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1. Corrigendum: Lack of Helios during neural development induces adult schizophrenia-like behaviors associated with aberrant levels of the TRIF-recruiter protein WDFY1

Author

Anna Sancho-Balsells, Veronica Brito, Belissa Fernández, Mónica Pardo, Marco Straccia, Silvia Ginés, Jordi Alberch, Isabel Hernández, Belén Arranz, Josep M. Canals, and Albert Giralt

Subjects
hippocampus, putamen, cortex, FENS1, psychosis, negative symptoms, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Published
2025
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2. The GRP78-PERK axis contributes to memory and synaptic impairments in Huntington's disease R6/1 mice

Author

Marc Espina, Nadia Di Franco, Martina Brañas-Navarro, Irene Rodriguez Navarro, Veronica Brito, Laura Lopez-Molina, Carlos Costas-Insua, Manuel Guzmán, and Silvia Ginés

Subjects
Huntington's disease, hippocampus, ER stress, Memory, PERK, Therapeutics, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Increasing evidence indicates that a key factor in neurodegenerative diseases is the activation of the unfolded protein response (UPR) caused by an accumulation of misfolded proteins in the endoplasmic reticulum (ER stress). Particularly, in Huntington's disease (HD) mutant huntingtin (mHtt) toxicity involves disruption of the ER-associated degradation pathway and loss of the ER protein homeostasis leading to neuronal dysfunction and degeneration. Besides the role of the UPR in regulating cell survival and death, studies that demonstrate the contribution of sustained UPR activation, particularly of PERK signaling, in memory disturbances and synaptic plasticity deficiencies are emerging. Given the contribution of hippocampal dysfunction to emotional and cognitive deficits seen in HD, we have analyzed the involvement of ER stress in HD memory alterations. We have demonstrated that at early disease stages, ER stress activation manifested as an increase in GRP78 and CHOP is observed in the hippocampus of R6/1 mice. Genetic reduction of GRP78 expression resulted in preventing hippocampal-dependent memory alterations but no motor deficits. Accordingly, hippocampal neuropathology namely, dendritic spine loss and accumulation of mHtt aggregates was ameliorated by GRP78 reduction. To elucidate the signaling pathways, we found that the inactivation of PERK by GSK2606414 restored spatial and recognition memories in R6/1 mice and rescued dendritic spine density in CA1 pyramidal neurons and protein levels of some specific immediate early genes. Our study unveils the critical role of the GRP78/PERK axis in memory impairment in HD mice and suggests the modulation of PERK activation as a novel therapeutic target for HD intervention.

Published
2023
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3. Genetically related genotypes of cowpea present similar bacterial community in the rhizosphere

Author

Tayná Mendes de Albuquerque, Lucas William Mendes, Sandra Mara Barbosa Rocha, Jadson Emanuel Lopes Antunes, Louise Melo de Souza Oliveira, Vania Maria Maciel Melo, Francisca Andrea Silva Oliveira, Arthur Prudêncio de Araujo Pereira, Veronica Brito da Silva, Regina Lucia Ferreira Gomes, Francisco de Alcantara Neto, Angela Celis de Almeida Lopes, Maurisrael de Moura Rocha, and Ademir Sergio Ferreira Araujo

Subjects
Medicine, Science
Abstract

Abstract Plant breeding reduces the genetic diversity of plants and could influence the composition, structure, and diversity of the rhizosphere microbiome, selecting more homogeneous and specialized microbes. In this study, we used 16S rRNA sequencing to assess the bacterial community in the rhizosphere of different lines and modern cowpea cultivars, to investigate the effect of cowpea breeding on bacterial community assembly. Thus, two African lines (IT85F-2687 and IT82D-60) and two Brazilian cultivars (BRS-Guariba and BRS-Tumucumaque) of cowpea were assessed to verify if the generation advance and genetic breeding influence the bacterial community in the rhizosphere. No significant differences were found in the structure, richness, and diversity of bacterial community structure between the rhizosphere of the different cowpea genotypes, and only slight differences were found at the OTU level. The complexity of the co-occurrence network decreased from African lines to Brazilian cultivars. Regarding functional prediction, the core functions were significantly altered according to the genotypes. In general, African lines presented a more abundance of groups related to chemoheterotrophy, while the rhizosphere of the modern cultivars decreased functions related to cellulolysis. This study showed that the genetic breeding process affects the dynamics of the rhizosphere community, decreasing the complexity of interaction in one cultivar. As these cowpea genotypes are genetically related, it could suggest a new hypothesis of how genetic breeding of similar genotypes could influence the rhizosphere microbiome.

Published
2022
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4. Lack of Helios During Neural Development Induces Adult Schizophrenia-Like Behaviors Associated With Aberrant Levels of the TRIF-Recruiter Protein WDFY1

Author

Anna Sancho-Balsells, Veronica Brito, Belissa Fernández, Mónica Pardo, Marco Straccia, Silvia Ginés, Jordi Alberch, Isabel Hernández, Belén Arranz, Josep M. Canals, and Albert Giralt

Subjects
hippocampus, putamen, cortex, FENS1, psychosis, negative symptoms, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

The role of the WDFY1 protein has been studied as a TLR3/4 scaffold/recruiting protein in the immune system and in different oncogenic conditions. However, its function in brain remains poorly understood. We have found that in mice devoid of Helios (He–/– mice), a transcription factor specifically expressed during the development of the immune cells and the central nervous system, there is a permanent and sustained increase of Wdfy1 gene expression in the striatum and hippocampus. Interestingly, we observed that WDFY1 protein levels were also increased in the hippocampus and dorsolateral prefrontal cortex of schizophrenic patients, but not in the hippocampus of Alzheimer’s disease patients with an associated psychotic disorder. Accordingly, young He–/– mice displayed several schizophrenic-like behaviors related to dysfunctions in the striatum and hippocampus. These changes were associated with an increase in spine density in medium spiny neurons (MSNs) and with a decrease in the number and size of PSD-95-positive clusters in the stratum radiatum of the CA1. Moreover, these alterations in structural synaptic plasticity were associated with a strong reduction of neuronal NF-κB in the pyramidal layer of the CA1 in He–/– mice. Altogether, our data indicate that alterations involving the molecular axis Helios-WDFY1 in neurons during the development of core brain regions could be relevant for the pathophysiology of neuropsychiatric disorders such as schizophrenia.

Published
2020
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5. Pyk2 modulates hippocampal excitatory synapses and contributes to cognitive deficits in a Huntington’s disease model

Author

Albert Giralt, Veronica Brito, Quentin Chevy, Clémence Simonnet, Yo Otsu, Carmen Cifuentes-Díaz, Benoit de Pins, Renata Coura, Jordi Alberch, Sílvia Ginés, Jean-Christophe Poncer, and Jean-Antoine Girault

Subjects
Science
Abstract

Several kinases regulate spine morphology and plasticity. Here, the authors show that the tyrosine kinase Pyk2 regulates hippocampal plasticity and contributes to cognitive and hippocampal plasticity deficits in a mouse model of Huntington’s disease.

Published
2017
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6. CD200 is up-regulated in R6/1 transgenic mouse model of Huntington's disease.

Author

Andrea Comella Bolla, Tony Valente, Andres Miguez, Veronica Brito, Silvia Gines, Carme Solà, Marco Straccia, and Josep M Canals

Subjects
Medicine, Science
Abstract

In Huntington's disease (HD), striatal medium spiny neurons (MSNs) are particularly sensitive to the presence of a CAG repeat in the huntingtin (HTT) gene. However, there are many evidences that cells from the peripheral immune system and central nervous system (CNS) immune cells, namely microglia, play an important role in the etiology and the progression of HD. However, it remains unclear whether MSNs neurodegeneration is mediated by a non-cell autonomous mechanism. The homeostasis in the healthy CNS is maintained by several mechanisms of interaction between all brain cells. Neurons can control microglia activation through several inhibitory mechanisms, such as the CD200-CD200R1 interaction. Due to the complete lack of knowledge about the CD200-CD200R1 system in HD, we determined the temporal patterns of CD200 and CD200R1 expression in the neocortex, hippocampus and striatum in the HD mouse models R6/1 and HdhQ111/7 from pre-symptomatic to manifest stages. In order to explore any alteration in the peripheral immune system, we also studied the levels of expression of CD200 and CD200R1 in whole blood. Although CD200R1 expression was not altered, we observed and increase in CD200 gene expression and protein levels in the brain parenchyma of all the regions we examined, along with HD pathogenesis in R6/1 mice. Interestingly, the expression of CD200 mRNA was also up-regulated in blood following a similar temporal pattern. These results suggest that canonical neuronal-microglial communication through CD200-CD200R1 interaction is not compromised, and CD200 up-regulation in R6/1 brain parenchyma could represent a neurotrophic signal to sustain or extend neuronal function in the latest stages of HD as pro-survival mechanism.

Published
2019
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7. Microbiological testing of adults hospitalised with community-acquired pneumonia: an international study

Author

Manuela Carugati, Stefano Aliberti, Luis Felipe Reyes, Ricardo Franco Sadud, Muhammad Irfan, Cristina Prat, Nilam J. Soni, Paola Faverio, Andrea Gori, Francesco Blasi, Marcos I. Restrepo, Patricia Karina Aruj, Silvia Attorri, Enrique Barimboim, Juan Pablo Caeiro, María I. Garzón, Victor Hugo Cambursano, Adrian Ceccato, Julio Chertcoff, Florencia Lascar, Fernando Di Tulio, Ariel Cordon Díaz, Lautaro de Vedia, Maria Cristina Ganaha, Sandra Lambert, Gustavo Lopardo, Carlos M. Luna, Alessio Gerardo Malberti, Nora Morcillo, Silvina Tartara, Claudia Pensotti, Betiana Pereyra, Pablo Gustavo Scapellato, Juan Pablo Stagnaro, Florencio Varela, Sonali Shah, Felix Lötsch, Florian Thalhammer, Kurt Anseeuw, Camille A. Francois, Eva Van Braeckel, Jean Louis Vincent, Marcel Zannou Djimon, Jules Bashi, Roger Dodo, Simone Aranha Nouér, Peter Chipev, Milena Encheva, Darina Miteva, Diana Petkova, Adamou Dodo Balkissou, Eric Walter Pefura Yone, Bertrand Hugo Mbatchou Ngahane, Ning Shen, Jin-fu Xu, Carlos Andres Bustamante Rico, Ricardo Buitrago, Fernando Jose Pereira Paternina, Jean-Marie Kayembe Ntumba, Vesna Vladic Carevic, Marko Jakopovic, Mateja Jankovic, Zinka Matkovic, Ivan Mitrecic, Marie-Laure Bouchy Jacobsson, Anette Bro Christensen, Uffe Christian Heitmann Bødtger, Christian Niels Meyer, Andreas Vestergaard Jensen, Gertrud Baunbæk-Knudsen, Pelle Trier Petersen, Stine Andersen, Ibrahim El-Said Abd El-Wahhab, Nesreen Elsayed Morsy, Hanaa Shafiek, Eman Sobh, Kedir Abdella Abdulsemed, Fabrice Bertrand, Christian Brun-Buisson, Etienne de Montmollin, Muriel Fartoukh, Jonathan Messika, Pierre Tattevin, Abdo Khoury, Bernard Ebruke, Michael Dreher, Martin Kolditz, Matthias Meisinger, Mathias W. Pletz, Stefan Hagel, Jan Rupp, Tom Schaberg, Marc Spielmanns, Petra Creutz, Norton Suttorp, Beatrice Siaw-Lartey, Katerina Dimakou, Dimosthenis Papapetrou, Evdoxia Tsigou, Dimitrios Ampazis, Evangelos Kaimakamis, Mina Gaga, Mohit Bhatia, Raja Dhar, George D'Souza, Rajiv Garg, Parvaiz A. Koul, P.A. Mahesh, B.S. Jayaraj, Kiran Vishnu Narayan, Hirennappa B. Udnur, Shashi Bhaskara Krishnamurthy, Surya Kant, Rajesh Swarnakar, Sneha Limaye, Sundeep Salvi, Keihan Golshani, Vera M. Keatings, Ignacio Martin-Loeches, Yasmin Maor, Jacob Strahilevitz, Salvatore Battaglia, Maria Carrabba, Piero Ceriana, Marco Confalonieri, Antonella d'Arminio Monforte, Bruno Del Prato, Marino De Rosa, Riccardo Fantini, Giuseppe Fiorentino, Maria Antonia Gammino, Francesco Menzella, Giuseppe Milani, Stefano Nava, Gerardo Palmiero, Roberta Petrino, Barbra Gabrielli, Paolo Rossi, Claudio Sorino, Gundi Steinhilber, Alessandro Zanforlin, Fabio Franzetti, Manuela Morosi, Elisa Monge, Mauro Carone, Vincenzo Patella, Simone Scarlata, Andrea Comel, Kiyoyasu Kurahashi, Zeina Aoun Bacha, Daniel Barajas Ugalde, Omar Ceballos Zuñiga, José F. Villegas, Milic Medenica, E.M.W. van de Garde, Deebya Raj Mihsra, Poojan Shrestha, Elliott Ridgeon, Babatunde Ishola Awokola, Ogonna N.O. Nwankwo, Adefuye Bolanle Olufunlola, Segaolu Olumide, Kingsley N. Ukwaja, Lukasz Minarowski, Skoczyński Szymon, Felipe Froes, Pedro Leuschner, Mariana Meireles, Sofia B Ravara, Victoria Brocovschii, Chesov Ion, Doina Rusu, Cristina Toma, Daniela Chirita, Carmen Mihaela Dorobat, Alexei Birkun, Anna Kaluzhenina, Abdullah Almotairi, Zakeya Abdulbaqi Ali Bukhary, Jameela Edathodu, Amal Fathy, Abdullah Mushira Abdulaziz Enani, Nazik Eltayeb Mohamed, Jawed Ulhadi Memon, Abdelhaleem Bella, Nada Bogdanović, Branislava Milenkovic, Dragica Pesut, Charles Feldman, Ho Kee Yum, Luis Borderìas, Noel Manuel Bordon Garcia, Hugo Cabello Alarcón, Catia Cilloniz, Antoni Torres, Vicens Diaz-Brito, Xavier Casas, Alicia Encabo González, Maria Luisa Fernández-Almira, Miguel Gallego, Inmaculada Gaspar-GarcÍa, Juan González del Castillo, Patricia Javaloyes Victoria, Elena Laserna Martínez, Rosa Malo de Molina, Pedro J. Marcos, Rosario Menéndez, Ana Pando-Sandoval, Cristina Prat Aymerich, Jordi Rello, Silvia Moyano, Francisco Sanz, Oriol Sibila, Ana Rodrigo-Troyano, Jordi Solé-Violán, Ane Uranga, Job F.M. van Boven, Ester Vendrell Torra, Jordi Almirall Pujol, Arnauld Attannon Fiogbe, Ferdaous Yangui, Semra Bilaceroglu, Levent Dalar, Ufuk Yilmaz, Artemii Bogomolov, Naheed Elahi, Devesh J. Dhasmana, Andrew Feneley, Rhiannon Ions, Julie Skeemer, Gerrit Woltmann, Carole Hancock, Adam T. Hill, Banu Rudran, Silvia Ruiz-Buitrago, Marion Campbell, Paul Whitaker, Alexander Youzguin, Anika Singanayagam, Karen S. Allen, Veronica Brito, Jessica Dietz, Claire E. Dysart, Susan M. Kellie, Ricardo A. Franco-Sadud, Garnet Meier, Thomas L. Holland, Stephen P. Bergin, Fayez Kheir, Mark Landmeier, Manuel Lois, Girish B. Nair, Hemali Patel, Katherine Reyes, William Rodriguez-Cintron, Shigeki Saito, Julio Noda, Cecilia I. Hinojosa, Stephanie M. Levine, Luis F. Angel, Antonio Anzueto, K. Scott Whitlow, John Hipskind, Kunal Sukhija, Vicken Totten, Richard G. Wunderink, Ray D. Shah, Kondwelani John Mateyo, Lorena Noriega, Ezequiel Alvarado, Mohamed Aman, and Lucía Labra

Subjects
Medicine
Abstract

This study aimed to describe real-life microbiological testing of adults hospitalised with community-acquired pneumonia (CAP) and to assess concordance with the 2007 Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) and 2011 European Respiratory Society (ERS) CAP guidelines. This was a cohort study based on the Global Initiative for Methicillin-resistant Staphylococcus aureus Pneumonia (GLIMP) database, which contains point-prevalence data on adults hospitalised with CAP across 54 countries during 2015. In total, 3702 patients were included. Testing was performed in 3217 patients, and included blood culture (71.1%), sputum culture (61.8%), Legionella urinary antigen test (30.1%), pneumococcal urinary antigen test (30.0%), viral testing (14.9%), acute-phase serology (8.8%), bronchoalveolar lavage culture (8.4%) and pleural fluid culture (3.2%). A pathogen was detected in 1173 (36.5%) patients. Testing attitudes varied significantly according to geography and disease severity. Testing was concordant with IDSA/ATS and ERS guidelines in 16.7% and 23.9% of patients, respectively. IDSA/ATS concordance was higher in Europe than in North America (21.5% versus 9.8%; p

Published
2018
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8. Breeding-induced changes in the rhizosphere microbial communities in Lima bean (Phaseolus lunatus)

Author

Brito, Karla Annielle da Silva Bernardo, Rocha, Sandra Mara Barbosa, Lopes, Ângela Celis de Almeida, Silva, Verônica Brito, Gomes, Regina Lucia Ferreira, Matos Filho, Carlos Humberto Aires, Pereira, Arthur Prudêncio de Araujo, Melo, Vania Maria Maciel, de Medeiros, Erika Valente, Mendes, Lucas William, de Miranda, Ana Roberta Lima, and Araujo, Ademir Sérgio Ferreira

Published
2025
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9. Domestication of Lima Bean (Phaseolus lunatus) Changes the Microbial Communities in the Rhizosphere

Author

da Silva, Josieli Lima, Mendes, Lucas William, Rocha, Sandra Mara Barbosa, Antunes, Jadson Emanuel Lopes, Oliveira, Louise Melo de Souza, Melo, Vania Maria Maciel, Oliveira, Francisca Andrea Silva, Pereira, Arthur Prudêncio de Araujo, Costa, Gérson do Nascimento, da Silva, Veronica Brito, Gomes, Regina Lucia Ferreira, de Alcantara Neto, Francisco, Lopes, Angela Celis de Almeida, and Araujo, Ademir Sérgio Ferreira

Published
2023
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10. Rhizospheric microbial community in plant species from the Phaseolus genus

Author

Lopes, Angela Celis de Almeida, Mendes, Lucas William, Brito, Karla Annielle da Silva Bernardo, da Silva, Josieli Lima, Rocha, Sandra Mara Barbosa, Antunes, Jadson Emanuel Lopes, Oliveira, Louise Melo de Souza, Melo, Vania Maria Maciel, Oliveira, Francisca Andrea Silva, Pereira, Arthur Prudêncio de Araujo, Costa, Gérson do Nascimento, da Silva, Veronica Brito, Gomes, Regina Lucia Ferreira, de Alcantara Neto, Francisco, and Araujo, Ademir Sergio Ferreira

Published
2023
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12. GRUPO DE ESTUDOS VIRTUAL DE GENÉTICA E BIOLOGIA CELULAR PARA O ENEM

Author

Silva, Maria Francisca de Sousa, primary, Costa, Matheus Gomes, additional, Campos, Renata Dourizete Costa, additional, Costa, Carlos Pedro de Menezes, additional, Vale, Kaline Aguiar Gonzalez, additional, Silva, Josieli Lima da, additional, Silva, Veronica Brito da, additional, and Brito, Marilha Vieira de, additional

Published
2022
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14. The lima bean breeding decreases the ability of segregating generations to nodulate with indigenous rhizobia

Author

Brito, Karla Annielle da Silva Bernardo, Rocha, Sandra Mara Barbosa, Antunes, Jadson Emanuel Lopes, Pereira, Arthur Prudêncio de Araujo, Costa, Gérson do Nascimento, Sousa, Juliana de Oliveira, da Silva, Verônica Brito, Matos Filho, Carlos Humberto Aires, Gomes, Regina Lucia Ferreira, Lopes, Ângela Celis de Almeida, and Araujo, Ademir Sérgio Ferreira

Published
2023
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16. Domestication of Lima Bean (Phaseolus lunatus) Changes the Microbial Communities in the Rhizosphere

Author

Josieli Lima da Silva, Lucas William Mendes, Sandra Mara Barbosa Rocha, Jadson Emanuel Lopes Antunes, Louise Melo de Souza Oliveira, Vania Maria Maciel Melo, Francisca Andrea Silva Oliveira, Arthur Prudêncio de Araujo Pereira, Gérson do Nascimento Costa, Veronica Brito da Silva, Regina Lucia Ferreira Gomes, Francisco de Alcantara Neto, Angela Celis de Almeida Lopes, and Ademir Sérgio Ferreira Araujo

Subjects
Ecology, Soil Science, Ecology, Evolution, Behavior and Systematics
Abstract

Plants modulate the soil microbiota and select a specific microbial community in the rhizosphere. However, plant domestication reduces genetic diversity, changes plant physiology, and could have an impact on the associated microbiome assembly. Here, we used 16S rRNA gene sequencing to assess the microbial community in the bulk soil and rhizosphere of wild, semi-domesticated, and domesticated genotypes of lima bean (Phaseolus lunatus), to investigate the effect of plant domestication on microbial community assembly. In general, rhizosphere communities were more diverse than bulk soil, but no differences were found among genotypes. Our results showed that the microbial community's structure was different from wild and semi-domesticated as compared to domesticated genotypes. The community similarity decreased 57.67% from wild to domesticated genotypes. In general, the most abundant phyla were Actinobacteria (21.9%), Proteobacteria (20.7%), Acidobacteria (14%), and Firmicutes (9.7%). Comparing the different genotypes, the analysis showed that Firmicutes (Bacillus) was abundant in the rhizosphere of the wild genotypes, while Acidobacteria dominated semi-domesticated plants, and Proteobacteria (including rhizobia) was enriched in domesticated P. lunatus rhizosphere. The domestication process also affected the microbial community network, in which the complexity of connections decreased from wild to domesticated genotypes in the rhizosphere. Together, our work showed that the domestication of P. lunatus shaped rhizosphere microbial communities from taxonomic to a functional level, changing the abundance of specific microbial groups and decreasing the complexity of interactions among them.

Published
2022

17. Domestication of Lima Bean (Phaseolus lunatus) Changes the Microbial Communities in the Rhizosphere

Author

da Silva, Josieli Lima, primary, Mendes, Lucas William, additional, Rocha, Sandra Mara Barbosa, additional, Antunes, Jadson Emanuel Lopes, additional, Oliveira, Louise Melo de Souza, additional, Melo, Vania Maria Maciel, additional, Oliveira, Francisca Andrea Silva, additional, Pereira, Arthur Prudêncio de Araujo, additional, Costa, Gérson do Nascimento, additional, da Silva, Veronica Brito, additional, Gomes, Regina Lucia Ferreira, additional, de Alcantara Neto, Francisco, additional, Lopes, Angela Celis de Almeida, additional, and Araujo, Ademir Sérgio Ferreira, additional

Published
2022
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18. Genetically related genotypes of cowpea present similar bacterial community in the rhizosphere

Author

de Albuquerque, Tayná Mendes, primary, Mendes, Lucas William, additional, Rocha, Sandra Mara Barbosa, additional, Antunes, Jadson Emanuel Lopes, additional, Oliveira, Louise Melo de Souza, additional, Melo, Vania Maria Maciel, additional, Oliveira, Francisca Andrea Silva, additional, Pereira, Arthur Prudêncio de Araujo, additional, da Silva, Veronica Brito, additional, Gomes, Regina Lucia Ferreira, additional, de Alcantara Neto, Francisco, additional, Lopes, Angela Celis de Almeida, additional, de Moura Rocha, Maurisrael, additional, and Araujo, Ademir Sergio Ferreira, additional

Published
2022
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21. Aspiration Risk Factors, Microbiology, and Empiric Antibiotics for Patients Hospitalized With Community-Acquired Pneumonia

Author

Judith Marin-Corral, Sergi Pascual-Guardia, Francesco Amati, Stefano Aliberti, Joan R Masclans, Nilam Soni, Alejandro Rodriguez, Oriol Sibila, Francisco Sanz, Giovanni Sotgiu, Antonio Anzueto, Katerina Dimakou, Roberta Petrino, Ewoudt van de Garde, Marcos I Restrepo, GLIMP investigators, Patricia Karina Aruj, Silvia Attorri, Enrique Barimboim, Juan Pablo Caeiro, María I Garzón, Victor Hugo Cambursano, V H Dr Cazaux A Adrian Ceccato, Julio Chertcoff, Florencia Lascar, Fernando Di Tulio, Ariel Cordon Díaz, Lautaro de Vedia, Maria Cristina Ganaha, Sandra Lambert, Gustavo Lopardo, Carlos M Luna, Alessio Gerardo Malberti, Nora Morcillo, Silvina Tartara, Claudia Pensotti, Betiana Pereyra, Pablo Gustavo Scapellato, Juan Pablo Stagnaro, Sonali Shah, Felix Lötsch, Florian Thalhammer, Kurt Anseeuw, Camille A Francois, Eva Van Braeckel, Jean Louis Vincent, Marcel Zannou Djimon, Jules Bashi, Roger Dodo, Simone Aranha Nouér, Peter Chipev, Milena Encheva, Darina Miteva, Diana Petkova, Adamou Dodo Balkissou, Eric Walter Pefura Yone, Bertrand Hugo Mbatchou Ngahane, Ning Shen, Jin-Fu Xu, Carlos Andres Bustamante Rico, Ricardo Buitrago, Fernando Jose Pereira Paternina, Jean-Marie Kayembe Ntumba, Vesna Vladic Carevic, Marko Jakopovic, Mateja Jankovic, Zinka Matkovic, Ivan Mitrecic, Marie-Laure Bouchy Jacobsson, Anette Bro Christensen, Uffe Christian Heitmann Bødtger, Christian Niels Meyer, Andreas Vestergaard Jensen, Gertrud Baunbæk-Knudsen, Pelle Trier Petersen, Stine Andersen, Ibrahim El-Said Abd El-Wahhab, Nesreen Elsayed Morsy, Hanaa Shafiek, Eman Sobh, Kedir Abdella Abdulsemed, Fabrice Bertrand, Christian Brun-Buisson, Etienne de Montmollin, Muriel Fartoukh, Jonathan Messika, Pierre Tattevin, Abdo Khoury, Bernard Ebruke, Michael Dreher, Martin Kolditz, Matthias Meisinger, Mathias W Pletz, Stefan Hagel, Jan Rupp, Tom Schaberg, Marc Spielmanns, Petra Creutz, Norton Suttorp, Beatrice Siaw-Lartey, Dimosthenis Papapetrou, Evdoxia Tsigou, Dimitrios Ampazis, Evangelos Kaimakamis, Mohit Bhatia, Raja Dhar, George D'Souza, Rajiv Garg, Parvaiz A Koul, P A Mahesh, B S Jayaraj, Kiran Vishnu Narayan, Hirennappa B Udnur, Shashi Bhaskara Krishnamurthy, Surya Kant, Rajesh Swarnakar, Sneha Limaye, Sundeep Salvi, Keihan Golshani, Vera M Keatings, Ignacio Martin-Loeches, Yasmin Maor, Jacob Strahilevitz, Paola Faverio, Salvatore Battaglia, Maria Carrabba, Piero Ceriana, Marco Confalonieri, Antonella d'Arminio Monforte, Bruno Del Prato, Marino De Rosa, Riccardo Fantini, Giuseppe Fiorentino, Maria Antonia Gammino, Francesco Menzella, Giuseppe Milani, Stefano Nava, Gerardo Palmiero, Barbra Gabrielli, Paolo Rossi, Claudio Sorino, Gundi Steinhilber, Alessandro Zanforlin, Ospedale San Luca, Fabio Franzetti, Manuela Carugati, Manuela Morosi, Elisa Monge, Mauro Carone, Vincenzo Patella, Simone Scarlata, Andrea Comel, Kiyoyasu Kurahashi, Zeina Aoun Bacha, Daniel Barajas Ugalde, Omar Ceballos Zuñiga, José F Villegas, Milic Medenica, Deebya Raj Mihsra, Poojan Shrestha, Elliott Ridgeon, Babatunde Ishola Awokola, Ogonna N O Adefuye Bolanle Olufunlola, Segaolu Olumide, Kingsley N Ukwaja, Muhammad Irfan, Lukasz Minarowski, Skoczyński Szymon, Felipe Froes, Pedro Leuschner, Mariana Meireles, Cláudia Ferrão, João Neves, Abel Salazar, Sofia B Ravara, Victoria Brocovschii, Doina Rusu, Cristina Toma, Daniela Chirita, Carmen Mihaela Dorobat, Alexei Birkun, Anna Kaluzhenina, Abdullah Almotairi, Zakeya Abdulbaqi Ali Bukhary, Jameela Edathodu, Amal Fathy, Abdullah Mushira Abdulaziz Enani, Nazik Eltayeb Mohamed, Jawed Ulhadi Memon, Abdelhaleem Bella, Serbia Nada Bogdanović, Branislava Milenkovic, Dragica Pesut, Luis Borderìas, Noel Manuel Bordon Garcia, Hugo Cabello Alarcón, Catia Cilloniz, Antoni Torres, Vicens Diaz-Brito, Xavier Casas, Alicia Encabo González, Maria Luisa Fernández-Almira, Medicina Interna, Miguel Gallego, Inmaculada Gaspar-GarcÍa, Juan González Del Castillo, Patricia Javaloyes Victoria, Elena Laserna Martínez, Rosa Malo de Molina, Pedro J Marcos, Rosario Menéndez, Ana Pando-Sandoval, Cristina Prat Aymerich, Alicia Lacoma de la Torre, Ignasi García-Olivé, Jordi Rello, Silvia Moyano, Ana Rodrigo-Troyano, Jordi Solé-Violán, Ane Uranga, Job Fm van Boven, Ester Vendrell Torra, Jordi Almirall Pujol, Charles Feldman, Ho Kee Yum, Inje Univ Arnauld Attannon Fiogbe, Ferdaous Yangui, Semra Bilaceroglu, Izmir Dr Levent Dalar, Ufuk Yilmaz, Artemii Bogomolov, Naheed Elahi, Devesh J Dhasmana, Andrew Feneley, Adam T Hill, Banu Rudran, Silvia Ruiz-Buitrago, Marion Campbell, Paul Whitaker, Alexander Youzguin, Anika Singanayagam, C Hancock, David Villafuerte, Karen S Allen, Veronica Brito, Jessica Dietz, Claire E Dysart, Susan M Kellie, Clement J Ricardo A Franco-Sadud, Garnet Meier, Mina Gaga, Thomas L Holland, Stephen P Bergin, Fayez Kheir, Mark Landmeier, Manuel Lois, Girish B Nair, Hemali Patel, Katherine Reyes, William Rodriguez-Cintron, Shigeki Saito, Julio Noda, Cecilia I Hinojosa, Stephanie M Levine, Luis F Reyes, Luis F Angel, K Scott Whitlow, John Hipskind, Kunal Sukhija, Vicken Totten, Richard G Wunderink, Ray D Shah, Kondwelani John Mateyo, Lorena Noriega, Ezequiel Alvarado, Mohamed Aman, Lucía Labra, Marin-Corral J., Pascual-Guardia S., Amati F., Aliberti S., Masclans J.R., Soni N., Rodriguez A., Sibila O., Sanz F., Sotgiu G., Anzueto A., Dimakou K., Petrino R., van de Garde E., Restrepo M.I., Aruj P.K., Attorri S., Barimboim E., Caeiro J.P., Garzon M.I., Cambursano V.H., Adrian Ceccato V.H.D.C.A., Chertcoff J., Lascar F., Di Tulio F., Diaz A.C., de Vedia L., Ganaha M.C., Lambert S., Lopardo G., Luna C.M., Malberti A.G., Morcillo N., Tartara S., Pensotti C., Pereyra B., Scapellato P.G., Stagnaro J.P., Shah S., Lotsch F., Thalhammer F., Anseeuw K., Francois C.A., Van Braeckel E., Vincent J.L., Djimon M.Z., Bashi J., Dodo R., Nouer S.A., Chipev P., Encheva M., Miteva D., Petkova D., Balkissou A.D., Pefura Yone E.W., Mbatchou Ngahane B.H., Shen N., Xu J.-F., Bustamante Rico C.A., Buitrago R., Pereira Paternina F.J., Kayembe Ntumba J.-M., Carevic V.V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Bouchy Jacobsson M.-L., Christensen A.B., Heitmann Bodtger U.C., Meyer C.N., Jensen A.V., Baunbaek-knudsen G., Petersen P.T., Andersen S., El-Said Abd El-Wahhab I., Morsy N.E., Shafiek H., Sobh E., Abdulsemed K.A., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M.W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Creutz P., Suttorp N., Siaw-Lartey B., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., Bhatia M., Dhar R., D'Souza G., Garg R., Koul P.A., Mahesh P.A., Jayaraj B.S., Narayan K.V., Udnur H.B., Krishnamurthy S.B., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V.M., Martin-Loeches I., Maor Y., Strahilevitz J., Faverio P., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A.D., Del Prato B., De Rosa M., Fantini R., Fiorentino G., Gammino M.A., Menzella F., Milani G., Nava S., Palmiero G., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., San Luca O., Franzetti F., Carugati M., Morosi M., Monge E., Carone M., Patella V., Scarlata S., Comel A., Kurahashi K., Bacha Z.A., Ugalde D.B., Zuniga O.C., Villegas J.F., Medenica M., Mihsra D.R., Shrestha P., Ridgeon E., Awokola B.I., Adefuye Bolanle Olufunlola O.N.O., Olumide S., Ukwaja K.N., Irfan M., Minarowski L., Szymon S., Froes F., Leuschner P., Meireles M., Ferrao C., Neves J., Abel Salazar, Ravara S.B., Brocovschii V., Rusu D., Toma C., Chirita D., Dorobat C.M., Birkun A., Kaluzhenina A., Almotairi A., Ali Bukhary Z.A., Edathodu J., Fathy A., Abdulaziz Enani A.M., Mohamed N.E., Memon J.U., Bella A., Bogdanovic S.N., Milenkovic B., Pesut D., Borderias L., Bordon Garcia N.M., Alarcon H.C., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Gonzalez A.E., Fernandez-Almira M.L., Interna M., Gallego M., Gaspar-GarcIa I., Gonzalez del Castillo J., Victoria P.J., Martinez E.L., Malo de Molina R., Marcos P.J., Menendez R., Pando-Sandoval A., Aymerich C.P., Lacoma de la Torre A., Garcia-Olive I., Rello J., Moyano S., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J.F., Torra E.V., Pujol J.A., Feldman C., Yum H.K., Arnauld Attannon Fiogbe I.U., Yangui F., Bilaceroglu S., Levent Dalar I.D., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D.J., Feneley A., Hill A.T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., Hancock C., Villafuerte D., Allen K.S., Brito V., Dietz J., Dysart C.E., Kellie S.M., Ricardo A. 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Eman, Abdella Abdulsemed, Kedir, Bertrand, Fabrice, Brun-Buisson, Christian, de Montmollin, Etienne, Fartoukh, Muriel, Messika, Jonathan, Tattevin, Pierre, Khoury, Abdo, Ebruke, Bernard, Dreher, Michael, Kolditz, Martin, Meisinger, Matthia, W Pletz, Mathia, Hagel, Stefan, Rupp, Jan, Schaberg, Tom, Spielmanns, Marc, Creutz, Petra, Suttorp, Norton, Siaw-Lartey, Beatrice, Papapetrou, Dimostheni, Tsigou, Evdoxia, Ampazis, Dimitrio, Kaimakamis, Evangelo, Bhatia, Mohit, Dhar, Raja, D'Souza, George, Garg, Rajiv, A Koul, Parvaiz, A Mahesh, P, S Jayaraj, B, Vishnu Narayan, Kiran, B Udnur, Hirennappa, Bhaskara Krishnamurthy, Shashi, Kant, Surya, Swarnakar, Rajesh, Limaye, Sneha, Salvi, Sundeep, Golshani, Keihan, M Keatings, Vera, Martin-Loeches, Ignacio, Maor, Yasmin, Strahilevitz, Jacob, Faverio, Paola, Battaglia, Salvatore, Carrabba, Maria, Ceriana, Piero, Confalonieri, Marco, d'Arminio Monforte, Antonella, Del Prato, Bruno, De Rosa, Marino, Fantini, Riccardo, Fiorentino, Giuseppe, Antonia Gammino, Maria, Menzella, Francesco, Milani, Giuseppe, Nava, Stefano, Palmiero, Gerardo, Gabrielli, Barbra, Rossi, Paolo, Sorino, Claudio, Steinhilber, Gundi, Zanforlin, Alessandro, San Luca, Ospedale, Franzetti, Fabio, Carugati, Manuela, Morosi, Manuela, Monge, Elisa, Carone, Mauro, Patella, Vincenzo, Scarlata, Simone, Comel, Andrea, Kurahashi, Kiyoyasu, Aoun Bacha, Zeina, Barajas Ugalde, Daniel, Ceballos Zuñiga, Omar, F Villegas, José, Medenica, Milic, Raj Mihsra, Deebya, Shrestha, Poojan, Ridgeon, Elliott, Ishola Awokola, Babatunde, O Adefuye Bolanle Olufunlola, Ogonna N, Olumide, Segaolu, N Ukwaja, Kingsley, Irfan, Muhammad, Minarowski, Lukasz, Szymon, Skoczyński, Froes, Felipe, Leuschner, Pedro, Meireles, Mariana, Ferrão, Cláudia, Neves, João, Salazar, Abel, B Ravara, Sofia, Brocovschii, Victoria, Rusu, Doina, Toma, Cristina, Chirita, Daniela, Mihaela Dorobat, Carmen, Birkun, Alexei, Kaluzhenina, Anna, Almotairi, Abdullah, Abdulbaqi Ali Bukhary, Zakeya, Edathodu, Jameela, Fathy, Amal, Mushira Abdulaziz Enani, Abdullah, Eltayeb Mohamed, Nazik, Ulhadi Memon, Jawed, Bella, Abdelhaleem, Nada Bogdanović, Serbia, Milenkovic, Branislava, Pesut, Dragica, Borderìas, Lui, Manuel Bordon Garcia, Noel, Cabello Alarcón, Hugo, Cilloniz, Catia, Torres, Antoni, Diaz-Brito, Vicen, Casas, Xavier, Encabo González, Alicia, Luisa Fernández-Almira, Maria, Interna, Medicina, Gallego, Miguel, Gaspar-GarcÍa, Inmaculada, González Del Castillo, Juan, Javaloyes Victoria, Patricia, Laserna Martínez, Elena, Malo de Molina, Rosa, J Marcos, Pedro, Menéndez, Rosario, Pando-Sandoval, Ana, Prat Aymerich, Cristina, Lacoma de la Torre, Alicia, García-Olivé, Ignasi, Rello, Jordi, Moyano, Silvia, Rodrigo-Troyano, Ana, Solé-Violán, Jordi, Uranga, Ane, Fm van Boven, Job, Vendrell Torra, Ester, Almirall Pujol, Jordi, Feldman, Charle, Kee Yum, Ho, Univ Arnauld Attannon Fiogbe, Inje, Yangui, Ferdaou, Bilaceroglu, Semra, Dr Levent Dalar, Izmir, Yilmaz, Ufuk, Bogomolov, Artemii, Elahi, Naheed, J Dhasmana, Devesh, Feneley, Andrew, T Hill, Adam, Rudran, Banu, Ruiz-Buitrago, Silvia, Campbell, Marion, Whitaker, Paul, Youzguin, Alexander, Singanayagam, Anika, Hancock, C, Villafuerte, David, S Allen, Karen, Brito, Veronica, Dietz, Jessica, E Dysart, Claire, M Kellie, Susan, A Franco-Sadud, Clement J Ricardo, Meier, Garnet, Gaga, Mina, L Holland, Thoma, P Bergin, Stephen, Kheir, Fayez, Landmeier, Mark, Lois, Manuel, B Nair, Girish, Patel, Hemali, Reyes, Katherine, Rodriguez-Cintron, William, Saito, Shigeki, Noda, Julio, I Hinojosa, Cecilia, M Levine, Stephanie, F Reyes, Lui, F Angel, Lui, Scott Whitlow, K, Hipskind, John, Sukhija, Kunal, Totten, Vicken, G Wunderink, Richard, D Shah, Ray, John Mateyo, Kondwelani, Noriega, Lorena, Alvarado, Ezequiel, Aman, Mohamed, Labra, Lucía, Marin-Corral, J, Pascual-Guardia, S, Amati, F, Aliberti, S, Masclans, J, Soni, N, Rodriguez, A, Sibila, O, Sanz, F, Sotgiu, G, Anzueto, A, Dimakou, K, Petrino, R, van de Garde, E, Restrepo, M, Aruj, P, Attorri, S, Barimboim, E, Caeiro, J, Garzon, M, Cambursano, V, Adrian Ceccato, V, Chertcoff, J, Lascar, F, Di Tulio, F, Diaz, A, de Vedia, L, Ganaha, M, Lambert, S, Lopardo, G, Luna, C, Malberti, A, Morcillo, N, Tartara, S, Pensotti, C, Pereyra, B, Scapellato, P, Stagnaro, J, Shah, S, Lotsch, F, Thalhammer, F, Anseeuw, K, Francois, C, Van Braeckel, E, Vincent, J, Djimon, M, Bashi, J, Dodo, R, Nouer, S, Chipev, P, Encheva, M, Miteva, D, Petkova, D, Balkissou, A, Pefura Yone, E, Mbatchou Ngahane, B, Shen, N, Xu, J, Bustamante Rico, C, Buitrago, R, Pereira Paternina, F, Kayembe Ntumba, J, Carevic, V, Jakopovic, M, Jankovic, M, Matkovic, Z, Mitrecic, I, Bouchy Jacobsson, M, Christensen, A, Heitmann Bodtger, U, Meyer, C, Jensen, A, Baunbaek-knudsen, G, Petersen, P, Andersen, S, El-Said Abd El-Wahhab, I, Morsy, N, Shafiek, H, Sobh, E, Abdulsemed, K, Bertrand, F, Brun-Buisson, C, de Montmollin, E, Fartoukh, M, Messika, J, Tattevin, P, Khoury, A, Ebruke, B, Dreher, M, Kolditz, M, Meisinger, M, Pletz, M, Hagel, S, Rupp, J, Schaberg, T, Spielmanns, M, Creutz, P, Suttorp, N, Siaw-Lartey, B, Papapetrou, D, Tsigou, E, Ampazis, D, Kaimakamis, E, Bhatia, M, Dhar, R, D'Souza, G, Garg, R, Koul, P, Mahesh, P, Jayaraj, B, Narayan, K, Udnur, H, Krishnamurthy, S, Kant, S, Swarnakar, R, Limaye, S, Salvi, S, Golshani, K, Keatings, V, Martin-Loeches, I, Maor, Y, Strahilevitz, J, Faverio, P, Battaglia, S, Carrabba, M, Ceriana, P, Confalonieri, M, Monforte, A, Del Prato, B, De Rosa, M, Fantini, R, Fiorentino, G, Gammino, M, Menzella, F, Milani, G, Nava, S, Palmiero, G, Gabrielli, B, Rossi, P, Sorino, C, Steinhilber, G, Zanforlin, A, San Luca, O, Franzetti, F, Carugati, M, Morosi, M, Monge, E, Carone, M, Patella, V, Scarlata, S, Comel, A, Kurahashi, K, Bacha, Z, Ugalde, D, Zuniga, O, Villegas, J, Medenica, M, Mihsra, D, Shrestha, P, Ridgeon, E, Awokola, B, Adefuye Bolanle Olufunlola, O, Olumide, S, Ukwaja, K, Irfan, M, Minarowski, L, Szymon, S, Froes, F, Leuschner, P, Meireles, M, Ferrao, C, Neves, J, Abel, S, Ravara, S, Brocovschii, V, Rusu, D, Toma, C, Chirita, D, Dorobat, C, Birkun, A, Kaluzhenina, A, Almotairi, A, Ali Bukhary, Z, Edathodu, J, Fathy, A, Abdulaziz Enani, A, Mohamed, N, Memon, J, Bella, A, Bogdanovic, S, Milenkovic, B, Pesut, D, Borderias, L, Bordon Garcia, N, Alarcon, H, Cilloniz, C, Torres, A, Diaz-Brito, V, Casas, X, Gonzalez, A, Fernandez-Almira, M, Interna, M, Gallego, M, Gaspar-GarcIa, I, Gonzalez del Castillo, J, Victoria, P, Martinez, E, Malo de Molina, R, Marcos, P, Menendez, R, Pando-Sandoval, A, Aymerich, C, Lacoma de la Torre, A, Garcia-Olive, I, Rello, J, Moyano, S, Rodrigo-Troyano, A, Sole-Violan, J, Uranga, A, van Boven, J, Torra, E, Pujol, J, Feldman, C, Yum, H, Arnauld Attannon Fiogbe, I, Yangui, F, Bilaceroglu, S, Levent Dalar, I, Yilmaz, U, Bogomolov, A, Elahi, N, Dhasmana, D, Feneley, A, Hill, A, Rudran, B, Ruiz-Buitrago, S, Campbell, M, Whitaker, P, Youzguin, A, Singanayagam, A, Villafuerte, D, Allen, K, Brito, V, Dietz, J, Dysart, C, Kellie, S, Ricardo, A, Meier, G, Gaga, M, Holland, T, Bergin, S, Kheir, F, Landmeier, M, Lois, M, Nair, G, Patel, H, Reyes, K, Rodriguez-Cintron, W, Saito, S, Noda, J, Hinojosa, C, Levine, S, Reyes, L, Angel, L, Whitlow, K, Hipskind, J, Sukhija, K, Totten, V, Wunderink, R, Shah, R, Mateyo, K, Noriega, L, Alvarado, E, Aman, M, and Labra, L

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.drug_class, Aspiration risk, Antibiotics, Nursing home resident, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Critical Care and Intensive Care Medicine, Microbiology, anaerobic, aspiration, bacteria, pneumonia, risk factors, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Community-acquired pneumonia, Taverne, Anti-Bacterial Agent, medicine, Humans, Community-Acquired Infection, 030212 general & internal medicine, Stroke, Aged, Aged, 80 and over, business.industry, Respiratory Aspiration, Middle Aged, medicine.disease, Antibiotic coverage, Anti-Bacterial Agents, Community-Acquired Infections, Hospitalization, Pneumonia, 030228 respiratory system, Risk factors, risk factor, Female, Underweight, medicine.symptom, business, Cardiology and Cardiovascular Medicine
Abstract

Background: Aspiration community-acquired pneumonia (ACAP) and community-acquired pneumonia (CAP) in patients with aspiration risk factors (AspRFs) are infections associated with anaerobes, but limited evidence suggests their pathogenic role. Research Question: What are the aspiration risk factors, microbiology patterns, and empiric anti-anaerobic use in patients hospitalized with CAP? Study Design and Methods: This is a secondary analysis of GLIMP, an international, multicenter, point-prevalence study of adults hospitalized with CAP. Patients were stratified into three groups: (1) ACAP, (2) CAP/AspRF+ (CAP with AspRF), and (3) CAP/AspRF- (CAP without AspRF). Data on demographics, comorbidities, microbiological results, and anti-anaerobic antibiotics were analyzed in all groups. Patients were further stratified in severe and nonsevere CAP groups. Results: We enrolled 2,606 patients with CAP, of which 193 (7.4%) had ACAP. Risk factors independently associated with ACAP were male, bedridden, underweight, a nursing home resident, and having a history of stroke, dementia, mental illness, and enteral tube feeding. Among non-ACAP patients, 1,709 (70.8%) had CAP/AspRF+ and 704 (29.2%) had CAP/AspRF-. Microbiology patterns including anaerobes were similar between CAP/AspRF-, CAP/AspRF+ and ACAP (0.0% vs 1.03% vs 1.64%). Patients with severe ACAP had higher rates of total gram-negative bacteria (64.3% vs 44.3% vs 33.3%, P =.021) and lower rates of total gram-positive bacteria (7.1% vs 38.1% vs 50.0%, P 50% in all groups) independent of AspRFs or ACAP received specific or broad-spectrum anti-anaerobic coverage antibiotics. Interpretation: Hospitalized patients with ACAP or CAP/AspRF+ had similar anaerobic flora compared with patients without aspiration risk factors. Gram-negative bacteria were more prevalent in patients with severe ACAP. Despite having similar microbiological flora between groups, a large proportion of CAP patients received anti-anaerobic antibiotic coverage.

Published
2021

22. Práticas laboratoriais como ferramenta de ensino aprendizagem na disciplina de biologia celular, no curso de licenciatura em ciências biológicas / Laboratory practices as a tool for teaching and learning in cellular biology, in the bachelor's degree course in biological sciences

Author

Costa, Matheus Gomes da, primary, Silva, Maria Francisca de Sousa, additional, Campos, Renata Dourizete Costa, additional, Silva, Junielson Soares da, additional, Leite, Hernando Henrique Batista, additional, Sousa, Fabrício Soares de, additional, Silva, Veronica Brito da, additional, and Brito, Marilha Vieira de, additional

Published
2021
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23. Impact of Inappropriate Antibiotic Therapy in Vancomycin-Resistant Enterococcus Bacteremia

Author

Veronica Brito, Shirley F. Jones, Naomi E Mathew, Courtney Shaver, Shekhar Ghamande, Alejandro C. Arroliga, and Waqas Aslam

Subjects
medicine.medical_specialty, medicine.drug_class, Antibiotics, Bacteremia, 030204 cardiovascular system & hematology, medicine.disease_cause, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Vancomycin, Internal medicine, medicine, Humans, Pharmacology (medical), Vancomycin-resistant Enterococcus, Blood culture, 030212 general & internal medicine, Gram-Positive Bacterial Infections, Aged, Retrospective Studies, Pharmacology, medicine.diagnostic_test, business.industry, Septic shock, Mortality rate, Vancomycin Resistance, General Medicine, bacterial infections and mycoses, medicine.disease, Anti-Bacterial Agents, chemistry, Linezolid, Daptomycin, business, Enterococcus, medicine.drug
Abstract

Background Vancomycin-resistant Enterococcus (VRE) bacteremia has significant morbidity and mortality. Empiric antibiotic regimens for treating patients with risk factors for multidrug-resistant organisms may not have medications directed at treating VRE. Study question To evaluate the impact of antibiotic therapy (and other risk factors) on mortality in VRE bacteremia. Study design We identified 146 patients with VRE bacteremia, admitted at our institution over an 11 years period (2004-2014). All inpatients with an initial positive VRE blood culture were included only once in the analysis. Eighteen patients were excluded from the study because of inability to retrieve medical information regarding one or more important study variables. The retrospectively collected data from electronic medical records of 128 patients were analyzed. Results The inpatient, 30-day, and 1-year mortality rates from VRE bacteremia were 23%, 31%, and 59%, respectively. Only 19% patients were discharged home. Inappropriate antibiotics were prescribed in 19% patients. Appropriate antibiotics were prescribed in 81% patients (62% daptomycin and 37% linezolid); however, only 58% patients received appropriate antibiotics within 24 hours of the reported positive blood cultures. The 30-day and 1-year mortality rates for patients treated with inappropriate antibiotics were 54% and 67% compared with 26% and 50%, respectively, for those treated with appropriate antibiotics. The median survival rate for patients treated with inappropriate antibiotics was 1 month (95% confidence interval: 0.0-1.0) compared with 11 months (95% confidence interval: 4.0-13.0) for those treated with appropriate antibiotics. The advanced patient age (median age 75 years vs. 63 years) was a significant risk factor for inappropriate antibiotic therapy (P value = 0.02). The multivariate Cox regression model revealed inappropriate antibiotic therapy (P value = 0.003), septic shock (P value = 0.0004), albumin (P value = 0.04), and dementia (P value = 0.003) to be associated with 30-day mortality. Conclusions Our study highlights the detrimental effect of inappropriate antibiotic therapy and other risk factors on morbidity and mortality associated with VRE bacteremia.

Published
2020
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24. Editorial

Author

Verônica Brito Antunes

Subjects
Education, Science, Social Sciences
Published
2024

25. A Therapeutic Strategy for All Pneumonia Patients: A 3-Year Prospective Multicenter Cohort Study Using Risk Factors for Multidrug-resistant Pathogens to Select Initial Empiric Therapy

Author

Futoshi Higa, Masaru Amishima, Hiroyasu Kobayashi, Nobuaki Shime, Shigeru Suga, Kazuyuki Fujimoto, Takaya Maruyama, Veronica Brito, Hikaru Maeda, Masamichi Yoshida, Takao Fujisawa, Akihiro Ito, Michael S. Niederman, Yoshitaka Oyamada, Kiyoyuki Tsutsui, Shigeru Kohno, Tadashi Ishida, Shoji Suzuki, Hideaki Nagai, Naoyuki Miyashita, and Yoshifumi Imamura

Subjects
0301 basic medicine, Microbiology (medical), Male, medicine.medical_specialty, 030106 microbiology, Chronic liver disease, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Community-acquired pneumonia, Drug Therapy, Internal medicine, Drug Resistance, Multiple, Bacterial, medicine, Pneumonia, Bacterial, Humans, 030212 general & internal medicine, Prospective Studies, Aged, Aged, 80 and over, Cross Infection, business.industry, Mortality rate, Middle Aged, medicine.disease, Survival Analysis, respiratory tract diseases, Anti-Bacterial Agents, Multiple drug resistance, Community-Acquired Infections, Pneumonia, Infectious Diseases, Treatment Outcome, Female, business, Epidemiologic Methods, Empiric therapy, Classification of pneumonia, Cohort study
Abstract

BACKGROUND Empiric therapy of pneumonia is currently based on the site of acquisition (community or hospital), but could be chosen, based on risk factors for multidrug-resistant (MDR) pathogens, independent of site of acquisition. METHODS We prospectively applied a therapeutic algorithm based on MDR risks, in a multicenter cohort study of 1089 patients with 656 community-acquired pneumonia (CAP), 238 healthcare-associated pneumonia (HCAP), 140 hospital-acquired pneumonia (HAP), or 55 ventilator-associated pneumonia (VAP). RESULTS Approximately 83% of patients were treated according to the algorithm, with 4.3% receiving inappropriate therapy. The frequency of MDR pathogens varied, respectively, with VAP (50.9%), HAP (27.9%), HCAP (10.9%), and CAP (5.2%). Those with ≥2 MDR risks had MDR pathogens more often than those with 0-1 MDR risk (25.8% vs 5.3%, P < .001). The 30-day mortality rates were as follows: VAP (18.2%), HAP (13.6%), HCAP (6.7%), and CAP (4.7%), and were lower in patients with 0-1 MDR risks than in those with ≥2 MDR risks (4.5% vs 12.5%, P < .001). In multivariate logistic regression analysis, 5 risk factors (advanced age, hematocrit

Published
2018

26. DIFFERENT STABILITY METHODS FOR CULTIVAR RECOMMENDATION IN ELEPHANT-GRASS FOR ENERGY PURPOSES IN BRAZIL

Author

Silva, Veronica Brito da, Daher, Rogerio Figueiredo, Menezes, Bruna Rafaela da Silva, Oliveira, Maria Lorraine Fonseca, Araújo, Maria do Socorro Bezerra, and Novo, Antonio Alonso Cecon

Subjects
Genotype, Genótipo, Biomass, Biomassa, Corte, Alternative energy, Cutting interaction, Energia alternative
Abstract

The elephant-grass undergoes successive cutting and periodical evaluations that it possible to identify clones with high stability for dry matter production, which can be used for energy production. The present study was carried out to evaluate stability dry matter yield for different parametric and non-parametric methods in elephant grass genotypes for biomass production undergoes successive cutting in the agroclimatic conditions of the Norte Fluminense (RJ, Brazil). The variable measured in the 40 genotypes was dry matter yield (DMY) at 2009, 2010 and 2011 in a field study designed as randomized block design with two replicates. Each sample was grown in different environment condition. The stability methods tested were the Yates and Cochran’s, Plaisted and Peterson’s, Wricke’s ecovalence, Annicchiarico’s, Lin and Binns’ and Kang and Phan’s. Results indicated that cutting (E) and genotypes (G) influenced significantly on the performance of dry matter yield. The non-parametric stability methods were effective for the evaluation of stability in dry matter yield. Genotypes Mercker, Pinda-México, Mercker 86-México, Guaçu/IZ, Mercker Pinda, P-241-Piracicaba and Cubano Pinda were stable stability dry matter yield. Hence, there are genotypes may be exploited in future breeding programmes in order to improve productivity of upland elephant grass over environment. RESUMO O capim-elefante sofre sucessivos cortes em avaliações periódicas, possibilitando identificar clones com alta estabilidade para a produção de matéria seca, podendo ser utilizados para a produção de energia. O presente estudo foi realizado para avaliar a estabilidade na produção de matéria seca, considerando métodos paramétricos e não paramétricos, em genótipos de capim-elefante para produção de biomassa submetido a cortes sucessivos nas condições climáticas do Norte Fluminense (RJ, Brasil). A variável medida nos 40 genótipos foi a produção de matéria seca (DMY) em 2009, 2010 e 2011 em um experimento de campo em blocos casualizados com duas repetições. Cada amostra foi cultivada em diferentes condições ambientais. Os métodos de estabilidade testados foram de Yates e Cochran, Plaisted e Peterson, Wricke, Annicchiarico, Lin e Binns e Kang e Phan. Os resultados indicaram que o corte (E) e os genótipos (G) influenciaram significativamente no desempenho para a produção de matéria seca. Os métodos de estabilidade não-paramétrica foram eficientes para a avaliação da estabilidade no rendimento da matéria seca. Os genótipos Mercker, Pinda-México, Mercker 86-México, Guaçu/IZ, Mercker Pinda, P-241-Piracicaba e Cubano Pinda tiveram uma estabilidade estável na produção de matéria seca. Por conseguinte, existem genótipos que podem ser explorados em futuros programas de melhoramento, a fim de melhorar a produtividade de capim elefante no ambiente.

Published
2017

27. Noncontinuous Positive Airway Pressure Therapies for Obstructive Sleep Apnea

Author

Shirley F. Jones and Veronica Brito

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, Critical Care and Intensive Care Medicine, Positive-Pressure Respiration, Surgical therapy, Quality of life, Positive airway pressure, Humans, Medicine, Continuous positive airway pressure, Intensive care medicine, Nasal surgery, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure, business.industry, Patient Selection, Uvulopalatopharyngoplasty, medicine.disease, Oxygen, Obstructive sleep apnea, Quality of Life, Physical therapy, Patient Compliance, business, Mandibular Advancement, Surgical interventions
Abstract

While continuous positive airway pressure is the first-line treatment for obstructive sleep apnea, many patients find this form of therapy undesirable leading to treatment nonadherence. Both mandibular advancement devices and surgical therapy offer alternative solutions for such patients. This article serves to compare the types of surgical interventions and mandibular advancement devices available, their mechanisms of action, and expected side effects. Emphasis is made on the limitations and challenges in the interpretation of the available literature due to the varying definitions of curative success. The effects of mandibular advancement devices and surgical therapy on the apnea-hypopnea index and oxygen saturation are reviewed. Patient-centered outcomes of sleepiness, quality of life, treatment preference, adherence, and their effects on disease-related outcomes of hypertension are summarized. When available, comparative effectiveness trials between these therapies versus continuous positive airway pressure are emphasized. Patient selection criteria, practice parameters, and treatment limitations are discussed.

Published
2014
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28. A New Strategy for Healthcare-Associated Pneumonia: A 2-Year Prospective Multicenter Cohort Study Using Risk Factors for Multidrug-Resistant Pathogens to Select Initial Empiric Therapy

Author

Takao Fujisawa, Masamichi Yoshida, Takaya Maruyama, Hiroyasu Kobayashi, Kiyoyuki Tsutsui, Toshiaki Ihara, Hisamichi Yuda, Hikaru Maeda, Masataka Okuno, Osamu Taguchi, Naoyuki Miyashita, Michael S. Niederman, Veronica Brito, Yoshiyuki Takei, Esteban C. Gabazza, and Hirokazu Toyoshima

Subjects
Microbiology (medical), medicine.medical_specialty, business.industry, Odds ratio, medicine.disease, Surgery, Multiple drug resistance, Clinical trial, Pneumonia, Infectious Diseases, Internal medicine, Severity of illness, medicine, Risk factor, business, Empiric therapy, Cohort study
Abstract

Background. Optimal empiric therapy for hospitalized patients with healthcare-associated pneumonia (HCAP) is uncertain. Methods. We prospectively applied a therapeutic algorithm, based on the presence of risk factors for multidrug-resistant (MDR) pathogens in a multicenter cohort study of 445 pneumonia patients, including both community-acquired pneumonia (CAP; n = 124) and HCAP (n = 321). Results. MDR pathogens were more common (15.3% vs 0.8%, P< .001) in HCAP patients than in CAP patients, including Staphylococcus aureus (11.5% vs 0.8%, P< .001); methicillin-resistant S. aureus (6.9% vs 0%, P= .003); Enterobacteriaceae (7.8% vs 2.4%, P= .037); and Pseudomonas aeruginosa (6.9% vs 0.8%, P= .01). Using the proposed algorithm, HCAP patients with ≥2 MDR risk factors, one of which was severity of illness (n = 170), vs HCAP patients with 0–1 risk factor (n = 151) had a significantly higher frequency of MDR pathogens (27.1% vs 2%, P< .001). In total, 93.1% of HCAP patients were treated according to the therapy algorithm, with only 53% receiving broadspectrum empiric therapy, yet 92.9% received appropriate therapy for the identified pathogen. Thirty-day mortality was significantly higher for HCAP than for CAP (13.7% vs 5.6%, P= .017), but among HCAP patients with 0–1 MDR risk factor, mortality was lower than with ≥2 MDR risk factors (8.6% vs 18.2%, P= .012). In multivariate analysis, initial treatment failure, but not inappropriate empiric antibiotic therapy, was a mortality risk factor (odds ratio, 72.0). Conclusions. Basing empiric HCAP therapy on its severity and the presence of risk factors for MDR pathogens is a potentially useful approach that achieves good outcomes without excessive use of broad-spectrum antibiotic therapy. Clinical Trials Registration. Japan Medical Association Center for Clinical Trials, JMA-IIA00054.

Published
2013
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29. Global initiative for meticillin-resistant Staphylococcus aureus pneumonia (GLIMP): an international, observational cohort study

Author

Stefano Aliberti, Luis F Reyes, Paola Faverio, Giovanni Sotgiu, Simone Dore, Alejandro H Rodriguez, Nilam J Soni, Marcos I Restrepo, Patricia Karina Aruj, Silvia Attorri, Enrique Barimboim, Juan Pablo Caeiro, María I Garzón, Victor Hugo Cambursano, Adrian Ceccato, Julio Chertcoff, Florencia Lascar, Fernando Di Tulio, Ariel Cordon Díaz, Lautaro de Vedia, Maria Cristina Ganaha, Sandra Lambert, Gustavo Lopardo, Carlos M Luna, Alessio Gerardo Malberti, Nora Morcillo, Silvina Tartara, Claudia Pensotti, Betiana Pereyra, Pablo Gustavo Scapellato, Juan Pablo Stagnaro, Sonali Shah, Felix Lötsch, Florian Thalhammer, Jean Louis Vincent, Kurt Anseeuw, Camille A Francois, Eva Van Braeckel, Marcel Zannou Djimon, Jules Bashi, Roger Dodo, Simone Aranha Nouér, Peter Chipev, Milena Encheva, Darina Miteva, Diana Petkova, Adamou Dodo Balkissou, Eric Walter Pefura Yone, Bertrand Hugo Mbatchou Ngahane, Ning Shen, Jin-fu Xu, Carlos Andres Bustamante Rico, Ricardo Buitrago, Fernando Jose Pereira Paternina, Jean-Marie Kayembe Ntumba, Vesna Vladic Carevic, Marko Jakopovic, Mateja Jankovic, Zinka Matkovic, Ivan Mitrecic, Marie-Laure Bouchy Jacobsson, Anette Bro Christensen, Uffe Christian Heitmann Bødtger, Christian Niels Meyer, Andreas Vestergaard Jensen, Gertrud Baunbæk-knudsen, Pelle Trier Petersen, Stine Andersen, Ibrahim El-Said Abd El-Wahhab, Nesreen Elsayed Morsy, Hanaa Shafiek, Eman Sobh, Kedir Abdella Abdulsemed, Fabrice Bertrand, Christian Brun-Buisson, Etienne de Montmollin, Muriel Fartoukh, Jonathan Messika, Pierre Tattevin, Abdo Khoury, Bernard Ebruke, Michael Dreher, Martin Kolditz, Matthias Meisinger, Mathias W Pletz, Stefan Hagel, Jan Rupp, Tom Schaberg, Marc Spielmanns, Petra Creutz, Norton Suttorp, Beatrice Siaw-Lartey, Katerina Dimakou, Dimosthenis Papapetrou, Evdoxia Tsigou, Dimitrios Ampazis, Evangelos Kaimakamis, Mohit Bhatia, Raja Dhar, George D'Souza, Rajiv Garg, Parvaiz A Koul, P A Mahesh, B S Jayaraj, Kiran Vishnu Narayan, Hirennappa B Udnur, Shashi Bhaskara Krishnamurthy, Surya Kant, Rajesh Swarnakar, Sneha Limaye, Sundeep Salvi, Keihan Golshani, Vera M Keatings, Ignacio Martin-Loeches, Yasmin Maor, Jacob Strahilevitz, Salvatore Battaglia, Maria Carrabba, Piero Ceriana, Marco Confalonieri, Antonella d'Arminio Monforte, Bruno Del Prato, Marino De Rosa, Riccardo Fantini, Giuseppe Fiorentino, Maria Antonia Gammino, Francesco Menzella, Giuseppe Milani, Stefano Nava, Gerardo Palmiero, Roberta Petrino, Barbra Gabrielli, Paolo Rossi, Claudio Sorino, Gundi Steinhilber, Alessandro Zanforlin, Fabio Franzetti, Manuela Carugati, Manuela Morosi, Elisa Monge, Mauro Carone, Vincenzo Patella, Simone Scarlata, Andrea Comel, Kiyoyasu Kurahashi, Zeina Aoun Bacha, Daniel Barajas Ugalde, Omar Ceballos Zuñiga, José F Villegas, Milic Medenica, E M W van de Garde, Deebya Raj Mihsra, Poojan Shrestha, Elliott Ridgeon, Babatunde Ishola Awokola, Ogonna N O Nwankwo, Adefuye Bolanle Olufunlola, Segaolu Olumide, Kingsley N Ukwaja, Muhammad Irfan, Lukasz Minarowski, Skoczynski Szymon, Felipe Froes, Pedro Leuschner, Mariana Meireles, Cláudia Ferrão, João Neves, Sofia B Ravara, Victoria Brocovschii, Chesov Ion, Doina Rusu, Cristina Toma, Daniela Chirita, Carmen Mihaela Dorobat, Alexei Birkun, Anna Kaluzhenina, Abdullah Almotairi, Zakeya Abdulbaqi Ali Bukhary, Jameela Edathodu, Amal Fathy, Abdullah Mushira Abdulaziz Enani, Nazik Eltayeb Mohamed, Jawed Ulhadi Memon, Abdelhaleem Bella, Nada Bogdanovic, Branislava Milenkovic, Dragica Pesut, Luis Borderìas, Noel Manuel Bordon Garcia, Hugo Cabello Alarcón, Catia Cilloniz, Antoni Torres, Vicens Diaz-Brito, Xavier Casas, Alicia Encabo González, Maria Luisa Fernández-Almira, Miguel Gallego, Inmaculada Gaspar-GarcÍa, Juan González del Castillo, Patricia Javaloyes Victoria, Elena Laserna Martínez, Rosa Malo de Molina, Pedro J Marcos, Rosario Menéndez, Ana Pando-Sandoval, Cristina Prat Aymerich, Alicia Lacoma de la Torre, Ignasi García-Olivé, Jordi Rello, Silvia Moyano, Francisco Sanz, Oriol Sibila, Ana Rodrigo-Troyano, Jordi Solé-Violán, Ane Uranga, Job FM van Boven, Ester Vendrell Torra, Jordi Almirall Pujol, Charles Feldman, Ho Kee Yum, Arnauld Attannon Fiogbe, Ferdaous Yangui, Semra Bilaceroglu, Levent Dalar, Ufuk Yilmaz, Artemii Bogomolov, Naheed Elahi, Devesh J Dhasmana, Andrew Feneley, Rhiannon Ions, Julie Skeemer, Gerrit Woltmann, Carole Hancock, Adam T Hill, Banu Rudran, Silvia Ruiz-Buitrago, Marion Campbell, Paul Whitaker, Alexander Youzguin, Anika Singanayagam, Karen S Allen, Veronica Brito, Jessica Dietz, Claire E Dysart, Susan M Kellie, Ricardo A Franco-Sadud, Garnet Meier, Mina Gaga, Thomas L Holland, Stephen P Bergin, Fayez Kheir, Mark Landmeier, Manuel Lois, Girish B Nair, Hemali Patel, Katherine Reyes, William Rodriguez-Cintron, Shigeki Saito, Julio Noda, Cecilia I Hinojosa, Stephanie M Levine, Luis F Angel, Antonio Anzueto, K Scott Whitlow, John Hipskind, Kunal Sukhija, Vicken Totten, Richard G Wunderink, Ray D Shah, Kondwelani John Mateyo, Lorena Noriega, Ezequiel Alvarado, Mohamed Aman, Lucía Labra, Aliberti, S., Reyes, L. F., Faverio, P., Sotgiu, G., Dore, S., Rodriguez, A. H., Soni, N. J., Restrepo, M. I., Aruj, P. K., Attorri, S., Barimboim, E., Caeiro, J. P., Garzon, M. I., Cambursano, Vh., Ceccato, A., Chertcoff, J., Lascar, F., Di Tulio, F., Cordon Diaz, A., de Vedia, L., Ganaha, M. C., Lambert, S., Lopardo, G., Luna, C. M., Malberti, A. G., Morcillo, N., Tartara, S., Pensotti, C., Pereyra, B., Scapellato, P. G., Stagnaro, J. P., Shah, S., Lotsch, F., Thalhammer, F., Vincent, J. L., Anseeuw, K., Francois, C. A., Van Braeckel, E., Djimon, M. Z., Bashi, J., Dodo, R., Aranha Nouer, S., Chipev, P., Encheva, M., Miteva, D., Petkova, D., Balkissou, A. D., Pefura Yone, E. W., Mbatchou Ngahane, B. H., Shen, N., Xu, J. F., Bustamante Rico, C. A., Buitrago, R., Pereira Paternina, F. J., Kayembe Ntumba, J. M., Vladic Carevic, V., Jakopovic, M., Jankovic, M., Matkovic, Z., Mitrecic, I., Bouchy Jacobsson, M. L., Bro Christensen, A., Heitmann Bodtger, U. C., Meyer, C. N., Vestergaard Jensen, A., Baunbaek-Knudsen, G., Trier Petersen, P., Andersen, S., El-Said Abd El-Wahhab, I., Elsayed Morsy, N., Shafiek, H., Sobh, E., Abdulsemed, K. A., Bertrand, F., Brun-Buisson, C., de Montmollin, E., Fartoukh, M., Messika, J., Tattevin, P., Khoury, A., Ebruke, B., Dreher, M., Kolditz, M., Meisinger, M., Pletz, M. W., Hagel, S., Rupp, J., Schaberg, T., Spielmanns, M., Creutz, P., Suttorp, N., Siaw-Lartey, B., Dimakou, K., Papapetrou, D., Tsigou, E., Ampazis, D., Kaimakamis, E., Bhatia, M., Dhar, R., D'Souza, G., Garg, R., Koul, P. A., Mahesh, P. A., Jayaraj, B. S., Narayan, K. V., Udnur, H. B., Krishnamurthy, S. B., Kant, S., Swarnakar, R., Limaye, S., Salvi, S., Golshani, K., Keatings, V. M., Martin-Loeches, I., Maor, Y., Strahilevitz, J., Battaglia, S., Carrabba, M., Ceriana, P., Confalonieri, M., d'Arminio Monforte, A., Del Prato, B., De Rosa, M., Fantini, R., Fiorentino, G., Gammino, M. A., Menzella, F., Milani, G., Nava, S., Palmiero, G., Petrino, R., Gabrielli, B., Rossi, P., Sorino, C., Steinhilber, G., Zanforlin, A., Franzetti, F., Carugati, M., Morosi, M., Monge, E., Carone, M., Patella, V., Scarlata, S., Comel, A., Kurahashi, K., Aoun Bacha, Z., Barajas Ugalde, D., Ceballos Zuniga, O., Villegas, J. F., Medenica, M., van de Garde, Emw., Raj Mihsra, D., Shrestha, P., Ridgeon, E., Ishola Awokola, B., Nwankwo, Ono., Olufunlola, A. B., Olumide, S., Ukwaja, K. N., Irfan, M., Minarowski, L., Szymon, S., Froes, F., Leuschner, P., Meireles, M., Ferrao, C., Neves, J., Ravara, S. B., Brocovschii, V., Ion, C., Rusu, D., Toma, C., Chirita, D., Dorobat, C. M., Birkun, A., Kaluzhenina, A., Almotairi, A., Bukhary, Zaa., Edathodu, J., Fathy, A., Mushira Abdulaziz Enani, A., Eltayeb Mohamed, N., Ulhadi Memon, J., Bella, A., Bogdanovic, N., Milenkovic, B., Pesut, D., Borderias, L., Bordon Garcia, N. M., Cabello Alarcon, H., Cilloniz, C., Torres, A., Diaz-Brito, V., Casas, X., Encabo Gonzalez, A., Fernandez-Almira, M. L., Gallego, M., Gaspar-GarcIa, I., Gonzalez Del Castillo, J., Javaloyes Victoria, P., Laserna Martinez, E., Malo de Molina, R., Marcos, P. J., Menendez, R., Pando-Sandoval, A., Prat Aymerich, C., Lacoma de la Torre, A., Garcia-Olive, I., Rello, J., Moyano, S., Sanz, F., Sibila, O., Rodrigo-Troyano, A., Sole-Violan, J., Uranga, A., van Boven, J. F., Vendrell Torra, E., Pujol, J. A., Feldman, C., Kee Yum, H., Fiogbe, A. A., Yangui, F., Bilaceroglu, S., Dalar, L., Yilmaz, U., Bogomolov, A., Elahi, N., Dhasmana, D. J., Feneley, A., Ions, R., Skeemer, J., Woltmann, G., Hancock, C., Hill, A. T., Rudran, B., Ruiz-Buitrago, S., Campbell, M., Whitaker, P., Youzguin, A., Singanayagam, A., Allen, K. S., Brito, V., Dietz, J., Dysart, C. E., Kellie, S. M., Franco-Sadud, R. A., Meier, G., Gaga, M., Holland, T. L., Bergin, S. P., Kheir, F., Landmeier, M., Lois, M., Nair, G. B., Patel, H., Reyes, K., Rodriguez-Cintron, W., Saito, S., Noda, J., Hinojosa, C. I., Levine, S. M., Angel, L. F., Anzueto, A., Whitlow, K. S., Hipskind, J., Sukhija, K., Totten, V., Wunderink, R. G., Shah, R. D., Mateyo, K. J., Noriega, L., Alvarado, E., Aman, M., Labra, L., Aliberti S., Reyes L.F., Faverio P., Sotgiu G., Dore S., Rodriguez A.H., Soni N.J., Restrepo M.I., Aruj P.K., Attorri S., Barimboim E., Caeiro J.P., Garzon M.I., Cambursano VH., Ceccato A., Chertcoff J., Lascar F., Di Tulio F., Cordon Diaz A., de Vedia L., Ganaha M.C., Lambert S., Lopardo G., Luna C.M., Malberti A.G., Morcillo N., Tartara S., Pensotti C., Pereyra B., Scapellato P.G., Stagnaro J.P., Shah S., Lotsch F., Thalhammer F., Vincent J.L., Anseeuw K., Francois C.A., Van Braeckel E., Djimon M.Z., Bashi J., Dodo R., Aranha Nouer S., Chipev P., Encheva M., Miteva D., Petkova D., Balkissou A.D., Pefura Yone E.W., Mbatchou Ngahane B.H., Shen N., Xu J.F., Bustamante Rico C.A., Buitrago R., Pereira Paternina F.J., Kayembe Ntumba J.M., Vladic Carevic V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Bouchy Jacobsson M.L., Bro Christensen A., Heitmann Bodtger U.C., Meyer C.N., Vestergaard Jensen A., Baunbaek-Knudsen G., Trier Petersen P., Andersen S., El-Said Abd El-Wahhab I., Elsayed Morsy N., Shafiek H., Sobh E., Abdulsemed K.A., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M.W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Creutz P., Suttorp N., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., Bhatia M., Dhar R., D'Souza G., Garg R., Koul P.A., Mahesh P.A., Jayaraj B.S., Narayan K.V., Udnur H.B., Krishnamurthy S.B., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V.M., Martin-Loeches I., Maor Y., Strahilevitz J., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., d'Arminio Monforte A., Del Prato B., De Rosa M., Fantini R., Fiorentino G., Gammino M.A., Menzella F., Milani G., Nava S., Palmiero G., Petrino R., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., Franzetti F., Carugati M., Morosi M., Monge E., Carone M., Patella V., Scarlata S., Comel A., Kurahashi K., Aoun Bacha Z., Barajas Ugalde D., Ceballos Zuniga O., Villegas J.F., Medenica M., van de Garde EMW., Raj Mihsra D., Shrestha P., Ridgeon E., Ishola Awokola B., Nwankwo ONO., Olufunlola A.B., Olumide S., Ukwaja K.N., Irfan M., Minarowski L., Szymon S., Froes F., Leuschner P., Meireles M., Ferrao C., Neves J., Ravara S.B., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Dorobat C.M., Birkun A., Kaluzhenina A., Almotairi A., Bukhary ZAA., Edathodu J., Fathy A., Mushira Abdulaziz Enani A., Eltayeb Mohamed N., Ulhadi Memon J., Bella A., Bogdanovic N., Milenkovic B., Pesut D., Borderias L., Bordon Garcia N.M., Cabello Alarcon H., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Encabo Gonzalez A., Fernandez-Almira M.L., Gallego M., Gaspar-GarcIa I., Gonzalez Del Castillo J., Javaloyes Victoria P., Laserna Martinez E., Malo de Molina R., Marcos P.J., Menendez R., Pando-Sandoval A., Prat Aymerich C., Lacoma de la Torre A., Garcia-Olive I., Rello J., Moyano S., Sanz F., Sibila O., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J.F., Vendrell Torra E., Pujol J.A., Feldman C., Kee Yum H., Fiogbe A.A., Yangui F., Bilaceroglu S., Dalar L., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D.J., Feneley A., Ions R., Skeemer J., Woltmann G., Hancock C., Hill A.T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., Allen K.S., Brito V., Dietz J., Dysart C.E., Kellie S.M., Franco-Sadud R.A., Meier G., Gaga M., Holland T.L., Bergin S.P., Kheir F., Landmeier M., Lois M., Nair G.B., Patel H., Reyes K., Rodriguez-Cintron W., Saito S., Noda J., Hinojosa C.I., Levine S.M., Angel L.F., Anzueto A., Whitlow K.S., Hipskind J., Sukhija K., Totten V., Wunderink R.G., Shah R.D., Mateyo K.J., Noriega L., Alvarado E., Aman M., Labra L., Aliberti, S, Reyes, L, Faverio, P, Sotgiu, G, Dore, S, Rodriguez, A, Soni, N, and Restrepo, M

Subjects
Male, antibiotic resistance, Prevalence, MRSA, medicine.disease_cause, pneumonia, staphylococcus aureus, Global Health, Cohort Studies, 0302 clinical medicine, Community-acquired pneumonia, Risk Factors, Retrospective Studie, Community-Acquired Infection, 030212 general & internal medicine, education.field_of_study, Cross Infection, Respiratory tract infections, Methicillin-Resistant Staphylococcus aureu, Staphylococcal Infections, Hospitals, Community-Acquired Infections, Infectious Diseases, Infectious diseases, Female, Human, Methicillin-Resistant Staphylococcus aureus, medicine.medical_specialty, Population, Admission, staphylococcus aureu, Settore MED/10 - Malattie Dell'Apparato Respiratorio, 03 medical and health sciences, Hospital, Internal medicine, medicine, Humans, Risk factor, education, Intensive care medicine, Staphylococcal Infection, Retrospective Studies, Aged, business.industry, Risk Factor, Odds ratio, Pneumonia, medicine.disease, Methicillin-resistant Staphylococcus aureus, 030228 respiratory system, Methicillin Resistance, Cohort Studie, business
Abstract

BACKGROUND: Antibiotic resistance is a major global health problem and pathogens such as meticillin-resistant Staphylococcus aureus (MRSA) have become of particular concern in the management of lower respiratory tract infections. However, few data are available on the worldwide prevalence and risk factors for MRSA pneumonia. We aimed to determine the point prevalence of MRSA pneumonia and identify specific MRSA risk factors in community-dwelling patients hospitalised with pneumonia.METHODS: We did an international, multicentre study of community-dwelling, adult patients admitted to hospital with pneumonia who had microbiological tests taken within 24 h of presentation. We recruited investigators from 222 hospitals in 54 countries to gather point-prevalence data for all patients admitted with these characteristics during 4 days randomly selected during the months of March, April, May, and June in 2015. We assessed prevalence of MRSA pneumonia and associated risk factors through logistic regression analysis.FINDINGS: 3702 patients hospitalised with pneumonia were enrolled, with 3193 patients receiving microbiological tests within 24 h of admission, forming the patient population. 1173 (37%) had at least one pathogen isolated (culture-positive population). The overall prevalence of confirmed MRSA pneumonia was 3·0% (n=95), with differing prevalence between continents and countries. Three risk factors were independently associated with MRSA pneumonia: previous MRSA infection or colonisation (odds ratio 6·21, 95% CI 3·25-11·85), recurrent skin infections (2·87, 1·10-7·45), and severe pneumonia disease (2·39, 1·55-3·68).INTERPRETATION: This multicountry study shows low prevalence of MRSA pneumonia and specific MRSA risk factors among community-dwelling patients hospitalised with pneumonia.FUNDING: None.

Published
2016
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31. Pneumonia in the Older Patient

Author

Veronica Brito and Michael S. Niederman

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Bacteria, business.industry, Prognosis, medicine.disease, Anti-Bacterial Agents, respiratory tract diseases, Pneumonia, Older patients, Risk Factors, Pneumonia, Bacterial, medicine, Humans, Approaches of management, Morbidity, Nursing homes, business, Intensive care medicine, Aged
Abstract

This article examines the bacteriology, clinical features, therapy for, and prevention of pneumonia in older patients. The discussion focuses on patients who develop pneumonia out of the hospital, including individuals with community-acquired pneumonia and health care-associated pneumonia. Health care-associated pneumonia incorporates patients who live in nursing homes when they develop pneumonia and in many instances requires management similar to nosocomial pneumonia. We have chosen not to discuss nosocomial pneumonia in older patients because it does not have distinctive features or a different management approach than when this illness arises in younger patients.

Published
2007
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32. Obesity hypoventilation syndrome in the critically ill

Author

Veronica Brito, Shirley F. Jones, and Shekhar Ghamande

Subjects
Obesity hypoventilation syndrome, medicine.medical_specialty, Noninvasive Ventilation, Critically ill, business.industry, medicine.medical_treatment, Critical Illness, General Medicine, Disease, Critical Care and Intensive Care Medicine, Hypercapnic respiratory failure, medicine.disease, Intensive Care Units, Anesthesia, Obesity Hypoventilation Syndrome, medicine, Respiratory Mechanics, Humans, Continuous positive airway pressure, Intensive care medicine, business
Abstract

This article summarizes available data on the obesity hypoventilation syndrome and its pertinence to intensivists, outlines clinical and pathophysiologic aspects of the disease, discusses multidisciplinary treatments, and reviews the available literature on outcomes specific to the critically ill patient.

Published
2015

33. Effect of diabetes mellitus on sleep quality

Author

Shekhar Ghamande, Veronica Brito, Asif Surani, and Salim Surani

Subjects
Health related quality of life, Gerontology, Sleep quality, business.industry, Endocrinology, Diabetes and Metabolism, Psychological intervention, Minireviews, medicine.disease, Sleep in non-human animals, Obstructive sleep apnea, Quality of life (healthcare), Diabetes mellitus, Internal Medicine, medicine, business, Glycemic
Abstract

Diabetes mellitus (DM) is a highly prevalent condition affecting about 347 million people worldwide. In addition to its numerous clinical implications, DM also exerts a negative effect on patient's sleep quality. Impaired sleep quality disrupts the adequate glycemic control regarded as corner stone in DM management and also lead to many deleterious effects causing a profound impact on health related quality of life. This article outlines various factors leading to impaired sleep quality among diabetics and delineates how individual factor influences sleep. The article also discusses potential interventions and lifestyle changes to promote healthy sleep among diabetics.

Published
2015

35. How can we improve the management and outcome of pneumonia in the elderly?

Author

Michael S. Niederman and Veronica Brito

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Surrogate endpoint, business.industry, Adverse outcomes, Incidence (epidemiology), Medical record, Mortality rate, medicine.disease, humanities, Pneumonia, medicine, Hospital discharge, Intensive care medicine, business, Nursing homes
Abstract

Community-acquired pneumonia (CAP) is a common illness, with increased mortality in certain populations, particularly the elderly and those with severe illness 1–3. The association between advanced age and mortality is well known; Sir William Osler's infamous view was that pneumonia was the “friend of the aged” that often allowed patients with advanced illness to die peacefully. In spite of this viewpoint, it remains uncertain whether ageing itself adds to this mortality risk or whether the adverse outcomes of CAP in the elderly are the consequence of other factors, some of which might be modified, such as the presence of comorbid illnesses and the therapies required to manage them, or the delays in the diagnosis of pneumonia that result from indistinct clinical presentations in the elderly. Fry et al. 1 studied the data of the National Hospital Discharge Survey and found that in older hospitalised patients with pneumonia, at least one underlying medical condition was reported in most medical records. Marston et al. 2 studied hospitalised patients with CAP for 1 yr in two counties in Ohio, USA. Amongst the 2,776 patients studied, the incidence and mortality of pneumonia in the elderly was much higher than in younger populations. Kaplan et al. 3 reported the 1-yr mortality of elderly patients admitted for CAP and observed that beyond the immediate 12% in-patient mortality rate, there was a 1-yr death rate of >40%, raising the question as to whether pneumonia is a surrogate marker of other types of serious illness in the elderly. Numerous factors could contribute to the high mortality rate of CAP in the elderly. It is more difficult to diagnose pneumonia in the elderly than in young patients because the usual clinical clues for its diagnosis might be absent at the time of onset of illness. Riquelme et …

Published
2008
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36. Effect of nitrogen and potassium fertilizations on elephant grass genotypes used for energy purposes in Northern Rio de Janeiro State, Brazil

Author

Brunno, de Oliveira Almeida, primary, Rogerio, Figueiredo Daher, additional, Antonio, Alonso Cecon Novo, additional, Geraldo, de Amaral Gravina, additional, Marcelo, Vivas, additional, Cassia, Roberta de Oliveira Moraes, additional, Bruna, Rafaela da Silva Menezes, additional, Eduardo, Peres Furlani, additional, Maria, do Socorro Bezerra de Araujo, additional, and Veronica, Brito da Silva, additional

Published
2016
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38. Postoperative pulmonary complications after gynecologic surgery

Author

B. Khoury, Pete Smith, S. Pappachen, F. Bader, Siddarth Shah, and Veronica Brito

Subjects
Adult, Lung Diseases, medicine.medical_specialty, Hysterectomy, Gynecologic Surgical Procedures, Postoperative Complications, Risk Factors, medicine, Humans, Pooled data, Prospective Studies, Prospective cohort study, Retrospective Studies, Lung, business.industry, Medical record, Smoking, Obstetrics and Gynecology, Retrospective cohort study, General Medicine, Length of Stay, Surgery, medicine.anatomical_structure, Abdomen, Female, Complication, business, Abdominal surgery
Abstract

Objective: Investigate the frequency of, and risks for postoperative pulmonary complications after surgery for non-malignant gynecologic disorders. Method: A retrospective component included medical record data for one year. A prospective component enrolled 300 patients consecutively who were scheduled for gynecologic surgeries. Result: Postoperative pulmonary complications occurred in 1.22% of 328 open abdominal procedures in the retrospective study, and 2.16% of 232 in the prospective study. Pooling the data yielded a frequency estimate of 1.61%. Mean hospital length of stay (pooled data) increased 1.75 days in those with postoperative pulmonary complications. Smoking was the only significant risk factor (relative risk = 3.9 using pooled data). Conclusion: Postoperative pulmonary complications after surgery for non-malignant gynecologic disorders are infrequent but increase hospital length of stay. Smokers are at increased risk.

Published
2006
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39. Effects of Obesity on OSA and Its Treatment

Author

Shirley F. Jones and Veronica Brito

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Intermittent hypoxia, medicine.disease, Polycystic ovary, Obesity, nervous system diseases, respiratory tract diseases, Obstructive sleep apnea, Weight loss, Internal medicine, Diabetes mellitus, Cardiology, Medicine, Continuous positive airway pressure, Steatohepatitis, medicine.symptom, business
Abstract

Obesity affects obstructive sleep apnea (OSA) via changes in the anatomy and physiology of respiration. Intermittent hypoxia may play a role between OSA and obesity comorbid diseases such as diabetes mellitus, non-alcoholic steatohepatitis (NASH), and pseudotumor cerebri. Obesity and androgen excess are risk factors for OSA in polycystic ovary syndrome (PCOS). Medical or surgical weight loss can lead to improvements in the severity of OSA; however, cure may not be possible and continuous positive airway pressure (CPAP) may still be required. While CPAP may improve metabolic outcomes, there does not appear to be a clear effect of CPAP on weight loss or change in body composition.

Published
2014
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41. Incentive Spirometry Versus Deep Breathing Exercises For Mitigation Of Lung Volume Decline After Lower Abdominal Surgery

Author

Stephan Pappachen, Pete Smith, Thalia N. Casimire, Asim Ayaz, Siddarth Shah, Peter Homel, Michael Bergman, Vidushi Golla, and Veronica Brito

Subjects
Deep breathing exercises, medicine.medical_specialty, Incentive spirometry, business.industry, Anesthesia, Physical therapy, medicine, Lung volumes, business, Abdominal surgery
Published
2012
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43. Postnatal Foxp2 regulates early psychiatric-like phenotypes and associated molecular alterations in the R6/1 transgenic mouse model of Huntington's disease

Author

Ened Rodríguez-Urgellés, Irene Rodríguez-Navarro, Iván Ballasch, Daniel del Toro, Ignacio del Castillo, Verónica Brito, Jordi Alberch, and Albert Giralt

Subjects
Striatum, Adolescent mice, Tor1A, Proteomics, Impulsivity, Hyperactivity, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Huntington's Disease (HD) is a devastating disorder characterized by a triad of motor, psychiatric and cognitive manifestations. Psychiatric and emotional symptoms appear at early stages of the disease which are consistently described by patients and caregivers among the most disabling. Here, we show for the first time that Foxp2 is strongly associated with some psychiatric-like disturbances in the R6/1 mouse model of HD. First, 4-week-old (juvenile) R6/1 mice behavioral phenotype was characterized by an increased impulsive-like behavior and less aggressive-like behavior. In this line, we identified an early striatal downregulation of Foxp2 protein starting as soon as at postnatal day 15 that could explain such deficiencies. Interestingly, the rescue of striatal Foxp2 levels from postnatal stages completely reverted the impulsivity-phenotype and partially the social impairments concomitant with a rescue of dendritic spine pathology. A mass spectrometry study indicated that the rescue of spine loss was associated with an improvement of several altered proteins related with cytoskeleton dynamics. Finally, we reproduced and mimicked the impulsivity and social deficits in wild type mice by reducing their striatal Foxp2 expression from postnatal stages. Overall, these results imply that early postnatal reduction of Foxp2 might contribute to the appearance of some of the early psychiatric symptoms in HD.

Published
2022
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44. List of Contributors

Author

Moustafa Ahmed, A. Katie Allen, Penny Andrews, Djillali Annane, Valerie A. Arkoosh, John G.T. Augoustides, Joan R. Badia, Dimitry Baranov, Philip S. Barie, Adrian Barbul, John Bates, Simon V. Baudouin, Rinaldo Bellomo, Mette M. Berger, Yuval Bitan, Edward A. Bittner, Josée Bouchard, Pavan Brahmamdam, Jason Brainard, Aimee Brame, Benjamin Braslow, John Brennan, Veronica Brito, Alain F. Broccard, Naomi E. Cahill, Maurizio Cecconi, Maurizio Cereda, John Chandler, Jill Cherry-Bukowiec, Jason D. Christie, Terence M. Cone, Maya Contreras, David James Cooper, Craig M. Coopersmith, Bryan A. Cotton, Caitlin S. Curtis, Heidi Dalton, Tracey Dechert, Edwin A. Deitch, Clifford S. Deutschman, Carol Donagh, Todd Dorman, Tomas Drabek, Craig Dunlop, Charles G. Durbin, Soumitra R. Eachempati, Luminita Eid, Ali A. El Solh, John E. Ellis, E. Wesley Ely, Timothy W. Evans, Adam Fang, Niall Fanning, Niall D. Ferguson, Katherine Finan, Marianne Fitzgerald, Lee A. Fleisher, Noel M. Flynn, Jonathan K. Frogel, Wesley M. Garmon, Erik Garpestad, Gerd G. Gauglitz, Jane M. Gervasio, Anthony C. Gordon, Vicente Gracias, Jacob Gutsche, Nader M. Habashi, Rachel A. Hadler, Isaac Halickman, Scott D. Halpern, C. William Hanson, Patrick Hassett, J. Steven Hata, Ivan Hayes, Daren K. Heyland, Nicholas S. Hill, Eliotte Hirshberg, R. Duncan Hite, Daniel Holena, Steven M. Hollenberg, Jiri Horak, Richard S. Hotchkiss, John R. Hotchkiss, Marc G. Jeschke, Jeremy M. Kahn, Sunil Karhadkar, Mark T. Keegan, Rachel R. Kelz, Leo G. Kevin, Rachel G. Khadaroo, Kurt Kleinschmidt, Patrick M. Kochanek, W. Andrew Kofke, Benjamin A. Kohl, Jay L. Koyner, Corry J. Kucik, Kenneth A. Kudsk, John G. Laffey, David Lappin, Peter Le Roux, Joshua M. Levine, Richard J. Levy, Pamela A. Lipsett, Kathleen D. Liu, Conan MacDougall, Larami MacKenzie, Brian Marsh, John C. Marshall, Jeevendra A. Martyn, Michael A. Matthay, Mervyn Maze, Danny F. McAuley, Gráinne Mc Dermott, E.R. McFadden, Michael McKenny, James S. McKinney, Maureen O. Meade, Ravindra L. Mehta, Steven R. Messé, Ben Messer, Vivek K. Moitra, Alan H. Morris, Patrick T. Murray, Lena Napolitano, Patrick J. Neligan, Ana Paula Neves, Alistair Nichol, Michael S. Niederman, Sean A. Nix, Mark E. Nunnally, Rory O'Donoghue, Michael O'Connor, Hollis R. O'Neal, Anthony O'Regan, Michelle O'Shaughnessy, Mauro Oddo, Thida Ong, Steven M. Opal, Pratik P. Pandharipande, Eleni Patrozou, Ville Pettila, Vadim Pisarenko, Lauren A. Plante, David J. Powner, Jean-Charles Preiser, John P. Pryor, Caroline M. Quill, Madhav V. Rao, Lynn Redahan, Donal Reddan, Patrick M. Reilly, Andrew Rhodes, William P. Riordan, James A. Russell, Ho-Geol Ryu, Robert D. Sanders, Babak Sarani, Michael Scully, Chirag V. Shah, Adam Shiroff, Chuin Siau, Carrie A. Sims, Renee D. Stapleton, Kimberly D. Statler, S. Peter Stawicki, Andrew C. Steel, Thomas E. Stewart, Michelle L. Strong, Ramakrishnan Subramaniam, Rob Mac Sweeney, Kyla P. Terhune, Stephen R. Thom, Joss Thomas, Samuel A. Tisherman, Maria Tuccillo, Avery Tung, Shigehiko Uchino, Tatiana Veloso, Jean-Louis Vincent, Criona M. Walshe, Lorraine B. Ware, Edward Warren, Liza Weavind, Alan Weier, Yoram G. Weiss, Stuart Joel Weiss, Linda C. Wendell, Pauline Whyte, Jeanine Wiener-Kronish, Katherine Yang, and Zdravka Zafirova

Published
2010
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45. Postoperative pulmonary complications after laparotomy

Author

M. Bergman, Pete Smith, Veronica Brito, Fayez Bader, Antonio Alfonso, and Muhammad Ahsan Baig

Subjects
Pulmonary and Respiratory Medicine, Lung Diseases, Male, medicine.medical_specialty, medicine.medical_treatment, Atelectasis, law.invention, Postoperative Complications, law, Risk Factors, Laparotomy, medicine, Humans, Aged, Retrospective Studies, business.industry, Medical record, Incidence (epidemiology), Incidence, Retrospective cohort study, Middle Aged, medicine.disease, Intensive care unit, Surgery, Respiratory failure, Female, business, Complication
Abstract

Background: The frequency of, and risks for, postoperative pulmonary complications (PPCs) after laparotomy are incompletely understood. The wide-ranging incidence of PPCs in the literature reflects methodological issues including variable definitions of PPCs and varied patient populations. Objectives: We sought to elucidate the incidence of PPCs after laparotomy and clarify risks for their development. Methods: We conducted a retrospective study of all laparotomies in adult patients on the general surgery service at our university-affiliated hospital in 2004. The definition of PPCs was rigorous and relevant in terms of key outcomes (morbidity, mortality, length of stay). We used a template for the review of medical records to identify PPCs and their consequences. Results: Twenty-five PPCs (7.0%) occurred in 359 laparotomies. Logistic regression modeling identified the following independent predictors of risk: upper abdominal incisions (OR 15.3; p = 0.025), reoperation (OR 7.1; p = 0.013), emergency surgery (OR 6.3; p = 0.001) and nasogastric tubes (OR 5.4; p = 0.008). PPCs were associated with increased mortality (OR 6.17; p = 0.01), intensive care unit care (OR 13.0; p = 0.001), increased mean hospital length of stay (17.7 days longer; p = 0.001) and longer mean postoperative length of stay (15.2 days longer; p = 0.001). Conclusions: The incidence of PPCs after laparotomy in this study is lower than in many prior reports and reflects the relevant definition of PPCs used. Upper abdominal surgery carried the greatest risk. Reoperation was a risk not identified previously. Emergency procedures and the use of nasogastric tubes were confirmed as key risks. Morbidity, mortality and lengths of stay were significantly increased after PPCs.

Published
2009

46. Healthcare-associated pneumonia is a heterogeneous disease, and all patients do not need the same broad-spectrum antibiotic therapy as complex nosocomial pneumonia

Author

Veronica Brito and Michael S. Niederman

Subjects
Microbiology (medical), Adult, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Antibiotics, Disease, Drug resistance, Wound care, Pharmacotherapy, Drug Resistance, Bacterial, medicine, Humans, Intensive care medicine, Clinical Trials as Topic, Cross Infection, business.industry, Pneumonia, medicine.disease, United States, Anti-Bacterial Agents, Clinical trial, Infectious Diseases, Hemodialysis, business
Abstract

Healthcare-associated pneumonia (HCAP) develops in patients who have recently had contact with nosocomial and drug-resistant pathogens, because of a history of hospitalization in the past 90 days, need for hemodialysis or home wound care, or residence in a nursing home. HCAP was included in the 2005 American Thoracic Society/Infectious Diseases Society of America guidelines for nosocomial pneumonia, with the recommendation that all such patients receive empiric therapy with a multidrug regimen directed against drug-resistant organisms. The purpose of this review was to examine articles published since the guidelines were developed to see whether this therapy recommendation is correct.All articles published since July 2004 were identified using PubMed and the key words HCAP, nursing home-acquired pneumonia, and antibiotic therapy. The search was limited to adults, with a focus on clinical trials, reviews, meta-analyses, or practice guidelines.We identified eight unique studies of HCAP, which were either prospective or retrospective series, with bacteriologic data on both Gram-negative and Gram-positive organisms. We also examined three prospective, randomized therapy trials of nursing home-acquired pneumonia that included limited bacteriologic data. We found that patients with HCAP were a heterogeneous group, with some at risk for multidrug-resistant organisms, and others not, and this accounted for the observation that many patients were successfully treated with monotherapy regimens or with regimens used for patients with community-acquired pneumonia. Patients at risk for multidrug-resistant pathogens were those with severe illness or those with other risk factors including: hospitalization in the past 90 days, antibiotic therapy in the past 6 months, poor functional status as defined by activities of daily living score, and immune suppression.On the basis of the risk factors identified in recent studies, we developed an algorithm for empiric therapy of HCAP, which suggests that not all such patients require a broad-spectrum multidrug regimen in order to achieve appropriate and effective therapy. This algorithm needs validation in future studies.

Published
2009

48. AQP4 expression in striatal primary cultures is regulated by dopamine--implications for proliferation of astrocytes

Author

Eva, Küppers, Corinna, Gleiser, Veronica, Brito, Britta, Wachter, Thorsten, Pauly, Bernhard, Hirt, and Stephan, Grissmer

Subjects
Aquaporin 4, Mice, Inbred BALB C, Dopamine, Down-Regulation, Tetraethylammonium, Water-Electrolyte Balance, Corpus Striatum, Mice, Animals, Newborn, Astrocytes, Potassium Channel Blockers, Animals, Fibroblast Growth Factor 2, RNA Interference, Gliosis, RNA, Messenger, Cells, Cultured, Cell Proliferation
Abstract

Proliferation of astrocytes plays an essential role during ontogeny and in the adult brain, where it occurs following trauma and in inflammation and neurodegenerative diseases as well as in normal, healthy mammals. The cellular mechanisms underlying glial proliferation remain poorly understood. As dopamine is known to modulate proliferation in different cell populations, we investigated the effects of dopamine on the proliferation of striatal astrocytes in vitro. We found that dopamine reduced proliferation. As proliferation involves, among other things, a change in cell volume, which normally comes with water movement across the membrane, water channels might represent a molecular target of the dopamine effect. Therefore we studied the effect of dopamine on aquaporin 4 (AQP4) expression, the main aquaporin subtype expressed in glial cells, and observed a down-regulation of the AQP4-M23 isoform. This down-regulation was the cause of the dopamine-induced decrease in proliferation as knockdown of AQP4 using siRNA techniques mimicked the effects of dopamine on proliferation. Furthermore, stimulation of glial proliferation by basic fibroblast growth factor was also abolished by knocking down AQP4. In addition, blocking of AQP4 with 10 mum tetraethylammonium inhibited osmotically induced cell swelling and stimulation of glial cell proliferation by basic fibroblast growth factor. These results demonstrate a clear-cut involvement of AQP4 in the regulation of proliferation and implicate that modulation of AQP4 could be used therapeutically in the treatment of neurodegenerative diseases as well as in the regulation of reactive astrogliosis by preventing or reducing the glia scar formation, thus improving regeneration following ischemia or other trauma.

Published
2008

49. A reproducible and quantifiable model of choroidal neovascularization induced by VEGF A165 after subretinal adenoviral gene transfer in the rabbit

Author

Sylvie, Julien, Florian, Kreppel, Susanne, Beck, Peter, Heiduschka, Veronica, Brito, Sven, Schnichels, Stefan, Kochanek, and Ulrich, Schraermeyer

Subjects
Vascular Endothelial Growth Factor A, genetic structures, Choroid, Lasers, Endothelial Cells, Reproducibility of Results, Immunohistochemistry, Models, Biological, eye diseases, Choroidal Neovascularization, Retina, Adenoviridae, Cell Line, Ophthalmoscopy, Microscopy, Electron, Transduction, Genetic, Animals, Humans, sense organs, Rabbits, Fluorescein Angiography, Research Article
Abstract

Purpose To determine the effects of the vascular endothelial growth factor (VEGF)-A165 delivered using a high capacity adenoviral vector (HC Ad.VEGF-A) on vascular growth and pathological changes in the rabbit eye. To combine different detection methods of VEGF-A165 overexpression-induced neovascularization in the rabbit. Methods HC Ad.VEGF-A165 was constructed and injected at 5x106 infectious units (iu) into the subretinal space of rabbit eyes. Two and four weeks postinjection, the development of neovascularization and the expression of HC Ad-transduced VEGF-A165 protein were followed up in vivo by scanning laser ophthalmoscopy, fluorescein and indocyanine green angiographies and ex vivo by electron microscopy and immunohistochemistry Results We observed a choroidal neovascularization (CNV) with leakage in 83% of the rabbit eyes. Our findings present clear indications that there is a significant effect on the endothelial cells of the choriocapillaris after subretinal transduction of the retinal pigment epithelium (RPE) with VEGF-A165 vector. The choroidal endothelial cells were activated, adherent junctions opened, and the fenestration was minimized, while the extracellular matrix localized between the RPE and the endothelium of the choriocapillaris was enlarged toward the lumen of the vessels, inducing a deep invagination of the endothelial cells into the vessel lumen. They also proliferated and formed pathological vessels in the subretinal space. Moreover,there was an increased expression of basic fibroblast growth factor and VEGF-A accompanied by macrophage stimulation, retinal edema, and photoreceptor loss. Conclusions This is the first model of VEGF-induced CNV in the rabbit in which the pathological events following overexpression of VEGF by RPE cells have been described in detail. Many of the features of our experimental CNV resemble those observed clinically in patients having wet age-related macular degeneration.

Published
2007

50. BDNF-dependent stimulation of dopamine D5 receptor expression in developing striatal astrocytes involves PI3-kinase signaling

Author

Veronica, Brito, Cordian, Beyer, and Eva, Küppers

Subjects
Mice, Mice, Inbred BALB C, Phosphatidylinositol 3-Kinases, Gene Expression Regulation, Astrocytes, Brain-Derived Neurotrophic Factor, Receptors, Dopamine D1, Animals, Receptors, Dopamine D5, Embryo, Mammalian, Cells, Cultured, Corpus Striatum, Signal Transduction
Abstract

It is well known that brain-derived neurotrophic factor (BDNF) and the early nigrostriatal dopaminergic input are implicated in the regulation of developmental processes in the neostriatum. There is growing evidence that interactions between these developmental signals rather than singular actions are critical for cellular differentiation and compartmentation of the striatum. In the present report, our goal is to identify striatal target cells for BDNF and dopamine. Using primary neuronal and astroglial cell cultures, we have demonstrated that BDNF selectively regulates D(5) but not D(1) receptor expression in astrocytes. This effect was not observed in neurons. Pharmacological approaches indicated that BDNF effects on dopamine D(5) receptor expression were mediated at the intracellular level by an activation of the PI3- but not MAP-kinase cascade. FACS analysis and confocal laser microscopy revealed that the newly synthesized D(5) receptors were integrated into the plasma membrane of astrocytes. Our findings clearly show that developing striatal astrocytes are targets for BDNF. Furthermore, BDNF appears to regulate the dopamine responsiveness of astrocytes. This implicates that functional interactions between BDNF, dopamine, and astrocytes are necessary to warrant proper differentiation of the striatal anlage.

Published
2004

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