Antimicrobial Susceptibility Monitoring of Bacterial Pathogens Isolated from Urinary Tract Infections in Dogs and Cats Across Europe: ComPath Results

Microbial Drug Resistance , Vol. 0, No. 0.


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Suppression of HBXIP Reduces Cell Proliferation, Migration and Invasion In Vitro, and Tumorigenesis In Vivo in Human Urothelial Carcinoma of the Bladder

Cancer Biotherapy & Radiopharmaceuticals , Vol. 0, No. 0.


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Endoclip therapy of post-sphincterotomy bleeding using a transparent cap-fitted forward-viewing gastroscope

Abstract

Background

The incidence of post-endoscopic sphincterotomy (ES) bleeding is reportedly 2.0–5.0 %. Among various hemostatic methods, endoclip therapy is an effective modality in gastrointestinal bleeding. However, endoclip application for post-ES hemorrhage has not been widely studied, partly because of the difficulty in placing of clips using a duodenoscope. A cap-fitted forward-viewing gastroscope can easily visualize the major papilla and overcome the technical difficulty in applying endoclips. We aimed to determine the efficacy and safety of endoclips for the treatment of post-ES hemorrhage using a cap-fitted forward-viewing gastroscope.

Methods

From January 2011 to December 2015, a total of 1448 endoscopic retrograde cholangiopancreatography procedures with ES were retrospectively assessed and followed-up. Patients with post-ES hemorrhage who did not respond to balloon compression or to spray or injection of a diluted epinephrine solution at the bleeding focus underwent endoclip therapy using a cap-fitted forward-viewing gastroscope. Bleeding patterns (oozing, pulsatile, and exposed vessel) were recorded.

Results

ES-induced uncontrolled hemorrhage occurred in 57 patients (3.93 %). The mean age was 68.9 ± 14.5 years, and the sex ratio (male/female) was 37 (64.9 %):20 (35.1 %) in 57 patients. Of the 57 cases of hemorrhage, early uncontrolled and delayed hemorrhage occurred in 45 (3.1 %) and 12 (0.82 %), respectively. Visible bleeding patterns following ES were: 50 oozing (57.7 %), 6 pulsatile (10.5 %), and 1 exposed vessel (1.8 %). Hemostasis was achieved by endoclipping using a cap-fitted forward-viewing gastroscope in 57 of 57 patients (100 %). The median number of clips used was 1.8 (range 1–3). No evidence of further bleeding or procedure-related complications was seen.

Conclusions

We concluded that endoclip application using a cap-fitted forward-viewing gastroscope is feasible and safe and may be an effective technique for the treatment and/or prevention of post-ES hemorrhage.

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Autism-related protein MeCP2 regulates FGF13 expression and emotional behaviors

Publication date: Available online 19 October 2016
Source:Journal of Genetics and Genomics
Author(s): Bo Yuan, Tian-lin Cheng, Kan Yang, Xu Zhang, Zilong Qiu




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Evolutionary Insights into Taste Perception of the Invasive Pest Drosophila suzukii

Chemosensory perception allows insects to interact with the environment by perceiving odorant or tastant molecules; genes encoding chemoreceptors are the molecular interface between the environment and the insect, and play a central role in mediating its chemosensory behavior. Here we explore how the evolution of these genes in the emerging pest Drosophila suzukii correlates with the peculiar ecology of this species. We annotated approximately 130 genes coding for gustatory receptors (GRs) and divergent ionotropic receptors (dIRs) in D. suzukii and in its close relative Drosophila biarmipes. We then analyzed the evolution, in terms of size, of each gene family as well of the molecular evolution of the genes in a fourteen Drosophila species phylogenetic framework. We show that the overall evolution of GRs parallels that of dIRs not only in D. suzukii, but also in all other analyzed Drosophila. Our results reveal an unprecedented burst of gene family size in the lineage leading to the suzukii subgroup, as well as few genomic changes that characterize D. suzukii, in particular duplications and strong sign of positive selection in the putative bitter-taste receptor GR59d. Expression studies of duplicate genes in D. suzukii support a spatio-temporal sub-functionalization of the duplicate isoforms. Our results suggest that D. suzukii is not characterized by gene loss, as observed in other specialist Drosophila species, but rather by a dramatic acceleration of gene gains, compatible with a highly generalist feeding behavior. Overall, our analyses provide candidate taste receptors specific for D. suzukii which may correlate with its specific behavior and which may be tested in functional studies to ultimately enhance its control in the field.

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A Genetic Screen to Assess Dopamine Receptor (DopR1) Dependent Sleep Regulation in Drosophila

Sleep is an essential behavioral state of rest that is regulated by homeostatic drives to ensure a balance of sleep and activity, as well as independent arousal mechanisms in the central brain. Dopamine has been identified as a critical regulator of both sleep behavior and arousal. Here we present results of a genetic screen that selectively restored the Dopamine Receptor (DopR/DopR1/dumb) to specific neuroanatomical regions of the adult Drosophila brain to assess requirements for DopR in sleep behavior. We have identified subsets of the mushroom body that utilize DopR in daytime sleep regulation. These data are supported by multiple examples of spatially restricted genetic rescue data in discrete circuits of the mushroom body, as well as immunohistochemistry that corroborates the localization of DopR protein within mushroom body circuits. Independent loss of function data using an inducible RNAi construct in the same specific circuits also supports a requirement for DopR in daytime sleep. Additional circuit activation of discrete DopR⁺ mushroom body neurons also suggests roles for these subpopulations in sleep behavior. These conclusions support a new separable function for DopR in daytime sleep regulation within the mushroom body. This daytime regulation is independent of the known role of DopR in nighttime sleep, which is regulated within the Fan Shaped Body. This study provides new neuroanatomical loci for exploration of dopaminergic sleep functions in Drosophila, and expands our understanding of sleep regulation during the day versus night.

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Time-resolved record of 236U and 239,240Pu isotopes from a coral growing during the nuclear testing program at Enewetak Atoll (Marshall Islands)

Publication date: December 2016
Source:Journal of Environmental Radioactivity, Volume 165
Author(s): M.B. Froehlich, W.Y. Chan, S.G. Tims, S.J. Fallon, L.K. Fifield
A comprehensive series of nuclear tests were carried out by the United States at Enewetak Atoll in the Marshall Islands, especially between 1952 and 1958. A Porites Lutea coral that was growing in the Enewetak lagoon within a few km of all of the high-yield tests contains a continuous record of isotopes, which are of interest (e.g. ¹⁴C, ²³⁶U, ^239,240Pu) through the testing period. Prior to the present work, ¹⁴C measurements at ∼2-month resolution had shown pronounced peaks in the Δ¹⁴C data that coincided with the times at which tests were conducted. Here we report measurements of ²³⁶U and ^239,240Pu on the same coral using accelerator mass spectrometry, and again find prominent peaks in the concentrations of these isotopes that closely follow those in ¹⁴C. Consistent with the ¹⁴C data, the magnitudes of these peaks do not, however, correlate well with the explosive yields of the corresponding tests, indicating that smaller tests probably contributed disproportionately to the debris that fell in the lagoon. Additional information about the different tests can also be obtained from the ²³⁶U/²³⁹Pu and ²⁴⁰Pu/²³⁹Pu ratios, which are found to vary dramatically over the testing period. In particular, the first thermonuclear test, Ivy-Mike, has characteristic ²³⁶U/²³⁹Pu and ²⁴⁰Pu/²³⁹Pu signatures which are diagnostic of the first arrival of nuclear test material in various archives.



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Evaluation of a Self-Instructional CPR Program for Parents With Children Enrolled in Community Swim Lessons

This project evaluated an evidence-based self-instructional program aimed at improving cardiopulmonary resuscitation (CPR) knowledge and confidence in parents with children in swim lessons.

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NC ambulance strike team deploys for Hurricane Matthew

The strike team is a group of EMS resources that assembles to deploy to disaster areas and provide EMS support.

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NC ambulance strike team deploys for Hurricane Matthew

The strike team is a group of EMS resources that assembles to deploy to disaster areas and provide EMS support.

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Decline of miR-124 in myeloid cells promotes regulatory T cell development in HCV infection

Immunology

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Comparing the effectiveness of a novel suction set-up using an adult endotracheal tube connected to a meconium aspirator vs. a traditional Yankauer suction instrument

The Journal of Emergency Medicine

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The value of indirect serum markers in predicting severity of fibrosis in treatment naive patients with non-cirrhotic hepatitis C virus infection

2016-10-19T02-25-44Z
Source: Medicine Science | International Medical Journal
Murat Afyon, Cumhur Artuk, Ercan Yenilmez, Berksan Simsek, Ayper Kaya.
We conducted this study for determining the value of indirect serum markers such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), INR (International Normalized Ratio) and platelet counts and the roles of the scores such as AST-to-ALT ratio (AAR), AST-to-platelet ratio index (APRI), FIB-4 index, Kings score, Goteborg University Cirrhosis Index (GUCI) and FibroQ in predicting severity of fibrosis in treatment naive patients with non-cirrhotic hepatitis C virus (HCV) infection. Treatment naive non-cirrhotic chronic HCV patients who underwent percutaneous liver biopsy between 01 January 2012 and 01 June 2015 were included in the study. For evaluating the difference in variables, patients were divided into 2 groups such as no or minimal fibrosis group (fibrosis score


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A Hat-Trick Knock-Reversible Triple Organ Injury in a New Mother With HELLP Syndrome.

No abstract available

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Can the IROMEC robot support play in children with severe physical disabilities? A pilot study.

The aim of this study was to explore the application of the IROMEC (Interactive social RObotic Mediators as Companions) robot to support play for children with severe physical disabilities in rehabilitation and special education. Within a 2-month pilot study, physically disabled children with a developmental age between 2 and 8 years participated in sessions with the robot. A combination of qualitative and quantitative outcome measures was used to collect data on aspects of feasibility, usability, barriers for the child as well as the therapist and an indication of the effects on playfulness and the achievement of therapeutic and educational goals. A total of 11 children participated in this study (four boys, seven girls). Individually Prioritized Problem Assessment scores indicated a positive effect of the IROMEC robot on the achievement of goals for the children. Professionals did observe meaningful application possibilities, but the lacking adaptability, expandability and technical stability of the robot platform make application in daily care practice impossible. The application of a robot like IROMEC for children with severe physical disabilities seems to be positive and worthwhile, but usability and feasibility aspects are crucial for success. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Time Since Inciting Event Is Associated With Higher Centralized Pain Symptoms in Patients Diagnosed With Complex Regional Pain Syndrome.

Background and Objectives: We hypothesized that patients with complex regional pain syndrome (CRPS) with a longer time since their inciting event would demonstrate more symptoms of centralized pain. Methods: We conducted a cross-sectional analysis of 160 patients with CRPS using validated measures of pain, negative mood, and functioning at the time of their new patient evaluation. The 2011 Fibromyalgia Survey Criteria is a validated self-report measure of widespread body pain and comorbid symptoms (eg, trouble thinking, headaches). The measure was used as a surrogate for centralized pain symptoms. Univariate analyses and multivariate linear regression models were used to assess the associations between patient characteristics and the duration of CRPS. Results: The cohort was divided into tertiles based on the time since the inciting event (3 years) for univariate comparisons. Unlike the other measures of pain, mood, and function, the fibromyalgia survey score was significantly associated with a longer duration of symptoms. In a multivariate model adjusting for age and sex, each year since the inciting event was associated with an increase of 0.28 in fibromyalgia survey score (Est 0.28; 95% confidence interval, 0.11-0.46; P = 0.002). The finding was distinct from self-reported spread of CRPS symptoms, which was not different based on time since the inciting event. Conclusions: Our findings suggest that the longer the patients have CRPS the more likely they are to report symptoms suggestive of centralized pain. These data may explain why some patients with a longer duration of CRPS do not respond to peripherally directed therapies. Copyright (C) 2016 by American Society of Regional Anesthesia and Pain Medicine.

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Quadratus Lumborum Block Versus Transversus Abdominis Plane Block for Postoperative Pain After Cesarean Delivery: A Randomized Controlled Trial.

Background and Objectives: Effective postoperative analgesia after cesarean delivery enhances early recovery, ambulation, and breastfeeding. In a previous study, we established the effectiveness of the quadratus lumborum block in providing pain relief after cesarean delivery compared with patient-controlled analgesia (morphine). In the current study, we hypothesized that this method would be equal to or better than the transversus abdominis plane block with regard to pain relief and its duration of action after cesarean delivery. Methods: Between April 2015 and August 2015, we randomized 76 patients scheduled for elective cesarean delivery under spinal anesthesia to receive the quadratus lumborum block or the transversus abdominis plane block for postoperative pain relief. This trial was registered prospectively (NCT 024489851). Results: Patients in the quadratus lumborum block group used significantly less morphine than the transversus abdominis plane block group (P

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The Use of Epinephrine in Caudal Anesthesia Increases Stroke Volume and Cardiac Output in Children.

Background and Objectives: Caudal anesthesia is a common and effective regional anesthesia technique in pediatric patients. The addition of epinephrine to local anesthetics in caudal anesthesia is a frequent practice; however, changes in hemodynamic and cardiac parameters produced by epinephrine in caudal anesthesia are not well studied. Using data collected with the ICON noninvasive cardiac output monitor, we examined the hemodynamic changes associated with the administration of epinephrine containing local anesthetics during caudal anesthesia in children. Methods: We performed a retrospective analysis of 40 patients who received caudal anesthesia among 402 patients from whom we prospectively collected continuous noninvasive cardiac output data using the ICON monitor, which estimates cardiac output by measuring changes in thoracic bioimpedance during the cardiac cycle. Twenty-three children received epinephrine with local anesthetic (ELA), and 17 children received only local anesthetic (OLA) in their caudal blocks. We compared heart rate (HR), stroke volume (SV), cardiac output (CO), and cardiac index (CI) changes from baseline before caudal injection to 1-minute intervals over 15 minutes after caudal injection for both ELA and OLA groups (Table, Supplemental Digital Content 1, http://ift.tt/2e57VL7). We also performed subgroup analysis of the same parameters comparing both ELA and OLA groups in infants younger than 6 months and in children 6 months or older. Results: Stroke volume, CO, and CI are significantly increased after caudal injection in the ELA group compared with baseline values at caudal injection time. Conversely, there were no statistically significant changes in SV, CO, and CI in the OLA group. There were no significant HR or blood pressure changes observed in either the ELA or OLA group within 15 minutes compared with baseline caudal injection time. In infants younger than 6 months, no significant differences were found in HR, SV, and CI in children in the ELA group compared with the OLA group. In children 6 months or older, SV and CI increased significantly in the ELA group compared with the OLA group. Conclusions: Epinephrine added to local anesthetic injected for caudal anesthesia produces significant increases in SV, CO, and CI in children. Stroke volume and CI changes from epinephrine added to local anesthetic for caudal anesthesia seem to take place only in children 6 months or older. Copyright (C) 2016 by American Society of Regional Anesthesia and Pain Medicine.

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Effect of Topical Morphine on Acute and Chronic Postmastectomy Pain: What Is the Optimum Dose?.

Background and Objectives: Poorly controlled postoperative pain is strongly associated with the development of chronic pain. We aimed to investigate the effect of topical morphine (in 1 of 3 doses: 5, 10, or 15 mg) on acute and chronic neuropathic pain after modified radical mastectomy for cancer breast. Methods: In this registered clinical trial ( ClinicalTrials.gov identifier: NCT02462577), 90 patients were allocated to receive 10 mL plain bupivacaine 0.5% plus either 5, 10, or 15 mg morphine (designated by the group names Morphine5, Morphine10, and Morphine15, respectively). The combination was diluted by saline 0.9% to 20 mL and irrigated in the wound before skin closure. Groups were compared for the following: time to first postoperative analgesia; intravenous patient-controlled analgesia (PCA) morphine consumption; pain scores; hemodynamics; sedation; adverse events in first postoperative 48 hours; and Leeds Assessment of Neuropathic Symptoms and Signs scores in first and third postoperative months. Results: No patient in the Morphine15 group requested postoperative PCA morphine versus 19 and 8 in the Morphine5 and Morphine10 groups, respectively (P

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The Analgesic Efficacy of Nonsteroidal Anti-inflammatory Agents (NSAIDs) in Patients Undergoing Cesarean Deliveries: A Meta-Analysis.

Background and Objectives: Postoperative pain after cesarean delivery, which accounts for approximately 1 in 3 live births in the United States, can be severe in many patients. Nonsteroidal anti-inflammatory agents (NSAIDs) are potent analgesics that are effective in the treatment of postoperative pain. In this meta-analysis, we assessed the analgesic efficacy of NSAIDs in postoperative cesarean delivery patients. Methods: An electronic literature search of the Library of Medicine's PubMed, Cochrane CENTRAL, Scopus, and EMBASE databases was conducted in May 2013 and updated in January 2015 (Appendix, Supplemental Digital Content 1, http://ift.tt/2et3iJ2). Searches were limited to randomized controlled trials. The primary outcome variable was visual analog scale or numerical rating scale pain scores. Secondary outcomes included cumulative postoperative opioid consumption and opioid-related adverse effects (drowsiness/sedation, nausea, and vomiting). Data extraction was performed independently by 2 reviewers. Extracted data were input into Review Manager. Results: Twenty-two randomized controlled trials compared a NSAID (n = 639) to a control (n = 674). Patients in the NSAID group versus control reported lower pain scores at 12 hours (P = 0.003) and at 24 hours (P

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Isosmotic is not always isotonic: the five-minute version

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Winter course in physiology: a successful example of continuing education for secondary school teachers in Brazil

In international surveys, Brazilian students have been consistently ranking low in science. Continuing education for secondary school teachers is certainly a way to change this situation. To update teachers and provide teaching and learning experiences for graduate students, our department organized a "Winter Course in Physiology" where schoolteachers had the opportunity to attend lectures that were offered by graduate students and participate in discussions on teaching and learning strategies and their applicability, considering different schools and student age groups. This work evaluated the ways in which the Winter Course in Physiology improves continuing education for secondary school teachers. Graduate students prepared, presented, and discussed with the audience the concepts, content, and topics of the program, which were previously presented to the organizing committee and a supervising professor. Potential participants were recruited based on their curriculum vitae and a letter of intent. During the course, they completed a questionnaire that graded different aspects of course organization and lectures. The results indicated that the Winter Course was positively evaluated. Most topics received a grade of ≥4.0, considering a range of 1.0 (low) to 5.0 (high). In a followup, both the participants and instructors reported positive impacts on their overall knowledge in physiology. Schoolteachers reported improvements in the performance and participation of their students. In conclusion, the results suggested that the Winter Course is a good way to promote continuing education for schoolteachers and promote university outreach. It also provided an important experience for graduate students to develop teaching skills.

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Physiology and pathophysiology of potassium homeostasis

Total body potassium content and proper distribution of potassium across the cell membrane is of critical importance for normal cellular function. Potassium homeostasis is maintained by several different methods. In the kidney, total body potassium content is achieved by alterations in renal excretion of potassium in response to variations in intake. Insulin and beta-adrenergic tone play critical roles in maintaining the internal distribution of potassium under normal conditions. Despite homeostatic pathways designed to maintain potassium levels within the normal range, disorders of altered potassium homeostasis are common. The clinical approach to designing effective treatments relies on understanding the pathophysiology and regulatory influences which govern the internal distribution and external balance of potassium. Here we provide an overview of the key regulatory aspects of normal potassium physiology. This review is designed to provide an overview of potassium homeostasis as well as provide references of seminal papers to guide the reader into a more in depth discussion of the importance of potassium balance. This review is designed to be a resource for educators and well-informed clinicians who are teaching trainees about the importance of potassium balance.

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Residual neuromuscular blockade: management and impact on postoperative pulmonary outcome.

Purpose of review: To revise the current literature on concepts for neuromuscular block management. Moreover, consequences of incomplete neuromuscular recovery on patients' postoperative pulmonary outcome are evaluated as well. Recent findings: The incidence of residual paralysis may be as high as 70% and even small degrees of residual paralysis may have clinical consequences. Neostigmine should not be given before return of the fourth response of the train-of-four-stimulation and no more than 40-50 [mu]g/kg should be given. Sugammadex acts more rapidly and more predictably than neostigmine. Finally, there is convincing evidence in the literature that incomplete neuromuscular recovery may lead to a poor postoperative pulmonary outcome. Summary: New evidence has emerged about the pathophysiological implications of incomplete neuromuscular recovery. Not only are the pulmonary muscles functionally impaired, but respiratory control is also affected. Residual paralysis endangers the coordination of the pharyngeal muscles and the integrity of the upper airway. However, neuromuscular monitoring and whenever needed pharmacological reversal prevent residual paralysis. Copyright (C) 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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