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To estimate the healthcare costs associated with post-stroke dysphagia during acute hospitalisation and to identify factors influencing these costs in a tertiary hospital setting in Vietnam.
A cross-sectional study using clinical and billing data from hospital records.
The study was conducted at the Neurology Center of Bach Mai Hospital, a tertiary care facility in Hanoi, Vietnam, between June 2020 and January 2022.
A total of 951 patients aged ≥18 years with acute ischaemic stroke confirmed by CT or MRI were included. Dysphagia was assessed using the Gugging Swallowing Screen.
Direct healthcare costs during hospitalisation were collected from the hospital billing system and categorised as medications, diagnostic imaging, medical supplies, accommodation, food, procedures and laboratory tests. All costs were converted to USD. Associations between patient characteristics and total healthcare costs were analysed using generalised linear models (Gamma distribution with log link), applying robust standard errors.
The median treatment cost was 10.08 million VND (436.24 USD) in the dysphagia group vs 6.37 million VND (275.78 USD) in the non-dysphagia group. Costs increased with dysphagia severity, reaching 22.64 million VND (979.49 USD) among patients with severe dysphagia. In multivariate analysis, dysphagia was associated with a 21% increase in costs (exp(β) = 1.21; 95% CI 1.10 to 1.33; p14, pneumonia, prolonged hospitalisation and higher educational level.
Post-stroke dysphagia substantially increases acute hospitalisation costs in Vietnam. Early screening, standardised management and preventive care for complications may improve outcomes and reduce costs.
The study was registered on the Research Registry website (https://www.researchregistry.com/) under the unique identification number: researchregistry8203.
by Shanhe Liu, Shuailin Li, Shao-Lun Hsu, Fabian N. Fries, Zhen Li, Swarnali Kundu, Berthold Seitz, Maryam Amini, Shweta Suiwal, Julia Zimmermann, Simon Trusen, Tanja Stachon, Nóra Szentmáry
PurposeThe aim of this study was to investigate apoptosis in primary aniridia limbal stromal cells (LSCs) and to assess changes in the expression of genes and proteins associated with the apoptotic pathway in response to cobalt chloride (CoCl2)-induced hypoxic stress, in vitro.
MethodsPrimary human limbal stromal cells were isolated from the limbal region of both aniridia (AN-LSCs; n = 8) and healthy (LSCs; n = 8) donors. The cells were treated with 0 µM, 50 µM, and 75 µM CoCl2 for 48 hours. Apoptosis in each group was assessed by Flow cytometry (FC). The expression levels of apoptosis-related genes, including CASP 3/7/8/9/10, BCL2, BID, BAX, CDKN1A (p21), CDKN1B (p27), TNFα, XIAP, and BIRC5 (Survivin), were measured by qPCR. Protein level of these markers was analyzed by FC. TNFα protein expression in the supernatant was quantified using ELISA.
ResultsFlow cytometry analysis revealed a significantly higher apoptosis rate in AN-LSCs compared to LSCs (p BCL2 mRNA levels (p = 0.0291), Caspase-8 (p = 0.0341), Caspase-10 (p = 0.0085), Bcl-2 (p = 0.0014), XIAP (p = 0.0003) and Survivin (p = 0.0074) protein levels were significantly higher in LSCs than in AN-LSCs. Conversely, Caspase-3 (p = 0.0366), Caspase-9 (p = 0.0354), p21 (p = 0.0003), and p27 (p = 0.0164) protein levels were significantly higher in AN-LSCs than in LSCs. In LSCs, exposure to 75 µM CoCl₂ led to a reduction in BCL2 mRNA (p = 0.0102) and protein levels (p = 0.0484), accompanied by an increase in CDKN1B mRNA level (p = 0.0265). In AN-LSCs, 75 µM CoCl₂ treatment resulted in a decrease in CASP3 (p = 0.049), CASP7 (p = 0.041) and BCL2 (p = 0.0218) mRNA and Bcl-2 protein levels (p = 0.0405) and an increase of TNF-α protein levels in the cell culture supernatant (p = 0.0251).
ConclusionsThe apoptosis rate of LSCs from patients with congenital aniridia is higher than that of the control group, accompanied by alterations in multiple apoptosis-related markers. Additionally, CoCl₂-induced hypoxic stress further increases apoptosis in AN-LSCs and leads to changes in the expression of Caspase 3, Caspase 7, Bcl-2, and CDKN1B (p27). Further research is needed to elucidate the potential therapeutic targets in AAK, with the aim of preventing or slowing the progression of aniridia-associated keratopathy.
by Mai Dinh Thanh, Gemma Agustí, Anneluise Mader, Francesc Codony
Staphylococcus (S.) aureus is a prominent foodborne pathogen that can cause food poisoning due to its staphylococcal toxins. Controlling the viable levels of S. aureus is crucial for ensuring food safety. The detection of S. aureus during routine quality control is still primarily conducted using traditional culture-based methods, which are time-consuming and unable to detect viable but non-culturable cells. Viability PCR (vPCR) – a combination of traditional (or quantitative) PCR with photo-reactive DNA-intercalating dye(s) – has been introduced as an alternative to detect viable cells by excluding those with compromised membranes using molecular methods. Despite the success of the vPCR methodology, avoiding false-positive results remains a significant challenge. To enhance the accuracy of vPCR results for S. aureus, several approaches have been proposed by various researchers in the past decade; however, complete PCR signal suppression of dead cells has not been achieved. In this study, we developed a strategy to detect only viable S. aureus cells by combining double PMA treatment with a low PMA concentration and performing a tube change between the last dark incubation and light exposure to improve the vPCR protocol. For pure cultures, the optimized protocol was able to completely suppress DNA signals from 5.0 × 107 dead cells in a final reaction volume of 200 µl. For artificially contaminated food samples with such a high dead cell count, complete PCR signal reduction was observed in ground pepper, - oregano, and infant milk powder, while ground paprika, - allspice, and - pork exhibited PCR signals close to the detection limit. To simulate conditions in real samples, we artificially contaminated ground paprika, - pork, and milk powder with a low number of viable cells (~1.9 cfu/ml) and a high number of heat-inactivated S. aureus (~4.8 × 10⁶ cells/ml). The results showed that the optimized protocol is effective in detecting only the desired live cells, even in the presence of a high dead cell count. Our findings highlight that vPCR can be an accurate and reliable method with strong potential for high-throughput detection of live S. aureus cells in certain food matrices.
FreshRSS 