Effectiveness and Safety of a Treatment Regimen Based on Isoniazid Plus Vaccination with Mycobacterium tuberculosis cells' Fragments: Field-Study with Naturally Mycobacterium caprae-Infected Goats

The identification of a herd of goats with tuberculosis let us test a new treatment regimen against latent tuberculosis infection (LTBI). Using large animal experimental models allows a better approach to understanding human tuberculosis according to immunopathological parameters. Based on an initial study showing a correlation between the ESAT-6-specific interferon (IFN)-γ secretion and the severity of pulmonary lesions, this parameter was used in combination with an X-ray examination to screen the animals to be included in the efficacy and safety studies. All the animals proved to be infected with Mycobacterium caprae . The efficacy study was run in animals distributed in three experimental groups according to treatment: untreated (CT), treated with isoniazid (INH), and treated with INH + RUTI (a vaccine based on M. tuberculosis cell fragments) inoculated twice. RUTI temporarily increased the IFN-γ production after stimulating the peripheral blood with ESAT-6, purified protein derivative and RUTI in vitro . The INH chemotherapy reduced both pulmonary and extra pulmonary affectation, but not disease in pulmonary lymph nodes. The addition of RUTI may have decreased extrapulmonar disease further but had no benefit to lung or lung lymph-nodes itself. Safety studies showed that inoculation of RUTI caused a temporary increase of rectal temperature (1–2 °C) and local swelling, both adverse effects being well tolerated. Neither systemic toxicity nor mortality was induced by the vaccination. The control of goats' infection by the therapeutic regimen consisting in INH chemotherapy + RUTI as well as its safety, represented a further step towards testing its effects in human LTBI in a future.     

Displasia femoral focal proximal: diagnóstico prenatal y evolución

We report two cases of prenatal diagnosis of proximal femoral focal hypoplasia. Despite the established relationship with poor control diabetes, one of the cases was not in a diabetic patient.     

Leiomiomatosis intravascular

Uterine leiomyomas are the most common tumors in women and are found in 20-30% of patients older than 30 years and in 75% of hysterectomies. These tumors have estrogen and progesterone receptors and their growth is influenced by hormone levels. Although histologically benign, uterine leiomyomas can be considered aggressive due to their high recurrence index and life-threatening consequences, whether due to metastases or vascular invasion. Although vascular invasion is extremely rare, these tumors can spread through the gonadal veins to the iliac and inferior vena cava and reach the heart cavities. At this site, the infiltration causes blood flow obstruction and severe alterations in vascular dynamics and favors the development of pulmonary embolism.     

Competition-colonization dynamics in an RNA virus

During replication, RNA viruses rapidly generate diverse mutant progeny which differ in their ability to kill host cells. We report that the progeny of a single RNA viral genome diversified during hundreds of passages in cell culture and self-organized into two genetically distinct subpopulations that exhibited the competition-colonization dynamics previously recognized in many classical ecological systems. Viral colonizers alone were more efficient in killing cells than competitors in culture. In cells coinfected with both competitors and colonizers, viral interference resulted in reduced cell killing, and competitors replaced colonizers. Mathematical modeling of this coinfection dynamics predicted selection to be density dependent, which was confirmed experimentally. Thus, as is known for other ecological systems, biodiversity and even cell killing of virus populations can be shaped by a tradeoff between competition and colonization. Our results suggest a model for the evolution of virulence in viruses based on internal interactions within mutant spectra of viral quasispecies.     

Relative adrenal insufficiency and hemodynamic status in cardiopulmonary bypass surgery patients. A prospective cohort study

Background  

The objectives of this study were to determine the risk factors for relative adrenal insufficiency in cardiopulmonary bypass patients and the impact on postoperative vasopressor requirements.     

Social and clinical effects of a leisure program on adults with autism spectrum disorder

Using a pre-test, post-test experimental design, effects of a 1-year group leisure program were examined on 31 participants (20 male and 11 female), ages 27–38 (M = 32.05 at start of program), with an autism spectrum disorder (ASD) diagnosis randomly assigned to the experimental condition and a group of 20 adults with ASD randomly assigned to the control group (13 male and 7 female), ages 24–38 (M = 31.75, at the program start). The Facial Discrimination Battery (FDB)-Spanish version and the Vineland Adaptive Behavior Scales-Interview Edition Survey Form (VABS) were used to measure social–emotional cognition and the Color Trails Test (CTT) and the Tower of London-Drexel Edition were used to measure executive functioning cognitive. In consideration of the ecological perspective, the Dysexecutive Questionnaire (DEX) and the Frontal Systems Behavior Scale (FrSBe), were used. Mean scores for the experimental group were higher after completing the program than during baseline and compared to the control group across all social and emotional scales. Although statistical significance of results of the socio-emotional indicators and executive function was mixed, the VABS composite that focuses on social behavior of people with ASD was significant and demonstrated the largest difference between performance at baseline and performance after the 12-month intervention. Implications for future leisure service delivery are discussed.     

Childbirth Self‐Efficacy Inventory: psychometric testing of the Spanish version

Title. Childbirth Self‐Efficacy Inventory: psychometric testing of the Spanish version. Aim. This paper is a report of a study of the psychometric properties of the Spanish version of the Childbirth Self‐efficacy Inventory. Background. Enhancing the confidence of women in their ability to cope with pain in labour is a key element of effective childbirth education programs. The Childbirth Self‐efficacy Inventory is a suitable instrument for testing hypotheses about the development of self‐efficacy for childbirth. Analysing its psychometric properties in the light of Bandura’s Self‐Efficacy Theory is relevant for the validation of the instrument. Methods. Translation and back‐translation of the questionnaire took place in 2002 using a pilot sample of 12 women. The study was conducted using a sample of 146 childbearing women recruited from different national healthcare centres in Spain during the last 6 months of 2003. The psychometric study was carried out using the Statistical Package for Social Sciences. Results. Principal components analysis supported the ability of the Self‐Efficacy Inventory to distinguish between outcome and self‐efficacy expectancies. Internal Consistency Reliability of the Inventory was found adequate. Previous knowledge was identified as the most important factor influencing the confidence of a woman to coping with labour. Conclusion. Results are consistent with previous findings, and contribute to give support to the reliability and validity of the Inventory. The findings provide an additional and useful insight into practical ways of enhancing a woman’s confidence to coping with childbirth: self‐efficacy can be strengthened through persuasion by healthcare professionals, childbirth educators, and family and friends who offer support to the pregnant woman.     

Menopausal hormone therapy and new-onset diabetes in the French Etude Epidemiologique de Femmes de la Mutuelle Générale de l’Education Nationale (E3N) cohort

Aims/hypothesis  

Two US randomised trials found a lower incidence of type 2 diabetes in women treated by menopausal hormone therapy (MHT) with oral conjugated equine oestrogen combined with medroxyprogesterone acetate. The purpose of this study was to evaluate the influence of various MHTs, according to their formulation and route of administration, on new-onset diabetes in a cohort of postmenopausal French women.