Individual Repeatability of Locomotor Kinematics and Swimming Performance in a Gymnotiform Swimmer.

AbstractGymnotiform swimming is a specialized form of swimming wherein thrust is produced by the ribbonlike motion of an elongate anal fin, while the body is held relatively stiff. This form of swimming has been extensively examined in relation to the biomechanics of thrust production, the kinematics of the anal fin, and neuromuscular control, whereas few studies have examined whole-animal performance parameters of this swimming mode. The goals of this research were to (1) assess the maximum abilities and repeatability of two swimming performance measures, sprinting and prolonged swimming, which would indicate that these performance measures in a gymnotiform swimmer may be a target for selection, similar to body-caudal fin-swimming fish; (2) examine how a gymnotiform swimmer modulates swimming speed; and (3) determine whether modulatory behavior is consistent across different-sized fish and within individuals across time. Sprinting and prolonged swimming were examined in black ghost knifefish (Apteronotus albifrons; N=15), multiple times on the same day, and were measured again 4 wk later. Sprinting ability was measured by chasing a fish down a photocell-lined racetrack and obtaining the fastest speed between any 8-cm span. Prolonged swimming abilities were measured in a constant acceleration test (Ucat) in a Brett-style swim tunnel by measuring the maximum speed the fish could attain against a steadily increasing water velocity. We determined frequency, wavelength, and amplitude of the anal fin sine wave in fish swimming at different speeds during the Ucat trials. We found repeatable measures of sprint speed and Ucat performance over short (day) and medium (4 wk) time periods for both tests. Neither sprint nor Ucat performance was significantly dependent on size, suggesting that the primary driver of performance variation was individual differences in physiology. Most modulation of swimming speed occurred through changes in the frequency of the wave train processing down the anal fin, with only modest changes to the wavelength and minimal changes to amplitude. Finally, we compare our measures of swimming performance in this gymnotiform swimmer to published values of body-caudal fin swimmers to demonstrate that this form of locomotion results in comparable sprint and constant-acceleration values.

Oxygen consumption rate v. rate of energy utilization of fishes: a comparison and brief history of the two measurements.

Accounting for energy use by fishes has been taking place for over 200 years. The original, and continuing gold standard for measuring energy use in terrestrial animals, is to account for the waste heat produced by all reactions of metabolism, a process referred to as direct calorimetry. Direct calorimetry is not easy or convenient in terrestrial animals and is extremely difficult in aquatic animals. Thus, the original and most subsequent measurements of metabolic activity in fishes have been measured via indirect calorimetry. Indirect calorimetry takes advantage of the fact that oxygen is consumed and carbon dioxide is produced during the catabolic conversion of foodstuffs or energy reserves to useful ATP energy. As measuring [CO2 ] in water is more challenging than measuring [O2 ], most indirect calorimetric studies on fishes have used the rate of O2 consumption. To relate measurements of O2 consumption back to actual energy usage requires knowledge of the substrate being oxidized. Many contemporary studies of O2 consumption by fishes do not attempt to relate this measurement back to actual energy usage. Thus, the rate of oxygen consumption (M˙O2 ) has become a measurement in its own right that is not necessarily synonymous with metabolic rate. Because all extant fishes are obligate aerobes (many fishes engage in substantial net anaerobiosis, but all require oxygen to complete their life cycle), this discrepancy does not appear to be of great concern to the fish biology community, and reports of fish oxygen consumption, without being related to energy, have proliferated. Unfortunately, under some circumstances, these measures can be quite different from one another. A review of the methodological history of the two measurements and a look towards the future are included.

Acute kidney injury after open ventral hernia repair: an analysis of the 2005-2012 ACS-NSQIP datasets.

PURPOSE: Acute kidney injury (AKI) is a serious postoperative complication, negatively impacting mortality rates, extending length of stay, and raising hospital costs. The purpose of this study was to examine AKI following open ventral hernia repair (OVHR) using a large, heterogeneous database to determine the incidence and identify risk factors for this complication. METHODS: Using the 2005-2012 ACS-NSQIP database, patients undergoing open ventral hernia repair were identified by CPT codes. Patients with acute kidney injury within 30 days of surgery were compared to controls by multivariate logistic regression across preoperative and intraoperative characteristics. RESULTS: Of 48,629 open ventral hernia repair patients identified in the dataset, AKI developed in 1.4% (681 patients). Multivariate logistic regression determined a number of factors associated with AKI. These include WHO Class III obesity (OR = 2.57, p < 0.001), history of cardiovascular disease (OR = 1.81, p < 0.001), diabetes (OR = 1.29, p = 0.028), hypoalbuminemia (OR = 1.42, p = 0.004), and chronic kidney disease (for a baseline GFR of 60-89 mL/min/1.73 m2, OR = 1.62, p = 0.001; for 30-59 mL/min/1.73 m2, OR = 2.25, p < 0.001; for 15-29 mL/min/1.73 m2, OR = 4.96, p < 0.001). Intraoperative factors include prolonged operative time (for ≥1 SD above the mean, OR = 1.68, p = 0.002; for ≥2SD above the mean, OR = 2.76, p < 0.001) and intraoperative transfusion (OR = 2.44, p < 0.001). CONCLUSIONS: Patients with a history of obesity, chronic kidney disease, cardiovascular history, diabetes, and hypoalbuminemia are at increased risk for AKI when undergoing OVHR. Intraoperative variables such as prolonged operative times and blood transfusions may also suggest increased risk. Preoperative identification of patients with these characteristics and perioperative hemodynamic stabilization are important first steps to minimize this complication.

Hypoxia tolerance variance between swimming and resting striped bass Morone saxatilis.

Individual striped bass Morone saxatilis were each exposed in random order to aquatic hypoxia (10% air saturation) either while swimming at 50% of their estimated critical swimming speed (Ucrit ) or while at rest until they lost equilibrium. Individuals were always less tolerant of hypoxia when swimming (P < 0.01); the average fish was over five times more tolerant to the same hypoxia exposure when not swimming. There was no relationship between an individual's rank order of hypoxia tolerance (HT) under the two flow regimes, suggesting that different factors determine an individual's HT when at rest than when swimming.

Readmission following ventral hernia repair: a model derived from the ACS-NSQIP datasets.

BACKGROUND: Institutions are now incentivized to decrease rates of preventable readmissions. The purpose of this study was to examine readmissions following open ventral hernia repair (VHR), to ultimately create a model to preoperatively identify high-risk patients. STUDY DESIGN: Utilizing the 2011 and 2012 ACS-NSQIP datasets, patients undergoing open VHR were identified by CPT codes. Patients who were readmitted in 2011 within 30 days of the procedure were compared to those who were not with regard to preoperative and operative characteristics. A bootstrap analysis was performed to identify internally validated risk factors to be included in the final logistic regression, which was utilized to create a weighted model to predict the risk of readmission. This model was then validated with VHR patients in 2012. RESULTS: Overall, 10,745 patients were included for model generation. Of these, 850 (7.9%) patients were readmitted within 30 days. The final bootstrap analysis demonstrated that active smoking, ASA ≥ 3, a history of bleeding disorder or anemia, long operative time, inpatient status, and concurrent panniculectomy were all independently associated with readmission following ventral hernia repair. Significant variables were assigned a weighted score, ranging from 1 to 3. Each patient was then placed into one of four cohorts according to their summed score. The internally validated model [Hernia Readmission Risk (HERR) Score] demonstrated that risk increased in a linear fashion, with the highest risk cohort having a 21% risk of 30-day readmission. CONCLUSIONS: Perioperative predictors of readmission following VHR include smoking, ASA score, operative magnitude, concurrent panniculectomy, and preoperative anemia and bleeding disorders. The presented model based on these factors can aid in perioperative risk stratification for readmission.

Wound risk assessment in ventral hernia repair: generation and internal validation of a risk stratification system using the ACS-NSQIP.

BACKGROUND: There is a need for validated risk models to better stratify surgical site occurrences (SSO) following open ventral hernia repair (OVHR). The addition of more generalizable and validated risk models will serve to improve perioperative care in OVHR patients. METHODS: We reviewed the 2005-2011 ACS-NSQIP databases identifying encounters for OVHR. The dependent outcome measure of interest was SSO, defined as superficial surgical site infection, deep infection, organ space infection, or wound dehiscence. Multivariate logistic regression of independently associated factors was performed and internally validated using a bootstrap technique. A composite risk score, the Hernia Wound Risk Assessment Tool (HW-RAT) was created using weighted beta coefficients. The HW-RAT was compared to existing models from the literature. RESULTS: A total of 60,187 patients who met inclusion criteria were identified in the 2005-2011 ACS-NSQIP databases. The incidence of SSO in the study was 6.2% (N = 3,732). SSO risk factors were broken down based on rounded risk scores into the following groups: mild, intermediate, moderate, and severe risk. Severe risk factors related to operative time and degree of wound contamination. Moderate risk factors included class III obesity, component separation, dependent functional status, and inpatient hernia surgery. Patient stratification was performed based on total risk score into HW-RAT risk groups 1 through 5 which demonstrated significant discrimination between and across each group (P < 0.01, C-statistic = 0.71) with an incidence of SSO that ranged from 3.3 to 26.5%. CONCLUSION: We present an internally validated risk model of SSO in OVHR (HW-RAT), which complements and builds upon current risk models. LEVEL OF EVIDENCE: Prognostic/risk category, level II.

Breaking wind to survive: fishes that breathe air with their gut.

Several taxonomically disparate groups of fishes have evolved the ability to extract oxygen from the air with elements of their gut. Despite perceived difficulties with balancing digestive and respiratory function, gut air breathing (GAB) has evolved multiple times in fishes and several GAB families are among the most successful fish families in terms of species numbers. When gut segments evolve into an air-breathing organ (ABO), there is generally a specialized region for exchange of gases where the gut wall has diminished, vascularization has increased, capillaries have penetrated into the luminal epithelium and surfactant is produced. This specialized region is generally separated from digestive portions of the gut by sphincters. GAB fishes tend to be facultative air breathers that use air breathing to supplement aquatic respiration in hypoxic waters. Some hindgut breathers may be continuous, but not obligate air breathers (obligate air breathers drown if denied access to air). Gut ABOs are generally used only for oxygen uptake; CO2 elimination seems to occur via the gills and skin in all GAB fishes studied. Aerial ventilation in GAB fishes is driven primarily by oxygen partial pressure of the water (PO2) and possibly also by metabolic demand. The effect of aerial ventilation on branchial ventilation and the cardiovascular system is complex and generalizations across taxa or ABO type are not currently possible. Blood from GAB fishes generally has a low blood oxygen partial pressure that half saturates haemoglobin (p50) with a very low erythrocytic nucleoside triphosphate concentration [NTP]. GAB behaviour in nature depends on the social and ecological context of the animal as well as on physiological factors.

Individual variation and repeatability in aerobic and anaerobic swimming performance of European sea bass, Dicentrarchus labrax.

Studies of inter-individual variation in fish swimming performance may provide insight into how selection has influenced diversity in phenotypic traits. We investigated individual variation and short-term repeatability of individual swimming performance by wild European sea bass in a constant acceleration test (CAT). Fish were challenged with four consecutive CATs with 5 min rest between trials. We measured maximum anaerobic speed at exhaustion (U(CAT)), gait transition speed from steady aerobic to unsteady anaerobic swimming (U(gt)), routine metabolic rate (RMR), post-CAT maximum metabolic rate (MMR), aerobic scope and recovery time from the CATs. Fish achieved significantly higher speeds during the first CAT (U(CAT)=170 cm s(-1)), and had much more inter-individual variation in performance (coefficient of variation, CV=18.43%) than in the subsequent three tests (U(CAT)=134 cm s(-1); CV=7.3%), which were very repeatable among individuals. The individual variation in U(CAT) in the first trial could be accounted for almost exclusively by variation in anaerobic burst-and-coast performance beyond U(gt). The U(gt) itself varied substantially between individuals (CV=11.4%), but was significantly repeatable across all four trials. Individual RMR and MMR varied considerably, but the rank order of post-CAT MMR was highly repeatable. Recovery rate from the four CATs was highly variable and correlated positively with the first U(CAT) (longer recovery for higher speeds) but negatively with RMR and aerobic scope (shorter recovery for higher RMR and aerobic scope). This large variation in individual performance coupled with the strong correlations between some of the studied variables may reflect divergent selection favouring alternative strategies for foraging and avoiding predation.

Human Cytomegalovirus US28: a functionally selective chemokine binding receptor.

Chemokines are small cytokines that are part of a large family of molecules that bind to G-protein coupled receptors, which, as a family, are the most widely targeted group of molecules in the treatment of disease. Chemokines are critical for recruiting and activating the cells of the immune system during inflammation especially during viral infections. However, a number of viruses including the large herpes virus human cytomegalovirus (HCMV) encode mechanisms to impede the effects of chemokines or has gained the ability to use these molecules to its own advantage. The Human Cytomegalovirus (HCMV)-encoded chemokine receptor US28 is the best characterized of the four unique chemokine receptor-like molecules found in the HCMV genome. US28 has been studied as an important virulence factor for HCMV-mediated vascular disease and, more recently, in models of HCMV-associated malignancy. US28 is a rare multi-chemokine family binding receptor with the ability to bind ligands from two distinct chemokine classes. Ligand binding to US28 activates cell-type and ligand-specific signaling pathways leading to cellular migration, which is an important example of receptor functional selectivity. Additionally, US28 has been demonstrated to constitutively activate phospholipase C (PLC) and NF-kB signaling pathways. Understanding the structure/function relationships between US28, its ligands and intracellular signaling molecules will provide essential clues for effective pharmacological targeting of this multifunctional chemokine receptor.

Mechanisms of cytomegalovirus-accelerated vascular disease: induction of paracrine factors that promote angiogenesis and wound healing.

Human cytomegalovirus (HCMV) is associated with the acceleration of a number of vascular diseases such as atherosclerosis, restenosis, and transplant vascular sclerosis (TVS). All of these diseases are the result of either mechanical or immune-mediated injury followed by inflammation and subsequent smooth muscle cell (SMC) migration from the vessel media to the intima and proliferation that culminates in vessel narrowing. A number of epidemiological and animal studies have demonstrated that CMV significantly accelerates TVS and chronic rejection (CR) in solid organ allografts. In addition, treatment of human recipients and animals alike with the antiviral drug ganciclovir results in prolonged survival of the allograft, indicating that CMV replication is a requirement for acceleration of disease. However, although virus persists in the allograft throughout the course of disease, the number of directly infected cells does not account for the global effects that the virus has on the acceleration of TVS and CR. Recent investigations of up- and downregulated cellular genes in infected allografts in comparison to native heart has demonstrated that rat CMV (RCMV) upregulates genes involved in wound healing (WH) and angiogenesis (AG). Consistent with this result, we have found that supernatants from HCMV-infected cells (HCMV secretome) induce WH and AG using in vitro models. Taken together, these findings suggest that one mechanism for HCMV acceleration of TVS is mediated through induction of secreted cytokines and growth factors from virus-infected cells that promote WH and AG in the allograft, resulting in the acceleration of TVS. We review here the ability of CMV infection to alter the local environment by producing cellular factors that act in a paracrine fashion to enhance WH and AG processes associated with the development of vascular disease, which accelerates chronic allograft rejection.

The role of angiogenic and wound repair factors during CMV-accelerated transplant vascular sclerosis in rat cardiac transplants.

Human cytomegalovirus (HCMV) accelerates transplant vascular sclerosis (TVS), a consequence of angiogenesis (AG) and wound repair (WR). While HCMV can be localized to TVS lesions, the low number of infected cells suggests a global effect on target tissues. We used microarray analysis followed by real-time-polymerase chain reaction (RT-PCR) in an RCMV-accelerated TVS rat cardiac transplant model to determine whether CMV activates host WR and AG factors. Dysregulated cellular genes in allografts from RCMV-infected recipients were compared to those from uninfected recipients and native hearts. We demonstrated that RCMV upregulates the genes involved in WR and AG, which was highest during the critical time of TVS acceleration (21-28 days). Using a standard in vitro AG assay, virus and serum-free supernatants collected at 48 h postinfection significantly induced endothelial cell (EC) migration, branching and tubule formation compared to supernatants from mock-infected cells. Supernatants from ultraviolet (UV)-inactivated RCMV-infected cells failed to induce AG, indicating that virus replication is required. Upregulation of WR and AG genes occurs during the critical period of CMV-accelerated TVS. Targeting these genes may prevent this process and improve allograft survival.

Acceptability of self-collection of specimens for HPV DNA testing in an urban population.

PURPOSE: To assess the acceptability of self-collection of specimens for human papillomavirus (HPV) DNA testing and to explore whether use of self-collected specimens would increase intention to participate in regular screening among low-income, inner-city, minority women. METHODS: A written survey was administered to 172 women after they underwent gynecological examination and self-collection of a sample for HPV DNA testing. RESULTS: Participants agreed that ease of use (69%), less painful procedure (62%), "could do it myself" (56%), and privacy (52%) were desirable characteristics of the self-sampling procedure they performed. Most of the participants (57%) reported that there was nothing they did not like about self-sampling; however, the majority (68%) preferred the clinician-collected test. Those recruited through a sexually transmitted disease (STD) clinic were significantly more likely than those recruited at a cancer screening clinic (57% vs. 24%), those with some or more college education were significantly more likely than those with less education (43% vs. 26%), and those who were not Hispanic were significantly more likely than those who were Hispanic (49% vs. 28%) to prefer the self-collected test. Although most women (47%) reported that they would be most likely to attend regular screening if tested by a clinician during a pelvic examination, 21% asserted that self-collection at home would increase their likelihood of participation in screening. CONCLUSIONS: Although most of the predominantly Hispanic, low-income, uninsured, and recently screened women in the study preferred clinician-collected HPV tests to self-collected sampling, self-sampling is acceptable to the majority and may increase the likelihood of participation in cervical cancer screening programs.

Coregistration of quantitative proton magnetic resonance spectroscopic imaging with neuropathological and neurophysiological analyses defines the extent of neuronal impairments in murine human immunodeficiency virus type-1 encephalitis.

Relatively few immune-activated and virus-infected mononuclear phagocytes (MP; perivascular macrophages and microglia) may affect widespread neuronal dysfunction during human immunodeficiency virus type 1 (HIV-1)-associated dementia (HAD). Indeed, histopathological evidence of neuronal dropout often belies the extent of cognitive impairment. To define relationships between neuronal function and histopathology, proton magnetic resonance spectroscopic imaging (1H MRSI) and hippocampal long-term potentiation (LTP) were compared with neuronal and glial immunohistology in a murine model of HIV-1 encephalitis (HIVE). HIV-1(ADA)-infected human monocyte-derived macrophages (MDM) were stereotactically injected into the subcortex of severe combined immunodeficient (SCID) mice. Sham-operated and unmanipulated mice served as controls. Seven days after cell injection, brain histological analyses revealed a focal giant cell encephalitis, with reactive astrocytes, microgliosis, and neuronal dropout. Strikingly, significant reductions in N-acetyl aspartate concentration ([NAA]) and LTP levels in HIVE mice were in both injected and contralateral hemispheres and in brain subregions, including the hippocampus, where neuropathology was limited or absent. The data support the importance of 1H MRSI as a tool for assessing neuronal function for HAD. The data also demonstrate that a highly focal encephalitis can produce global deficits for neuronal function and metabolism.

Beyond U(crit): matching swimming performance tests to the physiological ecology of the animal, including a new fish 'drag strip'.

Locomotor performance of animals is of considerable interest from management, physiological, ecological and evolutionary perspectives. Yet, despite the extensive commercial exploitation of fishes and interest in the health of various fish stocks, the relationships between performance capacity, natural selection, ecology and physiology are poorly known for fishes. One reason may be the technical challenges faced when trying to measure various locomotor capacities in aquatic species, but we will argue that the slow pace of developing new species-appropriate swim tests is also hindering progress. A technique developed for anadromous salmonids (the U(crit) procedure) has dominated the fish exercise physiology field and, while accounting for major advances in the field, has often been used arbitrarily. Here we propose criteria swimming tests should adhere to and report on several attempts to match swimming tests to the physiological ecology of the animal. Sprint performance measured with a laser diode/photocell timed 'drag strip' is a new method employing new technology and is reported on in some detail. A second new test involves accelerating water past the fish at a constant rate in a traditional swim tunnel/respirometer. These two performance tests were designed to better understand the biology of a bentho-pelagic marine fish, the Atlantic cod (Gadus morhua). Finally, we report on a modified incremental velocity test that was developed to better understand the biology of the blacknose dace (Rhinichthys atratulus), a Nearctic, lotic cyprinid.

Contrasts in cortical magnesium, phospholipid and energy metabolism between migraine syndromes.

BACKGROUND: Previous single voxel (31)P MRS pilot studies of migraine patients have suggested that disordered energy metabolism or Mg(2+) deficiencies may be responsible for hyperexcitability of neuronal tissue in migraine patients. These studies were extended to include multiple brain regions and larger numbers of patients by multislice (31)P MR spectroscopic imaging. METHODS: Migraine with aura (MWA), migraine without aura (MwoA), and hemiplegic migraine patients were studied between attacks by (31)P MRS imaging using a 3-T scanner. RESULTS: Results were compared with those in healthy control subjects without headache. In MwoA, consistent increases in phosphodiester concentration [PDE] were measured in most brain regions, with a trend toward increase in [Mg(2+)] in posterior brain. In MWA, phosphocreatine concentration ([PCr]) was decreased to a minor degree in anterior brain regions and a trend toward decreased [Mg(2+)] was observed in posterior slice 1, but no consistent changes were found in phosphomonoester concentration [PME], [PDE], inorganic phosphate concentration ([Pi]), or pH. In hemiplegic migraine patients, [PCr] had a tendency to be lower, and [Mg(2+)] was significantly lower than in the posterior brain regions of control subjects. Trend analysis showed a significant decrease of brain [Mg(2+)] and [PDE] in posterior brain regions with increasing severity of neurologic symptoms. CONCLUSIONS: Overall, the results support no substantial or consistent abnormalities of energy metabolism, but it is hypothesized that disturbances in magnesium ion homeostasis may contribute to brain cortex hyperexcitability and the pathogenesis of migraine syndromes associated with neurologic symptoms. In contrast, migraine patients without a neurologic aura may exhibit compensatory changes in [Mg(2+)] and membrane phospholipids that counteract cortical excitability.

Once a fast cod, always a fast cod: maintenance of performance hierarchies despite changing food availability in cod (Gadus morhua).

To examine whether Atlantic cod maintain constant hierarchies of sprint speeds and muscle metabolic capacities under different feeding regimes, the physiological capacities of individual cod were followed through a starvation-feeding-starvation cycle. We examined sprint speeds and maximal enzyme activities in white-muscle biopsies at each period. We measured the glycolytic enzymes, phosphofructokinase (PFK) and lactate dehydrogenase (LDH), the mitochondrial enzyme, cytochrome C oxidase (CCO), and the biosynthetic enzyme, nucleotide diphosphate kinase (NDPK). Sprint speeds were measured in a laser diode/photocell-timed raceway. As expected, the feeding regime had a marked impact on the physiological capacities of cod, but the responses differed for sprint-swimming and muscle metabolic capacities. The different enzyme activities as well the condition index generally decreased during the first starvation, improved with feeding, and fell again during the second starvation. In contrast, sprint performance improved after feeding but did not fall with the second starvation. Although both the enzyme activities and the sprint speeds showed considerable interindividual variation, sprint speeds were not significantly correlated with the enzyme activities. The hierarchy of sprint performance of the cod was maintained, regardless of the preceding feeding regime, whereas those of muscle metabolic capacities were not.

Effect of spectral shaping and content on loudness discomfort.

The purpose of this investigation was to study the impact of spectral shape and content on thresholds of discomfort (TD) for listeners with normal hearing and listeners with hearing loss. Secondary to that purpose was to quantify binaural summation at high intensities across complex stimulus conditions for both groups of listeners. Forty subjects (20 with normal hearing, 20 with hearing loss) participated. Complex acoustic stimuli (multitone and continuous discourse) were filtered to have four spectral shapes: (1) flat spectrum, (2) long-term average speech spectrum, (3) reverse long-term average speech spectrum, and (4) the TD contour derived for each subject from pure-tone TD obtained with eight pure tones from 250 to 4000 Hz. The results suggest that (1) TD for complex stimuli are lower for subjects with hearing loss compared with those with normal hearing, suggesting increased loudness summation with this population; (2) binaural summation of approximately 6 dB (independent of stimulus type, filter shape, or spectral content), indicating that a correction of similar magnitude for bilateral hearing aid fittings is appropriate; and (3) TD obtained at 750, 1500, and 3000 Hz accounted for approximately 60 percent of the variance in the complex TD measures, suggesting that TD at these frequencies be used to set the output obtained from a hearing aid with a 90-dB pure-tone sweep as the input stimulus.

Do pathogens accelerate atherosclerosis?

Infection with the pathogens human cytomegalovirus (HCMV) or Chlamydia pneumonia (CP) is linked to the development of vascular disease, including atherosclerosis. The role of pathogens in vasculopathies has been controversial. However, animal models have demonstrated a direct link between infection with CP and herpesviruses and the development of vascular disease. Clinical studies have shown a direct association of HCMV and CP with the acceleration of vascular disease. This article will review the evidence supporting the role for CP and HCMV in the development of vascular disease and will suggest a potential mechanism for HCMV acceleration of the disease process. Vascular diseases are the result of either mechanical or immune-related injury followed by inflammation and subsequent smooth muscle cell (SMC) proliferation and/or migration from the vessel media to the intima, which culminates in vessel narrowing. A number of in vitro and in vivo models have provided potential mechanisms involved in pathogen-mediated vascular disease. Recently, we have demonstrated that HCMV infection of arterial but not venous SMC results in significant cellular migration in vitro. Migration was dependent on expression of the HCMV-encoded chemokine receptors, US28, and the presence of the chemokines, RANTES or MCP-1. Migration involved chemotaxis and provided the first evidence that viruses may induce migration of SMC toward sites of chemokine production through the expression of a virally encoded chemokine receptor in infected SMC. Because SMC migration into the neointimal space is the hallmark of vascular disease, these observations provide a molecular link between HCMV and the development of vascular disease.

Bartonella henselae serostatus is not correlated with neurocognitive decline in HIV infection.

Bartonella henselae has been implicated as a significant cause of HIV-associated dementia. We attempted to confirm this association by utilizing the database of the San Diego HIV Neurobehavioral Research Center, which collects longitudinal neurocognitive and laboratory data on over 500 HIV-infected participants. Utilizing an immunofluorescent assay we found that 11% of 177 subjects, half of whom had documented neurocognitive decline, were seropositive for B. henselae. There was no correlation between B. henselae seropositivity and neurocognitive decline. The role of B. henselae in HIV-associated dementia remains ambiguous.