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PURPOSE: The purpose of this work is to observe the effect of the cavity design of the direct composite restoration on a real case of the patient's tooth structures after applying his mandibular kinematics with finite element analysis. MATERIALS AND METHODS: Four complex maxillomandibular models of teeth 17 and 47 were constructed from the patient's cone-beam acquisition and the patient's kinematic data recorded with Modjaw® were added. Different shapes and sizes of mesio-occluso-distal (M.O.D.) composite restorations were simulated, including the polymerization shrinkage of this material. Finite element analyses were used to observe the Von Mises stresses occurring during polymerization and mastication. RESULTS: The stresses were observed at the cavity margin and the amplitude of the stresses was higher when the enamel volume was lower. The reduction in occlusal enamel volume with the open-angle vestibular and palatal walls resulted in a greater increase in stresses observed on the structures. CONCLUSIONS: The occlusal enamel is the area that bears the maximum masticatory stress, the loss of this enamel volume generates a much greater concentration of stress on the underlying structures. It is important to preserve as much enamel tissue as possible when designing a cavity for a direct composite restoration.
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Comprehensive sampling of natural genetic diversity with metagenomics enables highly resolved insights into the interplay between ecology and evolution. However, resolving adaptive, neutral, or purifying processes of evolution from intrapopulation genomic variation remains a challenge, partly due to the sole reliance on gene sequences to interpret variants. Here, we describe an approach to analyze genetic variation in the context of predicted protein structures and apply it to a marine microbial population within the SAR11 subclade 1a.3.V, which dominates low-latitude surface oceans. Our analyses reveal a tight association between genetic variation and protein structure. In a central gene in nitrogen metabolism, we observe decreased occurrence of nonsynonymous variants from ligand-binding sites as a function of nitrate concentrations, revealing genetic targets of distinct evolutionary pressures maintained by nutrient availability. Our work yields insights into the governing principles of evolution and enables structure-aware investigations of microbial population genetics.
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Ecología , Genética de Población , Océanos y Mares , Compuestos Orgánicos , Secuencia de Bases , Variación Genética , Evolución MolecularRESUMEN
OBJECTIVE: In vitro fertilization failure (IVF) is high in women with poor ovarian response or non-responder. For this reason, the addition of adjuvant treatments to IVF protocols has come to the fore. We assessed to investigate the effects of adjuvant GH therapy initiated in the mid-luteal phase on IVF success in poor ovarian response or non-responder women. PATIENTS AND METHODS: A retrospective study was performed in 93 poor ovarian response or non-responder women from a single center. GH treatment was added (GH-plus group) in the mid-luteal phase of the previous menstrual cycle to 47 of the women who underwent controlled ovarian stimulation with the flexible antagonist protocol. 46 women, as another group, were applied to a flexible antagonist-only protocol (GH-free group). The IVF outcome results were evaluated and compared within the groups. RESULTS: The number of retrieved oocytes was statistically significantly higher in the GH-plus group (2.28±1.975) than in the GH-free group (1.24±1.728) (p=0.01). Although statistically insignificant (p=0.55), the clinical pregnancy rate was higher in the GH-plus group [(8/47), 17%] than in the GH-free group [(5/46, 11%]. The cancellation rate was statistically significantly higher in the GH-free group (65.2%) than in the GH-plus group (44.7%) (p=0.04). No oocyte retrieved cycle rate was higher in the GH-free group (56%) than in the GH-plus group (25%) (p=0.002). CONCLUSIONS: Adjuvant GH therapy administration to IVF protocol in the mid-luteal phase gives poor ovarian response or non-responder women a chance to have a baby.
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Hormona del Crecimiento , Inducción de la Ovulación , Femenino , Fertilización In Vitro/métodos , Hormona Liberadora de Gonadotropina , Humanos , Inducción de la Ovulación/métodos , Embarazo , Índice de Embarazo , Estudios RetrospectivosRESUMEN
PURPOSE OF THE STUDY The aim of this study was to investigate the culture results of children undergoing debridement for suspected septic arthritis or acute osteomyelitis and to compare the laboratory parameters and clinical characteristics of culture-positive and culture-negative patients. MATERIAL AND METHODS Patients who underwent surgery in our hospital for septic arthritis and acute osteomyelitis between 2011 and 2019 were retrospectively analyzed. Seventy-two of 96 patients were included in the study. The patients had documented joint swelling, redness, pain with joint movement and weight-bearing failure. Fever was assessed preoperatively. Sedimentation rate, C-reactive protein level, white blood cell count and the leukocyte count in aspiration material as well as complications were evaluated preoperatively and 3 months postoperatively. RESULTS Twenty patients underwent surgery of the hip; 39 of the knee; 7 of the foot, ankle and distal tibia; 1 of the elbow; and 1 of the distal radius. Additionally, 4 patients had septic arthritis and acute osteomyelitis of the femur. The mean age of the patients was 7.8 years (1-16). The mean follow-up period was 16.2 months (3-42). Preoperative aspiration was performed in 44 of 72 patients. Thirty of 72 patients had positive cultures. No statistically significant difference in age, preoperative duration, C-reactive protein, sedimentation, white blood cell count, preoperative fever or complications was found when compared between patients with culture growth and those without reproduction (p > 0.05). There was a significant difference between the leukocyte count in the aspiration material (p < 0.05). CONCLUSIONS Prediagnosis of septic arthritis or acute osteomyelitis in pediatric patients is important in terms of future joint health and sepsis. According to our findings an inability to obtain bacteria does not exclude septic arthritis as a diagnosis. Empirical antibiotic therapy with a wide postoperative spectrum is important for joint health in these patients. Preoperative serum parameters cannot predict the agent needed for treatment. Key words: septic arthritis, osteomyelitis, pediatric septic arthritis, pediatric joint infection, pediatric infection.
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Artritis Infecciosa , Osteomielitis , Adolescente , Artritis Infecciosa/diagnóstico , Sedimentación Sanguínea , Niño , Preescolar , Humanos , Lactante , Recuento de Leucocitos , Osteomielitis/diagnóstico , Estudios RetrospectivosRESUMEN
This study aimed to compare medium-term results for partial capitate shortening (PCS) and radial shortening (RS) osteotomies on lunate bone revascularization and disease progression in patients with stage II or IIIA Kienböck's disease. Patients who underwent surgery for Kienböck's disease between March 2010 and July 2020 were retrospectively evaluated. Clinical evaluation included assessment of pain, joint range of motion, strength, DASH, visual analog scale (VAS) for pain, Modified Mayo Wrist Score (MMWS), satisfaction and time to return to work, with comparison as appropriate to the contralateral side. Preoperative and postoperative plain radiographs and magnetic resonance imaging (MRI) were used for radiological evaluation. Lichtman staging and signal changes in the lunate were evaluated using MRI. Group 1 (PCS) included 14 patients and Group 2 (RS) 14. Mean follow-up was 57.8 months (range 24-102) in Group 1 and 49.4 months (range 36-73) in Group 2. Clinical evaluation included pain on VAS, DASH score, MMWS, range of motion, and grip, palmar and key pinch strength. Regarding lunate bone vascularization, increased signal on final follow-up MRI was observed in 10 of the 14 patients in Group 1 and 7 of the 14 patients in Group 2. There was a positive correlation between revascularization and final follow-up MMWS (p = 0.006). The present study thus showed that functional scores were improved by revascularization in Kienböck's disease. Both osteotomies had clinically and radiologically satisfactory results. However, we believe that PCS osteotomy is preferable, as it leads to higher revascularization rates without increasing ulnolunate load.
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Hueso Grande del Carpo , Osteonecrosis , Hueso Grande del Carpo/diagnóstico por imagen , Hueso Grande del Carpo/cirugía , Humanos , Osteonecrosis/diagnóstico por imagen , Osteonecrosis/cirugía , Osteotomía/métodos , Radio (Anatomía)/patología , Radio (Anatomía)/cirugía , Estudios RetrospectivosRESUMEN
OBJECTIVE: Multiple sclerosis (MS) is a demyelinating, chronic, and progressive autoimmune disease of the central nervous system that causes the loss of axons and grey matter, and has a high prevalence in young female patients. Fingolimod is an oral treatment agent that acts by blocking the passage of the T lymphocytes responsible for the pathogenesis of MS from lymphoid tissue into the peripheral blood. We aimed to research the effects of menstrual cycles on leukocytes and lymphocyte levels in RRMS (relapsing-remitting MS) patients who received fingolimod treatment. PATIENTS AND METHODS: This study was performed to determine the most suitable phase of the menstrual cycle in patients with RRMS for follow-up assessment of lymphopaenia levels after fingolimod treatment. The study population consisted of 41 RRMS patients receiving fingolimod therapy and 33 healthy women of reproductive age. Complete blood counts were performed in three different phases of the menstrual cycle, and the two groups were compared. Variability in the total leukocyte, lymphocyte, and neutrophil immune cell numbers between cycles was examined. RESULTS: The results indicated that total leukocyte, neutrophil, and lymphocyte levels were decreased in RRMS patients receiving fingolimod treatment, but these changes were not related to the phase of the menstrual cycle. In our study, leukocyte levels in healthy individuals were significantly lower in the proliferative phase than in other phases. CONCLUSIONS: The results indicated that lymphocyte monitoring in RRMS patients receiving fingolimod treatment can be performed at any stage of the menstrual cycle.
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Clorhidrato de Fingolimod/farmacología , Linfopenia/tratamiento farmacológico , Ciclo Menstrual/efectos de los fármacos , Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Adolescente , Adulto , Proliferación Celular/efectos de los fármacos , Femenino , Humanos , Leucocitos/efectos de los fármacos , Recuento de Linfocitos , Linfocitos/efectos de los fármacos , Linfopenia/sangre , Linfopenia/patología , Ciclo Menstrual/sangre , Persona de Mediana Edad , Esclerosis Múltiple Recurrente-Remitente/sangre , Esclerosis Múltiple Recurrente-Remitente/patología , Neutrófilos/efectos de los fármacos , Adulto JovenRESUMEN
INTRODUCTION: Microbial residents of the human oral cavity have long been a major focus of microbiology due to their influence on host health and intriguing patterns of site specificity amidst the lack of dispersal limitation. However, the determinants of niche partitioning in this habitat are yet to be fully understood, especially among taxa that belong to recently discovered branches of microbial life. RESULTS: Here, we assemble metagenomes from tongue and dental plaque samples from multiple individuals and reconstruct 790 non-redundant genomes, 43 of which resolve to TM7, a member of the Candidate Phyla Radiation, forming six monophyletic clades that distinctly associate with either plaque or tongue. Both pangenomic and phylogenomic analyses group tongue-specific clades with other host-associated TM7 genomes. In contrast, plaque-specific TM7 group with environmental TM7 genomes. Besides offering deeper insights into the ecology, evolution, and mobilome of cryptic members of the oral microbiome, our study reveals an intriguing resemblance between dental plaque and non-host environments indicated by the TM7 evolution, suggesting that plaque may have served as a stepping stone for environmental microbes to adapt to host environments for some clades of microbes. Additionally, we report that prophages are widespread among oral-associated TM7, while absent from environmental TM7, suggesting that prophages may have played a role in adaptation of TM7 to the host environment. CONCLUSIONS: Our data illuminate niche partitioning of enigmatic members of the oral cavity, including TM7, SR1, and GN02, and provide genomes for poorly characterized yet prevalent members of this biome, such as uncultivated Flavobacteriaceae.
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Marcadores Genéticos , Metagenoma , Microbiota/genética , Boca/microbiología , Adaptación Fisiológica , Adulto , Bacterias/genética , Femenino , Genoma Bacteriano , Humanos , Secuencias Repetitivas Esparcidas , Masculino , Metagenómica , Persona de Mediana Edad , Filogenia , ARN Ribosómico 16SRESUMEN
OBJECTIVES: The purpose of this study was to study the effects on Young's modulus and conversion degree of variations in polymerization conditions during the 3-point bending test of composite samples in accordance with the ISO 4049 standard. METHODS: Three nanocomposites were used in the 3-point bending test based on the conditions described in the ISO 4049 standard. Samples of 2 mm × 2 mm x 25 mm were fabricated and tested with a different number of irradiation points and irradiation time. Conversion degree of the samples were also measured by micro-Raman spectroscopy and correlated with the Young's modulus values obtained for each one. RESULTS: The variations in curing protocol during specimen's realization influenced the Young's modulus and degree of conversion of all composites. These two properties correlated well. The ISO 4049 standard defines the conditions for performing the properties tests of composites to allow reproducibility and comparison of different studies. Concerning the 3-point bending test, even a minimal change in the state causes differences in the results obtained. The standard should thus clarify the tools that can be used when producing samples in order to minimize discrepancies. SIGNIFICANCE: The influence of the parameters surrounding the design of the samples should be controlled and defined so as not to include bias in the studies carried out. This will allow literature studies to be compared with more accuracy.
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Resinas Compuestas , Módulo de Elasticidad , Ensayo de Materiales , Polimerizacion , Reproducibilidad de los ResultadosRESUMEN
Sewage overflows, agricultural runoff, and stormwater discharges introduce fecal pollution into surface waters. Distinguishing these sources is critical for evaluating water quality and formulating remediation strategies. With the falling costs of sequencing, microbial community-based water quality assessment tools are under development. However, their application is limited by the need to build reference libraries, which requires extensive sampling of sources and bioinformatic expertise. Here, we introduce FORest Enteric Source IdentifiCation (FORENSIC; https://forensic.sfs.uwm.edu/), an online, library-independent source tracking platform based on random forest classification and 16S rRNA gene amplicon sequences to identify in environmental samples common fecal contamination sources, including humans, domestic pets, and agricultural animals. FORENSIC relies on a broad reference signature database of Bacteroidales and Clostridiales, two predominant bacterial groups that have coevolved with their hosts. As a result, these groups demonstrate cohesive and reliable assemblage patterns within mammalian species or among species sharing the same diet/physiology. We created a scalable and extensible platform that we tested for global applicability using samples collected in distant geographic locations. This Web application offers a fast and intuitive approach for fecal source identification, particularly in sewage-contaminated waters.IMPORTANCE FORENSIC is an online platform to identify sources of fecal pollution without the need to create reference libraries. FORENSIC is based on the ability of random forest classification to extract cohesive source microbial signatures to create classifiers despite individual variability and to detect the signatures in environmental samples. We primarily focused on defining sewage signals, which are associated with a high human health risk in polluted waters. To test for fecal contamination sources, the platform only requires paired-end reads targeting the V4 or V6 regions of the 16S rRNA gene. We demonstrated that we could use V4V5 reads trimmed to the V4 positions to generate the reference signature. The systematic workflow we describe to create and validate the signatures could be applied to many disciplines. With the increasing gap between advancing technology and practical applications, this platform makes sequence-based water quality assessments accessible to the public health and water resource communities.
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Arthropods often have obligate relationships with symbiotic microbes, and recent investigations have demonstrated that such host-microbe relationships could be exploited to suppress natural populations of vector carrying mosquitos. Strategies that target the interplay between agricultural pests and their symbionts could decrease the burden caused by agricultural pests; however, the lack of comprehensive genomic insights into naturally occurring microbial symbionts presents a significant bottleneck. Here we employed amplicon surveys, genome-resolved metagenomics, and scanning electron microscopy to investigate symbionts of the wheat stem sawfly (Cephus cinctus), a major pest that causes an estimated $350 million dollars or more in wheat yield losses in the northwestern United States annually. Through 16S rRNA gene sequencing of two major haplotypes and life stages of wheat stem sawfly, we show a novel Spiroplasma species is ever-present and predominant, with phylogenomic analyses placing it as a member of the ixodetis clade of mollicutes. Using state-of-the-art metagenomic assembly and binning strategies we were able to reconstruct a 714 Kb, 72.7%-complete Spiroplasma genome, which represents just the second draft genome from the ixodetis clade of mollicutes. Functional annotation of the Spiroplasma genome indicated carbohydrate-metabolism involved PTS-mediated import of glucose and fructose followed by glycolysis to lactate, acetate, and propionoate. The bacterium also encoded biosynthetic pathways for essential vitamins B2, B3, and B9. We identified putative Spiroplasma virulence genes: cardiolipin and chitinase. These results identify a previously undescribed symbiosis between wheat stem sawfly and a novel Spiroplasma sp., availing insight into their molecular relationship, and may yield new opportunities for microbially-mediated pest control strategies.
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Members of the SAR11 order Pelagibacterales dominate the surface oceans. Their extensive diversity challenges emerging operational boundaries defined for microbial 'species' and complicates efforts of population genetics to study their evolution. Here, we employed single-amino acid variants (SAAVs) to investigate ecological and evolutionary forces that maintain the genomic heterogeneity within ubiquitous SAR11 populations we accessed through metagenomic read recruitment using a single isolate genome. Integrating amino acid and protein biochemistry with metagenomics revealed that systematic purifying selection against deleterious variants governs non-synonymous variation among very closely related populations of SAR11. SAAVs partitioned metagenomes into two main groups matching large-scale oceanic current temperatures, and six finer proteotypes that connect distant oceanic regions. These findings suggest that environmentally-mediated selection plays a critical role in the journey of cosmopolitan surface ocean microbial populations, and the idea 'everything is everywhere but the environment selects' has credence even at the finest resolutions.
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Alphaproteobacteria/clasificación , Alphaproteobacteria/genética , Sustitución de Aminoácidos , Variación Genética , Filogeografía , Agua de Mar/microbiología , Proteínas Bacterianas/genética , Metagenómica , Mutación Missense , Selección GenéticaRESUMEN
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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BACKGROUND: The aims of our study were to compare the histomorphological characteristics of carotid plaques and glycosylated hemoglobin (HbA1c), which are risk factors for ischemic stroke, in patients who underwent carotid endarterectomy for carotid artery stenosis. Moreover, we aimed to identify the structures that were histologically affected by symptomatic carotid plaques in cases with elevated HbA1c. MATERIALS AND METHODS: A total of 64 patients who presented with ischemic stroke and had not previously been diagnosed with diabetes were retrospectively evaluated. All stroke risk factors were reviewed. Carotid plaques were graded separately by two different pathologists through microscopic assessment of the following parameters: plaque rupture, lipid core, fibrous cup thickness, inflammation, intraplaque hemorrhage, thrombus, calcification, necrotic core, and neovascularization. An HbA1c value <6.3% was accepted as normal or indicative of prediabetes (group 1), whereas patients with values ranging between 6.3-7.4%, 7.5-8.4%, and >8.4% were categorized into the effectively controlled (group 2), less effectively controlled (group 3), and uncontrolled (group 4) groups, respectively. RESULTS: The mean age of the patients was 73.0 ± 4.5 years in group 1, 69.7 ± 2.3 years in group 2, 66.0 ± 8.5 years in group 3, and 62.7 ± 7.1 years in group 4. A negative correlation was present between age and HbA1c. Smoking, hypertension, low-density lipoprotein cholesterol levels, and triglyceride levels were not significantly different among the four groups. According to the HbA1c classifications, the fibrous cup thickness was 2.64 ± 0.3 mm in group 1, 1.85 ± 0.4 mm in group 2, 1.68 ± 0.5 mm in group 3, and 1.45 ± 0.6 mm in group 4. The fibrous cup became thinner as the HbA1c value increased. Other parameters of unstable carotid plaques did not differ among the HbA1c groups. CONCLUSIONS: Increased HbA1c values seem to contribute to plaque instability through the formation of a thin fibrous cup. Thus, of the carotid artery plaque parameters including fibrous cup thickness, plaque rupture, lipid core, inflammation, intraplaque hemorrhage, thrombus, calcification, necrotic core, and neovascularization, fibrous cup thickness is the only histomorphological feature that affected by HbA1c.
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Arterias Carótidas/patología , Estenosis Carotídea/sangre , Estenosis Carotídea/patología , Hemoglobina Glucada/metabolismo , Placa Aterosclerótica/patología , Anciano , Isquemia Encefálica/etiología , Estenosis Carotídea/cirugía , Endarterectomía Carotidea , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de RiesgoRESUMEN
Wolbachia is a genus of obligate intracellular bacteria found in nematodes and arthropods worldwide, including insect vectors that transmit dengue, West Nile, and Zika viruses. Wolbachia's unique ability to alter host reproductive behavior through its temperate bacteriophage WO has enabled the development of new vector control strategies. However, our understanding of Wolbachia's mobilome beyond its bacteriophages is incomplete. Here, we reconstruct near-complete Wolbachia genomes from individual ovary metagenomes of four wild Culex pipiens mosquitoes captured in France. In addition to viral genes missing from the Wolbachia reference genome, we identify a putative plasmid (pWCP), consisting of a 9.23-kbp circular element with 14 genes. We validate its presence in additional Culex pipiens mosquitoes using PCR, long-read sequencing, and screening of existing metagenomes. The discovery of this previously unrecognized extrachromosomal element opens additional possibilities for genetic manipulation of Wolbachia.
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Culex/microbiología , Genoma Bacteriano/genética , Metagenoma/genética , Plásmidos/genética , Wolbachia/genética , Animales , Bacteriófagos/genética , Femenino , Francia , Interacciones Microbiota-Huesped/genética , Metagenómica/métodos , Mosquitos Vectores/microbiología , Ovario/microbiología , Análisis de Secuencia de ADN , Simbiosis/genética , Wolbachia/virologíaRESUMEN
BACKGROUND: Although the role of neurotrophins such as nerve growth factor and brain-derived neurotrophic factor in nasal polyps development has been studied, the contribution of neurotrophin-3 has not been evaluated yet. This study aimed to investigate the possible role of neurotrophin-3 in nasal polyps pathogenesis. METHODS: The study group comprised 70 non-allergic nasal polyps patients and the control group consisted of 53 patients with middle turbinate concha bullosa. Specimens were taken, during surgery, from the ethmoid sinus nasal polyps in the nasal polyps group and from the lateral part of the middle turbinate concha bullosa in the control group. Tissue and serum levels of neurotrophin-3 were assessed by immunohistochemistry and enzyme-linked immunosorbent assay, respectively. RESULTS: Nasal polyps patients had higher tissue neurotrophin-3 scores (p < 0.001). There was no statistically significant difference between groups regarding serum neurotrophin-3 levels (p = 0.417). Tissue neurotrophin-3 staining scores in the nasal polyps group had no statistically significant correlation with Lund-Mackay scores (p = 0.792). CONCLUSION: Neurotrophin-3 may have a local effect in nasal polyps pathogenesis, without joining systemic circulation.
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Pólipos Nasales/etiología , Pólipos Nasales/metabolismo , Factores de Crecimiento Nervioso/metabolismo , Adulto , Asma/complicaciones , Asma/metabolismo , Estudios de Casos y Controles , Senos Etmoidales/metabolismo , Femenino , Humanos , Masculino , Pólipos Nasales/patología , Neurotrofina 3 , Cornetes Nasales/metabolismoRESUMEN
In the version of this Article originally published, the surname of author Sandra M. McLellan was spelt incorrectly as 'MacLellan'. This has now been corrected. In addition, Fig. 2 was mistakenly duplicated in the Supplementary Information as Supplementary Fig. 2. This has now been replaced with the correct supplementary figure (shown below).
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Nitrogen fixation in the surface ocean impacts global marine nitrogen bioavailability and thus microbial primary productivity. Until now, cyanobacterial populations have been viewed as the main suppliers of bioavailable nitrogen in this habitat. Although PCR amplicon surveys targeting the nitrogenase reductase gene have revealed the existence of diverse non-cyanobacterial diazotrophic populations, subsequent quantitative PCR surveys suggest that they generally occur in low abundance. Here, we use state-of-the-art metagenomic assembly and binning strategies to recover nearly one thousand non-redundant microbial population genomes from the TARA Oceans metagenomes. Among these, we provide the first genomic evidence for non-cyanobacterial diazotrophs inhabiting surface waters of the open ocean, which correspond to lineages within the Proteobacteria and, most strikingly, the Planctomycetes. Members of the latter phylum are prevalent in aquatic systems, but have never been linked to nitrogen fixation previously. Moreover, using genome-wide quantitative read recruitment, we demonstrate that the discovered diazotrophs were not only widespread but also remarkably abundant (up to 0.3% of metagenomic reads for a single population) in both the Pacific Ocean and the Atlantic Ocean northwest. Our results extend decades of PCR-based gene surveys, and substantiate the importance of heterotrophic bacteria in the fixation of nitrogen in the surface ocean.
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Metagenómica/métodos , Fijación del Nitrógeno , Planctomycetales/aislamiento & purificación , Proteobacteria/aislamiento & purificación , Océano Atlántico , Proteínas Bacterianas/genética , Oxidorreductasas/genética , Océano Pacífico , Filogenia , Planctomycetales/clasificación , Planctomycetales/genética , Planctomycetales/metabolismo , Proteobacteria/clasificación , Proteobacteria/genética , Proteobacteria/metabolismo , Microbiología del AguaRESUMEN
OBJECTIVE: Foreign body aspiration (FBA) could be a serious life-threatening condition in children. Patients usually underwent bronchoscopy with suspicious of FBA alone. In this study, we aimed to determine which patients need to go to bronchoscopy based on pre-operative findings. METHODS: Retrospective analysis of patients underwent bronchoscopy between 1999 and 2015 was performed. Clinical symptoms, witnessed aspiration event (WAE), physical examination findings (PEFs) and radiological findings (RFs) were analyzed by multivariate analysis to evaluate the indications of bronchoscopy. RESULTS: 431 patients (266M, 165F) underwent bronchoscopy with a median age of 2 years (7 months-16 years). A foreign body was detected in 68% of the patients. Univariate analysis demonstrated that wheeze was the sole distinctive clinical symptom for detection of FBA (p<0.001). The rates of positive WAE, PEFs and RFs were 83%, 71.7% and 36.9%, respectively. All of them were identified as independent predictive parameters in the detection of FBA by univariate analysis (p = 0.003&p<0.001&p = 0.015). Multivariate analysis was performed with considering the association between them. The rate of positive bronchoscopy was 91.3% in patients with positive WAE, PEFs and RFs together(84/92). In patients with a positive WAE alone who had not got PEFs and RFs, the rate of positive bronchoscopy was 34.2% (25/73). A foreign body was detected in 84% of the patients who had not got a WAE but positive PEFs and RFs together(21/25). Bronchial laceration was occurred in one patient during bronchoscopy. Pneumothorax was not seen in any of the other patients. The rate of mortality was 0.4% in the overall group (2 patients). CONCLUSION: The indications of bronchoscopy in suspected FBA are usually based on clinical suspicious. The definition of " suspicous" could be a WAE or positive PEFs and RFs. The association of these factors increase the rate of positive bronchoscopies. In the light of our study, the classical indication for suspected FBA is still valid as "suspicious requires bronchoscopy".
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Broncoscopía/métodos , Cuerpos Extraños/diagnóstico , Sistema Respiratorio/lesiones , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Análisis Multivariante , Estudios RetrospectivosRESUMEN
BACKGROUND: Fecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infection and shows promise for treating other medical conditions associated with intestinal dysbioses. However, we lack a sufficient understanding of which microbial populations successfully colonize the recipient gut, and the widely used approaches to study the microbial ecology of FMT experiments fail to provide enough resolution to identify populations that are likely responsible for FMT-derived benefits. METHODS: We used shotgun metagenomics together with assembly and binning strategies to reconstruct metagenome-assembled genomes (MAGs) from fecal samples of a single FMT donor. We then used metagenomic mapping to track the occurrence and distribution patterns of donor MAGs in two FMT recipients. RESULTS: Our analyses revealed that 22% of the 92 highly complete bacterial MAGs that we identified from the donor successfully colonized and remained abundant in two recipients for at least 8 weeks. Most MAGs with a high colonization rate belonged to the order Bacteroidales. The vast majority of those that lacked evidence of colonization belonged to the order Clostridiales, and colonization success was negatively correlated with the number of genes related to sporulation. Our analysis of 151 publicly available gut metagenomes showed that the donor MAGs that colonized both recipients were prevalent, and the ones that colonized neither were rare across the participants of the Human Microbiome Project. Although our dataset showed a link between taxonomy and the colonization ability of a given MAG, we also identified MAGs that belong to the same taxon with different colonization properties, highlighting the importance of an appropriate level of resolution to explore the functional basis of colonization and to identify targets for cultivation, hypothesis generation, and testing in model systems. CONCLUSIONS: The analytical strategy adopted in our study can provide genomic insights into bacterial populations that may be critical to the efficacy of FMT due to their success in gut colonization and metabolic properties, and guide cultivation efforts to investigate mechanistic underpinnings of this procedure beyond associations.