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In this invited review, we discuss some unresolved and controversial issues concerning premature (<40 years) or early (40-45 years) bilateral oophorectomy. First, we clarify the terminology. Second, we summarize the long-term harmful consequences of bilateral oophorectomy. Third, we discuss the restrictive indications for bilateral oophorectomy in premenopausal women to prevent ovarian cancer that are justified by the current scientific evidence. Fourth, we explain the importance of estrogen replacement therapy when bilateral oophorectomy is performed. Hormone replacement therapy is indicated after bilateral oophorectomy until the age of expected natural menopause like in premature or early primary ovarian insufficiency. Fifth, we discuss the relationship between adverse childhood experiences, adverse adult experiences, mental health, gynecologic symptoms and bilateral oophorectomy. The acceptance and popularity of bilateral oophorectomy over several decades, and its persistence even in the absence of supporting scientific evidence, suggest that non-medical factors related to sex, gender, reproduction, cultural beliefs and socioeconomic structure are involved. We discuss some of these non-medical factors and the need for more research in this area.
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Menopausa Precoce , Insuficiência Ovariana Primária , Adulto , Terapia de Reposição de Estrogênios , Feminino , Humanos , Menopausa , Ovariectomia , Insuficiência Ovariana Primária/tratamento farmacológicoRESUMO
AIMS: The work aimed at developing and evaluating practically relevant methods for testing of disinfectants on contaminated personal protective equipment (PPE). METHODS AND RESULTS: Carriers were prepared from PPE fabrics and contaminated with Bacillus subtilis spores. Peracetic acid (PAA) was applied as a suitable disinfectant. In method 1, the contaminated carrier was submerged in PAA solution; in method 2, the contaminated area was covered with PAA; and in method 3, PAA, preferentially combined with a surfactant, was dispersed as a thin layer. In each method, 0·5-1% PAA reduced the viability of spores by a factor of ≥6 log10 within 3 min. The technique of the most realistic method 3 proved to be effective at low temperatures and also with a high organic load. Vaccinia virus and Adenovirus were inactivated with 0·05-0·1% PAA by up to ≥6 log10 within 1 min. The cytotoxicity of ricin was considerably reduced by 2% PAA within 15 min of exposure. CONCLUSIONS: PAA/detergent mixture enabled to cover hydrophobic PPE surfaces with a thin and yet effective disinfectant layer. SIGNIFICANCE AND IMPACT OF THE STUDY: The test methods are objective tools for estimating the biocidal efficacy of disinfectants on hydrophobic flexible surfaces.
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Desinfetantes/farmacologia , Desinfecção/métodos , Ácido Peracético/farmacologia , Equipamento de Proteção Individual/microbiologia , Bacillus subtilis/efeitos dos fármacos , Bacillus subtilis/crescimento & desenvolvimento , Desinfecção/instrumentaçãoRESUMO
Meticillin-resistant Staphylococcus aureus (MRSA) is a major cause of healthcare-associated infections in Europe. Many examples have demonstrated that the spread of MRSA within healthcare settings can be reduced by targeted infection control measures. The aim of this systematic literature analysis and review was to summarise the evidence for the use of bacterial cultures for active surveillance the benefit of rapid screening tests, as well as the use of decolonisation therapies and different types of isolation measures. We included 83 studies published between 2000 and 2012. Although the studies reported good evidence supporting the role of active surveillance followed by decolonisation therapy, the effectiveness of single-room isolation was mostly shown in non-controlled studies, which should inspire further research regarding this issue. Overall, this review highlighted that when planning the implementation of preventive interventions, there is a need to consider the prevalence of MRSA, the incidence of infections, the competing effect of standard control measures (e.g. hand hygiene) and the likelihood of transmission in the respective settings of implementation.
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Antibacterianos/uso terapêutico , Infecção Hospitalar/prevenção & controle , Controle de Infecções/métodos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Meticilina/uso terapêutico , Infecções Estafilocócicas/prevenção & controle , Infecção Hospitalar/microbiologia , Infecção Hospitalar/transmissão , Desinfecção das Mãos , Humanos , Controle de Infecções/normas , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/transmissãoRESUMO
Ultrasensitive assays have been developed which enable biomarkers of Alzheimer's disease pathology and neurodegeneration to be measured in blood. These biomarkers can aid in diagnosis, and have been used to predict risk of cognitive decline and Alzheimer's disease. The ease and cost-effectiveness of blood collections means that these biomarkers could be applied more broadly in population-based screening, however it is critical to first understand what other factors could affect blood biomarker levels. The aim of this review was to determine the extent that sociodemographic, lifestyle and health factors have been associated with blood biomarkers of Alzheimer's disease and neuropathology. Of the 32 studies included in this review, all but one measured biomarker levels in plasma, and age and sex were the most commonly investigated factors. The most consistent significant findings were a positive association between age and neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP), and females had higher GFAP than men. Apolipoprotein ε4 allele carriers had lower Aß42 and Aß42/40 ratio. Body mass index was negatively associated with GFAP and NfL, and chronic kidney disease with higher levels of all biomarkers. Too few studies have investigated other chronic health conditions and this requires further investigation. Given the potential for plasma biomarkers to enhance Alzheimer's disease diagnosis in primary care, it is important to understand how to interpret the biomarkers in light of factors that physiologically impact blood biomarker levels. This information will be critical for the establishment of reference ranges and thus the correct interpretation of these biomarkers in clinical screening.
Assuntos
Doença de Alzheimer , Biomarcadores , Humanos , Doença de Alzheimer/sangue , Doença de Alzheimer/diagnóstico , Biomarcadores/sangue , Doença Crônica , Peptídeos beta-Amiloides/sangue , Masculino , Feminino , Fatores Sexuais , Fatores Sociodemográficos , Proteínas de Neurofilamentos/sangue , Fatores Etários , Proteína Glial Fibrilar Ácida/sangue , Doenças Neurodegenerativas/sangue , Doenças Neurodegenerativas/diagnósticoRESUMO
Genipa americana (Rubiaceae) is a fruit tree with broad phytogeographic domain and suitable for different silvicultural systems in the tropics. The knowledge associated with the relative growth rate of species such as G. americana, provides important guidelines for the effective establishment and survival of seedlings after planting in the field. In this study we investigated differences in growth, biomass allocation and photosynthesis of seedlings originating from different mother plants of G. americana in southern Bahia, Brazil. For this, we evaluated fifteen variables associated with carbon balance at the whole plant and leaf scales of twelve G. americana progenies. All seedlings grew over a period of 198 days under similar microclimatic conditions with approximately 65% full sun. Our results showed significant differences in the relative growth rates (RGR), with the highest and lowest mean values being 29.0 and 38.0 mg g-1 day-1, respectively. Differences in RGR between G. americana progenies were highly related to differences in biomass allocation at both whole plant and leaf scales. From a practical point of view, we demonstrate that the selection of mother plants to produce seedlings with higher growth rates, and consequently greater establishment capacity in field plantings, can be made from evaluations of growth and biomass allocation variables at the whole plant scale.
Assuntos
Biomassa , Fotossíntese , Folhas de Planta , Rubiaceae , Plântula , Folhas de Planta/crescimento & desenvolvimento , Rubiaceae/crescimento & desenvolvimento , Rubiaceae/fisiologia , Plântula/crescimento & desenvolvimento , Fotossíntese/fisiologia , BrasilRESUMO
Background: Emerging evidence suggests that a number of factors can influence blood-based biomarker levels for Alzheimer's disease (AD) and Alzheimer's related dementias (ADRD). We examined the associations that demographic and clinical characteristics have with AD/ADRD blood-based biomarker levels in an observational continuation of a clinical trial cohort of older individuals with type 2 diabetes and overweight or obesity. Methods: Participants aged 45-76 years were randomized to a 10-year Intensive Lifestyle Intervention (ILI) or a diabetes support and education (DSE) condition. Stored baseline and end of intervention (8-13 years later) plasma samples were analyzed with the Quanterix Simoa HD-X Analyzer. Changes in Aß42, Aß40, Aß42/Aß40, ptau181, neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) were evaluated in relation to randomization status, demographic, and clinical characteristics. Results: In a sample of 779 participants from the Look AHEAD cohort, we found significant associations between blood-based biomarkers for AD/ADRD and 15 of 18 demographic (age, gender, race and ethnicity, education) and clinical characteristics (APOE, depression, alcohol use, smoking, body mass index, HbA1c, diabetes duration, diabetes treatment, estimated glomerular filtration rate, hypertension, and history of cardiovascular disease) . Conclusions: Blood-based biomarkers of AD/ADRD are influenced by common demographic and clinical characteristics. These factors should be considered carefully when interpreting these AD/ADRD blood biomarker values for clinical or research purposes.
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[This corrects the article DOI: 10.14283/jarlife.2024.1.].
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To investigate how and to what extent there are differences in the photosynthetic plasticity of trees in response to different light environments, six species from three successional groups (late successional, mid-successional, and pioneers) were exposed to three different light environments [deep shade - DS (5% full sunlight - FS), moderate shade - MS (35% FS) and full sunlight - FS]. Maximum net photosynthesis (Amax), leaf N partitioning, stomatal, mesophile, and biochemical limitations (SL, ML, and BL, respectively), carboxylation velocity (Vcmax), and electron transport (Jmax) rates, and the state of photosynthetic induction (IS) were evaluated. Higher values of Amax, Vcmax, and Jmax in FS were observed for pioneer species, which invested the largest amount of leaf N in Rubisco. The lower IS for pioneer species reveals its reduced ability to take advantage of sunflecks. In general, the main photosynthetic limitations are diffusive, with SL and ML having equal importance under FS, and ML decreasing along with irradiance. The leaf traits, which are more determinant of the photosynthetic process, respond independently in relation to the successional group, especially with low light availability. An effective partitioning of leaf N between photosynthetic and structural components played a crucial role in the acclimation process and determined the increase or decrease of photosynthesis in response to the light conditions.
Assuntos
Fotossíntese , Folhas de Planta , Luz Solar , Árvores , Fotossíntese/fisiologia , Árvores/fisiologia , Folhas de Planta/fisiologia , Folhas de Planta/efeitos da radiação , Folhas de Planta/metabolismo , Luz , Brasil , Aclimatação/fisiologia , Transporte de Elétrons , Ribulose-Bifosfato Carboxilase/metabolismo , Nitrogênio/metabolismoRESUMO
The recognition of infection clusters via determination of clonal relationships between pathogen isolates represents the major aim of pathogen subtyping during outbreaks. In addition, a continuing and comprehensive subtyping of pathogen isolates is a prerequisite for early recognition of changes within pathogen populations, especially of new pathogen types and variants. Here, in an exemplary manner, we outline the current practice in Germany for three important agents of food-borne infections, Salmonella enterica, Listeria monocytogenes and enterohemorrhagic Escherichia coli (EHEC). Pathogen subtyping is mostly performed in specialized laboratories. Collection of representative pathogen isolates is therefore critical for comprehensive pathogen surveillance. Salmonella and L. monocytogenes are usually isolated by sample culturing in primary diagnostic laboratories and a considerable number are sent to the respective reference laboratories for further subtyping. However, the current situation in terms of EHEC is problematic. As the detection of shiga toxin (or gene) is sufficient for diagnosis and case reporting, primary diagnostic laboratories actually rarely isolate EHEC; therefore, a concept for appropriate retrieval of isolates is needed to ensure effective EHEC surveillance in Germany.
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Infecções Bacterianas/microbiologia , Surtos de Doenças/prevenção & controle , Microbiologia de Alimentos/métodos , Doenças Transmitidas por Alimentos/microbiologia , Tipagem Molecular/métodos , Vigilância da População/métodos , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Análise de Alimentos/métodos , Análise de Alimentos/estatística & dados numéricos , Contaminação de Alimentos/análise , Contaminação de Alimentos/prevenção & controle , Contaminação de Alimentos/estatística & dados numéricos , Microbiologia de Alimentos/estatística & dados numéricos , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/epidemiologia , Alemanha/epidemiologia , HumanosRESUMO
From May to July 2011 [corrected] the world's largest outbreak of hemolytic uremic syndrome (HUS) occurred in northern Germany with dramatic consequences for the population, the health care system and the food industry. In the following we examine the detection of the outbreak, epidemic management and related public communication aspects based on scientific publications, media reports as well as own and new data analyses. The subsequent 17 recommendations concern issues such as participation in and implementation of existing and new surveillance systems particularly with respect to physicians, broad application of finely tuned microbiological typing, improved personnel capacity and crisis management structures within the public health service and evidence-based communication by administrations and scientific associations. Outbreaks of similar dimensions can inevitably occur again and result in costs which will far exceed investments needed for early detection and control. This societal balance should be taken into account in spite of limited resources in the public health sector.
Assuntos
Surtos de Doenças/prevenção & controle , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/prevenção & controle , Comunicação em Saúde/métodos , Síndrome Hemolítico-Urêmica/epidemiologia , Síndrome Hemolítico-Urêmica/prevenção & controle , Vigilância da População/métodos , Surtos de Doenças/estatística & dados numéricos , Infecções por Escherichia coli/epidemiologia , Síndrome Hemolítico-Urêmica/microbiologia , HumanosRESUMO
OBJECTIVE: The use of psychotropic medications in Alzheimer's disease (AD) has been associated with both deleterious and potentially beneficial outcomes. We examined the longitudinal association of psychotropic medication use with cognitive, functional, and neuropsychiatric symptom (NPS) trajectories among community-ascertained incident AD cases from the Cache County Dementia Progression Study. METHODS: A total of 230 participants were followed for a mean of 3.7 years. Persistency index (PI) was calculated for all antidepressants, selective serotonin reuptake inhibitors (SSRIs), antipsychotics (atypical and typical), and benzodiazepines as the proportion of observed time of medication exposure. Mixed-effects models were used to examine the association between PI for each medication class and Mini-Mental State Exam (MMSE), Clinical Dementia Rating Sum of Boxes (CDR-Sum), and Neuropsychiatric Inventory - Total (NPI-Total) trajectories, controlling for appropriate demographic and clinical covariates. RESULTS: At baseline, psychotropic medication use was associated with greater severity of dementia and poorer medical status. Higher PI for all medication classes was associated with a more rapid decline in MMSE. For antidepressant, SSRI, benzodiazepine, and typical antipsychotic use, a higher PI was associated with a more rapid increase in CDR-Sum. For SSRIs, antipsychotics, and typical antipsychotics, a higher PI was associated with more rapid increase in NPI-Total. CONCLUSIONS: Psychotropic medication use was associated with more rapid cognitive and functional decline in AD, and not with improved NPS. Clinicians may tend to prescribe psychotropic medications to AD patients at risk of poorer outcomes, but one cannot rule out the possibility of poorer outcomes being caused by psychotropic medications.
Assuntos
Doença de Alzheimer/tratamento farmacológico , Antidepressivos/uso terapêutico , Antipsicóticos/uso terapêutico , Benzodiazepinas/uso terapêutico , Cognição/efeitos dos fármacos , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Transtornos Cognitivos/tratamento farmacológico , Transtornos Cognitivos/psicologia , Progressão da Doença , Feminino , Humanos , Estudos Longitudinais , Masculino , Testes Neuropsicológicos , Escalas de Graduação PsiquiátricaRESUMO
The epidemiological situation of tuberculosis (TB) in Germany has improved considerably during the past few years. However, those in unprotected contact with infectious tuberculosis patients frequently and/or over longer periods of time and/or intensively continue to have a higher risk for TB infection. Rapid diagnosis, prompt initiation of effective treatment, and adequate infection control measures are of particular importance to prevent infection. The present recommendations depict the essentials of infection control as well as specific measures in the hospital (isolation, criteria for its duration and technical requirements, types of respiratory protection, disinfection measures, waste disposal). The specific requirements for outpatients (medical practice), at home, for ambulance services, and in congregate settings, including prisons, are also addressed. Compared with the previous recommendations the pattern of respiratory protection measures has been simplified. As a rule, hospital staff and those visiting infectious tuberculosis patients are advised to wear respiratory protection that satisfies the criteria of FFP2-masks (DIN EN 149), while patients should wear mouth-nose protectors (surgical masks) in the presence of others and outside the isolation room. A detailed depiction of criteria for isolation and its duration in smear positive and only culturally confirmed pulmonary tuberculosis has been added.
Assuntos
Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Vigilância da População/métodos , Tuberculose/epidemiologia , Tuberculose/prevenção & controle , Alemanha , Humanos , Guias de Prática Clínica como AssuntoRESUMO
Since 2004 the Robert Koch-Institute has supported the formation of regional networks for prevention of the spread of methicillin-resistant Staphylococcus aureus and multiresistant pathogens (MRSA/MRP, EpiBull 5/2005)). The third meeting of the coordinators of the regional MRP networks in Germany took place on 15 and 16 December 2011. A total of 60 representatives of the Public Health Services from 12 states participated. It must be emphasized that in the meantime many successfully established networks are active and not all coordinators of existing networks could participate merely due to the organizational format. Interested parties can obtain a good overview via a link to the corresponding internet homepage of each state under http://www.rki.de â Infektionsschutz â Krankenhaushygiene â Regionale Netzwerke. In summary it was clear that the number and the activity of regional MRP networks in Germany have further increased. The networks can synergistically benefit from important experiences through the different individual focal points of each network and a corresponding exchange of ideas.
Assuntos
Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/prevenção & controle , Controle de Doenças Transmissíveis/organização & administração , Redes Comunitárias/organização & administração , Infecção Hospitalar/prevenção & controle , Farmacorresistência Bacteriana Múltipla , Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas/prevenção & controle , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Estudos Transversais , Alemanha , Humanos , Higiene/normas , Internet , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologiaRESUMO
Healthcare-associated infections not only affect patients in acute care hospitals but also patients in need of long-term care. As the elderly are generally most affected, the demographic change in Germany faces a range of increasing challenges in the field of infection control. The ageing process itself is accompanied by several physiological and pathological changes which may result in an increase in the risk of infectious diseases. Elderly living in long-term care facilities (LTCFs) may in addition be exposed to further risks due to their everyday life in a community, nursing care and the, to some extent, inappropriate use of antibiotics. Bacteria that have become resistant to commonly used antimicrobial agents are meanwhile prevalent in nursing homes. Caregivers often feel left alone when facing the task of achieving a balance between the need for a comfortable familiar environment and the application of infection control measures according to a resolute prevention strategy. This review aims to give an overview about the characteristics of infections among the elderly, especially with respect to long-term care.
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Infecções Bacterianas/microbiologia , Infecções Bacterianas/prevenção & controle , Infecção Hospitalar/microbiologia , Infecção Hospitalar/prevenção & controle , Farmacorresistência Bacteriana Múltipla , Instituição de Longa Permanência para Idosos , Casas de Saúde , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/administração & dosagem , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/epidemiologia , Controle de Doenças Transmissíveis/métodos , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Estudos Transversais , Feminino , Alemanha , Humanos , Assistência de Longa Duração , Masculino , Pessoa de Meia-Idade , Dinâmica PopulacionalRESUMO
Rehabilitation facilities often apply the same standards for management of methicillin-resistant Staphylococcus aureus (MRSA) carriers as acute care hospitals. This makes it difficult to ensure access to the facilities and adequate rehabilitation for carriers. A working group of the Bavarian state committee for multiresistant pathogens addressed these problems by a systematic review of literature, expert group meetings and evaluation of existing hygiene plans. Thereby a model hygiene plan for rehabilitation facilities concerning management of MRSA carriers was derived. The management is based on physician risk assessment blending standards applied in acute and long-term care facilities. For rehabilitation typical risk scenario examples of risk analyses are given. The preventive measures are based on the respective objectives of protection. The risk analysis which gives the basis for the model hygiene plan described in this paper gives equal weight to two main objectives of protection: infection control and medical rehabilitation.
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Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/normas , Infecção Hospitalar/microbiologia , Infecção Hospitalar/prevenção & controle , Higiene , Staphylococcus aureus Resistente à Meticilina , Centros de Reabilitação/normas , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/prevenção & controle , Portador Sadio/microbiologia , Portador Sadio/prevenção & controle , Infecção Hospitalar/transmissão , Reservatórios de Doenças , Alemanha , Desinfecção das Mãos/normas , Humanos , Assistência de Longa Duração , Programas de Rastreamento/organização & administração , Programas de Rastreamento/normas , Gestão de Riscos/métodos , Gestão de Riscos/normas , Infecções Estafilocócicas/transmissãoRESUMO
The epidemiological situation of tuberculosis (TB) in Germany has improved considerably during the past few years. However, those in unprotected contact with infectious tuberculosis patients frequently and/or over longer periods of time and/or intensively continue to have a higher risk for TB infection. Rapid diagnosis, prompt initiation of effective treatment, and adequate infection control measures are of particular importance to prevent infection. The present recommendations depict the essentials of infection control as well as specific measures in the hospital (isolation, criteria for its duration and technical requirements, types of respiratory protection, disinfection measures, waste disposal). The specific requirements for outpatients (medical practice), at home, for ambulance services, and in congregate settings, including prisons, are also addressed. Compared with the previous recommendations the pattern of respiratory protection measures has been simplified. As a rule, hospital staff and those visiting infectious tuberculosis patients are advised to wear respiratory protection that satisfies the criteria of FFP2-masks (DIN EN 149), while patients should wear mouth-nose protectors (surgical masks) in the presence of others and outside the isolation room. A detailed depiction of criteria for isolation and its duration in smear positive and only culturally confirmed pulmonary tuberculosis has been added.
Assuntos
Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Vigilância da População/métodos , Guias de Prática Clínica como Assunto , Tuberculose/epidemiologia , Tuberculose/prevenção & controle , Alemanha , HumanosRESUMO
BACKGROUND: Brain accumulation of amyloid-ß is a hallmark event in Alzheimer's disease (AD) whose underlying mechanisms are incompletely understood. Case-control genome-wide association studies have implicated numerous genetic variants in risk of clinically diagnosed AD dementia. OBJECTIVE: To test for associations between case-control AD risk variants and amyloid PET burden in older adults, and to assess whether a polygenic measure encompassing these factors would account for a large proportion of the unexplained variance in amyloid PET levels in the wider population. METHODS: We analyzed data from the Mayo Clinic Study of Aging (MCSA) and the Alzheimer's Disease Neuroimaging Initiative (ADNI). Global cortical amyloid PET burden was the primary outcome. The 38 gene variants from Wightman et al. (2021) were analyzed as predictors, with PRSice-2 used to assess the collective phenotypic variance explained. RESULTS: Known AD risk variants in APOE, PICALM, CR1, and CLU were associated with amyloid PET levels. In aggregate, the AD risk variants were strongly associated with amyloid PET levels in the MCSA (pâ=â1.51×10-50) and ADNI (pâ=â3.21×10-64). However, in both cohorts the non-APOE variants uniquely contributed only modestly (MCSAâ=â2.1%, ADNIâ=â4.4%) to explaining variation in amyloid PET levels. CONCLUSION: Additional case-control AD risk variants added only modestly to APOE in accounting for individual variation in amyloid PET burden, results which were consistent across independent cohorts with distinct recruitment strategies and subject characteristics. Our findings suggest that advancing precision medicine for dementia may require integration of strategies complementing case-control approaches, including biomarker-specific genetic associations, gene-by-environment interactions, and markers of disease progression and heterogeneity.
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Doença de Alzheimer , Amiloidose , Idoso , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/genética , Amiloide/genética , Peptídeos beta-Amiloides/genética , Apolipoproteínas E/genética , Biomarcadores , Estudo de Associação Genômica Ampla , Humanos , Herança Multifatorial , Tomografia por Emissão de PósitronsRESUMO
The development of infections in elderly people living in long-term care facilities may have manifold causes. Infections are often treated with an antibiotic which can trigger the selection of multirestistant microorganisms and, therefore, represents an additional risk factor. In Germany as well as in other European countries, only a few prevalence studies on healthcare-associated infections (HCAI) in long-term care facilities have been performed and there is no continuous surveillance established for HCAI and antibiotic treatment. Therefore, the European prevalence study HALT (healthcare-associated infections in long-term care) was initiated to collect data of HCAI, antibiotic use, and the antibiotic resistance of microorganisms in long-term care facilities. From Germany, 73 institutions participated in the HALT project. The overall prevalence for an optional HCAI (at least one symptom) was 1.6 (CI 1.09-2.03) and for HCAI identified by the modified McGeer criteria 0.79 (CI 0.62-1.04). The overall prevalence for antibiotic use was 1.15 (CI 0.73-1.57). In the present paper, the German results of the HALT project are presented.
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Infecção Hospitalar/epidemiologia , Assistência de Longa Duração , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/etiologia , Infecção Hospitalar/prevenção & controle , Estudos Transversais , Avaliação da Deficiência , Farmacorresistência Bacteriana Múltipla , Uso de Medicamentos/estatística & dados numéricos , Europa (Continente) , Feminino , Alemanha , Humanos , Incidência , Masculino , Vigilância da População , Fatores de RiscoRESUMO
Root deformation (RD) caused by errors in the pricking out process are irreversible and very difficult to detect in container-grown seedlings at the time of planting in the field. The objective of this study was to evaluate the effects of RD on leaf gas exchange, growth, biomass allocation and mineral nutrition of G. americana seedlings during the recovery phase after soil flooding. Four-months-old seedlings, with and without RD, were flooded for 42 days and their recovery was evaluated 28 days after soil drainage. There were no significant interactions between RD and soil flooding for all leaf gas exchange, growth and mineral nutrition after soil drainage, with the exception of leaf P concentrations. In plants with no RD, the P concentration in leaves of non-flooded plants was significantly higher than that of plants with RD. Soil flooding and RD did not influence leaf or root N concentrations or whole-plant N content. RD increased the K concentration in the roots, but not in the leaves. Changes in the nutrient concentrations in leaves and roots indicate that RD may affect physiological performance of seedlings after planting in the field.
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Plântula , Solo , Inundações , Minerais , Folhas de Planta , Raízes de PlantasRESUMO
Facultative intracellular bacteria induce specific T cell responses of both the CD4+ and the CD8+ subsets. The immunohistological study of the tissue responses to Listeria monocytogenes in T cell subset-depleted, Listeria-primed mice revealed that CD4+ cells not only represent the predominant lymphocyte population in granulomatous lesions but mediate the attraction and accumulation of blood-borne monocytes into inflammatory foci. On the other hand, CD8+ T cells are able to mediate protection in the absence of CD4+ T cells, invading monocytes, and granulomatous inflammation, and therefore appear to activate resident macrophages for listericidal activity.