Infections and hospital bed-days among aging adults: A five-year retrospective study in a Belgian general hospital.

Background: Infectious disease in aging adults (≥61 years) often occurs in combination with other health conditions leading to long hospital stays. Detailed studies on infection in aging adults investigating this problem are sparse. Aim: To quantify the effect of primary and secondary diagnosed infections on hospitalization bed-days among aging adult patients. Design: Retrospective patient-file study. Setting: Ziekenhuis Netwerk Antwerpen (ZNA) Hospital, a 1,858-bed general hospital in Belgium, with 364 beds allocated to geriatric patients. Data source: Database of hospitalized adult patients aged ≥61 years. Methods: All adult patients aged ≥61 years hospitalized on two wards, Geriatrics and Pulmonology, from 2010 to 2014 were included. Primary diagnosed infections were defined as infections known at entry to be treated first. Secondary diagnosed infections included infections known at entry but treated in parallel to primary non-infectious causes of entry, infections unknown at entry, and hospital-acquired (nosocomial) infections. Data were analyzed by patient age, gender, year, ward type, bed-days of hospitalization, infection rates, and seasonality. Results: There were 3,306 primary diagnosed infections (18%) and 14,758 secondary infections (82%) identified in the two wards combined (54.7% of all hospital stays at those 2 wards). Secondary diagnosed infections accounted for a significantly higher proportion of hospitalizations in both wards (+40% for Geriatric ward; +20% for Pulmonology ward; p < 0.001) and were associated with a significantly longer average hospital stay (+4 days for Geriatric ward; +5 days for Pulmonology ward; p < 0.001). Nosocomial infections (12% for Geriatric ward; 7% for Pulmonology ward) were associated with particularly high bed-days of hospitalization, at approximately +15 days and +12 days on Geriatric and Pulmonology wards, respectively. Both wards showed marked seasonality for respiratory infections with winter peaks. Conclusion: Real-world data showed that secondary diagnosed infections in aging adults imposed a high burden on hospital care along with longer hospital stays. This hampered bed availability during peak seasons.

Extracting quantitative information from tissue--an industrial perspective.

The focus of this article is to provide an overview of the current technologies for the pharmaceutical and biotech industry. Disease processes express themselves in the functional and structural disturbance of cellular systems. Cells and their metabolites constitute the building blocks of tissues and entire organisms. Studying the spatial and temporal phenotype of disease processes in tissues at the cellular level reveals a multitude of information about the progress and status of a disease. Detailed exploration of tissues by slide-based cytometry is an important source of information about disease processes. Technological and analytical advances allow us to shed a new light on tissues and to come to a better understanding of the complexity of disease processes. Dealing with complex multidimensional datasets from tissue samples requires an advanced approach to image processing and data management. The increase in computing power and the continuing research into imaging algorithms allow us to improve the exploration of the data content of tissues.

Cytomics and drug discovery.

Pharmaceutical companies try to develop new drugs that have a high success rate of reaching the market. However, current disease models lack a strong correlation to clinical reality, because of the underestimation of the complexity and variability of clinical disease processes. This leads to high attrition rates late in drug development and soaring costs. Improvement of disease models is an important issue to reduce the high attrition rates in drug development. Using cell-based disease models, which should take into account the molecular diversity of the human cytome, will improve the predictive value of drug discovery.

In vitro studies of Flemish, Dutch, and wild-type beta-amyloid provide evidence for two-staged neurotoxicity.

Mutations in the beta-amyloid (Abeta) sequence of the amyloid precursor protein gene (APP) present with variable disease phenotypes. While patients with the Dutch APP mutation (E693Q) have predominantly hemorrhagic strokes, Flemish APP (A692G) patients develop both strokes and Alzheimer's disease (AD). To determine whether these diverse clinical and pathological presentations are due to mutant Abeta or APP, we studied the effect of Flemish, Dutch, and wild-type Abeta/APP on phosphorylation of specific tau epitopes observed in AD. No effect was observed in differentiated SH-SY5Y cells either stably expressing APP or treated with synthetic Abeta(12-42). However, we did observe a paradoxical temporal difference in the neurotoxic potential of mutant and wild-type Abeta. While long 24-h incubation at physiological levels of Abeta (2 microM) showed a higher amount of apoptosis for Dutch Abeta, a short 2-h incubation showed elevated apoptosis for Flemish and wild-type Abeta. The altered aggregating properties of Abeta, with Dutch Abeta aggregating faster and Flemish Abeta slower than wild type, elucidated a discrete two-phase Abeta neurotoxicity. We propose here that, at least in vitro, Abeta might be neurotoxic in an initial phase due to its soluble oligomeric or other early toxic Abeta intermediate(s), which is perhaps distinct from the late neurotoxicity incurred by aggregated larger assemblies of Abeta.