PA-457: a potent HIV inhibitor that disrupts core condensation by targeting a late step in Gag processing

New HIV therapies are urgently needed to address the growing problem of drug resistance. In this article, we characterize the anti-HIV drug candidate 3-O-(3',3'-dimethylsuccinyl) betulinic acid (PA-457). We show that PA-457 potently inhibits replication of both WT and drug-resistant HIV-1 isolates and demonstrate that the compound acts by disrupting a late step in Gag processing involving conversion of the capsid precursor (p25) to mature capsid protein (p24). We find that virions from PA-457-treated cultures are noninfectious and exhibit an aberrant particle morphology characterized by a spherical, acentric core and a crescent-shaped, electron-dense shell lying just inside the viral membrane. To identify the determinants of compound activity we selected for PA-457-resistant virus in vitro. Consistent with the effect on Gag processing, we found that mutations conferring resistance to PA-457 map to the p25 to p24 cleavage site. PA-457 represents a unique class of anti-HIV compounds termed maturation inhibitors that exploit a previously unidentified viral target, providing additional opportunities for HIV drug discovery.

Early versus late necrosectomy in severe necrotizing pancreatitis

BACKGROUND

Debate as to whether surgery in severe necrotizing pancreatitis (SNP) should be done early or late has been present ever since the disease was described. There are no prospective, randomized studies addressing this specific issue.

METHODS

Patients with SNP, documented clinically, with Ranson's criteria, and dynamic pancreatography (DP) findings were randomly allocated in two groups for treatment. Group A included early necrosectomy (within 48 to 72 hours of onset) and group B, late necrosectomy (at least 12 days after onset). Both groups continued with open packing and staged necrosectomies. Cultures were obtained at each laparotomy and necrosis was verified histologically in all instances.

RESULTS

During a 36-month study period, 150 patients with unequivocal acute pancreatitis were admitted for treatment. Forty-one with SNP initially entered the study; there were 5 drop outs. Patients in group A (25) and group B (11) had no difference in distribution by gender or mean age, etiology, mean Ranson's signs (4 versus 3.8), DP findings, rate of infected necrosis, or necrosectomies required per patient. Although the mortality rate (58% versus 27%) did not reach statistical significance, the odds ratio for mortality was 3.4 times higher in group A, which made us finish the study.

CONCLUSION

This prospective, randomized study from a single institution clearly demonstrates that early intensive conservative treatment with late necrosectomy for selected cases is the current rationale approach for SNP.

The neuroprotective effect of cannabidiol in an in vitro model of newborn hypoxic-ischemic brain damage in mice is mediated by CB(2) and adenosine receptors

To investigate the mechanisms involved in cannabidiol (CBD)-induced neuroprotection in hypoxic-ischemic (HI) immature brain, forebrain slices from newborn mice underwent oxygen and glucose deprivation in the presence of vehicle, or CBD alone or with selective antagonists of cannabinoid CB(1) and CB(2), and adenosine A(1) and A(2) receptors. CBD reduced acute (LDH efflux to the incubation medium) and apoptotic (caspase-9 concentration in tissue) HI brain damage by reducing glutamate and IL-6 concentration, and TNFalpha, COX-2, and iNOS expression. CBD effects were reversed by the CB(2) antagonist AM630 and by the A(2A) antagonist SCH58261. The A(1A) antagonist DPCPX only counteracted the CBD reduction of glutamate release, while the CB(1) antagonist SR141716 did not modify any effect of CBD. In conclusion, CBD induces robust neuroprotection in immature brain, by acting on some of the major mechanisms underlying HI cell death; these effects are mediated by CB(2) and adenosine, mainly A(2A), receptors.

Decrease in tear secretion and corneal sensitivity after laser in situ keratomileusis

PURPOSE

To evaluate tear secretion and corneal sensitivity after laser in situ keratomileusis (LASIK) for the correction of myopia.

METHODS

In a prospective study, 48 consecutive eyes (24 patients) underwent LASIK to correct myopia ranging from -3.5 to -12.25 diopters. Tear secretion tested by the tear function index and corneal sensitivity tested using the Cochet-Bonnet esthesiometer were evaluated preoperatively and 1 week and 1, 3, 6, and 9 months postoperatively.

RESULTS

Tear secretion and corneal sensitivity after LASIK were reduced during the first 3 months after surgery (p<0.001). Tear secretion returned to its preoperative values only after 9 months. Tear secretion and corneal sensitivity were more depressed in long-term contact lens wearers preoperatively and 6 months after surgery (p<0.05).

CONCLUSION

In the correction of myopia, tear secretion was depressed after LASIK during the first 6 months after surgery.

Impact of intensive care management on the prognosis of tetanus. Analysis of 641 cases

These studies show the results of intensive care management of 306 consecutive patients with tetanus compared with 335 patients treated conservatively in the same hospital before the institution of the ICU. The impact of the ICU treatment was manifested in a decrease in mortality, from 43.58 percent to 15 percent. In addition, while patients treated conservatively died as a consequence of early acute respiratory failure, the main cause of death in the ICU-treated patients was unexpected cardiac arrest, probably related to overactivity of the autonomic nervous system. We conclude that to ensure a high survival rate in patients with tetanus, the treatment must be performed according to established protocol in an ICU.

Selective vs argon laser trabeculoplasty: hypotensive efficacy, anterior chamber inflammation, and postoperative pain

PURPOSE

To compare selective laser trabeculoplasty (SLT) with conventional argon laser trabeculoplasty (ALT) in terms of hypotensive efficacy, anterior chamber inflammation, and pain reported by the patients treated.

METHODS

A prospective study performed on 40 consecutive patients. Group I (n = 20): SLT 180 degrees. Group II (n = 20): ALT 180 degrees. Intraocular pressure, flare (Laser-Flare-Meter, Kowa FM-500, Japan), and pain (Visual Analogue Scale) were measured before treatment and 1 h, 24 h,1 week, and 1, 3 and 6 months after treatment. Statistically significant differences were determined by an independent-sample Student's t-test.

RESULTS

At 6 months after treatment, pressure reduction was similar in both groups: SLT 22.2% (range 0-36.3%) and ALT 19.5% (range 0-30.2%), P= 0.741. The energy released during treatment was significantly lower in SLT (48.3 SD 7.4 mJ) than in ALT (4321 SD 241.7 mJ), P < 0.001. At 1 h after treatment,anterior chamber flare was also lower in SLT(13.3 SD 6.3 vs 20.7 SD 7.4 photons/ms),P = 0.003. Pain reported by the patients during the treatment was significantly lower in SLT(2.0 SD 0.7 vs 4.3 SD 1.3), P<0.001.

CONCLUSIONS

The hypotensive efficacy of both lasers at the end of follow-up was similar. The energy released during treatment and inflammation produced in the anterior chamber in the immediate postoperative period were significantly lower for SLT. The SLT procedure was better tolerated, producing less discomfort during treatment than conventional trabeculoplasty with argon.

Comparison of water wash, trimming, and combined hot water and lactic acid treatments for reducing bacteria of fecal origin on beef carcasses

Cleaning treatments, such as high-pressure water wash at 35 degrees C or trim, alone and combined with sanitizing treatments, such as hot water (95 degrees C at the source), warm (55 degrees C) 2% lactic acid spray, and combinations of these two sanitizing methods, were compared for their effectiveness in reducing inoculated numbers (5.0 to 6.0 log CFU/cm2) of Salmonella typhimurium, Escherichia coli O157:H7, aerobic plate counts, Enterobacteriaceae, total coliforms, thermotolerant coliforms, and generic E. coli on hot beef carcass surface areas in a model carcass spray cabinet. Log reductions in numbers of all tested organisms by water wash or trim alone were significantly smaller than the log reductions obtained by the different combined treatments. Regardless of the cleaning treatment (water wash or trim) or surface area, the range for mean log reductions by hot water was from 4.0 to > 4.8 log CFU/cm2, by lactic acid spray was from 4.6 to > 4.9 log CFU/cm2, by hot water followed by lactic acid spray was from 4.5 to > 4.9 log CFU/cm2, and by lactic acid spray followed by hot water was from 4.4 to > 4.6 log CFU/cm2, for S. typhimurium and E. coli O157:H7. Identical reductions were obtained for thermotolerant coliforms and generic E. coli. No differences in bacterial reductions were observed for different carcass surface regions. Water wash and trim treatments caused spreading of the contamination to other areas of the carcass surface while providing an overall reduction in fecal or pathogenic contamination on carcass surface areas. This relocated contamination after either water wash or trim was most effectively reduced by following with hot water and then lactic acid spray. This combined treatment yielded 0% positive samples for S. typhimurium, E. coli O157:H7, thermotolerant coliforms, and generic E. coli on areas outside the inoculated areas, whereas percent positive samples after applying other combined treatments ranged from 22 to 44% for S. typhimurium, 0 to 44% for E. coli O157:H7, and 11 to 33% for both thermotolerant coliforms and generic E. coli. From data collected in this study, it is possible to choose an effective, inexpensive treatment to reduce bacterial contamination on beef carcasses. In addition, the similar reduction rates of total coliforms, thermotolerant coliforms, or generic E. coli may be useful in identifying an indicator to verify the effectiveness of the selected treatment as a critical control point in a Hazard Analysis and Critical Control Point program.

Human papillomavirus detected in female breast carcinomas in Japan

To investigate the aetiological role of human papillomavirus (HPV) in breast cancer, we examined the presence, genotype, viral load, and physical status of HPV in 124 Japanese female patients with breast carcinoma. Human papillomavirus presence was examined by PCR using SPF10 primers, and primer sets targeting the E6 region of HPV-16, -18, and -33. The INNO-LiPA HPV genotyping kit was used to determine genotype. Human papillomavirus DNA was detected in 26 (21%) breast carcinomas. The most frequently detected HPV genotype was HPV-16 (92%), followed by HPV-6 (46%), HPV-18 (12%), and HPV-33 (4%). In 11 normal epithelium specimens adjacent to 11 HPV-16-positive carcinomas, 7 were HPV-16-positive. However, none of the normal breast tissue specimens adjacent to HPV-negative breast carcinomas were HPV-positive. The real-time PCR analysis suggested the presence of integrated form of viral DNA in all HPV-16-positive samples, and estimated viral load was low with a geometric mean of 5.4 copies per 10(4) cells. In conclusion, although HPV DNA was detected in 26 (21%) breast carcinomas and, in all HPV-16-positive cases, the HPV genome was considered integrated into the host genome, their low viral loads suggest it is unlikely that integrated HPV is aetiologically involved in the development of Japanese breast carcinomas that we examined.

Effect of initial glucose concentration and inoculation level of lactic acid bacteria in shrimp waste ensilation

Fermentation conditions and microorganisms were determined, based on acid production, glucose concentration as carbohydrate source. Inoculation levels to obtain a stable shrimp waste silage were also determined. Shrimp waste ensilation was an efficient method of preservation, allowing the recovery of chitin and another added-value products such as pigments, proteins and enzymes. From the various lactic acid bacteria tested, Lactobacillus pentosus and Lactobacillus sp. (B2) were the best lactic acid producers, although small quantities of acetic acid were detected in samples inoculated with Lactobacillus pentosus. Therefore B2 was chosen for the analysis of glucose consumption as well as for the determination of optimum inoculation levels. The best results were obtained at 10% (w/w wet basis) and 5% (v/w wet basis) respectively. Presence of starters and initial glucose concentration were critical factors in the fermentation of shrimp waste. High initial glucose and starter concentrations reduced the time and increased the amount of lactic acid produced. The fermentation pattern changed during ensilation from hetero to homofermentative. Shrimp waste ensilation prevented the growth of spoilage microorganisms keeping their microbial counts steady and pH values within the acid region.

Lactic acid sprays reduce bacterial pathogens on cold beef carcass surfaces and in subsequently produced ground beef

Organic acids have been shown to be effective in reducing the presence of pathogenic bacteria on hot beef carcass surfaces; however, application for decontaminating chilled carcasses has not been fully evaluated. In this study, a postchill, 30-s lactic acid spray (500 ml of 4% L-lactic acid, 55 degrees C) was applied onto outside rounds that had been contaminated with Escherichia coli O157:H7 and Salmonella Typhimurium, subsequent to prechill hot carcass treatments consisting of water wash alone or water wash followed by a 15-s lactic acid spray (250 ml of 2% L-lactic acid, 55 degrees C). The prechill treatments reduced both pathogens by 3.3 to 3.4 log cycles (water wash alone) to 5.2 log cycles (water wash and lactic acid). In all cases, the postchill acid treatment produced an additional reduction in E. coli O157:H7 of 2.0 to 2.4 log cycles and of 1.6 to 1.9 log cycles for Salmonella Typhimurium. The counts of both pathogens remained significantly lower in ground beef produced from the outside rounds that received prechill and postchill acid spray than from those that received a postchill spray only. These data indicate that organic acid sprays may be successfully applied for pathogen reduction in beef carcass processing after the cooler, especially when combined with prechill treatments.

Use of hot water for beef carcass decontamination

Hot water treatment of beef carcass surfaces for reduction of Escherichia coli O157:H7, Salmonella typhimurium, and various indicator organisms was studied using a model carcass spray cabinet. Paired hot carcass surface regions with different external fat characteristics (inside round, outside round, brisket, flank, and clod) were removed from carcasses immediately after the slaughter and dressing process. All cuts were inoculated with bovine feces containing 10(6)/g each of rifampicin-resistant E. coli O157:H7 and S. typhimurium, or with uninoculated bovine feces. Surfaces then were exposed to a carcass water wash or a water wash followed by hot water spray (95 degrees C). Counts of rifampicin-resistant Salmonella and E. coli or aerobic plate count (APC) and coliform counts were conducted before and after each treatment. All treatments significantly reduced levels of pathogens from the initial inoculation level of 5.0 log(10) CFU/cm2. Treatments including hot water sprays provided mean reductions of initial counts for E. coli O157:H7 and S. typhimurium of 3.7 and 3.8 log, APC reductions of 2.9 log, and coliform and thermotolerant coliform count reductions of 3.3 log. The efficacy of hot water treatments was affected by the carcass surface region, but not by delaying the treatment (30 min) after contaminating the surface. Verification of efficacy of hot water interventions used as critical control points in a hazard analysis critical control point (HACCP) system may be possible using coliform counts.

Lawson Criterion for Ignition Exceeded in an Inertial Fusion Experiment

For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion.

Endothelial damage with cataract surgery techniques

PURPOSE

To evaluate intraoperative endothelial damage after planned extracapsular cataract extraction (ECCE) with difference capsulotomy techniques and phacoemulsification.

SETTING

San Carlos University Hospital, Castroviejo Institute, Madrid, Spain.

METHODS

In this prospective, randomized study, 60 patients with senile cataract scheduled for cataract surgery were divided into three groups of 20 each: Group 1 had phacoemulsification; Group 2, planned ECCE with continuous curvilinear capsulorhexis; and Group 3, ECCE with letter-box capsulotomy. Preoperatively and 3 months postoperatively, endothelial cell density, percentage of hexagonality, and the cell size variation coefficient were determined by contact specular microscopy; endothelial permeability was examined by anterior segment fluorophotometry and central corneal thickness, by ultrasonic pachymetry. Results were analyzed using the two-tailed Student's t-test and analysis of variance.

RESULTS

In all three groups, endothelial permeability and cell loss increased significantly from the preoperative values, but there were not significant differences among the postoperative values. Mean cell loss was 11.8% in Group 1, 12.8% in Group 2, and 10.1% in Group 3. There were no differences between the preoperative and postoperative morphometric indexes. Postoperative pachymetric measurements were not significant.

CONCLUSIONS

Endothelial response was not statistically significantly different among the surgical techniques, although endothelial damage was lower in Group 3, which could indicate a protective effect of the anterior capsule during cataract extraction. Endothelial barrier function remained disturbed despite the apparent morphological stabilization.

Peripheral Melt of Flap after Laser in situ Keratomileusis

BACKGROUND

Laser in situ keratomileusis (LASIK) is an effective procedure to correct myopia. It may have complications related to the flap, such as epithelial ingrowth and stromal melt.

METHODS

We report on a patient who developed extensive epithelial ingrowth and partial keratolysis of the flap following LASIK. This complication was treated by lifting the flap and removing the epithelium from within the interface.

RESULTS

Progressive keratolysis (stromal melt) can result in irregular astigmatism and loss of vision as well as photophobia and ciliary injection. The pathogenesis is not completely understood although the epithelial ingrowth in the interface is always present, and epithelial-stromal interaction with production of proteases may be involved.

CONCLUSION

Epithelial ingrowth may develop in the lamellar interface after LASIK and be associated with melting of the edge of the flap. This undesirable complication can be successfully managed with early surgical removal of the epithelium and proper attachment of the flap.

Reduction of Escherichia coli O157:H7 and Salmonella typhimurium on beef carcass surfaces using acidified sodium chlorite

The efficacy of a phosphoric acid-activated acidified sodium chloride (PASC) spray and a citric acid-activated acidified sodium chlorite (CASC) spray applied at room temperature (22.4 to 24.7 degrees C) in combination with a water wash was compared with that of a water wash only treatment for reduction of Escherichia coli O157:H7 and Salmonella Typhimurium inoculated onto various hot-boned individual beef carcass surface regions (inside round, outside round, brisket, flank, and clod). Initial counts of 5.5 and 5.4 log CFU/cm2 were obtained after inoculation with E. coli O157:H7 and Salmonella Typhimurium, respectively. Initial numbers for both pathogens were reduced by 3.8 to 3.9 log cycles by water wash followed by PASC spray and by 4.5 to 4.6 log cycles by water wash followed by CASC spray. The sprays consisted of applying 140 ml of the appropriate sanitizing solution for 10 s at 69 kPa. Corresponding reduction values obtained by water wash alone were 2.3 log. The performance of CASC appeared to be consistently better than that of PASC. In general, no effect of the carcass surface region was observed on the log reductions for either pathogen, except for the inside round, which consistently had lower reductions. Both PASC and CASC were capable of effectively reducing pathogens spread to areas beyond the initial contaminated area of the cuts to levels close to or below the counting method detection limit (0.5 log CFU/cm2). However, 30 to 50% of the carcasses treated by these antimicrobial solutions still yielded countable colonies. Results of this study indicate that acidified sodium chlorite sprays are effective for decontaminating beef carcass surfaces.

Salmonella contamination during production of cantaloupe: a binational study

Six cantaloupe farms and packing plants in South Texas (950 cantaloupe, 140 water, and 45 environmental samples), including the Rio Grande Valley area, and three farms in Colima State, Mexico (300 cantaloupe, 45 water, and 15 environmental samples), were sampled to evaluate cantaloupe contamination with Salmonella and Escherichia coli during production and processing. Samples collected from external surfaces of cantaloupes, water, and the environments of packing sheds on cantaloupe farms were examined for the presence of Salmonella and E. coli. Of a total of 1,735 samples collected, 31 (1.8%) tested positive for Salmonella. Fifteen Salmonella serotypes were isolated from samples collected in Texas, and nine from samples collected in Colima. Two serotypes (Poona and Oranienburg) that have been associated with three large Salmonella outbreaks in the United States and Canada linked to the consumption of contaminated cantaloupe were found in water samples collected at four farms (three from the United States). Susceptibility of Salmonella isolates to 10 antimicrobials was evaluated by disk diffusion. Eighty-eight percent of the isolates from the United States and Mexico were pansusceptible to the antimicrobials tested; eight isolates from the United States demonstrated an intermediate susceptibility to streptomycin and only two isolates were resistant to the same antimicrobial. From Mexico, four isolates showed an intermediate susceptibility to streptomycin and one isolate was resistant to nalidixic acid and streptomycin. Repetitive sequence-based PCR analysis of Salmonella isolates helped to trace potential sources of Salmonella contamination in source water and in subsequent water samples obtained after the filtration systems of U.S. and Mexican cantaloupe farms. No differences could be seen between the levels of Salmonella contamination in melons from both countries.

Evaluation of peroxyacetic acid as a post-chilling intervention for control of Escherichia coli O157:H7 and Salmonella Typhimurium on beef carcass surfaces

Four experiments were conducted to test the efficacy of peroxyacetic acid as a microbial intervention on beef carcass surfaces. In these experiments, beef carcass surfaces were inoculated with fecal material (no pathogens) or fecal material containing rifampicin-resistant Escherichia coli O157:H7 and Salmonella Typhimurium. Inoculated surfaces were subjected to a simulated carcass wash with and without 2% l-lactic acid treatment before chilling. In Experiments 1 and 2, the chilled carcass surfaces were sprayed with peroxyacetic acid (200 ppm; 43°) for 15 s. Peroxyacetic acid had no effect on microbial counts of any organism measured on these carcass surfaces. However, lactic acid reduced counts of E. coli Type I (1.9log(10) CFU/cm(2)), coliforms (3.0log(10) CFU/cm(2)), E. coli O157:H7 (2.7log(10) CFU/cm(2)), and S. Typhimurium (2.8log(10) CFU/cm(2)) entering the chilling cooler and prevented growth during the chilling period. In Experiment 3, peroxyacetic acid at different concentrations (200, 600, and 1000 ppm) and application temperatures (45 and 55 °C) were used to investigate its effectiveness in killing E. coli O157:H7 and S. Typhimurium compared to 4% l-lactic acid (55 °C). Application temperature did not affect the counts of either microorganism. Peroxyacetic acid concentrations up to 600 ppm had no effect on these microorganisms. Concentrations of 1000 ppm reduced E. coli O157:H7 and S. Typhimurium by up to 1.7 and 1.3log(10) CFU/cm(2), respectively. However, 4% lactic acid reduced these organisms by 2.7 and 3.4log(10) CFU/cm(2), respectively. In Experiment 4, peroxyacetic acid (200 ppm; 43 °C) was applied to hot carcass surfaces. This treatment caused a 0.7log(10) CFU/cm(2) reduction in both E. coli O157:H7 and S. Typhimurium. The collective results from these experiments indicate that peroxyacetic acid was not an effective intervention when applied to chilled inoculated carcass piece surfaces.

Decontamination of beef carcass surface tissue by steam vacuuming alone and combined with hot water and lactic acid sprays

Hot beef carcass surface regions (outside round, brisket, and clod) contaminated with feces spread over a 5-cm2 (1-in2) area were cleaned using a steam-vacuum spot-cleaning system alone or combined with subsequent sanitizing treatments of hot water (95 degrees C at the nozzle), or warm (55 degrees C) 2% lactic acid spray, or combinations of these two sanitizing methods. These treatments were compared for effectiveness in reducing aerobic plate counts (APC) and counts of Enterobacteriaceae, total coliforms, thermotolerant coliforms, and Escherichia coli. All treatments significantly reduced the numbers of each group of bacteria on beef carcass surfaces. However, reductions obtained by steam vacuuming were significantly smaller than those obtained by a combination of steam vacuuming with any sanitizing treatment. No differences in bacterial reductions were observed between different carcass surface regions. Steam vacuuming reduced the number of different indicator organisms tested by ca. 3.0 log cycles but also spread the bacterial contamination to areas of the carcass surface adjacent to the contaminated sites. This relocated contamination after steam vacuuming was most effectively reduced by spraying with hot water and then lactic acid. This combined treatment consistently reduced the numbers of Enterobacteriaceae, total and thermotolerant coliforms, and E. coli to undetectable levels (<1.0 log10 CFU/cm2) on areas outside the initial 5-cm2 inoculated areas.

Human papillomavirus in high- and low-risk areas of oesophageal squamous cell carcinoma in China

To examine the potential roles of human papillomavirus (HPV) in oesophageal squamous cell carcinoma (ESCC) development, we examined the presence of HPV DNA in paraffin-embedded ESCC tissues collected from two areas with different ESCC incidence rates in China, that is, Gansu (n=26) and Shandong (n=33), using PCR with SPF10 primers, or PCR with GP5+/GP6+ primers combined with Southern blot hybridisation. HPV genotype was determined by the INNO-LiPA HPV genotyping kit. HPV DNA was detected in 17 cases (65%) in Gansu, where ESCC incidence is much higher than in Shandong, where HPV was positive in two samples (6%). HPV genotypes 16 and 18 were detected in 79 and 16% of HPV-positive samples, respectively. Real-time PCR analysis suggested the presence of integrated form of HPV DNA in all the HPV-16-positive samples, but its viral load was estimated to be only <1–2 copies cell⁻¹. We could not detect HPV 16/18 E6 protein expression by immunostaining in any of the HPV-16-positive samples. Neither p16^INK4a nor p53 expression was related to HPV presence in ESCCs. Further studies seem warranted to examine the possible aetiological roles of HPV in ESCC.

Long-term safety and efficacy of eslicarbazepine acetate in patients with focal seizures: results of the 1-year ESLIBASE retrospective study

BACKGROUND

Eslicarbazepine acetate (ESL) is a new antiepileptic drug (AED) licensed as adjunctive therapy in adults with partial-onset or focal seizures.

OBJECTIVE

To evaluate in a clinical practice setting the long-term efficacy and safety of ESL in patients with focal seizures.

METHODS

ESLIBASE was a retrospective study that included all patients with focal seizures who started ESL between January 2010 and July 2012 at 12 hospitals. ESL was prescribed individually according to real-life practice. Efficacy and safety were evaluated over 1 year. Switching from carbamazepine (CBZ) and oxcarbazepine (OXC) was assessed.

RESULTS

Three hundred and twenty-seven patients were included; 78% of patients were taking ≥2 other AEDs at baseline. Most (87%) began ESL because of poor seizure control and 13% because of adverse events (AEs) with CBZ or OXC. After 1 year, 237 patients (72.4%) remained on ESL. At 3, 6 and 12 months, the responder rate was 46.3%, 57.9%, and 52.5%, and 21.0%, 28.0%, and 25.3% of patients were seizure free. The responder rate significantly increased when ESL was combined with a non-sodium channel-targeting drug (non-SC drug) (66.7%) versus an SC drug (47.7%; p<0.001). At 12 months, 40.7% of patients had ≥1 AE; AEs led to treatment discontinuation in 16.2%. Dizziness, nausea, and somnolence were the most common AEs. The tolerability profile improved in >50% of the patients who switched from CBZ or OXC to ESL because of AEs.

CONCLUSIONS

ESL was well tolerated and effective in a real-world setting over 1 year. Side-effect profile improved when OXC and CBZ recipients were switched to ESL.

Ontogeny of IgM and IgM-bearing cells in rainbow trout

We have studied the ontogenic development of immunoglobulin M (IgM) and of IgM-bearing cells in the rainbow trout, Oncorhynchus mykiss. Lymphocytes showing cytoplasmic IgM were first observed in embryos at 12 days before hatch (14 degrees C). At this stage, no cells positive for surface IgM were present. Lymphocytes bearing surface IgM were observed at 8 days before hatch (14 degrees C). Unfertilized trout eggs contained detectable amounts of IgM (11.2 +/- 2.6 micrograms/g of egg weight), indicating that transfer of IgM from mother to embryo can occur in salmonids. The levels of IgM from whole fish increase slowly after the appearance of intraembryonic cells that express surface IgM. The amount of IgM/g of tissue peaks around hatch, but this parameter shows lower values up to 2 months after hatch.

Effect of memantine and CNQX in the acquisition, expression and reinstatement of cocaine-induced conditioned place preference

The present study evaluates the effect of memantine, a non-competitive N-methyl-d-aspartate (NMDA) glutamate receptor antagonist and CNQX, an alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA)/kainate receptor antagonist on the rewarding effects of cocaine in mice, using the conditioned place preference (CPP) paradigm. Cocaine-induced CPP was studied pairing this drug with different memantine or CNQX doses during either the acquisition or the expression phase of the procedure. Once CPP was established, and the preference extinguished, reinstatement was induced by a priming dose of cocaine. Both antagonists, which in themselves do not present motivational actions on the preference shown by the animals, abolished the acquisition and expression of the cocaine-induced CPP. Neither of the antagonists precipitated reinstatement of the preference induced by cocaine but memantine blocked the cocaine-primed reinstatement. Our results suggest that cocaine-induced CPP and reinstatement is largely dependent on glutamate neurotransmission, and confer a putative role for memantine among the tools useful for cocaine management and treatment.

Concentrations of Escherichia coli and genetic diversity and antibiotic resistance profiling of Salmonella isolated from irrigation water, packing shed equipment, and fresh produce in Texas

Fresh produce has been repeatedly implicated as a vehicle in the transmission of foodborne gastroenteritis. In an effort to assess the risk factors involved in the contamination of fresh produce with pathogenic bacteria, a total of 1,257 samples were collected from cantaloupe, oranges, and parsley (both in the field and after processing) and from the environment (i.e., irrigation water, soil, equipment, etc.). Samples were collected twice per season from two production farms per commodity and analyzed for the presence of Salmonella and Escherichia coli. E. coli was detected on all types of commodities (cantaloupe, oranges, and parsley), in irrigation water, and on equipment surfaces. A total of 25 Salmonella isolates were found: 16 from irrigation water, 6 from packing shed equipment, and 3 from washed cantaloupes. Salmonella was not detected on oranges or parsley. Serotyping, pulsed-field gel electrophoresis (PFGE), and repetitive element sequence-based PCR (rep-PCR) assays were applied to all Salmonella isolates to evaluate the genetic diversity of the isolates and to determine relationships between sources of contamination. Using PFGE, Salmonella isolates obtained from irrigation water and equipment were determined to be different from cantaloupe isolates; however, DNA fingerprinting did not conclusively define relationships between contamination sources. All Salmonella isolates were subjected to antimicrobial susceptibility testing using the disk diffusion method, and 20% (5 of 25) of the isolates had intermediate sensitivity to streptomycin. One Salmonella isolate from cantaloupe was resistant to streptomycin.

Comparison of rinsing and sanitizing procedures for reducing bacterial pathogens on fresh cantaloupes and bell peppers

Increased consumption of fruits and vegetables is linked to health benefits but also to an increase in the number of outbreaks of foodborne illness. To determine the effectiveness of different sanitizing treatments for reducing bacterial pathogens on fresh produce, fresh cantaloupes and bell peppers were harvested and inoculated with suspensions of Salmonella Typhimurium and Escherichia coli O157:H7. The inoculated fruits were treated with water wash alone or were washed and then waxed or rinsed with 200 mg/liter hypochlorite, 10% Ca(OH)2, or 2% lactic acid solutions applied by dipping for 15 s or spraying for 15 s. Preliminary experiments with chlorine treatments indicated that spraying with a 200, 600, or 1,000 mg/liter hypochlorite solution reduced populations of both pathogens by 2.1 to 2.6 and 1.5 to 2.1 log CFU for Salmonella Typhimurium and E. coli O157:H7, respectively. In general, no differences were observed between chlorine solutions without pH adjustment (pH 9.2) and those with pH adjusted to 6.0. When different wash regimes were applied to inoculated cantaloupes or bell peppers, water wash alone produced significantly lower counts of both pathogens on bell peppers in comparison to untreated controls. However, this reduction was not observed on cantaloupes, indicating a possible surface effect. Application of 2% L-lactic acid by spray was the treatment that resulted in the lowest bacterial counts on both cantaloupes and bell peppers. This treatment did not produce any deleterious change in the sensorial characteristics of the products tested. None of the pathogens studied was able to grow during refrigerated storage (5 degrees C for cantaloupes and 10 degrees C for bell peppers), although numbers close to the detection limit of the counting method were found in randomly tested individual samples at days 14 and 28 of storage, indicating that these pathogens can survive for long periods on the produce surface. These results indicate that selected produce commodities could be sanitized at the packing facility. However, these interventions should not be applied as a replacement for but only as a complement to good hygiene practices.

Long-term follow-up of patients with type 1 diabetes transplanted with neonatal pig islets

Pancreas transplantation is an option to achieve better metabolic control and decrease chronic complications in patients with diabetes. Xenotransplantation becomes an important alternative. In this study, we show the clinical outcome of patients with type 1 diabetes transplanted with neonatal pig islets without immunosuppression. In a longitudinal study of 23 patients with type 1 diabetes, who received porcine islets between 2000 and 2004, we registered demographic and clinical characteristics every 3 months and chronic complications evaluation yearly. Porcine C-peptide was measured in urine samples under basal conditions and after stimulation with l-arginine. More than 50% were female, median current age was 20·8 years, median diabetes duration at transplantation 5·5 years, median current diabetes duration 11 years and median time post-transplantation 5·7 years. Their media of glycosylated haemoglobin reduced significantly after the first transplantation. Insulin doses remain with a reduction greater than 33% in more than 50% of the patients. Before transplantation, 14 of the 21 patients presented mild chronic complications and currently only two patients presented these complications. Porcine C-peptide was present in all urine samples under basal conditions and increased post-stimulation with l-arginine. These patients achieved an excellent metabolic control after the first transplantation. This could explain, as well as the remaining function of transplanted cells, the low frequency of chronic complications compared to patients with similar diabetes duration and age.