Bacteriophages: biosensing tools for multi-drug resistant pathogens.

Pathogen detection is of utmost importance in many sectors, such as in the food industry, environmental quality control, clinical diagnostics, bio-defence and counter-terrorism. Failure to appropriately, and specifically, detect pathogenic bacteria can lead to serious consequences, and may ultimately be lethal. Public safety, new legislation, recent outbreaks in food contamination, and the ever-increasing prevalence of multidrug-resistant infections have fostered a worldwide research effort targeting novel biosensing strategies. This review concerns phage-based analytical and biosensing methods targeted towards theranostic applications. We discuss and review phage-based assays, notably phage amplification, reporter phage, phage lysis, and bioluminescence assays for the detection of bacterial species, as well as phage-based biosensors, including optical (comprising SPR sensors and fiber optic assays), electrochemical (comprising amperometric, potentiometric, and impedimetric sensors), acoustic wave and magnetoelastic sensors.

Demographic transition and potential for development: the case of Iraqi Kurdistan.

The effect of population growth and demographic transitionon economic developmenthas been well documented. The population growth in Iraqi Kurdistan is passing through a critical stage of demographic transition. It is, in fact, extremely likely that the region will fail to efficiently move through the demographic transition and will experience a long period in the demographic trap, i.e. the population will grow steadily and rapidly owing to the high fertility and low mortality rates. With correct government policies in terms of promoting family planning programmes, should the political context allow, demographic transition can pass smoothly through this critical stage. Furthermore, if demographic transition in Kurdistan moves to the next stage, it will provide an important window of opportunity for economic development. Proper exploitation of this demographic window through investment in education, on-the-job training and health services, in addition to proper and appropriate exploitation of economic resources and suitable and productive use of the labour force, will result in significant economic development over the next few decades.

Integrins in point contacts mediate cell spreading: factors that regulate integrin accumulation in point contacts vs. focal contacts.

We have studied the function and distribution of the alpha 1 beta 1, alpha 5 beta 1 and alpha 6 beta 1 heterodimers on type-1 astrocytes with antibodies specific for integrin subunits (alpha 1, alpha 5, alpha 6, and beta 1). The alpha 1 beta 1 heterodimer mediates adhesion to laminin and collagen, the alpha 5 beta 1 to fibronectin in an RGD-dependent manner. The alpha 5 beta 1 integrin is found in focal contacts in long-term cultures of well-spread astrocytes colocalizing with vinculin and the termini of actin stress fibers. alpha 1 beta 1 heterodimers can occasionally be found as small aggregates within focal contacts but they do not accumulate there. Instead, alpha 1 beta 1 integrins are found in punctate deposits called point contacts which are distributed over the upper and the lower cell surfaces whether laminin, collagen, fibronectin or polylysine is used as a substratum. Unlike focal contacts, point contacts contain clathrin but rarely codistribute with actin or vinculin. Two observations indicate that these point contacts are functional. First, mAb 3A3, directed against the rat alpha 1 subunit, inhibits the attachment of astrocytes to laminin and collagen. Second, during the spreading of astrocytes, a band of point contacts forms around the cell perimeter at a time when no focal contacts are visible. While alpha 1 beta 1 integrins are found only in point contacts in astrocytes, the alpha 6 beta 1 integrin, another laminin receptor, is localized within focal contacts. Moreover, alpha 1 beta 1 heterodimers accumulate in focal contacts in fibroblasts. Thus, the alpha subunit contributes, independent of its ligand, to functional integrin heterodimer accumulation in focal contacts or in point contacts. This accumulation varies among different cell types with apparently identical heterodimers as well as with the motile state (spreading vs. flattened) of the same cells.

Leukocytes as a reservoir of circulating oncogenic DNA and regulatory targets of tumor-derived extracellular vesicles.

Essentials Tumor-bearing mice were employed to follow oncogenic HRAS sequences in plasma, and blood cells. Cancer DNA accumulated in leukocytes above levels detected in exosomes, platelets and plasma. Extracellular vesicles and nucleosomes are required for uptake of tumor DNA by leukocytes. Uptake of tumor-derived extracellular vesicles by leukocytes triggers coagulant phenotype. SUMMARY: Background Tumor-derived extracellular vesicles (EVs) and free nucleosomes (NSs) carry into the circulation a wealth of cancer-specific, bioactive and poorly understood molecular cargoes, including genomic DNA (gDNA). Objective Here we investigated the distribution of extracellular oncogenic gDNA sequences (HRAS and HER2) in the circulation of tumor-bearing mice. Methods and Results Surprisingly, circulating leukocytes (WBCs), especially neutrophils, contained the highest levels of mutant gDNA, which exceeded the amount of this material recovered from soluble fractions of plasma, circulating EVs, platelets, red blood cells (RBCs) and peripheral organs, as quantified by digital droplet PCR (ddPCR). Tumor excision resulted in disappearance of the WBC-associated gDNA signal within 2-9 days, which is in line with the expected half-life of these cells. EVs and nucleosomes were essential for the uptake of tumor-derived extracellular DNA by neutrophil-like cells and impacted their phenotype. Indeed, the exposure of granulocytic HL-60 cells to EVs from HRAS-driven cancer cells resulted in a selective increase in tissue factor (TF) procoagulant activity and interleukin 8 (IL-8) production. The levels of circulating thrombin-antithrombin complexes (TAT) were markedly elevated in mice harboring HRAS-driven xenografts. Conclusions Myeloid cells may represent a hitherto unrecognized reservoir of cancer-derived, EV/NS-associated oncogenic gDNA in the circulation, and a possible novel platform for liquid biopsy in cancer. In addition, uptake of this material alters the phenotype of myeloid cells, induces procoagulant and proinflammatory activity and may contribute to systemic effects associated with cancer.

Prevalence of and factors associated with overweight and obesity among a group of Iraqi women.

We studied the prevalence and factors associated with overweight and obesity among 200 non-pregnant Iraqi women (> 18 years) attending 2 outpatient clinics in Baghdad. The women were interviewed using a questionnaire and had their body mass index (BMI) and waist-to-hip ratio (WHR) calculated. Only 24% of the women were normal weight: 39%, 25% and 12% were overweight (BMI 25-29.9 kg/m2), obese (> or =30 kg/m2) and morbidly obese (> or = 40 kg/m2) respectively. While the mean WHR was normal, the mean waist circumference was higher than normal. Factors significantly associated with overweight and obesity were older age, history of previous laparotomy and type of clothing worn (gown) inside the home.

Antiperspirant use as a risk factor for breast cancer in Iraq.

Some internet communications have addressed the link between antiperspirant use and breast cancer. We studied the possible association between the use of antiperspirants and some other factors with the development of breast cancer in Al-Kadhmia teaching hospital. Thus, 54 cases of breast cancer and 50 controls were interviewed. We found 82.0% of the controls used antiperspirants compared with 51.8% of cases (P< 0.05). The use of antiperspirants had no association with the risk of breast cancer, while family history and oral contraceptives use were found to be associated.

Bemiparin for thromboprophylaxis after benign gynecologic surgery: a randomized clinical trial.

BACKGROUND: Venous thromboembolism (VTE) is the leading cause of mortality and morbidity in women following gynecologic surgery. OBJECTIVES: To determine the efficacy of a second-generation low molecular weight heparin (bemiparin) for thromboprophylaxis after benign gynecologic surgery. METHODS: We performed a single-blind randomized controlled trial including women in the moderate-risk, high-risk and highest-risk groups for developing VTE after benign gynecologic surgery. Participants were randomized at a 1 : 1 ratio into parallel groups to receive either seven daily doses of 3500 IU of subcutaneous bemiparin or to a non-intervention group receiving standard rehydration and advice on ambulation. Participants were followed up for 7 days and 30 days postoperatively for symptomatic VTE, which was confirmed by compression Doppler ultrasound, magnetic resonance imaging, or computed tomographic pulmonary angiography, according to the type of VTE. RESULTS: In total, 387 participants were randomized to the bemiparin group and 387 to the non-intervention group. The incidence of symptomatic VTE (deep vein thrombosis and pulmonary embolism) events was lower (0/377) in participants who received bemiparin than in those who received no pharmacologic intervention (12/380, 3.2%; 95% confidence interval [CI] 0.002-0.6). Logistic regression analysis showed significant associations between VTE and immobility (odds ratio [OR] 7.1; 95% CI 1.3-36.2), varicose veins (OR 16.8; 95% CI 3.1-76.2), and thrombophilia (OR 39.3; 95% CI 1.5-1006.7). There were no major bleeding events or side effects related to the use of bemiparin. CONCLUSIONS: Bemiparin was an effective thromboprophylactic agent for preventing venous thrombosis after benign gynecologic surgery.

Effect of a new low-dosage oral contraceptive pill on blood electrolytes. A combined clinical and laboratory evaluation.

PIP: Effects of a new low-dosage combination oral contraceptive containing .5 mg WY3707 (a progestational substance) plus .05 mg ethinyl estradiol were studied on 30 normal women. Findings based on 25 patients remaining in the study for 5 months indicate a weight gain (64%), a tendency to hypo- and oligomenorrhea (58.3%), headache (52%), dizziness (44%) and nausea (20%) as common side-effects. Blood pressure recordings were below 140/90 and had no major variations. Blood sodium and potassium levels, measured before therapy initiation and 2 and 5 months after use, showed no significant changes. Discussion centers on 20 previous studies relating oral contraceptives to blood electrolytes and pressure and weight and menstrual changes.^ieng

[Repeated valvular replacements]. / Les remplacements valvulaires itératifs.

After more than two decades of cardiac valve replacement surgery, the number of reoperations has increased and third or even fourth replacements are no longer rare occurrences. Of the 2072 valves prostheses implanted at the Hôpital Foch between 1970 and December 1984, 134 (6.4%) have been changed at least once and 27 prostheses (1.3%) have been replaced three or more times in 23 patients. Eighteen patients were operated on three times and 5 patients 4 times, a total of 73 operations. Ten patients had aortic valve prostheses, 7 had mitral valve prostheses and 6 had double aortic and mitral valve prostheses. The technical difficulties due to previous cardiac surgery were not great or easily surmounted as every procedure was performed by a median sternotomy and only 2 out of 50 required cannulation of the femoral vessels for cardiopulmonary bypass. The repair itself consisted of simple valve replacement in 3 out of 4 cases (30 single and 3 double valve replacements, 3 valve reinsertions). The other operations required more complex techniques such as remodelling of the ring of insertion or the use of a valved tube. None of the patients died in the operating theatre. However, 3 patients died during the hospital period (13%) and there were 2 late deaths (10%) and 1 patient (5%) was lost to follow-up. The 17 survivors were followed up for 3 to 148 months (average 42 months). Half the patients are now in functional Classes I or II of the NYHA classification. These results show that repeated valve replacement has an acceptable operative risk.(ABSTRACT TRUNCATED AT 250 WORDS)

[Aortocoronary bypass with 10 years' follow-up. Apropos of 183 cases]. / Les pontages aorto-coronaires avec 10 ans de recul. A propos de 183 observations.

Between 1970 and 1972, 183 patients were admitted to the CMC Foch (Pr D. Guilmet) for saphenous vein aorto-coronary bypass surgery. Ten years later a questionnaire was sent to the patient and his cardiologist and the two replies were analysed. Before surgery, all patients had invalidating angina: 12 p. 100 had unstable angina, 61 p. 100 had previous myocardial infarction. Preoperative coronary angiography showed triple vessel disease in 64,5 p. 100, double vessel disease in 18,6 p. 100 and single vessel disease in 14,2 p. 100. There hundred and thirty two grafts were performed (average 1,8 per patient); 42 endarteriectomies were also carried out, 35 on the right coronary artery. Complete revascularisation was achieved in 95 cases (52 p. 100). The incidence of perioperative infarction was 17,5 p. 100 and operative mortality was 7,6 p. 100. Thirty two patients (19 p. 100) died during the 10 year study period; 11 deaths were of cardiovascular origin. The 10 year actuarial survival rate was 66 p. 100. Half the patients are asymptomatic and nearly two thirds take no anti-anginal therapy. The patency of the grafts was chacked in about half the cases and was found to be 72,8 p. 100 at one year. From the professional point of view, two thirds of patients returned to full time working one year after surgery. The degree of activity at 10 years is only known in 87 cases; half these patients are working and a quarter have retired normally. This study shows that: --coronary bypass surgery has excellent long-term effects on symptoms; --the incidence of infarction and survival are comparable to other reported studies; --patients with triple or double vessel disease may have lived longer after surgery than had they been treated medically.

[Surgery of recurrent aortic dissection. Apropos of 6 cases]. / Chirurgie des dissections aortiques itératives. A propos de six observations.

The authors report a series of 6 cases of recurrent dissection, 4 of which were treated surgically, out of a total of 64 acute dissections of the aorta referred to the CMC Foch, between January 1969 and October 1981. Three types of recurrent dissection were identified: --"de novo" recurrent dissection: a new dissection occurring in part of the aorta previously unaffected with a new intimal tear; --recurrent dissection due to extension of the previous dissection; --"in situ" recurrent dissection. Surgery is the treatment of choice because of the poor prognosis. Extensive resection (sometimes carried out in several stages) and deep hypothermia are valuable techniques when part of the aorta giving off arteries to vital organs has to be replaced. The use of GRF biological glue in the treatment of the original acute dissection has been a significant advance in the prophylaxis of recurrent dissection as it ensures better repair of the distal false lumen (27% persistent false lumens). With respect to an extensive replacement of the dissected vessel, the authors advise operation in several stages, especially in young subjects with Marfan's syndrome who are at high risk of recurrent dissection. All cases of acute dissection of the aorta, operated or not, should be followed up indefinitely with clinical and radiological examination, completed, when necessary, by an angioscan and an aortography.

[Computerized management of the medical record in cardiac surgery. Experience at Foch Hospital]. / La gestion informatisée du dossier médical en chirurgie cardiaque. Expérience de l'hôpital Foch.

Between 1979 and 1983, about 2 000 case reports of patients undergoing cardiac surgery were computerised. The availability of the centralised computer facilities of Hôpital Foch made this experiment possible. The computerised case notes were divided into several chapters in which a certain amount of data was compulsive and provision was made for the addition of further information. The data was introduced in the form of a numerical code out of a possible choice of 700 contained in a dictionary. A terminal located in the department was used to introduce the information or to consult a given case file directly. Statistical analysis of the cases was performed using APL language, the basis of which must be known in order to continue interrogation, the reply being almost immediate. Several examples of the use of the system are given: number of patients, average duration of surgery, characteristics of the ten oldest patients. Other studies include the use of double entry tables to determine the relationship between two variables such as the variation of cardiothoracic index and the degree of postoperative bleeding. Each case takes about 20 minutes to be coded; the number of cases not entered has decreased greatly year by year. The differences in language used in comparison with already existing systems are: the use of syntax, the possibility of dating events, an "open" dictionary. The main drawbacks of the system are: forgetting to code certain data and restrictions of interrogation (easier for fixed than for facultative data). The overall results have been clearly positive.(ABSTRACT TRUNCATED AT 250 WORDS)

[A new surgical technic for the treatment of left ventricular aneurysm: the overcoat aneurysmoplasty. Preliminary results. 11 cases]. / Nouvelle technique chirurgicale pour la cure des anévrysmes du ventricule gauche: l'anévrysmoplastie en paletot. Résultats préliminaires. 11 observations.

The classical surgical techniques used in post-myocardial infarction left ventricular aneurysms consist in resecting as much as possible of visible fibrous tissues and closure of the two borders by "U"--shaped sutures supported by a Teflon bond. There are two drawbacks to this approach: resection often involves the surface arterial network which often has a significant role to play in vascularising the remaining myocardium; fibrous, akinetic or dyskinetic zones of the anterior 2/3 of the interventricular septum cannot be resected. The proposed technique consists in limiting the surface of resection and in lowering the left border of the aneurysm as far as the posterior 1/3 of the septum. The septum is then sutured over the aneurysm to the antero-lateral wall of the left ventricle. Ten patients were operated using this technique: there were no operative deaths; preoperative cardiac failure regressed in 4 out of 5 patients; one patient was operated for unstable ventricular tachycardia, the arrhythmias disappeared after surgery; one patient operated during the 3rd week for left ventricular pseudo-aneurysm required intra-aortic balloon pumping and developed episodes of VT which finally resolved.

Microfilaraemia survey in Vientiane, Laos.

During the period June 1977-January 1978 a microfilariaemia survey was conducted for the first time in 27 villages (population: 9,300) of Vientiane province of Laos. A total of 2,339 persons, 1,372 males, 967 females, mostly adults, were blood tested between 2000--2400 hours; one thick smear, approximately 20 c.mm, was collected from each one and stained with 10% Giemsa for 30 minutes; only one positive was detected with microfilaria of W. bancrofti in a 22-year-old male; unusually the sheath was well stained. Two cases of elephantiasis of the left leg in two middle-aged women were also diagnosed during the clinical survey. All the three cases were probably infected in the north-eastern province of Houa Phanh.

Clearance of falciparum parasitaemia with a single dose sulfadoxine-pyrimethamine in Vientiane, Laos.

A total of 49 semi-immune Laotians aged 3 to 49 years, with falciparum malaria were treated with a single dose of sulfadoxine pyrimethamine (1500 mg, 75 mg, adult dose), in Vientiane, Laos. On day 7 after treatment the 49 cases were asymptomatic with complete disappearance of patent asexual parasitaemia. The result is compared with that obtained from treating 48 similar cases with a standard dose of chloroquine over 3 days.

[A new technic of cerebral protection. Surgery of the aortic arch]. / Nouvelle technique de protection cérébrale. Chirurgie de la crosse aortique.

A new technique of cerebral protection during surgery of the aortic arch is described. It is based on electric perfusion of the carotid arteries with low temperature (6 degrees-10 degrees) blood. This requires the adjunction on the cardiopulmonary bypass of an independent heat-exchanger. The first results obtained in 6 patients showed perfect protection of the brain throughout the surgical procedure, with early recovery from anaesthesia and complete absence of neurological sequelae. There were no deaths.

[Dissection of the ascending aorta after aortic valve replacement]. / Dissection de l'aorte ascendante après remplacement valvulaire aortique.

From October, 1969 to December, 1982, 1117 aortic valve replacements were performed at the Foch Medico-Surgical Centre. Five of these operations (0.4%) were followed, within 6 months to 6 years (mean 37 months), by acute dissection of the whole ascending aorta with a varying degree of extension further down. Such accidents raise problems of aetiology, diagnosis, treatment and possibly prevention. All 5 patients had an emergency operation with prosthetic replacement of the ascending aorta; in some cases the 2 cylinders were glued to the distal and proximal aortic stumps. The other forms of treatment were related to the lesions encountered. All patients survived and underwent follow-up angiography after 6 months to 5 1/2 years. Lesions of cystic necrosis of the media were regularly found at histology. In every case during the first operation the surgeon reported that the aorta was dilated or particularly fragile. The question therefore arises as to whether ascending aortas that are fragile and of more than 5 cm in diameter should be systematically replaced.

[Calcifying obstructive disease of the descending thoracic aorta]. / Maladie obstructive calcifiante de l'aorte thoracique descendante.

The authors present the first surgically treated case of calcifying obstructive disease of the descending thoracic aorta. The diagnosis was based upon the coexistence of an aortic isthmus coarctation syndrome together with massive calcifications seen by chest X-ray. The aetiology remains uncertain but the authors tend in favour of an atheromatous aetiology. Cure was obtained by simple surgical treatment.

Association between UTI and urinary tract abnormalities: a case-control study in Erbil City/Iraq.

OBJECTIVE: To determine the proportion of ultrasound abnormalities of the urinary system between two groups of children: affected with urinary tract infection (UTI) and unaffected (control). Further, to determine the most common microorganisms causing UTI in those children with urinary tract abnormalities. METHODS: A case-control study was carried out in Erbil, Iraq between September and December 2012. Ultrasound examinations were carried out on 64 children affected with UTI and on 64 unaffected with UTI (control) in order to detect differences, in the presence of abnormalities, in the urinary tract between the two groups. RESULTS: A majority (59.4%) of children affected with UTI had ultrasound abnormalities, compared with 26.6% of the control group (P<0.001). Escherichia coli was the most common microorganism in both groups, although the difference was not statistically significant. More than one half (75%) of patients with UTI were female, compared with 25% who were male (P<0.001). CONCLUSION: More than one half of the children in the present study who presented with UTI were found to have ultrasound abnormalities. E. coli was the most common causative pathogen for children with or without ultrasound abnormalities.

CMOS Conductometric System for Growth Monitoring and Sensing of Bacteria.

We present the design and implementation of a prototype complementary metal-oxide semiconductor (CMOS) conductometric integrated circuit (IC) for colony growth monitoring and specific sensing of Escherichia coli (E. coli) bacteria. The detection of E. coli is done by employing T4 bacteriophages as receptor organisms. The conductometric system operates by measuring the resistance of the test sample between the electrodes of a two-electrode electrochemical system (reference electrode and working electrode). The CMOS IC is fabricated in a TSMC 0.35-µm process and uses a current-to-frequency (I to F) conversion circuit to convert the test sample resistance into a digital output modulated in frequency. Pulsewidth control (one-shot circuit) is implemented on-chip to control the pulsewidth of the output digital signal. The novelty in the current work lies in the ability of the CMOS sensor system to monitor very low initial concentrations of bacteria (4×10(2) to 4×10(4) colony forming unit (CFU)/mL). The CMOS system is also used to record the interaction between E. coli and its specific receptor T4 bacteriophage. The prototype CMOS IC consumes an average power of 1.85 mW with a 3.3-V dc power supply.