The Relationship between S. aureus and Branched-Chain Amino Acids Content in Composite Cow Milk

The early diagnosis of mastitis is an essential factor for the prompt detection of the animal for further actions. In fact, if not culled, infected cows must be segregated from the milking herd and milked last, or milked with separate milking units. Besides microbiological analysis, the somatic cell count (SCC) commonly used as predictor of intramammary infection, frequently lead to a misclassification of milk samples. To overcome these limitations, more specific biomarkers are continuously evaluated. The total amino acid content increases significantly in mastitic milk compared to normal milk. S. aureus requires branched-chain amino acids (BCAAs-isoleucine, leucine, and valine) for protein synthesis, branched-chain fatty acids synthesis, and environmental adaptation by responding to their availability via transcriptional regulators. The increase of BCAAs in composite milk has been postulated to be linked to mammary infection by S. aureus. The aim of this work is to demonstrate, by a direct ion-pairing reversed-phase method, based on the use of the evaporative light-scattering detector (IP-RP-HPLC-ELSD), applied to 65 composite cow milk samples, a correlation between the concentration of isoleucine and leucine, and S. aureus load. The correlation coefficient, r, was found to be 0.102 for SCC (p = 0.096), 0.622 for isoleucine (p < 0.0001), 0.586 for leucine (p < 0.0001), 0.013 for valine (p = 0.381), and 0.07 for tyrosine (p = 0.034), standing for a positive correlation between S. aureus and isoleucine and leucine concentration. The link between the content of BCAAs, isoleucine and leucine, and udder infection by S. aureus demonstrated with our study has an important clinical value for the rapid diagnosis of S. aureus mastitis in cows.

Thyroid ultrasonography reporting: consensus of Italian Thyroid Association (AIT), Italian Society of Endocrinology (SIE), Italian Society of Ultrasonography in Medicine and Biology (SIUMB) and Ultrasound Chapter of Italian Society of Medical Radiology (SIRM)

Thyroid ultrasonography (US) is the gold standard for thyroid imaging and its widespread use is due to an optimal spatial resolution for superficial anatomic structures, a low cost and the lack of health risks. Thyroid US is a pivotal tool for the diagnosis and follow-up of autoimmune thyroid diseases, for assessing nodule size and echostructure and defining the risk of malignancy in thyroid nodules. The main limitation of US is the poor reproducibility, due to the variable experience of the operators and the different performance and settings of the equipments. Aim of this consensus statement is to standardize the report of thyroid US through the definition of common minimum requirements and a correct terminology. US patterns of autoimmune thyroid diseases are defined. US signs of malignancy in thyroid nodules are classified and scored in each nodule. We also propose a simplified nodule risk stratification, based on the predictive value of each US sign, classified and scored according to the strength of association with malignancy, but also to the estimated reproducibility among different operators.

Thyroid scintigraphy: an old tool is still the gold standard for an effective diagnosis of autonomously functioning thyroid nodules

BACKGROUND

Patients with autonomously functioning thyroid nodules (AFTN) may not have an abnormal TSH value, particularly in iodine-deficient areas.

AIM

To verify the accuracy of TSH as screening test in detecting AFTN and to evaluate ultrasonographic features of thyroid nodules which have resulted autonomously functioning at thyroid scintigraphy (TS).

METHODS

Seventy-eight patients with nodular goiter, no marker of autoimmunity and at least one AFTN at TS were selected and divided in: Group 1 (no.=25) with TSH>0.35 IU/l, and Group 2 (no.=53) with TSH≤0.35 IU/l.

RESULTS

In Group1 the mean nodule diameter was 19.8±9.4 mm; 12 nodules were isoechoic, 2 hyperechoic, and 11 hypoechoic. Vascular pattern was type I in 4, type II in 6 and type III in 15 nodules. In Group 2 the mean nodule diameter was 28.6±14.2 mm; 27 nodules were isoechoic, 9 hyperechoic and 17 hypoechoic. Vascular pattern was type I in 14, type II in 15 and type III in 24 nodules.

CONCLUSION

In our study TSH alone was not able to identify AFTN in 32% of the patients. All hot nodules predominantly showed an isoechoic pattern with peri-intranodular vascularization; however, the presence of this pattern was not statistically significant. Moreover, we noticed a weak inverse correlation between the diameter of AFTN and TSH level. In conclusion, TS is the most sensitive tool to detect AFTN, allowing a precocious diagnosis even in the presence of a normal TSH value.

[Preoperative and postoperative management of adrenal masses]

The surgical approach of adrenal masses requires a careful preoperative and postoperative management. In order to avoid iatrogenic hypocortisolism, Cushing patients have to be treated, before adrenal surgery and then every eight hours, with hydrocortisone 100 mg iv. The therapy should be gradually reduced to 10-20 mg/die by mouth for six-twelve months. In primary hyperaldosteronism the target of medical treatment is to control blood pressure and serum potassium values as well as to normalize the circulating aldosterone levels or to obtain mineralocorticoid receptor blockade. Epleronone and spironolactone are the most common used drugs. Spironolactone has long been the drug of choice while epleronone represents a newer more expensive alternative with fewer side effects. Postoperative management generally does not require steroid replacement therapy. The management of pheochromocytoma requires a careful medical preparation for surgery: in fact, the surgical removal of a pheochromocytoma is a high-risk procedure and an experienced surgeon/anesthesiologist team is required. The preoperative medical therapy is aimed at controlling hypertension (including preventing a hypertensive crisis during surgery) and at avoiding cardiac arrhythmia. The most common used drugs are alpha-adrenergic blockade: phenoxybenzamine is an irreversible, long-acting, nonspecific alpha-adrenergic blocking agent. Doxazosine is a selective alpha1-adrenergic blocking agent with a more favorable side-effect profile, being less related to postoperative hypotension. Postsurgical management is aimed at expanding plasma volume: a copious hydration is required while the use of dopamine in hemodynamin support is not effective because of the preoperative use of alpha-blocking agents.

Colloidal attraction induced by a temperature gradient

Colloidal crystals are of extreme importance for applied research and for fundamental studies in statistical mechanics. Long-range attractive interactions, such as capillary forces, can drive the spontaneous assembly of such mesoscopic ordered structures. However, long-range attractive forces are very rare in the colloidal realm. Here we report a novel strong, long-ranged attraction induced by a thermal gradient in the presence of a wall. By switching the thermal gradient on and off, we can rapidly and reversibly form stable hexagonal 2D crystals. We show that the observed attraction is hydrodynamic in nature and arises from thermally induced slip flow on particle surfaces. We used optical tweezers to measure the force law directly and compare it to an analytical prediction based on Stokes flow driven by Marangoni-like forces.

Hydrodynamic interactions in two dimensions

We measure hydrodynamic interactions between colloidal particles confined in a thin sheet of fluid. The reduced dimensionality, compared to a bulk fluid, increases dramatically the range of couplings. Using optical tweezers we force a two body system along the eigenmodes of the mobility tensor and find that eigenmobilities change logarithmically with particle separation. At a hundred radii distance, the mobilities for rigid and relative motions differ by a factor of 2, whereas in bulk fluids, they would be practically indistinguishable. A two dimensional counterpart of Oseen hydrodynamic tensor quantitatively reproduces the observed behavior, once the relevant boundary conditions are recognized. These results highlight the importance of dimensionality for transport and interactions in colloidal systems and proteins in biological membranes.

Shear-banding phenomena and dynamical behavior in a Laponite suspension

Shear localization in an aqueous clay suspension of Laponite is investigated through dynamic light scattering, which provides access both to the dynamics of the system (homodyne mode) and to the local velocity profile (heterodyne mode). When shear bands form, a relaxation of the dynamics typical of a gel phase is observed in both bands soon after the flow stops. Periodic oscillations of the flow behavior, typical of a stick-slip phenomenon, are also observed when shear localization occurs. Both results are discussed in the light of various theoretical models for soft glassy gels.

Aging after shear rejuvenation in a soft glassy colloidal suspension: evidence for two different regimes

The aging dynamics after shear rejuvenation in a glassy clay suspension have been investigated through dynamic light scattering (DLS). Two different aging regimes are observed: one is attained if the sample is rejuvenated before its gelation and one after the rejuvenation of the gelled sample. In the first regime, the application of shear fully rejuvenates the sample, as the system dynamics soon after shear cessation follow the same aging evolution characteristic of standard aging. In the second regime, aging proceeds very fast after shear rejuvenation, and classical DLS cannot be used. An original protocol to measure an ensemble-averaged intensity-correlation function is proposed and its consistency with classical DLS is verified. The fast aging dynamics of rejuvenated gelled samples exhibit a power-law dependence of the slow relaxation time on the waiting time.

Aging under shear: structural relaxation of a non-Newtonian fluid

The influence of an applied shear field on the dynamics of an aging colloidal suspension has been investigated by the dynamic light-scattering determination of the density autocorrelation function. Though a stationary state is never observed, the slow dynamics crosses between two different nonequilibrium regimes as soon as the structural relaxation time tau(s) approaches the inverse shear rate gamma (-1) . In the shear-dominated regime (at high gamma values) the structural relaxation time is found to be strongly sensitive to the shear rate ( tau(s) approximately gamma (-alpha) , with alpha approximately 1 ) while aging proceeds at a very slow rate. The effect of the shear on the detailed shape of the density autocorrelation function is quantitatively described, assuming that the structural relaxation process arises from the heterogeneous superposition of many relaxing units, each one independently coupled to shear with a parallel composition rule for time scales: 1/tau-->1/tau+A gamma .

Effectiveness of psychotherapy for personality disorders

OBJECTIVE

The authors examined the evidence for the effectiveness of psychotherapy for personality disorders in psychotherapy outcome studies.

METHOD

Fifteen studies were located that reported data on pretreatment-to-posttreatment effects and/or recovery at follow-up, including three randomized, controlled treatment trials, three randomized comparisons of active treatments, and nine uncontrolled observational studies. They included psychodynamic/interpersonal, cognitive behavior, mixed, and supportive therapies.

RESULTS

All studies reported improvement in personality disorders with psychotherapy. The mean pre-post effect sizes within treatments were large: 1.11 for self-report measures and 1.29 for observational measures. Among the three randomized, controlled treatment trials, active psychotherapy was more effective than no treatment according to self-report measures. In four studies, a mean of 52% of patients remaining in therapy recovered--defined as no longer meeting the full criteria for personality disorder--after a mean of 1.3 years of treatment. A heuristic model based on these findings estimated that 25.8% of personality disorder patients recovered per year of therapy, a rate sevenfold larger than that in a published model of the natural history of borderline personality disorder (3.7% recovered per year, with recovery of 50% of patients requiring 10.5 years of naturalistic follow-up).

CONCLUSIONS

Psychotherapy is an effective treatment for personality disorders and may be associated with up to a sevenfold faster rate of recovery in comparison with the natural history of disorders. Future studies should examine specific therapies for specific personality disorders, using more uniform assessment of core pathology and outcome.

[Post-ligation syndrome: a follow-up of 556 cases, 5 to 8 years after tubal sterilization]

Five to eight years later, we obtained an answer in 66.3% of 556 patients who had a sterilization between January 1978 and end of December 1981, in order to find any complication forming the so called Post-sterilization Syndrome. We traced back 80.6% of 62 patients who showed a genital pathology at the time of their surgery. We also could obtain an answer in 64.6% of 494 patients who had no apparent genital pathology at the time of their sterilization. We found that 12 patients of the first and 25 patients of the second group (10%) had suffered a major gynecological surgery since their sterilization. But in studying their records, we found that all their surgery was surgically indicated like for fibroids, prolapse, cervical cancer, etc. Three patients of the first and 16 patients of the second group (5%) showed bleeding problems which necessitated a D & C. In all, considering the age of the patients, there was no relationship between the sterilization and the rate of complications.