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1.
Nature ; 627(8002): 73-79, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38418887

RESUMEN

By directly altering microscopic interactions, pressure provides a powerful tuning knob for the exploration of condensed phases and geophysical phenomena1. The megabar regime represents an interesting frontier, in which recent discoveries include high-temperature superconductors, as well as structural and valence phase transitions2-6. However, at such high pressures, many conventional measurement techniques fail. Here we demonstrate the ability to perform local magnetometry inside a diamond anvil cell with sub-micron spatial resolution at megabar pressures. Our approach uses a shallow layer of nitrogen-vacancy colour centres implanted directly within the anvil7-9; crucially, we choose a crystal cut compatible with the intrinsic symmetries of the nitrogen-vacancy centre to enable functionality at megabar pressures. We apply our technique to characterize a recently discovered hydride superconductor, CeH9 (ref. 10). By performing simultaneous magnetometry and electrical transport measurements, we observe the dual signatures of superconductivity: diamagnetism characteristic of the Meissner effect and a sharp drop of the resistance to near zero. By locally mapping both the diamagnetic response and flux trapping, we directly image the geometry of superconducting regions, showing marked inhomogeneities at the micron scale. Our work brings quantum sensing to the megabar frontier and enables the closed-loop optimization of superhydride materials synthesis.

2.
Nature ; 597(7874): 45-50, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34471276

RESUMEN

Conventional wisdom holds that macroscopic classical phenomena naturally emerge from microscopic quantum laws1-7. However, despite this mantra, building direct connections between these two descriptions has remained an enduring scientific challenge. In particular, it is difficult to quantitatively predict the emergent 'classical' properties of a system (for example, diffusivity, viscosity and compressibility) from a generic microscopic quantum Hamiltonian7-14. Here we introduce a hybrid solid-state spin platform, where the underlying disordered, dipolar quantum Hamiltonian gives rise to the emergence of unconventional spin diffusion at nanometre length scales. In particular, the combination of positional disorder and on-site random fields leads to diffusive dynamics that are Fickian yet non-Gaussian15-20. Finally, by tuning the underlying parameters within the spin Hamiltonian via a combination of static and driven fields, we demonstrate direct control over the emergent spin diffusion coefficient. Our work enables the investigation of hydrodynamics in many-body quantum spin systems.

3.
Phys Rev Lett ; 131(10): 106501, 2023 Sep 08.
Artículo en Inglés | MEDLINE | ID: mdl-37739353

RESUMEN

When a system is swept through a quantum critical point, the quantum Kibble-Zurek mechanism makes universal predictions for quantities such as the number and energy of excitations produced. This mechanism is now being used to obtain critical exponents on emerging quantum computers and emulators, which in some cases can be compared to matrix product state (MPS) numerical studies. However, the mechanism is modified when the divergence of entanglement entropy required for a faithful description of many quantum critical points is not fully captured by the experiment or classical calculation. In this Letter, we study how low-energy dynamics of quantum systems near criticality are modified by finite entanglement, using conformally invariant critical points described approximately by a MPS as an example. We derive that the effect of finite entanglement on a Kibble-Zurek process is captured by a dimensionless scaling function of the ratio of two length scales, one determined dynamically and one by the entanglement restriction. Numerically we confirm first that dynamics at finite bond dimension χ is independent of the algorithm chosen, then obtain scaling collapses for sweeps in the transverse field Ising model and the three-state Potts model. Our result establishes the precise role played by entanglement in time-dependent critical phenomena and has direct implications for quantum state preparation and classical simulation of quantum states.

4.
Anaesthesia ; 77(9): 991-998, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35837762

RESUMEN

Residual neuromuscular blockade is associated with significant morbidity. It has been widely studied in anaesthesia; however, the incidence of residual neuromuscular blockade in patients managed in the ICU is unknown. We conducted a prospective observational study in a tertiary ICU to determine the incidence of residual neuromuscular blockade using quantitative accelerographic monitoring. We tested for residual neuromuscular blockade (defined as a train-of-four ratio < 0.9) before cessation of sedation in anticipation of tracheal extubation. We also surveyed 16 other ICUs in New Zealand to determine their use of neuromuscular monitoring. A total of 191 patients were included in the final analysis. The incidence (95%CI) of residual neuromuscular blockade was 43% (36-50%), with a similar incidence observed in non-postoperative and postoperative patients. There was a lower risk of residual neuromuscular blockade with atracurium than rocuronium (risk ratio (95%CI) of 0.39 (0.12-0.78)) and a higher risk with pancuronium than rocuronium (1.59 (1.06-2.49)). Our survey shows that, in New Zealand ICUs, monitoring of neuromuscular function is rarely carried out before tracheal extubation. When neuromuscular monitoring is undertaken, it is based on individual clinician suspicion and performed using qualitative measurements. No ICU reported using a quantitative monitor or a clinical guideline. The results demonstrate a high incidence of residual neuromuscular blockade in our ICU patients and identify the type of neuromuscular blocking drug as a possible risk factor. Monitoring neuromuscular function before tracheal extubation is not currently the standard of care in New Zealand ICUs. These data suggest that residual neuromuscular blockade may be an under-recognised problem in ICU practice.


Asunto(s)
Retraso en el Despertar Posanestésico , Bloqueo Neuromuscular , Fármacos Neuromusculares no Despolarizantes , Retraso en el Despertar Posanestésico/inducido químicamente , Retraso en el Despertar Posanestésico/epidemiología , Humanos , Bloqueo Neuromuscular/métodos , Monitoreo Neuromuscular , Fármacos Neuromusculares no Despolarizantes/efectos adversos , Rocuronio/efectos adversos
5.
Lett Appl Microbiol ; 74(1): 2-7, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34695222

RESUMEN

It is well known that black and green tea extracts, particularly polyphenols, have antimicrobial activity against various pathogenic microbes including viruses. However, there is limited data on the antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which emerged rapidly in China in late 2019 and which has been responsible for coronavirus disease 2019 (COVID-19) pandemic globally. In this study, 20 compounds and three extracts were obtained from black and green tea and found that three tea extracts showed significant antiviral activity against SARS-CoV-2, whereby the viral titre decreased about 5 logs TCID50 per ml by 1·375 mg ml-1 black tea extract and two-fold diluted tea bag infusion obtained from black tea when incubated at 25°C for 10 s. However, when concentrations of black and green tea extracts were equally adjusted to 344 µg ml-1 , green tea extracts showed more antiviral activity against SARS-CoV-2. This simple and highly respected beverage may be a cheap and widely acceptable means to reduce SARS-CoV-2 viral burden in the mouth and upper gastrointestinal and respiratory tracts in developed as well as developing countries.


Asunto(s)
COVID-19 , Camellia sinensis , Catequina , Antivirales/farmacología , Humanos , SARS-CoV-2 ,
6.
Lett Appl Microbiol ; 73(4): 400-407, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34219247

RESUMEN

Antimicrobial resistance (AMR) has now emerged as a global public health crisis, requiring the discovery of new and novel antimicrobial compounds, that may be precursors of future therapeutic antibiotics. Chinese Herbal Medicine (CHM) comes with a rich pedigree of holistic and empirical usage in Asia for the last 5000 years. Extracts of Anemarrhena asphodeloides Bunge, Angelica sinensis (Oliv.) Diels, Dianthus superbus L. Forsythiae fructus (Lian Qiao), Lonicerae flos (Jin Yin Hua), Naemorhedi cornu, Platycladus orientalis Franco, Polygonum aviculare, Polygonum cuspidatum, Poria cocos (Schw.), Rehmannia glutinosa (Gaertn.) DC, Rheum palmatum, Salvia miltiorrhiza Bunge, Scutellaria barbata, Scutellariae radix (Huang Qin) and Ursi fel (Xiong Dan) have shown to have antimicrobial properties against clinically significant Gram-negative and Gram-positive bacterial pathogens, as well as the mycobacteria (TB and non-tuberculous mycobacteria). Evidence is now beginning to emerge through systematic reviews of the outcomes of clinical studies employing CHM to treat infections. Of the 106 Cochrane systematic reviews on CHM, 16 (ca 15%) reviews examine CHM in the context of treating a specific infection disease or state. This update examines direct antimicrobial effect of CHM on bacterial pathogens, as well as synergistic effects of combining CHM with conventional antibiotics.


Asunto(s)
Antiinfecciosos , Medicamentos Herbarios Chinos , Antibacterianos/farmacología , Antiinfecciosos/farmacología , Farmacorresistencia Bacteriana , Frutas
7.
Lett Appl Microbiol ; 71(5): 506-509, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32745274

RESUMEN

There have been numerous reports in the literature describing the diversity of microbial flora isolated from woodwind and brass instruments, with potential infection risks for players, especially when such instruments are shared. Steam disinfection has become established as a trusted method of decontamination; however, there have been no reports on the employment of this technology to disinfect parts of musical instruments, hence it was the aim of this study to examine the fate of bacterial and yeast pathogens on artificially contaminated trumpet mouthpieces and to evaluate whether such disinfection is an effective method of disinfection for such instrument parts. Trumpet mouthpieces were artificially contaminated with 18 microbial strains (17 bacteria from four genera (Enterococcus, Escherichia, Staphylococcus and Streptococcus) and one yeast (Candida)), each at an inoculum density of approximately 1·5 × 107 colony forming units and subjected to a disinfection cycle. The experiment was repeated including 50% (v/v) sterile sputum as soil. No bacteria or yeast organisms were recovered post disinfection, including following recovery and with nonselective cultural enrichment techniques.


Asunto(s)
Bacterias/aislamiento & purificación , Candida/aislamiento & purificación , Desinfección/métodos , Contaminación de Equipos/prevención & control , Vapor , Enterococcus/aislamiento & purificación , Equipos y Suministros/microbiología , Escherichia/aislamiento & purificación , Humanos , Música , Staphylococcus/aislamiento & purificación , Streptococcus/aislamiento & purificación
8.
Med Mycol ; 57(2): 155-160, 2019 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-29554296

RESUMEN

Aspergillus fumigatus is commonly found in the airways of patients with cystic fibrosis (CF), and allergic bronchopulmonary aspergillosis (ABPA) is the most recognized associated clinical condition. However, accurate diagnosis remains challenging, and there is a paucity of clinical trials to guide clinical management of fungal disease. The aim of this survey was to assess the variability in current practice across the UK in diagnosis and management of fungal lung disease in CF patients. A 21 question anonymous online survey was sent to 94 paediatric and adult CF consultants in the UK. The response rate was 60.6% (32 adult physicians, 25 pediatricians) with 55 full and 2 partially completed surveys. For a first diagnosis of ABPA 20 (35.1%) treat with prednisolone alone, 38 (66.7%) use prednisolone with itraconazole and 2 (3.5%) choose voriconazole. Only 5 (8.8%) treat with prednisolone alone for a 1st relapse, 33 (58%) used prednisolone with itraconazole. To reduce treatment, 21 (36.8%) decrease steroids to zero over time and maintain azole therapy, 18 (31.6%) stop the azole and steroid after a fixed time, and 5 (8.8%) stop the azole after a fixed time and maintain a small steroid dose. Thirty-eight (66.7%) respondents believe Aspergillus colonization of the airway can cause clinical deterioration, and 37 (66.1%) would treat this. Scedosporium apiospermum infection has been diagnosed and treated by 35 (61.4%) of respondents. Results of this survey highlight the variance in clinical practice and the limited evidence available to guide management of fungal infection in CF.


Asunto(s)
Antifúngicos/administración & dosificación , Aspergilosis Broncopulmonar Alérgica/diagnóstico , Aspergilosis Broncopulmonar Alérgica/tratamiento farmacológico , Fibrosis Quística/complicaciones , Pautas de la Práctica en Medicina/estadística & datos numéricos , Aspergilosis Broncopulmonar Alérgica/complicaciones , Aspergillus fumigatus/aislamiento & purificación , Humanos , Scedosporium/aislamiento & purificación , Encuestas y Cuestionarios , Reino Unido
9.
J Biomech Eng ; 141(11)2019 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-31074761

RESUMEN

The phasic contractions of collecting lymphatic vessels are reduced in strength and occur at diminished frequency when a favorable pressure difference and the resulting antegrade flow create large fluid shear stresses at the luminal surface. This paper describes a minimal phenomenological model of this mechanism that is applied to a previously validated numerical model of a phasically contracting lymphangion. The parameters of the inhibition model are quantitatively matched to observations in isolated segments of rat lymphatic vessel, first for mesenteric lymphatics then for thoracic duct, and outcomes from the numerical model are then qualitatively compared with recent observations in isolated segments of rat thoracic duct.

10.
Lett Appl Microbiol ; 66(6): 537-541, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29537700

RESUMEN

Chronic Pseudomonas aeruginosa infection is associated with increased morbidity and mortality in patients with cystic fibrosis (CF). Current understanding of risk factors for acquisition is limited and so the aim of this study was to examine a large sample of environmental waters from diverse sources. Environmental water samples (n = 7904) from jacuzzis, hydrants, swimming pools, hot tubs, plunge pools, bottled natural mineral water, taps, springs, ice machines, water coolers, bores and showers were examined for the presence of P. aeruginosa. Pseudomonas aeruginosa was detected in 524/7904 (6·6%) waters examined. Hot tubs (51/243; 20·9%), tap water (3/40; 8%) and jacuzzis (432/5811; 7·4%) were the most likely environments where P. aeruginosa was isolated. Pseudomonas aeruginosa was isolated from bottled water (2/67; 3%). Our study highlights the ubiquitous nature of P. aeruginosa in the environment. Given CF patients are frequently counselled to make lifestyle changes to minimize P. aeruginosa exposure, these results have important implications. In particular, the occurrence of P. aeruginosa in tap water highlights the need to disinfect the CF patients' nebulizer after each use. SIGNIFICANCE AND IMPACT OF THE STUDY: This study examined a large number of water sources (n = 7904) over a 9-year period for the presence of Pseudomonas aeruginosa. The study highlighted that jacuzzis (n = 5811; 7% positive) and hot tubs had the highest occurrence of this organism (n = 243, 21% positive). Patients with cystic fibrosis (CF) are interested in knowing what water environments are likely to be contaminated with this organism, as this bacterium is an important cause of increased morbidity and mortality in such patients. With such information, CF patients and parents may make informed decisions about lifestyle choice and water environment avoidance.


Asunto(s)
Fibrosis Quística/microbiología , Agua Potable/microbiología , Infecciones por Pseudomonas/microbiología , Pseudomonas aeruginosa/aislamiento & purificación , Adulto , Femenino , Humanos , Microbiología del Agua
11.
Lett Appl Microbiol ; 66(4): 284-292, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29377174

RESUMEN

In the British Isles, the frequency of rain results in the formation of puddles on footpaths and roads in/around hospitals. No data are available demonstrating the microbiological composition of such puddles and therefore a study was undertaken to examine the microbiology of puddles in the grounds of two tertiary university-teaching hospitals (18 sites) and compared with control puddles from non-hospital rural environments (eight sites), estimating (i) total viable count; (ii) identification of organisms in puddles; (iii) enumeration of Escherichia coli: (iv) detection of Extended Spectrum ß-Lactamase producing organisms and (v) direct antimicrobial susceptibility testing. A mean count of 2·3 × 103  CFU per ml and 1·0 × 109  CFU per ml was obtained for hospital and non-hospital puddles respectively. Isolates (n = 77; 54 hospital and 23 non-hospital) were isolated comprising of 23 species among 17 genera (hospital sites), where the majority (10/16; 62·5%) of genera identified were Gram-negative approximately, a fifth (20·6%) were shared by hospital and non-hospital rural samples. Escherichia coli was detected in half of the hospital puddles and under-half (37·5%) of the rural puddles extended spectrum ß-lactamase organisms were not detected in any samples examined. Rainwater puddles from the hospital and non-hospital environments contain a diverse range of bacteria, which are capable of causing infections. SIGNIFICANCE AND IMPACT OF THE STUDY: This study demonstrated the presence of a wide diversity of bacterial taxa associated with rainwater puddles around hospitals, many of which are capable of causing human disease. Of clinical significance is the presence of Pseudomonas aeruginosa isolated from a hospital puddle, particularly for patients with cystic fibrosis. The presence of potentially disease-causing bacteria in puddles in and around hospitals identifies a new potential environmental reservoir of bacteria. Furthermore work is now needed to define their potential of entering or exiting hospital wards by contaminated footwear.


Asunto(s)
Antibacterianos/farmacología , Escherichia coli/aislamiento & purificación , Pseudomonas aeruginosa/aislamiento & purificación , Lluvia/microbiología , beta-Lactamasas/farmacología , Técnicas de Tipificación Bacteriana , Escherichia coli/clasificación , Escherichia coli/efectos de los fármacos , Hospitales de Enseñanza , Hospitales Universitarios , Humanos , Pruebas de Sensibilidad Microbiana , Pseudomonas aeruginosa/clasificación , Pseudomonas aeruginosa/efectos de los fármacos , Reino Unido , Universidades
12.
J Clin Pharm Ther ; 43(1): 92-100, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29293275

RESUMEN

WHAT IS KNOWN AND OBJECTIVE: The CFTR potentiator, ivacaftor (IVA), has been widely used in the treatment of cystic fibrosis (CF) patients with the G551D mutation. To date, there has been limited information on the microbiological status of patients on this therapy and no data on the effect (if any) on the in vivo antibiotic susceptibility of Pseudomonas aeruginosa isolated from patients on therapy. Although IVA intervention is not designed per se as anti-infective, the effect (if any) of this molecule to CF patients' microbiological status merits careful monitoring. Therefore, it was the aim of this observational study to examine the effect in patients, both before and after commencement of IVA therapy, on several commonly reported microbiological markers in CF patients, including (i) bacterial density, (ii) frequency (rate) of isolation of bacterial pathogens, particularly P. aeruginosa, and (iii) antimicrobial susceptibility of these isolates to commonly prescribed oral and iv antibiotics. In addition, we wished to examine the requirements for these antibiotics in CF patients, before and after commencement of IVA therapy. METHODS: Archived data from 15 adult cystic fibrosis patients with the c.1652G>A (G551D) mutation were followed from two years pre-IVA therapy to two years after commencement of IVA therapy. The microbiological parameters examined included (i) oral antibiotic courses taken, (ii) intravenous (iv) antibiotic courses taken, (iii) rate of isolation of non-mucoid Pseudomonas aeruginosa (NM-PA) and mucoid P. aeruginosa (M-PA), (iv) density of NM-PA and M-PA and (v) antimicrobial susceptibility of NM-PA and M-PA to 11 antibiotics [aminoglycosides, beta-lactams, polymyxin and fluoroquinolone]. RESULTS AND DISCUSSION: Following commencement of IVA therapy, patients required less iv antibiotic courses but no change in number of oral antibiotics courses. There was significant reduction in both the rate of isolation and density of M-PA (P = .02; P = .006, respectively). In contrast, there was no significant reduction in both the rate of isolation and density of NM-PA (P = .90; P = .07, respectively). Antimicrobial susceptibility in NM-PA and M-PA was not significantly reduced within any of the antibiotics classes or individual antibiotics examined. Increased susceptibility was noted in the beta-lactam class for NM-PA and M-PA, in particular with ceftazidime. WHAT IS NEW AND CONCLUSION: Overall, (i) the requirement for less iv antibiotic therapy, (ii) a reduction in the rate and density of M-PA and (iii) no reduction in antibiotic susceptibility indicate that microbiological parameters with patients on IVA therapy were not detrimentally affected.


Asunto(s)
Regulador de Conductancia de Transmembrana de Fibrosis Quística/genética , Fibrosis Quística/genética , Fibrosis Quística/microbiología , Mutación/genética , Infecciones por Pseudomonas/genética , Adolescente , Adulto , Aminofenoles/uso terapéutico , Antibacterianos/uso terapéutico , Fibrosis Quística/tratamiento farmacológico , Femenino , Humanos , Masculino , Pruebas de Sensibilidad Microbiana/métodos , Infecciones por Pseudomonas/tratamiento farmacológico , Pseudomonas aeruginosa/efectos de los fármacos , Quinolonas/uso terapéutico , Estudios Retrospectivos , Adulto Joven
13.
J Clin Pharm Ther ; 43(6): 836-843, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29959786

RESUMEN

WHAT IS KNOWN AND OBJECTIVE: Ivacaftor is a novel potentiator of defective cystic fibrosis transmembrane conductance regulator (CFTR) protein, which corrects the gating defect and increases ion-function of activated cell-surface CFTR. Bacteria also regulate their physiology through ion channels. However, little is known about the potential effects of ivacaftor on bacterial ion channels, which, in turn, may have a potential effect on transport across the bacterial cell membrane. Therefore, any change in the ability to transport molecules across cell membranes in bacteria could have an important impact on bacterial transport physiology. One area where this could be particularly important is in the movement of antibiotics, both into and out of the bacterial cell. An in vitro study was therefore performed to examine the influence of ivacaftor at therapeutic concentration on antibiotic susceptibility of 11 commonly used anti-pseudomonal antibiotics against a population of clinical Pseudomonas aeruginosa [PA], from CF and non-CF sources. METHOD: Pseudomonas aeruginosa (n = 80; including 70 ivacaftor-naïve clinical PA from sputa from adult CF patients and 10 control PA from non-CF clinical blood culture sources) were examined. Antibiotic susceptibility was determined by standard disc diffusion assay using CLSI criteria and measuring zone size (mm), against four classes of anti-pseudomonal antibiotics, including beta-lactams (temocillin, ceftazidime, piperacillin/tazobactam, imipenem, meropenem and aztreonam), aminoglycosides (gentamicin, tobramycin, amikacin), fluoroquinolone (ciprofloxacin) and polymyxin (colistin), in the absence and presence of ivacaftor (5 µmol/L), as previously determined. In addition, all CF and non-CF PA were examined phenotypically in vitro, as previously described, for changes linked to bacterial virulence, including (i) growth density (ii) pigmentation, (iii) presence of adhesins and (iv) change to mucoidy, in the presence/absence of ivacaftor at therapeutic concentration. RESULTS AND DISCUSSION: Antibiotic susceptibility did not decrease significantly with any of the antibiotics examined with CF PA isolates or with non-CF PA control organisms. There was a statistically significant increase in zone size (CF PA and amikacin, gentamicin, temocillin and ciprofloxacin; Non-CF PA and amikacin, gentamicin and aztreonam). However, at a population level, this did not translate into a shift in CLSI category to a more susceptible phenotype. None of the PA isolates examined were susceptible to ivacaftor alone, and additionally, no changes were noted with the four phenotypic parameters examined in the presence of ivacaftor. WHAT IS NEW AND CONCLUSION: This study showed that antibiotic susceptibility of commonly used anti-pseudomonal antibiotics was not negatively affected by ivacaftor, in a population of ivacaftor-naive P. aeruginosa.


Asunto(s)
Aminofenoles/farmacología , Antibacterianos/farmacología , Infecciones por Pseudomonas/tratamiento farmacológico , Pseudomonas aeruginosa/efectos de los fármacos , Quinolonas/farmacología , Adulto , Aminofenoles/administración & dosificación , Estudios de Casos y Controles , Agonistas de los Canales de Cloruro/administración & dosificación , Agonistas de los Canales de Cloruro/farmacología , Fibrosis Quística/tratamiento farmacológico , Fibrosis Quística/microbiología , Regulador de Conductancia de Transmembrana de Fibrosis Quística/efectos de los fármacos , Regulador de Conductancia de Transmembrana de Fibrosis Quística/metabolismo , Interacciones Farmacológicas , Humanos , Técnicas In Vitro , Pruebas de Sensibilidad Microbiana , Infecciones por Pseudomonas/microbiología , Pseudomonas aeruginosa/aislamiento & purificación , Quinolonas/administración & dosificación
14.
Dysphagia ; 33(4): 457-467, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29353401

RESUMEN

Self-perception of disease is increasingly recognized as a determinant of health. The Eating Assessment Tool-10 (EAT-10) is a functional health status questionnaire that measures the symptomatic severity of dysphagia from the patient's perspective. The objective of this work was to identify factors (demographics, clinical variables, swallowing physiology, health-related quality of life) associated with longitudinal change in EAT-10 scores in outpatients with oropharyngeal dysphagia at a multi-disciplinary, tertiary care clinic. All patients with swallowing concerns that were included in the UW Madison Voice and Swallowing Outcomes database from 12/2012 to 04/2015 were invited to complete EAT-10 and a general health-related quality of life survey (SF-12v2) at their initial evaluation and six months later. Forty-two patients were included in analysis (n = 42). Weaning from a gastrostomy tube was significantly associated with EAT-10 improvement. Approximately 70% of the sample had mild dysphagia, and floor effects were observed for all EAT-10 items in this sample subset. Mean SF-12v2 Physical Component Summary score was substantially lower than that of the general population. Significant, weak-moderate correlations were found between EAT-10 and SF-12v2 scores for all comparisons except for Physical Health Composite at six months (rs = = 0.24 to - 0.43). Weaning from a feeding tube appears to meaningfully improve self-perceived symptoms of dysphagia. Given the floor effects observed, validity of EAT-10 for patients with mild dysphagia should be examined. Future research should address contributors to self-perceived symptom change across the range of dysphagia severity.


Asunto(s)
Trastornos de Deglución/psicología , Calidad de Vida , Anciano , Deglución/fisiología , Femenino , Humanos , Masculino , Pacientes Ambulatorios , Estudios Prospectivos , Autoimagen , Atención Terciaria de Salud
15.
J Clin Pharm Ther ; 42(3): 259-267, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28374433

RESUMEN

WHAT IS KNOWN AND OBJECTIVE: Pseudomonas aeruginosa is the leading cause of lung infection in patients with cystic fibrosis (CF) and is associated with significant morbidity and mortality. Antibiotics are regarded as the foundational pharmacological treatment for the suppressive management of chronic P. aeruginosa infections and to eradicate the first infection by P. aeruginosa. Inhalation remains a preferred route for drug administration, providing direct access to the site of infection while minimizing systemic side effects. Effective suppressive management of P. aeruginosa infections, however, requires an understanding of the location of the bacteria in the lungs and consideration of the factors that could limit access of the inhaled antibiotic to the infected area. This review provides a systematic assessment of the scientific literature to gain insight into the location of P. aeruginosa in the lungs of patients with CF and its clinical implications. The characteristics of antibiotic inhalation systems are also discussed in this context. METHODS: We reviewed evidence-based literature from both human and animal studies in which P. aeruginosa lung location was reported. Relevant publications were identified through a screening strategy and summarized by reported P. aeruginosa location. RESULTS AND DISCUSSION: Most areas of the conductive and respiratory zones of the lungs are susceptible to P. aeruginosa colonization. Deposition of an inhaled antibiotic is dependent on the device and formulation characteristics, as well as the ability of the patient to generate sufficient inhaled volume. As patients with CF often experience a decline in lung function, the challenge is to ensure that the inhaled antibiotic can be delivered throughout the bronchial tree. WHAT IS NEW AND CONCLUSION: An effective drug delivery system that can target P. aeruginosa in both the respiratory and conductive zones is required. The chosen inhalation device should also offer a drug formulation that can be quickly and effectively delivered to specific lung locations, with minimal inspiratory effort from the patient.


Asunto(s)
Fibrosis Quística/complicaciones , Infecciones por Pseudomonas/microbiología , Infecciones del Sistema Respiratorio/microbiología , Administración por Inhalación , Animales , Antibacterianos/administración & dosificación , Enfermedad Crónica , Fibrosis Quística/microbiología , Humanos , Pulmón/microbiología , Infecciones por Pseudomonas/tratamiento farmacológico , Infecciones por Pseudomonas/etiología , Pseudomonas aeruginosa/aislamiento & purificación , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/etiología
16.
J R Army Med Corps ; 163(4): 235-241, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28039342

RESUMEN

Meningococcal disease is a worldwide life-threatening infection associated in many cases with debilitating long-term sequelae, both within the military and civilian populations. Military recruits are at a higher risk of acquiring this infection due to numerous factors, such as young recruits in the age group 18-25 years, high carriage rates of meningococci, communal and crowed living quarters and global deployment or training in regions with different meningococcal serogroup epidemiology. Although these increased risk factors among young recruits remain, the increased incidence of disease is now historic. Numerous outbreaks have been reported among military personnel, however although the incidence of the disease continues to decrease, there are still sporadic cases. The non-specific symptoms, sudden onset and rapid progression of the infection results in a limited time frame to both diagnose and successfully treat the patient. Many developments have been made in relation to the microbiological diagnosis of the disease, particularly in the era of molecular diagnostics, which have the potential to diagnose the infection more quickly. Developments in vaccinology, and in particular with relation to biotechnology and reverse vaccinology, have led to the availability of new meningococcal vaccines, further enabling disease prevention. This paper outlines the history of meningococcal disease in relation to the military and highlights the new developments in both diagnostics and vaccination, which have the potential to diagnose, treat and control meningococcal disease in a more efficient manner.


Asunto(s)
Infecciones Meningocócicas/epidemiología , Infecciones Meningocócicas/prevención & control , Vacunas Meningococicas , Personal Militar , Brotes de Enfermedades , Humanos , Factores de Riesgo
17.
Gene Ther ; 23(1): 108-12, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26289666

RESUMEN

CRISPR/Cas9-based therapeutics hold the possibility for permanent treatment of genetic disease. The potency and specificity of this system has been used to target dominantly inherited conditions caused by heterozygous missense mutations through inclusion of the mutated base in the short-guide RNA (sgRNA) sequence. This research evaluates a novel approach for targeting heterozygous single-nucleotide polymorphisms (SNPs) using CRISPR/Cas9. We determined that a mutation within KRT12, which causes Meesmann's epithelial corneal dystrophy (MECD), leads to the occurrence of a novel protospacer adjacent motif (PAM). We designed an sgRNA complementary to the sequence adjacent to this SNP-derived PAM and evaluated its potency and allele specificity both in vitro and in vivo. This sgRNA was found to be highly effective at reducing the expression of mutant KRT12 mRNA and protein in vitro. To assess its activity in vivo we injected a combined Cas9/sgRNA expression construct into the corneal stroma of a humanized MECD mouse model. Sequence analysis of corneal genomic DNA revealed non-homologous end-joining repair resulting in frame-shifting deletions within the mutant KRT12 allele. This study is the first to demonstrate in vivo gene editing of a heterozygous disease-causing SNP that results in a novel PAM, further highlighting the potential for CRISPR/Cas9-based therapeutics.


Asunto(s)
Sistemas CRISPR-Cas , División del ADN , Marcación de Gen , Queratina-12/genética , Polimorfismo de Nucleótido Simple , Alelos , Animales , Secuencia de Bases , Femenino , Terapia Genética , Heterocigoto , Queratina-12/metabolismo , Ratones , Ratones Endogámicos C57BL , Modelos Animales , Datos de Secuencia Molecular , Mutación Missense
18.
Phys Rev Lett ; 117(24): 240601, 2016 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-28009202

RESUMEN

We examine localization phenomena associated with generic, high entropy, states of a translation-invariant, one-dimensional spin ladder. At early times, we find slow growth of entanglement entropy consistent with the known phenomenology of many-body localization in disordered, interacting systems. At intermediate times, however, anomalous diffusion sets in, leading to full spin polarization decay on an exponentially activated time scale. We identify a single length scale which parametrically controls both the spin transport times and the apparent divergence of the susceptibility to spin glass ordering. Ultimately, at the latest times, the exponentially slow anomalous diffusion gives way to diffusive thermal behavior. We dub the intermediate dynamical behavior, which persists over many orders of magnitude in time, quasi-many-body localization.

19.
Br J Biomed Sci ; 73(2): 56-66, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27181172

RESUMEN

BACKGROUND: Thermophilic Campylobacter are important bacterial pathogens of foodborne diseases worldwide. These organisms' physiology requires a microaerophilic atmosphere. To date, little is known about the protective catalase mechanism in urease-positive thermophilic campylobacters (UPTC); hence, it was the aim of this study to identify and characterise catalase and catalase-like protein genes in these organisms. MATERIALS AND METHODS: Catalase (katA) and catalase (Kat)-like protein genes from the Japanese UPTC CF89-12 strain were molecularly analysed and compared with C. lari RM2100 and other C. lari and thermophilic Campylobacter reference isolates. RESULTS: A possible open reading frame of 1,422 base pairs, predicted to encode a peptide of 474 amino acid residues, with calculated molecular weight of 52.7 kilo Daltons for katA, was identified within UPTC CF89-12. A probable ribosome binding site, two putative promoters and a putative ρ-independent transcription terminator were also identified within katA. A similar katA cluster also existed in the C. lari RM2100 strain, except that this strain carries no DcuB genes. However, the Kat-like protein gene or any other homologue(s) were never identified in the C. lari RM2100 strain, or in C. jejuni and C. upsaliensis. CONCLUSIONS: This study demonstrates the presence of catalase/catalase-like protein genes in UPTC organisms. These findings are significant in that they suggest that UPTC organisms have the protective genetic capability of helping protect the organisms from toxic oxygen stress, which may help them to survive in physiologically harsh environments, both within human and animal hosts, as well as in the natural environment.


Asunto(s)
Campylobacter/clasificación , Campylobacter/enzimología , Catalasa/química , Catalasa/genética , Ureasa/metabolismo , Secuencia de Aminoácidos , Secuencia de Bases , Sitios de Unión , Campylobacter/aislamiento & purificación , Activación Enzimática , Peso Molecular , Unión Proteica , Conformación Proteica , Especificidad de la Especie
20.
Am J Physiol Heart Circ Physiol ; 308(7): H697-706, 2015 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-25617358

RESUMEN

The shear stress applied to lymphatic endothelial cells (LEC) by lymph flow changes dramatically under normal conditions as well as in response to disease conditions and immune reactions. In general, LEC are known to regulate the contraction frequency and strength of lymphatic pumping in response to shear stress. Intracellular calcium concentration ([Ca(2+)]i) is an important factor that regulates lymphatic contraction characteristics. In this study, we measured changes in the [Ca(2+)]i under different shear stress levels and determined the source of this calcium signal. Briefly, human dermal LEC were cultured in custom-made microchannels for 3 days before loading with 2 µM fura-2 AM, a ratiometric calcium dye to measure [Ca(2+)]i. Step changes in shear stress resulted in a rapid increase in [Ca(2+)]i followed by a gradual return to the basal level and sometimes below the initial baseline (45.2 ± 2.2 nM). The [Ca(2+)]i reached a peak at 126.2 ± 5.6 nM for 10 dyn/cm(2) stimulus, whereas the peak was only 71.8 ± 5.4 nM for 1 dyn/cm(2) stimulus, indicating that the calcium signal depends on the magnitude of shear stress. Removal of the extracellular calcium from the buffer or pharmocological blockade of calcium release-activated calcium (CRAC) channels significantly reduced the peak [Ca(2+)]i, demonstrating a role of extracellular calcium entry. Inhibition of endoplasmic reticulum (ER) calcium pumps showed the importance of intracellular calcium stores in the initiation of this signal. In conclusion, we demonstrated that the shear-mediated calcium signal is dependent on the magnitude of the shear and involves ER store calcium release and extracellular calcium entry.


Asunto(s)
Señalización del Calcio , Células Endoteliales/metabolismo , Endotelio Linfático/metabolismo , Mecanotransducción Celular , Bloqueadores de los Canales de Calcio/farmacología , Canales de Calcio/metabolismo , Señalización del Calcio/efectos de los fármacos , ATPasas Transportadoras de Calcio/metabolismo , Técnicas de Cultivo de Célula , Línea Celular , Retículo Endoplásmico/metabolismo , Células Endoteliales/efectos de los fármacos , Endotelio Linfático/efectos de los fármacos , Humanos , Mecanotransducción Celular/efectos de los fármacos , Estrés Mecánico , Factores de Tiempo
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