Among adults undergoing noncardiac surgery, MINS is common and associated with substantial mortality.
We have used comparative genomic hybridization (CGH) on a full-genome Campylobacter jejuni microarray to examine genome-wide gene conservation patterns among 51 strains isolated from food and clinical sources. These data have been integrated with data from three previous C. jejuni CGH studies to perform a metaanalysis that included 97 strains from the four separate data sets. Although many genes were found to be divergent across multiple strains (n ؍ 350), many genes (n ؍ 249) were uniquely variable in single strains. Thus, the strains in each data set comprise strains with a unique genetic diversity not found in the strains in the other data sets. Despite the large increase in the collective number of variable C. jejuni genes (n ؍ 599) found in the meta-analysis data set, nearly half of these (n ؍ 276) mapped to previously defined variable loci, and it therefore appears that large regions of the C. jejuni genome are genetically stable. A detailed analysis of the microarray data revealed that divergent genes could be differentiated on the basis of the amplitudes of their differential microarray signals. Of 599 variable genes, 122 could be classified as highly divergent on the basis of CGH data. Nearly all highly divergent genes (117 of 122) had divergent neighbors and showed high levels of intraspecies variability. The approach outlined here has enabled us to distinguish global trends of gene conservation in C. jejuni and has enabled us to define this group of genes as a robust set of variable markers that can become the cornerstone of a new generation of genotyping methods that use genome-wide C. jejuni gene variability data.Campylobacter jejuni is a human pathogen, a commensal inhabitant of many domestic animals, and globally, the most common cause of acute bacterial enteritis (for a review, see reference 31). Two well-established serotyping methods, namely, Penner typing based on heat-stable antigens and Lior typing based on heat-labile antigens, have been in use for more than two decades to study species diversity, to track epidemiological trends, and to determine important epidemiological correlations (15,23). Technical limitations on the production of high-quality typing sera have limited the availability of these reagents. Culturing conditions can affect the expression of serotyping determinants, which affects serotyping results, and several strains are nontypeable (32). Additionally, serotype relatedness is not always indicative of genetic relatedness since members of different serotypes of C. jejuni are genetically related, despite differences in heat-stable antigen expression (16).The need for alternative subtyping schemes has been recognized, leading to the development of a number of different methods based on differences at the DNA level (i.e., genotyping). The techniques used at present range from analysis of polymorphisms in groups of housekeeping genes (multilocus sequence typing [5,26]), amplified fragment length polymorphism analysis (28), restriction fragment length polymorphism analysi...
clinicaltrials.gov Identifier: NCT01082874.
Purpose of reviewAcute kidney injury (AKI) is an increasingly common problem among hospitalized patients. Patients who survive an AKI-associated hospitalization are at higher risk of de novo and worsening chronic kidney disease, end-stage kidney disease, cardiovascular disease, and death. For hospitalized patients with dialysis-requiring AKI, outpatient follow-up with a nephrologist within 90 days of hospital discharge has been associated with enhanced survival. However, most patients who survive an AKI episode do not receive any follow-up nephrology care. This narrative review describes the experience of two new clinical programs to care for AKI patients after hospital discharge: the Acute Kidney Injury Follow-up Clinic for adults (St. Michael’s Hospital and University Health Network, Toronto, Canada) and the AKI Survivor Clinic for children (Cincinnati Children’s Hospital, USA).Sources of informationMEDLINE, PubMed, ISI Web of ScienceFindingsThese two ambulatory clinics have been in existence for close to two (adult) and four (pediatric) years, and were developed separately and independently in different populations and health systems. The components of both clinics are described, including the target population, referral process, medical interventions, patient education activities, and follow-up schedule. Common elements include targeting patients with KDIGO stage 2 or 3 AKI, regular audits of the inpatient nephrology census to track eligible patients, medication reconciliation, and education on the long-term consequences of AKI.LimitationsDespite the theoretical benefits of post-AKI follow-up and the clinic components described, there is no high quality evidence to prove that the interventions implemented in these clinics will reduce morbidity or mortality. Therefore, we also present a plan to evaluate the adult AKI Follow-up Clinic in order to determine if it can improve clinical outcomes compared to patients with AKI who do not receive follow-up care.ImplicationsFollow-up of AKI survivors is low, and this review describes two different clinics that care for patients who survive an AKI episode. We believe that sharing the experiences of the AKI Follow-up Clinic and AKI Survivor Clinic provide physicians with a feasible framework to implement their own clinics, which may help AKI patients receive outpatient care commensurate with their high risk status.Electronic supplementary materialThe online version of this article (doi:10.1186/s40697-015-0071-8) contains supplementary material, which is available to authorized users.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.