Vimentin Regulates Chemokine Expression and NOD2 Activation in Brain Endothelium during Group B Streptococcal Infection.

Streptococcus agalactiae (group B Streptococcus, or GBS) is an opportunistic pathogen capable of causing invasive disease in susceptible individuals, including the newborn. Currently, GBS is the leading cause of meningitis in the neonatal period. We have recently shown that GBS interacts directly with host type III intermediate filament vimentin to gain access to the central nervous system. This results in characteristic meningeal inflammation and disease progression; however, the specific role of vimentin in the inflammatory process is unknown. Here, we investigate the contribution of vimentin to the pathogenesis of GBS meningitis. We show that a CRISPR-targeted deletion of vimentin in human cerebral microvascular endothelial cells (hCMEC) reduced GBS induction of neutrophil attractants interleukin-8 (IL-8) and CXCL-1 as well as NF-κB activation. We further show that inhibition of vimentin localization also prevented similar chemokine activation by GBS. One known chemokine regulator is the nucleotide-binding oligomerization domain containing protein 2 (NOD2), which is known to interact directly with vimentin. Thus, we hypothesized that NOD2 would also promote GBS chemokine induction. We show that GBS infection induced NOD2 transcription in hCMEC comparably to the muramyl dipeptide (MDP) NOD2 agonist, and the chemokine induction was reduced in the presence of a NOD2 inhibitor. Using a mouse model of GBS meningitis, we also observed increased NOD2 transcript and NOD2 activation in brain tissue of infected mice. Lastly, we show that NOD2-mediated IL-8 and CXCL1 induction required vimentin, further indicating the importance of vimentin in mediating inflammatory responses in brain endothelium.

Direct Structural Identification and Quantification of the Split-Vacancy Configuration for Implanted Sn in Diamond.

We demonstrate formation of the ideal split-vacancy configuration of the Sn-vacancy center upon implantation into natural diamond. Using ß^{-} emission channeling following low fluence ^{121}Sn implantation (2×10^{12} atoms/cm^{2}, 60 keV) at the ISOLDE facility at CERN, we directly identified and quantified the atomic configurations of the Sn-related centers. Our data show that the split-vacancy configuration is formed immediately upon implantation with a surprisingly high efficiency of ≈40%. Upon thermal annealing at 920 °C ≈30% of Sn is found in the ideal bond-center position. Photoluminescence revealed the characteristic SnV^{-} line at 621 nm, with an extraordinarily narrow ensemble linewidth (2.3 nm) of near-perfect Lorentzian shape. These findings further establish the SnV^{-} center as a promising candidate for single photon emission applications, since, in addition to exceptional optical properties, it also shows a remarkably simple structural formation mechanism.

Tension hydrothorax: Emergency decompression of a pleural cause of cardiac tamponade.

INTRODUCTION: A tension hydrothorax is defined as a massive pleural effusion presenting with hemodynamic abnormalities secondary to mediastinal compression. In these patients pleural volume increases intrathoracic pressure to the point of compromising diastolic filling and cardiac output simulating a cardiac tamponade physiology. This is an uncommon yet potentially fatal medical emergency that if left untreated may progress to cardiac arrest. Early detection and rapid intervention of these patients prevents cardiorespiratory collapse. CASE PRESENTATION: We present a two-case report of patients presenting with malignant tension hydrothoraxes decompressed with ultrasound-guided thoracentesis and tube thoracostomy in the ED. CONCLUSION: Although these life-saving decompressive interventions appear simple, not having proper training is an independent factor for chest tube and thoracentesis complications. Courses and simulation training can benefit physicians to minimize potential complications when managing emergency conditions such as tension hydrothoraxes which continue to be a medical challenge. Whether thoracentesis or thoracostomy is superior in managing this condition remains in debate and a clinical dilemma.

Structure of Self-Assembled Mn Atom Chains on Si(001).

Mn has been found to self-assemble into atomic chains running perpendicular to the surface dimer reconstruction on Si(001). They differ from other atomic chains by a striking asymmetric appearance in filled state scanning tunneling microscopy (STM) images. This has prompted complicated structural models involving up to three Mn atoms per chain unit. Combining STM, atomic force microscopy, and density functional theory we find that a simple necklacelike chain of single Mn atoms reproduces all their prominent features, including their asymmetry not captured by current models. The upshot is a remarkably simpler structure for modeling the electronic and magnetic properties of Mn atom chains on Si(001).

[The cost of polypharmacy in patients with type 2 diabetes mellitus]. / Costo de la polifarmacia en el paciente con diabetes mellitus tipo 2.

BACKGROUND: Polypharmacy or the concomitant use of three or more medications, may increase the complexity of health care and its costs. AIM: To determine the costs of polypharmacy in patients with Type 2 Diabetes Mellitus in a Mexican population sample. PATIENTS AND METHODS: Analysis of health care costs in 257 patients with Type 2 Diabetes Mellitus from two family care facilities, who had at least five consultations during one year. The cost of professional care by family physicians, pharmacological care and medications were considered to calculate the total expenses. The price of medications and the number of units consumed in one year were used to determine pharmacological expenses. Medications were grouped to determine costs derived from complications and concomitant diseases. Costs were calculated in US dollars (USD). RESULTS: The mean cost derived from family physician fees was USD 82.32 and from pharmacy fees USD 29.37. The mean cost of medications for diabetes treatment was USD 33.31, for the management of complications USD 13.9 and for management of concomitant diseases USD 23.7, rendering a total cost of USD 70.92. Thus, the total annual care cost of a diabetic patient was USD 182.61. CONCLUSIONS: Medications represent less than 50% of total expenses of diabetic patients with polypharmacy.

A relationship between acute respiratory illnesses and weather.

Weekly data from 7 years (2004-2010) of primary-care counts of acute respiratory illnesses (ARIs) and local weather readings were used to adjust a multivariate time-series vector error correction model with covariates (VECMX). Weather variables were included through a partial least squares index that consisted of weekly minimum temperature (coefficient = - 0·26), weekly median of relative humidity (coefficient = 0·22) and weekly accumulated rainfall (coefficient = 0·5). The VECMX long-term test reported significance for trend (0·01, P = 0·00) and weather index (1·69, P = 0·00). Short-term relationship was influenced by seasonality. The model accounted for 76% of the variability in the series (adj. R 2 = 0·76), and the co-integration diagnostics confirmed its appropriateness. The procedure is easily reproducible by researchers in all climates, can be used to identify relevant weather fluctuations affecting the incidence of ARIs, and could help clarify the influence of contact rates on the spread of these diseases.

Magnetic phase diagram of CuO via high-resolution ultrasonic velocity measurements.

High-resolution ultrasonic velocity measurements have been used to determine the temperature-magnetic-field phase diagram of the monoclinic multiferroic CuO. A new transition at T(N3)=230 K, corresponding to an intermediate state between the antiferromagnetic noncollinear spiral phase observed below T(N2)=229.3 K and the paramagnetic phase, is revealed. Anomalies associated with a first order transition to the commensurate collinear phase are also observed at T(N1)=213 K. For fields with B || b, a spin-flop transition is detected between 11 T-13 T at lower temperatures. Moreover, our analysis using a Landau-type free energy clearly reveals the necessity for an incommensurate collinear phase between the spiral and the paramagnetic phase. This model is also relevant to the phase diagrams of other monoclinic multiferroic systems.

Correlation between the latitudinal profile of the 7Be air concentration and the Hadley cell extent in the Southern Hemisphere.

The cosmogenic radionuclide 7Be is one of the best tracers for aerosol transport since its half-life of 53 days is in the time scale of many atmospheric circulation phenomena. In this work, we analyze a 12-years-long daily time-series for the airborne 7Be concentration for nine air filtering stations in the Southern Hemisphere or close to it. The observed latitudinal distribution of 7Be concentration, with its maximum at the southern subtropical high-pressure belt, is similar to the one in the Northern Hemisphere. A good time correlation was found between the 7°-shift of the 7Be concentration latitudinal distribution and the seasonal displacement of the extent of the Hadley cell. This is consistent with tropopause folding events, mostly occurring in spring, being the main contribution for the injection of stratospheric 7Be into the descending branch of the Hadley cell.

[Main causes of orthopedic external consultation in a Second Level Clinic in Mexico]. / Principales motivos de consulta externa ortopédica en un hospital de segundo nivel en México.

INTRODUCTION: The epidemiology of diseases allows the generation of preventive measures, for the modification of their natural evolution or to prevent their appearance. In second-level hospitals of care, most of the pathologies of each medical specialty are treated. Therefore, knowing the main reasons for external consultation in orthopedics and their seasonal predominance is a tool for implementing strategies for the benefit of patients. MATERIAL AND METHODS: Observational study carried out with the patient population of the external orthopedic consultation service of a second-level hospital of care, from January to December 2017. Patients over the age of 18 who first attended consultation were included. RESULTS: 11,704 consultations granted in the period, 7,862 (67.17%) women and 3,842 (32.82%) men. The average age of patients was 51.84 ± 0.14. The most common cause of consultation was arthropathies (47.65%). During the autumn, the largest number of consultations (32.33) were granted. CONCLUSIONS: Arthropathies, specifically gonarthrosis, were the main reason for external consultation, accounting for nearly half of the consultations granted. It is transcendental to identify the modifiable risk factors of these pathologies with the aim of reducing the negative impact it generates at the functional, economic and quality of life level. Clinical relevance: Further epidemiological studies on orthopedic pathologies will improve preventive strategies and optimize resources to improve patient care.

INTRODUCCIÓN: La epidemiología de las enfermedades permite la generación de medidas preventivas para la modificación de su evolución natural o para evitar su aparición. En los hospitales de segundo nivel de atención se tratan la mayor parte de las patologías de cada especialidad médica. Por lo tanto, saber los principales motivos de consulta externa en ortopedia y su predominio estacional es una herramienta para la implementación de estrategias en beneficio de los pacientes. MATERIAL Y MÉTODOS: Estudio observacional realizado con la población de pacientes del servicio de consulta externa de ortopedia de un hospital de segundo nivel de atención de Enero a Diciembre del año 2017. Se incluyeron pacientes mayores de 18 años que acudieron a consulta por primera vez. RESULTADOS: De 11,704 consultas otorgadas en el período, 7,862 (67.17%) fueron mujeres y 3,842 (32.82%) hombres. La edad promedio de los pacientes fue de 51.84 ± 0.14. La causa más frecuente de consulta fueron las artropatías (47.65%). Durante el otoño se otorgó el mayor número de consultas (32.33%). CONCLUSIONES: Las artropatías, específicamente la gonartrosis, fue el principal motivo de consulta externa, representando casi la mitad de las consultas otorgadas. Es transcendental identificar los factores de riesgo modificables de estas patologías con el objetivo de disminuir el impacto negativo que genera a nivel funcional, económico y de calidad de vida. Importancia clínica: La realización de más estudios epidemiológicos sobre las patologías ortopédicas permitirá mejorar las estrategias preventivas y optimizar los recursos para mejorar la atención de los pacientes.

The emerging Hispanic population: a foundation for cancer prevention and control.

Although making up only 9% of the U.S. population and concentrated in urban areas of a few states, Hispanics are found throughout the country and represent a mix of historical and cultural backgrounds. This diverse group cuts across racial and ethnic lines, with origins in various countries of Europe and North, Central, and South America. The Hispanic population has several distinguishing demographic characteristics, including its rapid growth rate, relative youth, and low educational and socioeconomic levels. However, considerable differences exist among Hispanic groups, particularly in median age, household size, education, and family income. The majority of Hispanics face barriers to health care access, including a lack of health insurance coverage, underrepresentation in health care fields, and cultural and language differences. These distinct demographic characteristics and barriers have a direct impact on the risk of cancer in Hispanics and on the development of prevention and control strategies. The purpose of this review is to examine the demographic and socioeconomic characteristics of Hispanics and issues of access to health care among this population within the context of cancer prevention and control.

Screening practices and knowledge, attitudes, and beliefs about cancer among Hispanic and non-Hispanic white women 35 years old or older in Nueces County, Texas.

A telephone survey was conducted among women 35 years old or older in Nueces County, Tex., to assess ethnic differences between Hispanic and non-Hispanic white women in self-reported cancer-screening practices and knowledge, attitudes, and beliefs about cancer and to evaluate the effect of ethnicity as a predictor for screening practices. A total of 233 Hispanic and 332 non-Hispanic white women participated in the survey. Hispanics were younger and had lower educational and income levels. Overall, Hispanics had lower rates than did non-Hispanics of lifetime mammography (65% versus 79%), clinical breast examination (86% versus 96%), monthly performance of breast self-examination (37% versus 49%), and lifetime fecal occult blood testing (36% versus 69%). After control for confounding factors, Hispanics were still less likely to have ever had a clinical breast examination and fecal occult blood test. Our results suggest the need for more culturally sensitive health promotion efforts to improve knowledge about cancer and early detection practices among Hispanic women.

Community level cancer control in a Texas barrio: Part II--Base-line and preliminary outcome findings.

In a quasiexperimental demonstration study, screening rates for breast and cervical cancers were measured among Mexican-American women in selected areas of San Antonio and Houston, Tex. This research was primarily designed to evaluate a cancer-screening promotion program in San Antonio by comparing changes in screening rates in panels from the two barrio communities. In a base-line population survey, we found a small, but significant, proportion of women (10%-15%) lacking Pap smears and a larger proportion (30%-40%) lacking mammography. In a panel study following women who lacked screening at base line, there was a trend toward greater Pap smear use among younger women and a significant increase in mammography for all age groups in San Antonio compared with groups in Houston. Although there was a difference in language use between the communities, rates of newly initiated screening within the communities were similar among monolingual Spanish speakers and among those who used English, supporting the hypothesis that the program increased both groups' participation in breast-cancer screening.

Targeting Hispanic populations: future research and prevention strategies.

Minority populations face a wide variety of economic, institutional, and cultural barriers to health care. These barriers and low levels of education and income pose significant challenges for health professionals in developing cancer research and prevention-control strategies. It is suggested that specific segments of Hispanic populations fit the model of an underdeveloped country in the intermediate stage of epidemiological transition. Since noncommunicable diseases have not yet fully emerged in some of these Hispanic population segments, the opportunity exists to apply primordial prevention strategies. Such campaigns would focus on dissuading members of these populations from adopting negative health behaviors while promoting positive lifestyle choices. Optimal programs would increase cancer screening participation and discourage risk behaviors through community-oriented, population-based interventions. Future directions in prevention and control efforts for minority populations should include expanded health insurance coverage, improved access to health care, greater emphasis on minority recruitment in health care fields, focused epidemiologic and clinical research, and identification and replication of effective components within existing prevention-control programs.

Social networks and cancer screening in four U.S. Hispanic groups.

BACKGROUND: Evidence shows that social relationships play an important role in health and health behavior. We examined the relationship between social networks and cancer screening among four U.S. Hispanic groups. METHODS: We used telephone surveys to collect data in eight U.S. regions that have concentrations of diverse Hispanic-origin populations. We interviewed 8903 Hispanic adults, for a response rate of 83%; analysis was restricted to the 2383 women aged > or =40. As a measure of social integration, we formed a social network index from items on the number of close relatives and friends, frequency of contact, and church membership. We used logistic regression to estimate the effects of social integration on screening, adjusting for sociodemographic factors. RESULTS: Among Mexican, Cuban, and Central-American women, the effect of social integration on mammography screening was slight. The odds ratios (OR) per unit change in social integration category ranged from 1.16 to 1.22 with confidence intervals (CI) that overlapped with the null. For Pap smear screening, the effect was strongest among Mexican-American women (OR=1.44, 95% CI=1.21 to 1.72), but also evident among Central-American women (OR=1.22, 95% CI=0.72 to 2.06) and Cuban women (OR = 1.25, 95% CI = 0.81 to 1.93). Among Puerto Rican women, social integration had no effect on either mammography (OR=1.03) or Pap smear screening (OR=1.08). CONCLUSIONS: Independent of socioeconomic factors, social integration appears to influence cancer screening participation of Hispanic women. The modest effect is not universal across Hispanic groups and was stronger for Pap smear than for mammography screening behavior. Researchers should recognize Hispanic group differences in social network characteristics and the potential of social networks to change screening behavior.

Changes in pupil size induced by phacoemulsification and posterior chamber lens implantation: consequences for multifocal lenses.

PURPOSE: Because the optical performance of eyes implanted with multifocal intraocular lenses will theoretically depend upon the size and position of the pupil relative to the near and distance zones of the lens, we designed a study to determine whether preoperative pupil size is useful in predicting the postoperative pupil size of patients having phacoemulsification with posterior chamber lens implantation. SETTING: Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas. METHODS: We prospectively measured pupil sizes preoperatively and postoperatively in 71 consecutive patients who had phacoemulsification with posterior chamber lens implantation. Pupil sizes were photographed under five lighting and viewing conditions that simulated a range of normal functional situations. RESULTS: The mean change in preoperative to postoperative pupil size was less than 0.5 mm in all five testing conditions. However, changes in pupil diameter of 1.0 mm or more were noted in approximately 10% of patients in each testing situation. Sex, iris color, and the presence or absence of intraoperative iris trauma were not predictive factors for determining which patients sustained large postoperative changes in pupil size. CONCLUSIONS: Preoperative pupil size does not predict postoperative size with sufficient consistency to ensure a good match between pupil diameter and the zone sizes of multizone multifocal intraocular lenses.

Pavlovian conditioning of social-affiliative behavior in the Mongolian gerbil (Meriones unguiculatus).

Gerbils learned to approach a spatial-olfactory stimulus that signaled access to their pairmate. Experiments 1 and 3 used a discrimination procedure in which 1 conditioned stimulus (the CS+) was presented immediately before access to the pairmate and another (the CS-) was presented alone. Both male and female gerbils came to approach the CS+ sooner than the CS- and spent more time near the CS+ than the CS-. Discrimination learning was facilitated by making the CS+ and CS- spatially distinct (Experiment 3). Learning also was demonstrated in male gerbils, using a between-subjects design with a single CS. Pairing the CS with the opportunity for social interaction resulted in greater approach to the CS within 10 trials than presenting the CS and social opportunity in an unpaired fashion (Experiment 2). These findings demonstrate social-affiliative learning in the Mongolian gerbil. Similarities and differences between these findings and sexual conditioning effects in other species are discussed.

Coumamidines, new broad spectrum antibiotics of the cinodine type. I. Discovery, taxonomy of the producing organism and fermentation.

Coumamidines are water-soluble basic antibiotics related to the glycocinnamoylspermidines. They are produced by a soil isolate designated Saccharopolyspora sp. AB 1167L-65. The coumamidines have broad spectrum activity and were selected in a screen for substances which inhibit Pseudomonas aeruginosa.

Are obstetrical personnel required for intraoperative fetal monitoring during nonobstetric surgery?

OBJECTIVE: To determine if the scientific literature supports the practice of electronic monitoring of the fetal heart rate (FHR) during nonobstetric surgery. STUDY DESIGN: A search of the literature from 1966 to 1995 was performed using MEDLINE. RESULTS: No fetal hypoxic mortality or morbidity has been documented from nonobstetric surgery without occurrence of a maternal hypoxic complication regardless of the use of FHR monitoring or whether alterations of the FHR occurred. CONCLUSIONS: Fetal monitoring is an indirect assessment of maternal anesthetic and surgical management that is not as specific or effective as direct assessment of the maternal parameters to detect respiratory compromise. Current clinical evidence obtained does not substantiate the need for obstetric personnel to monitor FHR changes during surgical procedures because no change in fetal outcome has been documented.

[Medical treatment of biliary lithiasis. Orally administered biliary acids]. / Tratamiento médico de la litiasis biliar. Acidos biliares por vía oral.

In the western world, gallstones are constituted completely by or have more than 70% of cholesterol. This is a consequence of a metabolic derangement in the biliary lipids composition. With the administration of quenodesoxicholic and ursodesoxicholic acids, the molar relationship between the biliary lipids modified in order to dissolve the gallstones. With the use of the bile acids alone or in combination we accomplished the complete dissolution in 38-55% of selected patients. In the present paper we review the rationale, indications, posology and monitorization of the patients submitted to treatment with orally bile acids.

[Granulosa cell tumor with liver metastasis treated with partial hepatectomy and chemotherapy. Report of a case]. / Tumor de células de la granulosa metastásico a hígado tratado con hepatectomía parcial y quimioterapia. Reporte de un caso.

A patient with granulosa cell tumor recurrence 14 years after primary resection, was treated with partial hepatectomy and adjuvant chemotherapy (vinblastine, cisplatin and bleomycin). She achieved complete remission and is free of disease 18 months after treatment.