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Purpose: Information about dynamic changes occurring in the parameters and morphology of erythrocytes and platelets during the coronavirus disease 2019 (COVID-19) infection and convalescence is scarce. To explore potential associations between dynamic erythrocyte and platelet parameters, morphological changes, and the course or severity of the disease is essential. Patients and Methods: From January 17th, 2020, to February 20th, 2022, we followed up on 35 patients with non-severe and 11 patients with severe COVID-19 following their discharge. We collected clinical features, dynamic complete blood count (CBC), and peripheral blood smears (PBS) and analyzed parameter and morphological changes of erythrocytes and platelets depending on the course or severity of the disease. The course of the disease included four periods, namely onset (T1), discharge (T2), 1-year follow-up (T3), and 2-year follow-up (T4). Results: Red blood cell (RBC) counts and hemoglobin were the lowest in T2, followed by T1, and lower in T1 and T2 than in T3 and T4. Inversely, the red blood cell distribution width (RDW) was the highest in T2, followed by T1, and higher than in T3 and T4. Compared to non-severe patients, the platelet of severe patients was lower in T1 and T2. In contrast, the mean platelet volume (MPV) and platelet distribution width (PDW) tended to be higher in severe patients. Similarly, anisocytosis was more common in peripheral blood smears at early stages and in severe patients. Finally, large platelets were more common in severe patients. Conclusion: Anisocytosis of erythrocytes and large platelets are found in patients with severe COVID-19, these changes may help primary hospitals to identify patients with a high risk of severe COVID-19 at an early stage.
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Waste-activated sludge (WAS) is regarded as a source of hazardous waste pollution from sewage treatment plants. To efficiently deal with WAS, vortex cavitation circulating fluidised grinding technology (VCCFGT) was proposed as a novel circulating fluidisation technology (CFT) to disintegrate WAS. To be specific, we investigated the effects of disintegration duration, pressure, and filling ratio of mill balls on sludge disintegration. The results of chemical and physical evaluation showed that the values of soluble chemical oxygen demand (SCOD), disintegration degree (DDSCOD), DNA, protein, carbohydrate, and NH4+-N increased with the increase in the filling ratio of the mill balls. Under a pressure and filling ratio of 0.30 MPa and 1.6%, respectively, the maximum effect was achieved after 60 min of treatment. Compared to those in the treatment without mill balls, the values of SCOD, DDSCOD, DNA, protein, carbohydrate, and NH4+-N in the treatment using mill balls increased by 218, 229, 230, 177, 371, and 190%, respectively. As a result of this technology, the temperature of the sludge dramatically increased, rising approximately 42.9 °C. Compared to that of the raw sludge, the sludge particle size after treatment was reduced by 83.25% at most, and the morphology of the sludge comprised smaller flocs. Compared to that of the ball-milling method, the mill balls filling ratio of VCCFGT reduced by 93.60-98.12%. Compared to that of sludge disintegration by the vortex cavitation method, VCCFGT indicating good disintegration degree (increased by 229%) and economic feasibility. VCCFGT has good application prospects for sludge disintegration. The main mechanisms of sludge disintegration and organic release include centrifugal force, grinding, shear force, cavitation, and cyclic fatigue effects, among which grinding plays a leading role. This study concluded that CFT can effectively disintegrate sludge flocs and disrupt bacterial cell walls.
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Aguas del Alcantarillado , Eliminación de Residuos Líquidos , Fenómenos Químicos , Tamaño de la Partícula , Temperatura , Eliminación de Residuos Líquidos/métodosRESUMEN
Concomitant coagulation disorder can occur in severe patients withCOVID-19, but in-depth studies are limited. This study aimed to describe the parameters of coagulation function of patients with COVID-19 and reveal the risk factors of developing severe disease. This study retrospectively analyzed 113patients with SARS-CoV-2 infection in Taizhou Public Health Center. Clinical characteristics and indexes of coagulation function were collected. A multivariate Cox analysis was performed to identify potential biomarkers for predicting disease progression. Based on the results of multivariate Cox analysis, a Nomogram was built and the predictive accuracy was evaluated through the calibration curve, decision curve, clinical impact curve, and Kaplan-Meier analysis. Sensitivity, specificity, predictive values were calculated to assess the clinical value. The data showed that Fibrinogen, FAR, and D-dimer were higher in the severe patients, while PLTcount, Alb were much lower. Multivariate Cox analysis revealed that FAR and PLT count were independent risk factors for disease progression. The optimal cutoff values for FAR and PLT count were 0.0883 and 135*109/L, respectively. The C-index [0.712 (95% CI = 0.610-0.814)], decision curve, clinical impact curve showed that Nomogram could be used to predict the disease progression. In addition, the Kaplan-Meier analysis revealed that potential risk decreased in patients with FAR<0.0883 and PLT count>135*109/L.The model showed a good negative predictive value [(0.9474 (95%CI = 0.845-0.986)].This study revealed that FAR and PLT count were independent risk factors for severe illness and the severity of COVID-19 might be excluded when FAR<0.0883 and PLT count>135*109/L.
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Betacoronavirus , Infecciones por Coronavirus/sangre , Fibrinógeno/análisis , Nomogramas , Pandemias , Recuento de Plaquetas , Neumonía Viral/sangre , Albúmina Sérica Humana/análisis , Adulto , Área Bajo la Curva , Biomarcadores/sangre , Pruebas de Coagulación Sanguínea , COVID-19 , China/epidemiología , Infecciones por Coronavirus/epidemiología , Progresión de la Enfermedad , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Neumonía Viral/epidemiología , Valor Predictivo de las Pruebas , Pronóstico , Modelos de Riesgos Proporcionales , Curva ROC , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2 , Evaluación de SíntomasRESUMEN
Objectives In December 2019, there was an outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, and since then, the disease has been increasingly spread throughout the world. Unfortunately, the information about early prediction factors for disease progression is relatively limited. Therefore, there is an urgent need to investigate the risk factors of developing severe disease. The objective of the study was to reveal the risk factors of developing severe disease by comparing the differences in the hemocyte count and dynamic profiles in patients with severe and non-severe COVID-19. Methods In this retrospectively analyzed cohort, 141 confirmed COVID-19 patients were enrolled in Taizhou Public Health Medical Center, Taizhou Hospital, Zhejiang Province, China, from January 17, 2020 to February 26, 2020. Clinical characteristics and hemocyte counts of severe and non-severe COVID patients were collected. The differences in the hemocyte counts and dynamic profiles in patients with severe and non-severe COVID-19 were compared. Multivariate Cox regression analysis was performed to identify potential biomarkers for predicting disease progression. A concordance index (C-index), calibration curve, decision curve and the clinical impact curve were calculated to assess the predictive accuracy. Results The data showed that the white blood cell count, neutrophil count and platelet count were normal on the day of hospital admission in most COVID-19 patients (87.9%, 85.1% and 88.7%, respectively). A total of 82.8% of severe patients had lymphopenia after the onset of symptoms, and as the disease progressed, there was marked lymphopenia. Multivariate Cox analysis showed that the neutrophil count (hazard ratio [HR] = 4.441, 95% CI = 1.954-10.090, p = 0.000), lymphocyte count (HR = 0.255, 95% CI = 0.097-0.669, p = 0.006) and platelet count (HR = 0.244, 95% CI = 0.111-0.537, p = 0.000) were independent risk factors for disease progression. The C-index (0.821 [95% CI, 0.746-0.896]), calibration curve, decision curve and the clinical impact curve showed that the nomogram can be used to predict the disease progression in COVID-19 patients accurately. In addition, the data involving the neutrophil count, lymphocyte count and platelet count (NLP score) have something to do with improving risk stratification and management of COVID-19 patients. Conclusions We designed a clinically predictive tool which is easy to use for assessing the progression risk of COVID-19, and the NLP score could be used to facilitate patient stratification management.
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Biomarcadores/sangre , Infecciones por Coronavirus/diagnóstico , Hemocitos/citología , Neumonía Viral/diagnóstico , Adulto , Betacoronavirus/patogenicidad , COVID-19 , China , Coronavirus/patogenicidad , Infecciones por Coronavirus/sangre , Progresión de la Enfermedad , Femenino , Humanos , Recuento de Leucocitos/métodos , Leucopenia , Recuento de Linfocitos/métodos , Masculino , Persona de Mediana Edad , Neutrófilos , Pandemias , Recuento de Plaquetas/métodos , Neumonía Viral/sangre , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2RESUMEN
BACKGROUND: Despite the declining burden of malaria in China, the disease remains a significant public health problem with periodic outbreaks and spatial variation across the country. A better understanding of the spatial and temporal characteristics of malaria is essential for consolidating the disease control and elimination programme. This study aims to understand the spatial and spatiotemporal distribution of Plasmodium vivax and Plasmodium falciparum malaria in China during 2005-2009. METHODS: Global Moran's I statistics was used to detect a spatial distribution of local P. falciparum and P. vivax malaria at the county level. Spatial and space-time scan statistics were applied to detect spatial and spatiotemporal clusters, respectively. RESULTS: Both P. vivax and P. falciparum malaria showed spatial autocorrelation. The most likely spatial cluster of P. vivax was detected in northern Anhui province between 2005 and 2009, and western Yunnan province between 2010 and 2014. For P. falciparum, the clusters included several counties of western Yunnan province from 2005 to 2011, Guangxi from 2012 to 2013, and Anhui in 2014. The most likely space-time clusters of P. vivax malaria and P. falciparum malaria were detected in northern Anhui province and western Yunnan province, respectively, during 2005-2009. CONCLUSION: The spatial and space-time cluster analysis identified high-risk areas and periods for both P. vivax and P. falciparum malaria. Both malaria types showed significant spatial and spatiotemporal variations. Contrary to P. vivax, the high-risk areas for P. falciparum malaria shifted from the west to the east of China. Further studies are required to examine the spatial changes in risk of malaria transmission and identify the underlying causes of elevated risk in the high-risk areas.
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Malaria Falciparum/epidemiología , Malaria Vivax/epidemiología , Topografía Médica , China/epidemiología , Humanos , Prevalencia , Análisis Espacio-TemporalRESUMEN
The physicochemical, structural and functional properties of citric-acid-deamidated wheat gluten at controlled degrees of deamidation (25%, 40% and 55%), which were obtained by using different acid concentrations (3.93×10(-5), 3.14×10(-3) and 2.36×10(-2)mol/L) and temperatures (70°C 2h, 90°C 1h and 110°C 40min), were compared. Various deamidation processing conditions leading to the same degree of deamidation resulted in proteins with different physicochemical and structural characteristics, as indicted by the degree of hydrolysis, Z-potential, surface hydrophobicity, particle size, SDS-PAGE results, SEC-HPLC results, intrinsic fluorescence and FTIR spectra. Agglomerative hierarchical clustering analysis and principal component analysis qualitatively indicated a significant effect of pH on protein deamidation. Three samples at 40% deamidation, which were produced by a moderate acid concentration, showed the best emulsifying and foaming properties. Processes conducted at greater than 90°C causing protein aggregation and at a high acid concentration rupturing peptide bonds, impaired protein quality. These findings demonstrated that a limited amount of H(+) could function well in the catalysis of the deamidation of amide groups without an excess of H(+), which hydrolyses peptide bonds in a stronger hydrothermal treatment.
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Amidas/química , Ácidos Carboxílicos/química , Manipulación de Alimentos/métodos , Glútenes/química , Triticum/química , Fenómenos Químicos , Ácido Cítrico/química , Calor , Hidrólisis , Interacciones Hidrofóbicas e Hidrofílicas , Estructura MolecularRESUMEN
Limited studies have examined the associations between air pollutants [particles with diameters of 10 µm or less (PM10), sulphur dioxide (SO2), and nitrogen dioxide (NO2)] and fasting blood glucose (FBG). We collected data for 27,685 participants who were followed during 2006 and 2008. Generalized Estimating Equation models were used to examine the effects of air pollutants on FBG while controlling for potential confounders. We found that increased exposure to NO2, SO2 and PM10 was significantly associated with increased FBG levels in single pollutant models (p<0.001). For exposure to 4 days' average of concentrations, a 100 µg/m(3) increase in SO2, NO2, and PM10 was associated with 0.17 mmol/L (95% CI: 0.15-0.19), 0.53 mmol/L (95% CI: 0.42-0.65), and 0.11 mmol/L (95% CI: 0.07-0.15) increase in FBG, respectively. In the multi-pollutant models, the effects of SO2 were enhanced, while the effects of NO2 and PM10 were alleviated. The effects of air pollutants on FBG were stronger in female, elderly, and overweight people than in male, young and underweight people. In conclusion, the findings suggest that air pollution increases the levels of FBG. Vulnerable people should pay more attention on highly polluted days to prevent air pollution-related health issues.
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Contaminación del Aire/estadística & datos numéricos , Glucemia/fisiología , Exposición a Riesgos Ambientales/estadística & datos numéricos , Adulto , Anciano , Contaminantes Atmosféricos/análisis , China , Ayuno , Femenino , Humanos , Estudios Longitudinales , Masculino , Modelos Estadísticos , Dióxido de Nitrógeno/análisis , Material Particulado , Dióxido de Azufre , Adulto JovenRESUMEN
BACKGROUND: Human rhinovirus (hRV) infections commonly cause acute upper respiratory infections and asthma exacerbations. Environmental cigarette smoke exposure is associated with a significant increase in the risk for these infections in children. OBJECTIVE: To determine the impact of short-term exposure to cigarette smoke on innate immune responses of airway epithelial cells infected with hRV. METHODS: A human bronchial epithelial cell line (HBEC-3KT) was exposed to cigarette smoke extract (CSE) for 30 min and subsequently infected with hRV serotype 1B. Viral-induced cytokine release was measured with AlphaLISA and viral replication quantified by shed viral titer and intracellular viral copy number 24h post-infection. RESULTS: CSE induced a concentration-dependent decrease in CXCL10 (p<0.001) and IFN-ß (p<0.001), with a 79% reduction at the highest dose with an associated 3-fold increase in shed virus. These effects were maintained when infection was delayed up to 24h post CSE exposure. Exogenous IFN-ß treatment at t=0 after infection blunts the effects of CSE on viral replication (p<0.05). CONCLUSION: A single exposure of 30 min to cigarette smoke has a lasting impact on epithelial innate defence providing a plausible mechanism for the increase in respiratory infections seen in children exposed to second-hand tobacco smoke.
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Bronquios/inmunología , Inmunidad Innata , Nicotiana/efectos adversos , Rhinovirus/inmunología , Humo/efectos adversos , Células Cultivadas , Quimiocina CXCL10/genética , Células Epiteliales/inmunología , Humanos , Interferón beta/metabolismo , Interferón beta/farmacología , Interleucina-8/metabolismoRESUMEN
BACKGROUND: Airway epithelial cells (AEC) from patients with asthma, appear to have an impaired interferon (IFN)-ß and -λ response to infection with rhinovirus. OBJECTIVES: To determine if impaired IFN responses can be identified in young children at risk of developing asthma due to atopy and/or early life wheeze, and if the site of infection or the infecting virus influence the antiviral response. METHODS: Nasal (N) and tracheal (T) epithelial cells (EC) were collected from children categorised with atopy and/or wheeze based on specific IgE to locally common aeroallergens and a questionnaire concerning respiratory health. Submerged primary cultures were infected with respiratory syncytial virus (RSV) or human metapneumovirus (hMPV), and IFN production, inflammatory cytokine expression and viral replication quantified. RESULTS: Nasal epithelial cells (NEC), but not tracheal epithelial cells (TEC), from children with wheeze and/or atopy produced less IFN-ß, but not IFN-λ, in response to RSV infection; this was associated with higher viral shedding. However, IFN-regulated factors IRF-7, Mx-1 and CXCL-10, and inflammatory cytokines were not differentially regulated. NECs and TECs from children with wheeze and/or atopy demonstrated no impairment of the IFN response (ß or λ) to hMPV infection. Despite this, more hMPV was shed from these cells. CONCLUSIONS: AECs from children with wheeze and/or atopy do not have an intrinsic defect in the production of IFN-ß or -λ, however, this response is influenced by the infecting virus. Higher viral load is associated with atopy and wheeze suggesting an impaired antiviral response to RSV and hMPV that is not influenced by production of IFNs.
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Asma/inmunología , Células Epiteliales/inmunología , Inmunidad Innata/inmunología , Mucosa Nasal/inmunología , Ruidos Respiratorios/inmunología , Infecciones por Virus Sincitial Respiratorio/inmunología , Virus Sincitiales Respiratorios/inmunología , Anticuerpos Antivirales/inmunología , Asma/patología , Asma/virología , Células Cultivadas , Niño , Preescolar , Citocinas/metabolismo , Células Epiteliales/patología , Células Epiteliales/virología , Femenino , Humanos , Interferón beta/inmunología , Interferones/inmunología , Masculino , Mucosa Nasal/patología , Mucosa Nasal/virología , Infecciones por Virus Sincitial Respiratorio/patología , Infecciones por Virus Sincitial Respiratorio/virología , Virus Sincitiales Respiratorios/aislamiento & purificación , Carga ViralRESUMEN
RATIONALE: Vitamin D deficiency is associated with chronic lung disease. We have previously shown in an in vivo mouse model that maternal vitamin D deficiency is associated with alterations in early life lung structure and function. However, there are limited data to support a relationship between maternal vitamin D deficiency during the early stages of lung development and postnatal lung function in human populations. OBJECTIVES: To assess the association between maternal vitamin D deficiency, postnatal lung function, and asthmatic status in a longitudinal birth cohort. METHODS: Serum was collected at 16 to 20 weeks' gestation at the time of recruitment in a community-based prospective birth cohort for measurement of vitamin D (25[OH]D). Lung function was assessed by spirometry according to American Thoracic Society guidelines in children at 6 and 14 years of age. Demographic and clinical history data were collected by questionnaire at recruitment and at the follow-up visits. MEASUREMENTS AND MAIN RESULTS: FVC Z-scores in both sexes (ß, 0.007 [95% confidence interval (CI), 0.001-0.013]; P = 0.02) and FEV1 Z-scores in girls (ß, 0.007 [95% CI, 0.001-0.013]; P = 0.02) were positively associated with maternal serum 25(OH)D at 6 years of age. These associations were mostly absent at 14 years of age. Maternal vitamin D deficiency was positively associated with asthma at 6 years of age but only in boys (odds ratio, 3.03 [95% CI, 1.02-9.02]; P = 0.04). CONCLUSIONS: This study supports the notion that vitamin D deficiency during lung development may impact on postnatal lung growth and increase the risk of developing lung disease.
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Asma/epidemiología , Pulmón/embriología , Pulmón/crecimiento & desarrollo , Complicaciones del Embarazo/epidemiología , Efectos Tardíos de la Exposición Prenatal/epidemiología , Deficiencia de Vitamina D/epidemiología , Adolescente , Calcifediol/sangre , Niño , Estudios de Cohortes , Femenino , Volumen Espiratorio Forzado , Humanos , Modelos Lineales , Estudios Longitudinales , Masculino , Embarazo , Complicaciones del Embarazo/sangre , Segundo Trimestre del Embarazo , Factores Sexuales , Espirometría , Capacidad Vital , Deficiencia de Vitamina D/sangreRESUMEN
Introducción: Recientemente se han establecido rangos de referencia multiétnicos de los valores de la espirometría para un uso en todo el mundo. Comparativamente, los valores de referencia de la técnica de oscilación forzada (TOF) se limitan a un equipamiento específico y unas poblaciones de estudio concretas, con los rangos de referencia actualmente disponibles que se elaboraron en una población caucásica. Nuestro objetivo fue establecer rangos de referencia de la TOF en niños en edad preescolar mexicanos y compararlos con los rangos de referencia actuales de la TOF. Pacientes y métodos: Se efectuaron determinaciones de la resistencia respiratoria (Rrs) y de la reactancia (Xrs) en niños mexicanos sanos de entre 3 y 5 años de edad, con el empleo de un equipo de TOF comercializado. Se determinó la relación entre la altura y los valores de Rrs y Xrs mediante el empleo de un análisis de regresión, teniendo en cuenta la edad, el peso, el sexo y la exposición a humo de tabaco. Se calcularon las ecuaciones de referencia para los niños mexicanos y se determinaron las puntuaciones Z para Rrs y Xrs a 6 y 8 Hz. Se utilizó una prueba de t para evaluar la diferencia de las puntuaciones Z entre los valores de referencia australianos y los establecidos en la cohorte mexicana. Resultados: Se determinó satisfactoriamente la TOF en un total de 584 niños. La altura fue un factor predictivo significativo de la Rrs y la Xrs a 6 y 8 Hz (p < 0,05). Las puntuaciones Z calculadas con el empleo de las ecuaciones de referencia australianas sobrevaloraron la función pulmonar en los niños mexicanos tanto para la Rrs como para la Xrs a 6 y 8 Hz (p < 0,001) (AU)
Conclusión: El desarrollo de rangos de referencia de la TOF específicos para los niños de edad preescolar mexicanos permitirá una interpretación correcta de las determinaciones de la TOF. Este estudio puso de relieve también que los rangos de referencia actuales de la TOF sobrevaloran la función pulmonar en los niños mexicanos. Esto resalta la importancia de utilizar rangos de referencia apropiados al origen étnico para interpretar la función pulmonar (AU)
Introduction: Recently, multi-ethnic reference ranges for spirometry have been created for use worldwide. In comparison, forced oscillation technique (FOT) reference values are limited to specific equipment and study populations, with current FOT reference ranges created in a Caucasian population. We aimed to develop FOT reference ranges for preschool-aged Mexican children and to compare these with current FOT reference ranges. Patients and methods: Respiratory resistance (Rrs) and reactance (Xrs) were measured in healthy Mexican children three to five years of age using commercial FOT equipment. The relationship between height and Rrs and Xrs was determined using regression analyses, taking into account age, weight, sex, and exposure to tobacco smoke. Reference equations were calculated for the Mexican children and Z-scores determined for Rrs and Xrs at 6 and 8 Hz. A paired t-test assessed the difference in Z-scores between the Australian reference values and those created for the Mexican cohort. Results: FOT was successfully measured in 584 children. Height was a significant predictor of Rrs and Xrs at 6 and 8 Hz (P<0.05). Z-scores calculated using the Australian reference equations overestimated lung function in Mexican children for both Rrs and Xrs at 6 and 8 Hz (P<0.001). Conclusion: The development of FOT reference ranges specific to Mexican preschool-aged children will allow for the correct interpretation of FOT measurements. This study also showed that current FOT reference ranges overestimate lung function in Mexican children. The importance of using ethnic appropriate reference ranges for interpreting lung function is highlighted (AU)
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Humanos , Masculino , Femenino , Preescolar , Volumen Espiratorio Forzado/fisiología , Capacidad Vital/fisiología , Valores de Referencia , Distribución por Etnia , MéxicoRESUMEN
BACKGROUND: Bronchiectasis develops early in the course of cystic fibrosis, being detectable in infants as young as 10 weeks of age, and is persistent and progressive. We sought to determine risk factors for the onset of bronchiectasis, using data collected by the Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST CF) intensive surveillance program. METHODS: We examined data from 127 consecutive infants who received a diagnosis of cystic fibrosis after newborn screening. Chest computed tomography (CT) and bronchoalveolar lavage (BAL) were performed, while the children were in stable clinical condition, at 3 months and 1, 2, and 3 years of age. Longitudinal data were used to determine risk factors associated with the detection of bronchiectasis from 3 months to 3 years of age. RESULTS: The point prevalence of bronchiectasis at each visit increased from 29.3% at 3 months of age to 61.5% at 3 years of age. In multivariate analyses, risk factors for bronchiectasis were presentation with meconium ileus (odds ratio, 3.17; 95% confidence interval [CI], 1.51 to 6.66; P=0.002), respiratory symptoms at the time of CT and BAL (odds ratio, 2.27; 95% CI, 1.24 to 4.14; P=0.008), free neutrophil elastase activity in BAL fluid (odds ratio, 3.02; 95% CI, 1.70 to 5.35; P<0.001), and gas trapping on expiratory CT (odds ratio, 2.05; 95% CI, 1.17 to 3.59; P=0.01). Free neutrophil elastase activity in BAL fluid at 3 months of age was associated with persistent bronchiectasis (present on two or more sequential scans), with the odds seven times as high at 12 months of age and four times as high at 3 years of age. CONCLUSIONS: Neutrophil elastase activity in BAL fluid in early life was associated with early bronchiectasis in children with cystic fibrosis. (Funded by the National Health and Medical Research Council of Australia and Cystic Fibrosis Foundation Therapeutics.)
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Bronquiectasia/etiología , Líquido del Lavado Bronquioalveolar/química , Fibrosis Quística/complicaciones , Elastasa de Leucocito/metabolismo , Pulmón/enzimología , Preescolar , Fibrosis Quística/enzimología , Femenino , Humanos , Ileus , Lactante , Recién Nacido , Estudios Longitudinales , Masculino , Meconio , Análisis Multivariante , Prevalencia , Factores de RiesgoRESUMEN
INTRODUCTION: Recently, multi-ethnic reference ranges for spirometry have been created for use worldwide. In comparison, forced oscillation technique (FOT) reference values are limited to specific equipment and study populations, with current FOT reference ranges created in a Caucasian population. We aimed to develop FOT reference ranges for preschool-aged Mexican children and to compare these with current FOT reference ranges. PATIENTS AND METHODS: Respiratory resistance (Rrs) and reactance (Xrs) was measured in healthy Mexican children three to five years of age using commercial FOT equipment. The relationship between height and Rrs and Xrs was determined using regression analyses, taking into account age, weight, sex, and exposure to tobacco smoke. Reference equations were calculated for the Mexican children and Z-scores determined for Rrs and Xrs at 6 and 8Hz. A paired t-test assessed the difference in Z-scores between the Australian reference values and those created for the Mexican cohort. RESULTS: FOT was successfully measured in 584 children. Height was a significant predictor of Rrs and Xrs at 6 and 8Hz (P<.05). Z-scores calculated using the Australian reference equations overestimated lung function in Mexican children for both Rrs and Xrs at 6 and 8Hz (P<.001). CONCLUSION: The development of FOT reference ranges specific to Mexican preschool-aged children will allow for the correct interpretation of FOT measurements. This study also showed that current FOT reference ranges overestimate lung function in Mexican children. Highlighting, the importance of using ethnic appropriate reference ranges for interpreting lung function.
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Preescolar/estadística & datos numéricos , Oscilometría/normas , Espirometría/normas , Resistencia de las Vías Respiratorias , Australia , Estatura , Peso Corporal , Etnicidad/estadística & datos numéricos , Femenino , Estudios de Seguimiento , Humanos , Masculino , México , Oscilometría/instrumentación , Oscilometría/métodos , Valores de Referencia , Espirometría/instrumentación , Espirometría/métodos , Contaminación por Humo de Tabaco/estadística & datos numéricosRESUMEN
BACKGROUND: Reporting of known and suspected child abuse and neglect is a fundamental responsibility of health professionals in many countries including Australia. Nurses' duties to report child abuse and neglect are expressed in legislation, or in occupational policy documents. In this paper factors influencing nurses' compliance with mandated reporting are examined. OBJECTIVE: The purpose of this study was to examine the relationship between nurse characteristics, training, knowledge of legislative reporting duty and attitudinal factors on the reporting by nurses of different types of child abuse and neglect. METHODS: Logistic regression analyses were conducted to examine relationships between variables. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional survey using the Child Abuse and Neglect Nurses' Questionnaire (CANNQ) was conducted. The respondents were 930 Registered Nurses (RNs) currently working across metropolitan, rural and remote locations throughout the state of Queensland, Australia. RESULTS: Nurses were confident and knowledgeable in their obligation to report physical [CPA] and sexual [CSA] abuse. They were less confident and knowledgeable about emotional abuse [CEA] and neglect [CN]. Recognition of the extent of harm to abused and neglected children was poor. Positive attitudes to mandatory reporting influenced better recognition of all forms of abuse and neglect and the likelihood of reporting CSA, CEA and CN; parenting experience influenced intention to report child sexual abuse, and CAN training predicted reporting of child neglect. CONCLUSIONS AND PRACTICE IMPLICATIONS: Results indicate that with training, nurses are a key choice for mandating child abuse and neglect reporting. Educational preparation and training for nurses should emphasise the serious impact of child abuse and neglect on children and families to improve recognition of the extent of harm and the likelihood of reporting. From a perspective of increasing compliance with the legislative duty, particular attention needs to be paid to recognition and reporting of CEA and CN. Further research is needed to determine whether factors influencing sound reporting can be successfully modified.
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Maltrato a los Niños/diagnóstico , Notificación Obligatoria , Enfermeras y Enfermeros , Actitud del Personal de Salud , Australia , Niño , Estudios Transversales , Humanos , Análisis Multivariante , Encuestas y CuestionariosRESUMEN
The objective of this research was to identify the level of detail regarding the external causes of death in Australia and ascertain problematic areas where data quality improvement efforts may be focused. The 2003 national mortality dataset of 12,591 deaths with an external cause of injury as the underlying cause of death (UCOD) or multiple cause of death (MCOD) based on ICD-10 code assignment from death certificate information was obtained. Logistic regression models were used to examine the precision of coded external cause of injury data. It was found that overall, accidents were the most poorly defined of all intent code blocks with over 30% of accidents being undefined, representing 2,314 deaths in 2003. More undefined codes were identified in MCOD data than for UCOD data. Deaths certified by doctors were more likely to use undefined codes than deaths certified by a coroner or government medical office. To improve the quality of external cause of injuries leading to or associated with death, certifiers need to be made aware of the importance of documenting all information pertaining to the cause of the injury and the intent behind the incident, either through education or more explicit instructions on the death certificate and accompanying instructional materials. It is important that researchers are aware of the validity of the data when they make interpretations as to the underlying causes of fatal injuries and causes of injury associated with deaths.
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Causas de Muerte , Codificación Clínica/normas , Heridas y Lesiones/mortalidad , Accidentes/mortalidad , Australia/epidemiología , Interpretación Estadística de Datos , Certificado de Defunción , Humanos , Clasificación Internacional de Enfermedades/clasificación , Modelos Logísticos , Conducta Autodestructiva/mortalidad , Violencia/estadística & datos numéricos , Heridas y Lesiones/etiologíaRESUMEN
BACKGROUND: Transplantation of vasculogenic progenitor cells (VPC) improves neovascularization after ischemia. However, patients with type 2 diabetes mellitus show a reduced VPC number and impaired functional activity. Previously, we demonstrated that p38 kinase inhibition prevents the negative effects of glucose on VPC number by increasing proliferation and differentiation towards the endothelial lineage in vitro. Moreover, the functional capacity of progenitor cells is reduced in a mouse model of metabolic syndrome including type 2 diabetes (Lepr(db)) in vivo. FINDINGS: The aim of this study was to elucidate the underlying signalling mechanisms in vitro and in vivo. Therefore, we performed DNA-protein binding arrays in the bone marrow of mice with metabolic syndrome, in blood-derived progenitor cells of diabetic patients as well as in VPC ex vivo treated with high levels of glucose. The transcriptional activation of ETS transcription factors was increased in all samples analyzed. Downregulation of ETS1 expression by siRNA abrogated the reduction of VPC number induced by high-glucose treatment. In addition, we observed a concomitant suppression of the non-endothelial ETS-target genes matrix metalloproteinase 9 (MMP9) and CD115 upon short term lentiviral delivery of ETS-specific shRNAs. Long term inhibition of ETS expression by lentiviral infection increased the number of cells with the endothelial markers CD144 and CD105. CONCLUSION: These data demonstrate that diabetes leads to dysregulated activation of ETS, which blocks the functional activity of progenitor cells and their commitment towards the endothelial cell lineage.
Asunto(s)
Diabetes Mellitus Tipo 2/patología , Regulación hacia Abajo/genética , Síndrome Metabólico/patología , Proteínas Proto-Oncogénicas c-ets/genética , Animales , Médula Ósea , Proteínas de Unión al ADN/análisis , Diabetes Mellitus Tipo 2/metabolismo , Células Endoteliales/patología , Humanos , Metaloproteinasa 9 de la Matriz , Síndrome Metabólico/metabolismo , Ratones , Proteína Proto-Oncogénica c-ets-1/genética , ARN Interferente Pequeño/farmacología , Receptor de Factor Estimulante de Colonias de Macrófagos , Transducción de Señal , Células Madre/patología , Activación TranscripcionalRESUMEN
In 2005, legislation commenced requiring Queensland nurses to make reports of suspected child abuse and neglect to government child protection authorities. This development further harmonised Australian mandatory reporting laws and their application to the nursing profession, although inconsistencies still exist between States and Territories. As indicated by research published in 2006, little is known about nurses and the reporting of child abuse and neglect. The legislative change in Queensland provided a new opportunity to study nurses' attitudes to reporting, knowledge of the legal reporting duty, and reporting practice, all of which provides much-needed evidence about the reporting of child abuse and neglect, and about the laws themselves. This article describes results from a State-wide survey of Queensland nurses. Findings have implications for law reform, nursing practice, and nurses' training in child abuse and neglect reporting.
Asunto(s)
Actitud , Maltrato a los Niños/legislación & jurisprudencia , Competencia Clínica , Notificación Obligatoria , Personal de Enfermería/legislación & jurisprudencia , Adulto , Australia , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To highlight issues relating to suicide coding that have an impact on the final reported mortality data by the Australian Bureau of Statistics. METHOD: This paper presents an outline of the way in which the official Australian suicide data is captured and coded and highlights issues relating to the classification used, coronial processes, documentation requirements and data sources that have an impact on the final reported data, especially deaths associated with coronial investigations. RESULTS: Issues related to the coding of Australian suicide data are: *Disparity between jurisdictions due to differences in documentation about accidental or undetermined causes of death. *Lack of standardisation in the way that coronial deaths are reported across Australia. *Lack of a standard form for police reports. *Administrative processes that cause delays in reporting the results of coronial investigations. *Reluctance on the part of some coroners to report deaths as suicides. CONCLUSIONS: Researchers and policy makers need to be aware of the constraints under which suicide can be reported as such in the official data before interpreting time trends.
Asunto(s)
Certificado de Defunción , Suicidio/estadística & datos numéricos , Australia/epidemiología , Médicos Forenses/estadística & datos numéricos , Control de Formularios y Registros/normas , Control de Formularios y Registros/estadística & datos numéricos , Humanos , Clasificación Internacional de EnfermedadesRESUMEN
Complete and accurate information about hospitalised injuries is essential for injury risk and outcome research, though the accuracy and reliability of hospital data for injury surveillance are often questioned. To ascertain clinical coders' views of the reasons for a lack of specificity in external cause code usage and ways to improve external cause coding, a nationwide survey of coders was conducted in Australia in 2006. Four hundred and two coders participated in the questionnaire. The results of this study show that discharge summaries and doctors' notes were the poorest source of information regarding external causes, place of injury occurrence, and activity at the time of injury. Coders viewed missing external cause information and missing documentation as having the greatest impact on the quality of external cause coding. A large majority of coders suggested that improving clinical documentation in the emergency department and introducing a centralised structured form for external cause information would improve the quality of external cause coding. Clinical coders are a valuable source of information regarding problems with, and solutions to the collection of high quality data and this research has highlighted several areas where improvements can be made and further research is needed.
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Control de Formularios y Registros , Vigilancia de la Población , Heridas y Lesiones/etiología , Adulto , Anciano , Australia , Recolección de Datos , Documentación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Medición de Riesgo , Factores de Riesgo , Encuestas y Cuestionarios , Heridas y Lesiones/clasificaciónRESUMEN
About 12% of all de novo acute myeloid leukemias are characterized by the translocation t(8;21), which generates the oncogenic fusion protein RUNX1/ETO. RUNX1/ETO has a modular structure and contains several docking sites for heterologous proteins, including transcriptional co-repressors like N-CoR, SMART, and mSIN3A. RUNX1/ETO is found in high molecular weight complexes, which are crucial for the block in myeloid differentiation observed in RUNX1/ETO-transformed cells. Essential for high molecular weight complex formation is the nervy homology region 2 (NHR2) within ETO, which serves as interacting surface for oligomerization as well as association with members of the ETO protein family. Here, we show that the expression of a fusion peptide consisting of 128 amino acids (NC128), including the entire NHR2 domain of ETO, disrupts the stability of the RUNX1/ETO high molecular weight complexes, restores transcription of RUNX1/ETO target genes, and reverts the differentiation block induced by RUNX1/ETO in myeloid cells. In the presence of NC128, RUNX1/ETO-transformed cells lose their progenitor cell characteristics, are arrested in cell cycle progression, and undergo cell death. Our results indicate that selective interference with the oligomerization domain of ETO could provide a promising strategy to inhibit the oncogenic properties of the leukemia-associated fusion protein RUNX1/ETO.