Clinical features of infections and colonization by Acinetobacter genospecies 3

Two hundred twenty-one isolates of Acinetobacter baumannii and 15 of Acinetobacter genospecies 3 (AG3) were consecutively collected in a 30-day period during the nationwide project GEIH-Ab2000. Nosocomial acquisition (P=0.01), intensive care unit admission (P=0.02), and antibiotic pressure (P = 0.03) were observed to be lower in the AG3 group. AG3 isolates were more frequently implied in wound infections (P=0.05), while A. baumannii tended to be recovered from respiratory samples (P=0.08). To our knowledge, this is the first report analyzing the clinical differences among Acinetobacter genospecies, with our findings suggesting that clinical features of AG3 may not be equivalent to those traditionally described for A. baumannii.     

Influence of the structure of new generation prostheses on shrinkage after implant in the abdominal wall

When a biomaterial is used to repair an abdominal wall defect, wound contraction can cause the prosthesis to shrink, and the tension generated can provoke recurrence of the defect. This study was designed to determine whether the structure of a prosthesis can directly influence prosthetic shrinkage. Abdominal wall defects (7 x 5 cm) in rabbits were repaired using the laminar prosthesis DualMesh (DM), the composites Sepramesh (Se) and Vypro II (Vy), and the reticular prosthesis Surgipro (PP). The animals were sacrificed 14 and 90 days after surgery, at which time implant specimens were morphologically and immunohistochemically examined to establish the presence of myofibroblasts and macrophages. The size of each prosthesis was measured at the end of the study through image analysis. Morphometric measurements revealed greatest prosthesis shrinkage for Se, PP, and Vy (16.05% +/- 5.08%; 13.75% +/- 4.22%; 16.16% +/- 6.34%), while the DM prostheses only showed a 7.57% +/- 0.62% decrease in size (p < 0.05). In the DM implants, the macrophage response and myofibroblast labeling were reduced. Both biomaterial structure and the macrophage reaction induced at the implant site modulate prosthetic shrinkage, laminar prostheses of the ePTFE type undergoing less shrinkage than reticular meshes. Reduced DM shrinkage was linked to decreased myofibroblast numbers 2 weeks postimplant.     

A New View of the Things We Use: Using Purchasing Data to Predict Common Mixture Exposures

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Humans are exposed to a multitude of chemicals,1 typically in mixtures. Testing substances individually using traditional methods can be time consuming and cost prohibitive;2 the number of possible chemical combinations makes this type of testing unrealistic for mixtures.3 To circumvent these challenges, scientists at the U.S. Environmental Protection Agency (EPA) used a data-driven approach to identify and prioritize relevant chemical combinations, as reported recently in Environmental Health Perspectives.3Open in a separate windowBy identifying patterns in purchasing data, investigators can estimate common ingredient combinations that consumers are exposed to in the products they use regularly. Knowledge of common co-exposures could help direct experimental toxicology assessments. Image: © iStock/Prostock-Studio.Other efforts to identify high-priority co-exposures have not captured the full spectrum of chemical combinations because of either the lack of ingredient information or insufficient purchase and use data.2^,4^,5 “This study is unique because of the way we were able to integrate multiple data sets to improve our overall understanding of human exposure,” says Zachary Stanfield, a postdoctoral researcher at the U.S. EPA and first author of the study.Stanfield and colleagues matched consumer purchasing data from a marketing database compiled in 2012 with ingredient data obtained from the U.S. EPA’s Chemical and Product Database.6 The combined data streams included approximately 2.4 million purchases by about 53,000 households of 31,000 products. Using frequent item set mining,7 a well-established method for identifying patterns in behavior, the group sifted through the extremely high number of theoretical chemical combinations to identify the truly relevant ones.“Our findings show that, from a risk standpoint, we don’t need to concern ourselves with all possible chemical combinations,” notes Kristin Isaacs, senior author of the study. “This ‘top-down’ approach can supplement others that ‘look under the lamppost’ at specific chemicals.”“This is an important start,” says Julia Brody, executive director of the Silent Spring Institute. “It creates a resource so we can evaluate the combined effects on health [of specific chemicals].” She notes that products’ ingredient data were incomplete and calls for additional ingredient disclosure. “In the U.S., manufacturers can use ingredients without testing first for effects on health, and they don’t have to list all the ingredients on product labels, so we’re always playing catch-up to understand how [products] affect people’s health,” she explains. Brody was not involved in the study.The study revealed exposure variations across demographic groups. Focused analysis comparing predominant purchases and demographic patterns showed several distinct patterns. For example, chemical mixtures most frequently encountered by households with children, households headed by women of color, and lower-income households diverged from those encountered by the rest of the study households.“This suggests a need for further study of the product chemical combinations, such as from hair products used by Black women, that may be contributing to health inequalities,” says Brody. More in-depth studies should look at the factors underlying differences in purchasing behavior within households and communities—for example, how choice, brand, or product availability influences chemical mixture exposures. Brody says information like this can better inform public health policy aimed at eliminating racial inequities in environmental health.     

Low prevalence of BRCA1 and BRCA2 mutations in the sporadic breast cancer of Spanish population

The true prevalence of BRCA1/BRCA2 (BRCAs) germline mutations in sporadic breast or ovarian cancer (SBC/SOC) in Caucasian population is not well established. The aim of the study is to establish the prevalence of BRCAs mutations in SBC to ponder its relevance in the programs of genetic counseling in cancer and to explore the genotype-phenotype relationship of these particular breast cancers. The study was performed in 495 SBC. We sought 46 BRCA1 and 53 BRCA2 pathogenic mutations reported in the Spanish population. We followed a high resolution melting method performed in the LightCycler 480 (Roche Diagnostics) for the screening of these Spanish mutations using 49 primer pairs. Eight different deleterious mutations, one of them novel, were detected in nine patients, five without family history of BC/OC, what yields a true prevalence of 1.05% for BRCAs mutations in SBC. Furthermore, we found 18 unknown variants. Larger tumour size (T?>?1) and earlier presentation are the independent parameters associated with the presence of BRCAs pathogenic mutations in SBC (P?相似文献   

Aspiration of normal or asymptomatic pathological joints for diagnosis and research: indications, technique and success rate

Although joint aspiration is a basic clinical skill, aspiration of normal joints, or asymptomatic clinically quiescent joints, is only rarely undertaken. There are two main indications for this procedure. Firstly, for definitive diagnosis of crystal-associated arthritis (gout and pseudogout) during the intercritical period and for subsequent monitoring of treatment success of gout; and secondly, to obtain normal synovial fluid for biomarker research. The justification for these indications, the success rate and the technical aspects related to this procedure are presented in this article.     

Trypanosoma cruzi congenital transmission in wild bats

Trypanosoma cruzi congenital transmission in wild bats (Molossus molossus), associated with infected Rhodnius prolixus in a natural habitat from a rural locality in western Venezuela, is reported. T. cruzi blood circulating trypomastigotes in a pregnant bat were detected by parasitological methods. Polymerase chain reaction (PCR) assays carried out in samples from the heart and the fetus of the same infected female, revealed the presence of T. cruzi-specific DNA in both of the tissues, demonstrating transmission of the infection from the mother to the offspring. Eighty percent of the captured bats and 100% of the examined fetuses from pregnant specimens were shown to be infected by T. cruzi, indicating that M. molossus is a very susceptible species for this parasite, and that T. cruzi congenital transmission is a common phenomenon in nature. To our knowledge, this seems to be the first report on congenital T. cruzi transmission in wild bats in Venezuela. The circulation of T. cruzi lineage I in the study area was demonstrated by typing the isolates from bats and triatomine bugs captured in the same habitat. The potential epidemiological implication of these findings in areas where Chagas disease is endemic is discussed.