Chlamydia trachomatis is the most common bacterial sexually transmitted infection amongst individuals between the ages of 14-39 within the United States [1]. The immune system responds to the recognition of Chlamydia infection by inducing an inflammatory response and recruiting T cells to fight the pathogen. The proposed experiment evaluates whether pregnancy has an influence on the course of Chlamydia muridarum infection in a murine model. Previous studies show production of type 1 helper T cells (T_h1) are important for aiding in the clearance of Chlamydia. However, pregnancy elicits type 2 helper T cells (T_h2) to protect the fetus, which aren't effective in fighting an infection.[2] In my experiment, pregnant and nonpregnant C57BL/6 mice were infected with Chlamydia muridarum. Vaginal secretion and vaginal swabs were collected everyday for eleven days. It is hypothesized a T_h2 cytokine production will not protect against Chlamydia infection, but may contribute to the development of persistent infection. In my study, infection can be tracked without sacrificing mice at different time points. This allows for minimal usage of mice. It will also illustrate a real-time course of infection throughout pregnancy. The findings provide a murine model that can be applied in illustrating the possible outcomes of infection in humans during pregnancy.

Porphyromonas gingivalis and Fusobacterium nucleatum, Gram-negative anaerobic bacteria, have been identified as major contributing pathogens in the etiology of mild to acute periodontitis. They are opportunistic pathogens that are highly adapted to colonize the oral epithelial tissues. P. gingivalis has also been associated with a variety of other chronic and inflammatory conditions including orodigestive cancers, rheumatoid arthritis, liver disease, and diabetes. Whereas, F. nucleatum has been linked to Lemierre’s syndrome and skin ulcers. Recognition and clearance of these pathogens are regulated by inflammation and host immune response. We aimed to study the mechanisms and inflammatory responses (focusing on the effect with intracellular complexes known as inflammasomes) used by P. gingivalis and F. nucleatum to survive and persist during infection in gingival epithelial cells (GECs). Our findings indicate P. gingivalis infection inhibits inflammasome activation and release of pro-inflammatory cytokines by secretion of nucleoside-diphosphate kinase (NDK) to hydrolyze extracellular ATP. By defining NDK as a key enzyme for influencing inflammation in P. gingivalis infection, therapeutic methods can be designed to possibly target NDK to prevent and treat periodontitis. On the other hand, GECs infected with F. nucleatum induce an opposite immune response of upregulated cytokine production and release as a result of inflammasome activation. In vivo studies with BALB/c and C57BL/6 mice also show pro-inflammatory response during infection. Our findings can be used as a model of invasion during F. nucleatum infection in vitro and in vivo. Expanding our understanding of host response to pathogenic bacteria is important for limiting progression of periodontitis and other emerging systematic disease linked to these bacteria.

Introduction: To determine emergency physician (EP) opinions of prehospital patient care reports (PCRs) and whether such reports are available at the time of emergency department (ED) medical decision-making.

Methods: Prospective, cross-sectional, electronic web-based survey of EPs regarding preferences and availability of prehospital PCRs at the time of ED medical decision-making.

Results: We sent the survey to 1,932 EPs via 4 American College of Emergency Physicians (ACEP) email lists. As a result, 228 (11.8%) of email list members from 31 states and the District of Columbia completed the survey. Most respondents preferred electronic prehospital PCRs as opposed to handwritten prehospital PCRs (52.2% [95% confidence interval (CI): 49.1, 55.3] vs. 17.1% [95%CI: 11.7, 22.5]). The remaining respondents (30.5% [95%CI: 26.0, 35.0]) had no preference or had seen only one type of PCR. Of the respondents, 45.6% [95%CI: 42.1, 48.7] stated PCRs were “very important” while 43.0% [95% CI: 39.3, 46.7] rated PCRs as “important” in their ED practice. Most respondents (79.6% [95%CI: 76.5, 82.7]) reported electronic prehospital PCRs were available ≤50% of the time for medical decision-making while 20.4% [95%CI: 9.2, 31.6] reported that electronic prehospital PCRs were available > 50% of the time (P=0.00). A majority of participants (77.6% [95%CI: 74.5, 80.7]) reported that handwritten prehospital PCRs were available ≥ 50% while 22.4% [95%CI: 11.8, 33.0] of the time for medical decision-making (P=0.00).

Conclusion: EPs in this study felt that prehospital PCRs were important to their ED practice and preferred electronic prehospital PCRs over handwritten PCRs. However, most electronic prehospital PCRs were unavailable at the time of ED medical decision-making. Although handwritten prehospital PCRs were more readily available, legibility and accuracy were reported concerns. This study suggest that strategies should be devised to improve the overall accuracy of PCRs and assure that electronic prehospital PCRs are delivered to the receiving ED in time for consideration in ED medical decision-making. [West J Emerg Med. 2013;14(5):482–488.]

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