Background
Microbiome sequencing has brought increasing attention to the polymicrobial context of chronic infections. However, clinical microbiology continues to focus on canonical human pathogens, which may overlook informative, but non-pathogenic, biomarkers. We address this disconnect in lung infections in people with cystic fibrosis (CF).
Methods
We collected health information (lung function, age, BMI) and sputum samples from a cohort of 77 children and adults with CF. Samples were collected during a period of clinical stability and 16S rDNA sequenced for airway microbiome compositions. We use Elastic Net regularization to train linear models predicting lung function and extract the most informative features.
Results
Models trained on whole microbiome quantitation outperform models trained on pathogen quantitation alone, with or without the inclusion of patient metadata. Our most accurate models retain key pathogens as negative predictors (Pseudomonas, Achromobacter) along with established correlates of CF disease state (age, BMI, CF related diabetes). In addition, our models select non-pathogen taxa (Fusobacterium, Rothia) as positive predictors of lung health.
Conclusions
These results support a reconsideration of clinical microbiology pipelines to ensure the provision of informative data to guide clinical practice.
Introduction: Acute scrotal pain sometimes requires prompt surgical intervention and therefore accurate diagnosis of different etiologies of acute scrotal pain has great therapeutical and prognostic significance. The aim of this study was to analyze the incidence, symptomatology and results of treatment of acute scrotal pain in children. Material and Method: The study included patients hospitalized at the Pediatric Surgery Clinic with a diagnosis of acute scrotal pain. We retrospectively analyzed anamnestic data (age of patient and duration of anamnesis prior to admission), clinical parameters obtained during physical examination, mode of treatment (operative or medical), intraoperative findings and (postoperative) treatment. Results: The study included 256 patients with acute scrotal pain, aged from several hours up to 17 years of age (average 9.73 years). The average duration of symptoms prior to admission was 56.74 h. Acute epididymitis was diagnosed in 110 patients (43.0%), torsion of the testicular appendage in 104 patients (40.6%), torsion of the testis in 30 patients (11.7%) and other pathologies in another 12 patients. 166 patients (64.8%) underwent surgery, 42 patients with orchiepididymitis (38.2%), 92 patients with torsion of the testicular appendage (88.5%), and 16.6% of the patients with other pathologies. 22 patients with torsion of the testis underwent surgery (73.3%), while the rest of the 8 patients underwent manual detorquation of the testis. Conclusion: Regardless of the etiology of the acute scrotal pain, it is of great importance that the patient seeks medical assistance promptly. It is therefore important to educate the parents and patients about the problems related to acute scrotal pain.
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