ORCID Profile
0000-0003-3584-9752
Current Organisations
Finnish Institute for Health and Welfare
,
John Hunter Hospital
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Publisher: European Respiratory Society (ERS)
Date: 02-2018
DOI: 10.1183/13993003.01241-2017
Abstract: Both protective and adverse effects of indoor microbial exposure on asthma have been reported, but mostly in children. To date, no study in adults has used non-targeted methods for detection of indoor bacteria followed by quantitative confirmation. A cross-sectional study of 198 asthmatic and 199 controls was conducted within the European Community Respiratory Health Survey (ECRHS) II. DNA was extracted from mattress dust for bacterial analysis using denaturing gradient gel electrophoresis (DGGE). Selected bands were sequenced and associations with asthma confirmed with four quantitative PCR (qPCR) assays. 15 out of 37 bands detected with DGGE, which had at least a suggestive association (p .25) with asthma, were sequenced. Of the four targeted qPCRs, Clostridium cluster XI confirmed the protective association with asthma. The association was dose dependent (aOR 0.43 (95% CI 0.22–0.84) for the fourth versus first quartile, p for trend 0.009) and independent of other microbial markers. Few significant associations were observed for the three other qPCRs used. In this large international study, the level of Clostridium cluster XI was independently associated with a lower risk of prevalent asthma. Results suggest the importance of environmental bacteria also in adult asthma, but need to be confirmed in future studies.
Publisher: Wiley
Date: 23-06-2022
DOI: 10.1111/NEP.14078
Publisher: Springer Science and Business Media LLC
Date: 05-03-2021
DOI: 10.1038/S41598-021-84790-W
Abstract: Living with dogs appears to protect against allergic diseases and airway infections, an effect possibly linked with immunomodulation by microbial exposures associated with dogs. The aim of this study was to characterize the influence of dog ownership on house dust microbiota composition. The bacterial and fungal microbiota was characterized with Illumina MiSeq sequencing from floor dust s les collected from homes in a Finnish rural-suburban (LUKAS2, N = 182) birth cohort, and the results were replicated in a German urban (LISA, N = 284) birth cohort. Human associated bacteria variable was created by summing up the relative abundances of five bacterial taxa. Bacterial richness, Shannon index and the relative abundances of seven bacterial genera, mostly within the phyla Proteobacteria and Firmicutes , were significantly higher in the dog than in the non-dog homes, whereas the relative abundance of human associated bacteria was lower. The results were largely replicated in LISA. Fungal microbiota richness and abundance of Leucosporidiella genus were higher in dog homes in LUKAS2 and the latter association replicated in LISA. Our study confirms that dog ownership is reproducibly associated with increased bacterial richness and ersity in house dust and identifies specific dog ownership-associated genera. Dogs appeared to have more limited influence on the fungal than bacterial indoor microbiota.
Publisher: Wiley
Date: 15-11-2022
DOI: 10.1111/NEP.13995
Publisher: Springer Science and Business Media LLC
Date: 02-05-2015
Publisher: Oxford University Press (OUP)
Date: 12-06-2015
Abstract: To establish current knowledge of patient safety and quality of care in developing countries in Southeast Asia, current interventions and the knowledge gaps. Systematic review and narrative synthesis. Key words, synonyms and subject headings were used to search seven electronic databases in addition to manual searching of relevant journals. Titles and abstracts of publications between 1990 and 2014 were screened by two reviewers and checked by a third. Full text articles were screened against the eligibility criteria. Data on design, methods and key findings were extracted and synthesized. Four inter-related safety and quality concerns were evident from 33 publications: (i) the risk of patient infection in healthcare delivery, (ii) medications errors/use, (iii) the quality and provision of maternal and perinatal care and (iv) the quality of healthcare provision overall. Large-scale prevalence studies are needed to identify the full range of safety and quality problems in developing countries in Southeast Asia. Sharing lessons learnt from extensive quality and safety work conducted in industrialized nations may contribute to significant improvements. Yet the applicability of interventions utilized in developed countries to the political and social context in this region must be considered. Strategies to facilitate the collection of robust safety and quality data in the context of limited resources and the local context in each country are needed.
Publisher: Elsevier BV
Date: 05-2021
Publisher: Springer Science and Business Media LLC
Date: 22-11-2019
DOI: 10.1038/S41598-019-53527-1
Abstract: This study evaluates the association between indoor microbial ersity early in life and hyperactivity/inattention symptoms in children at ages 10 and 15 years.A random s le enriched with subjects with hyperactivity/inattention at age 15 years was selected from the German LISA birth cohort. Bedroom floor dust was collected at age 3 months and 4 bacterial and fungal ersity measures [number of observed operational taxonomic units (OTUs), Chao1, Shannon and Simpson indices] were calculated from Illumina MiSeq sequencing data. Hyperactivity/inattention was based on the Strengths and Difficulties Questionnaire at ages 10 and 15 (cut-off ≥7). Adjusted associations between 4 ersity measures in tertiles and hyperactivity/inattention were investigated with weighted and survey logistic regression models. We included 226 in iduals with information on microbial ersity and hyperactivity/inattention. Early life bacterial ersity was inversely associated with hyperactivity/inattention at age 10 [bacterial OTUs (medium vs low: aOR = 0.4, 95%CI = (0.2–0.8)) and Chao1 (medium vs low: 0.3 (0.1–0.5) high vs low: 0.3 (0.2–0.6)], whereas fungal ersity was directly associated [Chao1 (high vs low: 2.1 (1.1–4.0)), Shannon (medium vs low: 2.8 (1.3–5.8)), and Simpson (medium vs low: 4.7 (2.4–9.3))]. At age 15, only Shannon index was significantly associated with hyperactivity/inattention [bacteria (medium vs low: 2.3 (1.2–4.2) fungi (high vs low: 0.5 (0.3–0.9))]. In conclusion, early life exposure to microbial ersity may play a role in the psychobehavioural development. We observe heterogeneity in the direction of the associations encouraging further longitudinal studies to deepen our understanding of the characteristics of the microbial community underlying the observed associations.
Publisher: Hindawi Limited
Date: 16-10-2017
DOI: 10.1111/INA.12427
Abstract: Microbial exposures in homes of asthmatic adults have been rarely investigated specificities and implications for respiratory health are not well understood. The objectives of this study were to investigate associations of microbial levels with asthma status, asthma symptoms, bronchial hyperresponsiveness (BHR), and atopy. Mattress dust s les of 199 asthmatics and 198 control subjects from 7 European countries participating in the European Community Respiratory Health Survey II study were analyzed for fungal and bacterial cell wall components and in idual taxa. We observed trends for protective associations of higher levels of mostly bacterial markers. Increased levels of muramic acid, a cell wall component predominant in Gram-positive bacteria, tended to be inversely associated with asthma (OR's for different quartiles: II 0.71 [0.39-1.30], III 0.44 [0.23-0.82], and IV 0.60 [0.31-1.18] P for trend .07) and with asthma score (P for trend .06) and with atopy (P for trend .02). These associations were more pronounced in northern Europe. This study among adults across Europe supports a potential protective effect of Gram-positive bacteria in mattress dust and points out that this may be more pronounced in areas where microbial exposure levels are generally lower.
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.IJHEH.2012.12.013
Abstract: Exposure to biocontaminants is associated with behavioural problems and poorer cognitive function. Our study assesses the associations between early life exposure to home d ness, pets and farm animal contact and cognitive function and social competences in 4-year old children, and the associations between these indoor factors and microbial compounds (bacterial endotoxin and fungal extracellular polysaccharides). A Spanish population-based birth-cohort enrolled 482 children, and 424 of them underwent psychometric testing at 4 years of age, including the McCarthy Scales of Child Abilities (MSCA) and the California Preschool Social Competence Scale (CPSCS). Information on pet ownership, farm animal contact and home d ness was periodically reported by the parents through questionnaires. Microbial compounds were measured in living room sofa dust collected at the age of 3 months. Persistent home d ness during early life significantly decreased the general score of MSCA by 4.9 points (95% CI: -8.9 -0.8), and it decreased the CPSCS by 6.5 points (95% CI: -12.2 -0.9) in the child's bedroom. Cat or dog ownership were not associated with the outcomes, but occasional farm animal contact increased the general cognitive score of MSCA by 5.6 points (95% CI: 1.8 9.3). Cat and dog ownership were associated with higher levels of endotoxins in home dust. None of the measured microbial compounds were related with the psychometric tests scores. In conclusion, d housing in early life may have adverse effects on neuropsychological development at 4 years old. More research is needed to explore the possible involvement of mycotoxins in the observed results.
Publisher: Hindawi Limited
Date: 13-10-2011
DOI: 10.1111/J.1600-0668.2011.00740.X
Abstract: Endotoxin exposures have manifold effects on human health. The geographical variation and determinants of domestic endotoxin levels in Europe have not yet been extensively described. To investigate the geographical variation and determinants of domestic endotoxin concentrations in mattress dust in Europe using data collected in the European Community Respiratory Health Survey follow-up (ECRHS II). Endotoxin levels were measured in mattress dust from 974 ECRHS II participants from 22 study centers using an immunoassay. Information on demographic, lifestyle, and housing characteristics of the participants was obtained in face-to-face interviews. The median endotoxin concentration in mattress dust ranged from 772 endotoxin units per gram (EU/g) dust in Reykjavik, Iceland, to 4806 EU/g in Turin, Italy. High average outdoor summer temperature of study center, cat or dog keeping, a high household crowding index, and visible d patches in the bedroom were significantly associated with a higher endotoxin concentrations in mattress dust. There is a large variability in domestic endotoxin levels across Europe. Average outdoor summer temperature of study center, which explains only 10% of the variation in domestic endotoxin level by center, is the strongest meteorological determinant. The observed variation needs to be taken into account when evaluating the health effects of endotoxin exposures in international contexts. The incoherent observations of the health effects of endotoxin may be partly owing to the geographical heterogeneity of endotoxin exposure. Therefore, the observed variation should be considered in further studies. Measurements of indoor endotoxin are recommended as an indicator for the level of exposures of in idual domestic environments.
Publisher: Wiley
Date: 28-10-2022
DOI: 10.1111/IMJ.15959
Abstract: Fibrillary (FGN) and immunotactoid (IT) glomerulonephritis are uncommon. To evaluate the prevalence, clinicopathological correlations and outcomes of FGN and IT in our regional centre in Australia. We interrogated a renal biopsy database for cases of FGN and IT from 2000 to 2020. Data included demographics, serum creatinine, haematuria status, proteinuria, comorbidities and histopathological findings. We had 14 cases of FGN and t of IT. The mean presenting age was 59.8 years, and 42.9% were males. No patients with FGN had dysproteinaemia, whereas both patients with IT had chronic lymphocytic leukaemia. At presentation, 75% of patients with FGN and both patients with IT had haematuria all had proteinuria. Mean albumin-creatinine ratio at presentation was 254 mg/mmol for FGN and 604 mg/mmol for IT. Mean presenting serum creatinine was 149 μmol/L for FGN and 95 μmol/L for IT. Four patients with FGN (28.6%) received immunomodulatory therapy. The prognosis of FGN was poor, with six patients (46.2%) reaching end-stage kidney disease after a median of 42 months (range 1-96 months). All patients presenting with proteinuria <30 mg/mmol entered complete remission patients with higher-grade proteinuria exhibited progressive chronic kidney disease. Patients with IT had complete remission with treatment of underlying haematological disease. FGN is rare, with poor response to immunomodulatory therapy. It carries poor renal prognosis. Less proteinuria at diagnosis may predict a more benign disease course. IT is associated with haematological malignancy and carries better prognosis and response to treatment.
Publisher: Wiley
Date: 16-06-2022
DOI: 10.1111/TID.13880
No related grants have been discovered for Adrienne Cohen.