Multiresistance and virulence factors of Staphylococcus aureus isolated from pigs / [Multirresistência e fatores de virulência de Staphylococcus aureus isolados de suínos]

The emergence of livestock-associated methicillin-resistant Staphylococcus aureus strains (LA-MRSA) and the potential role of pigs in the evolution of these strains has led to increased interest in research of these microorganisms. However, this has contributed to a lack of research in the isolation and characterization of methicillin-susceptible S. aureus strains (MSSA). In this study, the prevalence of S. aureus in pigs in the nursery and finishing stages were analyzed. The susceptibility profiles to antibiotics, tolerance to heavy metals, and biofilm production of the isolates were evaluated using phenotypic and genotypic techniques. A total of 1,250 colonies suggestive of Staphylococcus spp. were isolated from 128 pigs, of which 63.6% (n = 795) belonged to this microbial genus. Sixty-seven colonies isolated from 34 animals (26.5%) were confirmed as S. aureus (8.4%). No strains resistant to copper, zinc, or methicillin were detected; however, all strains presented a resistance profile to at least three different classes of antimicrobials and 21 produced biofilms. These data are of concern, as they indicate the need for increased surveillance in the use of antimicrobials as well as reinforce the importance of studies on MSSA strains.(AU)

A emergência de cepas de Staphylococcus aureus resistentes à meticilina associadas à pecuária (LA-MRSA) e o papel potencial dos suínos na evolução dessas cepas têm levado ao aumento do interesse na pesquisa desses microrganismos. No entanto, isso tem contribuído para a falta de estudos sobre o isolamento e a caracterização de cepas de S. aureus sensíveis à meticilina (MSSA). Neste estudo, foi analisada a prevalência de S. aureus em suínos nas fases de creche e terminação. Os perfis de suscetibilidade aos antibióticos, a tolerância a metais pesados e a produção de biofilme dos isolados foram avaliados por meio de técnicas fenotípicas e genotípicas. Um total de 1.250 colônias sugestivas de Staphylococcus spp. foi isolado de 128 suínos, das quais 63,6% (n = 795) pertenciam a esse gênero microbiano. Sessenta e sete colônias isoladas de 34 animais (26,5%) foram confirmadas como S. aureus (8,4%). Nenhuma cepa resistente ao cobre, ao zinco ou à meticilina foi detectada; entretanto, todas as cepas apresentaram perfil de resistência a pelo menos três classes diferentes de antimicrobianos e 21 produziam biofilme. Esses dados são preocupantes, pois indicam a necessidade de maior vigilância no uso de antimicrobianos, bem como reforçam a importância de estudos com cepas de MSSA.(AU)

Arbuscular mycorrhizal fungi decrease Meloidogyne enterolobii infection of Guava seedlings.

Guava (Psidium guajava L.) production is prominent in the irrigated fruit growing area of Brazil. However, the parasite Meloidogyne enterolobii (a phytonematode) has caused a decrease in guava production. Arbuscular mycorrhizal fungi (AMF) are known to be beneficial to plants; however, their ability to protect plants against nematodes such as M. enterolobii remains poorly known. This study aimed to monitor M. enterolobii infection in guava seedlings inoculated with three AMF species. After AMF inoculation, the seedlings were grown in sterile soil for 60 days before inoculation with 2000 M. enterolobii eggs. Plant growth parameters, mycorrhizal colonization and the number of Meloidogyne in the roots were determined over time (30 and 60 days after Meloidogyne inoculation). The AMF enhanced guava seedling growth, and reduced the amount of Meloidogyne in the roots at 30 and 60 days after nematode inoculation, indicating that these AMF species could serve as biocontrol agents of M. enterolobii in guava cultivation.

Carboximaltosa férrica intravenosa en el tratamiento de la anemia en enfermedad renal crónica / Intravenous ferric carboxymaltose for the treatment of anemia in chronic renal disease

No disponible

Influencia de la técnica anestésica en el riesgo de recidiva tumoral en el cáncer de mama tras la cirugía / No disponible

La enfermedad metastásica es la principal causa de muerte relacionada con el cáncer. La técnica anestésica y los diversos fármacos empleados pueden interactuar con el sistema inmune celular y modificar los resultados a largo plazo. Hay un interés particular en la actualidad en el efecto de la anestesia regional, que pudiera ser beneficiosa en ciertas cirugías oncológicas. Análisis retrospectivos han demostrado un beneficio de la anestesia-analgesia paravertebral en los resultados tras cirugía del cáncer de mama. La evidencia disponible sugiere que los agentes anestésicos tienen efectos a corto plazo reversible en la inmunidad del huésped, y no existe todavía ninguna evidencia que sugiera que una técnica de anestesia se asocie con mejores resultados en pacientes con cáncer(AU)

Metastatic disease is the most important cause of cancer-related death. Anaesthetic technique and drug choice can interact with the cellular immune system and effect long-term outcome. There is particular interest at present in the effect of regional anaesthesia, which appears to be beneficial. Retrospective analyses have shown an outcome benefit for paravertebral analgesia for breast cancer surgery. Available evidence suggests that anaesthetic agents have short-term reversible effects on host immunity, and there is as yet no evidence to suggest that one anaesthetic technique is associated with better outcomes in cancer patients(AU)

Lipopolysaccharide-binding protein and CD14 are increased in the bronchoalveolar lavage fluid of smokers.

Lipopolysaccharide-binding protein (LBP) and CD14 contribute to the recognition of pathogens by cells, which triggers the activation of defence responses. Smoking is a risk factor for the development of chronic obstructive pulmonary disease (COPD) and respiratory infections. The current authors theorised that levels of LBP and CD14 in the lungs of smokers would be higher than those in the lungs of never-smokers. These elevated levels could affect host responses upon infection. LBP, soluble CD14 (sCD14) and interleukin (IL)-8 were detected by ELISA. Nuclear factor (NF)-kappaB, p38 and the inhibitor IkappaBalpha were studied by immunoassays. Gene expression was assessed by RT-PCR. Bronchoalveolar lavage levels of LBP and CD14 were significantly higher in smokers and COPD patients than in never-smokers, whereas levels of both proteins were not significantly different between smokers and COPD patients. IL-6, IL-1beta and cigarette smoke condensate induced the expression of LBP and CD14 by airway epithelial cells. LBP and sCD14 inhibited the nontypeable Haemophilus influenzae (NTHi)-dependent secretion of IL-8 and the activation of NF-kappaB and p38 mitogen-activated protein kinase signalling pathways but they increased the internalisation of NTHi by airway epithelial cells. Thus, in the inflamed airways of smokers both proteins could contribute to inhibit bacteria-dependent cellular activation without compromising the internalisation of pathogens by airway cells.

Emulsões O/A contendo Cetoconazol 2,0%: avaliação da estabilidade acelerada e estudos de liberação in vitro / O/W Emulsion Containing 2.0% Ketoconazole: Accelerated Stability Test and in vitro Release

Os objetivos do estudo foram desenvolver e avaliar a estabilidade físico-química de emulsões O/A contendo cetoconazol a 2,0% e determinar seu perfil de liberação in vitro. As formulações foram preparadas com bases auto-emulsionáveis com diferentes características químicas. A estabilidade do sistema foi avaliada de acordo com o Guia para Realização de Testes de Estabilidade em Produtos Farmacêuticos, utilizando diferentes temperaturas (4ºC, 37ºC e 45ºC) por um período de tempo de três meses. Os parâmetros avaliados durante o ensaio foram: as características organolépticas,o pH, o comportamento reológico e a concentração do ativo. A emulsão considerada estável foi submetida ao ensaio de liberação in vitro utilizando célula de difusão de Franz. A quantificação do cetoconazol na formulação e na solução receptora foi realizada por método espectrofotométrico no ultravioleta a 244 nm. Dentre as formulações testadas, somente aquela preparada com álcool cetoestearílico e estearato de polietilenoglicol (PEG20) manteve suas características físico-químicas estáveis durante o teste. O estudo de liberação in vitro demonstrou que o fármaco foi liberado do sistema gradualmente no decorrer do tempo, apresentando uma cinética pseudo zero ordem.

The goal of this work was to develop and assess the physicochemical stability of O/W emulsions containing 2.0% ketoconazole and to determine their in vitro release profile. These formulations were prepared with self-emulsifying bases that differed in their chemical characteristics. The stability of the system was assessed, as recommended in the Guide to Drug Product Stability Tests, over 3 months at 3 different temperatures (4ºC, 37ºC and 45ºC). The characteristics assessed during the test were the organoleptic properties, pH, rheological behavior and drug concentration. The most stable emulsion was subjected to an in vitro release test in a Franz diffusion cell system. The ketoconazole in both the formulation and receptor phase was determined by UV spectrophotometry at 244 nm. The O/W emulsion prepared with cetearyl alcohol and polyethylene glycol (PEG20) stearate was the only one that maintained its physicochemical characteristics throughout the test. The in vitro release test demonstrated that the drug was released gradually, exhibiting pseudo zero-order kinetics.

Evaluation of a 1-h 75-g oral glucose tolerance test in the diagnosis of gestational diabetes.

In order to evaluate the performance of a 1-h 75-g oral glucose tolerance test (OGTT) for the diagnosis of gestational diabetes mellitus (GDM), a cohort of 4998 women, 20 years or older, without previous diabetes being treated in prenatal care clinics in Brazil answered a questionnaire and performed a 75-g OGTT including fasting, 1-h and 2-h glucose measurements between their 24th and 28th gestational weeks. Pregnancy outcomes were transcribed from medical registries. GDM was defined according to WHO criteria (fasting: >/=126 mg/dL; 2-h value: >/=140 mg/dL) and macrosomia as a birth weight equal to or higher than 4000 g. Areas under the receiver operator characteristic curve (AUC) were compared and diagnostic properties of various cut-off points were evaluated. The AUCs for the prediction of macrosomia were 0.606 (0.572-0.637) for the 1-h and 0.589 (0.557-0.622) for the 2-h plasma glucose test. Similar predictability was demonstrable regarding combined adverse outcomes: 0.582 (0.559-0.604) for the 1-h test and 0.572 (0.549-0.595) for the 2-h test. When the 1-h glucose test was evaluated against a diagnosis of GDM defined by the 2-h glucose test, the AUC was 0.903 (0.886-0.919). The cut-off point that maximized sensitivity (83%) and specificity (83%) was 141 mg/dL, identifying 21% of the women as positive. A cut-off point of 160 mg/dL, with lower sensitivity (62%), had higher specificity (94%), labeling 8.6% as positive. Detection of GDM can be done with a 1-h 75-g OGTT: the value of 160 mg/dL has the same diagnostic performance as the conventional 2-h value (140 mg/dL). The simplification of the test may improve coverage and timing of the diagnosis of GDM.

Evaluation of a 1-h 75-g oral glucose tolerance test in the diagnosis of gestational diabetes

In order to evaluate the performance of a 1-h 75-g oral glucose tolerance test (OGTT) for the diagnosis of gestational diabetes mellitus (GDM), a cohort of 4998 women, 20 years or older, without previous diabetes being treated in prenatal care clinics in Brazil answered a questionnaire and performed a 75-g OGTT including fasting, 1-h and 2-h glucose measurements between their 24th and 28th gestational weeks. Pregnancy outcomes were transcribed from medical registries. GDM was defined according to WHO criteria (fasting: greater than or equal to 126 mg/dL; 2-h value: greater than or equal to 140 mg/dL) and macrosomia as a birth weight equal to or higher than 4000 g. Areas under the receiver operator characteristic curve (AUC) were compared and diagnostic properties of various cut-off points were evaluated. The AUCs for the prediction of macrosomia were 0.606 (0.572-0.637) for the 1-h and 0.589 (0.557-0.622) for the 2-h plasma glucose test. Similar predictability was demonstrable regarding combined adverse outcomes: 0.582 (0.559-0.604) for the 1-h test and 0.572 (0.549-0.595) for the 2-h test. When the 1-h glucose test was evaluated against a diagnosis of GDM defined by the 2-h glucose test, the AUC was 0.903 (0.886-0.919). The cut-off point that maximized sensitivity (83%) and specificity (83%) was 141 mg/dL, identifying 21% of the women as positive. A cut-off point of 160 mg/dL, with lower sensitivity (62%), had higher specificity (94%), labeling 8.6% as positive. Detection of GDM can be done with a 1-h 75-g OGTT: the value of 160 mg/dL has the same diagnostic performance as the conventional 2-h value (140 mg/dL). The simplification of the test may improve coverage and timing of the diagnosis of GDM.

Interferon-induced sarcoidosis.

Interferons (IFNs) are widely used for the treatment of various medical diseases. They have marked immunomodulatory effects, and many reports have been published associating IFN therapy with the induction of autoimmune phenomena and other disorders of immune regulation such as sarcoidosis. The clinical presentation of IFN-induced sarcoidosis (IIS) is insidious and can be confused with common constitutional side effects of these drugs. The age of onset of IIS is later than that of naturally occurring sarcoidosis. The most common organs involved are the lungs and skin. In the majority of cases, IIS follows a benign course. As we show in an illustrative case report, complete resolution after discontinuation of IFN therapy can be expected. This review summarises 65 cases of IIS reported in the literature and highlights the pathophysiology, clinical features, diagnostic modalities and therapeutic options for this increasingly recognised phenomenon.

The pmrF polymyxin-resistance operon of Yersinia pseudotuberculosis is upregulated by the PhoP-PhoQ two-component system but not by PmrA-PmrB, and is not required for virulence.

The Yersinia pseudotuberculosis chromosome contains a seven-gene polycistronic unit (the pmrF operon) whose products share extensive homologies with their pmrF counterparts in Salmonella enterica serovar Typhimurium (S. typhimurium), another Gram-negative bacterial enteropathogen. This gene cluster is essential for addition of 4-aminoarabinose to the lipid moiety of LPS, as demonstrated by MALDI-TOF mass spectrometry of lipid A from both wild-type and pmrF-mutated strains. As in S. typhimurium, 4-aminoarabinose substitution of lipid A contributes to in vitro resistance of Y. pseudotuberculosis to the antimicrobial peptide polymyxin B. Whereas pmrF expression in S. typhimurium is mediated by both the PhoP-PhoQ and PmrA-PmrB two-component regulatory systems, it appears to be PmrA-PmrB-independent in Y. pseudotuberculosis, with the response regulator PhoP interacting directly with the pmrF operon promoter region. This result reveals that the ubiquitous PmrA-PmrB regulatory system controls different regulons in distinct bacterial species. In addition, pmrF inactivation in Y. pseudotuberculosis has no effect on bacterial virulence in the mouse, again in contrast to the situation in S. typhimurium. The marked differences in pmrF operon regulation in these two phylogenetically close bacterial species may be related to their dissimilar lifestyles.

Recurrent portopulmonary hypertension after liver transplantation: management with epoprostenol and resolution after retransplantation.

We report a case of portopulmonary hypertension in which the pulmonary hypertension resolved after initial orthotopic liver transplantation. Portopulmonary hypertension recurred when the transplanted liver failed and again resolved after a second liver transplantation. Intravenous epoprostenol was administered perioperatively to control the pulmonary hypertension in both instances.

Activation of Toll-like receptor-2 by glycosylphosphatidylinositol anchors from a protozoan parasite.

Glycosylphosphatidylinositol (GPI) anchors and glycoinositolphospholipids (GIPLs) from parasitic protozoa have been shown to exert a wide variety of effects on cells of the host innate immune system. However, the receptor(s) that are triggered by these protozoan glycolipids has not been identified. Here we present evidence that Trypanosoma cruzi-derived GPI anchors and GIPLs trigger CD25 expression on Chinese hamster ovary-K1 cells transfected with CD14 and Toll-like receptor-2 (TLR-2), but not wild-type (TLR-2-deficient) Chinese hamster ovary cells. The protozoan-derived GPI anchors and GIPLs containing alkylacylglycerol and saturated fatty acid chains or ceramide were found to be active in a concentration range of 100 nM to 1 microM. More importantly, the GPI anchors purified from T. cruzi trypomastigotes, which contain a longer glycan core and unsaturated fatty acids in the sn-2 position of the alkylacylglycerolipid component, triggered TLR-2 at subnanomolar concentrations. We performed experiments with macrophages from TLR-2 knockout and TLR-4 knockout mice, and found that TLR-2 expression appears to be essential for induction of IL-12, TNF-alpha, and NO by GPI anchors derived from T. cruzi trypomastigotes. Thus, highly purified GPI anchors from T. cruzi parasites are potent activators of TLR-2 from both mouse and human origin. The activation of TLR-2 may initiate host innate defense mechanisms and inflammatory response during protozoan infection, and may provide new strategies for immune intervention during protozoan infections.

A woman with recurrent abdominal pain.

Papillary cystic and solid tumor of the pancreas is a rare neoplasm with low malignancy potential generally found in young women. Although its presentation is typically one of vague abdominal complaints, its radiographic and histologic characteristics are distinct. Recognition of the clinical and pathological spectrum of papillary cystic and solid tumor of the pancreas is essential for diagnosing this uncommon condition and differentiating it from other pancreatic masses encountered in the young.

[Chemical composition of food products derived from wheat and corn produced in Costa Rica]. / Composición química de productos alimenticios derivados de trigo y maíz elaborados en Costa Rica.

Twenty one wheat and corn based food products elaborated in Costa Rica were analyzed by chemically with the purpose of having data on local foods. The analytical methods to determine proximate composition were AOAC's. Energy was estimated by calorimetric bomb and dietary fiber (DF) by the gravimetric enzymatic method. Also food portion size was estimated and related with DF content for food classification. The values of the nutrients per food were established and compared with others reported in foreign tables commonly used in the country. Fat and energy content in cookies are higher than in salad breads and crackers. Wheat and corn based food products are classified either as low or very low DF sources (< 2.9 g FD/portion). Corn "tortilla" DF content duplicates bread's and the fiber is basically insoluble. Marked differences were founded in the nutritive composition of specific foods when compared with values reported in foreign food tables. In other foods, as corn based products, similarities in the chemical composition were common. The chemical composition of the studied local foods shows the potential of the diet to be atherogenic, an important aspect to be considered with relation to the main causes of mortality in Costa Rica population. The more compatible food composition table with our data is the Central American, followed by the Latin American one. The necessity of having data on the chemical composition of local foods has been demonstrated.

Heteroduplex mobility assay for rapid, sensitive and specific detection of mycobacteria.

We report an improved method for the detection and identification of mycobacteria using PCR and the heteroduplex mobility shift assay (HMA). The HMA for detection of mycobacteria was based on the microheterogeneity within the DNA coding sequences for 16S rRNA. A remarkable shift between single-stranded, heteroduplex and homoduplex bands in PAGE was observed among the Mycobacterium spp. tested. The Mycobacteria HMA (MHMA) of amplified PCR products from mycobacteria DNA coding for 16S rDNA derived from culture showed a specific heteroduplexes formed among different Mycobacterium species. Other bacterium species were distinguished from Mycobaterium due to slow migrating heteroduplexes mobility bands observed when M. bovis (BCG), M. avium, or M. fortuitum were used as a standard. The specific heteroduplexes were detected when as little as 1 etag of DNA template was used, although better results were obtained with 5 etag and when PCR products of sample test and mycobacterium standard were mixed at a ratio of 1.8. To correctly evaluate the feasibility of using MHMA to detect and identify mycobacteria, 15 clinical sample patients were tested. All MTB-positive clinical samples were identified by MHMA as well as the negative samples. In addition, MHMA will, in principle, be applicable to the detection and classification of any microorganism showing differences within the 16S rRNA as well as to the identification of new and unrecognized bacterial species.

Protein domains involved in nuclear transport of Fos.

The protein encoded by the proto-oncogene c-fos is constitutively nuclear in most cell types analyzed. It has a predicted molecular weight of about 55 kDa. Proteins with a molecular weight above 40 kDa cannot enter the nucleus passively. Our interest was to study which regions in the protein are involved in the nuclear transport. We prepared a series of deletions and point mutations of the protein and cloned the mutated genes into a eukaryotic expression vector. Cos-1 cells were used to express the mutants transiently. Using indirect immunofluorescence we studied the subcellular localization, analyzing the percentage of cells containing the protein in the nucleus, the cytoplasm, or both locations. Our studies showed that the Fos protein contains several regions which can act independently to translocate the protein into the nucleus.