The Complete Nucleotide Sequence of the Carbapenem Resistance-Conferring Conjugative Plasmid pLD209 from a Pseudomonas putida Clinical Strain Reveals a Chimeric Design Formed by Modules Derived from Both Environmental and Clinical Bacteria

The complete sequence of the carbapenem-resistance-conferring conjugative plasmid pLD209 from a Pseudomonas putida clinical strain is presented. pLD209 is formed by 3 well-defined regions: an adaptability module encompassing a Tn402-like class 1 integron of clinical origin containing bla_VIM-2 and aacA4 gene cassettes, partitioning and transfer modules, and a replication module derived from plasmids of environmental bacteria. pLD209 is thus a mosaic of modules originating in both the clinical and environmental (nonclinical) microbiota.     

Automated transfer and injection of hyperpolarized molecules with polarization measurement prior to in vivo NMR

Hyperpolarized magnetic resonance via dissolution dynamic nuclear polarization necessitates the transfer of the hyperpolarized molecules from the polarizer to the imager prior to in vivo measurements. This process leads to unavoidable losses in nuclear polarization, which are difficult to evaluate once the solution has been injected into an animal. We propose a method to measure the polarization of the hyperpolarized molecules inside the imager bore, 3 s following dissolution, at the time of the injection, using a precise quantification of the infusate concentration. This in situ quantification allows for distinguishing between signal modulations related to variations in the nuclear polarization at the time of the injection and signal modulations related to physiological processes such as tissue perfusion. In addition, our method includes a radical scavenging process that leads to a minor reduction in sample concentration and takes place within a couple of seconds following the dissolution in order to minimize the losses due to the presence of paramagnetic polarizing agent in the infusate. We showed that proton exchange between vitamin C, the scavenging molecule and the deuterated solvent shortens the long carboxyl ¹³C longitudinal relaxation time in [1‐¹³C]acetate. This additional source of dipolar relaxation can be avoided by using deuterated ascorbate. Overall, the method allows for a substantial gain in polarization and also leads to an extension of the time window available for in vivo measurements. Copyright © 2013 John Wiley & Sons, Ltd.     

Abnormal electrocardiogram in a patient with amyotrophic lateral sclerosis mimicking myocardial ischaemia

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder that almost exclusively involves motor neurons although autonomic dysfunction has also been reported. We present an 84-year-old female with no documented history of heart disease, who was admitted with negative T waves in the electrocardiogram precordial leads mimicking myocardial ischaemia. No other abnormalities were shown in the rest of the cardiologic evaluation, suggesting autonomic nervous system dysfunction. A neurophysiological study demonstrated acute and chronic denervation in multiple muscles with normal nerve conduction studies, confirming ALS diagnosis. Previous studies have shown that subclinical sympathetic hyperfunction and parasympathetic hypofunction might result in cardiovascular dysfunction in ALS patients. It is important to detect disturbances of autonomic cardiac control because this dysfunction may influence survival and quality of life, leading to a decrease in life expectancy in ALS patients. This Case Report may support the impairment of cardiac autonomic control in patients with ALS.     

Toward Computational Identification of Multiscale “Tipping Points” in Acute Inflammation and Multiple Organ Failure

Sepsis accounts annually for nearly 10% of total U.S. deaths, costing nearly $17?billion/year. Sepsis is a manifestation of disordered systemic inflammation. Properly regulated inflammation allows for timely recognition and effective reaction to injury or infection, but inadequate or overly robust inflammation can lead to Multiple Organ Dysfunction Syndrome (MODS). There is an incongruity between the systemic nature of disordered inflammation (as the target of inflammation-modulating therapies), and the regional manifestation of organ-specific failure (as the subject of organ support), that presents a therapeutic dilemma: systemic interventions can interfere with an individual organ system’s appropriate response, yet organ-specific interventions may not help the overall system reorient itself. Based on a decade of systems and computational approaches to deciphering acute inflammation, along with translationally-motivated experimental studies in both small and large animals, we propose that MODS evolves due to the feed-forward cycle of inflammation?→?damage?→?inflammation. We hypothesize that inflammation proceeds at a given, “nested” level or scale until positive feedback exceeds a “tipping point.” Below this tipping point, inflammation is contained and manageable; when this threshold is crossed, inflammation becomes disordered, and dysfunction propagates to a higher biological scale (e.g., progressing from cellular, to tissue/organ, to multiple organs, to the organism). Finally, we suggest that a combination of computational biology approaches involving data-driven and mechanistic mathematical modeling, in close association with studies in clinically relevant paradigms of sepsis/MODS, are necessary in order to define scale-specific “tipping points” and to suggest novel therapies for sepsis.