Usefulness of consecutive biomarkers measurement in the management of community-acquired pneumonia

The aim of this study was to investigate whether procalcitonin (PCT), neopterin, C-reactive protein (CRP), and mid regional pro-atrial natriuretic peptide (MR-proANP) levels at admission and during the clinical course can be useful for the management of patients with pneumonia. The study population consisted of 75 patients with clinical and radiological diagnosis of pneumonia. Serum samples were collected at admission and during hospitalization. Complications were defined as intensive care unit (ICU) admission or death. The levels of PCT were significantly higher in pneumonia of definite bacterial origin in comparison to probable bacterial or unknown origin. The PCT levels were higher in pneumococcal pneumonia. The PCT and MR-proANP levels increased significantly according to the Pneumonia Severity Index (PSI). All biomarkers levels are higher in patients developing complications and who were dying. The serial levels of MR-proANP remain significantly elevated in patients developing complications and in patients classified in PSI and CURB-65 risk groups. In patients not developing complications, there is a significant decrease in the PCT levels. PCT can be useful for identifying pneumonia etiology. PCT and MR-proANP levels correlate with pneumonia severity rules. PCT and MR-proANP serial measurements can be useful for predicting short-term prognosis. Systemic biomarkers can provide additional information regarding clinical evolution, because these are dynamic and can be measured daily.

Chemokine response induced by Chlamydia trachomatis in prostate derived CD45+ and CD45- cells

The role of innate cells and their receptors within the male genital tract remains poorly understood. Much less is known about the relative contribution of different genital tract cells such as epithelial/stromal cells and resident leucocytes. In this study, we examined innate immune responses to Chlamydia trachomatis by prostate epithelial/stromal cells and prostate resident leucocytes. Murine prostate primary cultures were performed and leucocyte and epithelial/stromal cells were sorted based on surface protein expression of CD45 by magnetism-activated cell sorting or fluorescence-activated cell sorting. Prostate derived CD45- and CD45+ cells were infected with C. trachomatis and chemokine secretion assayed by ELISA. Similar experiments were performed using prostate CD45+ and CD45- cells from myeloid differentiation factor 88 (Myd88(-/-)) mice or toll-like receptor (Tlr2(-/-)) and Tlr4(mutant) double-deficient mice. Moreover, a TLR-signalling pathway array was used to screen changes in different genes involved in TLR-signalling pathways by real-time PCR. Prostate derived CD45- and CD45+ cells responded to chlamydial infection with the production of different chemokines. Both populations expressed genes involved in TLR signalling and required to respond to pathogen-associated molecular patterns and to C. trachomatis infection. Both populations required the adaptor molecule MYD88 to elicit chemokine response against C. trachomatis. TLR2-TLR4 was essential for chemokine production by CD45+ prostate derived cells, but in their absence, CD45- cells still produced significant levels of chemokines. We demonstrate that C. trachomatis is differentially recognised by prostate derived CD45+ and CD45- cells and suggest that diverse strategies are taking place in the local microenvironment of the host in response to the infection.

From Río Tinto to Mars: the terrestrial and extraterrestrial ecology of acidophiles

The recent geomicrobiological characterization of Río Tinto, Iberian Pyrite Belt (IPB), has proven the importance of the iron cycle, not only in generating the extreme conditions of the habitat (low pH, high concentration of toxic heavy metals) but also in maintaining the high level of microbial diversity, both prokaryotic and eukaryotic, detected in the water column and the sediments. The extreme conditions of the Tinto basin are not the product of industrial contamination but the consequence of the presence of an underground bioreactor that obtains its energy from the massive sulfide minerals of the IPB. To test this hypothesis, a drilling project was carried out to intersect ground waters that interact with the mineral ore in order to provide evidence of subsurface microbial activities and the potential resources to support these activities. The oxidants that drive the system appear to come from the rock matrix, contradicting conventional acid mine drainage models. These resources need only groundwater to launch microbial metabolism. There are several similarities between the vast deposits of sulfates and iron oxides on Mars and the main sulfide-containing iron bioleaching products found in the Tinto. Firstly, the short-lived methane detected both in Mars' atmosphere and in the sediments and subsurface of the IPB and secondly, the abundance of iron, common to both. The physicochemical properties of iron make it a source of energy, a shield against radiation and oxidative stress as well as a natural pH controller. These similarities have led to Río Tinto's status as a Mars terrestrial analogue.

[Chagas' disease as a cause of cerebral mass in a patient with lymphoblastic leukemia in remission]

We report the case of a 15-year-old female patient, native of the province of Chaco, diagnosed with lymphoblastic leukemia 2 years ago. She was currently in maintenance therapy, with good response to treatment. Twenty days before she began with headache and fever. At admission, blood cultures were negative, and brain computed tomography showed a hypodense lesion with involvement of white matter in left occipital-parietal area. A brain MRI was performed, and a hypointense left occipital lesion was observed in T1. The lesion showed peripheral gadolinium enhancing and was hyperintense on T2, with a hypodense central area surrounded by significant edema with mass effect. Chagas serology was positive, as well as the parasitemia. The patient was treated with benznidazole, with good response to therapy: a significant clinical improvement and mass reduction were observed, within the first month of treatment.

Alternatives for biosurfactants and bacteriocins extraction from Lactococcus lactis cultures produced under different pH conditions

AIMS

Study of the potential of Lactococcus lactis CECT-4434 as a biosurfactants and nisin (the only bacteriocin allowed to be used in the food industry) producer for industrial applications, exploiting the possibility of recovering separately both metabolites, taking into account that L. lactis is an interesting micro-organism with several applications in the food industry because it is recognized as GRAS.

METHODS AND RESULTS

The results showed the ability of this strain to produce cell-bound biosurfactants, under controlled pH, and cell-bound biosurfactants and bacteriocins, when pH was not controlled. Three extraction procedures were designed to separately recover these substances.

CONCLUSIONS

The strain L. lactis CECT-4434 showed to be a cell-bound biosurfactants and bacterocins producer when fermentations were carried out under uncontrolled pH. Both products can be recovered separately.

SIGNIFICANCE AND IMPACT OF THE STUDY

Development of a convenient tool for the extraction of cell-bound biosurfactants and bacteriocins from the fermentation broth.

Spanish radiobiological pattern of care in lung cancer: a GOECP/SEOR study

INTRODUCTION

A survey regarding radiobiological questions in the treatment of lung cancer (LC) was done to study the clinical aspects of radiotherapy in Spain, in order to standardise treatment decisions.

METHODS AND MATERIALS

From November 2007 to March 2008, a survey was performed among radiation oncologists in Spain specialising in LC treatment via e-mail, which included questions regarding different radiobiological aspects of radiotherapy LC treatment. The extent of the resulting material made it necessary to divide it into two parts; the first is presented in this article. The second, which includes items about alpha/beta-NTCP/TCP values and reirradiation criteria, will be reported elsewhere.

RESULTS

Thirty-one radiation therapists from 29 radiation oncology departments answered the survey. 77.4-93.5% of responders used the basic formula from the linear-quadratic model and/or computer software for radiobiological calculations; 100% used lung (mostly V20, median <30%) and spinal cord constraints (mostly a median of physical maximum dose <45.5 Gy); and 90.3% used heart and oesophagus constraints (very heterogeneous parameters in both organs).

CONCLUSIONS

Radiobiological considerations are clearly present in the planning process of radiotherapy of LC in Spain, with a high coincidence with the literature regarding lung and spinal cord constraints. The heterogeneity shown for oesophagus and heart results demonstrates the need for continuing investigation into the standardisation of clinical, dosimetric and radiobiologic aspects of the treatment of this cancer.

Cutaneous leishmaniasis due to Leishmania chagasi/Le. infantum in an endemic area of Guarico State, Venezuela

This study reports cutaneous leishmaniasis (CL) caused by Leishmania chagasi/Le. infantum in Venezuela, with some atypical characteristics. Out of 63 cases of CL in the suburbs of Altagracia de Orituco, Guarico State, Venezuela, 30 presented clinical, parasitological, immunological and epidemiological features different from those of the classical CL known in the country. The initial lesion was small and nodular, which, if not treated, might progress to a superficial ulcer. No secondary infection was observed. The identification of the isolates was carried out by molecular techniques. Twelve species of phlebotomine sandflies were caught, the most abundant being Lutzomyia evansi and Lu. longipalpis s.l., known vectors of Le. chagasi/Le. infantum. The existence of Le. chagasi/Le. infantum and its vectors in an endemic area of CL has implications and we suggest that epidemiological studies should be carried out to obtain a clearer picture of the extent of this CL form in Venezuela.

[Heterotopic pancreas in gallbladder]

Heterotopic pancreas in the gallbladder is uncommon.condition and its clinical presentation is as an intramural nodule near the cystic duct, with an incidental finding in most cases.

OBJECTIVE

to update Heterotopic pancreas condition in the gallbladder. We reported a case of a 18-year-old female, suffering with biliar colic who was operated on with diagnosis of acute cholecystitis. Six mixed gallstones were found in the surgery and the gallbladder was distended and edematous with serosal exudate and the serosa appeared discolored and hemorrhagic. The wall was thickened with edema and hemorrhage. Microscopic findings were: congestive mucosa , edema, acute inflammatory cells and fibrin deposition on the wall and a subtle (myo)-fibroblastic proliferation. The nodule was diagnosed as macroscopic heterotopic pancreatic tissue in the gallbladder wall thickness, without neoplastic changes. Clinical presentation as acute cholecystitis has been rarely reported in the presence of heterotopic pancreatic tissue.

Process for capturing CO2 arising from the calcination of the CaCO3 used in cement manufacture

This paper outlines a new CaCO3 calcination method for producing a stream of CO2 (suitable for permanent geological storage after purification and compression). The process is based on the use of very hot CaO particles (T >1000 degrees C) to transfer heat from a circulating fluidized bed combustor (CFBC) to a calciner (fluidized with CO2 and/or steam). Since the fluidized bed combustor and calciner have separate atmospheres, the CO2 resulting from the decomposition of CaCO3 can be captured, while the CO2 generated in the combustion of the fuel in air is emitted to the atmosphere. We demonstrate that with this system it is possible to reduce the CO2 emissions of a cement plant by around 60%. Furthermore, since the key pieces of equipment are similar to the commercial CFBCs used in power generation plants, it is possible to establish the additional investment required for the system and to estimate the cost per ton of CO2 avoided for this process to be about 19 $/tCO2 avoided.

[Urinary stress incontinence: surgical experience in our center]

INTRODUCTION

For the treatment of the urinary stress incontinence, there are many techniques, and today the gold standard is that described by Burch. We compared the global and each technique results about rates of postoperative continence and complications seen in our experience.

MATERIALS AND METHODS

We made a retrospective analysis of 292 women that have the first surgery for urinary stress incontinence in our centre, between 1991 and 2006. We considered cure the patient who did not have any level of incontinence postoperative, we made a Kaplan-Meier analysis for the postoperative continence evaluation. Besides we studied the behaviour of the postoperative complications found.

RESULTS

Mean age was 53.6 years old, and mean time of follow up was 15.6 months. The vaginal techniques were the most practised (138), followed by the TVT (57), abdominal Burch (38), vaginal wall Sling (33), and the less was the laparoscopic Burch (26). The best rates of postoperative continence after 2 years were observed in the patients treated by TVT (87.6%), then with vaginal wall Sling (84.9%), laparoscopic Burch (59.3%), abdominal Burch (59.1%), and the worst with vaginal techniques (48.2%) (p = 0.007). We found more urgency and urge incontinence in the patients treated by TVT (36.8% y 21.1% respectively), and postoperative pain with vaginal techniques (36.2%). Postoperative urine retention and postoperative high residual urine more with the vaginal wall sling (54.5%) and vaginal techniques (26.1%) respectively.

CONCLUSIONS

We have the best results for the incontinence treatment in our population with the TVT technique.

A new coumarin from the fruits of Coutarea hexandra

A new 5-O-beta-D-glucopyranosyl-4-(4-hydroxyphenyl)-7-methoxy-2H-chromen-2-one (1), together with four known compounds, one coumarin, 5-O-beta-D-galactopyranosyl-4-(4-hydroxyphenyl)-7-methoxy-2H-chromen-2-one (2) and three cucurbitacins, 23,24-dihydrocucurbitacin F (3), 23,24-dihydro-25-acetylcucurbitacin F (4) and 2-O-beta-D-glucopyranosyl-23,24-dihydrocucurbitacin F (5) have been isolated and characterised from the ethanol extract of Coutarea hexandra fruits. Their structures have been established by spectroscopic analysis (NMR and MS). Interpretation of the HMQC, HMBC, COSY-45 and NOESY experiments permitted us to establish stereochemistry of the natural products. All compounds were tested in cytotoxicity assays against the breast (MCF-7), lung (H-460), and central nervous system (SF-268) human cancer cell lines.

Nickel localization on tissues of hyperaccumulator species of phyllanthus L. (Euphorbiaceae) from ultramafic areas of Cuba

Two species of perennial Phyllanthus (Euphorbiaceae) (Phyllanthus orbicularis and Phyllanthus discolor, both endemic to ultramafic areas of Cuba, and their natural hybrid, Phyllanthus xpallidus) were selected for metal localization microanalysis. Different plant tissues were analyzed by X-ray fluorescence, inductively coupled plasma-atomic emission spectroscopy, and scanning electron microscopy coupled with an energy-dispersive X-ray probe. All of the studied taxa are nickel (Ni) hyperaccumulators and significant concentrations of this element were found in different leaf and stem tissues. The highest Ni content was found in the laticifer tubes, whereas leaf epidermis Ni content resulted to be much more relevant in terms of total metal storage. Calcium and magnesium were found more evenly distributed in leaf and stem tissues.