Methicillin-resistantStaphylococcus aureus disease in a portuguese hospital: Characterization of clonal types by a combination of DNA typing methods

Fifteen pediatric patients as well as the five nursing staff of the Burn Unit of the Hospital D. Estefania in Lisbon, Portugal, were assayed at weekly intervals over a five-month period in order to identify the nature and number of methicillin-resistantStaphylococcus aureus (MRSA) clones associated with colonization and wound infection. Methicillin resistance was confirmed by amec-specific DNA probe. MRSA isolates were classified into chromosomal types (clones) on the basis of a variety of techniques: (i) ribotyping; (ii) restriction digestion by the endonucleaseClaI followed by Southern hybridization with themecA-specific DNA probe and (iii) by hybridization with Tn554; and (iv) pulsed-field electrophoresis (PFE) ofSmaI digests followed by (v) Southern hybridization with themecA DNA probe. A sixth, physiological technique (population analysis) was used to define the mode of phenotypic expression of methicillin resistance in each isolate. All isolates carried a single, common polymorph (ClaI type III) of themecA gene. Hybridization with Tn554 resolved these isolates to two novel patterns (alpha and beta), of which one (Tn554 alpha) was predominant (90 %). This pattern could be further resolved to four closely related PFE types (A through D). In contrast, all isolates with the Tn554 beta pattern belonged to an additional, grossly different PFE type E. The Tn554 beta class was also unique in that these bacteria carried themecA gene in aSmaI fragment smaller (about 170 kb) than that found in the alpha type strains (194 kb). Most isolates (83 %) showed a single heterogeneous (population analysis Class 3) mode of resistance expression. The data demonstrate the full capacity of the globally rare (ClaI type III) MRSA clone for colonization and virulence. The results also document the stability of the complex heterogeneous resistance phenotype as well as the stability of the chromosomal types under conditions of in vivo carriage over a period of several months. In a few isolates the samemecA polymorph was present in several, grossly different genetic backgrounds, suggesting horizontal transfer of themecA gene.     

Mutation of the p53 tumor suppressor gene in spontaneously occurring osteosarcomas of the dog

Inactivation of the p53 tumor suppressor gene has been implicated in the pathogenesis of numerous human cancers, including osteosarcomas. Appendicular osteosarcomas of the dog appear to be a good model for their human equivalent with regard to biologic behavior, epidemiology and histopathology. We individually screened exons 5-8 of the p53 gene for mutations in 15 canine appendicular osteosarcomas using 'Cold' SSCP to compare the role of this gene in human and canine osteosarcoma tumorigenesis. Seven of the tumors (47%) exhibited point mutations, with one tumor possessing two mutations within different exons. Of these, seven were missense mutations and the eighth was a 'silent' mutation potentially affecting the exon 6-7 splicing region. Five of the missense mutations were located in highly conserved regions IV and V, while another corresponded with the highly conserved codon 220 mutational hotspot located outside the conserved domains. The locations and types of mutations were nearly identical to those reported in human cancer. These findings provide strong evidence of the involvement of p53 mutations in the development of canine appendicular osteosarcomas. Canine osteosarcomas appear to be a promising model for their human equivalent on a clinical, pathologic, and molecular level.      

Extracción de DIU mediante histeroscopia en la gestación precoz: nuestra experiencia en 4 casos

Objectives

To evaluate the utility and effectiveness of hysteroscopic retrieval of intrauterine devices (IUDs) in early pregnancy.

Subjects and methods

We followed-up four pregnant women with IUDs with retracted tails removed by hysteroscopy before 10 weeks of pregnancy from 2003 to 2005.

Results

After hysteroscopy, pregnancy course was successful in three women, without complications that could be attributed to the procedure. There was one abortion due to rupture of fetal membranes at 15 weeks’ gestation.

Conclusions

The application of hysteroscopy in pregnancy has always been limited. In all patients, a possible optic nerve lesion in the fetus should be evaluated. This technique should not be performed after the 10th week of pregnancy. In most patients, pregnancy continues without complications after IDU removal.     

Primary peritoneal borderline tumour: report of an unusual case

Primary peritoneal borderline tumour is a rare lesion, histologically indistinguishable from non-invasive peritoneal implants found in association with ovarian tumours of borderline malignancy. We report a case of a primary peritoneal borderline tumour diagnosed in a 30-year-old patient with pelvic pain, infertility and elevated serum CA-125.     

Posterior cortical atrophy: a single case cognitive and radiological follow-up

Posterior cortical atrophy (PCA) is a rare neurodegenerative syndrome characterized by initial predominant visuoperceptual deficits followed by a progressive decline in other cognitive functions. This syndrome has not been as thoroughly described as other dementias, particularly from a neuropsychological evolution perspective with only a few studies describing the evolution of its cognitive progression. In this investigation we review the literature on this rare condition and we perform a 7-year neuropsychological and neuroradiological follow-up of a 64-year-old man with PCA. The subject’s deficits initially appeared in his visuoperceptual skills with later affectation appearing in language and other cognitive functions, this being coherent with the patient’s parieto-temporal atrophy evolution.