Effect of DMPEI coating against biofilm formation on PVC catheter surface.

Urinary tract infections (UTIs) are a significant cause of morbidity in healthcare systems and are prominently associated with applying urethral catheters, particularly in surgeries. Polyvinyl chloride (PVC) is extensively utilized in the fabrication of catheters. Biofilms, complex polymeric constructions, provide a protective milieu for cell multiplication and the enhancement of antibiotic resistance. Strategies to counteract biofilm development on medical apparatuses' surfaces incorporate antimicrobial agents such as N,N-dodecyl, and methyl polyethylenimine (DMPEI). This research endeavored to characterize the morphology of PVC and PVC-DMPEI surfaces utilizing Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM) and to gauge hydrophobicity through contact angle measurements. Employing Escherichia coli, Staphylococcus aureus, and Candida albicans in adhesion assays enabled the assessment of DMPEI's efficacy in preventing microbial adherence to PVC. Butanol successfully solubilized 2 mg.mL-1 DMPEI without altering the PVC structure. SEM results substantiated the formation of a DMPEI layer on the PVC surface, which led to decreased surface roughness, as validated by AFM, and increased hydrophilicity, as demonstrated by contact angle evaluations. E. coli, S. aureus, and C. albicans exhibited significant adhesion reduction, 89.3%, 94.3%, and 86.6% on PVC-DMPEI surfaces. SEM visualizations confirmed reduced cellular colonization on PVC-DMPEI and highlighted considerable morphological modifications in E. coli. Consequently, DMPEI films effectively minimize the adhesion of E. coli, S. aureus, and C. albicans on PVC surfaces. DMPEI, with its potential as a protective coating for innovative medical devices, promises to inhibit biofilm adherence effectively.

Effects of high-definition transcranial direct current stimulation combined with inspiratory muscle training for treating respiratory sequelae of long COVID: A case series.

INTRODUCTION: Long COVID occurs when numerous symptoms begin 3 weeks after acute infection and last for 12 months or more. High-definition transcranial direct current stimulation (HD-tDCS) has been tested in patients with COVID-19; however, previous studies did not investigate the HD-tDCS use combined with inspiratory muscle training (IMT) for respiratory sequelae of long COVID. CASE PRESENTATION: Six individuals (four women and two men) aged between 29 and 71 years and presenting with respiratory sequelae of long COVID were included. They were submitted to an intervention that comprised HD-tDCS combined with IMT twice a week for 5 weeks. Lung function and respiratory muscle assessments were performed at baseline and after 5 weeks of intervention. IMPLICATIONS ON PHYSIOTHERAPY PRACTICE: HD-tDCS may enhance the IMT effects by increasing respiratory muscle strength, efficiency, and lung function of individuals with long COVID.

Sorting of phosphoglucomutase to glycosomes in Trypanosoma cruzi is mediated by an internal domain.

Trypanosoma cruzi relies on highly galactosylated molecules as virulence factors and the enzymes involved in sugar biosynthesis are potential therapeutic targets. The synthesis of UDP-galactose in T. cruzi requires the activity of phosphoglucomutase (PGM), the enzyme that catalyzes the interconversion of glucose-6-phosphate and glucose-1-phosphate. Several enzymes that participate in carbohydrate metabolism in trypanosomes are confined to specialized peroxisome-like organelles called glycosomes. The majority of glycosomal proteins contain peroxisome-targeting signals (PTS) at the COOH- or at the amino-terminus, which drive their transport to glycosomes. We had previously identified the T. cruzi PGM gene (TcPGM) and demonstrated that it encodes a functional enzyme. Here, we show that, in contrast to yeast and mammalian cells, TcPGM resides in glycosomes of the parasite. However, no classical PTS1 or PTS2 motif is present in its sequence. We investigated glycosomal targeting by generating T. cruzi cell lines expressing different domains of TcPGM fused to the green fluorescent protein (GFP). The analysis of the subcellular localization of fusion proteins revealed that an internal targeting signal of TcPGM, residing between amino acid residues 260 and 380, is capable of targeting GFP to glycosomes. These results demonstrate that, in T. cruzi, PGM import into glycosomes is mediated by a novel non-PTS domain that is located internally in the protein.

Extended Central Tendency Measure and difference plot for heart rate variability analysis.

Heart rate variability (HRV) is a non-invasive alternative to analyze the role of the autonomic nervous system (ANS) on heart functioning. Many tools have been developed to analyze collected cardiac data. Among them, the Central Tendency Measure (CTM) is a quantitative method for variability analysis of RR intervals. The values of the CTM must be between 0 and 1 (inclusive) for different radius, which follows the intrinsic characteristics of each time series. Using the conventional CTM, the successive differences of the time series may be calculated, and it can classify and differentiate the disturbances in the ANS involving HRV. This method was extended (e-CTM) to analyze the differences between RR interval time series. In this extension, a new parameter is added, which allows analysis of long time intervals, instead of successive and adjacent RR intervals. The ability of the e-CTM to differentiate the groups of the RR interval time series was verified with 145 RR interval time series divided into three groups: subjects with congestive heart failure, healthy subjects, and nurses during one hour of their workday. Results evidence that the new parameter added differentiates the group with pathology (and subsequent impairment of ANS) and group under stress at work (temporary impairment of ANS). These results suggest that the e-CTM is capable of detection long-term variations in the HRV according to the ANS impairment.

Surgical treatment of benign tracheal stenosis in adults.

Benign tracheal stenosis is responsible for considerable morbidity, and it is difficult to treat. Our objective is to present the results of surgical treatment. This was a retrospective chart review from the tertiary care center on Head and Neck Surgery in Hospital Ana Costa. We performed a retrospective review of 19 adult patients who underwent circumferential tracheal resection with end-to-end anastomosis from 1997 to 2003. Seventeen cases were caused by prolonged endotracheal intubation and tracheotomy; whereas, an invasive papillary thyroid carcinoma occurred in the other two. A minimum follow-up period of 12 months was considered for the final evaluation of the results. The patient ages varied from 18 to 70 years (median, 29 years). There were 16 men. In 6 patients, a T-shaped tube was kept in place because of extensive disease. The stenosis distance to the vocal folds varied from 11 to 22 mm. All the patients presented grades III or IV of narrowing. Four to eight rings were resected. The sleeve resection gave 89.5% success: one failure and one death. The success rate of tracheal resection with end-to-end anastomosis was 89.5%.

Leptospirosis in Rio Grande do Sul, Brazil: An Ecosystem Approach in the Animal-Human Interface.

BACKGROUND: Leptospirosis is an epidemic-prone neglected disease that affects humans and animals, mostly in vulnerable populations. The One Health approach is a recommended strategy to identify drivers of the disease and plan for its prevention and control. In that context, the aim of this study was to analyze the distribution of human cases of leptospirosis in the State of Rio Grande do Sul, Brazil, and to explore possible drivers. Additionally, it sought to provide further evidence to support interventions and to identify hypotheses for new research at the human-animal-ecosystem interface. METHODOLOGY AND FINDINGS: The risk for human infection was described in relation to environmental, socioeconomic, and livestock variables. This ecological study used aggregated data by municipality (all 496). Data were extracted from secondary, publicly available sources. Thematic maps were constructed and univariate analysis performed for all variables. Negative binomial regression was used for multivariable statistical analysis of leptospirosis cases. An annual average of 428 human cases of leptospirosis was reported in the state from 2008 to 2012. The cumulative incidence in rural populations was eight times higher than in urban populations. Variables significantly associated with leptospirosis cases in the final model were: Parana/Paraiba ecoregion (RR: 2.25; CI95%: 2.03-2.49); Neossolo Litolítico soil (RR: 1.93; CI95%: 1.26-2.96); and, to a lesser extent, the production of tobacco (RR: 1.10; CI95%: 1.09-1.11) and rice (RR: 1.003; CI95%: 1.002-1.04). CONCLUSION: Urban cases were concentrated in the capital and rural cases in a specific ecoregion. The major drivers identified in this study were related to environmental and production processes that are permanent features of the state. This study contributes to the basic knowledge on leptospirosis distribution and drivers in the state and encourages a comprehensive approach to address the disease in the animal-human-ecosystem interface.

Cytogenetic events after bone marrow transplantation for Philadelphia chromosome positive chronic myeloid leukemia.

Allogeneic bone marrow transplantation is the only way to cure patients with Ph1+ chronic myeloid leukemia. It is commonly assumed that, in order to obtain a cure for the patients, the leukemic clone must be completely destroyed by the conditioning treatment and the donor's bone marrow must repopulate the hemopoietic niches leading to a "complete chimera". However, cytogenetic analyses, supported by molecular ones, indicate that Ph1+ cells, far from being completely destroyed by chemo-radiotherapy may persist for a long time, probably in the majority of the patients. As demonstrated by the outcome of patients receiving T-cell depleted marrow, immune mechanisms must be involved in controlling and progressively reducing the size of the residual leukemic clone. Furthermore, immunodulating therapeutic strategies, represented by cyclosporin-A discontinuation or alpha interferon treatment, may successfully reduce the Ph1+ cell population even after a full relapse.

Cytogenetic and molecular studies in patients with chronic myeloid leukemia and variant Philadelphia translocations.

Out of 105 Philadelphia (Ph) positive chronic myeloid leukemia patients analyzed, six (5.7%) carried a variant Ph translocation, namely t(6;9;9;10;22)(q24;p13;q34;p15;q11); t(9;13;22)(q34;q21;q11);der(2)(2pter----2q31::9q21---- 9q34::22q11----22qter) and der(9)t(2;9) (9pter----9q21::2q31----2qter);t(7;9;22)(q11;q34 ;q11), 14q + ;t(7;9;22)(q35;q34;q11), and t(9;11;22) (q34;q13;q11), respectively. Five of these patients were analyzed with Southern blotting. Three of them showed an atypical molecular pattern; namely, the patient with t(9;13;22) showed no rearrangement in the breakpoint cluster region (bcr), the patient with t(7;9;22)(q35;q34;q11) showed a 3' deletion, and the patient with t(7;9;22), 14q + showed a bcr rearrangement 3' to the exon 4 of the M-BCR. Chromosome in situ hybridization studies demonstrated that in patient one, a two-step translocation occurred: the first step moved the 3' bcr from chromosome 22 to chromosome 9, and the second moved the terminal part of 22q, carrying the c-sis protooncogene, to 10p. Variant Ph translocations appear to be associated with atypical molecular breakpoints.

Selective light-induced modulation of bcl-XL and bax expressions in indocyanine green-loaded U937 cells: effects of continuous or intermittent photo-sensitization with low IR-light using a 805-nm diode laser.

The present study is concerned with the effects of an IR diode laser source emitting at 805 nm on a human leukaemic cell strain from a histiocytic lymphoma (U937) pre-loaded with the dye indocyanine green (ICG). The first aim of this work was the assessment of the earliest cellular defense events occurring upon ICG photosensitization. To this purpose, photosensitization was performed at low ICG concentration and low light energy density. The second aim was the comparative evaluation of the effects produced by continuous or fragmented irradiation. Independent of the irradiation method employed (continuous or fragmented), we could demonstrate that cells are forced to apoptosis, as indicated by the appearance in cell extracts of the 85-kDa proteolytic fragment of the poly(ADP-ribose)polymerase (PARP). This proteolysis, however, could be entirely prevented by a specific Caspase-3 inhibitor benzyloxycarbonyl-Asp-Glu-Val-Asp-fluoromethylketone (Z-DEVD-fmk). Indeed the only perceptible change in the expression of pro/antiapoptotic proteins produced by continuous photostimulation was a small, albeit reproducible, increase in Bax. In contrast, when the photostimulation was achieved by means of several consecutive pulses, we observed not only a remarkable increase in Bax but also a noticeable abatement in Bcl-XL expression. The potential involvement of singlet oxygen in this process has been directly demonstrated by ICG photo-mediated oxidation of dithiothreitol in water. It has also been demonstrated that this oxidation is apparently more efficient when ICG is photostimulated by light pulses.

Unfavourable outcome of a patient with M2 acute non lymphocytic leukemia and a 47,XY,t(5;7)(q34;q21), +8 karyotype.

We report a patient with M2 acute non-lymphocytic leukemia and a complex karyotype: 47,XY,t(5;7)(q34;q21), +8. After chemotherapy with Daunomycin and Arabinosyl Cytosine, a complete remission was reached, but two months later he relapsed and died because of sepsis. Only 5 other cases with translocations involving chromosomes 5 and 7 have been described, but with different breakpoints. Several genes related to cell proliferation and maturation have been identified on the long arms of chromosomes 5 and 7. The possible involvement of specific genes located at or very close to the breakpoints is hypothesized.

Humor coping, health status, and life satisfaction among older adults residing in assisted living facilities.

The present study examined the relationships between humor coping, health status, and life satisfaction among older residents of assisted living facilities. A structural equation model with latent variables was specified for the three variables. Health status was expected to directly affect humor coping and life satisfaction. Humor coping was hypothesized to have a direct association with life satisfaction and indirectly affect the relationship between health status and life satisfaction. Participants completed the Multidimensional Functional Assessment Questionnaire, Coping Humor Scale, and Life Satisfaction Index A. The relationships between health status and humor coping and health status and life satisfaction were statistically significant. Both the direct association of humor coping on life satisfaction and the intervening role between health status and life satisfaction were not supported. Humor as a coping strategy seems to be available to older adults who are in better health.

5q- and t(2;11) in a patient with M2 acute non-lymphocytic leukemia. Case report.

A patient with M2-ANLL and a 46,XX,del(5)(q22q33), t(2;11)(p21;q24) karyotype is described. The diagnosis was made after a short period of myelodysplastic syndrome. After chemotherapy consisting of Daunorubicin and Arabinosylcytosine in continuous infusion, the patient reached a complete remission. The chromosome pattern described here has been observed in two other patients with refractory anemia and refractory anemia with excess of blasts, respectively. The breakpoints on the chromosomes 2, 5 and 11 allow us to hypothesize the involvement of N-myc, c-fms, GM-CSF and IL-3 genes.

Comparative evaluation of differential leukocyte counts by Coulter VCS cytometer and direct microscopic observation.

Comparative analyses of the leukocyte differential counting were performed using a Coulter VCS Hematology Flow Cytometer and direct microscopic observation on 547 unselected individuals analyzed at the outpatient clinic of the Institute of Hematology "L. e A. Seràgnoli" of Bologna. The Coulter VCS is able to provide leukocyte differential counting by measuring cell volume, conductivity and laser light scatter. Negative (true negative: 50.8%) results were observed in 278 subjects by both automated and direct observation methods. Abnormal cells in the blood samples (true positive results) were detected both by VCS and by direct observation in 199 cases (36.4%). Regional distribution of the cells in specific "flags" on the scatterplot was often associated with specific cell types. In 66 cases (12.1%) no abnormal cell was detected by direct observation, while Coulter VCS gave an abnormal pattern, even if only to a slight extent (false positive cases). In 4 cases only (0.7%), false negative results were given by the VCS system. The correlation of the results given by the VCS system with those given by direct microscopic analysis was very high; however careful control by the operator was essential in evaluating the data given by the automated system and in identifying the type of abnormal cells detected.

Variability of the molecular defects corresponding to the presence of a Philadelphia chromosome in human hematologic malignancies.

By analyzing a total of 107 patients affected by chronic myelogenous leukemia (CML; chronic and blast crisis) or lymphoid and myeloid Philadelphia chromosome (Ph') positive acute leukemias, we have investigated the relationship between the molecular defect on the Ph' chromosome and the associated hematologic phenotype. As expected, approximately half of the Ph' positive acute leukemias showed a breakpoint on chromosome 22 falling outside the "breakpoint cluster region" (bcr) known to be involved in CML. Surprisingly, seven of 80 CML cases in chronic phase also showed rearrangements falling outside the bcr region. In two of these cases the breakpoint on chromosome 22 was mapped between 9 and 12 kb upstream to the bcr region. In another case, the breakpoint was located approximately 16 kb downstream to bcr. In the remaining four cases, the precise position of the rearrangement could not be localized with the available bcr probes. DNAs from patients with CML blast crises showed classical bcr rearrangements. No molecular changes were observed during the progression of the disease in six patients whose DNA from both a chronic and acute phase was available. Our results seem to indicate a greater degree of variability of chromosome 22 breakpoints in CML than previously observed, and the lack of additional rearrangements on the Ph' chromosome in CML blast crises with respect to chronic phase.

Molecular diagnosis of Philadelphia chromosome-positive chronic myeloid leukemia.

BACKGROUND: In virtually all Ph1 chromosome-positive CML patients, the breakpoint on chromosome 22 maps in a very restricted area of 5.8 Kb, which has been named "breakpoint cluster region" or "bcr". Several molecular probes of this region are presently available, and this makes the molecular diagnosis of CML a useful approach which can be particularly important in those cases in which cytogenetic analysis does not reveal the presence of a Ph1 chromosome. Here we report the problems and our experience during the molecular analysis of the 478 patients examined so far. METHODS: Molecular analyses were performed after digestion of the DNA with 2 to 4 restriction enzymes and hybridization with different probes. Individual samples were subjected to PCR since no rearrangements had been obtained with Southern blotting. RESULTS: Rearrangement bands were detected in all the samples examined. In 473 cases the breakpoint was located within the bcr. In one of these cases, it was detected only after PCR analysis, and in two cases only after the use of the PHL/BCR probe. In 5 cases the breakpoint was localized either 5' or 3' with respect to the bcr. CONCLUSIONS: In this paper, the criteria for a correct molecular diagnosis of CML are presented. The "PHL/BCR" probe appeared to be very specific and time-saving, since it required only one digestion to evidence the rearrangement. Our results confirm the high specificity of the breakpoint on chromosome 22 in CML and the relatively rare incidence of molecular variants.

Molecular and cytogenetic studies of a patient with Philadelphia-negative, BCR-positive chronic myeloid leukemia and t(12;12)(q13;p12).

A patient with Philadelphia (Ph1)-negative, breakpoint cluster region (bcr)-positive chronic myeloid leukemia (CML) is reported. Pulsed-field gel electrophoretic analysis demonstrated the comigration of both ABL and BCR sequences on the same BssHII and SacII fragment. Moreover, in situ hybridization studies demonstrated that ABL sequences had been moved from band 9q34 to 22q11 and that the additional t(12;12)(q13;p12) was not involved in the ABUBCR related translocation. Nevertheless, a possible role of oncogenes or regulatory sequences activated or inhibited by the additional translocation cannot be excluded.