Metal accumulation in cell wall: a possible mechanism of cadmium resistance by Pseudomonas stutzeri

A heavy metal resistant strain, Pseudomonas stutzeri (MTCC 101) has been investigated for its cadmium tolerance properties along with its antibiotic resistance. The organism could tolerate cadmium up to 1,200 μg/mL with LD50 value 700 μg/mL. The gene(s) involved in such high resistance appear(s) to be induced in the presence of the metal. Increasing concentrations of cadmium successively prolonged the lag phase of growth with delayed attainment of the stationary phase. Transmission electron microscope and scanning electron microscope-energy dispersive analysis of X-ray spectroscope analysis showed cadmium adsorption on the bacterial surface with morphological distortion. Atomic absorption spectrometric study corroborated this data, showing highest cadmium accumulation in the cell wall fraction of the bacteria. Additionally, the cell wall fraction showed synthesis of new proteins when grown under metal stress.

Organochlorine pesticide levels and risk of Alzheimer’s disease in north Indian population

Alzheimer’s disease (AD) could result from a multifactorial process involving both genetic predisposition and exposure to environmental factors like pesticides. A case control study of 70 patients of AD and 75 controls was done to examine the association between organochlorine pesticides (OCPs) and risk of AD. OCPs (hexachlorocyclohexane (HCH), aldrin, dieldrin, endosulfan, pp′-dichlorodiphenyldichloroethylene ( pp′-DDE), op′-DDE, pp′-dichlorodiphenyltrichloroethane ( pp′-DDT), op′-DDT, pp′-dichlorodiphenyldichloroethane ( pp′ -DDD) and op′-DDD) were extracted from blood and quantitatively estimated using gas chromatography. A Mann–Whitney U test revealed significant difference in β-HCH levels ( U = 1237.00, W = 4087.00, z = −6.296, p = 0.000, r = −0.71), dieldrin levels ( U = 1449.00, W = 4299.00, z = −5.809, p = 0.000, r = −0.68) and pp′-DDE levels ( U = 2062.00, W = 4912.00, z = −2.698, p = 0.007, r = −0.59) between AD patients and controls. In conclusion, this study supports epidemiological studies that associate exposure to pesticides with increased risk of AD, and we identified the specific pesticides β-HCH, dieldrin and pp′-DDE that are associated with the risk of AD in the north Indian population. However, further research is needed to establish the potential role of these OCPs as an etiologic agent for AD case.

Prevalence and Covariates of Undiagnosed Hypertension in the Adult Population of Puducherry, South India

Background Globally the prevalence of both hypertension and pre-hypertension are increasing and pre-hypertension has been associated with higher cardiovascular risk. The objective of this study was to find out the prevalence of undiagnosed hypertension and pre-hypertension and associated covariates among adults of rural and urban area of Puducherry. Material and Methods A population based cross-sectional study was carried out in the field practices area of Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute without intervention. Results Among 856 participants, 27.6 percent were hypertensive and 57 percent pre-hypertensive; the magnitude of both stage 1 and stage 2 hypertension increased with the age. Of the hypertensives, 26.3 and 28.7 percent were from rural and urban area respectively, whereas in pre-hypertension the corresponding figures were 61 and 53.4 percent.  Significantly increased risk of hypertension was noted among adults with increasing age, having less than six members in the family, suffering from obesity (general and abdominal obesity) and living sedentary life. On the other hand, the probability of having increased risk of pre-hypertension was significantly higher among adults living in the rural areas, having non-vegetarian dietary habit, suffering from obesity (general and abdominal obesity), living sedentary life and having family history of hypertension. Multivariate logistic regression however showed significant correlation of hypertension with increasing age, sedentary lifestyle, tobacco addiction and obesity (general and central). Significant correlates of pre-hypertensive were rural residence, sedentary living habits, family history of hypertension, tobacco addiction and obesity (general and central). Conclusion The present findings show high prevalence of hypertension and pre-hypertension among population of Puducherry in South India.DOI: http://dx.doi.org/10.3126/nje.v2i2.6576 Nepal Journal of Epidemiology 2012;2(2):191-199

Structural insights of rohu TLR3, its binding site analysis with fish reovirus dsRNA, poly I:C and zebrafish TRIF

In response to double stranded RNA (dsRNA) viruses, toll-like receptor 3 (TLR3) in fish activates signaling like human, and induces innate immunity. This suggested the existence of dsRNA binding domains in fish TLR3 as reported in higher vertebrates. In in silico analysis, leucine rich repeat (LRR) regions (4-6, 13-14, 20-22), and LRR (8-15, 17-24) were identified as key domains in rohu TLR3 as poly I:C and dsRNA of fish reovirus (AGCRV,VHSV and IHNV) binding regions. 3D-models of rohu TLR3-TIR and zebrafish TRIF were generated by homology and ab initio modeling respectively, and their interacting domains were predicted. This is the first report of TLR3 modeling in fish.

Molecular cloning and characterization of nucleotide binding and oligomerization domain-1 (NOD1) receptor in the Indian Major Carp, rohu (Labeo rohita), and analysis of its inductive expression and down-stream signalling molecules following ligands exposure and Gram-negative bacterial infections

Nucleotide binding and oligomerization domain-1 (NOD1) is a cytoplasmic pattern recognition receptor (PRR), and is a member of the NOD-like receptor (NLR) family. It senses a wide range of bacteria and viruses or their products, and plays a key role in inducing innate immunity. In this report, NOD1 gene was cloned and characterized in rohu (Labeo rohita), a fish species of highest commercial importance in the Indian subcontinent. The full-length rohu NOD1 (rNOD1) cDNA comprised of 3168 bp with a single open reading frame (ORF) of 2814 bp, encoding a polypeptide of 937 amino acids (aa) with an estimated molecular mass of 106.13 kDa. Structurally, it comprised of one caspase recruitment domain (CARD) at N-terminal, seven leucine rich repeat (LRR) regions at C-terminal and one NACHT domain in between N and C-terminals. Phylogenetically, rNOD1 was closely related to grass carp NOD1 (gcNOD1), and exhibited significant similarity (95.8%) and identity (91.0%) in their amino acids. Ontogenic expression analysis of rNOD1 and its associated down-stream signaling molecule RICK (receptor interacting serine–threonine kinase) by quantitative real-time PCR (qRT-PCR) revealed their constitutive expression in all embryonic developmental stages. Basal expression analysis of rNOD1 showed its wide range of expression in all examined tissues, highest was in spleen and the lowest was in blood. Inductive expression of rNOD1 was observed following LPS and poly I:C exposure, and Aeromonas hydrophila, Edwardsiella tarda and Shigella flexneri infections. Expression of RICK in various organs was significantly enhanced by ligands exposure and bacterial infections, and was correlated with the inductive expression of rNOD1. Together, these findings highlighted the important role of NOD1 in fish in response to pathogenic invasion.

Molecular characterization of toll-like receptor 2 (TLR2), analysis of its inductive expression and associated down-stream signaling molecules following ligands exposure and bacterial infection in the Indian major carp, rohu (Labeo rohita)

Toll-like receptors (TLRs) are one of the key components of innate immunity. Among various TLR types, TLR2 is involved in recognizing specific microbial structures such as peptidoglycan (PGN), lipoteichoic acid (LTA), zymosan etc., and after binding them it triggers myeloid differentiation primary response gene 88 (MyD88)-dependent signaling pathway to induce various cytokines. In this report, TLR2 gene was cloned and characterized in rohu (Labeo rohita), which is highly commercially important fish species in the farming-industry of Indian subcontinent. Full-length rohu TLR2 (rTLR2) cDNA comprised of 2691 bp with a single open reading frame (ORF) of 2379 bp encoding a polypeptide of 792 amino acids (aa) with an estimated molecular mass of 90.74 kDa. Structurally, it comprised of one leucine-rich repeat region (LRR) each at N-terminal (LRR-NT; 44-55 aa) and C-terminal (LRR-CT; 574-590 aa), 21 LRRs in between C and N-terminal, one trans-membrane (TM) domain (595-612 aa), and one TIR domain (645-790 aa). Phylogenetically, rohu TLR2 was closely related to common carp and exhibited significant similarity (93.1%) and identity (88.1%) in their amino acids. During embryogenesis, rTLR2 expression was detected as early as ∼7 h post fertilization indicating its importance in embryonic innate immune defense system in fish. Basal expression analysis of rTLR2 showed its constitutive expression in all the tissues examined, highest was in the spleen and the lowest was in the eye. Inductive expression of TLR2 was observed following zymosan, PGN and LTA exposure and Streptococcus uberis and Edwardsiella tarda infections. Expression of immunoregulatory cytokine interleukin (IL)-8, in various organs was significantly enhanced by ligands exposure and bacterial infections, and was correlated with inductive expression of TLR2. In vitro studies showed that PGN treatment induced TLR2, MyD88 and TRAF6 (TNF receptor associated factor 6) expression, NF-κB (nuclear factor kappa B) activation and IL-8 expression. Blocking NF-κB resulted in down-regulation of PGN mediated IL-8 expression indicating the involvement of NF-κB in IL-8 induction. Together, these findings highlighted the important role of TLR2 in immune surveillance of various organs, and in augmenting innate immunity in fish in response to pathogenic invasion. This study will be helpful in developing preventive measures against infectious diseases in fish.

Inductive expression of toll-like receptor 5 (TLR5) and associated downstream signaling molecules following ligand exposure and bacterial infection in the Indian major carp, mrigal (Cirrhinus mrigala)

Toll-like receptors (TLRs) are one of the key components of innate immunity. Among various types of TLRs, TLR5 is involved in recognizing bacterial flagellin and after binding, it triggers myeloid differentiation primary response gene 88 (MyD88)-dependent signaling pathway to induce pro-inflammatory cytokines. In this report, we analyzed the expression profile of TLR5 and its associated downstream signaling molecules like MyD88 and tumor necrosis factor (TNF) receptor-associated factor (TRAF) 6 in the Indian major carp (IMC), mrigal (Cirrhinus mrigala) which is highly commercially important fish species in the Indian subcontinent. Ontogeny analysis of TLR5, MyD88 and TRAF6 revealed constitutive expression of these genes in all embryonic developmental stages, and highlighted the importance of embryonic innate immune defense system in fish. Tissue specific expression analysis of these genes by quantitative real-time PCR (qRT-PCR) revealed their wide distribution in various organs and tissues; highest expression of TLR5 and MyD88 was in liver and TRAF6 was in kidney. Modulation of TLR5, MyD88 and TRAF6 gene expression, and the induction of interleukin (IL)-8 and TNF-α were analyzed in various organs by qRT-PCR following flagellin stimulation, and Aeromonas hydrophila and Edwardsiella tarda infection. In the treated fish, majority of the tested tissues exhibited significant induction of these genes, although with varied intensity among the tissues and with the types of treatments. Among the examined tissues, a significant relationship of TLR5 induction, MyD88 and TRAF6 up-regulation, and enhanced expression of IL-8 and TNF-α gene transcripts was observed in the blood and intestine of both flagellin stimulated and bacteria infected fish. These findings may indicate the involvement of TLR5 in inducing IL-8 and TNF-α, and suggest the important role of TLR5 in augmenting innate immunity in fish in response to pathogenic invasion. This study will enrich the information in understanding the innate immune mechanism in fish and may be helpful in developing preventive measures against infectious diseases in fish.

Molecular characterization of nucleotide binding and oligomerization domain (NOD)-2, analysis of its inductive expression and down-stream signaling following ligands exposure and bacterial infection in rohu (Labeo rohita)

Nucleotide-binding and oligomerization domain (NOD)-2 is a cytoplasmic pattern recognition receptor (PRR) and is a member of NOD like receptor (NLR) family. It senses a wide range of bacteria and viruses or their products and is involved in innate immune responses. In this report, NOD-2 gene was cloned and characterized from rohu (Labeo rohita) which is highly commercially important fish species in the Indian subcontinent. The full length rohu NOD-2 (rNOD-2) cDNA comprised of 3176 bp with a single open reading frame (ORF) of 2949 bp encoding a polypeptide of 982 amino acids (aa) with an estimated molecular mass of 109.65 kDa. The rNOD-2 comprised two N-terminal CARD domains (at 4-91 aa and 111-200 aa), one NACHT domain (at 271-441 aa) and seven C-terminal leucine rich repeat (LRR) regions. Phylogenetically, rNOD-2 was closely related to grass carp NOD-2 (gcNOD2) and exhibited significant similarity (94.2%) and identity (88.6%) in their amino acids. Ontogeny analysis of rNOD-2 showed its constitutive expression across the developmental stages, and highlighted the embryonic innate defense system in fish. Tissue specific analysis of rNOD-2 by quantitative real-time PCR (qRT-PCR) revealed its wide distribution; highest expression was in liver followed by blood. In response to PGN and LTA stimulation, Aeromonas hydrophila and Edwardsiella tarda infection, and poly I:C treatment, expression of rNOD-2 and its associated downstream molecules RICK and IFN-γ were significantly enhanced in the treated fish compared to control. These findings suggested the key role of NOD-2 in augmenting innate immunity in fish in response to bacterial and viral infection. This study may be helpful for the development of preventive measures against infectious diseases in fish.

Time interval as a quality measure: What is our baseline prior to nurse navigator implementation?

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Background: There are various outcome measures to evaluate the quality of multidisciplinary care for breast cancer patients. The National Consortium of Breast Centers defines quality of breast cancer care as accurate evaluation and appropriate services in a timely manner. In a tertiary academic center a diverse referral pattern possibly influences time to treatment. We choose to examine two outcome measures before the start of a nurse navigator: Time from initial diagnosis to first consultation and if the pretreatment consultation for those receiving neoadjuvant chemotherapy or hormonal therapy included all subspecialists.

Methods: Electronic medical records of female patients with breast cancer seen during January-June 2010 were reviewed. Patients with stage IV breast cancer were excluded.

Results: 150 patients were divided into 4 categories: external pathology consult (B1), internally diagnosed with a primary care physician (PCP) at our institution (B2), evaluated by a surgical oncologist before the biopsy (B3), and internally diagnosed with PCP outside of the institution (B4). For B2, B3 and B4 we examined the time intervals to first surgical oncology appointment after diagnosis as shown in the table. For all patients (n=10) who received neoadjuvant therapy, 1 patient saw a surgical oncologist, medical oncologist and radiation oncologist, 9 patients saw 2 subspecialties prior to initiation of first treatment.

Conclusions: Patients are seen within an average of 2 weeks whether they are diagnosed internally (B2, B3) or externally (B4). The group seen by a surgical oncologist prior to biopsy (B3) were seen sooner. For the patients receiving neoadjuvant therapy, 10% saw all 3 specialties prior to initiation of therapy. In July 2010 a nurse navigator was added to the care team. With this new position, our goal is to decrease the time from biopsy to visit by 33% and have 100% of patients receiving neoadjuvant therapy evaluated by all 3 specialists prior to treatment. Our intent is to quantify the effect of a nurse navigator in a large academic center as a quality metric in improving care.

[Table: see text]

A qualitative study of women's preferences for treatment of pelvic floor disorders

OBJECTIVE

to explore women's perceptions of new and established treatments for stress urinary incontinence (SUI) and prolapse, and to identify factors important to women in decision-making about treatments.

DESIGN

qualitative interview study.

SETTING

urogynaecology unit in a large UK district general hospital.

POPULATION

women referred from their general practitioner with SUI and/or prolapse symptoms.

METHODS

each woman was given a questionnaire detailing nonsurgical and surgical treatments for SUI and/or prolapse. This briefly detailed the treatment, together with published success and complication rates. Participants were taken through a semi-structured interview based on their perceptions of each treatment, and the factors that lead them to find treatments acceptable or not acceptable. Interviews were conducted by a member of the research team before the initial appointment with the clinical team. Interviews were transcribed and subjected to thematic analysis using constant comparison derived from grounded theory.

MAIN OUTCOME MEASURE

themes identified from analysis of interview transcripts.

RESULTS

a total of 16 women were interviewed. Their median age was 54 years (range 48-70 years). Women with SUI were keen to have the treatment with the highest chance of long-term success, even if this was more invasive. Women with prolapse were more unsure about this, and less willing to risk potential complications for a higher chance of long-term success.

CONCLUSIONS

many factors affect women's decision-making with regards to treatment choices. This analysis highlights the need for careful exploration of women's hopes and expectations before embarking on treatment.

Transperineal ultrasound to assess the effect of tension-free vaginal tape position on flow rates

OBJECTIVE

To determine whether the position of the tension-free vaginal tape (TVT) has an effect on postoperative flow rates and voiding function in women successfully cured of urodynamic stress incontinence.

METHODS

Postoperatively 72 women who had undergone TVT surgery had a transperineal ultrasound examination to assess the position of the TVT on the urethra. The tape was categorized as proximal, mid or distal urethral. The effect on voiding was assessed using the maximum flow rate (MFR) centiles corrected for voided volume and detrusor pressure at maximum flow.

RESULTS

Forty-six women had distal tapes and 26 mid-urethral tapes. A tape lying on the mid urethra was associated with a fall in MFR centile (P = 0.04) while a tape lying on the distal urethra did not cause a fall in the MFR centile (P = 0.52). There was no significant change in the detrusor pressure at maximum flow between mid and distally placed tapes.

CONCLUSIONS

Distally placed tapes cause less alteration in flow rates than do mid-urethrally placed tapes. This may be beneficial in certain patient groups.

A randomised trial of a retropubic tension-free vaginal tape versus a mini-sling for stress incontinence

OBJECTIVE

To compare a mini-sling with a retropubic tension-free vaginal tape (TVT) in the treatment of stress urinary incontinence (SUI) and urodynamic stress incontinence (USI).

DESIGN

Randomised trial.

SETTING

Urogynaecology unit in large UK district general hospital.

POPULATION

Women with USI resistant to conservative management and requiring a suburethral sling.

METHODS

A total of 71 women with SUI and confirmed USI were randomised to undergo treatment with either a retropubic TVT or mini-sling. Follow-up was at 6 weeks, with a history, examination and quality of life questionnaire, and at 6 months with further subjective evaluation and twin-channel subtraction cystometry and pressure-flow studies.

MAIN OUTCOME MEASURES

The presence of SUI at 6 weeks and 6 months after treatment.

RESULTS

The mini-sling was associated with a significantly higher rate of persistent SUI at 6 weeks (OR 9.49, 95% CI 2.8-32.6) and 6 months (OR 8.14, 95% CI 2.7-24.7), and of USI at 6 months (OR 7.58, 95% CI 2.7-24.7). The rate of complication was similar in the two groups.

CONCLUSIONS

The mini-sling is associated with a higher failure rate than a retropubic TVT. Longer term and multicentre outcome data are necessary to explore these findings further. Until this is available, the mini-sling should be used with caution.

Clinicians' views on the NICE guideline on the management of female urinary incontinence

In October 2006, the National Institute for Health and Clinical Excellence (NICE) released Guideline No. 40: The management of female urinary incontinence. The objective of this study was to investigate the opinions of members of the British Society of Urogynaecology (BSUG) regarding the recommendations contained in the guideline. A closed format questionnaire using stems taken directly from the NICE guideline was sent to all UK-based members of BSUG. There was a 64% response rate. When asked if the guidance overall reflected their current practice, 56.8% agreed/strongly agreed. In terms of changing their practice to comply fully with the guideline, 53.3% disagreed/strongly disagreed. There were two major areas of disagreement. Some 80% of respondents disagreed that preoperative cystometry was not necessary in 'clinically pure' stress urinary incontinence; 72% of respondents disagreed that immediate release oxybutynin should be the first-line treatment for women with an overactive bladder (OAB). A smaller proportion disagreed with the statements on the use of duloxetine. The majority of the guidance formalises current practice among gynaecologists and urogynaecologists practicing in the UK. There are significant concerns regarding some of the recommendations, and the results indicate that over half of the respondents would not change their practice to follow these recommendations.

Poisoning, stings and bites in children-- what is new? An experience from a tertiary care hospital in Kolkata

Poisonings, stings and bites continue to be important cause of pediatric morbidity and hospitalization. The toxic product involved in the poisoning varies in different geographical areas and in same area over time. A retrospective study was conducted amongst the children of the age group up to 12 years admitted to a tertiary care hospital in Kolkata from January 2005 to December 2008. Total number of admissions was 17019 and that for accidental poisoning was 451 (2.65%). Kerosene constituted the largest group (54.55%). Mosquito coil and refill liquid were the new additions to the list of poisons and their ingestion was cause for admission of 15 (3.33%) children. The number of admissions due to stings and bites was 108 (0.63% of all admissions) during the above period. Of all the cases, 9 (1.83%) cases of accidental poisoning and 4 (3.7%) cases of stings and bites died.

Retropubic urethrolysis of colposuspension: does it improve voiding and overactive bladder symptoms?

The study aimed to assess the efficacy of retropubic urethrolysis (RU) on obstructive and overactive bladder (OAB) symptoms and to assess the effect on voiding parameters in a small series of six women. Each patient had significant obstructive or OAB symptoms, and was obstructed on urodynamics. RU was performed if conservative measures, anticholinergics and urethral dilatation failed. The mean time since colposuspension was 10 years. All patients complained of poor flow, with 5/6 complaining of OAB symptoms. Postoperatively, all the women reported improved voiding. The maximum flow rate increased from a mean of 11.2 ml/s to 16.4 ml/s, with the Pdet at a maximum flow decreasing from a mean of 43.2 cm H(2)O to 34.7 cm H(2)O. The post-void residual was less than 100 ml in all six patients postoperatively. One reported improved OAB symptoms. There are variable success rates for RU reported in the literature. Careful patient selection and counselling is necessary.