Human Brucella canis outbreak linked to infection in dogs.

The zoonotic risk of Brucella canis has been considered fairly high for persons who handle breeding dogs in kennels or are exposed to infected animals. Transmission to humans in other circumstances has been thought to be rare. We describe an uncommon outbreak of brucellosis caused by B. canis which, to the best of our knowledge, is the first reported in the literature. This outbreak involved six persons (three children and three adults), a bitch and three puppies which had close daily contact with the family. The clinical symptoms of the index case led to an erroneous diagnosis and the infection would have gone undiagnosed if culture had not been positive. This report aims to increase awareness of medical personnel of the need to order screening tests for children, immunodeficient persons or pregnant women presenting with fever of unknown origin, unexplained spleen or liver enlargement or other systemic signs. The emerging zoonotic potential of this disease in urban areas and the need to coordinate canine brucellosis surveillance systems should be evaluated.

[Community-acquired methicillin-resistant Staphylococcus aureus infections in a hospital for acute diseases]. / Infecciones adquiridas en la comunidad por Staphylococcus aureus resistente a meticilina en un hospital de agudos.

Community-acquired methicillin-resistant Staphylococcus aureus infections in a hospital for acute diseases. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most prevalent pathogens associated with nosocomial infections. However, most recently, MRSA has arisen as an emerging community pathogen, causing serious infections, mainly among young patients. We herein describe 33 cases of infections caused by community-acquired MRSA (C-MRSA), diagnosed between May 2005 and June 2006, at "Eva Perón" Hospital. The isolations were retrospectively studied. Methicillin resistance was confirmed by means of the detection of the mecA gene, and the genes for two virulence factors (Panton-Valentine Leucocidin -PVL- and gamma-haemolysin) as well as the cassette mec type were screened by PCR. All the patients were previously healthy. Four patients under 12, presented bacteremia, one had serious pneumonia, and the three remaining patients had osteoarticular infections; all the patients over 12, had skin and soft tissue infections without systemic damage. The C-MRSA strains harboured cassette mec type IV, and the PVL and gamma-haemolysin genes. They were methicillin-resistant, with no other associated resistances. It is important to consider the presence of these community- acquired strains in order to develop strategies for their correct treatment.

Infecciones adquiridas en la comunidad por Staphylococcus aureus resistente a meticilina en un hospital de agudos / Community-acquired methicillin-resistant Staphylococcus aureus infections in a hospital for acute diseases

Staphylococcus aureus resistente a meticilina (SAMR) es uno de los principales agentes asociados a infecciones intrahospitalarias; sin embargo, en los últimos años ha surgido como un patógeno emergente de la comunidad, causando infecciones graves, principalmente en jóvenes. Se describen 33 casos de infecciones por SAMR de origen comunitario, diagnosticadas entre mayo de 2005 y junio de 2006 en el HIGA "Eva Perón". Se estudiaron retrospectivamente los aislamientos; se confirmó la resistencia a meticilina mediante la detección del gen mecA, se investigó la presencia de genes que codifican dos factores de virulencia (leucocidina de Panton-Valentine -LPV- y g-hemolisina) y el tipo de casete mec mediante PCR. Todos los pacientes se encontraban sanos previamente. Cuatro pacientes menores de 12 años presentaron bacteriemia, uno con neumonía grave y los 3 restantes con infección osteoarticular; todos los pacientes mayores de 12 años presentaron infecciones de piel y partes blandas sin compromiso sistémico. Se constató la presencia de casete mec tipo IV en todos los aislamientos; la resistencia a meticilina no se acompañó de resistencia a otros antimicrobianos; los aislamientos fueron portadores de genes que codifican para LPV y para g-hemolisina. Es importante considerar la presencia de estas cepas de origen comunitario a fin de elaborar estrategias para su correcto tratamiento.

Methicillin- resistant Staphylococcus aureus (MRSA) is one of the most prevalent pathogens associated with nosocomial infections. However, most recently, MRSA has arisen as an emerging community pathogen, causing serious infections, mainly among young patients. We herein describe 33 cases of infections caused by community-acquired MRSA (CMRSA), diagnosed between May 2005 and June 2006, at "Eva Perón" Hospital. The isolations were retrospectively studied. Methicillin resistance was confirmed by means of the detection of the mecA gene, and the genes for two virulence factors (Panton-Valentine Leucocidin -PVL- and g-haemolysin) as well as the cassette mec type were screened by PCR. All the patients were previously healthy. Four patients under 12, presented bacteremia, one had serious pneumonia, and the three remaining patients had osteoarticular infections; all the patients over 12, had skin and soft tissue infections without systemic damage. The C-MRSA strains harboured cassette mec type IV, and the PVL and g-haemolysin genes. They were methicillin-resistant, with no other associated resistances. It is important to consider the presence of these community- acquired strains in order to develop strategies for their correct treatment.

Saccadic eye movements are impaired in Duchenne muscular dystrophy.

Extraocular muscles are generally considered to be spared in Duchenne Muscular Dystrophy (DMD). However, this assumption is based mainly on clinical observations, as systematic eye movement recordings have been performed in a very limited number of cases. Our goal was to analyze several saccade parameters in a higher number of cases, in order to reveal a possible ocular-motor impairment in DMD. Data were collected from a population of 9 subjects with DMD and 9 healthy male subjects of comparable age as controls. We used the electrooculographic (EOG) technique coupled with advanced digital signal processing; saccade duration, amplitude, mean velocity, peak velocity and K factor (ratio mean/peak velocity) were measured. The DMD group showed saccades with significantly longer duration and lower velocity, with respect to controls; these differences were accounted for mainly by the largest movements, whereas there were no significant differences at the smallest eccentricity tested (3 deg). Neither amplitude nor K factor were significantly different from controls for any of the eccentricities tested. To our knowledge. this is the first study to suggest significant impairment of eye movements in Duchenne muscular dystrophy.

Bilateral representation of sequential finger movements in human cortical areas.

The spatial distribution of cortical neural clusters activated during movement of either hand ('bilateral' population), or only of one hand, was investigated in healthy right-handed volunteers performing a sequential finger opposition task, using echo-planar functional magnetic resonance imaging. 'Bilateral' clusters were found in the mesial premotor, perirolandic and adjacent lateral premotor cortex of the two hemispheres, and in the left superior parietal lobule. In the precentral gyrus, their spatial extent was larger on the left hemisphere. Clusters activated exclusively during contralateral finger movements were equally distributed in the left and right perirolandic cortex. No cluster activated exclusively during ipsilateral finger movements was detected. These findings support a role of the motor/lateral premotor cortex of the dominant hemisphere in bilateral motor control.

Functional magnetic resonance imaging as a tool for investigating human cortical motor function.

Non-invasive functional magnetic resonance imaging (fMRI) mapping techniques sensitive to the local changes of blood flow, blood volume, and blood oxygenation which accompany neuronal activation have been widely used over the last few years to investigate the functional organization of human cortical motor systems, and specifically of the primary motor cortex. Validation studies have demonstrated a good correspondence between quantitative and topographic aspects of data acquired by fMRI and positron emission tomography. The spatial and temporal resolution affordable by fMRI has allowed to achieve new important information on the distributed representation of hand movements in multiple functional modules, and on the intensity and spatial extent of neural activation in the contralateral and ipsilateral primary motor cortex in relation to parametric and nonparametric aspects of movement and to the degree of handedness. Neural populations with different functional characteristics have been identified in anatomically defined regions, and the temporal aspects of the activation during voluntary movement tracked in different components of the motor system. Finally, this technique has proved useful to deepen our understanding of the neural basis of motor imagery, demonstrating increased activity in the primary motor cortex during mental representation of sequential finger movements.

Olivofloccular circuit in oculomotor control: binocular optokinetic stimulation.

The metabolic activation of the olivocerebellar pathway during binocular optokinetic stimulation was studied in the guinea pig, by means of the semiquantitative 14C-2-deoxyglucose (2DG) technique. The experimental group underwent binocular horizontal stimulation, whereas the control animals were either kept in the dark or allowed to view a stationary pattern. The local metabolic activity index in the dorsal cap of the inferior olive was higher on the side contralateral to the eye that had been stimulated in the temporonasal (T-N) direction in the horizontal group; in contrast, the floccular region showed higher activity on the side ipsilateral to the T-N-stimulated eye. These findings support the involvement of the olivocerebellar pathway in the horizontal optokinetic response. A phylogenetic hypothesis is suggested to explain inconsistent results found in the literature.

CNS pattern of metabolic activity during tonic pain: evidence for modulation by beta-endorphin.

CNS correlates of acute prolonged pain, and the effects of partial blockade of the central beta-endorphin system, were investigated by the quantitative 2-deoxyglucose technique in unanaesthetized, freely moving rats. Experiments were performed during the second, tonic phase of the behavioural response to a prolonged chemical noxious stimulus (s.c. injection of dilute formalin into a forepaw), or after minor tissue injury (s.c. saline injection). During formalin-induced pain, local glucose utilization rates in the CNS were bilaterally increased in the grey matter of the cervical spinal cord, in spinal white matter tracts and in several supraspinal structures, including portions of the medullary reticular formation, locus coeruleus, lateral parabrachial region, anterior pretectal nucleus, the medial, lateral and posterior thalamic regions, basal ganglia, and the parietal, cingulate, frontal, insular and orbital cortical areas. Pretreatment with anti-beta-endorphin antibodies, injected i.c.v., led to increased metabolism in the tegmental nuclei, locus coeruleus, hypothalamic and thalamic structures, putamen, nucleus accumbens, diagonal band nuclei and dentate gyrus, and in portions of the parietal, cingulate, insular, frontal and orbital cortex. In formalin-injected rats, pretreated with anti-beta-endorphin, behavioural changes indicative of hyperalgesia (increased licking response) were found, which were paralleled by a significant enhancement of functional activity in the anterior pretectal nucleus and in thalamo-cortical systems. A positive correlation was found between the duration of the licking response and metabolic activity of several forebrain regions. These results provide a map of the CNS pattern of metabolic activity during tonic somatic pain, and demonstrate a modulatory role for beta-endorphin in central networks that process somatosensory inputs.

Neural circuits underlying ketamine-induced oculomotor behavior in the rat: 2-deoxyglucose studies.

Time-related changes in oculomotor function and of metabolic activity patterns in selected brain networks, as assessed by the quantitative 2-deoxyglucose technique, were investigated in Long-Evans rats following intraperitoneal administration of a ketamine anesthetic dose. During ketamine-induced anesthesia a nystagmic-like behavior was present, characterized by uni-directional slow ocular drifts with superimposed paroxystic bursts of quick (saccadic-like) eye movements; all quick movements were executed in the horizontal direction, were strictly confined to an ocular hemifield of vision, and were followed by a backward (centripetal) drift. A metabolic hyperactivity was found in the dorso-medial shoulder region of the frontal cortex, corresponding to the rat saccadic cortical generator area, whereas functional activity levels were decreased in cerebellum and in several brainstem regions, including portions of the reticular formation and medial vestibular nuclei, putatively indicated as the locus of the oculomotor neural integrator. Starting 2 h after drug injection, a gradual recovery of oculomotor function occurred, with the disappearance of slow ocular drifts. However, an almost uninterrupted sequence of individual saccades was still present. Significant metabolic increases were found at this time in the cingulate and frontal cortex, basal ganglia, superior colliculus, paramedian reticular formation and oculomotor nuclei, the cerebellar vermis and paraflocculus. In medial vestibular nuclei, metabolic levels were undistinguishable from controls. These results suggest different concentration-dependent actions of ketamine on cortical and subcortical circuits involved in saccade generation and gaze holding. These effects are likely to be related at least in part to antagonism of N-methyl-D-aspartate receptor-mediated functions.

Correlation between amount of retinal afferents to the pretectal nucleus of the optic tract and dorsal terminal accessory optic nucleus and performance of horizontal optokinetic reflex in rat.

Intraocular kainic acid injection in Long-Evans rats induces loss of retinal afferents to subcortical visual centers as assessed by the axoplasmic transport of [14C]valine. The optical terminal fields of the pretectal nucleus of the optic tract (NOT), superior colliculus and accessory optic system (AOS) nuclei appear particularly affected. Since NOT and the AOS dorsal terminal nucleus (DTN) represent the first relay station of the visuomotor pathway mediating horizontal optokinetic nystagmus (HOKR), we have studied the characteristics of HOKR after various degrees of retinal deafferentation of these nuclei induced by intraocular KA injection. Taking advantage of the arrangement of the primary optic projections to NOT-DTN, that in rats are almost entirely crossed, in each animal, monocular HOKR induced by stimulation of the injected eye was compared to monocular HOKR elicited by stimulation of the intact, ipsilateral eye. Following NOT-DTN optic denervation, HOKR gain always worsened, and in a way, that the greater the deficits of retinal afferents, the greater the HOKR inability to compensate for visual motion. Furthermore, for any given retinal denervation the higher the stimulus velocity, the greater the HOKR deficit. While the correlation between HOKR gain and the amount of retinal afferents to NOT-DTN would seem to indicate a functional homogeneity of the retinal ganglion cells sending axons to these nuclei, the finding that the extent of HOKR impairment also varied with velocity might not support the above view.

Vergence movements in comitant strabismus.

Vergence movements induced by base-out prisms were recorded, with an infrared eye tracker, for 6 patients with comitant esotropia (i.e., convergent strabismus) and anomalous retinal correspondence and for 6 normal subjects. Vergence movements of strabismic subjects were much slower and showed characteristics different from those of controls. It may be argued that vergence movements are induced by disparity and represent the motor fusion component left over in strabismus. In fact, in this study accommodative as well as proximal vergence had been ruled out. Therefore, the movements recorded can be considered the objective representation of the well-known phenomenon of prism compensation or adaptation, found in many strabismic patients.

Correlation between retinal afferent distribution, neuronal size, and functional activity in the guinea pig medial terminal accessory optic nucleus.

The intrinsic morpho-functional organization of the medial terminal nucleus of the accessory optic system was investigated in the guinea pig. The distribution of the retinal afferents, as assessed by the axoplasmic transport of 14C-valine, showed a remarkable asymmetry within the nucleus. Thus, while the retinal terminal field covered the entire medial terminal nucleus, by far the largest density of labeled retinofugal axon terminals was found within its dorsal division. In this same portion of the nucleus, we found the greatest density of large cells and the maximum intensity of functional activation, this latter as estimated by the increase in metabolic activity of neurons using the 14C-2-deoxyglucose autoradiographic method in the vertical and horizontal whole-field movement in the visual field.

The interstitial nucleus of the superior fasciculus, posterior bundle (INSFp) in the guinea pig: another nucleus of the accessory optic system processing the vertical retinal slip signal.

As in rabbit, gerbil, and rat, the guinea pig interstitial nucleus of the superior fasciculus, posterior bundle (INSFp) is a sparse assemblage of neurons scattered among the fibers forming the fasciculus bearing this name. Most of the INSFp neurons are small and are ovoid in shape. Interspersed among these, are a few larger, elongated neurons whose density becomes greater and whose shape becomes fusiform in correspondence to the zone of transition from the superior fasciculus to the ventral part of the medial terminal nucleus (MTN). Like the MTN, the INSFp is activated by retinal-slip signals evoked by whole-field visual patterns moving in the vertical direction, as shown by the increase of 14C-2-deoxyglucose (2DG) uptake into this nucleus. At the same level of luminous flux, neither pattern moving in the horizontal direction nor the same pattern held stationary can elicit increases in the INSFp 2DG assumption. The specificity of the observed increases in metabolic rates in INSFp following vertical whole-field motion suggests that this assemblage of neurons relays visual signals used in the control of vertical optokinetic nystagmus.

Vertical and horizontal visual whole-field motion differently affect the metabolic activity of the rat medial terminal nucleus.

The metabolic activity of the medial terminal nucleus (MTN) of the Accessory Optic System was studied by means of the [14C]2-deoxyglucose (2-DG) method in Long-Evans rats exposed to moving and stationary visual stimuli. In particular we explored the rate of local cerebral glucose utilization (LCGU) and the spatial distribution of 2-DG uptake within MTN related to visual stimuli capable of triggering optokinetic nystagmus. It was found that increases in MTN metabolism accompanied the retinal slip signals evoked by whole-field visual patterns moving in the vertical as well as in the horizontal direction. At the same level of luminous flux neither the same but stationary pattern, nor constant, diffuse illumination were able to elicit comparable changes in MTN metabolic rates. The effects of vertical and horizontal motions differed, however, from each other. In binocular testing LCGU rates resulted significantly higher after vertically moving patterns and upon the same stimulus condition the spatial distribution of 2-DG matched very closely the spatial distribution of the retinal afferents and the cellular density within MTN, in sharp contrast with the diffuse spreading out of the label across the nucleus following horizontal motion. In monocular testings only the vertically moving patterns were able to increase LCGU rates significantly and then in contralateral MTN alone. However, comparison between the levels of glucose consumption measured in binocular and in monocular vision also showed the involvement of the uncrossed retinal path in relaying the retinal slip signals to MTN. No difference in LCGU and in spatial distribution of the label were finally observed in relation to the upward or to the downward direction of the moving pattern.

Oculomotor corollary discharge in the cat pretectum.

Unit activity bursting after the onset of spontaneous eye movements made in total darkness has been recorded from the nucleus of the optic tract (NOT) of the cat pretectum. The present experiments are aimed at determining the functional significance of these neuronal reactions, namely whether the NOT discharge results from an afferent input arising from eye muscle proprioceptors or from a central signal (corollary discharge or efference copy). The results point to a central, rather than a peripheral, origin for NOT discharge. After both eyes have been paralysed, and therefore after eye-muscle proprioceptive input has been removed, NOT activity remained time-locked with increased activity in motoneurons of the III nerve nucleus.

[14C]deoxyglucose uptake of the rat visual centres under monocular optokinetic stimulation.

Monocular optokinetic stimulation ( OKS ) in Long-Evans rats enhances the uptake of [14C]2-deoxy-D-glucose (2-DG) in the pretectal nucleus of the optic tract (NOT) and superior colliculus (SC) contralaterally to the open eye regardless of the movement direction. Metabolic increases in NOT and SC are therefore found to be unrelated to the ocular nystagmus that in monocularly viewing rats follows only to OKS nasalward for the seeing eye. Since the oculomotor asymmetry has been attributed to the directional selective properties of NOT neurons responding to nasalward movement in the contralateral visual field but being inhibited by opposite ( temporalward ) movement, the enhanced 2-DG uptakes observed in the present experiments seem to represent the NOT excitatory metabolic work in the case of nasalward movement and the NOT inhibitory metabolic expenditure in the case of temporalward movement.

Optokinetic visual detection in the rat visual centres. A [14C]-2-deoxy-D-glucose study.

Following forty-five min of binocular optokinetic stimulation (OKS) the autoradiographic maps of [14C]-2-deoxy-D-glucose (2DG) assumption of Long-Evans brain reveal clearly different patterns of optical density within visual centres. The most superficial layers of superior colliculus (SC) and a pretectal area including the nucleus of the optic tract (NOT) appear symmetrically, strongly darker than other visual structures such as lateral geniculate nucleus (LGN) and visual cortex (VC). Whereas the lack of metabolic increase at LGN and VC levels entirely confirms the non-involvement of the geniculo-cortical path in mediating the optomotor response following OKS in Rodents, it is postulated that the symmetrical increase of 2DG uptake even upon unidirectional OKS found even at pretectal level may represent a commissural transfer of visual information between homologous pretectal areas like the nuclei of the optic tract.

Eye movements during the waking-sleep cycle of the encéphale isolé semichronic cat preparation.

In 'semichronic encéphale isolé (EI) cats' the spatio-temporal characteristics of eye displacements were measured with the scleral coil technique, in the dark, during active wakefulness, slow wave sleep and activated sleep. To active waking (AW) there corresponded spatial patterns of ocular movements with a clear-cut monotonous back and forth orientation in the horizontal or slightly oblique plane. Most often the AW patterns showed a periodic behaviour resulting in a true nystagmoid shape since slow, drifting deviations of the eyes were regularly followed by counter-saccades, whose speed very seldom exceeded 100 deg/sec. As slow wave sleep (SS) supervened, this fixed pattern disappeared, being replaced by large, disjunctive, slow (less than 10 deg/sec) deviations with a prevailing vertical orientation. At SS deepest stage the eyes remained still most of the time and always elevated well above the level of direct forward gaze (up to 30--35 degrees). The rare residual movements slowed down more and more, eventually acquiring the characteristics of disjunctive drifts. At the onset of activated sleep (AS) the eyes moved in a downward direction, even reaching a position at 10--15 degrees below the centre of gaze. From this position the globes started to move in the upward direction and executed loop shaped trajectories with the major axis oriented vertically. The loop paths nearly always returned to their original position and only after displaying several loops did the eyes pass, through a slow horizontal deviation, to a new position from which they executed another series of loops over and over again. The fastest phase of the loop pattern corresponded to the upward component (up to 55 deg/sec), in contrast with waking saccades, whose maximal speed was achieved when they were executed over a horizontal or slightly oblique plane. In sharp contrast with disjunctive eye deviations of SS, the AS ocular movements were always conjugated like waking saccades. Both the maximal velocity and the relationship between maximal velocity and amplitude consistently differentiated, however, the fastest (upward) component of AS loop patterns from the quickest (horizontal) AW saccades, the former resulting as if they were somewhat filtered saccades. Nevertheless, the occurrence of a fixed directional orientation in space of a non-random loop-shaped eye movement pattern during AS, must be considered a reflection of well coordinated central oculomotor activity such as that occurring in AW, even if the intrinsic organizations differ from each other.

Analogue analyser for on-line eye movement detection.

A system of single movement detection is obtained by discriminating the velocities and orientations of eye ball displacements. The orthogonal components of eye velocity (Vx and Vy) are generated from the horizontal (X) and the vertical (Y) components of the movements by means of two derivative circuits and the velocity modulus (V) is generated through a vector operator from Vx and Vy. The onset and end of individual movements are detected on the basis of a preselected V, Vx or Vy threshold and, for every movement thus identified, the integral function of V(t), Vx(t) or Vy(t), characteristic of the type of movement, is generated in such a way that its final value represents ball displacement.