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Κυριακή 11 Δεκεμβρίου 2022

Duration of antibiotic treatment for acute graft pyelonephritis: What's the standard of care?

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Duration of antibiotic treatment for acute graft pyelonephritis: What's the standard of care?


Abstract

Background

Limited evidence is available to inform the duration of antibiotic treatment in kidney transplant recipients with bacterial acute graft pyelonephritis. Guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation suggest a 14–21 day duration.

Methods

A four-question survey was constructed to determine the current standard of practice for the duration of treatment for acute graft pyelonephritis. The survey was distributed among members of the Infectious Diseases and the Kidney Pancreas Communities of Practice of the American Society of Transplantation.

Results

Among 144 survey respondents, 87 (60%) were infectious disease physicians, and 36 (25%) were transplant nephrologists. Although most (55%) respondents preferred a 14-day duration, a spread between 7 and 28 days was observed. Goals of treatment and drivers for longer duration differed between infectious disease physicians and transplant nephrologists.

Conclusions

Although most respondents prefer a 14-day duration of treatment for acute graft pyelonephritis, a wide range of responses was seen between 7 and 28 days. More evidence is needed to inform optimal treatment duration in this common infectious complication after transplantation.

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Πέμπτη 8 Δεκεμβρίου 2022

Association between masticatory dysfunction and gastroesophageal reflux disease: a population‐based study in the elderly

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

Caries and periodontal disease may cause tooth losses and chewing difficulty, especially in the elderly. Ingesting poorly chewed food may delay gastric emptying and favor the development of gastroesophageal reflux disease (GERD).

Objective

This study investigated the association between masticatory dysfunction and GERD in the elderly from a rural area in southern Brazil.

Methods

This census invited all 489 elderly from a city to participate. The study used a GERD symptoms questionnaire, followed by an oral examination. Masticatory dysfunction was analyzed based on the chewing difficulty for some food groups. Tooth loss and chewing self-perception were also considered as exposure variables. Poisson regression determined the association among variables by calculating the prevalence ratio [PR(95% confidence interval)].

Results

The response rate was 93.1% (n=455, average age of 70.9 years, 50.5% men). The prevalence of GERD in this population was 36.9%. GERD was associated with chewing difficulty for vegetables (PR=1.54), meats (PR=1.34), and cereals (PR=1.43) but not with poor chewing self-perception (PR=0.80) and tooth loss (PR=1.22). GERD was also associated with xerostomia (PR=1.63) and the female gender (PR=1.35).

Conclusions

Elderly people from a rural area with a reduced number of teeth present chewing difficulty and a high prevalence of GERD, indicating an association between GERD and masticatory dysfunction.

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Tonsillectomy vs Modified Uvulopalatopharyngoplasty for Hypertrophy and Obstructive Sleep Apnea

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This randomized clinical trial examines whether modified uvulopalatopharyngoplasty is more effective than tonsillectomy alone for treating adults with tonsillar hypertrophy and moderate to severe obstructive sleep apnea.
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Berichtetes und gemessenes Riech- und Schmeckvermögen in einer Long-COVID-Kohorte

alexandrossfakianakis shared this article with you from Inoreader

Laryngorhinootologie
DOI: 10.1055/a-1970-6510

Einleitung Störungen des Riech- und Schmecksinns werden häufig zahlenmäßig übereinstimmend als Long-COVID-Symptom beklagt. Anhand von Befunden einer Spezialsprechstunde (HNO-LCS) soll geklärt werden, wie groß tatsächlich der Anteil pathologischer olfaktorischer bzw. gustatorischer Diagnosen in dieser Kohorte ist. Methodik 48 erwachsene Patienten, die die HNO-LCS aus eigenem Leidensdruck aufsuchten, wurden nach ihrer Anamnese befragt, sie schätzten ihr Riech- (SER) und Schmeckvermögen (SES) mit Schulnoten ein und absolvierten als Riechtest den erweiterten Sniffin'Sticks-Test und als Schmecktest den 3-Tropfen-Test. Aus dem SDI-Riechscore und dem totalen Schmeckscore (SScore-total) wurden anhand von Normwerten Diagnosen erstellt. Zwischen den gemessenen Scores und der Selbsteinschätzung und zwischen SER und SES wurden Korrelationen berechnet. Ergebnisse Tatsächliche pathologische chemosensorische Diagnosen bestanden bei 90% der Patienten. Pathologische olfaktorische Diagnosen waren doppelt so häufig wie gustatorische. Bei 10% der Kohorte war keine pathologische Diagnose verifizierbar. Bei 6 Patienten wurde ein Anosmie-Ageusie-Syndrom diagnostiziert. SER korrelierte stark mit SDI. SES korrelierte moderat mit SScore-total. SER korrelierte stark mit SES. Schlussfolgerungen Bei der Interpretation berichteter chemosensorischer Symptome besteht die Gefahr einer Konfusion von Riechen und Schmecken durch die Betroffenen. Deshalb ist die Überprüfung der chemischen Sinne mit validierten Tests in Long-COVID-Ambulanzen wichtig.
[...]

Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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Τετάρτη 7 Δεκεμβρίου 2022

No Reduction in the 226-Hz Probe Tone Acoustic Reflex Amplitude Following Severe Inner Hair Cell Loss in Chinchillas

alexandrossfakianakis shared this article with you from Inoreader
AbstractThe relationship between the middle ear acoustic reflex (AR) and inner hair cell (IHC) loss is currently unknown. Given that IHC are believed to convey nearly all acoustic information to the central auditory nervous system, it has been assumed that loss of IHC would significantly impact the AR. To evaluate this relationship, we assessed the presence and amplitude of the AR in chinchillas before and after treatment with carboplatin, an anticancer drug that reliably and selectively destroys IHC in this species. Baseline measures of hearing sensitivity, including auditory brainstem response (ABR) thresholds and distortion product otoacoustic emissions (DPOAE), were assessed and then re-evaluated following carboplatin treatment. Post-carboplatin ABR thresholds and DPOAE were found to b...
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Main Causal Agents of Occupational Asthma

alexandrossfakianakis shared this article with you from Inoreader
Abstract
Objectives
The definition of work-related Asthma (WRA) has changed in recent years and new etiologies and agents have been identified. The aim of this study is to describe the main causal agents of WRA in France in the period 2001–2018 in the main work sectors.
Methods
Data were collected from the French national network of occupational health surveillance and prevention [Réseau National de Vigilance et de Prévention des Pathologies Professionnelles (RNV3P)], Data between 2001 and 2018 with at least a probable or certain association with one occupational agent, were included.
Results
Work sectors with more cases OF WRA included personal service activities (10.6%), food industry (10.2%) and healthcare activities (7.6%). WRA cases were most frequently related to flour (10%), quaternary ammoniums compounds (5.3%), isocyanates (5.1%) and cleaning products (4.8%).
Conclusion
Occupational exposure to specific ag ents capable of causing WRA is still present, and four agents represent more than 25% of the cases. Actions to prevent respiratory exposure are still relevant.
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Τρίτη 6 Δεκεμβρίου 2022

Helicobacter pyhlori regulated microRNA map of human gastric cells

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

Helicobacter pylori is an infection of concern for its chronic colonization leading to peptic ulcers and gastric cancer. In recent times, microRNAs have been extensively studied to understand their role in the pathogenesis of this bacteria in diverse contexts of gastric diseases. The current analysis reports the microRNA-mRNA interactions that are associated with effective survival and virulence of this pathogen.

Materials and Methods

We convened differentially regulated human microRNAs responsive to H. pylori infection (HP-hDEmiRs) at different multiplicity of infection and time points in human gastric cell lines through retrospective data mining of experimental studies. In view of the molecular disparity of clinical samples and animal models, data from tissue, serum/plasma, urine, and ascites were excluded. Further, we utilized diverse bioinformatics approaches to retrieve experimentally validated, high-confidence targets of the HP-hDEmiRs to analyze the microRNA-mRNA interactions that are relevant to H. pylori pathogenesis.

Results

A total of 39 HP-hDEmiRs that showed unidirectional expression of either overexpression or downregulation were identified to modulate 23 targets explicitly studied under this infection. We also identified 476 experimentally validated targets regulated by at least 4 of the HP-hDEmiRs. In addition to the pathways prior-associated with H. pylori infection, the microRNA-mRNA interactome analysis identified several cellular processes and pathways highly associated with cell cycle, cell division, migration, and carcinogenesis.

Conclusion

This study generated a platform to study the mechanisms utilized by this pathogen using microRNAs as surrogate.

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