Vancomycin-Variable Enterococcus faecium: In Vivo Emergence of Vancomycin Resistance in a Vancomycin-Susceptible Isolate

We report the emergence of vancomycin resistance in a patient colonized with a vanA-containing, vanRS-negative isolate of Enterococcus faecium which was initially vancomycin susceptible. This is a previously undescribed mechanism of drug resistance with diagnostic and therapeutic implications.     

Prevalence of fasciolosis and dicrocoeliosis in slaughtered sheep and goats in Amol Abattoir,Mazandaran, northern Iran

Objective

The liver flukes, Fasciola spp. and Dicrocoelium dendriticum, infect ruminants and other mammalian extensively and cause major diseases of livestock that produce considerable economic losses.

Methods

A survey of 2391 sheep and goats slaughtered at an abattoir in Amol region, northern Iran was used to determine the prevalence of the liver flukes infection based on season, sex and specie of the animals.

Results

The results revealed that the prevalence rate of Fasciola spp. and Dicrocoelium dendriticum was 6.6% and 4.3% respectively. Dicrocoeliosis was more dominant in female animals (7.1%) whereas there was no sex-related difference in the prevalence of Fasciola spp. in male and female animals. Furthermore, Fasciolosis was significantly more prevalent than dicrocoeliosis in both sheep and goats. The Seasonal prevalence of Fasciola spp. was highest (P<0.005) during spring (8.3%) followed in order by autumn (8.1%), winter (5.9%) and summer (4.0%) but Dicrocoeliosis did not follow any seasonal pattern.

Conclusions

According to this study, it can be concluded that Amol is regarded as an endemic region for Fasciola spp and D. dandriticum infection. Moreover, Fasciola spp. is the most widespread liver fluke found in sheep and goats which is more dominant in sheep than goats.     

Elevated hippocampal resting-state connectivity underlies deficient neurocognitive function in aging

The brain is not idle during rest. Functional MRI (fMRI) studies have identified several resting-state networks, including the default mode network (DMN), which contains a set of cortical regions that interact with a hippocampus (HC) subsystem. Age-related alterations in the functional architecture of the DMN and HC may influence memory functions and possibly constitute a sensitive biomarker of forthcoming memory deficits. However, the exact form of DMN–HC alterations in aging and concomitant memory deficits is largely unknown. Here, using both task and resting data from 339 participants (25–80 y old), we have demonstrated age-related decrements in resting-state functional connectivity across most parts of the DMN, except for the HC network for which age-related elevation of connectivity between left and right HC was found along with attenuated HC–cortical connectivity. Elevated HC connectivity at rest, which was partly accounted for by age-related decline in white matter integrity of the fornix, was associated with lower cross-sectional episodic memory performance and declining longitudinal memory performance over 20 y. Additionally, elevated HC connectivity at rest was associated with reduced HC neural recruitment and HC–cortical connectivity during active memory encoding, which suggests that strong HC connectivity restricts the degree to which the HC interacts with other brain regions during active memory processing revealed by task fMRI. Collectively, our findings suggest a model in which age-related disruption in cortico–hippocampal functional connectivity leads to a more functionally isolated HC at rest, which translates into aberrant hippocampal decoupling and deficits during mnemonic processing.The brain is not idle at rest (1). Rather, intrinsic neuronal signaling, which manifests as spontaneous fluctuations in the blood oxygen level-dependent (BOLD) functional MRI (fMRI) signal, is ubiquitous in the human brain and consumes a substantial portion of the brain’s energy (2). Coherent spontaneous activity has been revealed in a hierarchy of networks that span large-scale functional circuits in the brain (3–6). These resting-state networks (RSNs) show moderate-to-high test–retest reliability (7) and replicability (8), and some have been found in the monkey (9) and infant (10) brain. In the adult human brain, RSNs include sensory motor, visual, attention, and mnemonic networks, as well as the default mode network (DMN). There is evidence that the DMN entails interacting subsystems and hubs that are implicated in episodic memory (11–13). One major hub encompasses the posterior cingulate cortex and the retrosplenial cortex. Other hubs include the lateral parietal cortex and the medial prefrontal cortex. In addition, a hippocampus (HC) subsystem is distinct from, yet interrelated with, the major cortical DMN hubs (12, 14).The functional architecture of the DMN and other RSNs is affected by different conditions, such as Alzheimer’s disease (AD), Parkinson’s disease, and head injury, suggesting that measurements of the brain’s intrinsic activity may be a sensitive biomarker and a putative diagnostic tool (for a review, see ref. 15). Alterations of the DMN have also been shown in age-comparative studies (16, 17), but the patterns of alterations are not homogeneous across different DMN components (18). Reduced functional connectivity among major cortical DMN nodes has been reported in aging (16, 17) and also in AD (19) and for asymptomatic APOE e4 carriers at increased risk of developing AD (20). Reduced cortical DMN connectivity has been linked to age-impaired performance on episodic memory (EM) tasks (21, 22). For instance, Wang and colleagues (21) showed that functional connectivity between cortical and HC hubs promoted performance on an EM task and was substantially weaker among low-performing elderly. This and other findings suggest that reductions in the DMN may be a basis for age-related EM impairment. However, elevated connectivity has been observed for the HC in individuals at genetic risk for AD (23, 24) and for elderly with memory complaints (25). Furthermore, a trend toward elevated functional connectivity for the medial temporal lobe (MTL) subsystem was observed in healthy older adults (26). Critically, higher subcortical RSN connectivity was found to correlate negatively with EM performance in an aging sample (27). Moreover, a recent combined fMRI/EEG study observed age increases in HC EEG beta power during rest (28).Thus, the association of aging with components of the DMN is complex, and it has been argued that age-related increases in functional connectivity need further examination (18). Such increases could reflect a multitude of processes, including age-related degenerative effects on the brain’s gray and white matter (18). Additionally, increases in HC functional connectivity may reflect alterations in proteolytic processes, such as amyloid deposition (29). Amyloid deposition is most prominent in posterior cortical regions of the DMN (29). It has been argued that there is a topological relationship between high neural activity over a lifetime within the DMN and amyloid deposition (30). Increased amyloid β protein burden within the posterior cortical DMN may cause cortico–hippocampal functional connectivity disruption (31), leading to a more functionally isolated HC network, which translates into aberrant hippocampal decoupling (30, 32, 33). Correspondingly, a recent model hypothesized that progressively less inhibitory cortical input would cause HC hyperactivity in aging (34).Elevated HC resting-state connectivity might thus be a sign of brain dysfunction, but the evidence remains inconclusive. Here, using data from a population-based sample covering the adult age span (n = 339, 25–80 y old), we tested the hypothesis that aging differentially affects distinct DMN components. A data-driven approach, independent component analysis (ICA), was used to identify DMN subsystems (4). We expected to observe age-related decreases in the connectivity of the cortical DMN. We also examined age-related alterations of HC RSN connectivity, and tested whether such alterations were related to HC volume and white matter integrity. We predicted that if increased HC connectivity was found, it would be accompanied by age-related decreases in internetwork connectivity of the HC RSN with cortical DMN regions. To constrain interpretations of age-related alterations, the DMN components were related to cognitive performance. Elevated HC RSN should negatively correlate with level and longitudinal change in EM performance. Such negative correlations could reflect an inability to flexibly recruit the HC and functionally associated areas during EM task performance due to aberrant hippocampal decoupling (23, 24). We tested this prediction by relating the HC RSN, within-person, to HC recruitment during an EM fMRI task (35, 36).     

Ultra-high-speed videography of resin–dentin interface failure dynamics under tensile load

ObjectivesUltra-high-speed (UHS) videography was used to visualize the fracture phenomena at the resin–dentin interface during micro-tensile bond strength (μTBS) test. We also investigated whether UHS videography is applicable for failure-mode analysis.MethodsTen human mid-coronal dentin surfaces were bonded using Clearfil SE Bond either in self-etching (SE) or etch-and-rinse (ER) mode. After 24-h water storage, the samples were cut into beams for μTBS test and tested at a cross-head speed of 1 mm/min. The fracture phenomena at the bonded interface were captured using a complementary metal–oxide–semiconductor digital UHS camera at 299,166 frames per second. The failure modes were classified using UHS videography, followed by scanning electron microscopy (SEM) analysis. The failure-mode distributions determined by UHS videography and SEM analysis were statistically analyzed using Fisher’s exact test with Bonferroni correction.ResultsThe crack-propagation speed exceeded 1,500 km/h. No significant difference was found between the SEM and UHS videography failure-mode distributions in the SE mode. A significant difference appeared between them in the ER mode. Significant differences in the incidence of cohesive failures within the adhesive and at the adhesive–composite interface between the SE and ER modes were identified by both SEM and UHS videography.SignificanceUHS videography enabled visualization of the fracture dynamics at the resin– dentin interfaces under tensile load. However, the resolution at such high frame rate was insufficient to classify the failure mode as precisely as that of SEM. Nevertheless, UHS videography can provide more detailed information about the fracture origin and propagation.     

Non-Viral Related Liver Enzymes Elevation After Kidney Transplantation

Background:

Liver enzymes elevations (LEE) can be observed after kidney transplantation due to multifactorial causes.

Objectives:

We performed a retrospective study on 1589 kidney transplants, 971 male and 618 female, who were hepatitis B surface antigen (HBsAg) and hepatitis C virus-antibody (HCV Ab) negative, and had no other liver diseases, to detect the prevalence of LEE and its risk factors in these patients between May 2008 and May 2010.

Patients and methods:

Liver enzymes and other biochemical parameters were measured in all recipients. Patients were divided into three groups, according to laboratory test time since transplantation: Group I, less than 3 months, Group II, 4 - 12 months after transplantation, and Group III, more than one year post-transplantation.

Results:

The highest LEE was more frequent in older patients (P < 0.001) and male individuals (P < 0.001). Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were higher in patients who received kidneys from deceased donors (10.4% and 23.8%, respectively) as compared to living donor transplants (5.6% and 14.8%, respectively) (P < 0.001). The elevation of ALT was the liver enzyme abnormality after kidney transplantation with the highest prevalence (34.3%). The levels of ALT and AST were significantly elevated within the first 3 months after transplantation, followed by the 4-12 months period (P < 0.001). There was a reverse correlation between liver enzyme levels and renal allograft function in both univariate and linear regression analyses. This correlation increased over time. There was also a significant relation between cyclosporine blood levels and liver enzyme values in the univariate analysis. However, this relationship was attenuated over time. Elevated liver enzymes also correlated with anemia.

Conclusions:

The LEE is a common finding among kidney transplant recipients. Serial monitoring of aminotransferases, particularly ALT, should be performed in all patients after kidney transplantation.     

Ultrasonographic findings of mesenchymal chondrosarcoma of the mandible: report of a case

Today, ultrasound imaging is being widely used to assess soft tissue lesions in the maxillofacial region. However, ultrasound investigations of intra-osseous lesions are rare, especially for tumors of the jaws. This report emphasized the capability of this useful imaging modality in identification of the characteristics of malignant conditions involving the bone. Mesenchymal chondrosarcoama, one of the unusual malignant conditions of the jaw, was presented in a young male with significant facial swelling. Different imaging modalities parallel with the histopathologic investigation confirmed the diagnosis. Interestingly, destruction of the bony cortex and new bone formation with a characteristic "sun ray appearance", highly suggestive of sarcomas, was manifested on the ultrasonograph. Thus, this report presented the ultrasonographic features of chondrosarcoma of mandible and considered the ultrasonography to be a useful imaging modality to evaluate intra-osseous jaw lesions.     

Serum concentrations of antiphospholipid and anticardiolipin antibodies are higher in HIV-infected women

Manifestations of viral infections like human immune deficiency virus (HIV) differ between women and men. There are some reports due to a higher risk of thrombosis due to antiphospholipid syndrome in HIV-infected women compared with men. The purpose of this study was demonstrating the impact of gender on serum concentration of antiphospholipid and anticardiolipin antibodies in HIV-infected patients. A total of 58 HIV-infected patients and 58 age, sex-matched healthy adults were enrolled. We measured platelets count, hemoglobin, partial thromboplastin time (PTT); prothrombin time (PT), international normalized ratio (INR), antiphospholipid IgG/IgM and anticardiolipin IgG/IgM serotypes in our studied population. Age, male-to-female ratio, hemoglobin level, PT, INR, antiphospholipid IgM isotype, anticardiolipin IgM and IgG isotypes levels were not significantly different between HIV-infected patients and healthy individuals, when CD4+ T-cell count, CD8+ T-cell count, platelet count, and PTT were significantly lower, and antiphospholipid IgG isotype levels was significantly higher in HIV patients. Antiphospholipid IgG isotypes (3.2 [2.8–4.2] vs. 2.5 [2.3–3.1]; P?<?0.001) and anticardiolipin IgG isotypes (2.2 [1.9–2.7] vs. 1.4 [1.4–1.9]; P?<?0.001) were significantly higher in HIV-infected women than in HIV-infected men. Antiphospholipid IgG/IgM and anticardiolipin IgG/IgM were significantly correlated in HIV-infected men and women when they did not had any correlation in controls. We suggest that HIV infection accelerate thrombosis in women more profoundly than in men, as a result of differences in disease progression and response to therapy in these patients.