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Life Sciences in Space Research May 2024The space environment poses substantial challenges to human physiology, including potential disruptions in gastrointestinal health. Gut permeability has only recently... (Review)
Review
The space environment poses substantial challenges to human physiology, including potential disruptions in gastrointestinal health. Gut permeability has only recently become widely acknowledged for its potential to cause adverse effects on a systemic level, rendering it a critical factor to investigate in the context of spaceflight. Here, we propose that astronauts experience the onset of leaky gut during space missions supported by transcriptomic and metagenomic analysis of human and murine samples. A genetic map contributing to intestinal permeability was constructed from a systematic review of current literature. This was referenced against our re-analysis of three independent transcriptomic datasets which revealed significant changes in gene expression patterns associated with the gut barrier. Specifically, in astronauts during flight, we observed a substantial reduction in the expression genes that are crucial for intestinal barrier function, goblet cell development, gut microbiota modulation, and immune responses. Among rodent spaceflight studies, differential expression of cytokines, chemokines, and genes which regulate mucin production and post-translational modifications suggest a similar dysfunction of intestinal permeability. Metagenomic analysis of feces from two murine studies revealed a notable reduction probiotic, short chain fatty acid-producing bacteria and an increase in the Gram-negative pathogens, including Citrobacter rodentium, Enterobacter cloacea, Klebsiella aerogenes, and Proteus hauseri which promote LPS circulation, a recipe for barrier disruption and systemic inflammatory activation. These findings emphasize the critical need to understand the underlying mechanisms and develop interventions to maintain gastrointestinal health in space.
Topics: Space Flight; Astronauts; Humans; Animals; Permeability; Gastrointestinal Microbiome; Mice; Transcriptome; Gastrointestinal Tract
PubMed: 38670644
DOI: 10.1016/j.lssr.2024.03.003 -
European Review For Medical and... Nov 2023Proteus syndrome (PS) is an extremely rare disorder with ocular manifestations. In this study, we aimed to describe the ophthalmic characteristics and the clinical...
BACKGROUND
Proteus syndrome (PS) is an extremely rare disorder with ocular manifestations. In this study, we aimed to describe the ophthalmic characteristics and the clinical course of an unusual PS patient to acquire a comprehensive and intensive understanding of ocular PS and highlight the importance of collaborative treatment by ophthalmologists.
CASE PRESENTATION
A case of PS with atypical ocular features and syndromes was observed in a Chinese female. Her proptosis and vision impairment were relieved after Endoscope-Navigation system (ENS)-aided optic canal decompression. A 1.5-year follow-up showed that the treatment was temporarily effective, but the disease continued to develop. A review of the literature was conducted: forty-eight patients met the inclusion criteria. Although ocular manifestations play important roles in PS diagnosis, only a limited number of cases have been reported to have ocular abnormalities. And to date, almost none of these reports have described the treatment in detail. Therefore, PS patients with ocular manifestations were reviewed.
CONCLUSIONS
PS is a complex disorder with variable characteristics and progressive imbalances. In this paper, the clinical symptoms, molecular characteristics, and differential diagnosis of PS are introduced. More importantly, the ocular manifestations, treatment, and prognosis of PS cases to date are summarized and discussed. This study aimed to acquire a comprehensive and intensive understanding of ocular PS and to reveal the importance of collaborative treatment by ophthalmologists.
Topics: Humans; Female; Proteus Syndrome; Eye
PubMed: 37975355
DOI: 10.26355/eurrev_202311_34306 -
One Health Outlook Sep 2023Although antimicrobial resistance (AMR) bacteria present a significant and ongoing public health challenge, its magnitude remains poorly understood, especially in many... (Review)
Review
Drug resistance and extended-spectrum β-lactamase (ESBLs) - producing Enterobacteriaceae, Acinetobacter and Pseudomonas species from the views of one-health approach in Ethiopia: a systematic review and meta-analysis.
BACKGROUND
Although antimicrobial resistance (AMR) bacteria present a significant and ongoing public health challenge, its magnitude remains poorly understood, especially in many parts of the developing countries. Hence, this review was conducted to describe the current pooled prevalence of drug resistance, multidrug- resistance (MDR), and Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, Acinetobacter, and Pseudomonas species in humans, the environment, and animals or food of animal origin in Ethiopia.
METHODS
PubMed, Google Scholar, and other sources were searched for relevant articles as per the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A critical appraisal for screening, eligibility, and inclusion in the meta-analysis was made based on the Joanna Briggs Institute's (JBI) essential appraisal tools. The meta-analysis was done on Statistical Software Package (STATA) version 17.0.
RESULTS
A total of 33 research articles were included in this systematic review and meta-analysis. Escherichia coli, Klebsiella species, Acinetobacter, and Pseudomonas species were the most frequently reported bacteria from two or more sources. More than 50% of Klebsiella species and 25% to 89% of Escherichia coli from two or more sources were resistant to all analysed antibiotics, except carbapenems. Fifty-five percent (55%) to 84% of Acinetobacter species and 33% to 79% of Pseudomonas species from human and environmental sources were resistant to all analyzed antibiotics. Carbapenem resistance was common in Acinetobacter and Pseudomonas species (38% to 64%) but uncommon in Enterobacteriaceae (19% to 44%). Acinetobacter species (92%), Klebsiella species (86%), and Pseudomonas species (79%) from human sources, and Proteus species (92%), and Acinetobacter species (83%), from environmental sources, were the common multidrug-resistant isolates. About 45% to 67% of E. coli, Klebsiella, Acinetobacter, and Pseudomonas species from human and environmental sources were ESBL producers.
CONCLUSION
Our review report concluded that there was a significant pooled prevalence of drug resistance, MDR, and ESBL-producing Enterobacteriaceae, Acinetobacter, and Pseudomonas species from two or more sources. Hence, our finding underlines the need for the implementation of integrated intervention approaches to address the gaps in reducing the emergence and spread of antibiotic- resistant bacteria.
PubMed: 37697359
DOI: 10.1186/s42522-023-00088-z -
Journal of Intelligence Jul 2023As an artificial space extended from the physical environment, the virtual environment (VE) provides more possibilities for humans to work and be entertained with less... (Review)
Review
As an artificial space extended from the physical environment, the virtual environment (VE) provides more possibilities for humans to work and be entertained with less physical restrictions. Benefiting from anonymity, one of the important features of VEs, users are able to receive visual stimuli that might differ from the physical environment through digital representations presented in VEs. Avatars and contextual cues in VEs can be considered as digital representations of users and contexts. In this article, we analyzed 21 articles that examined the creativity-boosting effects of different digital user and contextual representations. We summarized the main effects induced by these two digital representations, notably the effect induced by the self-similar avatar, Proteus effect, avatar with Social Identity Cues, priming effect induced by contextual representation, and embodied metaphorical effect. In addition, we examined the influence of immersion on creativity by comparing non-immersive and immersive VEs (i.e., desktop VE and headset VE, respectively). Last, we discussed the roles of embodiment and presence in the creativity in VEs, which were overlooked in the past research.
PubMed: 37504787
DOI: 10.3390/jintelligence11070144 -
The Journal of Spinal Cord Medicine Jul 2023Despite a high urinary tract infection (UTI) rate in spinal cord injured patents in China, there is limited evidence on the epidemiological character of that. (Meta-Analysis)
Meta-Analysis
Epidemiology of pathogens and antimicrobial resistance of nosocomial urinary tract infections in patients with spinal cord injuries in China: A systematic review and meta-analysis.
CONTEXT
Despite a high urinary tract infection (UTI) rate in spinal cord injured patents in China, there is limited evidence on the epidemiological character of that.
OBJECTIVE
The purpose of our article was to characterize the distribution of pathogens of UTI patients with spinal cord injuries (SCI) and the resistance profile of pathogens.
METHODS
A literature search of six electronic databases was carried out to identify the incidence, pathogen distribution, and drug resistance of UTI after SCI based on our inclusion and exclusion criteria. Meta-analysis was carried out using R 4.0.2 software; a subgroup analysis was performed by the year 2012.
RESULTS
We screened 1110 eligible studies, 33 were included in our final review. A total of 7271 bacterial species were included in our studies; 6092 were gram-negative (81.13% [76.83-85.11]) and 1003 were gram-positive (14.89% [11.70-18.38]). Before 2012, (45.43%) was the predominant isolated pathogen, followed by Klebsiella (7.49%) and Enterococcus (6.01%). After 2012, (50.23%) was the main pathogen, followed by Klebsiella (12.47%) and Proteus (6.88%). was more likely to be resistant to Levofloxacin, Amikacin, sulfonamides, 4th-generation cephalosporins and Nitrofurantoin before 2012 (81.8% vs. 62.9%, 32.0% vs. 7.6%, 81.3% vs. 61.6%, 81.8% vs. 24.1%, 33.5% vs. 5.1%), whereas was more frequently resistant to Inhibitor-resistant β-lactamas after 2012 (56.3% vs. 34.0%). was more likely to be resistant to Aztreonam, Amikacin before 2012 (80.0% vs. 39.8%, 48.1% vs. 19.0%). presented a high resistance to Levofloxacin, Inhibitor-resistant β-lactamas after 2012 (61.8% vs. 35.6%, 59.1% vs. 5.7%).
CONCLUSIONS
UTI in patients with SCI in China were mainly caused by gram-negative bacteria. We observed a remarkable modification in resistance profiles of pathogen distribution before 2012 and after 2012, which suggests reasonable control of the use of antibiotics has a positive effectiveness on resistance profiles.
Topics: Humans; Anti-Bacterial Agents; Amikacin; Levofloxacin; Cross Infection; Escherichia coli; Drug Resistance, Bacterial; Spinal Cord Injuries; Urinary Tract Infections
PubMed: 36622339
DOI: 10.1080/10790268.2022.2129154 -
Journal of Clinical and Experimental... Oct 2022Patients with odontogenic infections are commonly prescribed antimicrobials on an experiential base without knowing the precise microorganisms implicated. The aim of... (Review)
Review
BACKGROUND
Patients with odontogenic infections are commonly prescribed antimicrobials on an experiential base without knowing the precise microorganisms implicated. The aim of this systematic scoping review is to evaluate the prevalence and proportions of antimicrobial-resistant species in patients with odontogenic infections.
MATERIAL AND METHODS
A systematic scoping review of scientific evidence was accomplished involving different databases.
RESULTS
Eight randomized clinical trials and 13 prospective observational studies were included. These investigations analyzed 1506 patients. The species that showed higher levels of resistance included aerobic and facultative anaerobe such as , and . In obligate anaerobes sampled were Peptostreptococcos spp., Bacteroides spp., and Prevotella spp. Staphylococcus showed resistance to ampicillin, piperacillin, clindamycin, amoxicillin, metronidazole, and penicillin. Streptococcus had resistance to metronidazole, clindamycin, doxycycline, penicillin, and amoxicillin. Peptostreptococcus spp. presented resistance to penicillin, amoxicillin, erythromycin, and cefalexin. Gram-negative microorganisms had resistance to tetracycline, ciprofloxacin, azithromycin, amoxicillin, erythromycin, and penicillin. Bacteroides spp. exhibited resistance to penicillin, erythromycin, and gentamicin. Prevotella spp. showed resistance to penicillin, amoxicillin, erythromycin, clindamycin, levofloxacin, and imipenem. Finally, Klebsiella spp. displayed resistance to ampicillin, amoxicillin, moxifloxacin, and cefalexin. Interestingly, one clinical trial showed that after therapy there was a reduction in sensitivity of 18% for azithromycin and 26% for spiramycin.
CONCLUSIONS
Most of the microorganisms had resistance to diverse groups of antimicrobials. Suitable antimicrobials must be prescribed founded on the microbial samples, culture susceptibility, and clinical progression of the odontogenic infection. Furthermore, it was observed high levels of resistance to antimicrobials that have been used in local and systemic therapy of oral cavity infections. A preponderance of anaerobic microorganisms over aerobic ones was observed. Antibiotic resistance, odontogenic infections, efficacy, microorganisms, scoping review.
PubMed: 36320675
DOI: 10.4317/jced.59830 -
Journal of Cancer Survivorship :... Jun 2023The most common cause of mortality for many cancer survivors is cardiovascular disease (CVD). This requires a shift in thinking where control of CVD risk factor-related... (Review)
Review
PURPOSE
The most common cause of mortality for many cancer survivors is cardiovascular disease (CVD). This requires a shift in thinking where control of CVD risk factor-related comorbidity is paramount. Our objective was to provide an understanding of adherence to medications for the management of CVD risk factor-related comorbidities among cancer survivors.
METHODS
We systematically searched for articles indexed in MEDLINE (via PubMed), Embase, Cochrane (Wiley), PsycINFO, and Scopus (via Elsevier) for articles published from inception to October 31, 2019, and updated the search on June 7, 2021. English language, original research that assessed medication adherence to common CVD risk factor-related comorbidities among cancer survivors was included. We assessed risk of bias using the Mixed Methods Appraisal Tool.
RESULTS
Of the 21 studies included, 57% focused on multiple cancer types. Seventy-one percent used pharmacy-based adherence measures. Two were prospective. Adherence was variable across cancer types and CVD risk factor-related comorbidities. Among the studies that examined changes in comorbid medication adherence, most noted a decline in adherence following cancer diagnosis and throughout cancer treatment. There was a focus on breast cancer populations.
CONCLUSIONS
CVD risk factor-related medication adherence is low among cancer survivors and declines over time. Given the risk for CVD-mortality among cancer survivors, testing of interventions aimed at improving adherence to non-cancer medications is critically needed.
IMPLICATIONS FOR CANCER SURVIVORS
For many cancer survivors, regularly taking medications to manage CVD risk is important for longevity. Engaging with primary care throughout the cancer care trajectory may be important to support cardiovascular health.
Topics: Humans; Female; Cardiovascular Diseases; Prospective Studies; Cancer Survivors; Medication Adherence; Breast Neoplasms; Risk Factors
PubMed: 35578150
DOI: 10.1007/s11764-022-01212-0 -
Antimicrobial Resistance and Infection... Jan 2022Antimicrobial resistance is swiftly increasing all over the world. In Africa, it manifests more in pathogenic bacteria in form of antibiotic resistance (ABR). On this... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Antimicrobial resistance is swiftly increasing all over the world. In Africa, it manifests more in pathogenic bacteria in form of antibiotic resistance (ABR). On this continent, bacterial contamination of commonly used herbal medicine (HM) is on the increase, but information about antimicrobial resistance in these contaminants is limited due to fragmented studies. Here, we analyzed research that characterized ABR in pathogenic bacteria isolated from HM in Africa since 2000; to generate a comprehensive understanding of the drug-resistant bacterial contamination burden in this region.
METHODS
The study was conducted according to standards of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). We searched for articles from 12 databases. These were: PubMed, Science Direct, Scifinder scholar, Google scholar, HerbMed, Medline, EMBASE, Cochrane Library, International Pharmaceutical Abstracts, Commonwealth Agricultural Bureau Abstracts, African Journal Online, and Biological Abstracts. Prevalence and ABR traits of bacterial isolates, Cochran's Q test, and the I statistic for heterogeneity were evaluated using MedCalcs software. A random-effects model was used to determine the pooled prevalence of ABR traits. The potential sources of heterogeneity were examined through sensitivity analysis, subgroup analysis, and meta-regression at a 95% level of significance.
FINDINGS
Eighteen studies met our inclusion criteria. The pooled prevalence of bacterial resistance to at least one conventional drug was 86.51% (95% CI = 61.247-99.357%). The studies were highly heterogeneous (I = 99.17%; p < 0.0001), with no evidence of publication bias. The most prevalent multidrug-resistant species was Escherichia coli (24.0%). The most highly resisted drug was Ceftazidime with a pooled prevalence of 95.10% (95% CI = 78.51-99.87%), while the drug-class was 3 generation cephalosporins; 91.64% (95% CI = 78.64-96.73%). None of the eligible studies tested isolates for Carbapenem resistance. Extended Spectrum β-lactamase genes were detected in 89 (37.2%) isolates, mostly Salmonella spp., Proteus vulgaris, and K. pneumonia. Resistance plasmids were found in 6 (5.8%) isolates; the heaviest plasmid weighed 23,130 Kilobases, and Proteus vulgaris harbored the majority (n = 5; 83.3%).
CONCLUSIONS
Herbal medicines in Africa harbor bacterial contaminants which are highly resistant to conventional medicines. This points to a potential treatment failure when these contaminants are involved in diseases causation. More research on this subject is recommended, to fill the evidence gaps and support the formation of collaborative quality control mechanisms for the herbal medicine industry in Africa.
Topics: Africa; Anti-Bacterial Agents; Bacteria; Drug Contamination; Drug Resistance, Bacterial; Food Contamination; Herbal Medicine
PubMed: 35063036
DOI: 10.1186/s13756-022-01054-6 -
Archives of Gynecology and Obstetrics Sep 2022Globally, antimicrobial resistance (AMR) restricted the armamentarium of the health care providers against infectious diseases, mainly due to the emergence of multidrug... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Globally, antimicrobial resistance (AMR) restricted the armamentarium of the health care providers against infectious diseases, mainly due to the emergence of multidrug resistant. This review is aimed at providing contemporary bacterial profile and antimicrobial resistance pattern among pregnant women with significant bacteriuria.
METHODS
Electronic biomedical databases and indexing services such as PubMed/MEDLINE, Web of Science, EMBASE and Google Scholar were searched. Original records of research articles, available online from 2008 to 2021, addressing the prevalence of significant bacteriuria and AMR pattern among pregnant women and written in English were identified and screened. The relevant data were extracted from included studies using a format prepared in Microsoft Excel and exported to STATA 14.0 software for the outcome measure analyses and subgrouping.
RESULTS
The data of 5894 urine samples from 20 included studies conducted in 8 regions of the country were pooled. The overall pooled estimate of bacteriuria was 15% (95% CI 13-17%, I = 77.94%, p < 0.001) with substantial heterogeneity. The pooled estimate of Escherichia coli recovered from isolates of 896 urine samples was 41% (95% CI 38-45%) followed by coagulase-negative Staphylococci, 22% (95% CI 18-26%), Staphylococcus aureus, 15% (95% CI 12-18%), Staphylococcus saprophytic, 12% (95% CI 6-18%) Proteus mirabilis, 7% (95% CI 4-10%), Enterococcus species, 6% (0-12%), Pseudomonas aeruginosa, 4% (2-6%), Citrobacter species, 4% (95% CI 2-4%), Group B streptococcus, 3% (1-5%), and Enterobacter species, 2% (1-4%). Multidrug resistance proportions of E. coli, Klebsiella species, Staphylococcus aureus and Coagulase negative staphylococci, 83% (95% CI 76-91%), 78% (95% CI 66-90%), 89% (95% CI 83-96%), and 78% (95% CI 67-88%), respectively.
CONCLUSION
The result of current review revealed the occurrence of substantial bacteriuria among pregnant women in Ethiopia. Resistance among common bacteria (E. coli, Klebsiella species, Staphylococci species) causing UTIs in pregnant women is widespread to commonly used antibiotics. The high rate of drug resistance in turn warrants the need for regular epidemiological surveillance of antibiotic resistance and implementation of an efficient infection control and stewardship program.
Topics: Anti-Bacterial Agents; Bacteria; Bacteriuria; Coagulase; Drug Resistance, Bacterial; Escherichia coli; Ethiopia; Female; Humans; Microbial Sensitivity Tests; Pregnancy; Pregnant Women; Staphylococcal Infections; Staphylococcus aureus
PubMed: 35032208
DOI: 10.1007/s00404-021-06365-4 -
Journal of General Internal Medicine Mar 2022A culture of improvement is an important feature of high-quality health care systems. However, health care teams often need support to translate quality improvement (QI)...
BACKGROUND
A culture of improvement is an important feature of high-quality health care systems. However, health care teams often need support to translate quality improvement (QI) activities into practice. One method of support is consultation from a QI coach. The literature suggests that coaching interventions have a positive impact on clinical outcomes. However, the impact of coaching on specific process outcomes, like adoption of clinical care activities, is unknown. Identifying the process outcomes for which QI coaching is most effective could provide specific guidance on when to employ this strategy.
METHODS
We searched multiple databases from inception through July 2021. Studies that addressed the effects of QI coaching on process of care outcomes were included. Two reviewers independently extracted study characteristics and assessed risk of bias. Certainty of evidence was assessed using GRADE.
RESULTS
We identified 1983 articles, of which 23 cluster-randomized trials met eligibility criteria. All but two took place in a primary care setting. Overall, interventions typically targeted multiple simultaneous processes of care activities. We found that coaching probably has a beneficial effect on composite process of care outcomes (n = 9) and ordering of labs and vital signs (n = 6), and possibly has a beneficial effect on changes in organizational process of care (n = 5), appropriate documentation (n = 5), and delivery of appropriate counseling (n = 3). We did not perform meta-analyses because of conceptual heterogeneity around intervention design and outcomes; rather, we synthesized the data narratively. Due to imprecision, inconsistency, and high risk of bias of the included studies, we judged the certainty of these results as low or very low.
CONCLUSION
QI coaching interventions may affect certain processes of care activities such as ordering of labs and vital signs. Future research that advances the identification of when QI coaching is most beneficial for health care teams seeking to implement improvement processes in pursuit of high-quality care will support efficient use of QI resources.
PROTOCOL REGISTRATION
This study was registered and followed a published protocol (PROSPERO: CRD42020165069).
Topics: Delivery of Health Care; Health Services; Humans; Mentoring; Quality Improvement; Quality of Health Care
PubMed: 34981354
DOI: 10.1007/s11606-021-07217-2