- Infection-induced endothelial amyloids impair memory. [Journal Article]
- FJFASEB J 2019 Jun 18; :fj201900322R
- Patients with nosocomial pneumonia exhibit elevated levels of neurotoxic amyloid and tau proteins in the cerebrospinal fluid (CSF). In vitro studies indicate that pulmonary endothelium infected with …
Patients with nosocomial pneumonia exhibit elevated levels of neurotoxic amyloid and tau proteins in the cerebrospinal fluid (CSF). In vitro studies indicate that pulmonary endothelium infected with clinical isolates of either Pseudomonas aeruginosa, Klebsiella pneumoniae, or Staphylococcus aureus produces and releases cytotoxic amyloid and tau proteins. However, the effects of the pulmonary endothelium-derived amyloid and tau proteins on brain function have not been elucidated. Here, we show that P. aeruginosa infection elicits accumulation of detergent insoluble tau protein in the mouse brain and inhibits synaptic plasticity. Mice receiving endothelium-derived amyloid and tau proteins via intracerebroventricular injection exhibit a learning and memory deficit in object recognition, fear conditioning, and Morris water maze studies. We compared endothelial supernatants obtained after the endothelia were infected with P. aeruginosa possessing an intact [P. aeruginosa isolated from patient 103 (PA103) supernatant] or defective [mutant strain of P. aeruginosa lacking a functional type 3 secretion system needle tip complex (ΔPcrV) supernatant] type 3 secretion system. Whereas the PA103 supernatant impaired working memory, the ΔPcrV supernatant had no effect. Immunodepleting amyloid or tau proteins from the PA103 supernatant with the A11 or T22 antibodies, respectively, overtly rescued working memory. Recordings from hippocampal slices treated with endothelial supernatants or CSF from patients with or without nosocomial pneumonia indicated that endothelium-derived neurotoxins disrupted the postsynaptic synaptic response. Taken together, these results establish a plausible mechanism for the neurologic sequelae consequent to nosocomial bacterial pneumonia.-Balczon, R., Pittet, J.-F., Wagener, B. M., Moser, S. A., Voth, S., Vorhees, C. V., Williams, M. T., Bridges, J. P., Alvarez, D. F., Koloteva, A., Xu, Y., Zha, X.-M., Audia, J. P., Stevens, T., Lin, M. T. Infection-induced endothelial amyloids impair memory.
- Diagnostic accuracy of lung ultrasound performed by novice versus advanced sonographers for pneumonia in children: A systematic review and meta-analysis. [Journal Article]
- AEAcad Emerg Med 2019 Jun 18
- CONCLUSIONS: LUS can accurately diagnose pneumonia in children. However, this test demonstrates operator-dependent variability, with more experienced sonographers having higher diagnostic accuracy. Further work on evidence-based educational methods to train novice sonographers in LUS is required. This article is protected by copyright. All rights reserved.
- Ethanol exposure impairs AMPK signaling and phagocytosis in human alveolar macrophages: Role of ethanol metabolism. [Journal Article]
- ACAlcohol Clin Exp Res 2019 Jun 18
- CONCLUSIONS: EtOH-induced impaired phagocytosis, oxidative stress, ER stress and dysregulated AMPK signaling are plausibly associated with formation of FAEEs, and may participate in pathogenesis of non-specific pulmonary inflammation. This article is protected by copyright. All rights reserved.
- Oral Antibiotic Prescribing in Healthcare-associated Pneumonia Patients at Hospital Discharge. [Journal Article]
- CIClin Infect Dis 2019 Apr 26
- Vaccine Reduces Pneumonia in Kenya. [Journal Article]
- JAMAJAMA 2019 Jun 18; 321(23):2273
- Adverse Outcomes Associated With Potentially Inappropriate Antibiotic Use in Heart Failure Admissions. [Journal Article]
- OFOpen Forum Infect Dis 2019; 6(6):ofz220
- CONCLUSIONS: ADHF patients who received IVAB without evidence of infection had longer lengths of stay, required more diuretics, and were more likely to be readmitted compared with ADHF patients not exposed to IVAB. ADHF patients are a promising target of antibiotic stewardship interventions.
- Impact of the change in WHO's severe pneumonia case definition on hospitalized pneumonia epidemiology: case studies from six countries. [Journal Article]
- BWBull World Health Organ 2019 Jun 01; 97(6):386-393
- CONCLUSIONS: The revision of WHO's definition of severe pneumonia affects pneumonia epidemiology, and hence the interpretation of any pneumonia intervention impact evaluation.
- Management of ventilator-associated pneumonia (VAP) caused by resistant gram-negative bacteria: which is the best strategy to treat? [Journal Article]
- ERExpert Rev Respir Med 2019 Jun 18
- Introduction: Treatment of ventilator-associated pneumonia (VAP) is a major challenge. The increase in multi-drug resistant bacteria has not been accompanied by the validation of new drugs, or by any…
Introduction: Treatment of ventilator-associated pneumonia (VAP) is a major challenge. The increase in multi-drug resistant bacteria has not been accompanied by the validation of new drugs, or by any new antimicrobial strategies to exploit the available agents. VAP due to Gram-negative bacteria has increased mortality, both due to the resistant pathogens themselves and due to inappropriate treatment. Local epidemiology, patients' characteristics and clinical responses provide the most important information for therapeutic decision-making. Moreover, data on VAP therapy due to resistant bacteria are lacking, and the choice of treatment is often based on clinical practice and individual experience. Areas covered: This review summarizes the strategies available for treating the three most prevalent resistant Gram-negative organisms causing VAP: Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacteriaceae. The review covers the results of a Pubmed search, clinical practice guidelines and reviews, and the authors' experience. Expert opinion: The existing evidence focuses on bloodstream infections or other sites rather than pneumonia and there are no recommendations for the treatment of VAP by multi-drug resistant Gram-negative bacteria, especially for combination regimens. The approval of new drugs is needed to provide effective and safe alternatives for treating carbapenemase-producing strains. Precision medicine and personalized approach are also fundamental in future research.
- Valor pronóstico de la proadrenomedulina y el NT-proBNP en los pacientes procedentes de urgencias con síndrome gripal. [Journal Article]
- EEmergencias 2019; 31(3):180-184
- CONCLUSIONS: NT-proBNP and MR-proADM were the only biomarkers with prognostic value. Only NT-proBNP was a useful predictor in patients with confirmed influenza.
New Search Next
- The role of flexible bronchoscopy in lung tuberculosis mimicking mediastinal mass in an Infant: A rare case report. [Case Reports]
- IJInt J Mycobacteriol 2019 Apr-Jun; 8(2):199-201
- Tuberculosis (TB) is a systemic disease that can affect all parts in the body. The clinical manifestations sometimes mislead to other diagnoses. Mediastinal mass-like of TB in children is a rare mani…
Tuberculosis (TB) is a systemic disease that can affect all parts in the body. The clinical manifestations sometimes mislead to other diagnoses. Mediastinal mass-like of TB in children is a rare manifestation. A 5-month-old boy presented to our hospital with respiratory distress, fever for 2 months, body weight loss, cough, and history of recurrent pneumonia. The lung sound decreased on the right hemithorax. Lung computed tomography revealed multiple irregular cysts with thick walls on the anterosuperior mediastinal area, consolidation on the right lobe, and suspected gangrenous lung disease. The right main bronchus stenosis with cheesy-like vegetation was found on flexible bronchoscopy procedure. Xpert/MTB RIF from bronchoalveolar lavage revealed Mycobacterium tuberculosis and sensitive to rifampicin. Anti-TB drugs were given for 12 months. He has clinical and radiological improvement. We must increase the awareness of TB disease in case of mediastinal mass-like appearance in the high-endemic area. The flexible bronchoscopy plays an important role in diagnostic purpose.