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This comprehensive review delves into cancer's complexity, focusing on adhesion, metastasis, and inhibition. It explores the pivotal role of these factors in disease progression and therapeutic strategies. This review covers cancer cell migration, invasion, and colonization of distant organs, emphasizing the significance of cell adhesion and the intricate metastasis process. Inhibition approaches targeting adhesion molecules, such as integrins and cadherins, are discussed. Overall, this review contributes significantly to advancing cancer research and developing targeted therapies, holding promise for improving patient outcomes worldwide. Exploring different inhibition strategies revealed promising therapeutic targets to alleviate adhesion and metastasis of cancer cells. The effectiveness of integrin-blocking antibodies, small molecule inhibitors targeting Focal adhesion kinase (FAK) and the Transforming Growth Factor ß (TGF-ß) pathway, and combination therapies underscores their potential to disrupt focal adhesions and control epithelial-mesenchymal transition processes. The identification of as FAK, Src, ß-catenin and SMAD4 offers valuable starting points for further research and the development of targeted therapies. The complex interrelationships between adhesion and metastatic signaling networks will be relevant to the development of new treatment approaches.
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Cadherinas , Neoplasias , Humanos , Adherencias Tisulares , Terapia Combinada , Adhesión Celular , Movimiento Celular , IntegrinasRESUMEN
Tuberculosis (TB) causes major public health problems worldwide. Fighting TB requires sustained efforts in health prevention, diagnosis and treatment. Previous literature has shown that conventional diagnostic methods like X-ray and sputum microscopy often miss early or extrapulmonary TB due to their limited sensitivity. Blood tests, while useful, lack the anatomical detail needed for precise localization of TB lesions. A possible step forward in the fight against TB could be the use of Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) and Computed Tomography (CT). This meta-analysis discusses the current literature, including the methods, results and implications of using FDG-PET-CT in the early diagnosis of TB. Analysis of the studies showed that the sensitivity of FDG-PET-CT as a potential method for early detection of TB was 82.6%.
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Diagnóstico Precoz , Fluorodesoxiglucosa F18 , Tomografía Computarizada por Tomografía de Emisión de Positrones , Tuberculosis , Humanos , Tuberculosis/diagnóstico , Tuberculosis/diagnóstico por imagen , Sensibilidad y EspecificidadRESUMEN
We investigated the impact of parathyroidectomy on sleep quality in patients with primary hyperparathyroidism (pHPT). Thirty consecutive patients with pHPT were enrolled in the study within 1 year. pHPT was diagnosed by typical symptoms accompanied by an elevated level of parathormone. The Pittsburgh Sleep Quality Index (PSQI) was used for the evaluation of sleep 1 day before and 6 months after parathyroidectomy. The mean total PSQI score was elevated to 6.8 ± 0.6 points before surgery, which was in the pathological cut-off of greater than ≥5, indicating impaired sleep quality. After parathyroidectomy, the total score declined insignificantly, amounting to 5.6 ± 0.4 (p > 0.05). Nevertheless, the number of patients with a score of ≥5 before surgery decreased from 21 (70%) to 16 (53%) after surgery. There also was a significant improvement in sleep latency (p = 0.05) and sleep efficiency (p = 0.02) domains of PSQI. We conclude that 70% of patients with untreated pHPT suffered from sleep disorders that improved after parathyroidectomy. The clinical consequence is that patients with pHPT should be questioned about having sleep disorders, which might influence the decision-making concerning parathyroidectomy. With the relation reversed, patients without pHPT but suffering from sleep disturbance should be tested for pHPT.
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Hiperparatiroidismo Primario , Trastornos del Sueño-Vigilia , Humanos , Hiperparatiroidismo Primario/complicaciones , Hiperparatiroidismo Primario/cirugía , Hormona Paratiroidea , Paratiroidectomía , Sueño , Trastornos del Sueño-Vigilia/etiologíaRESUMEN
Cognitive functioning after transplantation, which could influence medication compliance and independence, has not been well studied. This study investigated cognitive impairment after lung transplantation. Patients undergoing bilateral transplant between March 2013 and October 2015 underwent comprehensive neuropsychological assessment at 60.1 ± 44.1 months post-transplantation: verbal memory (Auditory-Verbal Learning Test, digit span forward), visual memory (Corsi Block-Tapping Test forward, Benton Visual Retention Test), concentration/speed of processing/attention (D2 Test of Attention, Trail Making Test (TMT) A, Grooved Pegboard), and executive functioning (TMT B, Stroop Color-Word Test, semantic and phonematic verbal fluency, digit span backward, Corsi Block-Tapping Test backward). Mean scores were compared with a normative dataset using a one-sample t-test. A cognitive domain was judged impaired if the score on two or more domain-specific tests was greater than one standard deviation below the normative dataset age range mean. Of 124 lung transplant recipients (51% male, 54.3 ± 9.0 years), 70% showed cognitive impairment in one or more domains. Executive function was most often impaired (78% of recipients not within the age range) followed by verbal memory impairment (72% not within the age range). Cognitive function reductions were largely independent of age, gender, education, immunosuppressive medications, and time since transplantation. The findings show that cognitive impairment is common after lung transplantation and should be subject to rehabilitation and psychological resilience strategies.
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Cognición , Trasplante de Pulmón , Función Ejecutiva , Femenino , Humanos , Trasplante de Pulmón/efectos adversos , Masculino , Pruebas Neuropsicológicas , Prueba de Secuencia AlfanuméricaRESUMEN
The prevalence of sleep-disordered breathing (SDB) after lung transplantation (LTX) is high. It is well-established that SDB is associated with decreased health-related quality of life (HRQoL), but the impact of SDB on exercise capacity is less clear. In this study we investigated HRQoL and exercise capacity in LTX recipients with or without SDB. In addition, we also investigated associations between sleep parameters and both HRQoL and exercise capacity. There were 53 stable LTX recipients (age > 18 years, 31 males, time from LTX 9-120 months) enrolled into the study. They all underwent polysomnography examination. HRQoL was assessed using the Short Form-36 (SF-36). Exercise capacity was measured using the 6-min walk test and cardiopulmonary exercise testing (CPET). We found inverse correlations between severity of SDB and both the predicted maximal workload (r = 0.24, p = 0.04) and maximal oxygen uptake (r = -0.26, p = 0.03) during CPET. Relative oxygen uptake positively correlated with sleep efficiency (r = 0.27, p = 0.03). SF-36 scores did not differ between patients with and without SDB, and were not significantly associated with SDB parameters. In conclusion, the presence of SDB is associated with a slight reduction in maximal exercise capacity in LTX recipients, and there is no appreciable relationship between SDB and HRQoL.
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Tolerancia al Ejercicio , Trasplante de Pulmón , Calidad de Vida , Síndromes de la Apnea del Sueño , Receptores de Trasplantes , Adulto , Femenino , Humanos , Trasplante de Pulmón/psicología , Trasplante de Pulmón/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Polisomnografía , Receptores de Trasplantes/psicología , Receptores de Trasplantes/estadística & datos numéricosRESUMEN
The extracapsular tumor extension (ECE) of nodal metastasis is an important prognostic factor in different types of malignancies. However, there is a lack of recent data in patients with non-small-cell lung cancer (NSCLC). In addition, the TNM staging system does not include ECE status as a prognostic factor. This systematic review and meta-analysis has been conducted to summarize and pool existing data to determine the prognostic role of ECE in patients with lymph node-positive NSCLC. Two authors performed an independent search in PubMed using a predefined keyword list, without language restrictions with publication date since 1990. Prospective or retrospective studies reporting data on prognostic parameters in subjects with NSCLC with positive ECE or with only intracapsular lymph node metastasis were retrieved. Data were summarized using risk ratios (RR) for the survival with 95% confidence intervals (CI). The data was analyzed using Mix 2 (ref: Bax L: MIX 2.0 - Professional software for meta-analysis in Excel. Version 2.015. BiostatXL, 2016. https://www.meta-analysis-made-easy.com ). There 2,105 studies were reviewed. Five studies covering a total of 828 subjects met the inclusion criteria and were included in the meta-analysis. Two hundred and ninety-eight (35.9%) patients were categorized as ECE+, of whom 54 (18.1%) survived at the end of follow-up. In the ECE-negative group, 257 patients (48.4%) survived by the end of follow-up. Thus, ECE status is associated with a significantly decreased survival rate: pooled RR 0.45 (95% CI 0.35-0.59), Q (4) = 4.06, P value = 0.39, and I 2 = 68.00% (95 CI 0.00-79.55%). In conclusion, ECE has a significant impact on survival in NSCLC patients and should be considered in diagnostic and therapeutic decisions in addition to the current TNM staging. Postoperative radiotherapy may be an option in ECE-positive pN1 NSCLC patients.
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Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Neoplasias Pulmonares/mortalidad , Metástasis Linfática/diagnóstico , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Humanos , Neoplasias Pulmonares/diagnóstico , Metástasis Linfática/patología , Estadificación de Neoplasias , Pronóstico , Tasa de SupervivenciaRESUMEN
Malaria is an acute, life-threatening infectious disease that spreads in tropical and subtropical regions. Malaria is mainly brought over to Germany by travelers, so the disease can be overlooked due to its nonspecific symptoms and a lack of experience of attending physicians. The aim of this study was to analyze, retrospectively, epidemiological and clinical data from patients examined for malaria. Patient data were collected from hospital charts at the Department of Internal Medicine, Saarland University Medical Center, Germany, for the period of 2004-2012. The data of patients with and without malaria were compared in terms of their epidemiological, demographic, clinical, and medical treatment aspects. We identified found 15 patients with malaria (28.3 %, mean age 42.3 ± 16.5 years, three females [20 %]; 95 % confidence interval of 0.2-0.4) out of the 53 patients examined. Mainly locals brought malaria over to Homburg, Germany (p = 0.009). Malaria tropica was the most common species (p < 0.0001). One patient (6.7 %) with malaria, who had recently traveled, had a mixed infection of Plasmodium falciparum and Plasmodium malariae (p = 0.670). Malaria is characterized by thrombocytopenia (p = 0.047) and elevated C-reactive protein (p = 0.019) in serum, and fever is the leading symptom (p = 0.031). In most cases, malaria was brought from Ghana (33.3 %). Further, patients had contracted malaria despite malaria prophylaxis (33.3 %, p = 0.670). In conclusion, malaria test should be used in patients with fever after a journey from Africa. Malaria caused by Plasmodium falciparum is the most common species of brought over malaria. Mixed-species Plasmodium falciparum and Plasmodium malariae are uncommon in travelers with malaria.
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Coinfección/epidemiología , Coinfección/microbiología , Malaria/epidemiología , Malaria/microbiología , Plasmodium falciparum/aislamiento & purificación , Plasmodium malariae/aislamiento & purificación , Adulto , Proteína C-Reactiva/metabolismo , Estudios de Casos y Controles , Coinfección/metabolismo , Femenino , Fiebre/microbiología , Alemania/epidemiología , Humanos , Malaria/metabolismo , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , ViajeRESUMEN
Chronic kidney disease (CKD) often accompanies obstructive sleep apnea (OSA). A causative connection of the two disease entities is uncertain. However, eliminating OSA improves the prognosis of CKD patients. In the present study we examined a possible relationship between OSA and CKD, and whether there would be a mutual enhancing interaction in the severity of the two diseases. The study was of a retrospective nature and encompassed 382 patients over the period of 1 January 2014-30 June 2015. The OSA diagnosis was supported by a polysomnographic examination in 363 (95.0%) patients. Blood samples were taken for the determination of kidney function indices. The influence on OSA and CKD of comorbidities also was examined. We found a high probability of a simultaneous occurrence of OSA and CKD; with the odds ratio of 3.94 (95% CI 1.5-10.3%; p = 0.005). The 363 patients with OSA were stratified into 73 (20.1%) mild, 98 (27.0%) moderate, and 192 (52.9%) severe OSA cases according to the apnea-hypopnea index. CKD was found in 43 (58.9%) patients with mild OSA, 73 (74.5%) with moderate OSA, and 137 (71.4%) with severe OSA. Most OSA patients also suffered from hypertension and obesity. For comparison, CKD was detected in 7 (36.8%) out of the 19 patients without OSA (p < 0.003). We conclude that CKD develops significantly more often in patients with OSA than in those without it, and CKD frequency increases with the severity of OSA.
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Hipertensión/complicaciones , Insuficiencia Renal Crónica/complicaciones , Apnea Obstructiva del Sueño/complicaciones , Adulto , Anciano , Femenino , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Pruebas de Función Renal , Masculino , Persona de Mediana Edad , Polisomnografía , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/fisiopatología , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Apnea Obstructiva del Sueño/diagnóstico , Apnea Obstructiva del Sueño/fisiopatologíaRESUMEN
Asthma and chronic obstructive pulmonary disease (COPD) are two of the most common chronic lung diseases worldwide. Distinguishing between these different pulmonary diseases can be difficult in practice because of symptomatic similarities. A definitive diagnosis is essential for correct treatment. This review article presents the different symptoms of these two chronic inflammatory lung diseases following a selective search of the PubMed database for relevant literature published between 1996 and 2012. While cough occurs in both diseases, asthmatics often have a dry cough mainly at night, which is often associated with allergies. In contrast, COPD is usually caused by years of smoking. Paroxysmal dyspnea, which occurs in asthma, is characterized by shortness of breath, while in COPD it occurs during physical exertion in early stages and at rest in later stages of the disease. Asthma often begins in childhood or adolescence, whereas COPD occurs mainly in smokers in later life. It is possible to live with asthma into old age, whereas the life expectancy of patients with COPD is significantly limited. Currently, there is no general curative treatment for either disorder.
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Asma/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Edad de Inicio , Asma/diagnóstico , Asma/inmunología , Asma/terapia , Tos/etiología , Disnea/etiología , Eosinofilia/inmunología , Glucocorticoides/uso terapéutico , Humanos , Inmunoglobulina E/inmunología , Neutrófilos/inmunología , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/inmunología , Enfermedad Pulmonar Obstructiva Crónica/terapia , Fumar , EspirometríaRESUMEN
Older people are often especially susceptible to pneumonia and bacteria may develop resistance to antibiotics quicker in the elderly, whose immune systems gradually diminish. This study analyses, retrospectively, resistance to antibiotics in high-risk elderly patients with fatal pneumonia. Records of all patients aged over 65 who did not survive a bout with pneumonia were gathered from the records of the Department of Pneumology of HELIOS Clinic in Wuppertal, Germany from the period of 2004-2014. Susceptibility testing was executed for the study population, whose pneumonia was triggered by various kinds of bacteria. We detected 936 pneumonia patients of the overall mean age of 68.0 ± 13.6 years, with the following pneumonia types: 461 (49.3 %) community-acquired, 354 (37.8 %) nosocomial-acquired, and 121 (12.9 %) aspiration pneumonia. There were 631 (67.4 %) males and 305 (32.6 %) females there. We identified 672 (71.8 %) patients who had a high risk for pneumonia, especially staphylococcal pneumonia (p < 0.0001). The elderly patients had a higher risk of dying from pneumonia (2.9 odds ratio, 95 % confidence interval 1.8-4.6; p < 0.0001); of the 185 pneumonia-related deaths, 163 (88.1 %) were in the elderly. In those with fatal staphylococcal pneumonia, a high antibiotic resistance rate was found for piperacillin-tazobactam (p = 0.044), cefuroxime (p = 0.026), cefazolin (p = 0.043), levofloxacin (p = 0.018), erythromycin (p = 0.004), and clindamycin (p = 0.025). We conclude that elderly patients with staphylococcal pneumonia show resistance to common antibiotics. However, no significant antibiotic resistance could be ascribed for other types of pneumonia in these patients.
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Antibacterianos/farmacología , Farmacorresistencia Bacteriana , Neumonía Estafilocócica/mortalidad , Staphylococcus/efectos de los fármacos , Anciano , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Cefazolina/farmacología , Cefuroxima/farmacología , Clindamicina/farmacología , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/mortalidad , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/microbiología , Infección Hospitalaria/mortalidad , Eritromicina/farmacología , Femenino , Alemania/epidemiología , Humanos , Levofloxacino/farmacología , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Oportunidad Relativa , Ácido Penicilánico/análogos & derivados , Piperacilina , Combinación Piperacilina y Tazobactam , Neumonía Estafilocócica/tratamiento farmacológico , Neumonía Estafilocócica/microbiología , Estudios RetrospectivosRESUMEN
Central sleep apnea (CSA) is a sleep-related disorder characterized by pauses in breathing during sleep when the brain respiratory network momentarily interrupts transmission of impulses to the respiratory musculature. CSA presents significant problems being an independent risk factor for cardiovascular events and death. There are several available treatment options according to CSA severity. Currently, adaptive servo-ventilation is considered best for CSA patients. The goal of the present study was to retrospectively investigate different treatment methods employed for CSA, such as different modes of ventilation, oxygen therapy, and drugs to determine the most effective one. Data were obtained from hospital records during 2010-2015. The diagnosis of CSA and the optimal treatment method were supported by polysomnography examinations. Devices used during sleep to support breathing included continuous positive airway pressure, bi-level positive airway pressure, or adaptive servo-ventilation. We classified 71 (2.9 %) patients as having CSA from 2,463 patients with sleep-disordered breathing. Of those 71 patients, 54 (76.1 %, 95 % CI 66.2-86.0 %) were male and 17 (23.9 %, 95 % CI 14.0-33.8 %) were female, and they had a mean age of 67.1 ± 14.1. Four (5.6 %) patients underwent a combination therapy, 39 (54.9 %) received a ventilator in proper ventilation mode, 25 (35.2 %) received oxygen therapy, 7 (9.9 %) received medication, and 4 (5.6 %) received no treatment. We conclude that although the majority of patients needed treatment for central sleep apnea, a clear advantage in using ventilators when compared to oxygen therapy or drug therapy could not be found.
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Antagonistas Adrenérgicos alfa/uso terapéutico , Analgésicos Opioides/uso terapéutico , Presión de las Vías Aéreas Positiva Contínua/métodos , Dopaminérgicos/uso terapéutico , Hipnóticos y Sedantes/uso terapéutico , Terapia por Inhalación de Oxígeno/métodos , Antagonistas de la Serotonina/uso terapéutico , Apnea Central del Sueño/terapia , Anciano , Anciano de 80 o más Años , Clozapina/uso terapéutico , Femenino , Humanos , Levodopa/uso terapéutico , Masculino , Mianserina/análogos & derivados , Mianserina/uso terapéutico , Persona de Mediana Edad , Mirtazapina , Polisomnografía , Piridinas/uso terapéutico , Estudios Retrospectivos , Apnea Central del Sueño/diagnóstico , Tiazinas/uso terapéutico , Tilidina/uso terapéutico , Resultado del Tratamiento , ZolpidemRESUMEN
Cannabis is the most widely smoked illicit substance in the world. It can be smoked alone in its plant form, marijuana, but it can also be mixed with tobacco. The specific effects of smoking cannabis are difficult to assess accurately and to distinguish from the effects of tobacco; however its use may produce severe consequences. Cannabis smoke affects the lungs similarly to tobacco smoke, causing symptoms such as increased cough, sputum, and hyperinflation. It can also cause serious lung diseases with increasing years of use. Cannabis can weaken the immune system, leading to pneumonia. Smoking cannabis has been further linked with symptoms of chronic bronchitis. Heavy use of cannabis on its own can cause airway obstruction. Based on immuno-histopathological and epidemiological evidence, smoking cannabis poses a potential risk for developing lung cancer. At present, however, the association between smoking cannabis and the development of lung cancer is not decisive.
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Obstrucción de las Vías Aéreas/etiología , Bronquitis Crónica/etiología , Neoplasias Pulmonares/etiología , Fumar Marihuana/efectos adversos , Neumonía/etiología , Enfermedad Pulmonar Obstructiva Crónica/etiología , Humanos , Medición de Riesgo , Factores de RiesgoRESUMEN
BACKGROUND: The widespread overuse of antibiotics promotes the development of antibiotic resistance in bacteria, which can cause severe illness and constitutes a major public health concern. Haemophilus species are a common cause of community- and nosocomial-acquired pneumonia. The antibiotic resistance of these Gram-negative bacteria can be prevented through the reduction of unnecessary antibiotic prescriptions, the correct use of antibiotics, and good hygiene and infection control. This article examines, retrospectively, antibiotic resistance in patients with community- and nosocomial-acquired pneumonia caused by Haemophilus species. METHODS: The demographic, clinical, and laboratory data of all patients with community- and nosocomial-acquired pneumonia caused by Haemophilus species were collected from the hospital charts at the HELIOS Clinic, Witten/Herdecke University, Wuppertal, Germany, within a study period from 2004 to 2014. Antimicrobial susceptibility testing was performed for the different antibiotics that have been consistently used in the treatment of patients with pneumonia caused by Haemophilus species. RESULTS: During the study period of January 1, 2004, to August 12, 2014, 82 patients were identified with community- and nosocomial-acquired pneumonia affected by Haemophilus species. These patients had a mean age of 63.8 ± 15.5 (60 [73.2%, 95% CI 63.6%-82.8%] males and 22 [26.8%, 95% CI 17.2%-36.4%] females). Haemophilus species had a high resistance rate to erythromycin (38.3%), ampicillin (24.4%), piperacillin (20.8%), cefuroxime (8.5%), ampicillin-sulbactam (7.3%), piperacillin-sulbactam (4.3%), piperacillin-tazobactam (2.5%), cefotaxime (2.5%), and levofloxacin (1.6%). In contrast, they were not resistant to ciprofloxacin in patients with pneumonia (P = 0.016). CONCLUSION: Haemophilus species were resistant to many of the typically used antibiotics. Resistance toward ciprofloxacin was not detected in patients with pneumonia caused by Haemophilus species.
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Antibacterianos/farmacología , Ciprofloxacina/farmacología , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Haemophilus/efectos de los fármacos , Neumonía Bacteriana/microbiología , Anciano , Antibacterianos/uso terapéutico , Ciprofloxacina/uso terapéutico , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/microbiología , Femenino , Alemania , Haemophilus/patogenicidad , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Neumonía Bacteriana/tratamiento farmacológico , Estudios RetrospectivosRESUMEN
OBJECTIVES: Group B Streptococcus is a primary source of pneumonia, which is a leading cause of death worldwide. During the last few decades, there has been news of growing antibiotic resistance in group B streptococci to penicillin and different antibiotic agents. This clinical study retrospectively analyzes antimicrobial resistance in inpatients who were diagnosed with group B streptococcal pneumonia. METHODS: All of the required information from inpatients who were identified to have group B streptococcal pneumonia was sourced from the database at the Department of Internal Medicine of HELIOS Clinic Wuppertal, Witten/Herdecke University, in Germany, from 2004-2014. Antimicrobial susceptibility testing was performed for the different antimicrobial agents that were regularly administered to these inpatients. RESULTS: Sixty-six inpatients with a mean age of 63.3 ± 16.1 years (45 males [68.2%, 95% CI 60.0%-79.4%] and 21 females [31.8%, 95% CI 20.6%-43.0%]) were detected to have group B streptococcal pneumonia within the study period from January 1, 2004, to August 12, 2014. Group B Streptococcus had a high resistance rate to gentamicin (12.1%), erythromycin (12.1%), clindamycin (9.1%), and co-trimoxazole (3.0%), but it was not resistant to penicillin, cefuroxime, cefotaxime, or vancomycin (P < 0.0001). CONCLUSION: No resistance to penicillin, cefuroxime, cefotaxime, or vancomycin was detected among inpatients with pneumonia caused by group B streptococci.
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Farmacorresistencia Bacteriana , Neumonía Bacteriana/tratamiento farmacológico , Neumonía Neumocócica/tratamiento farmacológico , Infecciones Estreptocócicas/tratamiento farmacológico , Streptococcus agalactiae , Anciano , Cefotaxima/farmacología , Cefuroxima/farmacología , Resistencia a las Cefalosporinas , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/microbiología , Femenino , Alemania , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Resistencia a las Penicilinas , Neumonía Bacteriana/microbiología , Neumonía Neumocócica/microbiología , Estudios Retrospectivos , Infecciones Estreptocócicas/microbiología , Streptococcus agalactiae/efectos de los fármacos , Streptococcus agalactiae/aislamiento & purificación , Resistencia a la VancomicinaRESUMEN
Sleep apnea is characterized by pauses in breathing during sleep. There are three forms: central, obstructive, and complex, or mixed sleep apnea. Central sleep apnea, a manifestation of respiratory instability in many clinical conditions and with a variety of causes, is the result of a temporary cessation of breathing in which the inhibitory influences favoring the instability predominate over excitatory influences favoring stable breathing. In contrast to central sleep apnea, according to the published data from previous studies, an association exists between obstructive sleep apnea and various comorbidities, especially chronic obstructive pulmonary disease. This article examines retrospectively the possible association of central sleep apnea with special sleep-related symptoms and various co-morbidities. Data of all patients with different types of central sleep apnea were collected from our hospital charts within the Department of Pneumology, HELIOS Clinic, University of Witten/Herdecke, Wuppertal, Germany, within the study period of January 1, 2011 to September 19, 2014. After clinical examination, all patients underwent polysomnography in our sleep laboratory. We identified a total of 60 (3.5 %) patients with central sleep apnea from 1722 patients with assumed sleep disordered breathing of the mean age of 68.2 ± 13.7 years (44 males - 73.3 %, 95 % CI 0.6-0.9 and 16 females - 26.7 %, 95 % CI 0.2-0.4). Typical symptoms of sleep-disordered breathing were not observed. A relation to co-morbidities was not found. Central sleep apnea was often diagnosed in the elderly. A direct association between central sleep apnea and symptoms of sleep-disordered breathing and various co-morbidities was not detected. This is in direct contrast to the obstructive sleep apnea syndrome.
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Apnea Central del Sueño/complicaciones , Apnea Central del Sueño/fisiopatología , Anciano , Analgésicos Opioides/efectos adversos , Enfermedades Cardiovasculares/epidemiología , Comorbilidad , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Polisomnografía , Respiración , Estudios Retrospectivos , Factores de Riesgo , Apnea Central del Sueño/diagnóstico , Fases del Sueño , Análisis de SupervivenciaRESUMEN
Background: Sleep apnea, a prevalent global health issue, is characterized by repeated interruptions in breathing during sleep. This systematic review aggregates global data to outline a comprehensive analysis of its associated risk factors. Purpose: The systematic review underscores the global prevalence of sleep apnea and the universal importance of its early detection and management by delineating key risk factors contributing to its development. Material and Methods: We conducted a thorough systematic review of international medical databases up to July 31, 2023, including PubMed, Medline, and Cochrane Library, to ensure a wide-ranging collection of data reflective of various populations. Results: The systematic review identifies several risk factors such as obesity, age, gender, neck circumference, family history, smoking, alcohol use, underlying medical conditions, and nasal congestion, highlighting their prevalence across diverse demographics globally. Conclusion: Emphasizing lifestyle modifications and proactive interventions, our findings advocate for global health strategies to mitigate the risk of sleep apnea and enhance sleep health worldwide.
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BACKGROUND: This systematic review evaluated the health risks of electronic cigarettes (e-cigarettes) compared to traditional cigarettes. It examines various studies and research on the subject to provide a comprehensive analysis of potential health risks associated with both smoking methods. METHODS: The systematic review, incorporating searches in PubMed, Scopus, Web of Science, and the Cochrane Library up to July 2023, examines the results obtained in relevant studies, and provides a critical discussion of the results. RESULTS: E-cigarettes exhibit reduced exposure to harmful toxins compared to traditional cigarettes. CONCLUSION: However, concerns persist regarding respiratory irritation and potential health risks, especially among youth, emphasizing the need for comprehensive, long-term research and protective legislation.
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Sistemas Electrónicos de Liberación de Nicotina , Productos de Tabaco , Adolescente , Humanos , Nicotina/efectos adversos , Productos de Tabaco/efectos adversos , FumarRESUMEN
Tuberculosis remains a significant global health challenge. Tuberculosis affects millions of individuals worldwide. Early detection of tuberculosis plays a relevant role in the management of treatment of tuberculosis. This systematic review will analyze the findings of several published studies on the topic of the early detection of tuberculosis. This systematic review highlights their methodologies and limitations as well as their contributions to our understanding of this pressing issue. Early detection of tuberculosis can be achieved through tuberculosis screening for contacts. Comprehensive health education for household contacts can be used as early detection. The in-house deep learning models can be used in the X-ray used for automatic detection of tuberculosis. Interferon gamma release assay, routine passive and active case detection, portable X-ray and nucleic acid amplification testing, and highly sensitive enzyme-linked immunosorbent assay tests play critical roles in improving tuberculosis detection.
RESUMEN
Depression, anxiety, and panic disorders are common in chronic obstructive pulmonary disease (COPD) and important for the further course of the disease, as they are associated with increased hospital admissions, longer hospital stays, more frequent doctor visits, and a worsened quality of life. There are also indications of premature death in affected patients. Therefore, knowledge of the risk factors for depression in COPD patients is all the more important for early detection and treatment. Hence, Embase, the Cochrane Library, and the MEDLINE/PubMed databases were analyzed for studies on these risk factors. The main factors are as follows: female gender; older/younger age; living alone; higher education; unemployment; retirement; a low quality of life; social isolation; high/low income; high cigarette and alcohol consumption; poor physical fitness; severe respiratory symptoms; high/low body mass index, airway obstruction, dyspnea, exercise capacity index scores; and comorbidities (mainly heart disease, cancer, diabetes, and stroke). This article presents the analyzed medical literature.
Asunto(s)
Depresión , Enfermedad Pulmonar Obstructiva Crónica , Femenino , Humanos , Comorbilidad , Depresión/epidemiología , Depresión/etiología , Disnea , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/terapia , Calidad de Vida , Factores de RiesgoRESUMEN
Type 2 diabetes and obstructive sleep apnea (OSA) are diseases with high prevalence and major public health impact. There is evidence that regular snoring and OSA are independently associated with alterations in glucose metabolism. Thus, OSA might be a risk factor for the development of type 2 diabetes. Possible causes might be intermittent hypoxia and sleep fragmentation, which are typical features of OSA. OSA might also be a reason of ineffective treatment of type 2 diabetes. There is further evidence that the treatment of OSA by continuous positive airway pressure (CPAP) therapy might correct metabolic abnormalities in glucose metabolism. It is assumed that this depends on therapy compliance to CPAP. On the other hand, there are also hints in the literature that type 2 diabetes per se might induce sleep apnea, especially in patients with autonomic neuropathy. Pathophysiological considerations open up new insights into that problem. Based on the current scientific data, clinicians have to be aware of the relations between the two diseases, both from the sleep medical and the diabetological point of view. The paper summarizes the most important issues concerning the different associations of OSA and type 2 diabetes.