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Isolating Influenza RNA from Clinical Samples Using Microfluidic Oil-Water Interfaces

The effective and robust separation of biomolecules of interest from patient samples is an essential step in diagnostic applications. We present a platform for the fast extraction of nucleic acids from clinical specimens utilizing paramagnetic PMPs, an oil-water interface, a small permanent magnet and a microfluidic channel to separate and purify captured nucleic acids from...

The dysfunctional host response to influenza A H7N9: a potential treatment option?

The newly emerging human pathogen influenza A H7N9 represents a potentially major threat to human health. The virus was first shown to be pathogenic in humans in 2013, and outbreaks continue to occur in China to the present time. The current incident mortality rate is disturbingly high despite the frequent use of antiviral therapy and intensive care management. If the virus gains...

Over-distension of the airways by mechanical ventilation in the elderly: adding insult to injury

Setzer and colleagues demonstrate that older animals are more susceptible to ventilator-induced lung injury than young animals and develop a more pronounced local and systemic cytokine response to high tidal volumes. These data have significant implications for older patients receiving mechanical ventilation if these findings can be translated to human critical care medicine.

Novel Approaches to the Treatment of Systemic Anthrax

Anthrax continues to generate concern as an agent of bioterrorism and as a natural cause of sporadic disease outbreaks. Despite the use of appropriate antimicrobial agents and advanced supportive care, the mortality associated with the systemic disease remains high. This is primarily due to the pathogenic exotoxins produced by Bacillus anthracis as well as other virulence factors...

Coming soon to an ICU near you: severe pandemic influenza in ICU patients in Spain

A novel strain of swine influenza A H1N1 has already disseminated worldwide and has become a major clinical problem for intensive care units in selected areas. Many regions in the southern hemisphere are currently struggling to keep up with the influx of severely affected patients with acute respiratory failure from primary influenza pneumonia. The northern hemisphere is bracing...

Swine flu, pandemics, and critical care

Corresponding author: Steven M Opal 1 1 0 Infectious Disease Service, Memorial Hospital of Rhode Island , 111 Brewster Street, Pawtucket, RI 02860 , USA 1 References 1. Harper SA , Bradley JS

Microdroplet Sandwich Real-Time RT-PCR for Detection of Pandemic and Seasonal Influenza Subtypes

As demonstrated by the recent 2012/2013 flu epidemic, the continual emergence of new viral strains highlights the need for accurate medical diagnostics in multiple community settings. If rapid, robust, and sensitive diagnostics for influenza subtyping were available, it would help identify epidemics, facilitate appropriate antiviral usage, decrease inappropriate antibiotic usage...

Communal Living by Bacteria and the Pathogenesis of Urinary Tract Infections

bacterial species, uses some Competing Interests: The author has declared that no competing interests exist. Copyright: 2007 Steven M. Opal. This is an open-access article distributed under the terms of the

Bench-to-bedside review: Quorum sensing and the role of cell-to-cell communication during invasive bacterial infection

Opal 0 0 0 Infectious Disease Division, Warren Alpert Medical School of Brown University, Memorial Hospital of Rhode Island , 111 Brewster Street, Pawtucket, RI 02860 , USA Bacteria communicate

Clinical review: The role of biomarkers in the diagnosis and management of community-acquired pneumonia

Mirjam Christ-Crain 0 Steven M Opal 1 0 Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital Basel , Petersgraben 4, CH-4031 Basel , Switzerland 1 Warren Alpert Medical

Year in review 2008: Critical Care - sepsis

Corresponding author: Steven M Opal 0 Department of Medicine, Infectious Disease Division, Rhode Island Hospital, The Warren Alpert Medical School of Brown University , 593 Eddy Street, Providence

Coagulation abnormalities in critically ill patients

Many critically ill patients develop hemostatic abnormalities, ranging from isolated thrombocytopenia or prolonged global clotting tests to complex defects, such as disseminated intravascular coagulation. There are many causes for a deranged coagulation in critically ill patients and each of these underlying disorders may require specific therapeutic or supportive management. In...

A Peptide Antagonist of CD28 Signaling Attenuates Toxic Shock and Necrotizing Soft-Tissue Infection Induced by Streptococcus pyogenes

Staphylococcus aureus and group A Streptococcus pyogenes (GAS) express superantigen (SAg) exotoxin proteins capable of inducing lethal shock. To induce toxicity, SAgs must bind not only to the major histocompatibility complex II molecule of antigen-presenting cells and the variable β chain of the T-cell receptor but also to the dimer interface of the T-cell costimulatory receptor...

The Immunopathogenesis of Sepsis in Elderly Patients

Prominent among the numerous events that contribute to the enhanced susceptibility of elderly patients to infection is the decline of immune function that accompanies aging. Elderly patients experience a marked decline in cell-mediated immune function and reduced humoral immune function. Age-dependent defects in T and B cell function are readily demonstrable in elderly patients...

Bench-to-bedside review: Functional relationships between coagulation and the innate immune response and their respective roles in the pathogenesis of sepsis

The innate immune response system is designed to alert the host rapidly to the presence of an invasive microbial pathogen that has breached the integument of multicellular eukaryotic organisms. Microbial invasion poses an immediate threat to survival, and a vigorous defense response ensues in an effort to clear the pathogen from the internal milieu of the host. The innate immune...

Insights into Severe Sepsis in Older Patients: From Epidemiology to Evidence-Based Management

Up to 60% of patients who develop severe sepsis in the United States are ⩾65 years of age, and the incidence of sepsis in this population is steadily increasing. Elderly individuals have an increased risk of developing sepsis, compared with younger patients, because of frequent comorbidities, institutionalization, declining performance status, and altered immune function. The...

Bench-to-bedside review: Toll-like receptors and their role in septic shock

The Toll-like receptors (TLRs) are essential transmembrane signaling receptors of the innate immune system that alert the host to the presence of a microbial invader. The recent discovery of the TLRs has rapidly expanded our knowledge of molecular events that initiate host–pathogen interactions. These functional attributes of the cellular receptors provide insights into the...

A clinical evaluation committee assessment of recombinant human tissue factor pathway inhibitor (tifacogin) in patients with severe community-acquired pneumonia

Introduction The purpose of this analysis was to determine the potential efficacy of recombinant human tissue factor pathway inhibitor (tifacogin) in a subpopulation of patients with community-acquired pneumonia (CAP) from a phase III study of severe sepsis. Methods A retrospective review of patients with suspected pneumonia was conducted by an independent clinical evaluation...