Import of Aspartate and Malate by DcuABC Drives H2/Fumarate Respiration to Promote Initial Salmonella Gut-Lumen Colonization in Mice.

Initial enteropathogen growth in the microbiota-colonized gut is poorly understood. Salmonella Typhimurium is metabolically adaptable and can harvest energy by anaerobic respiration using microbiota-derived hydrogen (H2) as an electron donor and fumarate as an electron acceptor. As fumarate is scarce in the gut, the source of this electron acceptor is unclear. Here, transposon sequencing analysis along the colonization trajectory of S. Typhimurium implicates the C4-dicarboxylate antiporter DcuABC in early murine gut colonization. In competitive colonization assays, DcuABC and enzymes that convert the C4-dicarboxylates aspartate and malate into fumarate (AspA, FumABC), are required for fumarate/H2-dependent initial growth. Thus, S. Typhimurium obtains fumarate by DcuABC-mediated import and conversion of L-malate and L-aspartate. Fumarate reduction yields succinate, which is exported by DcuABC in exchange for L-aspartate and L-malate. This cycle allows S. Typhimurium to harvest energy by H2/fumarate respiration in the microbiota-colonized gut. This strategy may also be relevant for commensal E. coli diminishing the S. Typhimurium infection.

New horizons in anticoagulation: Direct oral anticoagulants and their implications in oral surgery.

BACKGROUND: Thrombotic disorders remain a leading cause of death in the Western World. For decades, vitamin K antagonists used in the prevention of this pathology, such as warfarin or sintrom, were the only oral agents available for long-term anticoagulation, in spite of their disadvantages. MATERIAL AND METHODS: An electronic database search was carried out on MedLine and The Cochrane Library Plus, without restrictions on the type of study nor dates, in English and Spanish. Abstracts were reviewed, and complete articles if necessary, considering all articles that included recommendations on DOACs and oral surgery. RESULTS: In recent years, the so-called "new oral anticoagulants" have been introduced in clinical practice to treat those patients whose medical conditions require long-term anticoagulant treatment, replacing traditional oral anticoagulants. CONCLUSIONS: The new oral anticoagulants represent new therapeutic options, with a number of advantages such as poor interaction with food, minor drug interactions, and do not require periodic dose adjustments or routine controls. The purpose of this review is to establish an update on the new oral anticoagulants: Dabigatran, Rivarozaban, Apixaban and Edoxaban.

[Axillary approach for surgical closure of atrial septal defect]. / Incisión axilar para el cierre quirúrgico de la comunicación interauricular.

Mid-line sternotomy is the routine approach for surgical repair of congenital heart diseases. However, its noticeable scar is a constant reminder of having undergone heart surgery. Several alternative approaches have been developed for simple cardiac conditions to hide the scar. Our series, consisting of 26 patients with axillary closure of atrial septal defect, is presented. The median age was 5.45 years (range 3-13), and median weight was 19.84 Kg. (range 13-37). The defect was closed directly in 13 cases, and with an autologous pericardial patch in the other 13. The number of surgical steps and time taken were the same as in median sternotomy. Functional recovery, intensive care unit stay, and hospital discharge were also standard. The cosmetic result, assessed both by patients and relatives, was excellent.

Rapid monitoring of Escherichia coli and Enterococcus spp. in bathing water using reverse transcription-quantitative PCR.

For accompanying actions to pollution crisis management of recreational waters, rapid methods providing a quantified faecal indicator which can be completed in less than half a day, are currently needed. Two sensitive rRNA-targeted Reverse Transcription-quantitative PCR (RT-qPCR) methods were developed for quantifying Escherichia coli and Enterococcus spp. cells in marine bathing waters. Threshold cycle (Ct) values were found to be linear with a target quantity over a 4log dynamic range (from 10(5) to 100 cell equivalents per 100ml). In order to confirm the scope of application of such alternative methods, 80 and 85 seawater samples from the Atlantic Ocean and Mediterranean sea were analysed by both RT-qPCR and ISO culture-based methods for E. coli and Enterococcus spp. enumerations. This study demonstrates that by giving reliable results in 3h, the RT-qPCR method has high potential as a rapid test for recreational water quality monitoring. In natural waters, significant linear log-log relations between the RT-qPCR and culture method measurements for E. coli and Enterococcus spp. assays were shown (correlation coefficient (r) values of 0.814 and 0.715, p<0.0001, respectively). The sensitivities (defined as the probability of a sample testing positive if the criterion number is exceeded) of RT-qPCR for E. coli and Enterococcus spp. were respectively 94.4% and 83.9%. By contrast, specificities (defined as the probability of a test being negative if a contamination is truly absent) could be considered as lower (65.9% and 50.0% for E. coli and Enterococcus spp.). This reflects that RT-qPCR assays detect all viable cells (culturable and non-culturable) whereas culture methods only detect cells which are viable and culturable.

Effect of interferon alpha-2b on endometrioma cells in vitro.

OBJECTIVE: To examine the effect of interferon alpha-2b on the growth of endometrioma cells and its effect on the DNA synthesis. METHODS: Cells from four separate endometrioma cell lines were seeded into six-well plates in M199 medium containing increasing levels of interferon alpha-2b: 0 (control), 50, 100, 500, 1000, and 2000 U/mL. All cells were counted on days 0, 3, 6, and 9 in quadruplicate, and the counts were averaged for each condition. A second experiment was run to demonstrate the effect of short-term exposure of interferon alpha-2b on the growth of endometrioma cells in culture. In a separate experiment, cells from two endometriomas were plated in quadruplicate to evaluate the DNA synthesis. On day 3, 1000 and 4000 U/mL of interferon alpha-2b were added and run simultaneously with control (0 U/mL) wells. 3H-thymidine was added to each condition for 24 and 48 hours' incubation. Cells were then harvested and counted in a scintillation counter to study the 3H-thymidine uptake. RESULTS: Interferon alpha-2b suppressed endometrioma cell growth in vitro. This effect increased with increasing concentrations of interferon alpha-2b (50-2000 U/mL) compared with the control (0 U/mL). The suppression of cell growth was statistically significant, but when interferon alpha-2b was removed from the culture cell growth increased. 3H-thymidine uptake by endometrioma cells decreased compared with the control after 24 and 48 hours for interferon alpha-2b concentrations of 1000 and 4000 U/mL, respectively. CONCLUSION: Interferon alpha-2b inhibits the growth and DNA synthesis of endometrioma cells in culture. This finding may have prospects for the treatment of endometriosis.

Effects of chocolate cyst fluid on endometrioma cell growth in culture.

OBJECTIVE: To evaluate the effect of chocolate cyst fluid on the proliferation of cultured human endometrioma cells and to assay the concentration of transforming growth factor-B1 in this fluid. DESIGN: Controlled in vitro study. SETTING: Department of Obstetrics and Gynecology, State University of New York Health Science Center. PATIENT(S): Five women with ovarian endometriomas. INTERVENTION(S): Endometrioma tissue and chocolate fluid from five different patients were entered in this study. MAIN OUTCOME MEASURE(S): Endometrioma cell proliferation in culture with and without chocolate cyst fluid. RESULT(S): Chocolate cyst fluid increased the proliferation of endometrioma cells compared with controls. Also, high concentrations of transforming growth factor-B1 were found in cysts' fluid. CONCLUSIONS: Chocolate cyst fluid has a growth-enhancing effect on endometrioma cells. One promoting growth factor is transforming growth factor-B1.

The role of estradiol, progesterone, and transforming growth factor on human endometrioma cell culture.

The present study demonstrates several aspects of endometrioma cells in culture, namely, 1) cell growth, proliferation, and morphology, 2) effect of cell culture on estrogen and progesterone receptor concentration, 3) effect of estradiol, progesterone, and transforming growth factor. The tissue sample was obtained from ovarian endometriomas that were removed via laparotomy or laparoscopy. The tissue sample was digested with collagenase. After washing, the tissue was cultured in endothelial cell culture medium. Cell count was done by flow cytometry. Receptor study was done by immunohistochemistry. The results demonstrated the growth and proliferation of endometrioma cell in culture medium. Electron microscopy showed stroma-like cells. The cells lost their estrogen and progesterone receptors. Estradiol and progesterone added to these cultures did not affect the rate of growth and proliferation of the cells. Transforming growth factor significantly increased the rate of growth and proliferation of these cells.

Respuesta simpática en piel en personas normales / Sympathetic skin response

La Respuesta Simpática en Piel (S.S.R), es un test simple, reproducible, de función de un reflejo polisináptico que tiene diversas vias aferentes a través de la Médula Espinal, fibras simpáticas pre y postganglionares y con las glándulas sudoríparas como efectoras. El reflejo es coordinado en el hipotálamo posterior o formación reticular del mesencéfalo. La Respuesta Simpática en piel ha sido usada en una variedad de desórdenes del sistema nervioso central y periférico. La S.S.R. se obtuvo en 25 personas normales con el objetivo de definir los parámetros de su respuesta. Se hizo estimulación eléctrica del nervio mediano en la muñeca, y la respuesta fué registrada de la mano opuesta. Se obtuvieron ondas bifásicas. La latencia al inicio del potencial en la mano fué de 1.465 +- 434,3 ms y la amplitud fué de 1.118+-488,9 uv. La fácil reproducibilidad de este test puede proveer un nuevo y confiable instrumento para el estudio del sistema nervioso autonómico.

The effect of CO2 laser laparoscopy for treatment of pelvic endometriosis on serum concentrations of antiendometrial antibodies.

This study uses antiendometrial antibodies as an indicator for follow-up of patients with endometriosis after surgical treatment. This is a prospective study of 32 patients with endometriosis. The patients were used as their own controls. Serum samples were obtained before surgery and 1 month, 3 months, and 6-9 months following surgery. All patients were treated with CO2 laser laparoscopy. Serum concentrations of antiendometrial antibodies decreased significantly at 1 month, 3 months, and 6-9 months following treatment in each group. There was no correlation between baseline concentration of antibodies and stage of the disease. This study confirms the value of using antiendometrial antibodies as an indicator for follow-up of endometriosis patients. Surgical treatment with CO2 laser laparoscopy is effective in lowering the antigenic effect of the disease in these patients. This beneficial effect is maintained for up to 9 months after treatment.

Argon laser laparoscopy for treatment of pelvic endometriosis associated with infertility and pelvic pain.

Argon laser laparoscopy was used for treatment of 46 patients with pelvic endometriosis. Infertility was the primary diagnosis in 31 patients, and pelvic pain was the primary diagnosis in 21 patients. A 600 mum laser fiber was used through the operative channel of the laparoscope, and the tip of the fiber was kept at a distance of 2-3 mm from the lesions. The power density used varied between 1604 and 1069 W/cm 2 at the tissue level. The pregnancy rate following treatment of the infertile group was 42%. Eighty-four percent of these pregnancies occurred within the first 8 months of treatment. In the group with pelvic pain, 8 patients experienced complete pain relief, and 13 patients experienced partial pain relief. Difficulties with the use of the fiber included breakage in 3 patients and melting of the fiber tip in 1 patient.

Endometrial antibodies in serum and peritoneal fluid of infertile patients with and without endometriosis.

Passive hemagglutination assay was used to evaluate endometrial antibodies in serum and peritoneal fluid of 37 patients with endometriosis and 54 patients without endometriosis. The results showed that the concentration of antibody titers in serum and peritoneal fluid was significantly higher for endometriosis than control patients. The severity of endometriosis has no effect on antibody concentration. Furthermore, the concentration of endometrial antibody titers was significantly higher in serum than peritoneal fluid of patients with endometriosis. These results suggest that serum endometrial antibody assay is specific and valuable for the diagnosis and progress of endometriosis.

The regulation of immunoglobulin production by B cells in patients with endometriosis.

Nineteen patients with endometriosis and 26 control infertile patients were included in the study. All patients were undergoing laparoscopy as part of their infertility evaluations. The study was conducted on sterile heparinized peripheral blood and peritoneal fluid. The age range was 20 to 37 years for both groups. Mononuclear cells were isolated on Ficoll-hypaque density gradients. T cells, B cells, and T cell subsets were identified by the specific immunobead rosette technique. Mononuclear cells 1 x 10(6) were cultured in Roswell Park Memorial Institute medium and stimulated in the presence or absence of pokeweed mitogen. Immunoglobulin production was measured by an enzyme-linked immunosorbent assay. Increased amounts of immunoglobulin (Ig) IgG and IgA were demonstrated in the peritoneal cell cultures (P less than 0.05), whereas peripheral blood cell cultures showed only an increase in IgG in patients with endometriosis (P less than 0.05). There was an increase in the number of T cells, B cells, and the ratio of CD4/CD8 lymphocytes in endometriosis compared with control patients (P less than 0.005) in both peritoneal fluid and peripheral blood. This study suggests that immunoglobulin production by the "activated" B cells may be regulated by the increased presence of T cells, specifically the helper cells (CD4) in endometriosis.

Loxocelismo: a proposito de un caso clinico / Loxoscelismo: aproposal of a clinical case

Loxoscelismo Laeta es una araña que está extendida en los valles del Rímac y Lurín. El Loxocelismo puede producir mortalidad de hasta 15%, cuando al cuadro de necrosis cutánea se asocia el síndrome viscerohemolítico. Se presenta el cuadro de un paciente de sexo femenino de 17 años de edad, procedente de zona urbana, quien sufre mordedura de araña en pabellon auricular izquierdo, el cual evolucionó a la necrosis. Se asocia insuficiencia respiratoria aguda que requirió ventilación asistida, e insuficiencia renal que -con hematuria, oliguria, y retención nitrogenada de 21 días- requirió diálisis peritoneal y hemodiálisis. La paciente recibió suero antiloxocélico a las 10 horas de la agresión pero no se logró evitar la necrosis ni el síndrome viscerohemolítico. A los 42 días se dio de alta a la paciente con recuperación total

Immune rosettes of T and B lymphocytes in infertile women with endometriosis.

We examined the cell-mediated immune response in women with pelvic endometriosis by quantitating their T and B lymphocytes. The study was conducted on heparinized peripheral blood and peritoneal fluid. The results were compared with those in a control group of women without evidence of endometriosis. Each patient underwent laparoscopy as part of her infertility evaluation. The ability of T cells to form rosettes with sheep erythrocytes was used to estimate the percentage of total and active T cells. B lymphocytes were quantitated by erythrocyte antibody complement binding capacity. In addition, T and B lymphocytes were assayed with the Immunobead technique using specific monoclonal antibodies. The helper T cell (T4) and suppressor T cell (T8) subsets of lymphocytes were evaluated with specific monoclonal antibodies coupled to microbeads. The results demonstrated an increased number of T and B cells in peritoneal fluid and peripheral blood from patients with endometriosis as compared with controls. Furthermore, the ratio T4:T8 was significantly increased in patients with endometriosis. These results suggest a cell-mediated immune response in the presence of endometriosis.

The effect of ethanol on the production of lactate, triglycerides, phospholipids, and free fatty acids in the perfused human placenta.

Eighteen fresh term placentas from normal deliveries were perfused to determine the biochemical response of the human placenta in the absence and presence of ethanol. The production rates were generally increased by ethanol administration; lactate, 22%; triglycerides, 49%; sphingomyelin, 362%; lecithin, 67%; lipid phosphorus, 780%; free fatty acids, 897%. Only the changes in lipid phosphorus and free fatty acids were significantly different (p less than 0.05). Glucose utilization rates were 600 and 551 mg per hour per placenta for eight control and 10 ethanol runs, respectively. The ethanol utilization rate was 442 mg per hour per placenta. Little difference in ultrastructural appearance between control and ethanol groups was observed at the level of ethanol administered. The general behavior of ethanol metabolism in human placenta seems qualitatively similar to that in the liver.