ABSTRACT
Corynebacterium striatum is emerging as an opportunistic pathogen in immunocompromised hosts. End-stage renal disease remains an underappreciated state of immunocompromise. We present a series of individuals with end-stage kidney disease on hemodialysis who developed Corynebacterium striatum bacteremia, which was initially thought to be a contaminant, but eventually recognized as the culprit pathogen. We review the bacteriology of C. striatum, increasing resistance, as well as known cases of C. striatum bacteremia in the setting of end-stage renal disease. These cases highlight the importance of a high index of suspicion when interpreting bacterial cultures in patients with end-stage renal disease.
Subject(s)
Bacteremia , Corynebacterium Infections , Kidney Failure, Chronic , Anti-Bacterial Agents/therapeutic use , Corynebacterium , Corynebacterium Infections/drug therapy , HumansABSTRACT
OBJECTIVE: To compare a cohort of transferred pediatric orthopaedic patients with orthopaedic patients who primarily presented to a Level 1 pediatric emergency department to identify risk factors for transfer. DESIGN: Retrospective cohort study. SETTING: Level 1 trauma center in New York. PATIENTS: The cohort consisted of patients younger than 18 years who presented to 1 Level 1 pediatric trauma center between January 1, 2013, and December 31, 2013, with an orthopaedic fracture diagnosis code (ICD-9 805.0-839.9). The control group included the patients who presented to that hospital primarily, and the study group included patients who were transferred to that same hospital from another institution. INTERVENTION: Demographic and injury-related data [age, sex, mechanism of injury, location of injury, injury severity score, and insurance status] were collected. MAIN OUTCOME MEASUREMENTS: Regression analysis was performed to assess for predictors of transfer to a Level 1 hospital. Subgroup analysis examined whether transfers were appropriate, based on the type of injury. RESULTS: There were 1064 patients in the nontransfer group and 67 patients in the transfer group. Transferred patients were more likely to have surgery within 24 hours (39.42% vs. 2.63%) and were more likely to have no insurance or Medicaid (50.75% vs. 33.24%). Injury severity score and insurance status were independent predictors for transfer. CONCLUSIONS: This study indicates that injury severity is the primary predictor in deciding to transfer a pediatric patient; however, insurance status may play a role in that decision. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Subject(s)
Emergency Service, Hospital/statistics & numerical data , Fractures, Bone/diagnosis , Patient Transfer/organization & administration , Trauma Centers/statistics & numerical data , Adolescent , Child , Child, Preschool , Female , Follow-Up Studies , Fractures, Bone/therapy , Humans , Injury Severity Score , Male , New York , Retrospective Studies , Risk FactorsABSTRACT
The utilization of unnatural amino acids (UAAs) in bioconjugations is ideal due to their ability to confer a degree of bioorthogonality and specificity. In order to elucidate optimal conditions for the preparation of bioconjugates with UAAs, we synthesized 9 UAAs with variable methylene tethers (2-4) and either an azide, alkyne, or halide functional group. All 9 UAAs were then incorporated into green fluorescent protein (GFP) using a promiscuous aminoacyl-tRNA synthetase. The different bioconjugations were then analyzed for optimal tether length via reaction with either a fluorophore or a derivatized resin. Interestingly, the optimal tether length was found to be dependent on the type of reaction. Overall, these findings provide a better understanding of various parameters that can be optimized for the efficient preparation of bioconjugates.
Subject(s)
Amino Acids/chemistry , Amino Acids/chemical synthesis , Green Fluorescent Proteins/chemistry , Alkynes/chemistry , Azides/chemistry , Chemistry Techniques, Synthetic , Halogens/chemistry , Models, Molecular , Protein Structure, SecondaryABSTRACT
The therapeutic importance of microRNA (miRNA) regulation has recently been realized as these small, noncoding RNAs have been demonstrated to be involved with a plethora of diseases and disorders. Due to the complex miRNA maturation process, the expression of these important biomolecules can be manipulated at various stages of the pathway. This review examines both in vivo and in vitro mechanisms and assays that have been developed to regulate miRNA levels. Modulation of miRNA maturation can be accomplished via several therapeutic agents, including small molecules and oligonucleotides, in both specific and nonspecific fashions. Due to the relevance of miRNAs, these novel therapeutic approaches represent new tools for the treatment of various cancers and other deleterious disorders.
