Longer intervals between SARS-CoV-2 infection and mRNA-1273 doses improve the neutralization of different variants of concern

The humoral immune response against SARS-CoV-2 variants of concern elicited by vaccination was evaluated in COVID-19 recovered individuals (Rec) separated 1-3 months (Rec2m) or 4-12 months (Rec9m) post infection and compared to the response in naïve participants. Antibody-mediated immune responses were assessed in 66 participants by three commercial immunoassays and a SARS-CoV-2 lentiviral-based pseudovirus neutralization assay. Immunoglobulin (Ig) levels against SARS-CoV-2 spike were lower in naïve participants after two doses than in Rec after a single dose (p<0.05). After two doses in Rec, levels of total Ig to receptor binding domain (RBD) were significantly increased in Rec9m compared to Rec2m (p<0.001). The neutralizing potency observed in Rec9m was consistently higher than in Rec2m against VOCs Alpha, Beta, Delta, and BA.1 sublineage of Omicron with 2.2-2.8-fold increases. Increasing the interval between SARS-CoV-2 infection and the vaccination with mRNA-based vaccines to more than 3 months generates a more efficient heterologous humoral immune response against VOCs by allowing enough time to mount a strong recall memory B cell response. This article is protected by copyright. All rights reserved.

Treatment with integrase inhibitors alters SARS-CoV-2 neutralization levels measured with HIV-based pseudotypes in people living with HIV

The presence of neutralizing antibodies (NAbs) is a major correlate of protection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Thus, different in vitro pseudoviruses-based assays have been described to detect NAbs against SARS-CoV-2. However, the determination of NAbs against SARS-CoV-2 in people living with HIV (PLWH) through HIV-based pseudoparticles could be influenced by cross-neutralization activity or treatment, impeding accurate titration of NAbs. Two assays were compared using replication-defective HIV or VSV-based particles pseudotyped with SARS-CoV-2 spike to measure NAbs in COVID-19-recovered and COVID-19-naïve PLWH. The assay based on HIV-pseudoparticles displayed neutralization activity in all COVID-19-recovered PLWH with a median neutralizing titer 50 (NT50) of 1417.0 (interquartile range [IQR]: 450.3-3284.0), but also in 67% of COVID-19-naïve PLWH (NT50: 631.5, IQR: 16.0-1535.0). Regarding VSV-pseudoparticles system, no neutralization was observed in COVID-19-naïve PLWH as expected, whereas in comparison with HIV-pseudoparticles assay lower neutralization titers were measured in 75% COVID-19-recovered PLWH (NT50: 100.5; IQR: 20.5-1353.0). Treatment with integrase inhibitors was associated with inaccurate increase in neutralization titers when HIV-based pseudoparticles were used. IgG purification and consequent elimination of drugs from samples avoided the interference with retroviral cycle and corrected the lack of specificity observed in HIV-pseudotyped assay. This study shows methodological alternatives based on pseudoviruses systems to determine specific SARS-CoV-2 neutralization titers in PLWH.

Quality changes of workplace health promotion in Austrian companies over time

Background

Workplace health promotion (WHP) is effective when it is implemented in a high-quality and sustainable manner. Companies in the Austrian quality management system can apply for a WHP quality certificate every three years. More and more companies are integrating WHP into their regular operations. This work investigates the WHP quality system and how the companies develop over time.

Methods

WHP quality is measured using 15 holistic quality criteria, which are assessed by an external, independent institute. For the period 2014-2021, evaluations from n = 570 companies with two and from n = 278 companies over three measurement points in time are available (initial and renewal awards). The (potential) change of the WHP quality is examined with a longitudinal design by the means of confirmatory factor analyses and autoregressive models with latent variables.

Results

The measurement of WHP quality shows acceptable to good measurement accuracy (internal consistency-reliability: α = 0.85-0.89), validity (convergent and discriminant validity) and metric measurement invariance over time. At structural level, relative stability of WHP quality can be demonstrated for the measurement points (β = 0.40-0.52, p &lt; 0.001). Both the quality of WHP and the temporal stability differentiate significantly according to the firm size and the experience of the company with WHP structures and processes.

Conclusions

The use of the criteria allows a reliable, valid and objective quality assessment of WHP quality due to the concept of the assessment process. WHP quality is a relatively stable characteristic of the company, which, however, varies according to temporal, structural and process-related aspects. Company size moderates to a lesser extent of quality changes over time. This is in line with expectations, but also indicates that small companies should be clearly motivated and supported for their WHP measures. The insights help to further develop quality assurance in WHP and public health.

Key messages

• The criteria used allow a reliable, valid and objective assessment of WHP quality.

• Because firm size moderates the change in WHP quality, small firms should be continuously encouraged and supported.

Baseline 18F-FDG PET/CT quantitative parameters as prognostic factors in esophageal squamous cell cancer

AIM

To determine the utility of [¹⁸F]FDG PET/CT quantitative parameters as prognostic factors for the response to neoadjuvant treatment, progression-free survival (PFS) and cancer-specific survival (CSS) in patients with esophageal squamous cell carcinoma (SCC).

MATERIAL AND METHODS

Thirty patients (29 men) diagnosed with SCC were retrospectively evaluated over a 6-year interval. Metabolic parameters were determined: maximum SUV (SUVmax), mean SUV (SUVmed), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) from baseline PET/CT study. After treatment with chemotherapy and/or radiotherapy, response to treatment and patient survival were assessed. The comparison of parameters between groups of responders and non-responders was carried out using a Mann-Whitney U test ROC curves and the Kaplan-Meier method were used for analysis of prognostic factors and survival curves.

RESULTS

The average follow-up was 22.4 months, with 22 recurrence-progressions and 25 deaths. Significant differences were demonstrated between responders and non-responders with respect to tumor size, MTV and TLG. Survival analysis found significant differences for SCE and CSS depending on these three parameters.

CONCLUSION

Metabolic parameters MTV and TLG, and tumor size were prognostic factors for neoadjuvant treatment response, PFS, and CSS in patients diagnosed with SCC. Neither SUVmax nor SUVmed were predictive for any of the evaluation criteria. Results could help to personalize patient treatment.

Baseline 18F-FDG PET/CT quantitative parameters as prognostic factors in esophageal squamous cell cancer

AIM

To determine the utility of 18F-FDG PET/CT quantitative parameters as prognostic factors for the response to neoadjuvant treatment, progression-free survival (PFS) and cancer-specific survival (CSS) in patients with esophageal squamous cell carcinoma (SCC).

MATERIAL AND METHODS

Thirty patients (29 men) diagnosed with SCC were retrospectively evaluated over a 6-year interval. Metabolic parameters were determined: maximum SUV (SUVmax), mean SUV (SUVmed), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) from baseline PET/CT study. After treatment with chemotherapy and/or radiotherapy, response to treatment and patient survival were assessed. The comparison of parameters between groups of responders and non-responders was carried out using a Mann-Whitney U test. ROC curves and the Kaplan-Meier method were used for analysis of prognostic factors and survival curves.

RESULTS

The average follow-up was 22.4months, with 22 recurrence-progressions and 25 deads. Significant differences were demonstrated between responders and non-responders with respect to tumor size, MTV and TLG. Survival analysis found significant differences for SCE and CSS depending on these three parameters.

CONCLUSION

Metabolic parameters MTV and TLG, and tumor size were prognostic factors for neoadjuvant treatment response, PFS, and CSS in patients diagnosed with SCC. Neither SUVmax nor SUVmed were predictive for any of the evaluation criteria. Results could help to personalize patient treatment.

18F-FDG PET/CT quantitative parameters as prognostic factor in localized and inoperable lung cancer

AIM

To assess the utility of ¹⁸F-FDG PET/CT quantitative parameters as prognostic factor in patients diagnosed with localized and inoperable lung cancer treated by stereotactic body radiotherapy (SBRT).

MATERIAL AND METHODS

Fifty patients (42 men) diagnosed in the last 7years with early-stage lung cancer and treated with SBRT alone were assessed by a prospective study. After PET/CT study, metabolic parameters maximum SUV (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were determined at different thresholds. The prognostic factors for overall survival (OS), cause-specific survival (CS) and disease-free survival (DFS) were analysed by Cox proportional hazards model and the survival analysis by Kaplan-Meier method.

RESULTS

The average follow-up was 39.6months, with 21 recurrences and 24 dead. Univariate analysis determined MTV₃₀ and MTV₄₀ as predictors for OS; MTV₃₀, MTV₄₀, TLG₃₀ and TLG₄₀ for CS, and MTV₂, MTV₃₀, MTV₄₀, TLG₂, TLG₃₀ and TLG₄₀ for DFS. Survival analysis found statistically significant differences for CS and DFS depending on tumor size and for DFS considering the cut-off values of MTV₂ and TLG₂ (threshold SUVmax=2). SUVmax, age and sex were not shown to be significant factors.

CONCLUSION

Pre-treatment quantitative assessment using metabolic parameters MTV₂ and TLG₂ as well as tumor size proved to be prognostic factors in patients diagnosed with localized and inoperable lung cancer treated by SBRT. Results could help to personalize treatment.

Cytology cell blocks are suitable for immunohistochemical testing for PD-L1 in lung cancer

Background

PD-L1 immunohistochemistry (IHC) testing is usually carried out on tissue blocks from core needle biopsy or surgical resections. In this study, we assessed the feasibility of using cytology cell blocks for PD-L1 IHC assay.

Methods

A total of 1419 consecutive cases of non-small-cell lung cancer (NSCLC), including 371 cytology cell blocks, 809 small biopsies, and 239 surgical specimens, were included in the study. The cytology cell blocks were prepared with formalin only, methanol/alcohol only or both. PD-L1 expression was examined by staining with Dako PD-L1 IHC 22C3 pharmDx kit. A Tumor Proportion Score (TPS) was categorized as <1%, 1%-49% and ≥50% tumor cells. A total of 100 viable tumor cells were required for adequacy.

Results

Of the cytology cell blocks, 92% of the specimens had an adequate number of tumor cells, not significantly different from small biopsies. The rate of TPS ≥50% differed between sample types and was observed in 42% of cytology cell blocks versus 36% of small biopsies (P = 0.04), and 29% of surgical resections (P = 0.001). The fixative methods did not affect the immunostaining, with overall PD-L1 high expression (TPS ≥50%) rates of 42% in formalin-fixed specimens versus 40% in specimens with combined fixation by methanol/alcohol and formalin (NS). The PD-L1 high expression rate was not associated with EGFR, ALK or KRAS molecular alterations. Higher stage (IV) was associated with higher PD-L1 TPS (P= 0.001).

Conclusion

Our results show that when the TPS ≥50% is used as the end point, PD-L1 IHC performs well with cytology cell blocks. Cell blocks should be considered as a valuable resource for PD-L1 testing in advanced NSCLC. The clinical significance of higher PD-L1 IHC scores in cytology specimens needs to be evaluated prospectively.

Consensus guidelines for diagnosis, treatment and follow-up of patients with pancreatic cancer in Spain

The management of patients with pancreatic cancer has advanced over the last few years. We convey a multidisciplinary group of experts in an attempt to stablish practical guidelines for the diagnoses, staging and management of these patients. This paper summarizes the main conclusions of the working group. Patients with suspected pancreatic ductal adenocarcinoma should be rapidly evaluated and referred to high-volume centers. Multidisciplinary supervision is critical for proper diagnoses, staging and to frame a treatment plan. Surgical resection together with chemotherapy offers the highest chance for cure in early stage disease. Patients with advanced disease should be classified in treatment groups to guide systemic treatment. New chemotherapeutic regimens have resulted in improved survival. Symptomatic management is critical in this disease. Enrollment in a clinical trial is, in general, recommended.

An Orientation-Based Pruning Tool to Speed Up Contact Determination between Translating Polyhedral Models

Contact determination in terms of edge-face intersection tests permits handling nonconvex polyhedra directly, without decomposing them into convex entities, which saves the decomposition time and avoids having to deal with fictitious features but requires checking all possible pairings. However, by considering only translations and departing from a noninterfering situation, the number of pairings to be checked decreases drastically. The set of critical pairings can be determined efficiently using the spherical face orientation graph (SFOG), a representation developed by the authors. An algorithm to exploit the SFOG in convex settings provides controlled evidence of the pruning potential of this approach: the number of critical pairings grows linearly with the complexity of the polyhedra, instead of quadratically as the total number of pairings does. Experiments with a similar algorithm on nonconvex settings confirm the expected potential of the approach: for workpieces with many concavities moving in close proximity, the contact determination procedure presented in this paper performs one order of magnitude faster than RAPID, at the expense of a much higher preprocessing time.

"Intrasellar Balloon Technique" in intraoperative MRI guided transsphenoidal endoscopic surgery for sellar region tumors. Usefulness on image interpretation and extent of resection evaluation. Technical note

BACKGROUND

Intraoperative magnetic resonance imaging (iMRI) is an effective and proven tool in transsphenoidal endoscopic surgery. However, image interpretation is not always easy and can be hindered by the presence of blood, tumor remains or the displacement of surrounding structures. In this article we present a novel technique based on using intrasellar ballons to reduce these difficulties and facilitate the surgeon's intraoperative assessment by iMRI.

METHODS

Eighteen patients with pituitary macroadenomas underwent transsphenoidal surgery during 2013-2014 under low-field iMRI control (PoleStar N20, 0.15 T). Intrasellar balloons were used in all of them to assess the presence of tumoral remnants. We compared the findings in iMRI and postoperative high-field MRI control scans and also analyzed the number of intermediate imaging controls needed during surgery using this technique.

RESULTS

In total, of the 18 patients, 14 underwent a complete resection. In the remaining four patients, a safe maximal resection was performed, leaving a remnant because of cavernous sinus invasion. In all cases, the balloons were a major help in distinguishing the anatomical structures from the tumoral remnants. Fewer imaging controls were required, and there were no false-positives or negative intraoperative findings. No complications related to the technique were registered.

CONCLUSION

The "intrasellar balloon technique" is a useful tool that facilitates surgeons' intraoperative decision making. It is an important contribution to overcome the limitations of low-field iMRI as it provides a precise delineation of the resection margins, reduces false-positives and -negatives, and decreases the number of intermediate imaging controls required.

Taenia solium tapeworms synthesize corticosteroids and sex steroids in vitro

Cysticercosis is a disease caused by the larval stage of Taenia solium cestodes that belongs to the family Taeniidae that affects a number of hosts including humans. Taeniids tapeworms are hermaphroditic organisms that have reproductive units called proglottids that gradually mature to develop testis and ovaries. Cysticerci, the larval stage of these parasites synthesize steroids. To our knowledge there is no information about the capacity of T. solium tapeworms to metabolize progesterone or other precursors to steroid hormones. Therefore, the aim of this paper was to investigate if T. solium tapeworms were able to transform steroid precursors to corticosteroids and sex steroids. T. solium tapeworms were recovered from the intestine of golden hamsters that had been orally infected with cysticerci. The worms were cultured in the presence of tritiated progesterone or androstenedione. At the end of the experiments the culture media were analyzed by thin layer chromatography. The experiments described here showed that small amounts of testosterone were synthesized from (3)H-progesterone by complete or segmented tapeworms whereas the incubation of segmented tapeworms with (3)H-androstenedione, instead of (3)H-progesterone, improved their capacity to synthesize testosterone. In addition, the incubation of the parasites with (3)H-progesterone yielded corticosteroids, mainly deoxicorticosterone (DOC) and 11-deoxicortisol. In summary, the results described here, demonstrate that T. solium tapeworms synthesize corticosteroid and sex steroid like metabolites. The capacity of T. solium tapeworms to synthesize steroid hormones may contribute to the physiological functions of the parasite and also to their interaction with the host.

Characterization of the prostaglandin E2 pathway in a rat model of esophageal adenocarcinoma

Accumulating evidence indicates that the cyclooxygenase-2 (COX-2)/prostaglandin E2 (PGE2) pathway plays a key role in esophageal carcinogenesis. A better understanding of the pathway downstream of COX-2 may reveal novel targets for the prevention of esophageal adenocarcinoma (EAC). The objective of this study was to characterize the profile of genes involved in PGE2 metabolism and signaling in an experimental model of EAC. Esophagojejunostomy with gastric preservation was performed in wistar rats to induce gastroduodenal reflux. Rats were sacrificed 2 or 4 months after surgery. Nine non-operated rats were used to obtain normal (control) esophageal tissues.

RESULTS

All rats that underwent esophagojejunostomy developed inflammation. In addition, 90% of the animals showed intestinal metaplasia; of those, 40% progressed to AC. This process was accompanied by a significant increase in esophageal PGE2 levels and the induction of both mRNA and protein levels of COX-2, COX-1, prostaglandin E synthase, 15-hydroxyprostaglandin dehydrogenase, and PGE2 receptors EP3, EP4 and especially EP2, which rose to particularly high levels in experimental rats. In addition, exposure to a selective COX-2 inhibitor (SC58125) or an EP1/EP2 antagonist (AH6809), but not an EP4 antagonist (AH23848B), significantly reduced cell proliferation of esophageal explants in 24 hour-organ culture experiments. Our data suggest that, in addition to COX-2, other components of the PGE2 pathway, including COX-1, may play important roles in the development of EAC induced by gastroduodenal reflux in the rat. Although it must be confirmed in vivo, the EP2 receptor may represent a promising selective target in the prevention of Barrett's associated AC.

Selection of antagonistic bacteria isolated from the Physalis peruviana rhizosphere against Fusarium oxysporum

AIMS

Cape gooseberries (Physalis peruviana) have become increasingly important in Colombia for both domestic consumption and the international export market. Vascular wilting caused by Fusarium oxysporum is the most damaging disease to P. peruviana crops in Colombia. The control of this pathogen is mainly carried out by chemical and cultural practices, increasing production costs and generating resistance. Therefore, the objectives of this study were to test rhizobacteria isolates from P. peruviana rhizosphere against F. oxysporum under in vitro and in vivo conditions.

METHODS AND RESULTS

Over 120 strains were isolated, and five were selected for their high inhibition of F. oxysporum growth and conidia production under in vitro conditions. These strains inhibited growth by 41-58% and reduced three- to fivefold conidia production. In the in vivo assays, all the tested isolates significantly reduced fungal pathogenicity in terms of virulence. Isolate B-3.4 was the most efficient in delaying the onset of the first symptoms. All isolates were identified as belonging to the genus Pseudomonas except for A-19 (Bacillus sp.).

CONCLUSIONS

Our results confirmed that there are prospective rhizobacteria strains that can be used as biological control agents; some of them being able to inhibit in vitro F. oxysporum growth and sporulation.

SIGNIFICANCE AND IMPACT OF THE STUDY

Incorporating these bacteria into biological control strategies for the disease that causes high economical losses in the second most exported fruit from Colombia would result in a reduced impact on environment and economy.

Molecular and flow cytometry characterization during the follow-up of three simultaneous lymphoproliferative disorders: hairy cell leukemia, monoclonal B-cell lymphocytosis, and CD4(++) /CD8(+/- dim) T-large granular lymphocytosis--a case report

The simultaneous diagnosis of hairy cell leukemia and monoclonal B-cell lymphocytosis with the characteristics of "indolent" chronic lymphocytic leukemia is rare but not unknown. However, an association with a third clonal lymphoproliferative disorder has not previously been described. We report the simultaneous presence of hairy cell leukemia, monoclonal B-cell lymphocytosis, and alpha beta CD4(++) /CD8(+) T-cell large granular lymphocytosis in a 63-year-old man. After the diagnosis, the three lymphoproliferative disorders (i.e., two of B-cell lineage and one of T-cell lineage) were characterized by analysis of multiple sequential bone marrow and peripheral blood samples using flow cytometry and molecular techniques. We discuss these findings in the context of chronic antigen stimulation, immunosuppression, and apoptotic pathway alterations, which might be implicated in the accumulation of these abnormal clones in the same patient. Because the phenotype of the three clones is compatible with fully differentiated B lymphocytes (consistent with a postgerminal origin) and T-CD4(++) cells, we favor the possibility of an antigen-driven mechanism and a dysregulation of homeostatic apoptosis in this patient.

Predicting mortality in hospitalized patients with 2009 H1N1 influenza pneumonia

BACKGROUND

Community-acquired pneumonia (CAP) severity scores can identify patients at low risk for mortality who may be suitable for ambulatory care. Here, we follow the clinical course of hospitalized patients with CAP due to 2009 H1N1 influenza.

OBJECTIVE

To evaluate the role of CAP severity scores as predictors of mortality.

METHODS

This was a secondary data analysis of patients hospitalized with CAP due to 2009 H1N1 influenza confirmed by reverse transcriptase polymerase chain reaction enrolled in the CAPO (Community-Acquired Pneumonia Organization) international cohort study. CAP severity scores PSI (Pneumonia Severity Index), CURB-65 (confusion, urea, respiratory rate, blood pressure, age ≥ 65 years) and CRB-65 (confusion, respiratory rate, blood pressure, age ≥ 65 years) were calculated. Actual and predicted mortality rates were compared. A total of 37 predictor variables were evaluated to define those associated with mortality.

RESULTS

Data from 250 patients with CAP due to 2009 H1N1 influenza were analyzed. Patients with low predicted mortality rates (0-1.5%) had actual mortality rates ranging from 2.6% to 17.5%. Obesity and wheezing were the only novel variables associated with mortality.

CONCLUSIONS

The decision to hospitalize a patient with CAP due to 2009 H1N1 influenza should not be based on current CAP severity scores, as they underestimate mortality rates in a significant number of patients. Patients with obesity or wheezing should be considered at an increased risk for mortality.

Prostaglandin EP2 receptor expression is increased in Barrett's oesophagus and oesophageal adenocarcinoma

BACKGROUND

Accumulating evidence suggests that cyclooxygenase-2 (COX-2)-derived prostaglandin E2 (PGE2) is involved in oesophageal adenocarcinogenesis. PGE2 exerts its biological action by binding to specific receptors (EP1, EP2, EP3 and EP4).

AIM

To investigate which PGE2 receptor subtypes regulate PGE2 signals in the oesophageal adenocarcinoma sequence.

METHODS

Expression was determined in oesophageal biopsies from 85 patients with oesophagitis, Barrett's metaplasia, intraepithelial neoplasia, oesophageal adenocarcinoma and normal oesophagus. Levels of mRNA and protein expression were determined by quantitative PCR, immunohistochemistry and western-blot. Expression of EP receptors was also determined in response to acid and bile exposure in the Barrett's adenocarcinoma cell line OE33.

RESULTS

All four EP receptors subtypes were expressed in human oesophageal tissues. COX-2 and, especially, EP2 were increased in the Barrett's metaplasia-intraepithelial neoplasia-adenocarcinoma sequence. Expression of the EP4 receptor protein was increased in oesophageal adenocarcinoma. In contrast, expression levels of COX-1 and EP3 receptor were decreased along the sequence. No differences in EP1 expression were found. Treatment with the bile acid deoxycholate increased COX-2, EP1, EP2 and EP4 expression in OE33 cells.

CONCLUSIONS

Our data suggest that in addition to COX-2, EP2 and EP4 receptors could be a selective target in the prevention and/or treatment of the Barrett's-associated adenocarcinoma.

First Report of Late Blight Caused by Phytophthora infestans on Cape Gooseberry (Physalis peruviana) in Colombia

Late blight caused by Phytophthora infestans is the most limiting disease for several species of the Solanaceae family in Colombia. A potential host for P. infestans is Cape gooseberry (Physalis peruviana), a species belonging to the Solanaceae family. Its center of origin is the highlands of Peru and it is grown at approximately 1,500 to 3,000 m above sea level. Cape gooseberry has become an important export fruit in Colombia. Consequently, in the last few years, the area cultivated with Physalis peruviana has increased dramatically. P. infestans was isolated from this crop in the province of Cundinamarca, Colombia. Symptoms caused by this oomycete appeared initially on the leaf margins as small, irregular, necrotic spots that expanded and merged, increasing the necrotic area. These spots had a soft texture resulting from the degradation of plant tissue by the pathogen. On old lesions, white mycelia and sporangia were observed. Affected plants were rarely killed, but under favorable conditions, severe symptoms were observed in leaves and yield was reduced. Ten isolates were obtained from infected tissue by placing a lesion directly on a potato slice in a moist chamber (2). Mycelia grown on the potato slice were then transferred to rye agar. Identification of the pathogen was performed based on morphological characteristics, specifically, sporangiophores of P. infestans are compoundly branched and develop sympodially, with swellings at the points where sporangia were attached (1). Further confirmation was obtained by sequencing the internal transcribed spacer (ITS) regions (GenBank Accession Nos. EF173467-EF173476). Koch's postulates were completed in the laboratory by spray inoculating detached leaves of Cape gooseberry with a zoospore suspension obtained from each of the 10 isolates. Inoculum was prepared by flooding 10-day-old cultures with sterile distilled water to obtain a 10⁴/ml sporangial suspension followed by zoospore induction at 4°C. Leaves were sprayed with this suspension, placed in moist chambers, and incubated at 20°C in the dark. Control leaves were sprayed with sterile distilled water. Two separate leaves were inoculated with each isolate. The pathogen was reisolated from leaf lesions in all cases. The period between infection and the appearance of symptoms ranged from 5 to 7 days. To our knowledge, this is the first report of P. infestans causing damage on Cape gooseberry in Colombia. Chemical control measures are to some extent successfully applied in most regions where solanaceous crops are grown in Colombia. Nevertheless, suitable disease management for Physalis peruviana has not been achieved and further studies on the epidemiology of the disease on this new host are needed. References: (1) D. C. Erwin and O. K. Ribeiro. Phytophthora Diseases Worldwide. The American Phytopathological Society. St. Paul, MN, 1996. (2) G. A. Forbes et al. Phytopathology 87:375, 1997.

Relationship between dental caries experience (DMFS) and dental fluorosis in 12-year-old Puerto Ricans

OBJECTIVES

Examine the relationship between (1) DMFS and community fluorosis index (CFI) scores, and (2) between individual DMFS and NIDR/Dean Index fluorosis scores.

DESIGN

Population-based, cross-sectional study.

SETTING

Public and private schools of Puerto Rico.

SUBJECTS

1435, 12-year old students.

METHOD

A probabilistic stratified sample was selected from 11 regions of Puerto Rico, according to type of school (public and private), and setting (urban and rural). Children were examined using NIDR criteria for DMFS and fluorosis. Regressions examined the relationship between DMFS means and CFI scores. Individual level DMFS was regressed on NIDR/Dean Index scores to test for linear and deviation from linear trends.

RESULTS

(1) There was no statistically significant relationship between regional DMFS and CFI scores, and (2) individual level fluorosis scores when dichotomized as 0-2 as the referent level to level 3-4 demonstrated a statistical significant higher DMFS with the higher fluorosis level. Gender and school setting were statistically significant in all models: females and public school attendance were associated with increased DMFS.

CONCLUSION

No ecological relationship between CFI and DMFS scores was found in 12-year-old children in Puerto Rico. Moderate and severe fluorosis were associated with higher DMFS levels relative to lower fluorosis scores, though this finding may be associated with restorations placed for cosmetic reasons. While controlling severe fluorosis is desirable, this will have little impact on overall high caries in Puerto Rican children. These findings suggest caution when interpreting caries experience using the DMFS index in populations with differing fluorosis levels.

TGFB1 gene polymorphisms: their relevance in the susceptibility to Helicobacter pylori-related diseases

Recent studies have revealed elevated expression of transforming growth factor beta1 (TGF-beta1) in gastric mucosa of patients with gastric cancer (GC) and those undergoing ulcer repair. As production of TGF-beta1 is genetically regulated, we aimed to assess whether functional polymorphisms of the TGFB1 gene are involved in susceptibility to and clinical characteristics of Helicobacter pylori-related diseases. DNA from 142 unrelated Spanish patients with GC, 200 with peptic ulcer and 342 healthy controls was typed for the MspA1I T+869C, and the Sau96I G+915C polymorphisms of the TGFB1 gene using polymerase chain reaction and RFLP analysis. H. pylori infection and CagA/VacA antibody status were determined by Western blot in patients and controls. H. pylori infection (odds ratio (OR): 11.44; 95% confidence interval (CI): 4.45-29.42; P<0.001) and non-steroidal anti-inflammatory drugs (OR: 5.07; 95% CI: 2.53-10.16; P<0.001) were identified as independent risks factors for duodenal ulcer (DU), whereas the TGFB1+869(*)C/C genotype was associated with reduced risk of developing the disease (OR: 0.32; 95% CI=0.15-0.68; P=0.003). Our results show that the TGFB1 T+869C gene polymorphism is involved in the susceptibility to DU and provide further evidence that host genetic factors play a key role in the pathogenesis of H. pylori-related diseases.

Metabolism of steroid hormones by Taenia solium and Taenia crassiceps cysticerci

Previous in vitro experiments showed that both, Taenia crassiceps and Taenia solium cysticerci have the ability to metabolize exogenous androstenedione to testosterone. Here we evaluate on the capacity of both cysticerci to synthesize several sex steroid hormones, using different hormonal precursors. Experiments using thin layer chromatography (TLC) showed that both cysticerci were able to produce (3)H-hydroxyprogesterone, (3)H-androstenedione and (3)H-testosterone when (3)H-progesterone was used as the precursor. They also synthesized (3)H-androstenediol and (3)H-testosterone when (3)H-dehydroepiandrosterone was the precursor. In addition, both cysticerci interconverted (3)H-estradiol and (3)H-estrone. These results, strongly suggest the presence and activity of the Delta4 and Delta5 steroid pathway enzymes, 3beta-hydroxysteroid dehydrogenase/Delta(5-4) isomerase-like enzyme (3beta-HSD), that converts androstenediol into testosterone; and the 17beta-hydroxysteroid dehydrogenase that interconverts estradiol and estrone, in both types of cysticerci.

Development of the high spatial resolution EMICAT2000 emission model for air pollutants from the north-eastern Iberian Peninsula (Catalonia, Spain)

Ozone (O(3)) pollution episodes take place in Catalonia (NE of the Iberian Peninsula), mainly during summertime. The complex O(3) behaviour could be understood by using a Chemical Transport Model (CTM). Emission inventories provide the spatial and temporal emissions distribution of the O(3) precursors and other pollutants required by this approach. We developed the EMICAT2000 model with high spatial (cells of 1 km(2)) and temporal (1h) resolutions, to estimate the emissions during the year 2000 from Catalonia. Total annual emissions were 107 kt yr(-1) of NO(x), 137 kt yr(-1) of NMVOC, 267 kt yr(-1) of CO, 65 kt yr(-1) of SO(2), 24 kt yr(-1) of TSP and 32,175 kt yr(-1) of equivalent CO(2). Main NO(x) sources are on-road traffic (58%) and industries (38%). Main NMVOC sources are on-road traffic (36%), vegetation (34%) and use of solvents (13%). Speciation was established according to the Carbon Bond IV mechanism. EMICAT2000 generates directly the data files required for the third generation CTM Models-3/CMAQ.

Taenia solium cysticerci synthesize androgens and estrogens in vitro

Cysticerci from Taenia solium develop in the pig muscle and cause severe diseases in humans. Here we report on the capacity of T. solium cysticerci to synthesize sex steroid hormones. T. solium cysticerci were dissected from infected pork meat. Parasites were incubated for different periods in culture media plus antibiotics and tritiated steroid precursors. Blanks and parasite culture media were extracted and analyzed by thin-layer chromatography (TLC) in two different solvent systems. In some experiments, the scoleces were incubated separately. Results showed that T. solium cysticerci transform [(3)H]androstenedione to [(3)H]testosterone in a time-dependent manner. The production was confirmed in two different solvent systems. The incubation with [(3)H]testosterone yielded only small amounts of [(3)H]androstenedione. The recrystallization procedure further demonstrated that the metabolite identified by TLC was testosterone. The isolated scoleces incubated in the presence of [(3)H]androstenedione yielded [(3)H]testosterone and small quantities of [(3)H]17beta-estradiol. The results reported here demonstrate that T. solium cysticerci have the capacity to synthesize steroid hormones.

[Prospective monitoring of vascular access in hemodialysis by means of a multidisciplinary team]

PURPOSE

Nowadays, expert guidelines recommend the monitoring programs of the vascular access (VA) by a multidisciplinary team.

MATERIAL AND METHOD

We present the experience over the last five years, of a prospective VA surveillance by a multidisciplinary team. The quality indicators reached are described as the associated factors for survival of the new VA.

RESULTS

Three hundred seventeen VA have been studied, 73% were arteriovenous fistulas(AVF) and the rest were polytetrafluoroethylene (PTFE) grafts at 282 patients. The main causes of dysfunctions were elevated dynamic venous pressure (42.5%) and the decreased blood flow (36.4%) with a 88% of positive predictive value. Over the 5 years there was 88 thrombosis (24 AVF and 64 PTFE grafts), that means a hazard thrombosis global rate of 0.15 access/year, which were distributed in 0.06 for AVF and 0.38 in PTFE grafts. Two hundred and one repairs of VA were done: 66.6% were elective repair after a proper review by the multidisciplinary team and the rest of them were done after the AV thrombosis happened. Urgent rescue surgeries were done in 76% of the thrombosis. 62.5% of the patients did not need a catheter after vascular access thrombosis. The complication relation with AVF and PTFE were 11.4% of the total patients hemodialysis hospitalizations. 65.2% of the VA were new access. 57% of patients were properly reviewed in the pre-dialysis unit at least once and 80% of them start haemodialysis with a mature access. The average survival (Kaplan Meier) of the new AVF was 1,575+/-55 days vs 1,087+/-102 of the PTFE grafts (p < 0.008). The survival after 1, 2 and 3 years for the AVF was 89%, 85% and 83% and for the PTFE graft 3% 67% and 51% respectively. The Cox regression has proved that the type of vascular access is the strongest factor associated to VA survival. The survival added of VA repaired due to dysfunction was 1,062 +/- 97 days vs 707 +/- 132 due to thrombosis, log rank 5.17 (p < 0,02). The increasing risk of those repaired after a thrombosis vs dysfunction is 4.2 p < 0,01.

CONCLUSIONS

The monitoring of the vascular access by a multidisciplinary team has reached:low rate of thrombosis, high elective number of repairs of the VA, high urgent rescue surgery after a thrombosis and a few number catheter needed and hospitalizations. AVF are associated with greater survival than PTFE. The VA repair due to dysfunction vs thrombosis had a greater survival as well.

Specific dose-dependent damage of Lieberkühn crypts promoted by large doses of type 2 ribosome-inactivating protein nigrin b intravenous injection to mice

Nigrin b is a non-toxic type 2 ribosome-inactivating protein as active as ricin at ribosomal level but 10(5) and 5 x 10(3) times less toxic for animal cell cultures and mice, respectively, than ricin. The purpose of the present study was to analyze the effects of intravenous injection of large amounts of nigrin b to the mouse. Injection through the tail vein of 16 mg/kg body weight killed all mice studied before 2 days. Analysis of several major tissues by light microscopy did not reveal gross nigrin b-promoted changes, except in the intestines which appeared highly damaged. As a consequence of the injury, the villi and crypt structures of the small intestine disappeared, leading to profuse bleeding and death. In contrast, intravenous injection of 5 mg/kg body weight was not lethal to mice but did trigger reversible toxic effects. In both cases, lethal and sub-lethal doses, the target of nigrin b appeared to be the highly proliferating stem cells of the intestinal crypts, which had undergone apoptotic changes. In contrast to nigrin b, the injection of 3 mug/kg of ricin kills all mice in 5 days but does not trigger apoptosis in the crypts. Therefore, the effect seen with sub-lethal nigrin b concentrations seems to be specific. Nigrin b killed COLO 320 human colon adenocarcinoma cells with an IC(50) of 3.1 x 10(-8) M and the effect was parallel to the extent of DNA fragmentation of these cells. Accordingly, despite the low general toxicity exerted by nigrin b as compared with ricin, intravenous injection of large amounts of nigrin b is able to kill mouse intestinal stem cells without threatening the lives of the animals, thereby opening a door for its use for the targeting of intestinal stem cells.

High variability of chloroplast DNA in three Mediterranean evergreen oaks indicates complex evolutionary history

Chloroplast DNA variation was studied in three evergreen Quercus species (Q. suber L., Q. ilex L. and Q. coccifera L.) from the Western Mediterranean Basin using PCR-RFLP. We studied five primer pair/enzyme combinations, four of them previously used in other European Quercus, obtaining a large number of haplotypes (81) grouped in three main types (suber type, ilex-coccifera I type and ilex-coccifera II type). Such level of haplotype diversity is higher than previously reported for the genus. Remarkable differences in haplotype richness between species have been found. Q. ilex and Q. coccifera usually share the same haplotypes, while a number of Q. suber populations possesses variants of the ilex-coccifera I type. This fact is interpreted as a result of genetic introgression between Q. suber and Q. ilex. Reproductive factors that could determine this exchange are discussed, as well as the influence of different species histories on the present structure of evergreen Quercus in the Western Mediterranean Basin.

Promyelocytic leukemia (PML) nuclear bodies are disorganized in colorectal tumors with total loss of major histocompatibility complex class I expression and LMP7 downregulation

The promyelocytic leukemia (PML) protein is the product of the PML gene that fuses with the retinoic acid receptor-alpha (RARalpha) gene in acute promyelocytic leukemia (APL) and produces disruption of PML bodies. Wild-type PML localizes in the nucleus with a typical speckled pattern. PML bodies accumulate several proteins involved in multiple cellular pathways such as apoptosis, transcriptional regulation, and proteasomal degradation of ubiquitinated proteins. The ubiquitin-proteasome pathway at PML bodies is dependent on proteasome component recruitment. Proteasome components such as low-molecular weight proteins (LMPs) are frequently downregulated in different tumor tissues that present impaired major histocompatibility complex (MHC) class I expression. We have recently documented LMP7 downregulation in colorectal tumors with total loss of MHC class I antigen. An immunohistochemical study of PML protein in these tumors revealed a disrupted pattern of PML bodies in a nuclear diffuse form, as observed in APL cells. Therefore, the disruption of the PML bodies was clearly associated with LMP7 downregulation.

Air quality data from large cities

This paper presents an assessment of the air quality for the principal cities in developed and developing countries. Part of the vast and widely dispersed information on air quality that is available at this time on the Internet was compiled, thus making possible a comprehensive evaluation of the tendencies that emerged at the end of the 20th century. Likewise, these values are compared to the air quality thresholds recommended by two international organizations: guideline levels of the World Health Organization (WHO) and limit values of the European Union (EU), in order to determine air quality concentration levels in large cities around the world. The current situation of air quality worldwide indicates that SO(2) maintains a downward tendency throughout the world, with the exception of some Central American and Asian cities. NO(2) maintains levels very close to the WHO guideline value around the world. For particulate matter, it is a major problem in almost all of Asia, exceeding 300 microg/m(3) in many cities. Ozone shows average values that exceed the selected guideline values in all of the analyses demonstrating that it is a global problem. In general, the worldwide trend is to a reduction in the concentrations of pollutants because of the increasingly strong restrictions which local governments and international organizations impose. However, in poor countries and those with low average incomes, concentrations of air pollutants remain high and the trend will be the elevation of their ground levels as they develop, making the problem even worse.

Total loss of MHC class I in colorectal tumors can be explained by two molecular pathways: beta2-microglobulin inactivation in MSI-positive tumors and LMP7/TAP2 downregulation in MSI-negative tumors

The mechanisms that lead to loss of MHC class I expression in different types of tumors are not yet fully known. Accordingly, we studied colorectal carcinomas to elucidate the specific mechanisms of evasion of the T-cell immune response. We selected tumors with total loss of MHC class I expression and studied 124 colorectal carcinomas with immunohistochemical staining and anti-HLA monoclonal antibodies (mAb). Fourteen of 124 (11%) tumors exhibited a phenotype with HLA class I total loss. Microsatellite instability (MSI) analysis was also carried out in the same tumor samples. The expression of beta2-microglobulin (beta2m), HLA-A, B, and C antigens, transporter associated with antigen processing 1 (TAP1), TAP2, low-molecular-weight protein 2 (LMP2), and LMP7 were analyzed using reverse-transcription polymerase chain reaction (RT-PCR) in microdissected tumor samples. Four of 14 microsatellite instability-positive (MSI+) and W6/32 mAb-negative tumors showed biallelic inactivation of beta2m and accumulation of HLA class I heavy chain in the cytoplasm. MSI-negative (MSI-)/W6/32 mAb-negative tumors presented alterations in the expression of components of the antigen processing machinery (APM). Nine of 10 tumor samples showed LMP7 gene downregulation, and four of 10 presented TAP2 dysregulation. This group apparently expressed normal levels of heavy chain and beta2m mRNA. Two major mechanisms in colorectal cancer appear to be responsible for the total loss of MHC surface expression (beta2m mutations and LMP7/TAP2 downregulation) that may contribute to the failure of T lymphocyte recognition during an immune response. The precise identification of the molecular defects that underlie HLA class I abnormalities will have important implications for patients receiving T-cell-based specific immunotherapy.

Evidence for distinct cellular internalization pathways of ricin and nigrin b

Nigrin b and ricin are type 2 (two chain) ribosome-inactivating proteins that exhibited nearly the same strong inhibitory activity on cell-free protein synthesis. Incubation of HeLa cells for 6 hr with ricin at 37 degrees C promoted protein synthesis inhibition with an IC50 of 0.2 ng/ml. Incubation of the cells for 6 hr at 18 degrees C abolished completely the inhibition. Incubation of HeLa cells with nigrin b for 6 hr at 37 degrees C was nearly 10(5) times less inhibitory than ricin. In contrast to the effects observed with ricin, incubation of HeLa cells with nigrin b at 18 degrees C slightly increased the inhibitory action on protein synthesis as compared with incubation at 37 degrees C. These results strongly support the hypothesis that the internalization of ricin and nigrin b could involve different receptors and therefore they could follow different intracellular pathways.

[Prolonged clinical pattern of brain death in patients under barbiturate sedation: usefulness of transcranial Doppler]

INTRODUCTION

Throughout the world, is fully accepted that a person is dead when brain death exists. In most situations, neurological criteria permit the diagnosis of brain death, but in some instances, as when high-dose barbiturate therapy has been used, confirmatory testing are required by law.

CLINICAL CASE

We report the case of a 17 year-old women who suffered high-dose barbiturate therapy due to post traumatic intracranial hypertension. During the period of the barbiturate infusion and until six days after the suppression of this therapy, neurological exploration and EEG findings seem to confirm brain death, while transcranial Doppler (TCD) study remained normal.

CONCLUSIONS

TCD is a fast, simple and accurate confirmatory testing in the determination of brain death and its findings are not affected by high-dose barbiturate therapy. We think that TCD must be present in all hospitals where mechanical ventilation and support of patients are carried out.

Calorimetric and computational study of 1,3,5-trithiane

To understand the differences in conformational behavior and reactivity of oxygen- and sulfur-containing 1,3,5-heterocyclohexanes, the enthalpies of formation and sublimation of 1,3,5-trithiane, 1, have been measured. The numerical value of the enthalpy of formation for this compound in the solid state is -8.6 +/- 2.6 kJ mol(-1), while the corresponding value in the gaseous state is 84.6 +/- 2.6 kJ mol(-1). The value for the enthalpy of sublimation is 93.2 +/- 0.2 kJ mol(-1). Standard ab initio molecular orbital calculations at the G2(MP2), G2, and G3 levels were performed, and the calculated enthalpies of formation are compared with the experimental data. These experimental and theoretical studies support the relevance of through-space lone pair-lone pair electronic repulsion in the sulfur heterocycle.

Sensitivity of cancer cell lines to the novel non-toxic type 2 ribosome-inactivating protein nigrin b

The cytotoxicity of the type 2 ribosome-inactivating proteins (RIPs) ricin and nigrin b was determined in a variety of cancer cells. Nigrin b, considered to be a novel non-toxic type 2 RIP as compared with ricin, was approximately 10(4)-10(5) times less toxic than ricin in all cancer cells studied, with the exception of melanoma cells. Cancer cells displayed considerable heterogeneity in their sensitivity to ricin, melanoma cells being the least sensitive. Rabbit polyclonal anti-nigrin b antibodies did not cross-react with ricin as analyzed by enzyme-linked immunosorbent assays. The low non-specific toxicity of nigrin b as compared with that of ricin and the lack of immunological cross-reaction between anti-nigrin b antibodies and ricin supports the use of nigrin b in the construction of cytotoxic conjugates as an alternative to ricin when anti-ricin antibodies are produced during cancer therapy.

[Mammary carcinoma ine ectopic breast tissue. A case report]

Ectopic breast tissue, that includes supernumerary breasts and aberrant breast tissue, develops along the mammary line. Malignancies rarely develop in this tissue. We report a 44 years old female subjected to a resection of a 3 cm Ø tumor located 2 cm below the right lower mammary sulcus. The pathological study reported an infiltrating ductal carcinoma. The patient was operated again and a metastatic carcinoma was detected in three resected axillary lymph nodes. Adjuvant chemotherapy and radiotherapy was indicated.

[Contribution to knowledge about the permanence and circulation of poliovirus vaccine in the environment]

The erradication of poliomyelitis in the world is a goal that requires the adoption of effective and safe strategies for its attainment. Knowing how long the strains of poliovirus derived from the oral attenuated virus vaccine may circulate and remain in the environment was essential to define the measures to be taken and was also the objective of our paper. Specimens of stools and sewage water, which were weekly obtained at the end of the National Polio Vaccination Campaign, in 1998, were analyzed. Viruses were isolated and identified by culture and neutralization tests for the identification of poliovirus. In the particular case of the sewage water, it was also used the polymerase chain reaction. The curves of elimination in both media were drawn and it was concluded that the permanence of viruses in the environment did not exceed the 12 weeks after the immunization with the oral attenuated virus vaccine.

[Isolated ventricular diverticulum in asymptomatic male]

Ventricular diverticulum are small outpouchings, in the cardiac wall, which are mostly described as a part of malformation syndromes. This finding is infrequent in asymptomatic patients with no pathology in the thoraco abdominal line. The case we present shows a diverticulum in the cardiac apex in a male patient with no cardiological clinic manifestations and with an abnormal electrocardiogram. At present, magnetic resonance is the best diagnostic test, for this kind of malformation, and is also the most reliable in the follow-up of these patients.

[Esophageal fibrovascular polyp: report of 2 cases]

Fibrovascular esophageal polyps are benign intraluminal tumors that, although of slow growth, may become large. We describe the features of two cases, diagnosed in our department, and emphasize the endoscopic aspects of the lesion.