Clinico-pathological findings of Clostridium perfringens type D enterotoxaemia in goats and its hemolytic activity in different erythrocytes

The present investigation was conducted to study the effects of experimental Clostridium perfringens type D enterotoxaemia in teddy goats. Clinical signs started to appear after 30 min of experimental infection like anorexia, diarrhea, dehydration, frothing and dyspnea. Gross lesions consisted of severe congestion in tissues of varying intensity with enlarged mesenteric lymph nodes while histological examination revealed edema of lungs, kidney, and lymph nodes and to some extent in brain along with hemorrhages in lungs and intestines. Clostridium perfringens type D carrying alpha and epsilon toxin genes were amplified with amplicon size about 247 bp and 665 bp, respectively. Human erythrocytes showed the highest hemolysis, 68%, followed by mice, 57%, against culture supernatants. The percentage of hemolysis was significantly higher at 37°C as compared to 25°C except for rabbit and dog.

Measurement of the isoscalar monopole response in the neutron-rich nucleus 68Ni

The isoscalar monopole response has been measured in the unstable nucleus (68)Ni using inelastic alpha scattering at 50A  MeV in inverse kinematics with the active target MAYA at GANIL. The isoscalar giant monopole resonance (ISGMR) centroid was determined to be 21.1 ± 1.9 MeV and indications for a soft monopole mode are provided for the first time at 12.9 ± 1.0 MeV. Analysis of the corresponding angular distributions using distorted-wave-born approximation with random-phase approximation transition densities indicates that the L = 0 multipolarity dominates the cross section for the ISGMR and significantly contributes to the low-energy mode. The L=0 part of this low-energy mode, the soft monopole mode, is dominated by neutron excitations. This demonstrates the relevance of inelastic alpha scattering in inverse kinematics in order to probe both the ISGMR and isoscalar soft modes in neutron-rich nuclei.

The heart and potassium: a banana republic

The importance of potassium in maintaining stable cardiac function is a clinically understood phenomenon. Physiologically the importance of potassium in cardiac function is described by the large number of different kinds of potassium ions channels found in the heart compared to channels and membrane transport mechanisms for other ions such as sodium and calcium. Potassium is important in physiological homeostatic control of cardiac function, but is also of relevance to the diseased state, as potassium-related effects may stabilize or destabilize cardiac function. This article aims to provide a detailed understanding of potassium-mediated cardiac function. This will help the clinical practitioner evaluate how modulation of potassium ion channels by disease and pharmacological manipulation affect the cardiac patient, thus aiding in decision making when faced with clinical problems related to potassium.

Fluoroquinolone and macrolide co-resistance in clinical isolates of Campylobacter species: a 15-year study in Karachi, Pakistan

Fluoroquinolone and macrolide antibiotics are generally considered as first-line drugs for the treatment of severe campylobacteriosis. This study was conducted to analyse the trend of erythromycin and ofloxacin resistance among Campylobacter spp. isolated from stool specimens over a period of 15 years (1992-2007) at The Aga Khan University clinical laboratory in Karachi, Pakistan. A total of 83 396 stool specimens were processed, with a 14% isolation rate for enteric pathogens. The isolation rate of Campylobacter spp. was low during 1992-93 (6%-13%), peaked in 1996 (46%), then ranged from 20% to 40%. We report a rising trend in ofloxacin resistance, re-emergence of erythromycin resistance and indications of co-resistance to both drugs in clinical isolates of Campylobacter spp.

Incidence of symptomatic brain metastasis following radical radiotherapy for non-small cell lung cancer: is there a role for prophylactic cranial irradiation?

OBJECTIVE

Brain metastases following radical radiotherapy for non-small cell lung cancer (NSCLC) are a recognised phenomenon; however, the incidence of symptomatic brain metastasis is currently unknown. The aim of the study was to identify the number of patients, staged in accordance with National Institute for Health and Clinical Excellence (NICE) guidance, who developed symptomatic brain metastasis following radical radiotherapy. There are two aims: to evaluate NICE guidance; and to provide vital information on the likely benefit of prophylactic cranial irradiation (PCI) in reducing neurological symptoms from brain metastasis.

METHODS

A retrospective review of 455 patients with NSCLC who had undergone radical radiotherapy in 2009 and 2010 was performed. Computer-based systems were used to identify patient and tumour demographics, the staging procedures performed and whether brain imaging had identified brain metastasis in the follow-up period.

RESULTS

The total number of patients with brain metastasis within 6 months was 3.7%. The proportion of brain metastasis within 6 months in Stage I, II and III NSCLC throughout both years was 2.8%, 1.0% and 5.7%, respectively. Within the follow-up period (median 16 months, range 6-30 months), the total number of patients who developed symptomatic brain metastasis was 7.9%.

CONCLUSION

Patients staged in accordance with NICE guidance, of whom only 7.7% underwent brain staging, have a minimal incidence of brain metastasis following radical radiotherapy. The number of patients developing symptoms from brain metastasis following radical radiotherapy may be less than the morbidity caused by PCI.

ADVANCES IN KNOWLEDGE

This finding supports the NICE guidance and brings into question the potential benefit of PCI.

Large hepatitis delta antigen activates STAT-3 and NF-κB via oxidative stress

Hepatitis delta virus (HDV) coinfection or superinfection in hepatitis B virus (HBV)-infected patients results in a more aggressive liver disease, with more often fulminant forms and more rapid progression to cirrhosis and hepatocellular carcinoma. The mechanism(s) for this pejorative evolution remains unclear. To explore a specific HDV pathogenesis, we used a model of transient transfection of plasmids expressing the small (sHDAg or p24) or the large (LHDAg or p27) delta antigen in hepatocyte cell lines. We found that the production of reactive oxygen species was significantly higher in cells expressing p27. Consequently, p27 activated the signal transducer and activator of transcription-3 (STAT-3) and the nuclear factor kappa B (NF-κB) via the oxidative stress pathway. Moreover in the presence of antioxidants (PDTC, NAC) or calcium inhibitors (TMB-8, BAPTA-AM, Ruthenium Red), p27-induced activation of STAT-3 and NF-κB was dramatically reduced. Similarly, using a mutated form of p27, where the cysteine 211-isoprenylation residue was replaced by a serine, a significant reduction of STAT-3 and NF-κB activation was seen, suggesting the involvement of isoprenylation in this process. Additionally, we show that p27 is able to induce oxidative stress through activation of NADPH oxidase-4. These results provide insight into the mechanisms by which p27 can alter intracellular events relevant to HDV-related liver pathogenesis.

Constraining the nuclear equation of state at subsaturation densities

Only one-third of the nucleons in 208Pb occupy the saturation density area. Consequently, nuclear observables related to the average properties of nuclei, such as masses or radii, constrain the equation of state not at the saturation density but rather around the so-called crossing density, localized close to the mean value of the density of nuclei: ρ is approximately equal to 0.11 fm(-3). This provides an explanation for the empirical fact that several equation of state quantities calculated with various functionals cross at a density significantly lower than the saturation one. The third derivative M of the energy per unit of volume at the crossing density is constrained by the giant monopole resonance measurements in an isotopic chain rather than the incompressibility at saturation density. The giant monopole resonance measurements provide M=1100±70 MeV (6% uncertainty), whose extrapolation gives K(∞)=230±40 MeV (17% uncertainty).

Detection and genetic characterization of foot-and-mouth disease viruses in samples from clinically healthy animals in endemic settings

A total of 1501 oral swab samples from Pakistan, Afghanistan and Tajikistan were collected from clinically healthy animals between July 2008 and August 2009 and assayed for the presence of foot-and-mouth disease virus (FMDV) RNA. The oral swab samples from two (of four) live animal markets in Pakistan (n = 245), one (of three) live animal market in Afghanistan (n=61) and both the live animal markets in Tajikistan (n=120) all tested negative. However, 2 of 129 (∼2%) samples from Gondal and 11 of 123 (9%) from Chichawatni markets in Pakistan were positive for FMDV RNA. Similarly, 12 of 81 (15%) samples from Kabul and 10 of 20 (50%) from Badakhshan in Afghanistan were found to be positive. Serotypes A and O of FMDV were identified within these samples. Oral swab samples were also collected from dairy colonies in Harbanspura, Lahore (n=232) and Nagori, Karachi (n=136), but all tested negative for FMDV. In the Landhi dairy colony, Pakistan, a cohort of 179 apparently healthy animals was studied. On their arrival within the colony, thirty-nine (22%) of these animals were found positive for FMDV RNA (serotype A was identified), while 130 (72.6%) had antibodies to FMDV non-structural proteins. Thus, newly introduced animals may be a significant source of the disease in the colony. Only two animals from the cohort were detected as becoming positive for FMDV RNA during a follow-up period of 4months; however, only 10 animals remained negative for anti-NSP antibodies during this period.

Genetic regulation of the ramA locus and its expression in clinical isolates of Klebsiella pneumoniae

Tigecycline resistance has been attributed to ramA overexpression and subsequent acrA upregulation. The ramA locus, originally identified in Klebsiella pneumoniae, has homologues in Enterobacter and Salmonella spp. In this study, we identify in silico that the ramR binding site is also present in Citrobacter spp. and that Enterobacter, Citrobacter and Klebsiella spp. share key regulatory elements in the control of the romA-ramA locus. RACE (rapid amplification of cDNA ends) mapping indicated that there are two promoters from which romA-ramA expression can be regulated in K. pneumoniae. Correspondingly, electrophoretic binding studies clearly showed that purified RamA and RamR proteins bind to both of these promoters. Hence, there appear to be two RamR binding sites within the Klebsiella romA-ramA locus. Like MarA, RamA binds the promoter region, implying that it might be subject to autoregulation. We have identified changes within ramR in geographically distinct clinical isolates of K. pneumoniae. Intriguingly, levels of romA and ramA expression were not uniformly affected by changes within the ramR gene, thereby supporting the dual promoter finding. Furthermore, a subset of strains sustained no changes within the ramR gene but which still overexpressed the romA-ramA genes, strongly suggesting that a secondary regulator may control ramA expression.

Effects of liquid swine manure on dissipation of 17β-estradiol in soil

17β-estradiol (E2), a natural estrogenic hormone, degrades within hours and bind strongly to soils and sediments; however, estrogens are frequently detected in the environment at concentrations that impact water quality. Colloidal (COC) and dissolved (DOC) organic carbon may enhance the persistence and mobility of E2. Soil batch experiments were used to identify the persistence and sorption of radiolabeled E2 dissolved in solutions of (i) COC/DOC derived from liquid swine manure and (ii) CaCl(2). Estradiol disappeared from the aqueous phase before 7 d in the CaCl(2) solution, yet persisted throughout the duration of the 14 d experiment in the liquid manure solution. There was also concomitant formation of estrone (E1; a metabolite of E2) as E2 dissipated in sterile batch experiments, which was attributed to abiotic oxidation. The liquid manure solution appeared to interact with the estrogen and/or oxidation reaction sites, reducing E2 degradation. Furthermore, the liquid manure solution reduced E2/E1 binding to the soil surface resulting in more E2/E1 in the aqueous layer compared to the CaCl(2) solution. Ultrafiltration results of liquid manure indicated that ∼1/3 of E2 was associated with COC, which may be responsible for the reduced degradation and sorption of E2 in the liquid manure solution.

Medicine management: pharmacokinetic update for community nurses

Medication management is a major part of nursing practice. Ensuring safety in medication management is all the more important in the community, where patients are not under constant observation of a health-care professional. One of the prime factors in maintaining safety with medication is establishing and maintaining adequate and safe drug levels in the body. Before drugs can have an effect, they are acted upon by the body; these processes change the drug, mainly to enhance its removal from the body. Study of these processes is called pharmacokinetics and includes the processes of absorption, distribution, metabolism and excretion. Pharmacokinetic processes determine the time of onset and duration of drug action. In turn drug pharmacokinetics is affected by concordance with medication regimes and systemic illness; factors which may render the medication useless or toxic. This article introduces the reader to the principles of pharmacokinetics and shows the link between pharmacokinetics and disease and administration of multiple drugs (polypharmacy). With an aim to equip the community nurse with a better understanding of how to recognize and foresee problems associated with medication management.