Environmental variables associated with an increased risk of invasive aspergillosis

Information on the environmental variables that may affect the incidence of invasive aspergillosis (IA) is scarce. We sought to determine the relationship between airborne spore counts, climatic conditions and IA. We also examined whether circulating respiratory viruses predispose patients to IA in a multicentre cohort study of hospitalized adults with IA. Data on environmental mould spores, climatic conditions and circulating respiratory viruses were obtained from the Environmental Department of the Autonomous University of Barcelona, the Meteorological Service of Catalonia and the Acute Respiratory Infection Surveillance Project in Catalonia, respectively. Between 2008 and 2011, 165 patients with IA were identified. Diagnosis was based on one or more of the following: culture (125 cases), galactomannan antigen (98) and histology (34). One hundred and twenty-seven cases (77%) had criteria for probable IA and the remainder for proven IA. Environmental mould spore counts from the period 28–42 days preceding infection presented significant associations with admissions due to IA. None of the climatic conditions were associated with an increased risk of IA, but the presence of circulating respiratory viruses was associated with a higher risk of infection: the most strongly associated viruses were respiratory syncytial virus, influenza A(H1N1)pdm09 and adenovirus. In conclusion, the presence of high numbers of spores in the air increases the risk of admission due to IA. Circulating respiratory viruses appear to be associated with a higher risk of developing IA. Physicians should be aware of this association in order to optimize prevention and diagnosis strategies for IA during viral epidemic periods.     

Ticagrelor to Reduce Myocardial Injury in Patients With High-Risk Coronary Artery Plaque

ObjectivesThe goal of this study was to determine whether ticagrelor reduces high-sensitivity troponin I concentrations in patients with established coronary artery disease and high-risk coronary plaque.BackgroundHigh-risk coronary atherosclerotic plaque is associated with higher plasma troponin concentrations suggesting ongoing myocardial injury that may be a target for dual antiplatelet therapy.MethodsIn a randomized, double-blind, placebo-controlled trial, patients with multivessel coronary artery disease underwent coronary ¹⁸F-fluoride positron emission tomography/coronary computed tomography scanning and measurement of high-sensitivity cardiac troponin I. Patients were randomized (1:1) to receive ticagrelor 90 mg twice daily or matched placebo. The primary endpoint was troponin I concentration at 30 days in patients with increased coronary ¹⁸F-fluoride uptake.ResultsIn total, 202 patients were randomized to treatment, and 191 met the pre-specified criteria for inclusion in the primary analysis. In patients with increased coronary ¹⁸F-fluoride uptake (120 of 191), there was no evidence that ticagrelor had an effect on plasma troponin concentrations at 30 days (ratio of geometric means for ticagrelor vs. placebo: 1.11; 95% confidence interval: 0.90 to 1.36; p = 0.32). Over 1 year, ticagrelor had no effect on troponin concentrations in patients with increased coronary ¹⁸F-fluoride uptake (ratio of geometric means: 0.86; 95% confidence interval: 0.63 to 1.17; p = 0.33).ConclusionsDual antiplatelet therapy with ticagrelor did not reduce plasma troponin concentrations in patients with high-risk coronary plaque, suggesting that subclinical plaque thrombosis does not contribute to ongoing myocardial injury in this setting. (Dual Antiplatelet Therapy to Reduce Myocardial Injury [DIAMOND]; NCT02110303)     

Psychotherapy Borealis

In January 1987 the somatic health, psychiatric behaviour, and social adjustment of 23 chronic mental hospital patients at Ralambshov's Hospital, aged 18–45 years, were studied. Most of the patients were single schizophrenic men who had received an average of 7 years of mental hospital care. Most of the patients belonged to a low-income group but had adequate housing. The percentage of patients with working-class backgrounds was not greater than that in their immediate environment. Most members of the group, however, did have unstable family background and limited education and were socially isolated.     

Cancer Mortality Among People Living in Areas With Various Levels of Natural Background Radiation

There are many places on the earth, where natural background radiation exposures are elevated significantly above about 2.5 mSv/year. The studies of health effects on populations living in such places are crucially important for understanding the impact of low doses of ionizing radiation. This article critically reviews some recent representative literature that addresses the likelihood of radiation-induced cancer and early childhood death in regions with high natural background radiation. The comparative and Bayesian analysis of the published data shows that the linear no-threshold hypothesis does not likely explain the results of these recent studies, whereas they favor the model of threshold or hormesis. Neither cancers nor early childhood deaths positively correlate with dose rates in regions with elevated natural background radiation.     

新疆民营医院法定代表人职业背景及融资特点分析调查

通过对新疆46家民营医院法定代表人职业背景、融资情况及新疆民营医院管理模式的调研,发现新疆民营医院法定代表人存在年纪轻,少数民族少,新疆本地法定代表人占半;医疗专业为主,学历、专业素质、职业化程度较低;缺乏专业化培训等特点,新疆民营医院管理模式以院长负责制为主,融资以民间借贷为主,融资风险自担,融资目的单一,缺乏软实力投入。     

乳腺磁共振背景实质强化的研究进展

乳腺癌作为女性最常见的恶性肿瘤,其发病率及死亡率都较高,且不同分子亚型乳腺癌生物学表现及临床治疗、预后各不相同,寻找乳腺癌针对性和个性化诊断及治疗的影像学标记物是目前研究的热点。乳腺背景实质强化(background parenchymal enhancement,BPE)是正常纤维腺体组织的生理性强化,受多种因素的影响,并在乳腺疾病的诊断及治疗预后方面有着重要的诊断价值,BPE水平升高与乳腺癌发病风险相关,并可能评估乳腺癌新辅助化疗的疗效。作者就BPE的影响因素及在乳腺癌筛查、诊断及治疗评估中的作用加以综述。     

Critical design aspects involved in the study of Paneth cells and the intestinal microbiota

Paneth cells are long-lived secretory cells that reside in the base of the crypts of Lieberkühn of the small intestine. They produce an arsenal of molecules that are involved in numerous biological processes, ranging from the control of gut microbial populations to supporting the intestinal stem cell niche. Because of these important functions, Paneth cell abnormalities are becoming implicated in a variety of disease processes. As such, it is necessary to establish parameters that will allow for the comprehensive study of Paneth cells in health and disease. In this addendum, we highlight critical design aspects involved in the study of Paneth cells and their downstream effects on the intestinal microbiota. The importance of this approach is demonstrated by our recent findings that Nod2 does not regulate mouse Paneth cell antimicrobial function, in contrast to previous reports. This work defines key issues to consider when studying Paneth cells in mouse systems.     

声音片段诱导的不同情绪背景对来源记忆的影响

目的 探讨声音片段诱导的不同情绪背景对来源记忆的影响.方法 采用来源记忆测试的多键范式,采用3×4二因素被试内设计,对不同情绪背景下来源记忆的反应时和正确率进行测试,分析其差异.结果 3种情绪背景下,来源正确和来源错误的反应时和正确率与新刺激差异有统计学意义(P＜0.01);正性和负性情绪背景下来源错误和来源正确的反应时和正确率差异有统计学意义(P＜0.01);被试的反应时和正确率的情绪效应不显著(P＞0.05).结论 声音片段诱导的不同情绪背景下来源记忆比项目记忆的认知操作更复杂,需时更长,而且在不能提取来源或对提取的来源不确定时,反应时会延长.