Effects of static magnetic fields on the enteropathogenic Escherichia coli.

This study reports the effects of exposing cells of the prototypical enteropathogenic Escherichia coli (EPEC) strain E2348/69 to static magnetic fields (SMF) of varying intensities to observe their capacity to autoaggregate and the effect on cell adherence. The results showed that bacteria exposure over the course of 5 min to an intensity of 53 mT reduced autoaggregation by 28%. However, with intensities of up to 100 mT with the same exposure time, bacteria autoaggregation was reduced by approximately 50%; and after 30 min at the same intensity, it was indistinguishable from that observed in a non-autoaggregative strain. Furthermore, it was observed that SMF treatment also modified the typical localized adherence pattern of EPEC E2348/69. The observed effects are not related to bacteria damage. The above was confirmed because, after a 107 mT SMF treatment over the course of 30 min, cell viability and membrane permeability were the same to that observed in untreated controls. The obtained results suggest that the SMF effect on the E2348/69 EPEC strain alters the expression of the bundle-forming pilus (BFP), due to the fact that the same strain without the EPEC adherence factor plasmid that encodes the BFP operon was unable to autoaggregate. Electron microscopic analyses revealed structural differences between cells exposed to SMF with respect to untreated controls. In conclusion, the SMF treatment of 107 mT for 30 min reduced EPEC E2348/69 autoaggregation and modified its adherence pattern, with both events likely being associated with changes in BFP expression. Bioelectromagnetics. 38:570-578, 2017. © 2017 Wiley Periodicals, Inc.

Multidisciplinary ICU Recovery Clinic Visits: A Qualitative Analysis of Patient-Provider Dialogues.

BACKGROUND: Research confirms the heterogeneous nature of patient challenges during recovery from the ICU and supports the need for modifying care experiences, but few data are available to guide clinicians seeking to support patients' individual recovery trajectories. RESEARCH QUESTION: What is the content of patient-provider dialogues in a telemedicine multidisciplinary ICU recovery clinic (ICU-RC)? STUDY DESIGN AND METHODS: We conducted a qualitative descriptive study in a telemedicine multidisciplinary ICU-RC at a tertiary academic medical center in the southeastern United States. The sample included 19 patients and 13 caregivers (≥ 18 years of age) attending a telemedicine ICU-RC visit after critical illness resulting from septic shock or ARDS. Patients and caregivers met with an ICU pharmacist, ICU physician, and a psychologist via a secure web-conferencing platform for 33 ICU-RC visits within 12 weeks of hospital discharge. Telemedicine ICU-RC visits were audio-recorded and transcribed verbatim for analysis. A coding system was developed using iterative inductive and deductive approaches. RESULTS: Two themes were identified from the patient-provider dialogue: (1) problem identification and (2) problem-solving strategies. We identified five subthemes that capture the types of problems identified: health status, mental health and cognition, medication management, health-care access and navigation, and quality of life. Problem-solving subthemes included facilitating care coordination and transitions, providing education, and giving constructive feedback and guidance. INTERPRETATION: Patients surviving a critical illness experience a complexity of problems that may be addressed best by a multidisciplinary ICU-RC. Through analysis of our telemedicine ICU-RC dialogues, we were able to identify problems and solutions to address challenges during a critical transitional phase of ICU recovery. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT03926533; URL: www. CLINICALTRIALS: gov.

Genetic data from Powerplex 16 system and Identifiler kits from Buenos Aires province (Argentina).

Allele frequencies for the 17 autosomic STRs loci including in the PowerPlex 16 System and Identifiler were estimated from unrelated individuals living in Buenos Aires province of Argentina.

KCTD5 and Ubiquitin Proteasome Signaling Are Required for Helicobacter pylori Adherence.

In order to establish infection, bacterial pathogens modulate host cellular processes by using virulence factors, which are delivered from the bacteria to the host cell leading to cellular reprogramming. In this context, several pathogens regulate the ubiquitin proteasome system in order to regulate the cellular effectors required for their successful colonization and persistance. In this study, we investigated how Helicobacter pylori affect the ubiquitination of the host proteins to achieve the adherence to the cells, using AGS gastric epithelial cells cultured with H. pylori strains, H. pylori 26695 and two isogenic mutants H. pylori cag::cat and vacA::apha3, to characterize the ability of H. pylori to reprogram the ubiquitin proteasome systems. The infection assays suggest that the ubiquitination of the total proteins does not change when cells were co-culture with H. pylori. We also found that the proteasome activity is necessary for H. pylori adhesion to AGS cells and the adherence increases when the level of KCTD5, an adaptor of Cullin-3, decrease. Moreover, we found that KCTD5 is ubiquitinated and degraded by the proteasome system and that CagA and VacA played no role on reducing KCTD5 levels. Furthermore, H. pylori impaired KCTD5 ubiquitination and did not increase global proteasome function. These results suggest that H. pylori affect the ubiquitin-proteasome system (UPS) to facilitate the adhesion of this microorganism to establish stable colonization in the gastric epithelium and improve our understanding of how H. pylori hijack host systems to establish the adherence.

A Case of Toxic Epidermal Necrolysis Secondary to Acetaminophen in a Child.

OBJECTIVE: To report and discuss a serious cutaneous adverse reaction in a child who was treated with acetaminophen (paracetamol). CASE SUMMARY: A five years old male child presented a pruriginous maculopapular rash and a "drug-induced Stevens-Johnson syndrome/Toxic Epidermal Necrolysis" was suspected. Applying Spanish Pharmacovigilance System probability algorithm (modified Karch-Lasagna algorithm) for the suspected drugs (acetaminophen, ibuprofen and azithromycin), the causality of this adverse reaction was possible for acetaminophen and unlikely for the other two drugs. In this case it was recommended suspending and avoiding treatment with acetaminophen. This adverse reaction was reported to the Spanish Pharmacovigilance System (notification number: 10-600428). DISCUSSION: Skin adverse reactions induced by drugs are uncommon but often serious and potentially fatal. There are few cases reports of "Stevens-Johnson syndrome/Toxic Epidermal Necrolysis" associated with acetaminophen in the literature. We present a documented case in a child. According to modified Karch-Lasagna algorithm, this case represents a possible adverse reaction. CONCLUSION: Hypersensitivity reactions with skin involvement are rarely associated with acetaminophen ingestion, but in a population such as the paediatric population, in which its use is widespread, the involvement of this drug should always be suspected if no other possible cause at sight.

Extended Hildebrand solubility approach applied to some structurally related sulfonamides in ethanol + water mixtures / Método extendido de Hildebrand en la estimación de la solubilidad de algunas sulfonamidas estructuralmente relacionadas en mezclas etanol + agua / Método ampliado de Hildebrand na estimação da solubilidade da algumas sulfamidas estruturalmente relacionadas em misturas do etanol + agua

Extended Hildebrand Solubility Approach (EHSA) was applied to evaluate the solubility of sulfadiazine, sulfamerazine, and sulfamethazine in some ethanol + water mixtures at 298.15 K. Reported experimental equilibrium solubilities and some fusion properties of these drugs were used for the calculations. In particular, a good predictive character of EHSA (with mean deviations lower than 3.0%) were found by using regular polynomials in order four correlating the interaction parameter W with the Hildebrand solubility parameter of solvent mixtures without drug. The predictive character of EHSA was the same as that obtained by direct correlation of drug solubilities with the same descriptor of polarity of the cosolvent mixtures.

Se aplicó el Método Extendido de Solubilidad de Hildebrand (MESH) al estudio de la solubilidad de sulfadiazina, sulfamerazina y sulfametazina en mezclas binarias etanol + agua a 298,15 K. Se utilizaron valores reportados de solubilidad en equilibrio y algunas propiedades fisicoquímicas de fusión de estos compuestos. Se obtuvo una adecuada capacidad predictiva del MESH (con desviaciones promedio menores del 3,0%) al utilizar modelos polinómicos regulares de cuarto orden relacionando el parámetro de interacción W con el parámetro de solubilidad de Hildebrand de las mezclas solventes. El carácter predictivo del MESH fue de magnitud semejante al que se obtuvo calculando esta propiedad directamente, donde se utilizó una regresión empírica regular de cuarto orden de la solubilidad experimental logarítmica de los fármacos en función del parámetro de solubilidad de las mezclas disolventes.

Na presente investigação, aplicou-se o Método Estendido de Solubilidade do Hildebrand (MESH) ao estudo da solubilidade da sulfadiazina, sulfamerazina e sulfametazina em misturas binárias etanol + agua a 298,15 K. Obteve-se uma adequada capacidade preditiva (com menor desvio padrão de 3,0%) do MESH ao utilizar modelos polinomiais regulares de quarta ordem relacionando o parâmetro de interação W com o parâmetro de solubilidade do Hildebrand das misturas de solventes. O caráter preditivo do MESH foi semelhante ao obtido pelo cálculo utilizando uma regressão empírica regular da quarta ordem, da solubilidade experimental logarítmica dos fármacos em função do parâmetro de solubilidade das misturas dissolventes.

Fracture risk in patients with prostate cancer on androgen deprivation therapy.

Although a decrease in bone mass is a well-known side effect of hormone therapy for prostate carcinoma, its clinical significance is unclear, as there is only scanty information about the incidence of fractures. Therefore, the aim of this study was to determine the risk of non-metastatic fractures in patients with prostate cancer undergoing androgen deprivation therapy. We performed a retrospective cohort study that comprised 288 patients with cancer who were subjected to androgen deprivation therapy (ADT). All were given LHRH agonists, and most of them also received peripheral androgen receptor blockers. The results were compared with a control group of 300 men that were not receiving ADT. The incidence rates of peripheral and vertebral fractures in the group of men on ADT were 1.9 and 0.8 per 100 patient-years, respectively. Incidence rates in the control group were 0.5 and 0.2, respectively. In the whole study group, 35 patients had at least one fracture during follow-up (25 on ADT, ten controls). Thus, the number of patients with at least one fracture was significantly higher in the group on ADT (P = 0.001 by the log-rank test). The unadjusted risk ratio was 4.2 (CI 2.0-8.9). A similar value (risk ratio 3.6; CI 1.6-7.7, P = 0.001) was found after it was adjusted for other factors, such as age or prior fractures. Therefore, ADT is associated with a fourfold increase in the incidence rate of both peripheral and vertebral fractures. Although the absolute incidence remains relatively small, preventive measures should be considered for high-risk patients.

Association between patient age and gabapentin serum concentration-to-dose ratio: a preliminary multivariate analysis.

OBJECTIVES: To evaluate the association between patient age and gabapentin (GBP) concentration-to-dose ratio by a multivariate analysis. METHODS: The association between patient age and the trough steady-state serum concentration of gabapentin (GBP) normalized to 1 mg/kg body weight or concentration-to-dose ratio (CDR) was retrospectively assessed by analysis of covariance. Potential confounding factors considered were GBP dosage, the number of GBP doses per day, and the presence of concomitant antiepileptic drugs (AEDs). Concentrations that had been measured in predose "trough" samples collected from 66 patients, aged 5-84 years, with partial seizures or neuropathic pain chronically receiving GBP BID (n = 21) or TID (n = 45), alone (n = 15) or in combination with other AEDs (n = 51) were used in this retrospective analysis. RESULTS: Average GBP CDR was 0.23 +/- 0.18 (mean +/- SD). The GBP CDR increased with age (r2 = 0.46, P < 0.001), and the correlation was improved when only samples from patients taking GBP BID were separately considered (r2 = 0.68, P < 0.001). The ratio was lower in the 10 children younger than 11 years of age (0.07 +/- 0.05) than in 8 adolescents aged 12 to 18 years (0.14 +/- 0.04), lower than in 35 adults aged 19 to 65 years (0.22 +/- 0.13), and lower than in 13 patients older than 65 years of age (0.45 +/- 0.20) by 1-way analysis of variance (F = 19.4, P < 0.001). Analysis of covariance showed a significant influence on GBP CDR of patient age (P < 0.001) and the number of GBP daily doses (P < 0.01), but GBP daily dosage or concomitant AEDs had no significant influence on the ratio. CONCLUSIONS: In this retrospective study of a small, select group of patients, (1) the GBP CDR increased significantly with age when potential confounding factors such as GBP dosage, number of GBP doses per day, and concomitant AEDs were considered by analysis of covariance, and (2) patients older than 65 years, even without any known renal disease, may have double GBP CDR than younger adults and, therefore, may need half of the GBP dose per body weight to achieve a similar concentration.