genomics Section, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health, Bethesda, Md
| | - W Blaine Lapin
- University of Connecticut School of Medicine, Farmington, Conn; Connecticut Children's Medical Center, Hartford, Conn
| | - Erica F Lawson
- University of California San Francisco, San Francisco, Calif
| | - Itay Marmor
- Dana-Dwek Children's Hospital Tel Aviv, Tel Aviv, Israel
| | - Joy Mombourquette
- Department of Pediatrics, Kaiser Permanente California, Roseville, Calif
| | - Benson Ogunjimi
- Centre for Health Economics Research and Modeling of Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Rebecca Olveda
- University of California San Francisco, San Francisco, Calif
| | - Michael J Ombrello
- Translational Genetics and Genomics Section, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health, Bethesda, Md
| | - Karen Onel
- Hospital for Special Surgery, New York, NY; Department of Pediatrics, Weill Cornell Medicine, New York, NY
| | | | | | - Angelo Ravelli
- IRCCS Istituto Giannina Gaslini, Genova, Italy; Università degli Studi di Genova, Genova, Italy
| | | | | | - Kelly Rouster-Stevens
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Ga; Children's Healthcare of Atlanta, Atlanta, Ga
| | - Nadine Saad
- University of Michigan, Michigan Medicine, Ann Arbor, Mich
| | - Rayfel Schneider
- Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Velma Selmanovic
- Children's Hospital University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Irmina Sefic Pasic
- Children's Hospital University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Susan Shenoi
- Seattle Children's Hospital Research Center, Seattle, Wash; Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash
| | - Natalie R Shilo
- Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pa
| | | | - Angeli Sura
- State University of New York (SUNY) Upstate Medical University, Syracuse, NY
| | - Sarah F Taber
- Hospital for Special Surgery, New York, NY; Department of Pediatrics, Weill Cornell Medicine, New York, NY
| | - Melissa Tesher
- University of Chicago Pritzker School of Medicine, Chicago, Ill
| | | | - Kathryn S Torok
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pa
| | - Cathy Mei Tsin
- Department of Pediatrics, Stanford University School of Medicine, Stanford, Calif
| | | | - Diana S Villacis Nunez
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Ga; Children's Healthcare of Atlanta, Atlanta, Ga
| | - Emily E Way
- Inova L.J. Murphy Children's Hospital, Falls Church, Va
| | | | - Lawrence S Zemel
- University of Connecticut School of Medicine, Farmington, Conn; Connecticut Children's Medical Center, Hartford, Conn
| | - Surbhi Sharma
- Department of Pediatrics, Stanford University School of Medicine, Stanford, Calif
| | - Marcelo A Fernández-Viña
- Histocompatibility & Immunogenetics Laboratory, Stanford Blood Center, Palo Alto, Calif; Department of Pathology, Stanford University School of Medicine, Stanford, Calif
| | - Elizabeth D Mellins
- Department of Pediatrics, Stanford University School of Medicine, Stanford, Calif
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