Detection of Cephalosporin and Fluoroquinolone Resistance Genes via Novel Multiplex qPCR in Fecal Salmonella Isolates From Northern Californian Dairy Cattle, 2002-2016.

The objectives of this study were to evaluate the prevalence of extended spectrum ß-lactamase (ESBL) genes, AmpC-type ß-lactamase (ACBL) genes, and plasmid mediated quinolone resistance (PMQR) genes in Salmonella isolated at a Veterinary Medical Teaching Hospital microbiology laboratory, examine trends in presence of these resistance genes, and to explore the correlation between phenotypic resistance and presence of specific genes. The presence of ESBL, ACBL, and PMQR genes were detected using a single, novel multiplex qPCR. Only the genes bla CMY-2 and bla TEM were detected in the 110 Salmonella isolates tested. PMQR genes were not detected in isolates screened. Of 94 third-generation cephalosporin resistant isolates, representing eight serotypes, 48% (n = 45) were positive for bla CMY-2 only and 50% (n = 47) were simultaneously positive for bla CMY-2 and bla TEM. Two third-generation cephalosporin resistant isolates were tested negative for all ß-lactamase genes in our qPCR assay and likely house ESBL genes not screened for by our qPCR assay. A logistic regression model revealed that for serotype Dublin isolates (n = 38) the odds ratio for testing positive for bla TEM when compared to all other serotypes was 51.6 (95% CI: 4.01-664.03, p = 0.0029). For serotype Typhimurium (n = 9) the odds ratio for testing positive for bla TEM when compared to all other serotypes was 43.3 (95% CI: 1.76-1000, p = 0.0216). Overall, our results suggest that the prevalence of resistance to cephalosporins and fluoroquinolones due to ESBLs, ACBLs, and PMQR genes present in bovine nontyphoidal Salmonella enterica isolates has remained relatively constant in the isolates screened over a 14-year period.

Resting kinetics of thallium-201 in patients with coronary artery disease.

The thallium washout was analyzed in 40 patients with angiographically documented CAD, using circumferential time-activity profiles of the initial and four-hour delayed images. A net washout pattern (fewer counts in delayed images than initial images) was observed in the distribution of normal and diseased vessels. A negative washout (wash-in) (a net increase in counts in the four-hour delayed images) was observed only in the presence of diseased vessels, even if the initial scans were normal. Quantitative analysis of thallium kinetics was shown to be important in rest images, and should be performed even if the initial images appear normal.

Granulocytic sarcoma. A new finding in the setting of preleukemia.

Preleukemia is a well-defined syndrome of hematopoietic dysfunction that may antedate the development of acute myelogenous leukemia. Granulocytic sarcoma refers to neoplastic infiltration in the skin, composed of immature cells of the granulocyte series. We report two cases of granulocytic sarcoma in the setting of preleukemia. The clinical importance of these cases, as well as the cutaneous manifestations of leukemia and the clinical spectrum of granulocytic sarcoma, are presented.

Morphological and metabolic changes in transgenic wheat with altered glycerol-3-phosphate acyltransferase or acyl-acyl carrier protein (ACP) thioesterase activities.

We have transformed varieties of wheat with a Pisum sativum glycerol-3-phosphate acyltransferase gene, and also with an Arabidopsis thaliana acyl-ACP thioesterase gene. Morphological (growth, organelle development) and metabolic changes (fatty acid labelling of chloroplast and non-chloroplast lipids) have been observed in transgenics with altered gene expression for either enzyme.

Ischemia at rest is independent of the extent of ventricular dysfunction and arrhythmias in patients with coronary artery disease.

To assess the relation between myocardial ischemia, ventricular arrhythmias (VA), and left ventricular (LV) dysfunction, we evaluated 74 patients with coronary artery disease (CAD) using radionuclide angiography (to determine the resting ejection fraction [EF]), resting thallium-201 scintigraphy (to ascertain the extent of resting ischemia), and 24-hour Holter monitoring (to assess VA). Thirty patients had resting ischemia, 26 had resting EF less than 30%, and 27 had repetitive VA. Patients with and without ischemia had similar EFs (36 +/- 14 vs 38 +/- 14, p = NS). Further, patients with and without repetitive forms of VA had a similar number of resting ischemic segments (1.1 +/- 1.7 vs 1.1 +/- 2.2, p = NS). Patients with EFs less than 30 had more VA than patients with EFs greater than or equal to 30 (Holter class 4.3 +/- 2.3 vs 3.0 +/- 1.8, p less than 0.01) but a similar extent of ischemia (1.4 +/- 2.2 vs 1.0 +/- 1.7, p = NS). Thus, while patients with lower EFs have more repetitive forms of VA, ischemia at rest is independent of VA and EF. These data suggest that prognostic stratification of patients with CAD for intervention studies should include a separate consideration of ischemia.

Percutaneous left heart catheterization and coronary arteriography with and without an arterial sheath in patients without peripheral vascular disease.

The advantages and disadvantages of an arterial sheath to introduce catheters percutaneously through the femoral artery were prospectively studied in 184 consecutive patients without peripheral vascular disease undergoing routine diagnostic left heart catheterization and coronary arteriography. The arterial sheath was used randomly in 91 patients (sheath group) and the standard Seldinger technique in 93 (control group). There were no differences in age or sex between the two groups. All patients were studied with no premedication and had the same dose of lidocaine local anesthesia and heparin. No major complication occurred in any of the patients in the sheath or control groups. There were no significant differences in groin hematomas between the two groups. The patients in the control group more commonly had severe or moderately severe discomfort requiring additional local anesthesia. We conclude that the use of an arterial sheath percutaneously for introduction of catheters for left heart catheterization and coronary arteriography is advisable, particularly for anxious patients who have a low pain threshold.