Blood-feeding performance of nymphs and adults of Triatoma brasiliensis on human hosts

The blood-feeding behaviour of nymphs and adults of Triatoma brasiliensis fed on the forearm of human volunteers was studied by electronic monitoring of the cibarial pump. Parameters of total contact time (TT), initial weight (IW), weight gain (WG), ingestion rate (IR), pump frequency (F), quantity of liquid ingested per cibarial pump stroke (QLC) and non-ingestive time (NIT) (cumulative probing time and pumping interruptions during blood feeding) were measured. Protein profile (SDS-PAGE) and quantity of proteins of salivary gland extracts (QP) were also determined for each stage. The TT reflects the feeding performance of the insects and differed between instars, varying between 18.3+/-2.5 min for the first instar and 33.9+/-2.3 min for the fifth instar. The observed increase in the IR when comparing different instars was related to the increase in the cibarial pump volume inferred from the QLC data. During development, the volume of the cibarial pump grew asymmetrically determining the different contact times observed among the instars. Males and females presented a remarkable sexual dimorphism in respect to the volume of the cibarial pump, females showing a better performance compared to males. Despite the differences, the results show that each of the development stages of T. brasiliensis was able to obtain a relatively fast bloodmeal, with few interruptions and without causing pain, providing further evidence of the capacity of this species to adapt to domestic environments.     

Endothelial adhesion molecules ICAM-1, VCAM-1 and E-selectin in patients with acute coronary syndrome

INTRODUCTION AND OBJECTIVES: The acute inflammatory response is an important phenomenon in the pathogenesis of myocardial damage during acute coronary syndrome. Endothelial dysfunction has been found in unstable angina and acute myocardial infarction, although the results are controversial. The purpose of this study was to determine the levels of the soluble endothelial adhesion molecules ICAM-1, VCAM-1 and E-selectin, in patients with unstable angina and acute myocardial infarction, compare the results in both groups, and analyze their relation with the degree of myocardial injury. METHODS: Serum concentrations of ICAM-1, VCAM-1, and E-selectin were measured in 37 control subjects and 43 patients (32 with acute myocardial infarction and 11 with unstable angina). Measurements were made at the time of admission and ten days later using commercial enzyme-linked immunoabsorbent assay (ELISA) kits (R&D Systems, UK). RESULTS: There was a significant increase in E-selectin (p < 0.05) in patients with unstable angina at admission and ten days later. In contrast, patients with acute myocardial infarction showed no significant differences in E-selectin compared with the control group at admission or ten days later. A significant increase in VCAM-1 levels was demonstrated in both groups of patients and ICAM-1 levels in acute myocardial infarction, but the concentrations of VCAM-1 and ICAM-1 in both groups of patients at admission and ten days later did not differ significantly. There was no relation between soluble endothelial adhesion molecule levels and the severity of myocardial damage estimated by cardiac enzymes or electrocardiographic changes. CONCLUSION: This study indicates that serum levels of E-selectin, measured at time of admission and ten days later, could be a marker for unstable angina and might be useful in the differential diagnosis with myocardial infarction.     

PML-RAR induces promyelocytic leukemias with high efficiency following retroviral gene transfer into purified murine hematopoietic progenitors

Acute promyelocytic leukemia (APL) is associated with chromosomal translocations resulting in fusion proteins of the retinoic acid receptor (RAR). Here, we report a novel murine model system for APL, based on the transduction of purified murine hematopoietic progenitors (lin(-)) using high-titer retroviral vectors encoding promyelocytic leukemia-RAR (PML-RAR), and the green fluorescent protein (GFP) as a marker. PML-RAR-expressing lin(-) cells were impaired in their ability to undergo terminal myeloid differentiation and showed increased proliferative potential in vitro. Inoculation of transduced lin(-) cells into syngeneic, irradiated mice resulted in the development of retinoic acid-sensitive promyelocytic leukemias at high frequency (> 80%) and short latency (approximately 4 months). Morphologic and immunophenotypic analysis revealed no gross abnormalities of the preleukemic bone marrows. However, hematopoietic progenitors from PML-RAR preleukemic mice showed a severe impairment in their ability to undergo myeloid differentiation in vitro. This result, together with the monoclonality or oligoclonality of the leukemic blasts, supports a "multiple-hit" model, where the fusion protein causes a "preleukemic" phase, and leukemia occurs after additional genetic lesions. This model system faithfully reproduces the main characteristics of human APL and represents a versatile tool for the in vitro and in vivo study of mechanisms of leukemogenesis and the design of protocols for differentiation treatment.     

EUS-guided trucut needle biopsies in patients with solid pancreatic masses: a prospective study

BACKGROUND: A trucut needle biopsy device that can be used to obtain specimens from the pancreas and other perigastric organs under EUS guidance has been developed and successfully tested in animals. Moreover, EUS-guided trucut needle biopsy has been used safely in humans and appears to provide more accurate results than EUS-guided FNA. This study prospectively assessed the clinical utility of this new device in patients with solid pancreatic masses. METHODS: Twenty-three consecutive patients with radiologically detected solid pancreatic masses underwent EUS-guided trucut needle biopsy. Pancreatic malignancy detected by EUS-guided trucut needle biopsy was considered a definitive diagnosis. Further diagnostic procedures and clinical course were used to establish or exclude the presence of malignancy in all other patients. RESULTS: Pancreatic tissue was obtained in 17 of the 23 patients (74%), including all patients in whom the transgastric approach was used. No acute or long-term complication was observed. Histopathologic evaluation revealed pancreatic cancer in 12 patients. CT-guided biopsy specimens were obtained in 4 of the 5 patients with a negative EUS-guided trucut needle biopsy result; two were positive for adenocarcinoma. Overall diagnostic accuracy was 61%. Subgroup analysis of the 16 patients in whom EUS-guided trucut needle biopsy was successful and who were available for follow-up revealed a diagnostic accuracy of 87.5%. CONCLUSIONS: This prospective study demonstrates that EUS-guided trucut needle biopsy, when performed transgastrically, is safe and accurate in the evaluation of patients with solid pancreatic masses.     

Designing Clinical Trials for Dystonia

With advances in the understanding of the pathophysiology of dystonia, novel therapeutics are being developed. Such therapies will require clinical investigation ranging from exploratory studies to examine safety, tolerability, dosage selection, and preliminary efficacy to confirmatory studies to evaluate efficacy definitively. As dystonia is a rare and complex disorder with clinical and etiological heterogeneity, clinical trials will require careful consideration of the trial design, including enrollment criteria, concomitant medication use, and outcome measures. Given the complexities of designing and implementing efficient clinical trials, it is important for clinicians and statisticians to collaborate closely throughout the clinical development process and that each has a basic understanding of both the clinical and statistical issues that must be addressed. To facilitate designing appropriate clinical trials in this field, we review important general clinical trial and regulatory principles, and discuss the critical components of trials with an emphasis on considerations specific to dystonia. Additionally, we discuss designs used in early exploratory, late exploratory, and confirmatory phases, including adaptive designs.     

Characterization of fifteen microsatellite markers for the kelp Laminaria ochroleuca and cross species amplification within the genus

The brown algal genus Laminaria (Phaeophyceae, Laminariales) is ecologically and economically important. Laminaria ochroleuca is the genus member with the southernmost distribution in the Northern hemisphere, from Southern Great Britain to Morocco. Here we describe the characterization of 15 microsatellite loci that can be used to study genetic diversity at different spatial scales and its dynamics in declining southern populations. These loci identified a number of alleles ranging from 3 to 26 (mean = 9). Expected heterozygosities range from 0.0824 to 0.9401. We also tested cross-amplification of these microsatellite markers in two other species within the genus, L. hyperborea and L. digitata. A total of eight and ten alleles cross-amplified in L. hyperborea and L. digitata, respectively. These 15 variable microsatellite loci are an important molecular tool to conduct population genetics studies in L. ochroleuca and other species within the genus.     

Treatment of anastomotic stenosis and leakage after colorectal resection for cancer with self-expandable metal stents

Background

Self-expandable metallic stents can be used to treat patients with symptomatic anastomotic complications after colorectal resection.

Methods

Twenty patients with symptomatic anastomotic stricture after colorectal resection were treated with endoscopic placement of a self-expandable metal stent. Ten patients had “simple” anastomotic stricture. In the remaining 10 patients, a leak was associated with the stricture.

Results

The anastomotic leakage healed without evidence of residual stricture or major fecal incontinence in 8 of 10 patients. Overall, the anastomotic stricture was resolved in 14 of the 20 patients.

Conclusions

Self-expandable metal stents represent a valid adjunctive to treat patients with symptomatic anastomotic complications after colorectal resection for cancer. They have a complementary role to balloon dilatation in case of simple anastomotic stricture, and they improve the rate of healing when the stricture is associated with a leak.