ABSTRACT
Prostate cancer (PCa) accounts for more than 1 in 5 diagnoses and is the second cause of cancer-related deaths in men. Although PCa may be successfully treated, patients may undergo cancer recurrence and there is a need for new biomarkers to improve the prediction of prostate cancer recurrence and improve treatment. Our laboratory demonstrated that HLA-B-associated transcript 1 (BAT1) was differentially expressed in patients with high Gleason scores when compared to low Gleason scores. BAT1 is an anti-inflammatory gene but its role in PCa has not been identified. The objective of this study is to understand the role of BAT1 in prostate cancer. In vitro studies showed that BAT1 down-regulation increased cell migration and invasion. In contrast, BAT1 overexpression decreased cell migration and invasion. RT-PCR analysis showed differential expression of pro-inflammatory cytokines (TNF-α and IL-6) and cell adhesion and migration genes (MMP10, MMP13, and TIMPs) in BAT1 overexpressed cells when compared to BAT1 siRNA cells. Our in vivo studies demonstrated up-regulation of TNF-α, IL-6, and MMP10 in tumors developed from transfected BAT1 shRNA cells when compared to tumors developed from BAT1 cDNA cells. These findings indicate that BAT1 down-regulation modulates TNF-α and IL-6 expression which may lead to the secretion of MMP-10 and inhibition of TIMP2.
ABSTRACT
Students with neurodevelopmental disorders (NDDs) are present in every school, and most likely, there are a few students in every class. School health care is responsible for providing support to all students, especially those with special needs. The aim of the study was to describe school nurses' experiences of supporting students with NDDs. A qualitative method consisting of seven focus group interviews (that included a total of 35 school nurses) in Southern Sweden was conducted. Three themes were identified in the findings: helping students with NDDs to interpret sensations, detecting early signs of distress among students with NDDs, and using an inclusive design for health education. This study highlights the importance of school nurses in identifying the needs of students with NDDs and promotes a person-centered approach to achieve a healthy and safe learning environment for all students.
Subject(s)
Neurodevelopmental Disorders , School Nursing , Adolescent , Attitude of Health Personnel , Child , Humans , Neurodevelopmental Disorders/nursing , Qualitative Research , Schools , Students , SwedenABSTRACT
A multidisciplinary science experiment was performed in K-12 classrooms focusing on the interconnection between technology with geology and chemistry. The engagement and passion for science of over eight hundred students across twenty-one classrooms, utilizing a combination of hands-on activities using relationships between Earth and space rock studies, followed by a remote access session wherein students remotely employed the use of a scanning electron microscope (SEM) and energy-dispersive spectroscopy (EDS) to validate their findings was investigated. Participants represent predominantly low-income minority communities, with little exposure to the themes and equipment used, despite being freely available resources. Students indicated greatly increased interest in scientific practices and careers, as well as a better grasp of the content as a result of the lab and remote access coupling format.
ABSTRACT
Introducción. En niños con sepsis, la sobrecarga hidrica como resultado de una terapia de resucitación agresiva o por la administración excesiva de fluidos puede afectar la función renal y aumentar la mortalidad. Objetivo. Determinar la asociación entre la sobrecarga hidrica y la tasa de falla renal en un grupo de niños con sepsis grave y shock séptico. Población y métodos. Estudio de cohortes prospectivo realizado en la Unidad de Cuidados Intensivos del Hospital Universitario de Pediatría "Dr. Agustín Zubillaga" (Barquisimeto, Estado Lara, Venezuela), entre marzo de 2013 y mayo de 2016, en niños con sepsis grave o shock séptico. Resultados. Un total de 149 niños fueron incluidos en el análisis. La sepsis predominó en el 59,7% de los casos; el promedio de edad fue 6,4 ± 3,3 años; el peso promedio fue 17,8 ± 3,6 kg; en el 30,2%, hubo sobrecarga hidrica y la mortalidad general fue 25,5%. Hubo falla renal en el 16,1% de los casos. Mediante un modelo de regresión logística binaria, se identificaron como predictores independientes de falla renal sobrecarga hidrica (OR 1,5; IC 95%: 1,2-4,9; p= 0,028) y shock mayor de dos días (OR 1,7; IC 95%: 1,3-6,3; p= 0,039). Además, se observó un incremento significativo del riesgo de mortalidad en los niños con falla renal y sobrecarga hidrica, según el método de Kaplan-Meier (p= 0,019). Conclusión. La sobrecarga hidrica y una duración del shock mayor de dos dias incrementan el riesgo de falla renal en niños criticamente enfermos con sepsis grave y shock séptico.
Introduction. In children with sepsis, fluid overload as a result of an aggressive fluid replacement or excessive fluid administration may result in kidney impairment and increased mortality.Objective. To determine the association between fluid overload and the rate of kidney failure in a group of children with severe sepsis and septicshock. Population and methods. This was a prospective cohort study conducted in the intensive care unit of Hospital Universitario de Pediatría Dr. Agustín Zubillaga (Barquisimeto, Lara State, Venezuela), between March 2013 and May 2016, in children with severe sepsis or septic shock.Results. One hundred and forty-nine patients were included in the analysis. Sepsis predominated in 59.7% of cases; patients' average age was 6.4 ± 3.3 years old, their average weight was 17.8 ± 3.6 kg, 30.2% had fluid overload, and overall mortality was 25.5%. Kidney failure occurred in 16.1% of cases. A binary logistic regression model was used to identify fluid overload (odds ratio [OR]: 1.5; 95% confidence interval [CI]: 1.2-4.9, p = 0.028) and shock for more than 2 days (OR: 1.7; 95% CI: 1.3-6.3, p = 0.039) as independent predictors of kidney failure. In addition, a significant increase in the risk of mortality among children with kidney failure and fluid overload was observed as per the Kaplan-Meier method (p= 0.019). Conclusion. Fluid overload and shock for more than 2 days increase the risk for kidney failure in critically ill children with severe sepsis and septic shock.
Subject(s)
Humans , Child, Preschool , Child , Sepsis/therapy , Renal Insufficiency/etiology , Fluid Therapy/adverse effects , Shock, Septic/therapy , Cohort Studies , Renal Insufficiency/epidemiology , Fluid Therapy/methodsABSTRACT
INTRODUCTION: In children with sepsis, fluid overload as a result of an aggressive fluid replacement or excessive fluid administration may result in kidney impairment and increased mortality.Objective. To determine the association between fluid overload and the rate of kidney failure in a group of children with severe sepsis and septic shock. POPULATION AND METHODS: This was a prospective cohort study conducted in the intensive care unit of Hospital Universitario de Pediatría "Dr. Agustín Zubillaga" (Barquisimeto, Lara State, Venezuela), between March 2013 and May 2016, in children with severe sepsis or septic shock. RESULTS: One hundred and forty-nine patients were included in the analysis. Sepsis predominated in 59.7% of cases; patients' average age was 6.4 ± 3.3 years old, their average weight was 17.8 ± 3.6 kg, 30.2% had fluid overload, and overall mortality was 25.5%. Kidney failure occurred in 16.1% of cases. A binary logistic regression model was used to identify fluid overload (odds ratio [OR]: 1.5; 95% confidence interval [CI]: 1.2-4.9, p = 0.028) and shock for more than 2 days (OR: 1.7; 95% CI: 1.3-6.3, p = 0.039) as independent predictors of kidney failure. In addition, a significant increase in the risk of mortality among children with kidney failure and fluid overload was observed as per the Kaplan-Meier method (p= 0.019). CONCLUSION: Fluid overload and shock for more than 2 days increase the risk for kidney failure in critically ill children with severe sepsis and septic shock.
En niños con sepsis, la sobrecarga hídrica como resultado de una terapia de resucitación agresiva o por la administración excesiva de fluidos puede afectar la función renal y aumentar la mortalidad.
Subject(s)
Fluid Therapy/adverse effects , Renal Insufficiency/etiology , Sepsis/therapy , Child , Cohort Studies , Female , Fluid Therapy/methods , Humans , Male , Renal Insufficiency/epidemiology , Shock, Septic/therapyABSTRACT
Introducción: El síndrome de distrés respiratorio agudo (SDRA) es una importante causa de falla respiratoria aguda, asociado a un riesgo significativo de mortalidad; a pesar de los avances actuales en ventilación mecánica y en ventilación pulmonar protectora. Objetivo: Determinar factores de riesgo para el desarrollo de SDRA en niños con más de 48 horas de ventilación mecánica. Materiales y Métodos: Se diseñó un estudio de casos y controles, donde se compararon 61 niños con SDRA con 183 controles, con edades entre 1 mes y 15 años. Fue creado un modelo de regresión logística para evaluar el efecto sobre el riesgo. Resultados: En el análisis univariable los factores asociados a SDRA fueron: PELOD, contusión pulmonar, politraumatismo, shock, transfusión de glóbulos rojos, sobrecarga de fluidos, relación PaO2/FiO2, índice de oxigenación, PEEP y pH sérico. Mediante regresión logística binaria se identificó como predictores independientes asociados al desarrollo del SDRA: Más de 3 transfusiones de glóbulos rojos (OR: 1.5; 95% IC 1.2 - 1.9, p = 0.010), sobrecarga de fluidos (OR: 1.3; 95% IC 1.1 - 5.7, p = 0.012) e índice de oxigenación mayor de 8 sin otros criterios de SDRA (OR: 1.9; 95% IC 1.4 - 2.6, p < 0.0001). La mortalidad fue mayor en el grupo con SDRA (37.7% vs. 6.0%, p < 0.0001). Conclusión: Más de 3 transfusiones de glóbulos rojos, la sobrecarga de fluidos y el índice de oxigenación mayor de 8 son factores de riesgo para el desarrollo de SDRA. El reconocimiento temprano de factores de riesgo para SDRA podría contribuir a disminuir su desarrollo.
Introduction: The acute respiratory distress syndrome (ARDS) is an important cause of acute respiratory failure, is associated with a significant risk of mortality; despite current progress in mechanical ventilation and protective lung ventilation. Objective: Determine risk factors for the development of ARDS in children with more than 48 hours of mechanical ventilation. Materials and Methods: Was designed a case-control study, where were compared 61 children with ARDS with 183 controls without ARDS with age between 1 month and 15 years. A logistic regression model was created to evaluate the effect on the risk. Results: In univariate analysis, the factors associated with ARDS were: PELOD score, pulmonary contusion, multiple trauma, shock, red blood cell transfusion, fluid overload, PaO2/FiO2 ratio, oxygenation index, PEEP and pH. Through binary logistic regression was identified as predictors for the development of ARDS: More than 3 red blood cell transfusions (OR: 1.5; 95% CI 1.2 - 1.9, p = 0.010), fluid overload (OR: 1.3; 95% CI 1.1 - 5.7, p = 0.012) and oxygenation index more than 8 without other criteria for ARDS (OR: 1.9; 95% CI 1.4 - 2.6, p < 0.0001). Mortality was higher in the group with ARDS (37.7% vs. 6.0%, p < 0.0001). Conclusion: More than 3 red blood cell transfusions, fluid overload and oxygenation index more than 8 are risk factors for the development of ARDS. Early recognition of risk factors of ARDS could help decrease its development.
ABSTRACT
UNLABELLED: Although the transfusionofblood products is common practice, its effects on the immune system have not been adequately studied. A prospective cohort study was conducted in critically ill children followed up until their death, transfer or discharge to establish an association between red blood cell transfusions (RBCTs) and nosocomial infections. A nosocomial infection was considered to be post-transfusional if it occurred within 14 days after RBCT. A total of 162 children were included in the study, 35 (21.6%) had a nosocomial infection, and 49 (30.2%) received a RBCT. Among those with a nosocomial infection, a RBCT was more common (48.5% versus 14.9%, OR: 5.4, 95% CI: 2.412.6, p ã 0.0001) and mortality rate was higher (45.7% versus 10.2%, OR: 7.4, 95% CI: 3.1-18.2, p ã 0.0001). The binary logistic regression showed that RBCT was independently associated with nosocomial infections (OR: 4.2, 95% CI: 2.1-20.2, p = 0.049). CONCLUSION: RBCT was associated with increased risk for nosocomial infections.
Aunque la transfusión de hemoderivados es una práctica común, los efectos sobre el sistema inmune no han sido bien estudiados. Para determinar la asociación entre transfusión de glóbulos rojos (TGR) e infecciones nosocomiales, se realizó un estudio de cohorte prospectivo con niños críticamente enfermos, seguidos hasta su fallecimiento, transferencia o egreso. Las infecciones nosocomiales se consideraron postransfusionales si ocurrieron dentro de los 14 días después de la TGR. Se incluyeron 162 niños, 35 adquirieron infección nosocomial (21,6%) y 49 recibieron TGR (30,2%). Los niños con infección nosocomial recibieron más frecuentemente TGR (48,5% vs. 14,9%; OR 5,4; IC 95%: 2,4-12,6; p ã 0,0001) y presentaron mayor mortalidad (45,7% vs. 10,2%; OR 7,4; IC 95%: 3,1-18,2; p ã 0,0001). En la regresión logística binaria, la TGR se mantuvo asociada independientemente a infección nosocomial (OR 4,2; IC 95%: 2,1-20,2; p = 0,049). Conclusión: La TGR se asoció a un incremento del riesgo de adquirir infecciones nosocomiales.
