[Microbiological diagnosis of infections due to Chlamydia spp. and related species]

Until recently the number of completed genomes belonging to Chlamydia trachomatis was very low, despite its importance in Public Health. Now, there are currently sixty-six completed genomes of C.trachomatis sequenced in different parts of the world. This genomic revolution has helped in understanding its biology, as well as improved the sensitivity and specificity in the diagnosis, and the development of epidemiological tools, not only for in C.trachomatis, but also for related species such as C.pneumoniae and C.psittaci. The diagnosis based on cell culture, serology and microimmunofluorescence is gradually being replaced by molecular techniques based on PCR or real-time PCR. This is because these molecular tests do not have cross-reactions problems and the procedures are easily standardised between laboratories. Moreover, molecular epidemiology tools described recently, such as Multi-Locus Sequence Typing (MLST) and Variable Number Tandem Repeat (VNTR), have increased our knowledge on local and global epidemiology. This article focuses on the impact of the genomics advances achieved over the last few years as applied to the diagnosis, epidemiology and biology of the family Chlamydiaceae family and related species.

Cytotoxic effect of novel dehydroepiandrosterone derivatives on different cancer cell lines

The aim of this study was to determine the cytotoxic effect of human cancer cells on three series of novel dehydroepiandrosterone derivatives containing triazole or pyrazole rings at C-17 and an ester moiety at C-3 of the androstane skeleton. The panel cancer cells used in this study were the following: PC-3, MCF-7 and SKLU-1. The results from this study indicated that the steroidal derivatives 4a-4e and 4f-4k showed the highest cytotoxic potency. This difference in this activity could be attributed to the ability of the triazole (three nitrogen atoms) to form stronger hydrogen bonds with the active site of the cell as compared to the pyrazole group having two nitrogen atoms. Compounds 4f-4k having an aromatic ester at C-3 showed an enhanced cytotoxic activity as compared to their aliphatic counterparts 4a-4e. Apparently the electronegative phenyl ring increased the polarity of the molecule, thus increasing the dipole-dipole association of the steroidal molecule with the reactive site of the cell.

Developing and testing a new instrument to measure women's satisfaction with controlled ovarian stimulation treatment

OBJECTIVES

To develop and test a new instrument (EFESO Questionnaire) to measure satisfaction with controlled ovarian stimulation (COS) treatment.

METHODS

Literature review and focus groups with clinical experts provided content for the questionnaire. A preliminary version was pilot tested in 10 women to assess comprehension and relevance. The final version was administered to 606 women receiving COS. Feasibility, reliability and validity were tested by calculating the proportion of patients completing all items, by calculating Cronbach's alpha for the overall score, and by investigating whether the instrument discriminated between patients classified according to the level of overall satisfaction and response to treatment. Factor analysis was performed.

RESULTS

The final questionnaire consisted of 17 items. 91.7% of patients completed all of the items. Cronbach's alpha was 0.93, indicating excellent reliability, and the instrument was capable of discriminating between patients categorized by responses to the question on overall satisfaction with treatment and by their response to treatment. Factor analysis showed the instrument to be unidimensional.

CONCLUSIONS

The EFESO questionnaire is feasible, reliable and valid for the measurement of satisfaction with treatment in patients receiving COS treatment.

Overall survival benefit for sequential doxorubicin-docetaxel compared with concurrent doxorubicin and docetaxel in node-positive breast cancer--8-year results of the Breast International Group 02-98 phase III trial

Background In women with node-positive breast cancer, the Breast International Group (BIG) 02-98 tested the incorporation of docetaxel (Taxotere) into doxorubicin (Adriamycin)-based chemotherapy, and compared sequential and concurrent docetaxel. At 5 years, there was a trend for improved disease-free survival (DFS) with docetaxel. We present results at 8-year median follow-up and exploratory analyses within biologically defined subtypes. Methods Patients were randomly assigned to one of four treatments: (i) sequential control: doxorubicin (A) (75 mg/m(2)) × 4 →classical cyclophosphamide, methotrexate, 5-fluorouracil (CMF); (ii) concurrent control: doxorubicin, cyclophosphamide (AC)(60/600 mg/m(2)) × 4 →CMF; (iii) sequential docetaxel: A (75 mg/m(2)) × 3 → docetaxel (T) (100 mg/m(2)) × 3 → CMF and (iv) concurrent docetaxel: AT(50/75 mg/m(2)) × 4 →CMF. The primary comparison evaluated docetaxel efficacy regardless of the schedule. Exploratory analyses were undertaken within biologically defined subtypes. Results Two thousand eight hundred and eighty-seven patients were enrolled. After 93.4 months of median follow-up, there were 916 DFS events. For the primary comparison, there was no significant improvement in DFS from docetaxel [hazard ratio (HR) = 0.91, 95% confidence interval (CI) = 0.80-1.05, P = 0.187]. In secondary comparisons, sequential docetaxel significantly improved DFS compared with sequential control (HR = 0.81, 95% CI = 0.67-0.99, P = 0.036), and significantly improved DFS (HR = 0.84, 95% CI = 0.72-0.99, P = 0.035) and overall survival (OS) (HR = 0.79, 95% CI = 0.65-0.98, P = 0.028) compared with concurrent doxorubicin-docetaxel. Luminal-A disease had the best prognosis. HRs favored addition of sequential docetaxel in all subtypes, except luminal-A; but this observation was not statistically supported because of limited numbers. Conclusion With further follow-up, the sequential docetaxel schedule resulted in significantly better OS than concurrent doxorubicin-docetaxel, and continued to show better DFS than sequential doxorubicin-based control.

Electronic nose for the identification of pig feeding and ripening time in Iberian hams

An electronic nose system to control the processing of dry-cured Iberian ham is presented. The sensors involved are tin oxide semiconductors thin films. They were prepared by RF sputtering. Some of the sensors were doped with metal catalysts as Pt and Pd, in order to improve the selectivity of the sensors. The multisensor with 16 semiconductor sensors, gave different responses from two types of dry-cured Iberian hams which differ in the feeding and curing time. The data has been analysed using the PCA (principal component analysis) and backpropagation and probabilistic neural networks. The analysis shows that different types of Iberian ham can be discriminated and identified successfully.

Influence of temperature on structure and magnetic properties of exchange coupled TbCo/FeNi bilayers

Among amorphous films of rare earth-transition metal (RE-TM) alloys as exchange-biasing layers in magnetoresistive heads and spin-valve sensors, the amorphous Tb-Co films have most high practical potential. In the present work the influence of the temperature and the heat treatment parameters on the structure and magnetic properties was studied for exchange bias FeNi/Tb35Co65 bilayers annealed in vacuum or a nitrogen flow. A simple explanation of the dependence of the magnetic properties on the temperature and the heat treatment parameters connected with structural changes in each one of the layers was proposed.

Glycemic and insulin responses in white sea bream Diplodus sargus, after intraperitoneal administration of glucose

A glucose tolerance test was performed in white sea bream Diplodus sargus, juveniles to evaluate the effect of a glucose load on plasma glucose, insulin, triacylglyceride levels, and on liver glycogen storage in order to study the capability of glucose utilization by this species. After being fasted for 48 h, fish were intraperitoneally injected with either 1 g of glucose per kg body weight or a saline solution. Plasma glucose rose from a basal level of 4 to a peak of 18-19 mmol l(-1), 2-4 h after glucose injection and fish exhibited hyperglycemia for 9 h. An insulin peak (from 0.5 to 0.8 ng ml(-1)) was observed 2-6 h after glucose injection, and basal value was attained within 9 h. Liver glycogen peaked 6-12 h after the glucose load and thereafter decreased to the basal value which was attained 24 h after injection. Plasma triacylglycerides in glucose-injected fish were only significantly higher than the basal value 12 h after injection. Glucose-injected fish generally showed lower plasma triacylglyceride levels than control fish. Our results indicate that under these experimental conditions, glucose acts as an insulin secretagogue in white sea bream juveniles. Moreover, insulin may have contributed to restoring basal plasma glucose levels by enhancing glucose uptake in the liver. Further studies are needed to corroborate the lipolytic action of glucose. Clearance of glucose from the blood stream was fast, comparatively to other species, indicating that white sea bream has a good capability of glucose utilization.

Nanoscale strain-induced pair suppression as a vortex-pinning mechanism in high-temperature superconductors

Boosting large-scale superconductor applications require nanostructured conductors with artificial pinning centres immobilizing quantized vortices at high temperature and magnetic fields. Here we demonstrate a highly effective mechanism of artificial pinning centres in solution-derived high-temperature superconductor nanocomposites through generation of nanostrained regions where Cooper pair formation is suppressed. The nanostrained regions identified from transmission electron microscopy devise a very high concentration of partial dislocations associated with intergrowths generated between the randomly oriented nanodots and the epitaxial YBa(2)Cu(3)O(7) matrix. Consequently, an outstanding vortex-pinning enhancement correlated to the nanostrain is demonstrated for four types of randomly oriented nanodot, and a unique evolution towards an isotropic vortex-pinning behaviour, even in the effective anisotropy, is achieved as the nanostrain turns isotropic. We suggest a new vortex-pinning mechanism based on the bond-contraction pairing model, where pair formation is quenched under tensile strain, forming new and effective core-pinning regions.

Linac stereotactic radiosurgery for the treatment of small arteriovenous malformations: lower doses can be equally effective

OBJECTIVE

The purpose of this study was to examine the efficacy and toxicity of treating small arteriovenous malformations (AVMs) (≤3 cm in diameter) with a median marginal applied dose of 14 Gy.

METHODS

Two hundred and thirteen patients diagnosed with AVMs were treated between January 1991 and December 2005. Seventy-three percent of the patients had hemorrhaged prior to treatment, 13% had had previous surgery and 19.2% had had previous embolization. The median follow-up duration was 48.1 months.

RESULTS

The Kaplan-Meier analysis estimated that the 36-month obliteration rate was 65.5% for patients undergoing their first stereotactic radiosurgery (SRS) and 68.3% for those undergoing repeated SRS. The Kaplan-Meier analysis estimated the 60-month AVMs obliteration rate for the entire cohort to be 82.4%. The median time to AVM obliteration was 40 ± 2.8 months. We found a statistically significant relationship between the time of obliteration and the following factors: site of the AVMs (sites other than brainstem), a higher prescribed dose and a positive history of previous hemorrhage. Thirteen patients (7.6%) experienced toxicities.

CONCLUSIONS

SRS was an effective and safe treatment for AVMs ≤3 cm in diameter, with acceptable toxicity.

Regulation of lipoprotein lipase gene expression by insulin and troglitazone in rainbow trout (Oncorhynchus mykiss) adipocyte cells in culture

Adipose tissue plays a central role regulating the balance between deposition and mobilization of lipid reserves. Lipoprotein lipase (LPL) is a key enzyme controlling lipid accumulation in mammals and fish. In the present study, we have examined the expression of LPL in rainbow trout cultured adipocytes and we have investigated the effect of troglitazone, a member of thiazolidinediones (TZDs), and insulin on its expression. LPL gene expression increased from day 1 until day 12 of culture, and the level was maintained up to day 21. The addition of insulin at 10 nM and 1.7 μM increased significantly LPL gene expression in undifferentiated cells (days 7 to 12 maintained in growth medium). Nevertheless, treatment of day 7 cells incubated in growth medium with troglitazone (5 μM) or troglitazone plus insulin (1 μM each), tended to enhance LPL expression. In addition, LPL mRNA levels increased significantly in the presence of 1 μM and 5 μM of troglitazone (days 7 to 12) when the cells were induced to differentiate by addition of differentiation medium. Although troglitazone alone (1 μM) did not stimulate lipid accumulation in the cells neither in growth nor in differentiation medium, the simultaneous presence of troglitazone (1 μM) and insulin (1 μM) increased significantly the content of triglycerides in adipocyte cells maintained in growth medium (days 7 to 12). These results indicate that insulin and troglitazone regulate LPL gene expression during adipocyte differentiation and suggest that both factors may have combined effects in the modulation of adipogenesis.

Low intrathecal immune response of anti-EBNA-1 antibodies and EBV DNA from multiple sclerosis patients

Numerous studies have been carried out to determine whether an Epstein-Barr virus (EBV) infection can be considered a risk factor for multiple sclerosis (MS), following the evidence of an increase in IgG response to nuclear antigen-1 (EBNA-1) in both serum and cerebrospinal fluid (CSF) from MS patients. However, the possible interaction between EBV and MS has still not been well characterized, and the possible pathogenic role is yet to be determined. A case-control study (76 cases and 75 controls) was conducted to investigate anti-EBV antibodies synthesis in serum and CSF through intrathecal specific IgG synthesis to EBNA-1, as well as the presence of EBV DNA in plasma, peripheral blood mononuclear cells, and CSF from MS patients. Intrathecal EBNA-1 specific IgG synthesis was detected in 6.6% MS patients and in 17.3% controls. No EBV DNA was found in plasma or CSF, and our findings showed no evidence of high intrathecal EBNA-1 specific IgG synthesis or of significant EBV DNA in CSF in MS patients.

Serological diagnosis of Chlamydia pneumoniae infection: limitations and perspectives

Chlamydia pneumoniae is an obligate intracellular human pathogen responsible for a wide range of acute and chronic human diseases, including pneumonia and other respiratory diseases. Serological methods for the diagnosis of C. pneumoniae infection vary widely, and several authors have reported significant inter- and intra-laboratory variability in diagnostic methods and criteria. Over the past 10 years, numerous studies have focused on the identification of specific antigens for application in serodiagnosis, including the diagnosis of persistent infections. The use of proteomics may enable the development of serological diagnosis kits that offer reliable sensitivity and specificity and might even differentiate between the various stages of infection with this pathogen.

Role of insulin and IGF-I on the regulation of glucose metabolism in European sea bass (Dicentrarchus labrax) fed with different dietary carbohydrate levels

The roles of insulin and insulin-like growth factor-I (IGF-I) in the regulation of glucose metabolism were assessed in European sea bass juveniles fed with distinct dietary carbohydrate levels. Three isonitrogenous diets were formulated to contain 10% (10%PGS) or 30% (30%PGS) pregelatinized starch or no starch (control). The highest plasma glucose and insulin levels were observed 6h after feeding in fish receiving the 30%PGS diet. Although plasma IGF-I was higher at 6h than at 24h after feeding, no effect of dietary carbohydrate level was noticed within each sampling time. Increasing dietary carbohydrate level resulted in an increase of liver but not of muscle glycogen content. Hepatic glucokinase (GK) and glucose-6-phosphate dehydrogenase (G6PD) activities increased with the dietary carbohydrate content, whereas pyruvate kinase (PK) activity was higher in fish fed the carbohydrate containing diets than the carbohydrate-free diet. GK activity was higher 6h than 24h after feeding, whereas the opposite was observed for G6PD activity. Data suggest that under the nutritional conditions assayed plasma glucose is an insulin secretagogue. Furthermore, insulin appears to have a more important role than IGF-I in stimulating hepatic glucose uptake, thus enhancing GK activity and leading to an increase in liver glycogen content to maintain glucose homeostasis.

Insulin and insulin-like growth factor I signaling pathways in rainbow trout (Oncorhynchus mykiss) during adipogenesis and their implication in glucose uptake

Primary cultures of rainbow trout ( Oncorhynchus mykiss ) adipocytes were used to examine the main signaling pathways of insulin and insulin-like growth factor I (IGF-I) during adipogenesis. We first determined the presence of IGF-I receptors (IGF-IR) and insulin receptors (IR) in trout preadipocytes ( day 5) and adipocytes ( day 14). IGF-IRs were more abundant and appeared to be in higher levels in differentiated cells than in preadipocytes, whereas IRs were detected in lower but constant levels throughout the culture. The cells were immunoreactive against ERK1/2 MAPK, and AKT/PI3K, components of the two main signal transduction pathways for insulin and IGF-I receptors. Stimulation of MAPK phosphorylation by IGF-I was higher in preadipocytes than in adipocytes, while no effects were observed in MAPK phosphorylation after incubation of cells with insulin. AKT phosphorylation increased in the presence of both insulin and IGF-I, with higher levels of stimulation in adipocytes than in preadipocytes. Activation of both pathways was blocked by the use of specific inhibitors of MAPK (PD98059) and AKT (wortmannin). We describe here, for the first time, the effects of IGF-I and insulin on 2-deoxyglucose uptake in primary culture of trout adipocytes. IGF-I was more potent in stimulating glucose uptake than insulin, and PD98059 and wortmannin inhibited the stimulation of glucose uptake by this growth factor, suggesting that IGF-I plays an important metabolic role in trout adipocytes. Our results suggest that differential activation of the MAPK and AKT pathways are involved in the IGF-I- and insulin-induced effects of trout adipocytes during the various stages of adipogenesis.

[Parkinsonism: alternative diagnosis beyond idiopathic Parkinson's disease]

Parkinsonism is manifested as bradykinesia; tremor with signs and symptoms suggesting Parkinson's disease. The most common cause of Parkinsonism is Idiopathic Parkinson's disease; however, there are other multiple pathologies and situation that have top be considered accordingly in this clinical setting. Since the treatment and outcomes varies widely between these conditions is of paramount importance to work up the Parkinsonism and try to achieve an accurate diagnosis. This review gives a general landscape of Parkinsonism and its most likely differentials.

Induction of tolerance in renal transplantation using splenic transplantation: experimental study in a canine model

OBJECTIVE

To evaluate in a canine model the induction of tolerance to renal transplantation after splenectomy and splenosis.

MATERIALS AND METHODS

This prospective, experimental, comparative, longitudinal study included 4 experimental groups, each comprising 4 dogs. Group 1 (control group) underwent renal transplantation only; group 2 underwent renal transplantation and splenectomy; group 3 underwent renal transplantation and splenosis; and group 4 underwent renal transplantation, splenectomy, and splenosis. Survival and degree of rejection were compared between the 4 groups.

RESULTS

Splenosis improved renal function after transplantation, as indicated by increased serum creatinine concentration (group 3, 6.2 mg/dL vs group 1, 12.9 mg/dL). Comparison of weighted survival curves (corrected for degree of rejection) demonstrated a significant difference between group 2 (66.0 days) and group 4 (66.2 days) vs group 1 (52.7 days) and group 3 (41.2 days) (P = .05, Wilcoxon rank sum test).

CONCLUSION

These results suggest that in this experimental model of renal transplantation, splenosis and splenectomy induce clinical tolerance, as indicated by improved renal function and prolonged recipient survival.

Activity of daptomycin against multiresistant clinical isolates of Staphylococcus aureus and Streptococcus agalactiae

The activity of daptomycin against 141 Staphylococcus aureus and 63 Streptococcus agalactiae isolates was assessed. The isolates were previously characterized and showed resistance to the antibiotics normally used against gram-positive cocci. Daptomycin was active against 100% of the isolates (minimum inhibitory concentration [MIC(90)] = 0.5 microg/ml, for both species). This antibiotic shows good in vitro activity; therefore, it is an excellent therapeutic alternative against these isolates.

Increasing early diagnosis of HIV through rapid testing in a street outreach program in Spain

Our goal was to analyze the results of a multicity program offering rapid HIV testing in a mobile unit in central locations. Between October 2006 and December 2007, 7138 persons were tested, providing a finger-prick blood sample and filling out a brief questionnaire while waiting for the results of the Determine((R)) test. Seventy people were classified as reactive and 3 as indeterminate. Confirmatory test results were obtained for 83.6%. Of the 56 reactive persons contacted, 2 were confirmed as negative, giving a positive predictive value of 96.6%. Those tested were primarily men (60.6%), persons with university education (47.4%), and included a large percentage of immigrants (26.2%), especially from Latin America, and 37.3% were men who have sex with men (MSM). Forty-seven percent had ever been tested for HIV. Global HIV prevalence was 0.98% (confidence interval [CI]: 0.75-1.21), 1.59%, (CI: 1.21-1.97) in men and 0.19%, (CI: 0.02-0.35) in women. In the tree analysis the high prevalence node included Latin Americans with only primary studies (study level finished at least at the age of 12). Of the 64% HIV-positive tests in 2007 with available CD4 counts, 18.75% had CD4 counts under 350. Street-based mobile units offering rapid HIV testing in selected sites, may diagnose HIV at an earlier stage of infection than clinic-based sites, and have a low rate of false-positives.

[Chlamydophila pneumoniae: from its proteomics to arteriosclerosis]

Chlamydophila pneumoniae is a highly prevalent intracellular human pathogen with a unique biphasic life cycle. It is a common cause of upper respiratory infection and pneumonia, and is currently being studied as a potential risk factor for the development of atherosclerotic cardiovascular disease. The outer membrane surface antigens of C. pneumoniae are highly complex: some, such as the major outer membrane protein, are specific, but poorly immunodominant, whereas others have stronger immunogenicity, but are cross-reactive among Chlamydia species. Therefore, new, highly immunodominant, species-specific antigens should be sought. In this regard, the polymorphic membrane proteins (PMPs) are a) unique to Chlamydiae, b) often exposed on the surface of the bacteria, and c) highly immunogenic; these factors make them potential candidates for application in laboratory assays. Other chlamydial antigens, such as heat shock protein (HSP) 60, have been associated with atherosclerotic lesions because of their ability to induce an immunological attack on the endothelial wall. Over the last decade, several studies have suggested a potential role of chronic C. pneumoniae infection in human atherosclerosis. Nevertheless, prospective studies with sufficiently large samples and a healthy comparison group, using a combination of direct and indirect microbiological techniques in the same subject and sample, are needed to establish a relationship between the infection and disease activity.