Acquisition of different carbapenem resistance mechanisms by an epidemic clonal lineage of Pseudomonas aeruginosa.

Multidrug-resistant isolates of a clonal lineage of Pseudomonas aeruginosa producing the VIM-2 metallo-beta-lactamase (MBL), involved in a large outbreak in an Italian hospital, were compared with MBL-negative strains that had caused outbreaks in two French hospitals. Although the isolates had different carbapenem MICs, the VIM-2-producing isolates from Italy carried identical, or very similar, allelic forms of the oprD gene, harboured a common class 1 integron, belonged to the same multilocus sequence type (ST111), and showed macrorestriction profiles that were related to those of the MBL-negative French strains. These results support the concept of independent acquisition of resistance determinants by members of a widespread clonal lineage of P. aeruginosa.     

Influence of the superior colliculus on visual responses of cells in the rabbit's lateral posterior nucleus

Summary The lateral posterior-pulvinar (LP-P) complex of mammals receives a major input from the superior colliculus (SC). We have studied the response properties of LP cells and investigated the effects of reversible inactivation of the colliculus on the visual responses of LP units in anesthetized and paralyzed rabbits. Cells in LP had large receptive fields responsive to either stationary or moving stimuli. One third of the motion-sensitive cells were direction selective. The size of the receptive fields increased with eccentricity and there was a retinotopic organization along the dorso-ventral axis. Comparison of the LP and superior colliculus properties revealed substantial differences in visual response characteristics of these two structures such as the size of the receptive fields and the number of direction-selective cells. Electrical stimulation of the LP evoked antidromic action potentials in tectal cells that were motion sensitive. We found a dorsoventral gradient in the projections of collicular cells. Units located more dorsally in the colliculus sent their axons to LP while cells lying more ventrally sent axons toward the region lying posterior to LP. A micropipette filled with lidocaine hydrochloride was lowered into the superficial layers of the superior colliculus in order to reversibly inactivate a small population of collicular cells. Rendering the superior colliculus inactive produced a sharp attenuation of visual responses in the majority of LP cells. Some neurons ceased all stimulus-driven activity after collicular blockade while a few cells exhibited increased excitability following collicular inactivation. These experiments also indicate that the tecto-LP path is topographically organized. An injection in the colliculus failed to influence the thalamic response when it was not in retinotopic register with the LP cells being recorded. Our results demonstrate that the superior colliculus input to LP is mainly excitatory in nature.     

Histopathological findings in rabbits after experimental acute exposure to the Loxosceles intermedia (brown spider) venom

Loxoscelism, the term used to describe envenomation with brown spiders, is characterized by a dermonecrotic lesion at the bite site. In the present investigation we submitted albino rabbits to an acute experimental envenomation protocol using Loxosceles intermedia (brown spider) venom, with in order to determine the pathogenesic features of the lesion induced by this spider, which is the cause of several accidents throughout the world. Rabbits received intradermal injections of the venom and were monitored over the first 4 h, and then at 12 h and 1, 2 and 5 days after envenomation. Histological specimens from 3 rabbits per time point were collected from euthanized animals and processed for histological examination by light microscopy. Major findings observed during the first 4 h were oedema, haemorrhage, degeneration of blood vessel walls, plasma exudation, thrombosis, neutrophil accumulation in and around blood vessels with an intensive diapedesis, a diffuse collection of inflammatory cells (polymorphonuclear leucocytes) in the dermis, and subcutaneous muscular oedema. Over the following hours and up to 5 days after envenomation the changes progressed to massive neutrophil infiltration (with no other leucocytes) into the dermis and even into subcutaneous muscle tissue, destruction of blood vessels, thrombosis, haemorrhage, myonecrosis, and coagulative necrosis on the 5th day.     

Ectopia lentis in Loeys‐Dietz syndrome type 4

Loeys‐Dietz syndrome is a heritable disorder of the connective tissue leading to multisystem involvement including craniofacial features, skeletal abnormalities, cutaneous findings and early‐onset and aggressive disease of the aorta and its branches. There are multiple types of Loeys‐Dietz syndrome related to pathogenic variants in TGFBR1, TGFBR2, SMAD3, TGFB2, and TGFB3. Individuals with Loeys‐Dietz syndrome may be misdiagnosed as having Marfan syndrome due to shared phenotypic features and aortic root dilation. However, ectopia lentis has been an important discriminating feature, being unique to Marfan syndrome and not reported to be associated with Loeys‐Dietz syndrome. We report the case of a 46‐year‐old woman with Loeys‐Dietz syndrome type 4 due to a pathogenic variant in TGFB2 who was diagnosed with ectopia lentis at age 44. The patient underwent whole exome sequencing and no other pathogenic variants were found to explain the ectopia lentis. Our findings indicate that ectopia lentis may be an uncommon finding in Loeys‐Dietz syndrome type 4 and emphasize the importance of genetic testing in familial thoracic aortic aneurysm disease.     

Orosensory Perception of Fat/Sweet Stimuli and Appetite-Regulating Peptides before and after Sleeve Gastrectomy or Gastric Bypass in Adult Women with Obesity

The aim of this study was to explore the impact of bariatric surgery on fat and sweet taste perceptions and to determine the possible correlations with gut appetite-regulating peptides and subjective food sensations. Women suffering from severe obesity (BMI > 35 kg/m²) were studied 2 weeks before and 6 months after a vertical sleeve gastrectomy (VSG, n = 32) or a Roux-en-Y gastric bypass (RYGB, n = 12). Linoleic acid (LA) and sucrose perception thresholds were determined using the three-alternative forced-choice procedure, gut hormones were assayed before and after a test meal and subjective changes in oral food sensations were self-reported using a standardized questionnaire. Despite a global positive effect of both surgeries on the reported gustatory sensations, a change in the taste sensitivity was only found after RYGB for LA. However, the fat and sweet taste perceptions were not homogenous between patients who underwent the same surgery procedure, suggesting the existence of two subgroups: patients with and without taste improvement. These gustatory changes were not correlated to the surgery-mediated modifications of the main gut appetite-regulating hormones. Collectively these data highlight the complexity of relationships between bariatric surgery and taste sensitivity and suggest that VSG and RYGB might impact the fatty taste perception differently.     

Lycium barbarum polysaccharide fraction associated with photobiomodulation protects from epithelium thickness and collagen fragmentation in a model of cutaneous photodamage

Lasers in Medical Science - Ultraviolet radiation (UVR) is the major etiologic agent of cutaneous photoaging, and different strategies are used to prevent and treat this condition. The...     

The influence of photobiomodulation on the temperature of the brachial biceps during muscle fatigue protocol

Lasers in Medical Science - Physical activity raises body temperature. However, the literature does not contain studies about whether the employment of hotobiomodulation (PMB) could significantly...     

Predictive Value of DXA Appendicular Lean Mass for Incident Fractures,Falls, and Mortality,Independent of Prior Falls,FRAX, and BMD: Findings from the Women's Health Initiative (WHI)

In the Women's Health Initiative (WHI), we investigated associations between baseline dual-energy X-ray absorptiometry (DXA) appendicular lean mass (ALM) and risk of incident fractures, falls, and mortality (separately for each outcome) among older postmenopausal women, accounting for bone mineral density (BMD), prior falls, and Fracture Risk Assessment Tool (FRAX^®) probability. The WHI is a prospective study of postmenopausal women undertaken at 40 US sites. We used an extension of Poisson regression to investigate the relationship between baseline ALM (corrected for height²) and incident fracture outcomes, presented here for major osteoporotic fracture (MOF: hip, clinical vertebral, forearm, or proximal humerus), falls, and death. Associations were adjusted for age, time since baseline and randomization group, or additionally for femoral neck (FN) BMD, prior falls, or FRAX probability (MOF without BMD) and are reported as gradient of risk (GR: hazard ratio for first incident fracture per SD increment) in ALM/height² (GR). Data were available for 11,187 women (mean [SD] age 63.3 [7.4] years). In the base models (adjusted for age, follow-up time, and randomization group), greater ALM/height² was associated with lower risk of incident MOF (GR = 0.88; 95% confidence interval [CI] 0.83–0.94). The association was independent of prior falls but was attenuated by FRAX probability. Adjustment for FN BMD T-score led to attenuation and inversion of the risk relationship (GR = 1.06; 95% CI 0.98–1.14). There were no associations between ALM/height² and incident falls. However, there was a 7% to 15% increase in risk of death during follow-up for each SD greater ALM/height², depending on specific adjustment. In WHI, and consistent with our findings in older men (Osteoporotic Fractures in Men [MrOS] study cohorts), the predictive value of DXA-ALM for future clinical fracture is attenuated (and potentially inverted) after adjustment for femoral neck BMD T-score. However, intriguing positive, but modest, associations between ALM/height² and mortality remain robust. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).     

IMXQB-80: A Quillaja brasiliensis saponin-based nanoadjuvant enhances Zika virus specific immune responses in mice

Vaccine adjuvants are compounds that enhance/prolong the immune response to a co-administered antigen. Saponins have been widely used as adjuvants for many years in several vaccines – especially for intracellular pathogens – including the recent and somewhat revolutionary malaria and shingles vaccines. In view of the immunoadjuvant potential of Q. brasiliensis saponins, the present study aimed to characterize the QB-80 saponin-rich fraction and a nanoadjuvant prepared with QB-80 and lipids (IMXQB-80). In addition, the performance of such adjuvants was examined in experimental inactivated vaccines against Zika virus (ZIKV). Analysis of QB-80 by DI-ESI-ToF by negative ion electrospray revealed over 29 saponins that could be assigned to known structures existing in their congener Q. saponaria, including the well-studied QS-21 and QS-7. The QB-80 saponins were a micrOTOF able to self-assembly with lipids in ISCOM-like nanoparticles with diameters of approximately 43 nm, here named IMXQB-80. Toxicity assays revealed that QB-80 saponins did present some haemolytical and cytotoxic potentials; however, these were abrogated in IMXQB-80 nanoparticles. Regarding the adjuvant activity, QB-80 and IMXQB-80 significantly enhanced serum levels of anti-Zika virus IgG and subtypes (IgG1, IgG2b, IgG2c) as well as neutralized antibodies when compared to an unadjuvanted vaccine. Furthermore, the nanoadjuvant IMXQB-80 was as effective as QB-80 in stimulating immune responses, yet requiring fourfold less saponins to induce the equivalent stimuli, and with less toxicity. These findings reveal that the saponin fraction QB-80, and particularly the IMXQB-80 nanoadjuvant, are safe and capable of potentializing immune responses when used as adjuvants in experimental ZIKV vaccines.     

Family planning in Italy

In the past 5 years, four knowledge, attitude and practice (KAP) surveys on family planning have been organized by the Unit of Population Survey Methodology of the Istituto Superiore di Sanita' (National Institute of Health). These surveys show that during the past 20 years, use of reliable contraceptives in Italy has increased, particularly in the North, encouraged by the more open attitude toward sexual behavior, following legalization of the provision of information on contraception and abortion upon request, and other social and cultural changes.In 1989 and 1991, 25% of women in Central and Southern Italy were using the pill or an IUD. However, the percentage of women not using contraceptives was still high (26% in 1989, and 19% in 1991) and withdrawal was the most widley used method (31% and 33%). The data show large regional differences.The main reasons for not using contraception, in the 1989 study, were fear of side-effects and ignorance, especially in the youngest and oldest women. Those least likely to use modern contraception were the young, the ill-educated and the nulliparous women.Lack of information seems to be the main problem in Italy. In fact, the 5044 women interviewed showed a medium level of knowledge of contraception, with only 63% who could identify correctly the fecund period in the menstrual cycle. However, their attitude toward the use of modern contraception was positive; 65% of the women interviewed said they would recommend the Pill or an IUD to a friend, and 10% of them would recommend condoms.Induced abortion is still common in Italy (13 reported abortions per 1000 women aged 15–44), although the incidence has steadily decreased since 1982. In the vast majority of cases, abortion was an emergency measure after the failure of contraceptive methods. It has been calculated that from 10% to 50% of induced abortions might be prevented in a short period through appropriate programs of health education and family planning involving the 2474 governmental maternal and child healt clinics in Italy.

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Resumen En los 5 últimos años, la Sección de Metodología de Encuestas Demográficas del Istituto Superiore di Sanità realizó cuatro estudios de conocimiento, actitud y práctica (KAP) respecto a la planificación familiar. Estos estudios indican que, en los 20 últimos años, el uso de anticonceptivos fiables en Italia ha aumentado, especialmente en el norte, fomentado por una actitud más abierta en cuanto a la conducta sexual, tras la legalización y otros cambios sociales y culturales.En 1989 y 1991, el 25% de las mujeres de la región central y meridional de Italia utilizaban la pídora o el DIU. Sin embargo, el porcentaje de mujeres que no utilizaban anticonceptivos continuaba siedo alto (26% en 1989 y 19% en 1991) y elcoitus interruptus era el método más utilizado (31% y 33%). Los datos indican grandes differencias regionales.Los motivos principales de la no utilización de anticonceptivos, en el estudio de 1989, eran el temor a los efectos secundarios y la ignorancia, especialmente entre las mujeres de menor y de mayor edad. Las que probablemente menos utilizaran anticonceptivos modernos eran las mujeres jóvenes, las de bajo nivel de educación y las nulíparas.La falta de información parece ser el problema principal en Italia. En realidad, las 5044 mujeres entrevistadas tenían un nivel medio de conocimiento y sólo el 63% pudo identificar correctamente el período de fecundidad del ciclo menstrual. Sin embargo, su actitud respecto al uso de anticonceptivos modernos era positiva; el 65% de las mujeres entrevistadas manifestaron que recomendarían la píldora o el DIU a una amiga y el 10% de ellas recomendarían preservativos.El aborto provocado continúa siendo común en Italia (13 abortos notificados por cada 1000 mujeres de 15–44 años de edad) si bien su incidencia ha disminuido constantemente desde 1982. En la gran mayoría de los casos, el aborto era una medida de emergencia después del fracaso de un método anticonceptivo. Se ha calculado que del 10 al 50% de los abortos provocados podría impedirse en un plazo breve mediante programas apropiados de educación sanitaria y planificación familiar con la participación de las 2474 clínicas maternoinfantiles estatales de Italia.

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Resumé Au cours de cinq dernières années, le service chargé de la méthodologie pour les enquêtes sur la population à l'Istituto Superiore di Sanità a organisé quatre enquêtes sur les connaissances, les attitudes et les pratiques en matière de planning familial. Ces enquêtes ont révélé qu'au cours de vingt dernières années en Italie, l'utilisation de contraceptifs fiables s'est répandue, notamment dans le nord du pays, encouragée par une attitude plus ouverte à l'égard du comportement sexuel à la suite de changements législatifs et autres dans le domaine social et culturel.En 1989 et 1991, 25% des femmes en Italie centrale et méridionale utilisaient la pilule ou un DIU. Le pourcentage de femmes ne faisant appel à aucune méthode de contraception était cependant encore élvé (26% en 1989 et 19% en 1991) et le retrait était la méthode la plus fréquemment adoptée (31% et 33%). Les données font apparaître d'importantes différences régionales. D'après l'étude de 1989, les raisons essentielles du non emploi des contraceptifs provenaient de la crainte d'éventuels effects secondaires et de l'ignorance, surtout chez les juenes et les femmes plus âgées. Les femmes les moins susceptibles de faire appel à la contraception moderne étaient les jeunes, les femmes peu éduquées et les nullipares.Le manque d'information semble être le problème principal en Italie. En fait, les 5044 femmes interrogées ont fait preuve de connaissances moyennes sur la contraception, 63% à peine étant capables d'identifier correctement la période de fécondité du cycle menstruel. Leur attitude à l'égard de la contraception moderne était cependant positive; 65% des femmes interrogées ont répondu qu'elles recommanderaient la pilule on un DIU à une amine, et 10% qu'elles recommanderaient le préservatif.Les avortements provoqués sont encore fréquents en Italie (13 avortements signalés pour 1000 femmes de 15 à 44 ans), mais leur incidence a progressivement diminué dequis 1982. Dans la grande majorité des cas, l'avortement est une mesure d'urgence après l'échec des méthodes de contraception. On a calculé que 10 à 50% des avortements provoqués pourraient être évités en peu de temps si l'on prévoyait des programmes appropriés d'éducation sanitaire et de planning familial dans les 2474 cliniques maternelles et infantiles qui existent en Italie.

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This paper is a revised version of one presented at the Workshop Acceptance and Effectiveness of Modern Contraception, organized by the International Health Foundation at the SAC Meeting, Barcelona, Spain, October 1992.