Isolation, characterization, and experimental infection of Streptococcus gallolyticus subspecies pasteurianus from commercial turkeys with acute septicemia: a pilot study.

Streptococcus gallolyticus (SG) is a Gram-positive cocci found as commensal gut flora in animals and humans. SG has emerged as a cause of disease in young poults between 1 and 3 wk of age. SG is associated with septicemia resulting in acute mortality with no premonitory signs in turkeys. Three SG isolates were obtained from clinical field cases of acute septicemia of commercial turkeys and used in three independent experiments. In Experiment 1, embryos were inoculated 25 d of embryogenesis with varying concentrations of SG1, SG2, or SG3. In Experiment 2, day of hatch, poults were inoculated with varying concentrations using different routes of administration of SG1, SG2, or SG3. In Experiment 3, day of hatch, poults were inoculated with only isolate SG1 using different paths. Poults were randomly selected for necropsy on d 8 and d 15 and sampled to collect spleen, heart, and liver for SG on d 21, the remaining poults were necropsied and cultured. Samples were plated on Columbia nalidixic acid and colistin agar (CNA) (40°C, 18-24 h). Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) confirmed suspect colonies. Data were analyzed using the chi-square test of independence, testing all possible combinations to determine significance (P < 0.05). Weight data were subjected to ANOVA using JMP with significance (P < 0.05). No differences were found in BW or BWG on d 0, 8, 15, or 22. Splenomegaly, focal heart necrosis, and pericarditis were observed in all groups in experiments 1 through 3. In Experiment 3, only airsacculitis was observed in a negative control in separate isolation (P > 0.05). On d 21 of Experiment 3, increased (P < 0.05) recovery of SG from spleens were observed in co-housed negative controls, as well as poults challenged by oral gavage (P > 0.05 for d 7 and d 14). These results confirm numerous previous studies indicating that SG subsp. pasteurianus is a primary infectious microorganism that causes septicemia in young poults.

Mortalidad cardiovascular en trasplante renal / No disponible

Las novedades más relevantes en el área de la patología cardiovascular en trasplante renal podemos dividirlas en varios aspectos. En cuanto a la evaluación cardiovascularantes del trasplante destaca que los pacientes que tuvieron un evento cardiovascular antes del trasplante tienen más riesgo de morbimortalidad cardiovascular post-tras-plante, que el eco cardiograma puede predecir mejor la su-pervivencia del paciente trasplantado renal que la coronariografía y que el resultado de la coronariografía no es pronostica en los paciente diabéticos. Por otro lado, muchos de los estudios publicados se han centrado en estudiar la obesidad como factor de riesgo cardiovascular. Aunque hay algún resultado contradictorio, parece que la obesidad influye negativamente en la supervivencia del injerto y del paciente, sobre todo en las situaciones más extremas. También se han publicado va-rios estudios que destacan la gran prevalencia de prediabetes y de diabetes en el primer año de trasplante, con la consecuente necesidad de realizar test de sobrecarga oral de glucosa a los pacientes no diabéticos. En cuanto a los marcadores intermedios de lesión de órgano diana, recalcar la importancia progresiva de la medición del grosor íntima-media carotídeo y de las calcificaciones coronarias en el seguimiento de los pacientes trasplanta-dos renales con alto riesgo cardiovascular. Las novedades más relevantes en el área de intervenciones terapéuticas son las derivadas del efecto de los diferentes inmunosupresores sobre los factores de riesgo cardiovascular y el efecto de los hipolipemiantes (estatinas, ezetimibe, aceite de pescado) en la evolución del injerto renal y del paciente trasplantado renal (AU)

The most relevant novelties in the area of cardiovascular disease in kidney transplant can be divided into various aspects. The most noteworthy findings with regard to pretransplant cardiovascular evaluation were that patients who had a cardiovascular event before transplant are at greater risk of cardiovascular morbidity and mortality post transplant, the echocardiogram can predict kidney transplant patient survival better than coronary angiography, and the result of coronary angiography is not prognostic in diabetic patients. On the other hand, many of the published studies focused on obesity as a cardiovascular risk factor. Although some results are contradictory, it seems that obesity adversely affects graft and patient survival, especially in more extreme situations. Various studies have also been published that stress the high prevalence of prediabetes and diabetes in first year after transplant, with the consequent need to perform the oral glucose tolerance test in non diabetic patients. With regard to intermediate markers of target-organ damage, the progressive importance of measuring carotid intima-mediathickness and coronary calcifications in the follow-up of kidney transplant patients with high cardiovascular risk should be stressed. The most relevant novelties in the area of therapeutic interventions are those related to the effect of different immunesuppressants on cardiovascular risk factors and the effect of hypolidemic agents (statins, ezetimibe, fish oil) on the course of the kidney graft and kidney transplant patient (AU)

[Cardiovascular mortality in kidney transplatation]. / Mortalidad cardiovascular en trasplante renal.

The most relevant novelties in the area of cardiovascular disease in kidney transplant can be divided into various aspects. The most noteworthy findings with regard to pretransplant cardiovascular evaluation were that patients who had a cardiovascular event before transplant are at greater risk of cardiovascular morbidity and mortality posttransplant, the echocardiogram can predict kidney transplant patient survival better than coronary angiography, and the result of coronary angiography is not prognostic in diabetic patients. On the other hand, many of the published studies focused on obesity as a cardiovascular risk factor. Although some results are contradictory, it seems that obesity adversely affects graft and patient survival, especially in more extreme situations. Various studies have also been published that stress the high prevalence of prediabetes and diabetes in first year after transplant, with the consequent need to perform the oral glucose tolerance test in nondiabetic patients. With regard to intermediate markers of target-organ damage, the progressive importance of measuring carotid intima-media thickness and coronary calcifications in the follow-up of kidney transplant patients with high cardiovascular risk should be stressed. The most relevant novelties in the area of therapeutic interventions are those related to the effect of different immunosuppressants on cardiovascular risk factors and the effect of hypolidemic agents (statins, ezetimibe, fish oil) on the course of the kidney graft and kidney transplant patient.

[Day-night differences of arterial pressure in "white coat" arterial hypertension]. / Diferencias día-noche de presión arterial en la hipertensión arterial de "bata blanca".

Prevalence and day-night differences of blood pressure (BP) are studied in "White Coat" Hypertension (AHT). An outpatient register of BP was performed during 24 hours in 95 patients with mild AHT. "White Coat" Hypertension was defined when diastolic BP during the day was below 90 mmHg (WCH group) and with no "White Coat" Hypertension (non-WCH) when it was over said figure. BP values for WCH group (n = 36) in comparison with non-WCH (n = 59) were: Day period 130 +/- 13/85 +/- 4 versus 143 +/- 14/99 +/- 7 mmHg (p < 0.001; p < 0.001). Night period 119 +/- 18/74 +/- 8 versus 127 +/- 15/84 +/- 8 mmHg (p < 0.05/p < 0.001). Day-night differences in BP were lower in WCH in comparison with non-WCH group: 11 +/- 9/11 +/- 8 versus 17 +/- 10/15 +/- 7 mmHg (p < 0.01; p < 0.01). A positive correlation was observed between BP variability in 24 hours and day-night difference in non-WCH group (Systolic BP: r = 0.512, p < 0.001; Diastolic BP: r = 0.676, p < 0.001). This correlation was not found in the WCH group. "White Coat" Hypertension is present in 38% of the subjects with mild AHT and could constitute an independent aspect of the alert reaction.

[Metabolic control, C peptide and lipids in insulin-dependent diabetes mellitus]. / Control metabólico, péptido C y lípidos en la diabetes mellitus insulin-dependiente.

Total cholesterol, HDL cholesterol, triglyceride, glycohaemoglobine and plasma glycoprotein levels were measured in 67 diabetic children and 40 nondiabetic ones. A dynamic study on C peptide secretion was also made in 28 diabetic patients. It was checked the fact that diabetic children showed normal whole cholesterol (172.1 +/- 32.1 mg/dl), HDL cholesterol (48.1 +/- 18.8 mg/dl) and triglyceride (58.3 +/- 26.8 mg/dl) levels, demonstrating no relationship with sex, age, length of diabetes, nor with the degree of metabolic control of disease, classified taking into account several clinical and biochemical indicators. C peptide concentration was found to be within normal levels in the whole group of patients under clinical remission phase of diabetes and also in 75% of children during the first 6 months of disease development. C peptide levels were higher in male than female diabetic children, showing an inverse relationship with duration of disease (r = -0.577, p less than 0.001) and with daily insulin requirements (r = -0.532, p less than 0.005). Discriminant analysis and multiple regression analysis results showed that the patients with a higher risk of bad control of diabetes were the older, those with a larger duration of disease, specially female, those with no remission phase of diabetes during clinical course of disease, and those showing bad motivation in relation to treatment.