Spinal gunshot wounds: A retrospective, multicenter, cohort study

INTRODUCTION AND OBJECTIVE

To describe the demographic and clinical characteristics and treatment of patients with spinal gunshot wounds across Latin America.

MATERIAL AND METHODS

Retrospective, multicenter cohort study of patients treated for gunshot wounds to the spine spanning 12 institutions across Latin America between January 2015 and January 2022. Demographic and clinical data were recorded, including the time of injury, initial assessment, characteristics of the vertebral gunshot injury, and treatment.

RESULTS

Data on 423 patients with spinal gunshot injuries were extracted from institutions in Mexico (82%), Argentina, Brazil, Colombia, and Venezuela. Patients were predominantly male civilians in low-risk-of-violence professions, and of lower/middle social status, and a sizeable majority of gunshots were from low-energy firearms. Vertebral injuries mainly affected the thoracic and lumbar spine. Neurological injury was documented in 320 (76%) patients, with spinal cord injuries in 269 (63%). Treatment was largely conservative, with just 90 (21%) patients treated surgically, principally using posterior open midline approach to the spine (79; 87%). Injury features distinguishing surgical from non-surgical cases were neurological compromise (P = 0.004), canal compromise (P < 0.001), dirty wounds (P < 0.001), bullet or bone fragment remains in the spinal canal (P < 0.001) and injury pattern (P < 0.001). After a multivariate analysis through a binary logistic regression model, the aforementioned variables remained statistically significant except neurological compromise.

CONCLUSIONS

In this multicenter study of spinal gunshot victims, most were treated non-surgically, despite neurological injury in 76% and spinal injury in 63% of patients.

Similarity to the self influences memory for social targets

The construct of the self is important in the domain of memory research. Recent work has shown that person memory is influenced by similarity of social targets to the self. The current experiments investigate self-similarity as defined by traits and political ideology to better understand how memory for social targets is organised. Across three experiments, participants formed positive or negative impressions based on each target's picture, a trait-implying behavior (Experiments 1 & 2), and/or political ideology (conservative/liberal label in Experiment 2; political-ideological belief statements in Experiment 3) followed by a memory test. Results showed a self-similarity effect dependent on valence in Experiment 1, but not in Experiments 2 or 3 when participants processed ideological information associated with targets. These results suggest that self-similarity has an effect on memory for social targets, but that ideological information disrupts self-focused processing of others, suggesting that ideological information also has a powerful influence on what people remember about others (i.e. social targets).

Acute kidney injury, urinary and histopathological disorders in kidney transplant patients with SARS-CoV2 infection

Background

Acute kidney injury (AKI) is a manifestation of SARS-CoV-2 infection. The evidence in kidney transplant (KT) is limited, as there are scarce data about the histologic features in graft biopsies of these patients.

Material and Methods

A retrospective cohort study of KTs with SARS-CoV-2 infection from August 28, 2020, to April 23, 2021. We collected the incidence of AKI and the presence of urinary and histopathological disorders. Both groups were compared (AKI vs no AKI). Immunohistochemical and reverse transcription-polymerase chain reaction studies were performed on the anatomopathological samples.

Results

In our study, 72 KTs had SARS-CoV-2 infection and, among them, 27 patients (35.1%) developed AKI related to increased severity and a worse evolution of the infection, defined by a greater presence of pneumonia (P < .001), hospitalization (P < .001), admission to the intensive care unit (P < .001), the need for ventilation support (P < .001), and continuous renal replacement therapy (P < .001). In the multivariable analysis, pneumonia behaved as an independent predictor for AKI development (P = .046). No differences were observed between proteinuria a month before and after infection (P = .224). In addition, 5 patients showed microhematuria and 2 patients presented transient glycosuria without hyperglycemia. Of the 5 kidney biopsies performed, 1 biopsy (20%) showed positive reverse transcription polymerase chain reaction for SARS-CoV-2.

Conclusions

AKI is a frequent and potentially serious complication in KT patients. Occasionally it could be accompanied by abnormalities in the urinary sediment. Of 5 biopsied patients, 1 patient had positive reverse transcription polymerase chain reaction in renal tissue, which suggests the systemic spread of the virus and the tropism for the renal graft.

Key plant species and detritivores drive diversity effects on instream leaf litter decomposition more than functional diversity: A microcosm study

Anthropogenic impacts on freshwater ecosystems cause critical losses of biodiversity that can in turn impair key processes such as decomposition and nutrient cycling. Forest streams are mainly subsidized by terrestrial organic detritus, so their functioning and conservation status can be altered by changes in forest biodiversity and composition, particularly if these changes involve the replacement of functional groups or the loss of key species. We examined this issue using a microcosm experiment where we manipulated plant functional diversity (FD) (monocultures and low-FD and high-FD mixtures, resulting from different combinations of deciduous and evergreen Quercus species) and the presence of a key species (Alnus glutinosa), all in presence and absence of detritivores, and assessed effects on litter decomposition, nutrient cycling, and fungal and detritivore biomass. We found (i) positive diversity effects on detritivore-mediated decomposition, litter nutrient losses and detritivore biomass exclusively when A. glutinosa was present; and (ii) negative effects on the same processes when microbially mediated and on fungal biomass. Most positive trends could be explained by the higher litter palatability and litter trait variability obtained with the inclusion of alder leaves in the mixture. Our results support the hypothesis of a consistent slowing down of the decomposition process as a result of plant biodiversity loss, and hence effects on stream ecosystem functioning, especially when a key (N-fixing) species is lost; and underscore the importance of detritivores as drivers of plant diversity effects in the studied ecosystem processes.

Diagnosis of multiple sclerosis using multifocal ERG data feature fusion

The purpose of this paper is to implement a computer-aided diagnosis (CAD) system for multiple sclerosis (MS) based on analysing the outer retina as assessed by multifocal electroretinograms (mfERGs). MfERG recordings taken with the RETI-port/scan 21 (Roland Consult) device from 15 eyes of patients diagnosed with incipient relapsing-remitting MS and without prior optic neuritis, and from 6 eyes of control subjects, are selected. The mfERG recordings are grouped (whole macular visual field, five rings, and four quadrants). For each group, the correlation with a normative database of adaptively filtered signals, based on empirical model decomposition (EMD) and three features from the continuous wavelet transform (CWT) domain, are obtained. Of the initial 40 features, the 4 most relevant are selected in two stages: a) using a filter method and b) using a wrapper-feature selection method. The Support Vector Machine (SVM) is used as a classifier. With the optimal CAD configuration, a Matthews correlation coefficient value of 0.89 (accuracy = 0.95, specificity = 1.0 and sensitivity = 0.93) is obtained. This study identified an outer retina dysfunction in patients with recent MS by analysing the outer retina responses in the mfERG and employing an SVM as a classifier. In conclusion, a promising new electrophysiological-biomarker method based on feature fusion for MS diagnosis was identified.

Evaluation of a Cooperia oncophora double-domain ASP-based vaccine against Cooperia spp. infections in cattle and sheep

A double-domain activation-associated secreted protein (dd-Co-ASP) isolated from the bovine small intestinal parasite Cooperia oncophora was previously shown to be an effective vaccine candidate to protect calves against a homologous challenge infection. The aim of this study was to investigate whether the dd-Co-ASP protein, purified from a Belgian C. oncophora isolate, would offer protection against a C. oncophora isolate from the southern hemisphere as well as other Cooperia species such as C. punctata in cattle and C. curticei in sheep. Two vaccination studies were performed, i.e. one in cattle and one in sheep, in which the protective effects of dd-Co-ASP, supplemented with Quil A as an adjuvant, were compared with an adjuvant control. Whereas our results showed a 75 % reduction in Cooperia spp. cumulative faecal egg counts, the results obtained in sheep demonstrated that dd-Co-ASP was ineffective in raising a protective immune response against a C. curticei challenge infection. Even though sequence analysis of the dd-Co-ASP gene revealed restricted sequence heterogeneity in the double domain ASP within and between bovine Cooperia species, the results of the vaccine study suggest that there is sufficient conservation at the protein level to yield cross-protection, holding promise for the development of a general Cooperia vaccine for use in cattle.

Macrolide resistance in Mycoplasma genitalium in Catalonia, Spain: a 1 year prospective study

BACKGROUND

Mycoplasma genitalium is an emergent cause of sexually transmitted disease (STD). The first-line treatment is azithromycin, but macrolide resistance is increasing due to mutations in the 23S rRNA gene.

OBJECTIVES

To determine the rates of M. genitalium infection and macrolide resistance in an area adjacent to Barcelona.

METHODS

This 1 year prospective study was performed in a heterogenous population that included both low- and high-risk patients. M. genitalium was detected in all specimens sent to our institution for STD detection. Epidemiological and relevant clinical data were collected in the positive cases. Characterization of macrolide-associated resistance was performed by 23S rDNA sequencing.

RESULTS

Of the 3540 patients included, 132 (3.7%) were positive for M. genitalium. Another sexually transmitted bacteria was detected in 20.4% of the M. genitalium cases, and Chlamydia trachomatis (11%) was the most frequently co-detected microorganism. Only 61.4% of patients received an adequate initial treatment against M. genitalium. The test of cure (TOC) was performed in 42% of patients, and therapeutic failure was detected in 10 cases. The rate of macrolide resistance was 12.6% and the most prevalent mutation was A2058G. There was an association between macrolide resistance and a previous history of M. genitalium detection (P < 0.001).

CONCLUSIONS

Our results support the contribution of the previous use of macrolides in resistant strains. Given the difficulties in performing TOC in all patients, the inclusion of macrolide resistance in the detection test should be mandatory.

An active x-ray beamstop based on single crystal CVD diamond at beamline SWING

A compact active x-ray beamstop has been developed for the SWING beamline at Synchrotron SOLEIL with two main functions, blocking the x-ray beam directly transmitted by the sample to protect the Dectris EigerX4M 2D detector and monitoring its intensity. The beamstop is composed of a sensor inserted in a well of tungsten carbide. The sensor is based on a piece of free-standing single crystal chemical vapor deposited diamond used in the ionization chamber mode. The beamstop has been installed on the beamline detector stage within the detection vacuum chamber, just upstream of the large 2D detector. The intensity monitoring performance (rms noise over signal) is shown to be better than 0.06% and the linearity is shown to be better than 2% for over more than five decades. The beamstop has been calibrated between 5 and 16 keV to provide the photon flux measurements in absolute units (ph/s). The specific design of the beamstop increases the small-angle x-ray scattering q-range by a factor of 1.5 in the low angle side, as compared to the previous active beamstop, based on a more standard commercial Si diode. The beamstop has been available for three years for SWING user operation (5-17 keV). It is fully compatible with the different beamline operating modes and fluxes, except in the microbeam mode, where the very divergent beam becomes too large at the beamstop position, and the previous, larger, beamstop is then more appropriate.

Recommendations for the evaluation and management of the anticipated and non-anticipated difficult airway of the Societat Catalana d'Anestesiologia, Reanimació i Terapèutica del Dolor, based on the adaptation of clinical practice guidelines and expert consensus

The Airway Division of the Catalan Society of Anaesthesiology, Intensive Care and Pain Management (SCARTD) presents its latest guidelines for the evaluation and management of the difficult airway. This update includes the technical advances and changes observed in clinical practice since publication of the first edition of the guidelines in 2008. The recommendations were defined by a consensus of experts from the 19 participating hospitals, and were adapted from 5 recently published international guidelines following an in-depth analysis and systematic comparison of their recommendations. The final document was sent to the members of SCARTD for evaluation, and was reviewed by 11 independent experts. The recommendations, therefore, are supported by the latest scientific evidence and endorsed by professionals in the field. This edition develops the definition of the difficult airway, including all airway management techniques, and places emphasis on evaluating and classifying the airway into 3 categories according to the anticipated degree of difficulty and additional safety considerations in order to plan the management strategy. Pre-management planning, in terms of preparing patients and resources and optimising communication and interaction between all professionals involved, plays a pivotal role in all the scenarios addressed. The guidelines reflect the increased presence of video laryngoscopes and second-generation devices in our setting, and promotes their routine use in intubation and their prompt use in cases of unanticipated difficult airway. They also address the increased use of ultrasound imaging as an aid to evaluation and decision-making. New scenarios have also been included, such as the risk of bronchoaspiration and difficult extubation Finally, the document outlines the training and continuing professional development programmes required to guarantee effective and safe implementation of the guidelines.

A7 Co-receptor tropism determined by genotypic assay in HIV-1 non-B subtypes circulating in Cuba: Implications for pathogenesis and Maraviroc resistance

The V3 loop of the HIV-1 envelope (env) gene is involved in binding to the chemokine receptors CCR5 and CXCR4, thus determining viral tropism. With the aim of genetically characterizing the C2V3 env region of HIV-1 samples from Cuban patients, naive to Maraviroc (MVC) therapy, 115 plasma samples were taken in the period of 2014–6 and analyzed by sequencing of the C2V3 region. HIV-1 subtyping was performed using COMET V.2 and Rega subtyping toolV.3 software. Subtypes were confirmed by phylogenetic analyses using Mega-6. Prediction of co-receptor tropism was performed using the geno2pheno algorithm. The viral mutations associated to MVC resistance were analyzed, as well as the association of the subtype with clinical, epidemiological, virological, and immunological variables. The subtypes detected using the C2V3 region were CRF20, 23, 24_BG (35 patients, 30.4%); Subtype B (33 patients, 28.7%); CRF19_cpx (30 patients, 26.1%); CRF18_cpx (10 patients, 8.7%); and others (7 patients, 6.1%). Overall, 60 per cent of the viruses exhibited R5 phenotype, 14.8 per cent were R5X4 and 25.2 per cent were X4. Interestingly, CRF19_cpx virus was associated with having phenotype X4 [46.7%, P = 0.0047, odds ratio (OR): 3.96, 95% confidence interval (95% CI): 1.59–9.84], with infection in young individuals (39.1%, P = 0.025, OR: 3,548; 95% CI: 1,136–11,077) and with higher values of viral load (P ≤ 0.05). The comparison of the amino acid sequences of the V3 loop showed differences between the B and non-B subtypes (P = 0.0001). Mutations reported to be associated with MVC resistance, were detected in 75.7 per cent of the samples, in positions 11 (6.1%), 13 (49.6%), 25 (6.1%), 316 (7.0%), 323 (11.3%), and 319 (3.5%) of Gp120, particularly in the recombinant forms CRF19_cpx and CRF_BGs. HIV variants that use the CXCR4 co-receptor were associated with more than 10 years of diagnosis, with older individuals, in the AIDS stage, with low CD4 counts and higher viral load levels (P < 0.05). The results support the hypothesis previously stated that CRF19_cpx viruses could be more pathogenic and would have limitations for the use of MVC. The high rate of mutations associated to MVC among non-B Cuban subtypes should be further studied.

Abstract P2-08-58: Prognostic factors of survival in node positive breast cancer patients after neoadjuvant chemotherapy in a large series after 5y follow-up: Can response overcome the poor prognosis of nodal stage?

Background: Status of the axilla is one of the most significant prognostic factors in breast cancer (BC) patients. On the other hand, response to neoadjuvant chemotherapy (NACT) is related to survival. The aim of the present study is to analyze which prognostic factors impact most on Node positive (N+) BC patient survival after NATC. Material and methods: Retrospective analyses on a series of N+ BC patients treated with NATC based on anthracyclines and taxanes +/- trastuzumab if HER2 positive tumors, between June 2008 and December 2016. Clinical, radiological and pathological outcomes have been evaluated. Residual cancer burden (RCB) 1 and the neoadjuvant response index (INR) 2 have been recorded. Survival was calculated with Kaplan-Meier survival curve since the start of NATC to the first documented disease recurrence (DFS) or death (OS). Hazard ratios (HRs) with 95% CIs were estimated with cox proportional hazards regression analysis and subgroups were compared with a two-sided log-rank test. Results: A total of 345 N+ BC patients were included. Pathological complete response was achieved in 72 (20.8%) patients. After NACT, 137 (39.6%) become ypN0, 9 (2.6%) ypN1 mic, 113 (32.7%) ypN1, 60 (17.3%) ypN2 and 26 (7.6%) N3. Those independent predictive factor of ypN0 were molecular subtype (TN and Her2+) with OR: 7.7, p&lt;0.001 and clinical response with OR 6.88, p: 0.04. At a mean follow-up of 58 months there have been 73 (21.1%) recurrences: 9 (2.3%) local, 45 (13%) systemic, 15 (4.3%) systemic+ local, 3 (0.9%) axilla, 1 (0.3%) supraclavicular. The estimated 5y OS was 87.8%. The univariate analysis according to DSF is detailed in Table1.

Adjusted univariate anaalysis cox regression of clinical and pathological factors of desease free survivalBMI10.989-1.010.963AGE0.9960.953-1.0420.876Dose NATC0.9940.979-1.0080.402Clinical Stage1.4021.077-1.8260.012Rx Image1.260.803-1.9940.311Rx size1.0090.995-1.0240.217Number suspicious ALN1.0950.801-1.4970.57Molecular subtype TN,HER20.8800.534-1.450.616Nottinghan grade1.0460.753-1.4530.789Histological subtype1.4651.044-2.0570.27MOlecular subtype1.1510.956-1.3850.137Vascular invasion1.6761.137-24710.009Clinical response2.3691.709-3.284&lt;0.001Fibrosis tumor bed0.980.972-0.989&lt;0.001Nodal fibrosis&gt;50%1.7950.874-3.6860.111Pathological tumoral response1.6861.175-2.4180.005ypN03.561.853-6.838&lt;0.001NRI0.330.192-0.565&lt;0.001RCB1.2741.106-1.4680.001

In the multivariate model those parameters that were independently prognostic were clinical response HR: 5.44 (IC95% 2.275-13.042, p&lt;0.001) and clinical stage HR: 2.364 (IC95% 1.018-5.490, p: 0.045). Conclusions: The most significant prognostic factor in our N+ series was response to NATC, followed by clinical stage. Those independently predictive factors of axillar response (ypN0) were molecular subtype (TN and Her2+) and clinical response. In conclusion, in those patients with chemo sensitive tumors, lymphadenectomy could be safely spared with a more selective axillary approach.

Citation Format: Fernandez S, Garcia A, Vethencourt A, Vazquez S, Petit A, Pla MJ, Ortega R, Pérez J, Gil M, Ponce J, Pernas S, Lopez A, Falo C. Prognostic factors of survival in node positive breast cancer patients after neoadjuvant chemotherapy in a large series after 5y follow-up: Can response overcome the poor prognosis of nodal stage? [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-58.

Identification of reference genes for real-time PCR cytokine gene expression studies in sheep experimentally infected with Fasciola hepatica

The aim of this study was to validate reference genes for gene normalisation using qRT-PCR in hepatic lymph nodes (HLN) and livers from sheep infected with Fasciola hepatica during early and late stages of infection. To this end, a comprehensive statistical approach (RefFinder) encompassing four different methods of analysis (geNorm, BestKeeper, ΔCt method and NormFinder) was used to validate ten candidate reference genes. Stability analysis of gene expression followed by pairwise variation (Vn/Vn + 1) analysis revealed that PGK1, HSP90AA1 and GYPC were the most stable reference genes and suitable for qRT-PCR normalisation in both HLN and liver tissues. These three genes were validated against FoxP3, IL-10, TGF-β, TNF-α and IL-1β genes in the HLN tissue of sheep vaccinated with Cathepsin L1 from F. hepatica and unvaccinated infected and uninfected controls during early stages of infection. In the liver, the three reference genes were validated against TNF-α and IL-1β during chronic stages of infection with F. hepatica and in uninfected controls. Our study is the first to evaluate and validate sheep reference genes in order to provide tools for monitoring cytokines in Fasciola hepatica infected sheep target organs. Our results present an approach to elucidate the role of different cytokines in F. hepatica vaccinated and infected sheep.

SEOM clinical guidelines to primary prevention of cancer (2018)

Cancer is the leading social and healthcare problem of the twenty-first century. The aim of primary prevention is to decrease the incidence of cancer by avoiding the known causes and risk factors. Nevertheless, it has been estimated that cancer diagnoses could be halved through primary prevention measures. A comprehensive review of the scientific evidence regarding the main carcinogens and risk factors and primary prevention recommendations have been put forth based on this evidence. The GRADE scale has been used to classify the grade of evidence. We present the scientific evidence and recommendations for primary prevention of the major modifiable risk factors: smoking, alcohol, diet, obesity, physical activity, occupational and environmental factors, ultraviolet radiation, infections, and socioeconomic factors. Primary prevention is a simple, effective means to lower the incidence of cancer. Preventive measures must be circulated in the fight against cancer.

La deformación del borde dorsal del cuello en burros en Andalucía y Extremadura, España

Se plantea como objetivo estudio de la incidencia de la deformación del borde dorsal del cuello en burros en Andalucía y Extremadura, España. Se practicó un examen clínico a cada uno de los burros mediante la inspección detallada y la palpación. Se realizó un estudio morfológico siguiendo el protocolo de adiposidad para la evaluación del borde dorsal del cuello descrito. Se analizo el grado de deformación del cuello, diámetro del cuello, largo del cuello, peso, actividad atlética, localización geográfica y tipo de alimentación, tipo de manejo, instalaciones. Se estudiaron a un total de 853 burros, la deformación del borde dorsal del cuello presento una mayor incidencia en burros de raza Andaluza de 70%, en raza Miniatura 14%, en Zamorano-Leonesa 9% y por último en la raza Catalana 7%. En relación al sexo el 65% fue macho y hembras 35%. El nivel de correlación entre el grado de deformidad y el sistema de manejo fue positivo de 0.18, también para la deformación del cuello y la altura del comedero 0.0835. La deformación del borde dorsal del cuello (Cuello de gato, cresta o cresty neck), presento una incidencia de 40%, con mayor número de observaciones en burros de raza Andaluza de 70%, en raza Miniatura 14%, en Zamorano-Leonesa 9% y por último en la raza Catalana 7%.

Study of peritoneal macrophage immunophenotype in sheep experimentally infected with Fasciola hepatica

During Fasciola hepatica infection, the parasite has the capability to modulate the host immune response towards a non-protector Th2 type instead of Th1. This type of immune response is closely related to the alternative activation of macrophages (M2 profile) as has been shown in vivo in murine models. In this study, an experiment was carried out in order to evaluate the expression of CD68, CD14, CD206 and iNOS in cells present in the peritoneal fluid of sheep during early stages of infection with F. hepatica (1, 3, 9 and 18 days post-infection, dpi) by immunocytochemistry. To the authors' knowledge, this is the first report that studies the in vivo immunophenotype of macrophages from the peritoneal fluid of sheep infected with F. hepatica. Throughout the experiments the absolute number of leucocytes progressively increased, reaching its highest value at 18 dpi, mainly due to the increase of eosinophils. This immunocytochemical study had two purposes: 1) CD68 expression was assessed with Hansel counterstaining, to optimally identify peritoneal macrophages, eosinophils and lymphocytes; 2) expression of CD14, CD206 and iNOS was evaluated to identify alternative or classical pathways of macrophage activation. The results showed a significant increase in CD14 from day 3 dpi compared with the non-infected group. CD206 expression at all time-points showed a significant and dramatic increase in comparison with the uninfected group. On the other hand, iNOS expression showed little variation, and was significantly decreased at 18 dpi in comparison with the uninfected group. These results suggest that F. hepatica induces an alternative activation of peritoneal macrophages of sheep from the first day post-infection, which may facilitate parasite survival. This is the first report describing M2 activation of peritoneal macrophages in ruminants infected with F. hepatica.

Demonstration of Single-Barium-Ion Sensitivity for Neutrinoless Double-Beta Decay Using Single-Molecule Fluorescence Imaging

A new method to tag the barium daughter in the double-beta decay of ^{136}Xe is reported. Using the technique of single molecule fluorescent imaging (SMFI), individual barium dication (Ba^{++}) resolution at a transparent scanning surface is demonstrated. A single-step photobleach confirms the single ion interpretation. Individual ions are localized with superresolution (∼2  nm), and detected with a statistical significance of 12.9σ over backgrounds. This lays the foundation for a new and potentially background-free neutrinoless double-beta decay technology, based on SMFI coupled to high pressure xenon gas time projection chambers.

Th1/Th2 balance in the liver and hepatic lymph nodes of vaccinated and unvaccinated sheep during acute stages of infection with Fasciola hepatica

The expression of IFNγ and IL4 was quantified using q-PCR in the liver and hepatic lymph nodes (HLN) of sheep during early stages of infection with Fasciola hepatica (1, 3, 9 and 18days post-infection, dpi). A group of animals (Group 1) were vaccinated with Fasciola hepatica recombinant cathepsin L1 (FhCL1) in montanide 70 VG prior to infection, a second group (group 2) was used as infected control and a third (group 3) was used as uninfected control. To study vaccine efficacy three additional groups were sacrificed 19 weeks post-infection (group 4 immunized with CL1, group 5 with the adjuvant and group 6 was used as infected control). The vaccinated group did not show significant fluke reduction compared to the adjuvant group and infected control group. IL4 expression was observed to increase at 9 dpi and was further elevated at 18 dpi in the liver and HLN of vaccinated and infected control groups compared to the uninfected group. IFNγ expression exhibited different dynamics in the liver and HLN compared to IL4; thus, in the liver this cytokine increased at 9 dpi in the vaccinated and at 18 dpi in vaccinated and infected control groups, while in the HLN it decreased gradually and significantly from 1 dpi onwards. These results suggest that a marked Th2 polarization is present from 9 dpi in HLN and from 18 dpi in the liver. The increase of IFNγ in the liver may correspond with tissue damage response with granuloma formation. The FhCL1 vaccine did not alter the Th1/Th2 balance when compared to unvaccinated and infected sheep. The study of IFNγ and IL4 in the various tissue compartments in sheep could facilitate selection of new adjuvants inducing a strong Th1 response for a more rationale vaccine formulation.

Apoptosis of peritoneal leucocytes during early stages of Fasciola hepatica infections in sheep

Several immunomodulatory properties have been described in Fasciola hepatica infections. Apoptosis has been shown to be an effective mechanism to avoid the immune response in helminth infections. The aim of the present work was to study apoptosis in peritoneal leucocytes of sheep experimentally infected with F. hepatica during the early stages of infection. Five groups (n=5) of sheep were used. Groups 2-5 were orally infected with 200 metacercariae (mc) and sacrificed at 1, 3, 9 and 18days post-infection (dpi), respectively. Group 1 was used as the uninfected control (UC). Apoptosis was detected using three different methods 1) immunocytochemistry (ICC) with a polyclonal antibody anti-active caspase-3; 2) an annexin V flow cytometry assay using the Annexin V-FITC/propidium iodide (PI); and 3) transmission electron microscopy (TEM). The differential leucocyte count revealed that the majority of peritoneal granulocytes were eosinophils, which increased significantly at 9 and 18 dpi with respect to the uninfected controls. The ICC study revealed that the percentage of caspase-3⁺ apoptotic peritoneal leucocytes increased significantly from 3 dpi onwards with respect to the uninfected controls. The flow cytometry annexin V assay detected a very significant (P<0.001) increase of apoptotic peritoneal macrophages, lymphocytes and granulocytes, which remained higher than in the UC until 18 dpi. Transmission electron microscopy studies also confirmed the presence of apoptosis in peritoneal eosinophils at 18 dpi. This is the first report of apoptosis induced by F. hepatica in the peritoneal leucocytes of sheep in vivo. The results of this work suggest the importance of apoptosis induction for the survival of the juvenile parasites in the peritoneal migratory stages of infection.

Assessment of parabens and ultraviolet filters in human placenta tissue by ultrasound-assisted extraction and ultra-high performance liquid chromatography-tandem mass spectrometry

Increasing concerns have been raised over recent decades about human exposure to Endocrine Disrupting Chemicals (EDCs), especially about their possible effects on embryo, foetus, newborn, and child. Parabens (PBs) and ultraviolet filters (UV-filters) are prevalent EDCs widely used as additives in cosmetics and personal care products (PCPs). The objective of this study was to determine the presence of four PBs and ten UV-filters in placental tissue samples using a novel analytical method based on ultrasound-assisted extraction (UAE) and ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). Multivariate optimization strategies were used to accurately optimize extraction and clean-up parameters. Limits of quantification ranged from 0.15 to 0.5μgkg^-1, and inter-day variability (evaluated as relative standard deviation) ranged from 3.6% to 14%. The method was validated using matrix-matched standard calibration followed by a recovery assay with spiked samples. Recovery percents ranged from 94.5% to 112%. The method was satisfactorily applied for the determination of the target compounds in human placental tissue samples collected at delivery from 15 randomly selected women. This new analytical procedure can provide information on foetal exposure to compounds, which has been little studied.

Bacillus species pseudo-outbreak: construction works and collateral damage

We describe the investigation and management of a pseudo-outbreak of Bacillus spp. bacteraemia associated with construction work in an emergency department (ED). During the pseudo-outbreak period 59 out of 3469 (1.7%) blood cultures yielded Bacillus spp. versus 24 out of 7628 (0.31%) in 2012. Material, surfaces, and air samples showed environmental contamination. Cases rapidly declined following the implementation of infection control measures and the end of construction. Construction works at the ED caused environmental contamination that most probably led to the pseudo-outbreak of Bacillus bacteraemia. In hospital settings, the lack of correctly implemented effective barriers during construction may place patients and healthcare providers at risk as well as lead to pseudo-outbreaks.

Distribution of Foxp3+ T cells in the liver and hepatic lymph nodes of goats and sheep experimentally infected with Fasciola hepatica

Foxp3 regulatory T cells (Tregs) are now considered to play a key role in modulation of immune responses during parasitic helminth infections. Immunomodulation is a key factor in Fasciola hepatica infection; however, the distribution and role of Foxp3⁺ Tregs cells have not been investigated in F. hepatica infected ruminants. The aim of this study was to evaluate the presence of Foxp3⁺ Tregs in the liver and hepatic lymph nodes from experimentally infected sheep and goats during acute and chronic stages of infection. Three groups of goats (n=6) and three groups of sheep (n=6) were used in this study. Goats in groups 1-2 and sheep in groups 4-5 were orally infected with metacercarie of ovine origin. Groups 1 and 4 were killed during the acute stage of the infection, at nine days post infection (dpi); groups 2 and 5 were killed during the chronic stage, at 15 and19 weeks post infection respectively (wpi). Groups 3 (goats) and 6 (sheep) were left as uninfected controls. Fluke burdens and liver damage were assessed and the avidin-biotin-complex method was used for the immunohistochemical study. At nine dpi in acute hepatic lesions, the number of both Foxp3⁺ and CD3⁺ T lymphocytes increased significantly in goats and sheep. In the chronic stages of infection (15-19wpi), the number of Foxp3⁺ and CD3⁺ T lymphocytes were also significantly increased with respect to control livers, particularly in portal spaces with severely enlarged bile ducts (response to adult flukes) while the increase was lower in granulomas, chronic tracts and smaller portal spaces (response to tissue damage). Foxp3⁺ Tregs were increased in the cortex of hepatic lymph nodes of sheep (chronic infection) and goats (acute and chronic infection). The estimated proportion of T cells which were Foxp3+ was significantly increased in the large bile ducts and hepatic lymph node cortex of chronically infected goats but not sheep. This first report of the expansion of Foxp3⁺ Tregs in acute and chronic hepatic lesions in ruminants suggests that these cells may be involved in both parasite survival and modulation of hepatic damage. Future studies should be focused on the investigation of parasite molecules and cytokines involved in this process.

Eosinophilic Enteritis in Horses with Motor Neuron Disease

BACKGROUND

Equine motor neuron disease (EMND) is a neuromuscular disorder that affects adult horses. Although EMND has been linked to vitamin E deficiency, its etiopathogenesis is poorly understood.

OBJECTIVES

To describe clinical features, laboratory results, and postmortem findings in a series of young horses with motor neuron disease (MND).

ANIMALS

A herd of 15 young Andalusian horses with weakness, weight loss, muscle atrophy, and muscle fasciculations related to restricted intake of green forage.

METHODS

A case series is presented in which horses were subjected to a clinical examination and plasma vitamin E measurement. Five severely affected horses were euthanized for detailed postmortem examination. Muscle specimens were taken from the M. sacrocaudalis dorsalis medialis and the M. gluteus medius for histopathologic and morphometric evaluation.

RESULTS

MND was diagnosed in 5 horses based on clinical signs, low serum levels of vitamin E (0.11 ± 0.05 mg/dL; normal range,: 0.3-1.5 mg/dL), changes in muscle histopathology (neurogenic atrophy), and spinal cord lesions (neuronal chromatolysis in ventral horns). An unexpected postmortem finding was the presence of intestinal inflammation (catarrhal enteritis, edema, and eosinophilic infiltrate) associated with the presence of giant ciliated protozoa in all of the horses.

CONCLUSIONS

Although a mechanistic link could not be established, it is hypothesized that intestinal inflammation may have been involved in the decreased absorption of vitamin E, thus favoring the development of MND.

Non-covalent stacking interactions directing the structural and photophysical features of mono- and dinuclear cyclometalated palladium(ii) complexes

Cyclometallated Pd(ii) complexes with different stackings show emission in solid state in relationship to them.

Fasciola hepatica induces eosinophil apoptosis in the migratory and biliary stages of infection in sheep

The aim of the present work was to evaluate the number of apoptotic eosinophils in the livers of sheep experimentally infected with Fasciola hepatica during the migratory and biliary stages of infection. Four groups (n=5) of sheep were used; groups 1-3 were orally infected with 200 metacercariae (mc) and sacrificed at 8 and 28 days post-infection (dpi), and 17 weeks post-infection (wpi), respectively. Group 4 was used as an uninfected control. Apoptosis was detected using immunohistochemistry with a polyclonal antibody against anti-active caspase-3, and transmission electron microscopy (TEM). Eosinophils were identified using the Hansel stain in serial sections for caspase-3, and by ultrastructural features using TEM. At 8 and 28 dpi, numerous caspase-3(+) eosinophils were mainly found at the periphery of acute hepatic necrotic foci. The percentage of caspase -3(+) apoptotic eosinophils in the periphery of necrotic foci was high (46.1-53.9) at 8 and 28 dpi, respectively, and decreased in granulomas found at 28 dpi (6%). Transmission electron microscopy confirmed the presence of apoptotic eosinophils in hepatic lesions at 8 and 28 dpi. At 17 wpi, apoptotic eosinophils were detected in the infiltrate surrounding some enlarged bile ducts containing adult flukes. This is the first report of apoptosis induced by F. hepatica in sheep and the first study reporting apoptosis in eosinophils in hepatic inflammatory infiltrates in vivo. The high number of apoptotic eosinophils in acute necrotic tracts during the migratory and biliary stages of infection suggests that eosinophil apoptosis may play a role in F. hepatica survival during different stages of infection.

Life history of the sand fly vector Lutzomyia cruciata in laboratory conditions

Lutzomyia cruciata Coquillet (Diptera: Psychodidae: Phlebotominae) is a potential vector of Leishmania sp.; its geographical distribution in Mexico is widespread, but its life history is unknown. The present study gives relevant information on the life cycle, morphology, survival and reproduction of Lu. cruciata observed over successive generations under laboratory conditions. Seven successive generations were produced. A total of 975 adults were obtained in a sexual proportion of 1.1 : 1 (female : male). Each Lu. cruciata female produced 20.7 eggs and 1.9 adults, approximately, with a proportion of eggs per female of 2.7% (first generation) and 21.3% (second generation). The life cycle of Lu. cruciata, from egg to adult, occurred in 52.7 ± 0.52 days. The largest percentage of mortality occurred during the egg stage (48.5%) and the first larval instar (26.5%), whereas in the pupal stage mortality was the lowest (9.1%). Lutzomyia cruciata exhibits sexual dimorphism based on size, which is exhibited as of the second larval instar, males being smaller than females. The maximum survival of females and males was 10 and 15 days, respectively. An overview of the immature stages of the species made with an electronic scanning microscope is included. This paper contributes basic information on aspects of Lu. cruciata that were previously unknown related to its life history.

Immunohistochemical characterisation of parasitic pneumonias of dolphins stranded in the Canary Islands

This is the first work that applies immunohistochemistry in the characterisation of the inflammatory infiltrate of verminous bronchopneumonia associated with lungworm parasites in stranded dolphins. Samples from three different species (Stenella coerulealba, Stenella frontalis and Delphinus delphis) stranded in the Canary Islands were used. The most common findings found in these animals varied from bronchitis to verminous bronchopneumonia with different degree of severity. The immunohistochemical study showed variable expressions of Lysozyme, MHC-II, iNOS and IgG. The main population presenting in the inflammatory infiltrates were CD3(+) lymphocytes. However, moderate number of Foxp3(+) lymphocytes was found in lymph nodes even though no Foxp3(+) cells were found in lung lesions in any of the samples analysed. This study revealed that lung lesions showed a chronic inflammatory infiltrate mainly composed by lymphocytes CD3(+). Deeper studies are needed in order to provide a more complete scope about the infiltrates involved in these types of lesions.

Would a two-stage N-removal be a suitable technology to implement at full scale the use of anammox for sewage treatment?

Sewage treatment with anammox could be implemented through a two-step reactor system, where the first reactor would be devoted to partial nitritation. A process design was sketched including control loops. The control strategy regulates the flow-rate of the rich ammonium sidestream produced after dewatering the digested sludge, to keep the ammonium concentration at a set point in the partial nitritation reactor by DOsing the SIde Stream (DOSIS). A second control loop manages the ammonium concentration set point based on the measurement of the total nitrogen in the partial nitritation reactor. A mathematical model was developed to assess the amount of sidestream required. Even in the case of a strong diurnal variability, simulations show how the control strategy is correctly performing, demonstrating the potential of the proposed technology.

Effect of Silymarin in Pdx-1 expression and the proliferation of pancreatic β-cells in a pancreatectomy model

In type 1 Diabetes Mellitus (DM) there is a destruction of pancreatic β-cells (80-90%) at the time of detection, in DM type 2 these cells are decreased significantly. The Pdx1 transcription factor plays a central role in pancreatic development and in insulin gene expression. Previously, we have demonstrated that Silymarin recovers the normal morphology and endocrine function of damaged pancreatic tissue in alloxan induced diabetic rats. The aim of this study was to analyze the effect of Silymarin in Pdx1 gene expression and its repercussion on insulin gene expression and β-cell proliferation. 72 Wistar rats were partially pancreatectomized (60%) and divided into 12 groups. Six groups were treated daily with Silymarin (200mg/kg p.o.) for 3, 7, 14, 21, 42 and 63 day periods. Also, an unpancreatectomized control group was performed. At each time interval three animals from each group were administered BrdU 18 h before the sacrifice. Insulin and Pdx-1 gene expression were assessed by RT-PCR assay in total pancreatic RNA. β-Cell proliferation was determined by immunoperoxidase assay. In contrast to the animals that were only pancreatectomized, the Silymarin treatment induced an increase in both Pdx1 and insulin gene expression as well as β-cell proliferation in pancreatic tissue (control=2.6±0.28%; untreated=14.25±0.56%; treated=39.08±4.62%). Consequently, serum insulin levels rose (control=1.01±0.02 ng/ml; untreated=1.18±0.42 ng/ml; treated=4.58±0.58 ng/ml) and serum glucose levels decreased in these animals (control=6.2±0.01 mM; untreated=9.02±0.41 mM; treated=6.41±0.32 mM). These results suggest that Silymarin may induce the proliferation of insulin-producing cells.