Examination of bacterial detection frequency and loads in Chinese adults may assist microbial studies of periodontal disease and will shed light on periodontal disease diagnosis and treatment using antibiotics in the Chinese population.
Objective: Survivors of ascending aortic dissection repair frequently require downstream aortic interventions. Because of a paucity of data, we assessed early and long-term outcomes, and risk factors, of these distal procedures.Methods: From January 1993 to January 2011, 305 patients underwent 429 distal aortic interventions after acute type A (95% DeBakey type I) dissection repair performed 3.8 years earlier (median); 11% of interventions used an endovascular approach. Maximum aortic size was 5.9 AE 1.3 cm. Median follow-up was 3.6 years.Results: Hospital mortality was 6.1%. Risk factors included graft infection, concomitant coronary artery bypass grafting, combined open arch and descending procedures, and lower distal anastomotic site. Within 10 years, the probability of patients undergoing a reintervention was 38%, with a cumulative incidence of 55 per 100 patients; however, 40 (9.3%) were stage-II elephant trunks. Patients with larger aortic diameters distal to the initial repair, and a stage-I elephant trunk, were more likely to undergo distal interventions. Survival was 65% at 10 years. Higher body mass index, a longer time between reinterventions, graft infection, combined open arch and descending procedures, and lower distal anastomosis sites were risk factors. The extent of aorta replaced was not associated with increased morbidity or mortality, unless it involved a combined open arch and descending aorta procedure.Conclusions: Distal interventions after ascending aortic dissection repair are feasible, but they are associated with early morbidity and subsequent reinterventions. Rigorous follow-up with early reintervention is important for improving short-and long-term outcomes. An extended hybrid endovascular repair for initial dissection warrants study.
Sex differences in the QRSd-response relationship among CRT patients with LBBB were unexplained by application of strict LBBB criteria or by BSA, but resolved by QRSd normalization for heart size using LV mass or volume.
The COVID-19 has become a pandemic. The timing and nature of the COVID-19 pandemic response and control varied among the regions and from one country to the other, and their role in affecting the spread of the disease has been debated. The focus of this work is on the early phase of the disease when control measures can be most effective. We proposed a modified susceptible-exposed-infected-removed model (SEIR) model based on temporal moving windows to quantify COVID-19 transmission patterns and compare the temporal progress of disease spread in six representative regions worldwide: three Chinese regions (Zhejiang, Guangdong and Xinjiang) vs. three countries (South Korea, Italy and Iran). It was found that in the early phase of COVID-19 spread the disease follows a certain empirical law that is common in all regions considered. Simulations of the imposition of strong social distancing measures were used to evaluate the impact that these measures might have had on the duration and severity of COVID-19 outbreaks in the three countries. Measure-dependent transmission rates followed a modified normal distribution (empirical law) in the three Chinese regions. These rates responded quickly to the launch of the 1
st
-level Response to Major Public Health Emergency in each region, peaking after 1–2 days, reaching their inflection points after 10–19 days, and dropping to zero after 11–18 days since the 1
st
-level response was launched. By March 29
th
, the mortality rates were 0.08% (Zhejiang), 0.54% (Guangdong) and 3.95% (Xinjiang). Subsequent modeling simulations were based on the working assumption that similar infection transmission control measures were taken in South Korea as in Zhejiang on February 25
th
, in Italy as in Guangdong on February 25
th
, and in Iran as in Xinjiang on March 8
th
. The results showed that by June 15
th
the accumulated infection cases could have been reduced by 32.49% (South Korea), 98.16% (Italy) and 85.73% (Iran). The surface air temperature showed stronger association with transmission rate of COVID-19 than surface relative humidity. On the basis of these findings, disease control measures were shown to be particularly effective in flattening and shrinking the COVID-10 case curve, which could effectively reduce the severity of the disease and mitigate medical burden. The proposed empirical law and the SEIR-temporal moving window model can also be used to study infectious disease outbreaks worldwide.
Abnormal diffusing capacity is common in HIV-infected individuals including never smokers. Etiologies for diffusing capacity impairment in HIV are not understood, particularly in those without a history of cigarette smoking.
A cross-sectional analysis of 158 HIV-infected individuals without acute respiratory symptoms or infection to determine associations between a DLCO % predicted and participant demographics, pulmonary spirometric measures (FEV1 and FEV1/FVC), radiographic emphysema (fraction of lung voxels <-950 Hounsfield units), pulmonary vascular/cardiovascular disease (echocardiographic tricuspid regurgitant jet velocity [TRV], N-terminal pro-brain natriuretic peptide), and airway inflammation (induced sputum cell counts), stratified by history of smoking.
Mean DLCO was 65.9% predicted, and 55 (34.8%) participants had a significantly reduced DLCO (<60 % predicted). Lower DLCO % predicted in ever smokers was associated with lower post-bronchodilator FEV1 % predicted (p<0.001) and greater radiographic emphysema (p=0.001). In never smokers, mean (standard deviation) DLCO was 72.7% (13.4%) predicted, and DLCO correlated with post-bronchodilator FEV1 (p=0.02), sputum neutrophils (p=0.03), and sputum lymphocytes (p=0.009), but not radiographic emphysema.
Airway obstruction, emphysema, and inflammation influence DLCO in HIV. Never smokers may have a unique phenotype of diffusing capacity impairment. The interaction of multiple factors may account for the pervasive nature of diffusing capacity impairment in HIV infection.
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