Characterization of monkey enteropathogenic Escherichia coli (EPEC) and human typical and atypical EPEC serotype isolates from neotropical nonhuman primates

Enteropathogenic Escherichia coli (EPEC) has been associated with infantile diarrhea and mortality in humans in developing countries. While diarrhea is also a major problem among primates kept in captivity, the role of E. coli is unclear. This study was designed to characterize diarrheagenic E. coli recovered from the feces of 56 New World nonhuman primates, primarily marmosets (Callithrix spp.). Seventeen of the 56 primates had signs of diarrhea and/or enteritis. E. coli recovered from feces from these animals was tested by PCR for genes encoding virulence factors of diarrheagenic E. coli and for patterns of adherence to HeLa cells. In addition, isolates were characterized by the fluorescence actin staining test and by their ability to induce attaching and effacing lesions. PCR for the eae gene was positive in 10 of the 39 (27%) apparently healthy animals and in 8 of the 17 (47%) animals with diarrhea and/or enteritis. Colonies of eae(+) E. coli were serotyped and examined by PCR for genes encoding EPEC virulence markers. The eae(+) E. coli isolates recovered from both healthy and sick nonhuman primates demonstrated virulence-associated attributes similar to those of EPEC strains implicated in human disease and are designated monkey EPEC. The results presented here indicate that EPEC may be a significant pathogen for nonhuman primates, deserving further investigation. The similarities between the affected animals investigated in this study and human EPEC infections suggest that marmosets may represent an important model for EPEC in humans.     

Acute respiratory insufficiency in burn patients from smoke inhalation

Respiratory injuries by smoke inhalation are one of the most frequent reasons for acute respiratory failure in burn victims. They are most often of chemical origin and are responsible of a 20 to 70% increase of the mortality compared to the mortality of patients with similar burn injuries, but without inhalation lesions. They are often associated to a certain degree to other factors of acute respiratory failure: superior air way obstruction by oedema in face and neck burns, thoracic expansion hindrance due to thoracic burns, lung trauma lesions by blast injury. The generalized inflammatory reaction due to the extent of burns and an initial inadequate resuscitation are worsening factors. The inflammatory process may be responsible of lung injuries similar to those induced by smoke inhalation, even when there is no inhalation. The treatment remains symptomatic and based on the oxygen therapy, mechanical ventilation, prevention of infections and maintain of homeostasis by hydroelectrolytic adequate resuscitation. The nitric oxyde associated to the almitrin allows in a certain number of cases to minimize intra pulmonary shunting and to normalize the VA/O ratio. The development of treatments allowing to modulate inflammatory mediators may lead to news therapies in the future.     

Evaluation of prognostic factors in the burned patient]

Mortality predictive factors of burned patients are analyzed in a population of 1929 patients by the statistical method of logistic regression. Among the variables studied (total burn skin area, deep burn area, superficial burn area, age, sex, burn location, preexisting disorders), two only, deep burn area and age, have been retained as predictive factors which, when associated, allow to classify 94.47% of the patients in either survival or death group. The prognosis weight of the deep burn area (SBP) is superior to that of the total burn skin area, yet retained in most previous studies. The superficial burn area, the inhalation injuries and the preexisting disorders are not factors determining prognosis. The F equation = e(-6.0061 + (0.0829*SBP) + (0.0443*%AGE)) resulting of the logistic regression, allows a direct evaluation of the death probability. A simple linear relation can be proposed as score of severity: IG = (2 x %SBP) + age. Below 80, mortality is close to zero, above mortality increases linearly up to 210, reaching 100%. This relation must be handled cautiously when comparing the severity score of two groups of patients, just as any other severity score that uses a linear relation with the burnt area associated or not to age.     

Accuracy of a computerized tomography-guided template-assisted implant placement system: an in vitro study

Objectives: To evaluate the accuracy of computer-assisted 3D planning and implant insertion using computerized tomography (CT).
Materials and methods: Nine implants were planned on pre-operative CTs of six resin models, which were acquired with radiographic templates, using a planning software (E implants). Each resin model contained three pre-existing control implants (C implants). Radiographic templates were converted into operative guides containing 4.8-mm-diameter titanium sleeves. A single set of insertable sleeves was used for consecutively drilling the six models, followed by implant insertion through the guide sleeves. Models were further divided into group A (the first three models) and group B (the last three models). Post-operative CTs were used to compare implant positions with pre-operative planned positions. Statistical analysis included the Mann–Whitney U test for E and C implants and the Wilcoxon's signed ranks test for groups A and B.
Results: The mean apex depth deviations for E and C implants [0.49 mm±0.36 standard deviation (SD) and 0.32 mm±0.21 SD, respectively], and the mean apex radial deviations (0.63 mm±0.38 SD and 0.49 mm±0.17 SD, respectively) were similar ( P >0.05). The mean angulation deviations for E and C implants were 2.17±1.06°SD and 1.33±0.69°SD, P <0.05. E implant deviations of all the parameters in group A were significantly smaller than E implant deviations in group B.
Conclusions: Computer-assisted implant planning and insertion provides good accuracy. Deviations are mainly related to system and reproducibility errors. Multiple use of drills and titanium sleeves significantly reduces system accuracy.     

Increased serum S-100B and neuron specific enolase - Potential markers of early nervous system involvement in essential hypertension

ObjectivesTo investigate the occurrence of subclinical neurologic involvement in patients with essential hypertension employing serum biochemical markers.Design and methodsFifty patients with essential hypertension and 42 controls with no clinical evidence of neurological disease were recruited. Serum S100B protein and neuron specific enolase (NSE) were determined by employing immunoassay kits from CanAg Diagnostics AB (Sweden). Brain MRI and fundoscopic exploration were conducted.ResultsS-100B and NSE levels were significantly higher in hypertensive patients than in controls. In hypertensive patients, multivariate analysis revealed that NSE was independently associated with two variables expressing severity of hypertension: diastolic blood pressure and grade of retinopathy. Brain MRI studies demonstrated higher NSE levels in patients with more severe white matter lesions.ConclusionsRaised NSE levels are associated with a higher severity of hypertension and of white matter lesions, providing preliminary evidence that suggests the presence of silent brain damage in a subset of hypertensive patients.     

Assessment of inflammation in large arteries with 18F-FDG-PET in elderly

This paper presents repeated measurements of atherosclerosis using bimodality positron emission tomography and computed tomography (PET/CT) with 18F-fluorodeoxyglucose (18F-FDG) to assess its uptake in aorta, iliac and femoral arteries in three groups of elderly subjects classified as normals (N), hypercholesterolemics (H) and with stable angina (A) in a 12 months follow-up (T0 to T12). The subjects in group H were taking rosuvastatin (20 mg/d) for 12 months before the second scan. The calcifications in the arteries were determined by CT imaging and the artery PET images were analyzed slice by slice. The standard uptake values (SUVs) for 18F-FDG uptake were classified in two main groups: calcified and non-calcified arteries and each main group comprises six sub-groups for the three subject groups N, H and A, and for the two measurements 12 months apart. Although the calcifications were present at some portions of the arteries in all subjects (23%, 36% and 44% of calcified sites to total sites analyzed, respectively, in groups N, H and A), the results show the most noticeable SUV changes after 12 months was in group N of non-calcified arteries. In the three groups, the calcified arteries showed no significant differences between T0 and T12 while significant differences were observed for the non-calcified arteries. However, there were no significant changes at T12 between groups N and H following rosuvastatin intake in group H. In conclusion, the quantitative analysis with 18F-FDG-PET/CT could be efficient in the localization of the inflammation and evaluation of its progression in atherosclerosis instead of global evaluations with systemic inflammation biomarkers.     

Simultaneous attenuation and scatter corrections in small animal PET imaging

The aim of this work is to simultaneously correct for attenuation and scatter in PET by analytically assessing the distribution of the scattered photons using the emission and the transmission images, the probability of scatter interactions and the detection efficiency. Above the usual lower energy threshold of 350 keV, the attenuated photons are dominantly those which have undergone a Compton scattering. By considering that each pixel in the image is the measurement of the transmitted photons through the subject, added to the contribution from the other sources by means of their scatter at this position, a simple equation is established accounting for the primaries by simultaneously correcting the data for attenuation and scatter for all emitting sources. This new method was applied in Monte Carlo simulated and measured data with the Sherbrooke small animal PET scanner in line sources, hot spot phantoms, and in rat hearts and tumors, and was compared to the approach developed by Watson et al.     

Modulation of ultraviolet (UV) transmission by emollients: relevance to narrowband UVB phototherapy and psoralen plus UVA photochemotherapy

BACKGROUND: Patients with psoriasis undergoing or about to undergo ultraviolet (UV) phototherapy and photochemotherapy often have thick scale on their plaques which can prevent the penetration of UV radiation. Emollients are used to moisturize the skin and to prevent or reduce some of the milder side-effects ('dryness', itching) sometimes experienced during UV therapy. However, emollients can alter the UV transmission of skin and thus may alter the clinical effects of phototherapy and photochemotherapy. OBJECTIVES: We tested 30 of the topical emollients in the British National Formulary (BNF) using a standard in vitro technique used to test sunscreens. We also surveyed U.K. phototherapy units to establish routine practice for emollient use in phototherapy and photochemotherapy. METHODS: We used a standard in vitro technique to measure the monochromatic protection factors (MPFs) of 30 non-bath emollients from the BNF. An application rate of 2 mg cm-2 was used. For the assessment of effects during narrowband UVB (TL-01) phototherapy, the mean of the protection factors at 310 and 315 nm was calculated; for psoralen plus UVA photochemotherapy the mean UVA protection factor was used. A questionnaire survey was used to assess routine practice concerning emollient use prior to phototherapies in phototherapy units throughout the U.K. RESULTS: In the UVA range, 17 of the 30 emollients gave protection factors of 1.2 or above. In the UVB range, 23 of 30 had an MPF of 1.2 or above. Yellow soft paraffin had the highest protection factor in the UVB range. Of 78 centres surveyed, 57 returned completed questionnaires (73%). Seventeen of 57 (30%) centres routinely used emollients immediately prior to administering phototherapy treatments. The remaining 40 of 57 (70%) did not. Forty-five (79%) responding centres recommended the use of emollients after phototherapy. CONCLUSIONS: This study has revealed considerable variability in the practice of emollient use before phototherapy treatments. Although the majority of centres included in this study did not routinely use emollients, almost one third did. Our in vitro measurement of 30 emollients revealed marked variation in UV transmission, with many emollients blocking sufficient UV to affect the response to therapy.