Identification and molecular characterization of a S. agalactiae strain lacking the capsular locus.

During a national surveillance program on Group B streptococci (GBS) maternal carriage and neonatal infections, a GBS strain isolated from a pregnant woman's vagino-rectal swab was non typable by either serological or molecular methods. Further molecular characterization demonstrated that the strain lacked the entire capsular locus, possibly by a recombination event that excised a 14,1 Kbase pairs genomic fragment extending from the regulatory protein cpsX gene to the neuA gene. The natural loss of the capsular locus by GBS isolated from a human has never been described so far. Such an event, while possibly a dead-end from the evolutionary point of view, leaves a still able-to-colonize organism unrecognizable by the vaccines currently under development.

Subducted organic matter buffered by marine carbonate rules the carbon isotopic signature of arc emissions.

Ocean sediments consist mainly of calcium carbonate and organic matter (phytoplankton debris). Once subducted, some carbon is removed from the slab and returns to the atmosphere as CO2 in arc magmas. Its isotopic signature is thought to reflect the bulk fraction of inorganic (carbonate) and organic (graphitic) carbon in the sedimentary source. Here we challenge this assumption by experimentally investigating model sediments composed of 13C-CaCO3 + 12C-graphite interacting with water at pressure, temperature and redox conditions of an average slab-mantle interface beneath arcs. We show that oxidative dissolution of graphite is the main process controlling the production of CO2, and its isotopic composition reflects the CO2/CaCO3 rather than the bulk graphite/CaCO3 (i.e., organic/inorganic carbon) fraction. We provide a mathematical model to relate the arc CO2 isotopic signature with the fluid-rock ratios and the redox state in force in its subarc source.

[French validation of the anger reactions and goals scale (RBC)]. / Validation française de l'échelle des réactions et des buts liés à la colère (RBC).

BACKGROUND: The study presents the French validation of a German scale (AERZ) [Diagnostica 49 (2003) 97-109, revised Eur J Pers (2009)] measuring anger regulation. The French validation (RBC scale) comprises two subscales measuring seven anger reactions and seven anger goals. Disentangling dimensions related to anger reactions and anger goals, respectively, is the main advantage of this scale. In addition to seven cognitive-behavioral anger reactions (i.e., venting, rumination, submission, feedback, distraction, humor and downplaying the incident's negative impact), the RBC scale also addresses the cognitive representations underlying anger reactions by exploring anger goals (i.e., enforcing personal standards, enforcing social standards, downregulating affect, avoiding conflicts, protecting one's reputation, weighing costs and gaining revenge). METHOD: The original scale was translated following the scientific guidelines and recommendations for cultural adaptation of instruments. The adapted French version was tested with a sample of students (n=184, 70.7% were females) from the University of Luxembourg (M=21.31, S.D.=1.93). Students filled in a questionnaire composed of the RBC scale, the SF-36 quality of life scale and the STAXI-II anger instrument. The RBC scale comprises 56 items; reactions are assessed on a 4 point Likert scale from "almost never" (1) to "always" (4), whereas goals are assessed on a 4 point Likert scale from "not at all" (1) to "completely" (4). RESULTS: Factor analysis revealed a seven-factor solution for the anger reactions subscale (that explained 63.13% of the common variance) and a six-factor solution for the anger goals subscale (that explained 57.45% of the common variance). The original factorial structure was examined in confirmatory factor analysis. For the anger reactions subscale, a good model fit was found, with chi(2)(329)=546.38, p<0.1, CFI=0.87, RMSEA=0.06. For the anger goals subscale, a satisfactory model fit was observed, with chi(2)(335)=658.52, p<0.1, CFI=0.78, RMSEA=0.07 revealing a six-factorial structure that differed from the original version in the combination of two dimensions ("downregulating affect" and "protecting one's reputation"). The RBC scale's internal consistencies were found satisfactory with Cronbach's alphas ranging from 0.60 to 0.83 for the various dimensions. Part-whole correlations ranged from r(it)=0.27 to 0.80. Gender differences showed that female participants used significantly more rumination strategies and emotional regulation, whereas male students demonstrated greater humor in anger situations. Significant correlations between RBC and STAXI-II confirmed the construct validity of the RBC scale. Criteria validity was analyzed using the predictive value of the RBC dimensions on the quality of life subscales of the SF-36. CONCLUSION: The present results support the validity, the reliability and the sensitivity of the 56 items scale on anger regulation and its use in psychological research. Although our findings need to be replicated and the test-retest validity is subject to future verification, the present validation of the RBC scale offers a multidimensional inventory for measuring anger reactions and anger goals. This inventory may be used, for example, as a diagnostic tool or for testing the effectiveness of anger management interventions.

Silicate dissolution boosts the CO2 concentrations in subduction fluids.

Estimates of dissolved CO2 in subduction-zone fluids are based on thermodynamic models, relying on a very sparse experimental data base. Here, we present experimental data at 1-3 GPa, 800 °C, and ∆FMQ ≈ -0.5 for the volatiles and solute contents of graphite-saturated fluids in the systems COH, SiO2-COH ( + quartz/coesite) and MgO-SiO2-COH ( + forsterite and enstatite). The CO2 content of fluids interacting with silicates exceeds the amounts measured in the pure COH system by up to 30 mol%, as a consequence of a decrease in water activity probably associated with the formation of organic complexes containing Si-O-C and Si-O-Mg bonds. The interaction of deep aqueous fluids with silicates is a novel mechanism for controlling the composition of subduction COH fluids, promoting the deep CO2 transfer from the slab-mantle interface to the overlying mantle wedge, in particular where fluids are stable over melts.Current estimates of dissolved CO2 in subduction-zone fluids based on thermodynamic models rely on a very sparse experimental data base. Here, the authors show that experimental graphite-saturated COH fluids interacting with silicates at 1-3 GPa and 800 °C display unpredictably high CO2 contents.

Neonatal protection and preterm birth reduction following maternal group B streptococcus vaccination in a mouse model.

PURPOSE: Evaluate effects of maternal immunization in a mouse model of Group B Streptococcus (GBS) vaginal colonization using clinical isolates. MATERIALS AND METHODS: Female pregnant mice were immunized with heat-killed GBS 21 days before pregnancy and were inoculated intravaginally with GBS cultures (5 × 107 CFU twice a day for three days) from the 16th day of pregnancy. Gestation period and mice survival were monitored. Maternal anti-GBS IgG levels have been determined by ELISA analysis in vaccinated, unvaccinated mothers and newborns. RESULTS: Maternal immunization before pregnancy provided protection to newborns for three of the four GBS strains used. Evaluation of the immunogenicity showed that this vaccination induced higher levels of IgG in vaccinated compared to unvaccinated dams and the presence of antibodies in the offspring at embryonic and postnatal age, and a Th1 response and high levels of IgG2a subclass antibody and IFN-γ were detected. A significant reduction of preterm births was observed in vaccinated mothers (p< 0.05). CONCLUSIONS: Our finding suggest that vaccinated mothers could protect their progeny from GBS infection and preterm birth through passive immunization. The proposed mouse model may represent a noninvasive and effective tool to investigate pathogenetic mechanisms of GBS ascending infection and for vaccine protection studies.

Virulence factors in enterococcal infections of orthopedic devices.

Enterococci are opportunistic pathogens which today represent one of the leading causes of nosocomial infections. We have examined a collection of 52 Enterococcus faecalis isolated from orthopedic infections to determine if they were characterized by a specific pattern of virulence factors. The isolates were evaluated for biofilm formation, presence of genes coding the enterococcal surface protein (esp) and gelatinase (gelE), as well as for gelatinase production. While the rate of esp-positive isolates was comparable to that found among strains from other clinical sources, we found a significantly higher rate of strong biofilm formers and gelatinase producers. Particularly high was the rate of gelE-carrying strains expressing the gene. Data suggest that these two factors in particular may play an important role in enterococcal infections associated with biomaterials.

Evaluation of the Two-Dimensional Performances of Low Activity Planar Catalysts: Development and Validation of a True Scanning Reactor.

The development of a scanning reactor for planar catalysts is presented here. With respect to other existing models, this reactor is able to scan catalysts even with low turnover frequencies with a minimum sensed circular area of approximately 6 mm in diameter. The downstream gas analysis is performed with a quaprupole mass spectrometer. The apparatus performances are presented for two different reactions: the hydrogenation of butadiene over palladium films and the oxidation of CO over a gold/titania catalyst. With the final setup, true scans in both X and Y directions (or even in a previously defined complex directional pattern) are possible within a scan speed ranging from 0.1 to 5.0 mm/min. Finally, this apparatus aims at becoming a valuable tool for high throughput and combinatorial experimentation to test patterned active surfaces and catalytic libraries.

A solid-phase enzyme immunoassay (EIA) for detection of HBeAg and anti-HBe.

A sensitive, reproducible and easily performed enzyme immunoassay (EIA) based on a sandwich technique is described for serological detection of HBeAg and anti-HBe. EIA appears to be 600 times more sensitive than immunodiffusion and counterimmunoelectrophoresis and its performance compares well with available radioimmunoassays.

Patients with chronic renal failure are not at a risk of developing chronic peptic ulcers.

This study reports the endoscopic and histological aspects of gastrointestinal mucosa in a consecutive series of 249 patients with chronic renal failure on conservative hemodialysis, who were awaiting renal transplantation. At endoscopy the mucosa was normal in 54.2% of the cases and revealed gross inflammatory changes in 34.1%. Duodenal ulcers were found in 11.2% of patients with only one gastric ulcer. Of the 28 duodenal ulcers, 16 were active and 12 inactive lesions. Gastric biopsies sampled from 44 non-ulcer patients showed signs of chronic gastritis in 29.6%, atrophic gastritis in 18.2, and reported normal in 52.3% of the cases. The above findings were not affected by the ages of patients or by the total duration of hemodialysis treatment. It is concluded that patients with chronic renal failure share the same risk of developing chronic peptic ulcers as the general population. Moreover, the overall endoscopic and histological appearance of the mucosa in these patients appears not to differ from data reported in the general population.

[Role of surgery in the multidisciplinary treatment of lithiasis of the common bile duct]. / Il ruolo della chirurgia nel trattamento multidisciplinare della litiasi della via biliare principale (VBP).

The efficacy of surgery was evaluated in 32 patients with common bile duct stones. Twenty-two patients have not undergone a previous cholecystectomy. In 13 cases an endoscopic approach was attempted before surgery. In 13 patients biliary-intestinal anastomoses were performed for large stones or bile duct strictures. In 19 cases common bile exploration with biliary drainage insertion was performed for uncomplicated biliary stones. We had no mortality and morbidity was 9%. We conclude that surgery is the treatment of choice in patients with gallbladder in situ or in cases of endoscopic failure. Endoscopic sphincterectomy may be preferred in poor-risk patients.

[Early gastric cancer. Survival and prognostic factors in 95 consecutive cases]. / Early gastric cancer. Sopravvivenza e fattori prognostici in 95 casi consecutivi.

In order to characterize prognostic factors and therapeutic strategies for EGC, we have studied 95 patients operated on from 1980 to 1988. EGC was limited to the mucosa in 36% and extended to the submucosa in 64% of the cases. Lymph nodes involvement was observed in 13 patients; in 12 of them EGC extended to the submucosa. Gastric resection was performed in 73 and total gastrectomy in 22 patients with a postoperative mortality of 6% and 16% respectively. During the follow-up 8 patients died for causes related to EGC, 8 for unrelated causes. The 5 years survival rate was 79, without differences according to site, type, size and histology of EGC, lymph nodes involvement, type of gastrectomy; only EGC limited to the mucosa was associated with a better survival experience (96% vs 70% of tumors extended to the submucosa p less than 0.05). The prognosis of EGC is good and a curative surgery may be accomplished, especially if the lesion is limited to the mucosa. In EGC extended to the submucosa an accurate lymphadenectomy may further improve the prognosis, while total gastrectomy--de principe--carries a higher postoperative mortality, without significant improvement of the long term prognosis.

[Groove pancreatitis. A case report of chronic focal pancreatitis]. / La "groove pancreatitis". Descrizione di un caso di pancreatite cronica focale.

The "groove pancreatitis" is a special form of segmental chronic pancreatitis affecting the "groove" between pancreatic head, duodenum and common bile duct. This type of chronic pancreatitis was first described in 1973 and only few cases have been reported in literature. Unlike other forms of chronic pancreatitis, this is often preceded by peptic ulcers, gastric resections or biliary tract diseases; it could be associated with cysts of the duodenal wall and pancreatic cysts. Abdominal pain, vomiting due to duodenal stenosis, obstructive jaundice and weight loss are the most common presenting symptoms. The radiological features show a pancreatic mass similar to a pancreatic head carcinoma and the discrimination of groove pancreatitis from pancreatic carcinoma is often difficult or even impossible in some patients. We describe a case of groove pancreatitis treated with pancreatoduodenectomy, reviewing the clinical and radiological features. We remark that the groove pancreatitis is a disease that must be known and should be considered in the differential diagnosis of pancreatic carcinoma.

[Endoscopic therapy of giant choledochal calculosis]. / Terapia endoscopica della calcolosi coledocica gigante.

The paper reports the results of conventional endoscopic treatment in 100 consecutive cases of giant lithiasis of the common bile duct. A giant calculus is one whose dimensions exceed 2 cm. Endoscopic therapy proved successful in 73% of cases, with an 8% incidence of complications. The success of endoscopic treatment is related to the anatomical conditions of the biliary tract and the diameter of calculi. Mechanical lithotripsy has proved efficacious in all cases where it was used, whereas poor results were obtained using MTBE infusion through a naso-biliary tube. ESWL provided encouraging results. Cases which were not resolved using endoscopic methods were treated using intervention radiology or surgery, or both.

Day Bed Unit at the Department of Gastro-enterology. Experience of a study group.

Day Bed Unit at the Department of Gastroenterology. Experience of a study group. We analyzed the activity of the Day-Bed Unit at the Department of Gastroenterology of Turin Hospital (Molinette). The quality of the service provided and the days of stay in hospital for each admission were evaluated in terms of cost benefit ratio. The average stay in hospital for each admission was 2.57 days as opposed to 9.3 in the in patient ward. Patients were divided in subsets according to the cause of admission. Stratifying the patients according to diagnosis showed a hospital stay of 2.73 days for liver disease and of 2.81 for pancreas and biliary disease. Among the admissions for liver disease, pre or posttranspiant patients required 2.89 days as opposed to 2.62 days of those who were treated for esophageal varices. Thus, the cause of admission was a factor influencing length of hospital stay. Patients needing non surgical treatment for liver cancer took 2.22 days if treated with percutaneous ethanol injection; those undergoing chemoembolization required 2.93 days. In conclusion, the day bed unit has proven to be able to provide a service with a good cost benefit ratio. Patients admitted to this service may be withdrawn from the waiting list of the in patient ward, thus reducing the waiting time. Optimization of this service needs integration with the surroudings Units within the Department and in the Hospital.

[A rare complication in the suppression of a porto-systemic shunt in disabling encephalopathy]. / Considerazioni su una rara complicanza nella soppressione di shunt porto-sistemico per encefalopatia invalidante.

The authors describe an uncommon complication in a case of side-to-side portacaval shunt which was suppressed due to disabling portal-systemic encephalopathy; the patient was treated by esophageal transection with esophagogastric devascularization and nonoperative secondary occlusion of the shunt by external elastic traction on a Silastic catheter surrounding the anastomosis: a stenosis of the caval vein under traction required another operation in order to close the shunt.

[Intrahepatic cholestasis in hyperthyroidism]. / Colestasi intraepatica in corso di ipertiroidismo.

Three cases of cholestatic liver disease related to hyperthyroidism are reported. Features indicative of a role of the endocrine disease in the pathogenesis of the cholestatic syndrome were the appearance of liver damage in temporal relation with the clinical onset of thyroid hyperfunction and its disappearance with the amelioration of the hyperthyroidism; the absence of congestive heart failure and of infectious, toxic or obstructive agents of liver damage; the pathological and biochemical findings of intrahepatic cholestasis. Hyperthyroidism can be rarely complicated by a severe cholestatic syndrome that may dominate the clinical presentation and course.

Trypsin-like immunoreactivity in the diagnosis of acute pancreatitis.

Elevated serum and urine amylase and serum lipase values are not always diagnostic of an acute pancreatitis, on the account of the extrapancreatic production of these enzymes. A diagnostic improvement can be made by using the CAm/CCr ratio, but this index too is abnormal in some non pancreatic diseases. Since trypsin measurement seems to be more specific in the evaluation of pancreatic condition, serum trypsin-like immunoreactivity has been measured in 28 patients with acute pancreatitis, 95 patients with a wide spectrum of gastroenterological diseases and in 30 patients with severe chronic renal failure. 85 normal subjects were used as controls. Abnormally high serum trypsin-like immunoreactivity (TLI) values were detected in 100% of patients with acute pancreatitis, without any overlap with normal controls. TLI values above the upper normal limit were also found in 70% of patients with severe renal damage, while none of the patients with liver disease, biliary disease, peptic ulcer an inflammatory bowel disease had elevated TLI levels. In 29 patients with hyperamylasemia due to extra-pancreatic diseases serum trypsin-like immunoreactivity was always within the normal range. It is concluded that the determination of serum TLI is a sensitive and reliable tool in the diagnosis of an acute pancreatic inflammation, providing that a severe renal failure is excluded.

Behavioral and neurophysiological investigation of the influence of verbal suggestion on tactile perception.

Recently we demonstrated that it is possible to influence tactile perception by applying a placebo manipulation consisting of verbal suggestion and conditioning and that this influence is associated to changes in the late components (N140 and P200) of somatosensory-evoked potentials (SEPs) (Fiorio et al., 2012). Due to the powerful effects of words in changing symptoms perception in the clinical domain, aim of this study was to investigate whether even in the tactile modality, perception can be changed by the mere use of persuasive words in a specific context. To this purpose, we adopted the same experimental setting of our previous study, apart from the conditioning procedure. A group of subjects (experimental group) has been verbally suggested about the effect of an inert cream in enhancing tactile perception, while a control group was informed about the inefficacy of the cream. In order to unveil the neurophysiological underpinnings of this effect, we compared the amplitude of late SEPs (P100, N140, P200), before and after treatment. Results showed that the experimental group did not perceive an increase of tactile sensation after the treatment and no modification occurred in the late SEPs. This study proves that verbal suggestion alone is not sufficient to induce enhanced tactile perception (at least with this experimental setting), suggesting that a conditioning procedure may be necessary in the tactile modality. The absence of changes in the late SEP components could reflect the lack of strong expectation following the placebo procedure.