Pediatric infection due to multiresistant Salmonella enterica serotype Infantis in Honduras

We report the case of a pediatric patient with a Salmonella enterica serotype Infantis infection. Detailed microbiological investigation revealed that this isolate carries four beta-lactamase genes (bla(TEM-1b) variant, bla(SHV-5), bla(CTX-M-15), and bla(CMY-2)) conferring resistance to all beta-lactams but imipenem. This is the first report of a Salmonella isolate with CTX-M and AmpC enzymes on the American continent, the first report of bla(CMY-2) in Salmonella serotype Infantis, and the first report of bla(CTX-M-15) in the genus Salmonella.     

Experimental studies of sensitization to beryllium, zirconium, and aluminum compounds in the rabbit

In a study designed to assess the potential sensitizing and granulomagenic capacities of selected metallic salts, rabbits were inoculated intradermally with zirconium aluminum glycinate (ZAG), sodium zirconium lactate (NZL), aluminum chlorhydrate (ACH), BeSO₄, and ovalbumin (OVA) by single and multiple injections. Animals immunized with BeSO₄ and with OVA developed delayed skin reactivity as well as antigen-specific alveolar macrophage migration inhibition. Neither single nor multiple injections of ZAG or ACH resulted in clear-cut positive skin reactivity, macrophage migration inhibitory factor (MIF) production, or lymphocyte stimulation. Rabbits inoculated with multiple injections of NZL (500 μg) showed some marginally positive macrophage migration inhibition and skin reactivity. Histologically, ZAG and ACH were found to induce well-organized foreign-body granulomas after intradermal injection in both normal and inoculated rabbits. NZL and BeSO₄ also induced skin granulomas, but these were less organized and distinct. Cell viability and ultrastructural studies indicated that BeSO₄ was highly toxic for isolated alveolar macrophages in vitro at concentrations above 10 μg/ml, but NZL and ZAG did not exert such an effect at these dose levels. BeSO₄ also depressed lymphocyte stimulation in sensitized animals which demonstrated delayed skin reactivity and macrophage migration inhibition.     

Dynamic contrast-enhanced magnetic resonance imaging of the sarcopenic muscle

Background  

Studies about capillarity of the aged muscle provided conflicting results and no data are currently available about the magnetic resonance imaging (MRI) in vivo characteristics of the microvascular bed in aged rats. We have studied age-related modifications of the skeletal muscle by in vivo T2-relaxometry and dynamic contrast-enhanced magnetic resonance imaging (CE-MRI) at high field intensity (4.7 T). The aim of the work was to test the hypothesis that the ageing process involves microvessels in skeletal muscle.     

Flow Cytometric Analysis of In Vitro Proinflammatory Cytokine Secretion in Peripheral Blood from Multiple Sclerosis Patients

The cytokines, interferon- (IFN-), tumor necrosis factor- (TNF-rpar;, and interleukin-2 (IL-2) are important endogenous proinflammatory proteins and have been linked to disease activity in multiple sclerosis. In this study, we use flow cytometric methodology to compare the secretion of IFN-, IL-2, and TNF- from peripheral blood-derived T cells of multiple sclerosis patients to the secretion in healthy controls. The percentages of IFN-, IL-2, and TNF- secreting cells are not significantly different between multiple sclerosis patients and controls. However, the TNF- secreting CDS cell percentage is correlated with the IFN- and IL-2 secreting CD3 cell percentages in multiple sclerosis patients. In the controls, only the TNF- secreting CD3 cell percentage is correlated with IFN-. These findings show that correlated secretion of cytokines occurs in multiple sclerosis and suggest that concerted intercytokine interactions may play an important role in the disease.     

The Value of Amniotic Fluid Interleukin-6, White Blood Cell Count,and Gram Stain in the Diagnosis of Microbial Invasion of the Amniotic Cavity in Patients at Term

PROBLEM: Subclinical microbial invasion of the amniotic cavity occurs in 18.8% of women with term labor and intact membranes and in 34% of patients with term PROM and is a risk factor for the development of puerperal infection related morbidity. Although amniotic fluid white blood cell count, interleukin-6 determination, and Gram stain examination have been used for the diagnosis of intrauterine infection in patients with preterm labor and preterm premature rupture of membranes, no information is available about the accuracy and specific cut-off values for these tests in patients at term. The purpose of this study was to compare the performance of the amniotic fluid Gram stain examination, white blood cell count, and interleukin-6 determination in the identification of microbial invasion of the amniotic cavity in patients at term with and without PROM. METHOD: Amniotic fluid was retrieved from 148 patients with term gestations (90 patients with spontaneous labor and intact membranes and 58 patients with PROM). Samples were cultured for bacteria and Mycoplasma species. Amniotic fluid Gram stain, white blood cell count, and interleukin-6 determinations (ELISA, sensitivity: 43 pg/ml) were performed in all samples. Microbial invasion of the amniotic cavity was defined as a positive amniotic fluid culture for microorganisms. Analysis was conducted using Mann-Whitney U test, Fisher's exact test, receiver operating characteristic curves and logistic regression. RESULTS: Patients with spontaneous labor and intact membranes: The prevalence of microbial invasion of amniotic cavity in this group was 15.6% (14/90). The most sensitive test for the detection of microbial invasion of the amniotic cavity was amniotic fluid interleukin-6 determination (sensitivity for: interleukin-6 ≥ 5.7 ng/ml = 86%, white blood cell count ≥ 20 cells/mm³ = 64%, Gram stain = 28%). The most specific test was the Gram stain of the amniotic fluid (specificity for: Gram stain = 84%, interleukin-6 = 79% and white blood cell count = 63%). Multiple logistic regression demonstrated that amniotic fluid interleukin-6 concentration was the only covariate that retained statistical significance when intrauterine infection was used as outcome variable. Patients with PROM: The prevalence of a positive amniotic fluid culture in this group was 39.7% (23/58). Logistic regression demonstrated that only interleukin-6 retained a significant relationship with the results of amniotic culture when all variables were entered simultaneously into a model to predict amniotic fluid culture results. The most sensitive tests for the detection of intrauterine infection were interleukin-6 determination and white blood cell count (sensitivity for interleukin-6 ≥ 3.4 ng/ml and white blood cell count ≥ 20 cells/mm³ = 69.6% for both). The most specific test was Gram stain (97.1%). CONCLUSIONS: Amniotic fluid interleukin-6 determination is the best rapid test for the detection of microbial invasion of the amniotic cavity in patients at term with and without PROM. When this test is not available, amniotic fluid Gram stain and white blood cell count represent valid diagnostic tools to assess the microbial state of amniotic cavity.     

Amorphous‐Smectic Glassy Main‐Chain LCPs, 1. Poly(ether esters) Derived from Hydroxybibenzoic Acid and (R,S)‐ and (R)‐2‐Methylpropane‐1,3‐diol

The synthesis and the characterization of main‐chain liquid‐crystalline poly(ether esters), derived from hydroxybibenzoic acid and (R,S)‐ and (R)‐2‐methylpropane‐1,3‐diol, are reported. These polymers show an interesting thermal behavior. They develop mesophases with a slow rate of formation, allowing the easy quenching of the melt into: a) the glassy amorphous state, b) the glassy liquid‐crystalline state, or c) a mixture of both, depending on the thermal treatment. The extent of the transformation and the symmetry of the different phases have been determined by means of calorimetric and X‐ray diffraction methods. Dielectric spectroscopy results provide additional evidence for the detection of distinct glass transitions. The results show that the racemic polymer forms a low‐ordered SmC_alt mesophase, while a more ordered phase is obtained in the case of the enantiomerically pure polymer. The comparison of the properties of the different states evidences the special behavior and properties of the glass transition (T_g) in these polymers. Emphasis is paid to the location of the T_g of the liquid‐crystalline state in comparison to the T_g of the amorphous state. It is found that the glass transition of the SmC_alt glass in R,S‐PBO3 (the poly(ether ester) derived from hydroxybibenzoic acid and (R,S)‐2‐methylpropane‐1,3‐diol) appears at lower temperatures than the glass transition of the amorphous state. However, in R‐PBO3 (the poly(ether ester) derived from hydroxybibenzoic acid and (R)‐2‐methylpropane‐1,3‐diol), where the more ordered phase is present, the glass transition follows the classical tendency of semicrystalline polymers.

     

Thyroid cancer and thyroiditis in Salta,Argentina: a 40-yr study in relation to iodine prophylaxis

The natural history of thyroid cancer and thyroiditis in relation to iodine prophylaxis in the region of Salta, Argentina, where goiter is common was investigated over a time span of 40 yr. For analysis of thyroid cancer, the specimens were divided into two periods. The first 15 yr (59 cases), including 5 yr before prophylaxis, was compared with the second 25 yr (182 cases), a period well after salt iodination. Papillary carcinomas formed the largest group of tumors in both periods, with a significant increase in their proportion in the second period (44 vs 60%, x ²: p<0.05), while the percentage of follicular and undifferentiated carcinomas decreased and medullary carcinoma remained about the same. The ratio of papillary to follicular carcinoma rose from 1.7:1 in the first period to 3.1:1 in the second. Four thyroid lymphomas of non-Hodgkin’s B-cell type occurred in the second period in females over age 50. A severe lymphoid thyroiditis was present in the two cases with assessable background thyroid tissue. The frequency of moderate to severe lymphoid infiltrate in females rose from 2 of 12 (16.6%) in the preprophylaxis period to 34 of 114 (28.0%) in the last 25 yr after prophylaxis. After salt prophylaxis, thyroiditis was more frequent in patients with papillary carcinoma (36.2%) than in those with nonpapillary tumors (14.7%) (x ², p<0.02). These observations indicate that a high dietary intake of iodine may be associated with a high frequency of papillary carcinoma and thyroiditis, and that thyroiditis is more commonly associated with papillary carcinoma than with other thyroid tumors. The occurrence of non-Hodgkin’s lymphomas only in the postprophylaxis period may be linked to an increase in thyroiditis.     

Secondary non-Hodgkin's B-cell lymphoma involving the breast: radiologic imaging

Secondary lymphomas involving the breast, although uncommon, represent the largest group of metastasic tumors to the breast. Primary non-Hodgkin lymphomas (NHLs) of the breast are also rare, accounting for 1.7% to 2.2% of extranodal NHL cases and 0.38 to 0.7% of all NHLs. Approximately 300 cases have been reported in the Medical literature. Mammographic appearances are described as round or oval areas of opacity. The breast mass may appear homogeneous or inhomogeneous. The lesion may be very well defined and may be mistaken for a benign process, most notable in patients younger than 35 years of age. Ultrasonographic appearance is described as a sharply defined mass with low or medium echoes. The posterior aspect of the mass is well defined (possibly with slight acoustic enhancement but with no associated posterior shadowing). In summary, the mammographic appearance of the breast lymphoma is nonspecific, but the diagnosis can possibly be excluded if calcifications or a desmoplastic reaction are present. Prominent lymph vessels in a patient with a breast mass should raise the suspicion of breast lymphoma. The most critical aspect in the workup of a breast mass is the tissue biopsy, since radiographically lymphomatous lesions are indeterminate. We present the case of a 79-year-old woman with abdominal pain and a palpable breast mass; we also make a brief summary of the clinical features and main imaging findings of NHL (plain radiograph, mammography, breast ultrasound and thorax tomography).