Simkania negevensis in bronchoalveolar lavage of lung transplant recipients: a possible association with acute rejection.
ABSTRACT Simkania negevensis is a novel organism closely related to chlamydiae. The organism has been associated with community acquired pneumonia and acute exacerbation of chronic obstructive pulmonary disease. The prevalence and pathogenic potential of S. negevensis is not known in lung transplant recipients.
In this multicenter study comparative analysis of bronchoalveolar lavage (BAL) in lung transplants (Tx) and kidney Tx, immunocompromised and nasopharyngeal (NP) washes of immunocompetent patients was done. The BAL specimens were tested by nested polymerase chain reaction (PCR) for C. pneumoniae and S. negevensis. Selected S. negevensis positive PCR cases were confirmed by culture.
In the initial 41 BAL samples S. negevensis was detected in 97.5% (40/41) of lung transplant recipients as compared to 14.1% (1/7) in other organ transplant recipients (P<0.0001). In the sequential samples of 19 lung transplant recipients, 59% (24/41) had concomitant positive PCR and rejection as compared to 30% (3/10) who had negative PCR but had rejection (P=0.16). S. negevensis infection had hazard ratio of 3.29 (95% CI: 0.73-14.76; P=0.11) for developing acute rejection.
S. negevensis is highly prevalent in liver Tx recipients and may be associated with acute rejection.
Conference Paper: LES: An expert system for infantry load planning[Show abstract] [Hide abstract]
ABSTRACT: Summary form only given. Load expert system (LES) formulates loads for individual infantry personnel at the squad level. The LES project was motivated by the historic soldier load problem an the Army's ongoing SIPE (soldier integrated protective ensemble) project. Currently running on PCs and the SIPE computer, LES can be used to plan soldier loads and provide instruction in principles governing load planning. Two versions of load expert system have been fielded: a standard desktop version and a soldier's computer version. Several enhancements are projected for LES. Preliminary results suggest LES is a viable solution to both the traditional soldier load problem and special cases, such as the SIPE configuration. Proven expert system technology has been applied to a non-trivial problem to yield a tool that can increase the probability of mission success by anticipating the soldier's ideal load for given METT-T (mission, enemy, terrain, troops, time) conditionsArtificial Intelligence for Applications, 1993. Proceedings., Ninth Conference on; 04/1993
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ABSTRACT: Control of host cell death is of paramount importance for the survival and replication of obligate intracellular bacteria. Among these, human pathogenic Chlamydia induces the inhibition of apoptosis in a variety of different host cells by directly interfering with cell death signaling. However, the evolutionary conservation of cell death regulation has not been investigated in the order Chlamydiales, which also includes Chlamydia-like organisms with a broader host spectrum. Here, we investigated the apoptotic response of human cells infected with the Chlamydia-like organism Simkania negevensis (Sn). Simkania infected cells exhibited strong resistance to apoptosis induced by intrinsic stress or by the activation of cell death receptors. Apoptotic signaling was blocked upstream of mitochondria since Bax translocation, Bax and Bak oligomerisation and cytochrome c release were absent in these cells. Infected cells turned on pro-survival pathways like cellular Inhibitor of Apoptosis Protein 2 (cIAP-2) and the Akt/PI3K pathway. Blocking any of these inhibitory pathways sensitized infected host cell towards apoptosis induction, demonstrating their role in infection-induced apoptosis resistance. Our data support the hypothesis of evolutionary conserved signaling pathways to apoptosis resistance as common denominators in the order Chlamydiales.PLoS ONE 01/2011; 6(7):e22528. · 3.53 Impact Factor
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ABSTRACT: Emergence delirium (ED) is a postanesthesia phenomenon occurring in both adults and children during recovery from general anesthesia. Although the pediatric population has been an ongoing focus of research and publications regarding ED, a renewed interest in ED has developed among military nurses and anesthesia providers because of its increasing incidence among the US military surgical population. The purpose of this article is to identify potential risk factors for emergence delirium in the US military population. Possible relationships between the physiological and psychological changes in US military veterans and the surgical experience are explored. A review of ED as it occurs among the pediatric, adult, and elderly populations is also provided to support potential etiologies for the occurrence of ED in the military population. Pain and physical and psychological trauma as a result of military duty are identified and linked to ED as potential risk factors. Identification of these risk factors may provide guidance for scientific inquiry into this phenomenon in the military population. Implications for future study are also explored.Journal of perianesthesia nursing: official journal of the American Society of PeriAnesthesia Nurses / American Society of PeriAnesthesia Nurses 12/2010; 25(6):392-401.