Plos One
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Staphylococcus aureus is a leading cause of bacteremia in hospitalized patients. Whether or not S. aureus bacteremia (SAB) is associated with clonality, implicating potential nosocomial transmission, has not, however, been investigated. Herein, we examined the epidemiology of SAB using whole genome sequencing (WGS). 152 SAB isolates collected over the course of 2015 at a single large Minnesota medical center were studied. ⋯ By cgMLST analysis, there were 9 allelic differences between two isolates, with the remaining 150 isolates differing from each other by over 40 alleles. The two isolates were retroactively epidemiologically linked by medical record review. Overall, cgMLST analysis resulted in higher resolution epidemiological typing than did multilocus sequence or spa typing.
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Clinical guidelines recommend early discharge of patients with low-risk pulmonary embolism (LRPE). This study measured the overall impact of early discharge of LRPE patients on clinical outcomes and costs in the Veterans Health Administration population. Adult patients with ≥1 inpatient diagnosis for pulmonary embolism (PE) (index date) between 10/2011-06/2015, continuous enrollment for ≥12 months pre- and 3 months post-index date were included. ⋯ Among long LOS patients, HACs (52) exceeded APEs (14 recurrent DVT, 5 bleeds). Short LOS incurred lower inpatient ($2,164 vs $5,100, 95% CI: $646.8-$5225.0) and total costs ($9,056 vs $12,544, 95% CI: $636.6-$6337.7). LRPE patients with short LOS had better net clinical outcomes at lower costs than matched LRPE patients with long LOS.
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Basic knowledge about the thoracic spinal flexibility is limited and to the authors' knowledge, no in vitro studies have examined the flexibility of every thoracic spinal segment under standardized experimental conditions using pure moments. In our in vitro study, 68 human thoracic functional spinal units including the costovertebral joints (at least n = 6 functional spinal units per segment from T1-T2 to T11-T12) were loaded with pure moments of ±7.5 Nm in flexion/extension, lateral bending, and axial rotation in a custom-built spine tester to analyze range of motion (ROM) and neutral zone (NZ). ROM and NZ showed symmetric motion behavior in all loading planes. ⋯ Comparing these ROM values with those in literature, they agree that ROM is lowest in flexion/extension and highest in axial rotation, as well as decreasing in the lower segments in axial rotation. Differences were found in flexion/extension and lateral bending in the lower segments, where, in contrast to the literature, no increase of the ROM from superior to inferior segments was found. The data of this in vitro study could be used for the validation of numerical models and the design of further in vitro studies of the thoracic spine without the rib cage, the verification of animal models, as well as the interpretation of already published human in vitro data.
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Renal involvement in Systemic Lupus Erythematous (SLE) patients is one of the leading causes of morbidity and a significant contributor to mortality. It's estimated that nearly 50% of SLE individuals develop kidney disease in the first year of the diagnosis. Class IV lupus nephritis (LN-IV) is the class of lupus nephritis most common in Colombian patients with SLE. ⋯ We identified 24 circulating microRNAs with differential abundance between LN-IV and CTL groups, fourteen of these microRNAs are described for the first time to lupus nephritis (hsa-miR-589-3p, hsa-miR-1260b, hsa-miR-4511, hsa-miR-485-5p, hsa-miR-584-5p, hsa-miR-543, hsa-miR-153-3p, hsa-miR-6087, hsa-miR-3942-5p, hsa-miR-7977, hsa-miR-323b-3p, hsa-miR-4732-3p and hsa-miR-6741-3p). These changes in the abundance of miRNAs could be interpreted as alterations in the miRNAs-mRNA regulatory network in the pathogenesis of LN, preceding the clinical onset of the disease. The findings thus contribute to understanding the disease process and are likely to pave the way towards identifying disease biomarkers for early diagnosis of LN.
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The diagnosis of ossification of the posterior longitudinal ligament (OPLL) on magnetic resonance imaging (MRI) is challenging. The purpose of this study is to evaluate the usefulness of the multiecho fast field echo (mFFE) MRI in the detection of ossification of the posterior longitudinal ligament and dural ossification (DO) of the cervical spine. ⋯ MRI with mFFE may be sufficient for the assessment of OPLL and DO, with good contrasts between OPLL and intervertebral disc, spinal cord, and cerebrospinal fluid.