Adv Exp Med Biol
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Polysomnography, a gold standard for the diagnosis of sleep-disordered breathing, is a complex investigation requiring access to the sleep laboratory. Thus, sleep-disordered breathing could be underdiagnosed. The aim of this paper was to investigate the feasibility and effectiveness of self-performed investigation of obstructive sleep apnea (OSA) in the home setting, using a portable device, and to assess the comfort and simplicity of the procedure from the patient's perspective. ⋯ All of the patients pointed to the comfort and ease of the diagnostic device. We conclude that home diagnosis of OSA is a relatively easy and cost-effective way to substitute for the hospital-linked polysomnography, particularly in severely ill patients who have a movement difficulty. A wider implementation of home-based diagnosis of OSA may substantially increase the number of patients investigated in a short time span, also leading to the plausibly upward correction of the disease prevalence.
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Outcome after traumatic brain injury (TBI) is worsened by hemorrhagic shock (HS); however, the existing volume expansion approach with resuscitation fluids (RF) is controversial as it does not adequately alleviate impaired microvascular cerebral blood flow (mCBF). We previously reported that resuscitation fluid with drag reducing polymers (DRP-RF) improves CBF by rheological modulation of hemodynamics. Here, we evaluate the efficacy of DRP-RF, compared to lactated Ringers resuscitation fluid (LR-RF), in reducing cerebral microthrombosis and reperfusion mitochondrial oxidative stress after TBI complicated by HS. ⋯ Post-mortem whole-brain visualization of DiI painted vessels revealed multiple microthromboses in both hemispheres that were 29 ± 3% less in DRP-RF vs. LR-RF group (p < 0.05). Resuscitation after TBI/HS using DRP-RF effectively restores mCBF, reduces hypoxia, microthrombosis formation, and mitochondrial oxidative stress compared to conventional volume expansion with LR-RF.
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β-hemolytic streptococci are major causes of necrotizing soft tissue infections (NSTIs), Streptococcus pyogenes (group A streptococcus; GAS) in particular. NSTIs caused by Streptococcus dysgalactiae (SD) have also been reported. In the INFECT cohort of 409 NSTIs patients, more than a third of the cases were caused by GAS (31%) or SD (7%). ⋯ As in other studies, a significant microbial diversity was observed, but with predominance of a few emm types. Overall, the INFECT study gives a comprehensive and contemporary picture of the clinical characteristics and the microbes involved in streptococcal NSTIs. The reported severity of disease underscores the need for new efforts aimed at identifying novel diagnostic measures and improved treatment.
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Food allergy is a global health problem, particularly in developed countries. It is mainly mediated by Th2 cell and IgE produced by B cells. While the pathogenesis of IgE-mediated food allergy is quite straightforward, the factors that lead to the development of food allergies at any age in children and adults are unclear. ⋯ Research on early exposure has disrupted the previous thinking of avoidance of food allergies to prevent sensitization in children, instead leading to recommendations that early introduction to foods may, in fact, induce tolerance. However, clear and unequivocal guidelines on how to approach this in the clinical setting have not been developed. The coming of the epigenetic era in food allergies is to provide better understanding of pathogenesis of food allergy, as well as providing therapeutic and preventive strategies for this very common condition.
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The global crisis provoked by the SARS-CoV-2 pandemic, and the economic and social consequences associated to the essential policies applied to contain it, necessitates the expedited development of therapeutic solutions. It is a priority to produce data both rapidly and accurately in order to identify current therapies that can be repurposed to offer protection from SARS-CoV-2 infection. ⋯ A systematic data analysis of exposure and infection rates among healthcare workers could yield patterns identifying common protective factors, such as medications with prophylactic potential against SARS-CoV-2, that can be fast-tracked into available therapies. With results suggesting their activity against other coronaviruses and their widespread adoption, Antiretroviral cocktails could be a promising initial target for such large-scale data analysis approach.