La figure de l'autorité magistrale à travers Jan Hus et Jérôme de Prague

Czech Academy of Sciences Publication Activity Database

Pavlíček, Ota

2011-01-01

Roč. 85, č. 3 (2011), s. 371-389 ISSN 0035-2217 R&D Projects: GA AV ČR(CZ) KJB900090903 Institutional research plan: CEZ:AV0Z90090514 Keywords : Jerome of Prague * John Hus * magisterial authority * truth * medieval thought * nationalism * Prague University Subject RIV: AA - Philosophy ; Religion

[Diet of neutropenic patients in pediatric oncology service; the experience of the university hospital of Strasbourg (HUS)].

Science.gov (United States)

Mutel, T; Foeglé, J; Belotti, L; Sery, V; Bourneton, O; Hernandez, C; Lutz, P; Lavigne, T

2012-12-01

This article clarifies the choices made by the HUS concerning the ways of preparing food reserved to neutropenic children hospitalized in pediatric oncology service. We will describe the results of microbiological analysis of food realized from 2002 to 2007. A specific team prepares this food which is canned and treated by "appertisation" (autoclaving). Each dish portion produced is provided to the service only if the microbiological results are conform, that is to say free of organisms. Three thousand and seventy-eight dishes were analysed: 82.9% of the analysed packs were conform. The contamination ratio decreased significantly (Pfood which is the most frequently "nonconform" is the dry food with a contamination rate of 37.9%. The identified concentrations remain mainly lower than 50 colony-forming units per millilitre (CFU/mL): 66.2% for the bacteria and 97.2% for the fungi. Considering the lack of consensus on the acceptable microbiological thresholds and on the food protection level, the HUS make it a rule to have a maximal precautionary principle. Currently, this principle appears to us to be a safety option required for the patients hospitalized in pediatric oncology service. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Paediatric HUS Cases Related to the Consumption of Raw Milk Sold by Vending Machines in Italy: Quantitative Risk Assessment Based on Escherichia coli O157 Official Controls over 7 years.

Science.gov (United States)

Giacometti, F; Bonilauri, P; Piva, S; Scavia, G; Amatiste, S; Bianchi, D M; Losio, M N; Bilei, S; Cascone, G; Comin, D; Daminelli, P; Decastelli, L; Merialdi, G; Mioni, R; Peli, A; Petruzzelli, A; Tonucci, F; Liuzzo, G; Serraino, A

2017-11-01

A quantitative risk assessment (RA) was developed to estimate haemolytic-uremic syndrome (HUS) cases in paediatric population associated with the consumption of raw milk sold in vending machines in Italy. The historical national evolution of raw milk consumption phenomenon since 2008, when consumer interest started to grow, and after 7 years of marketing adjustment, is outlined. Exposure assessment was based on the official Shiga toxin-producing Escherichia coli O157:H7 (STEC) microbiological records of raw milk samples from vending machines monitored by the regional Veterinary Authorities from 2008 to 2014, microbial growth during storage, consumption frequency of raw milk, serving size, consumption preference and age of consumers. The differential risk considered milk handled under regulation conditions (4°C throughout all phases) and the worst time-temperature field handling conditions detected. In case of boiling milk before consumption, we assumed that the risk of HUS is fixed at zero. The model estimates clearly show that the public health significance of HUS cases due to raw milk STEC contamination depends on the current variability surrounding the risk profile of the food and the consumer behaviour has more impact than milk storage scenario. The estimated HUS cases predicted by our model are roughly in line with the effective STEC O157-associated HUS cases notified in Italy only when the proportion of consumers not boiling milk before consumption is assumed to be 1%. Raw milk consumption remains a source of E. coli O157:H7 for humans, but its overall relevance is likely to have subsided and significant caution should be exerted for temporal, geographical and consumers behaviour analysis. Health education programmes and regulatory actions are required to educate people, primarily children, on other STEC sources. © 2016 Blackwell Verlag GmbH.

Poslední léta Gustáva Husáka ve vězení a jeho klopotná cesta ke svobodě (1958–1960)

Czech Academy of Sciences Publication Activity Database

Doskočil, Zdeněk

2014-01-01

Roč. 31, [1] (2014), s. 25-39 ISSN 1211-8184 Institutional support: RVO:67985963 Keywords : Gustáv Husák * Slovak Comunist representants * Czechoslovakia * Rehabilitation * Political processes * Communism Subject RIV: AB - History

The HUS solar flare and cosmic gamma-ray burst detector aboard the Ulysses spacecraft

International Nuclear Information System (INIS)

Boer, M.; Sommer, M.; Hurley, K.

1990-02-01

An overview of the instruments and of the scientific objectives of the Ulysses spacecraft is given. The experiment consists of two detectors: Two Si sensors operating in the range 5-20 keV, and two CsI (Tl) scintillators for the range 15-200 keV. The bit rate of the HUS experiment in the Ulysses telemetry is 40 bits/seconds and the time resolution is up to 4 s for the Si sensors and up to 8 ms for the scintillators. The total mass is 2.02 kg. The scientific objectives of the Ulysses mission are investigations on the physics of solar flares, such as their impulsive energy release, the heating and particle acceleration, the storage and the energy transport. The experiment will take place during the next solar maximum of 1991. (orig./HM)

Historik Josef Vítězslav Šimák a Johana Husáková, dcera semilského lékárníka

Czech Academy of Sciences Publication Activity Database

Kábová, Hana

2012-01-01

Roč. 25, č. 0 (2012), s. 251-260, 280 ISSN 1211-975X Institutional support: RVO:67985921 Keywords : Šimák, Josef Vítězslav * Husáková, Johana * Semily, Czech Republic) Subject RIV: AB - History

[The 2011 HUS epidemic in Germany. Challenges for disease control: what should be improved?].

Science.gov (United States)

Krause, G; Frank, C; Gilsdorf, A; Mielke, M; Schaade, L; Stark, K; Burger, R

2013-01-01

From May to July 2011 [corrected] the world's largest outbreak of hemolytic uremic syndrome (HUS) occurred in northern Germany with dramatic consequences for the population, the health care system and the food industry. In the following we examine the detection of the outbreak, epidemic management and related public communication aspects based on scientific publications, media reports as well as own and new data analyses. The subsequent 17 recommendations concern issues such as participation in and implementation of existing and new surveillance systems particularly with respect to physicians, broad application of finely tuned microbiological typing, improved personnel capacity and crisis management structures within the public health service and evidence-based communication by administrations and scientific associations. Outbreaks of similar dimensions can inevitably occur again and result in costs which will far exceed investments needed for early detection and control. This societal balance should be taken into account in spite of limited resources in the public health sector.

No evidence of the Shiga toxin-producing E. coli O104:H4 outbreak strain or enteroaggregative E. coli (EAEC found in cattle faeces in northern Germany, the hotspot of the 2011 HUS outbreak area

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Wieler Lothar H

2011-11-01

Full Text Available Abstract Background Ruminants, in particular bovines, are the primary reservoir of Shiga toxin-producing E. coli (STEC, but whole genome analyses of the current German ESBL-producing O104:H4 outbreak strain of sequence type (ST 678 showed this strain to be highly similar to enteroaggregative E. coli (EAEC. Strains of the EAEC pathotype are basically adapted to the human host. To clarify whether in contrast to this paradigm, the O104:H4 outbreak strain and/or EAEC may also be able to colonize ruminants, we screened a total of 2.000 colonies from faecal samples of 100 cattle from 34 different farms - all located in the HUS outbreak region of Northern Germany - for genes associated with the O104:H4 HUS outbreak strain (stx2, terD, rfbO104, fliCH4, STEC (stx1, stx2, escV, EAEC (pAA, aggR, astA, and ESBL-production (blaCTX-M, blaTEM, blaSHV. Results The faecal samples contained neither the HUS outbreak strain nor any EAEC. As the current outbreak strain belongs to ST678 and displays an en-teroaggregative and ESBL-producing phenotype, we additionally screened selected strains for ST678 as well as the aggregative adhesion pattern in HEp-2 cells. However, we were unable to find any strains belonging to ST678 or showing an aggregative adhesion pattern. A high percentage of animals (28% shed STEC, corroborating previous knowl-edge and thereby proving the validity of our study. One of the STEC also harboured the LEE pathogenicity island. In addition, eleven animals shed ESBL-producing E. coli. Conclusions While we are aware of the limitations of our survey, our data support the theory, that, in contrast to other Shiga-toxin producing E. coli, cattle are not the reservoir for the O104:H4 outbreak strain or other EAEC, but that the outbreak strain seems to be adapted to humans or might have yet another reservoir, raising new questions about the epidemiology of STEC O104:H4.

Appreciation of scientific achievements of Jozef Hus.

Science.gov (United States)

Spassov, S.; Geeraerts, R.

2009-04-01

In 2004, the Geophysical Centre of the Royal Meteorological Institute of Belgium (RMIB) in Dourbes (south Belgium) celebrated its 50th anniversary. Fifty years of top research to which Jozef Hus contributed considerably. When he started his career in this governmental institution more than 40 years ago, palaeomagnetic research was absent at the RIMB. After finishing studies in condensed matter physics at Ghent University (Belgium) in 1963, he became an assistant at the RMIB and developed with Prof. Dr. A. De Vuyst, in charge of the geomagnetic observatory, a method for absolute measurements of all geomagnetic field elements with a proton magnetometer. Wishing to extend the record of geomagnetic field observations in time, Jozef began to set up a laboratory of his own and started to construct and develop instruments for palaeomagnetic research with competence, great enthusiasm and concentrated passion. This world-class laboratory was constructed between 1976 ad 1980. In 1981, he received the title Doctor of Sciences from the Free University of Brussels based on his thesis entitled "De indirecte meting van de seculaire verandering van het geomagnetisch veld". Palaeomagnetism of Quaternary sediments and archaeo- and rock magnetism have been Jozef's most important research fields. In fact, a short sojourn in Prof. E. Thellier's Laboratory of Geomagnetism at Saint-Maur-de-Fossés (Paris) in 1965, raised Jozef's interest in archaeomagnetism. He formed a solid basis for the detailed establishment of reference curves for declination and inclination for the Belgian territory for historical and archaeological times. He studied the suitability of burned archaeological materials to record the Earth's magnetic field as well as effects which influence accurate field registration in archaeological materials, such as magnetic refraction and magnetic anisotropy. During his career, Jozef promoted archaeomagnetism as a valuable dating tool and strengthened the cooperation with the

Assesment, treatment and prevention of atypical hemolytic uremic syndrome

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Azar Nickavar

2013-01-01

Full Text Available Hemolytic uremic syndrome (HUS is a heterogeneous group of hemolytic disorders. Different terminologies have been described in HUS, which are as follows: (1 D+ HUS: Presentation with a preceding diarrhea; (2 typical HUS: D+ HUS with a single and self-limited episode; (3 atypical HUS (aHUS: Indicated those with complement dysregulation; (4 recurrent HUS: Recurrent episodes of thrombocytopenia and/or microangiopathic hemolytic anemia (MAHA after improvement of hematologic abnormalities; and (5 familial HUS: Necessary to distinct synchronous outbreaks of D+ HUS in family members and asynchronous disease with an inherited risk factor. aHUS is one of the potential causes of end-stage renal disease (ESRD in children. It has a high recurrence after renal transplantation in some genetic forms. Therefore, recognition of the responsible mechanism and proper prophylactic treatment are recommended to prevent or delay the occurrence of ESRD and prolong the length of survival of the transplanted kidney. A computerized search of MEDLINE and other databases was carried out to find the latest results in pathogenesis, treatment, and prevention of aHUS.

Sense Memory

DEFF Research Database (Denmark)

2011-01-01

Dramatikkens Hus/Podium, Oslo. Produced in cooperation with Dramatikkens Hus and The Arts Council Norway......Dramatikkens Hus/Podium, Oslo. Produced in cooperation with Dramatikkens Hus and The Arts Council Norway...

An audit analysis of a guideline for the investigation and initial therapy of diarrhea negative (atypical) hemolytic uremic syndrome.

NARCIS (Netherlands)

Johnson, S.; Stojanovic, J.; Ariceta, G.; Bitzan, M.; Besbas, N.; Frieling, M.; Karpman, D.; Landau, D.; Langman, C.; Licht, C.; Pecoraro, C.; Riedl, M.; Siomou, E.; Kar, N.C. van de; Walle, J.V.; Loirat, C.; Taylor, C.M.

2014-01-01

BACKGROUND: In 2009, the European Paediatric Study Group for Haemolytic Uraemic Syndrome (HUS) published a clinical practice guideline for the investigation and initial therapy of diarrhea-negative HUS (now more widely referred to as atypical HUS, aHUS). The therapeutic component of the guideline

Atypical hemolytic uremic syndrome: Laboratory characteristics, complement-amplifying conditions, renal biopsy, and genetic mutations

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Mohammad A Hossain

2018-01-01

Full Text Available Atypical hemolytic uremic syndrome (aHUS is characterized by microangiopathic hemolytic anemia, consumptive thrombocytopenia, and widespread damage to multiple organs including the kidney. The syndrome has a high mortality necessitating the need for an early diagnosis to limit target organ damage. Because thrombotic microangiopathies present with similar clinical picture, accurate diagnosis of aHUS continues to pose a diagnostic challenge. This article focuses on the role of four distinct aspects of aHUS that assist clinicians in making an accurate diagnosis of aHUS. First, because of the lack of a single specific laboratory test for aHUS, other forms of thrombotic microangiopathies such as thrombotic thrombocytopenic purpura and Shiga toxin-associated HUS must be excluded to successfully establish the diagnosis of aHUS. Second, application of the knowledge of complement-amplifying conditions is critically important in making an accurate diagnosis. Third, when available, a renal biopsy can reveal changes consistent with thrombotic microangiopathy. Fourth, genetic mutations are increasingly clarifying the underlying complement dysfunction and gaining importance in the diagnosis and management of patients with aHUS. This review concentrates on the four aspects of aHUS and calls for heightened awareness in making an accurate diagnosis of aHUS.

Atypical haemolytic uraemic syndrome treated with the complement inhibitor eculizumab: the experience of the Australian compassionate access cohort.

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Mallett, A; Hughes, P; Szer, J; Tuckfield, A; Van Eps, C; Cambell, S B; Hawley, C; Burke, J; Kausman, J; Hewitt, I; Parnham, A; Ford, S; Isbel, N

2015-10-01

This study aimed to report the clinical characteristics and outcomes of Australian patients treated with eculizumab for atypical haemolytic uraemic syndrome (aHUS). A retrospective cohort study was undertaken of all patients in Australia treated with eculizumab provided in a compassionate access programme for a clinical diagnosis of aHUS using prospectively collected clinical data. A total of 10 patients with a median age of 23.5 years (interquartile range (IQR) 24.83 years) received compassionate access eculizumab for aHUS in Australia. Eight patients were female, and three had a family history of aHUS. Three received eculizumab for an initial acute aHUS presentation, three for relapsing and refractory acute aHUS, two for de novo aHUS post-renal transplantation, and one each for aHUS recurrence post-transplantation and facilitation of transplantation with a history of aHUS. The median duration of eculizumab therapy has been 911.5 days (IQR 569 days) with a cumulative exposure of 9184 days. At baseline all patients had renal and extra-renal aHUS involvement, with up to three non-renal organs affected. All but one patient, who died from uncontrollable gastrointestinal aHUS manifestations, have continued. The nine continuing patients achieved remission of aHUS. Two of the four patients requiring renal replacement therapy (RRT) at eculizumab commencement subsequently ceased RRT. Clinical events occurring in this cohort while on eculizumab treatment included neutropenia (two), posterior reversible encephalopathy syndrome (one), cardiomyopathy (one), pulmonary embolus (one), antibody-mediated rejection resulting in renal graft failure (one), iron deficiency (one), gastrointestinal haemorrhage (one) and death (one). Eculizumab has been an effective therapy for aHUS in this cohort, including when other therapies have failed. © 2015 Royal Australasian College of Physicians.

Dissection of QTLs for Hull Silicon Content on the Short Arm of Rice Chromosome 6

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Ji-rong WU

2010-06-01

Full Text Available The QTL qHUS6 for hull silicon content in rice was previously located on the short arm of rice chromosome 6. By using an F2:3 population segregating in the RM587–RM19784 region harboring qHUS6 in an isogenic background, two QTLs for hull silicon content were detected, of which qHUS6-1 was located in the distal region and qHUS6-2 in the region proximal to the centromere. Three rice plants carrying small heterozygous segments in the target region were selected, of which two covered the qHUS6-1 region and the other covered the qHUS6-2 region. Three F2:3 populations were derived from the selfed seeds of the three plants, respectively. QTL mapping was performed using the two populations segregating in the qHUS6-1 region, and qHUS6-1 was delimited to a 147.0-kb region flanked by the markers RM510 and RM19417. Five groups of F3 lines with different genotypic compositions in the qHUS6-2 region were selected from the other F2:3 population. Two QTLs were separated with two-way ANOVA, of which qHUS6-2a was located in the interval defined by RM19706–RM19795 and qHUS6-2b in the interval RM314–RM19665.

ADAMTS13 Gene Mutations in Children with Hemolytic Uremic Syndrome

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Choi, Hyoung Soo; Cheong, Hae Il; Kim, Nam Keun

2011-01-01

We investigated ADAMTS13 activity as well as the ADAMTS13 gene mutation in children with hemolytic uremic syndrome (HUS). Eighteen patients, including 6 diarrhea-negative (D-HUS) and 12 diarrhea-associated HUS (D+HUS) patients, were evaluated. The extent of von Willebrand factor (VWF) degradation was assayed by multimer analysis, and all exons of the ADAMTS13 gene were PCR-amplified using Taq DNA polymerase. The median and range for plasma activity of ADAMTS13 in 6 D-HUS and 12 D+HUS patients were 71.8% (22.8-94.1%) and 84.9% (37.9-119.9%), respectively, which were not statistically significantly different from the control group (86.4%, 34.2-112.3%) (p>0.05). Five ADAMTS13 gene mutations, including 2 novel mutations [1584+2T>A, 3941C>T (S1314L)] and 3 polymorphisms (Q448E, P475S, S903L), were found in 2 D-HUS and one D+HUS patients, which were not associated with deficiency of ADAMTS13 activity. Whether these mutations without reduced ADAMTS13 activity are innocent bystanders or predisposing factors in HUS remains unanswered. PMID:21488199

haemolyticuraemic syndrome in children from south India

African Journals Online (AJOL)

Background. Haemolytic-uraemic syndrome (HUS) occurring without a diarrhoeal prodrome is termed D- HUS and has a poorer prognosis than D+ HUS, with high mortality and potential for long-term renal and non-renal morbidity. Methods. We studied nine children with D- HUS from the Pediatric Nephrology division of the ...

Arterial hypertension in children with hemolytic uremic syndrome after kidney transplantation.

Science.gov (United States)

Hoenecke, Johannes; Hartmann, Hans; Melk, Anette

2015-08-01

The development of arterial hypertension after KTX is a well-known complication. HUS is a systemic disease associated with arterial hypertension during long-term follow-up. Our goal was to report on the severity of arterial hypertension after KTX in patients with typical and atypical HUS. We analyzed the course of 197 patients with HUS, of which 22 (n = 10 with typical HUS; n = 12 with atypical HUS) developed ESRF and received KTX as renal replacement therapy. We analyzed data from 1766 casual BP and 85 24-h ABPM measurements. In addition, we evaluated the used antihypertensive strategy. Comparison between the two patient groups revealed that patients with atypical HUS had significantly higher casual SBP-SDS and DBP-SDS values after KTX despite similar intensity of antihypertensive treatment. These data were supported by analysis of ABPM profiles showing comparable results for the interval 1-5 yr after KTX. Patients with atypical HUS had a greater severity of arterial hypertension despite similar treatment strategies and intensity of treatment. Our observation, even though in a small cohort, supports recent genetic studies showing arterial hypertension closely associated with HUS-causing mutations in patients with atypical HUS. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Relative nephroprotection during Escherichia coli O157:H7 infections: association with intravenous volume expansion.

Science.gov (United States)

Ake, Julie A; Jelacic, Srdjan; Ciol, Marcia A; Watkins, Sandra L; Murray, Karen F; Christie, Dennis L; Klein, Eileen J; Tarr, Phillip I

2005-06-01

The hemolytic uremic syndrome (HUS) consists of hemolytic anemia, thrombocytopenia, and renal failure. HUS is often precipitated by gastrointestinal infection with Shiga toxin-producing Escherichia coli and is characterized by a variety of prothrombotic host abnormalities. In much of the world, E coli O157:H7 is the major cause of HUS. HUS can be categorized as either oligoanuric (which probably signifies acute tubular necrosis) or nonoligoanuric. Children with oligoanuric renal failure during HUS generally require dialysis, have more complicated courses, and are probably at increased risk for chronic sequelae than are children who experience nonoligoanuric HUS. Oligoanuric HUS should be avoided, if possible. The presentation to medical care of a child with definite or possible E coli O157:H7 infections but before HUS ensues affords a potential opportunity to ameliorate the course of the subsequent renal failure. However, it is not known whether events that occur early in E coli O157:H7 infections, particularly measures to expand circulating volume, affect the likelihood of experiencing oligoanuric HUS if renal failure develops. We attempted to assess whether pre-HUS interventions and events, especially the volume and sodium content of intravenous fluids administered early in illness, affect the risk for developing oligoanuric HUS after E coli O157:H7 infections. We performed a prospective cohort study of 29 children with HUS that was confirmed microbiologically to be caused by E coli O157:H7. Infected children were enrolled when they presented with acute bloody diarrhea or as contacts of patients who were known to be infected with E coli O157:H7, or if they had culture-confirmed infection, or if they presented with HUS. HUS was defined as hemolytic anemia (hematocrit parenteral fluid administered, were recorded and entered into analysis. Estimates of odds ratios were adjusted for possible confounding effects using logistic regression analysis. Twenty-nine children

Advanced Prostate Cancer Presenting as Hemolytic Uremic Syndrome

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R. Ramos

2013-01-01

Full Text Available Introduction. Hemolytic uremic syndrome (HUS is characterized by endothelial dysfunction, consumption thrombocytopenia, microangiopathic hemolytic anemia, and acute renal failure. HUS generally has a dismal prognosis, except when associated with gastroenteritis caused by verotoxin-producing bacteria. Cancer associated HUS is uncommon, and there are only scarce reports on prostate cancer presenting with HUS. Case Presentation. A 72-year-old man presented to the emergency department with oliguria, hematuria, and hematemesis. Clinical evaluation revealed acute renal failure, hemolysis, normal blood-clotting studies, and prostate-specific antigen value of 1000 ng/mL. The patient was started on hemodialysis, ultrafiltration with plasma exchange, and androgen blockade with bicalutamide and completely recovered from HUS. The authors review the 14 published cases on this association. Conclusion. The association of HUS and prostate cancer occurs more frequently in patients with high-grade, clinically advanced prostate cancer. When readily recognized and appropriately treated, HUS does not seem to worsen prognosis in prostate cancer patients.

Habitat Evaluation Procedures Report; Carl Property - Yakama Nation.

Energy Technology Data Exchange (ETDEWEB)

Ashley, Paul; Muse, Anthony

2008-02-01

A baseline habitat evaluation procedures (HEP) analysis was conducted on the Carl property (160 acres) in June 2007 to determine the number of habitat units to credit Bonneville Power Administration (BPA) for providing funds to acquire the property as partial mitigation for habitat losses associated with construction of McNary Dam. HEP surveys also helped assess the general ecological condition of the property. The Carl property appeared damaged from livestock grazing and exhibited a high percentage of invasive forbs. Exotic grasses, while present, did not comprise a large percentage of the available cover in most areas. Cover types were primarily grassland/shrubsteppe with a limited emergent vegetation component. Baseline HEP surveys generated 356.11 HUs or 2.2 HUs per acre. Habitat units were associated with the following HEP models: California quail (47.69 HUs), western meadowlark (114.78 HUs), mallard (131.93 HUs), Canada goose (60.34 HUs), and mink (1.38 HUs).

Idiopathic Atypical Haemolytic Uraemic Syndrome presenting with acute dystonia

LENUS (Irish Health Repository)

Maduemem, Rizwan K E

2017-09-01

Hemolytic Uremic Syndrome (HUS), a triad of microangiopathic hemolytic anemia, thrombocytopenia and acute kidney injury. The atypical HUS (aHUS) results from over activation of complement system with formation of micro thrombi and damage to endothelial cells resulting in renal impairment in 50 % and death in 25 %, commonly in untreated patients. We report an intriguing case of aHUS presenting with acute onset of movement disorder and fluctuating delirium.

Investigation of an outbreak of bloody diarrhea complicated with hemolytic uremic syndrome

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Otar Chokoshvili

2014-12-01

Full Text Available In July–August 2009, eight patients with bloody diarrhea complicated by hemolytic uremic syndrome (HUS were admitted to hospitals in Tbilisi, Georgia. We started active surveillance in two regions for bloody diarrhea and post-diarrheal HUS. Of 25 case-patients who developed HUS, including the initial 8 cases, half were ⩾15 years old, 67% were female and seven (28% died. No common exposures were identified. Among 20 HUS case-patients tested, Shiga toxin was detected in the stools of 2 patients (one with elevated serum IgG titers to several Escherichia coli serogroups, including O111 and O104. Among 56 persons with only bloody diarrhea, we isolated Shiga toxin-producing E. coli (STEC O104:H4 from 2 and Shigella from 10; 2 had serologic evidence of E. coli O26 infection. These cases may indicate a previously unrecognized burden of HUS in Georgia. We recommend national reporting of HUS and improving STEC detection capacity.

Guideline for the investigation and initial therapy of diarrhea-negative hemolytic uremic syndrome.

NARCIS (Netherlands)

Ariceta, G.; Besbas, N.; Johnson, S.; Karpman, D.; Landau, D.; Licht, C.; Loirat, C.; Pecoraro, C.; Taylor, C.M.; Kar, N.C.A.J. van de; Vandewalle, J.; Zimmerhackl, L.B.

2009-01-01

This guideline for the investigation and initial treatment of atypical hemolytic uremic syndrome (HUS) is intended to offer an approach based on opinion, as evidence is lacking. It builds on the current ability to identify the etiology of specific diagnostic sub-groups of HUS. HUS in children is

Atypical Hemolytic Uremic Syndrome post Kidney Transplantation: Two Case Reports and Review of the Literature

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Sami eAlasfar

2014-12-01

Full Text Available Atypical hemolytic uremic syndrome (aHUS is a rare disorder characterized by over-activation and dysregulation of the alternative complement pathway. Its estimated prevalence is 1-2 per million. The disease is characterized by thrombotic microangiopathy, which causes anemia, thrombocytopenia, and acute renal failure. aHUS has more severe course compared to typical (Infection-induced HUS and is frequently characterized by relapses that leads to end stage renal disease (ESRD. For a long time, kidney transplantation for these patients was contraindicated because of high rate of recurrence and subsequent renal graft loss. The post-kidney transplantation recurrence rate largely depends on the pathogenetic mechanisms involved. However, over the past several years, advancements in the understanding and therapeutics of aHUS have allowed successful kidney transplantation in these patients. Eculizumab, which is a complement C5 antibody that inhibits complement factor 5a (C5a and subsequent formation of the membrane attack complex, has been used in prevention and treatment of post-transplant aHUS recurrence. In this paper, we present two new cases of aHUS patients who underwent successful kidney transplantation in our center with the use of prophylactic and maintenance eculizumab therapy that have not been published before. The purpose of reporting these two cases is to emphasize the importance of using eculizumab as a prophylactic therapy to prevent aHUS recurrence post transplant in high-risk patients. We will also review the current understanding of the genetics of aHUS, the pathogenesis of its recurrence after kidney transplantation, and strategies for prevention and treatment of post-transplant aHUS recurrence.

Shigella sonnei and hemolytic uremic syndrome: A case report and literature review

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Casey Adams

2017-01-01

Full Text Available Hemolytic uremic syndrome (HUS is a well-described process that is known to cause severe renal dysfunction, thrombocytopenia, and anemia. HUS is typically associated with toxins (shiga-like and shigella toxin found in strains of E. coli and Shigella spp [1–3]. We present a case of a 27 year-old man with jaundice, thrombocytopenia, and renal dysfunction who was found to have HUS in the setting of Shigella sonnei infection. Outside of developing countries, cases of HUS related to S. sonnei are largely unreported.

Monocyte chemoattractant protein-1 and interleukin-8 levels in urine and serum of patents with hemolytic uremic syndrome.

Science.gov (United States)

van Setten, P A; van Hinsbergh, V W; van den Heuvel, L P; Preyers, F; Dijkman, H B; Assmann, K J; van der Velden, T J; Monnens, L A

1998-06-01

The epidemic form of the hemolytic uremic syndrome (HUS) in children is hallmarked by endothelial cell damage, most predominantly displayed by the glomerular capillaries. The influx of mononuclear (MO) and polymorphonuclear cells (PMNs) into the glomeruli may be an important event in the initiation, prolongation, and progression of glomerular endothelial cell damage in HUS patients. The molecular mechanisms for the recruitment of these leukocytes into the kidney are unclear, but monocyte chemoattractant protein-1 (MCP-1) and IL-8 are suggested to be prime candidates. In this study, we analyzed the presence of both chemokines in 24-h urinary (n = 15) and serum (n = 14) samples of HUS children by specific ELISAs. Furthermore, kidney biopsies of three different HUS children were examined for MO and PMN cell infiltration by histochemical techniques and electron microscopy. Whereas the chemokines MCP-1 and IL-8 were present in only very limited amounts in urine of 17 normal control subjects, serial samples of HUS patients demonstrated significantly elevated levels of both chemokines. HUS children with anuria showed higher initial and maximum chemokine levels than their counterparts without anuria. A strong positive correlation was observed between urinary MCP-1 and IL-8 levels. Whereas initial serum IL-8 levels were significantly increased in HUS children, serum MCP-1 levels were only slightly elevated compared with serum MCP-1 in control children. No correlation was found between urinary and serum chemokine concentrations. Histologic and EM studies of HUS biopsy specimens clearly showed the presence of MOs and to a lesser extent of PMNs in the glomeruli. The present data suggest an important local role for MOs and PMNs in the process of glomerular endothelial-cell damage. The chemokines MCP-1 and IL-8 may possibly be implicated in the pathogenesis of HUS through the recruitment and activation of MOs and PMNs, respectively.

End-stage kidney disease due to haemolytic uraemic syndrome – outcomes in 241 consecutive ANZDATA registry cases

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Tang Wen

2012-12-01

Full Text Available Abstract Background The aim of this study was to investigate the characteristics and outcomes of patients receiving renal replacement therapy for end-stage kidney disease (ESKD secondary to haemolytic uraemic syndrome (HUS. Methods The study included all patients with ESKD who commenced renal replacement therapy in Australia and New Zealand between 15/5/1963 and 31/12/2010, using data from the ANZDATA Registry. HUS ESKD patients were compared with matched controls with an alternative primary renal disease using propensity scores based on age, gender and treatment era. Results Of the 58422 patients included in the study, 241 (0.4% had ESKD secondary to HUS. HUS ESKD was independently associated with younger age, female gender and European race. Compared with matched controls, HUS ESKD was not associated with mortality on renal replacement therapy (adjusted hazard ratio [HR] 1.14, 95% CI 0.87-1.50, p = 0.34 or dialysis (HR 1.34, 95% CI 0.93-1.93, p = 0.12, but did independently predict recovery of renal function (HR 54.01, 95% CI 1.45-11.1, p = 0.008. 130 (54% HUS patients received 166 renal allografts. Overall renal allograft survival rates were significantly lower for patients with HUS ESKD at 1 year (73% vs 91%, 5 years (62% vs 85% and 10 years (49% vs 73%. HUS ESKD was an independent predictor of renal allograft failure (HR 2.59, 95% CI 1.70-3.95, p  Conclusions HUS is an uncommon cause of ESKD, which is associated with comparable patient survival on dialysis, an increased probability of renal function recovery, comparable patient survival post-renal transplant and a heightened risk of renal transplant graft failure compared with matched ESKD controls.

Analysis of patients with atypical hemolytic uremic syndrome treated at the Mie University Hospital: concentration of C3 p.I1157T mutation.

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Matsumoto, Takeshi; Fan, Xinping; Ishikawa, Eiji; Ito, Masaaki; Amano, Keishirou; Toyoda, Hidemi; Komada, Yoshihiro; Ohishi, Kohshi; Katayama, Naoyuki; Yoshida, Yoko; Matsumoto, Masanori; Fujimura, Yoshihiro; Ikejiri, Makoto; Wada, Hideo; Miyata, Toshiyuki

2014-11-01

Atypical hemolytic uremic syndrome (aHUS) is caused by abnormalities of the complement system and has a significantly poor prognosis. The clinical phenotypes of 12 patients in nine families with aHUS with familial or recurrent onset and ADAMTS13 activity of ≥20 % treated at the Mie University Hospital were examined. In seven of the patients, the first episode of aHUS occurred during childhood and ten patients experienced a relapse. All patients had renal dysfunction and three had been treated with hemodialysis. Seven patients experienced probable triggering events including common cold, influenza, bacterial infection and/or vaccination for influenza. All patients had entered remission, and renal function was improved in 11 patients. DNA sequencing of six candidate genes, identified a C3 p.I1157T missense mutation in all eight patients in six families examined and this mutation was causative for aHUS. A causative mutation THBD p.D486Y was also identified in an aHUS patient. Four missense mutations, CFH p.V837I, p.Y1058H, p.V1060L and THBD p.R403K may predispose to aHUS manifestation; the remaining seven missense mutations were likely neutral. In conclusion, the clinical phenotypes of aHUS are various, and there are often trigger factors. The C3 p.I1157T mutation was identified as the causative mutation for aHUS in all patients examined, and may be geographically concentrated in or around the Mie prefecture in central Japan.

Antibody Response to Shiga Toxins in Argentinean Children with Enteropathic Hemolytic Uremic Syndrome at Acute and Long-Term Follow-Up Periods

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Fernández-Brando, Romina J.; Bentancor, Leticia V.; Mejías, María Pilar; Ramos, María Victoria; Exeni, Andrea; Exeni, Claudia; Laso, María del Carmen; Exeni, Ramón; Isturiz, Martín A.; Palermo, Marina S.

2011-01-01

Shiga toxin (Stx)-producing Escherichia coli (STEC) infection is associated with a broad spectrum of clinical manifestations that include diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome (HUS). Systemic Stx toxemia is considered to be central to the genesis of HUS. Distinct methods have been used to evaluate anti-Stx response for immunodiagnostic or epidemiological analysis of HUS cases. The development of enzyme-linked immunosorbent assay (ELISA) and western blot (WB) assay to detect the presence of specific antibodies to Stx has introduced important advantages for serodiagnosis of HUS. However, application of these methods for seroepidemiological studies in Argentina has been limited. The aim of this work was to develop an ELISA to detect antibodies against the B subunit of Stx2, and a WB to evaluate antibodies against both subunits of Stx2 and Stx1, in order to analyze the pertinence and effectiveness of these techniques in the Argentinean population. We studied 72 normal healthy children (NHC) and 105 HUS patients of the urban pediatric population from the surrounding area of Buenos Aires city. Using the WB method we detected 67% of plasma from NHC reactive for Stx2, but only 8% for Stx1. These results are in agreement with the broad circulation of Stx2-expressing STEC in Argentina and the endemic behavior of HUS in this country. Moreover, the simultaneous evaluation by the two methods allowed us to differentiate acute HUS patients from NHC with a great specificity and accuracy, in order to confirm the HUS etiology when pathogenic bacteria were not isolated from stools. PMID:21559455

A case of atypical hemolytic uremic syndrome as an early manifestation of acute lymphoblastic leukemia

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Dong Kyun Han

2010-02-01

Full Text Available Hemolytic uremic syndrome (HUS is the most common cause of acute renal failure in children younger than 4 years and is characterized by microangiopathic hemolytic anemia, acute renal failure, and thrombocytopenia. HUS associated with diarrheal prodrome is usually caused by Shiga toxin-producing Escherichia coli O157:H7 or by Shigella dysenteriae, which generally has a better outcome. However, atypical cases show a tendency to relapse with a poorer prognosis. HUS has been reported to be associated with acute lymphoblastic leukemia (ALL in children. The characteristics and the mechanisms underlying this condition are largely unknown. In this study, we describe the case of an 11-year-old boy in whom the diagnosis of ALL was preceded by the diagnosis of atypical HUS. Thus, patients with atypical HUS should be diagnosed for the possibility of developing ALL.

End-stage renal disease from hemolytic uremic syndrome in the United States, 1995-2010.

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Sexton, Donal J; Reule, Scott; Solid, Craig A; Chen, Shu-Cheng; Collins, Allan J; Foley, Robert N

2015-10-01

Management of hemolytic uremic syndrome (HUS) has evolved rapidly, and optimal treatment strategies are controversial. However, it is unknown whether the burden of end-stage renal disease (ESRD) from HUS has changed, and outcomes on dialysis in the United States are not well described. We retrospectively examined data for patients initiating maintenance renal replacement therapy (RRT) (n = 1,557,117), 1995-2010, to define standardized incidence ratios (SIRs) and outcomes of ESRD from HUS) (n = 2241). Overall ESRD rates from HUS in 2001-2002 were 0.5 cases/million per year and were higher for patients characterized by age 40-64 years (0.6), ≥65 years (0.7), female sex (0.6), and non-Hispanic African American race (0.7). Standardized incidence ratios remained unchanged (P ≥ 0.05) between 2001-2002 and 2009-2010 in the overall population. Compared with patients with ESRD from other causes, patients with HUS were more likely to be younger, female, white, and non-Hispanic. Over 5.4 years of follow-up, HUS patients differed from matched controls with ESRD from other causes by lower rates of death (8.3 per 100 person-years in cases vs. 10.4 in controls, P < 0.001), listing for renal transplant (7.6 vs. 8.6 per 100 person-years, P = 0.04), and undergoing transplant (6.9 vs. 9 per 100 person-years, P < 0.001). The incidence of ESRD from HUS appears not to have risen substantially in the last decade. However, given that HUS subtypes could not be determined in this study, these findings should be interpreted with caution. © 2015 International Society for Hemodialysis.

Unusual Manifestation of Severe Conjugated Hyperbilirubinemia in an Infant with Streptococcus pneumoniae-associated Hemolytic Uremic Syndrome

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Jung-Pin Chen

2007-01-01

Full Text Available Streptococcus pneumoniae is an uncommon etiologic organism in children with hemolytic uremic syndrome (HUS. Historically, severe S. pneumoniae-associated HUS usually has a poor clinical outcome. The clinical manifestations of marked jaundice and hepatic dysfunction in this form of HUS are extremely rare. We report a 10-month-old female infant with S. pneumoniae-associated HUS who had the unusual manifestation of severely elevated conjugated bilirubin and hepatic transaminases. Screening for viral hepatitis was negative, and evidence of biliary obstruction and hepatotoxic drug exposure was also absent. The patient was treated with antihypertensive agents for 2.5 months and required peritoneal dialysis for a period of 26 days. Hepatic function returned to normal on the 8th day of hospitalization. Renal function was mildly impaired at 1-year follow-up. Our report suggests that severe conjugated hyperbilirubinemia is a rare manifestation of S. pneumoniae-associated HUS in children. It is important for pediatricians that pneumococcal infection with severe hematologic and renal disorders should be investigated for evidence of S. pneumoniae-associated HUS. [J Formos Med Assoc 2007;106(2 Suppl:S17-S22

Hemolytic uremic syndrome and hypertensive crisis post dengue hemorrhagic fever: a case report

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Mervin Tri Hadianto

2011-12-01

Full Text Available Hemolytic-uremic syndrome (HUS clinically manifests as acute renal failure, hemolytic anemia and thrombocytopenia. Acute renal failure with oliguria, hypertension, and proteinuria usually develops in affected patients.1,2 In children under 15 years of age, typical HUS occurs at a rate of 0.91 cases per 100,000 population.3 The initial onset of this disease usually happens in children below 3 years of age. Incidence is similar in boys and girls. Seasonal variation occurs, with HUS peaking in the summer and fall. In young children, spontaneous recovery is common. In adults, the probability of recovery is low when HUS is associated with severe hypertension.2

Successful Management of a Rare Cause of Hemolytic Uremic Syndrome With Eculizumab in a Child.

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Alparslan, Caner; Yavaşcan, Önder; Kasap Demir, Belde; Atmiş, Bahriye; Karabay Bayazit, Aysun; Leblebisatan, Göksel; Öncel, Elif P; Alaygut, Demet; Mutlubaş, Fatma; Aksu, Nejat

2018-03-23

Hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia, acute renal failure, and thrombocytopenia. It very rarely coexists with acute lymphoblastic leukemia (ALL) emerging before, simultaneously, or after the diagnosis has been made, and management of the patient may be difficult. We present the case of a 7-year-old boy who was diagnosed with HUS and initially managed by hemodialysis (HD). Thereafter, HUS progressed, and neurological findings developed. The patient was treated with eculizumab, agressive blood pressure control, and antiepileptic drugs. At the fifth month of follow-up, the patient was diagnosed with acute B-cell lymphoblastic leukemia with fever, bone pain, hepatosplenomegaly, and pancytopenia. After initiation of ALL treatment, he had no episodes of HUS, despite cessation of eculizumab. In conclusion, eculizumab may be a treatment of choice to prevent further systemic damage in recurrent HUS episodes of patients with borderline changes in the bone marrow until ALL is constantly diagnosed.

Risk factors for development of hemolytic uremic syndrome in a cohort of adult patients with STEC 0104:H4 infection.

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Alexander Zoufaly

Full Text Available The outbreak of Shiga toxin producing E.coli O104:H4 in northern Germany in 2011 was one of the largest worldwide and involved mainly adults. Post-diarrheal hemolytic uremic syndrome (HUS occurred in 22% of STEC positive patients. This study's aim was to assess risk factors for HUS in STEC-infected patients and to develop a score from routine hospital parameters to estimate patient risks for developing HUS. In a cohort analysis, adult patients with STEC infection were included in five participating hospitals in northern Germany between May and July 2011. Clinical data were obtained from questionnaires and medical records, laboratory data were extracted from hospitals' electronic data systems. HUS was defined as thrombocytopenia, hemolytic anemia and acute renal dysfunction. Random forests and multivariate logistic regression were used to identify risk factors for HUS and develop a score using the estimated coefficients as weights. Among 259 adults with STEC infection, vomiting (OR 3.48,95%CI 1.88-6.53, visible blood in stools (OR 3.91,95%CI1.20-16.01, age above 75 years (OR 3.27, 95%CI 1.12-9.70 and elevated leukocyte counts (OR 1.20, 95%CI 1.10-1.31, per 1000 cells/mm(3 were identified as independent risk factors for HUS. A score using these variables has an area under the ROC curve of 0.74 (95%CI 0.68-0.80. Vomiting, visible blood in stools, higher leukocyte counts, and higher age indicate increased risk for developing HUS. A score using these variables might help to identify high risk patients who potentially benefit from aggressive pre-emptive treatment to prevent or mitigate the devastating consequences of HUS.

Hemolytic Uremic Syndrome-associated Encephalopathy Successfully Treated with Corticosteroids.

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Hosaka, Takashi; Nakamagoe, Kiyotaka; Tamaoka, Akira

2017-11-01

The encephalopathy that occurs in association with hemolytic uremic syndrome (HUS), which is caused by enterohemorrhagic Escherichia coli (E. coli), has a high mortality rate and patients sometimes present sequelae. We herein describe the case of a 20-year-old woman who developed encephalopathy during the convalescent stage of HUS caused by E.coli O26. Hyperintense lesions were detected in the pons, basal ganglia, and cortex on diffusion-weighted brain MRI. From the onset of HUS encephalopathy, we treated the patient with methylprednisolone (mPSL) pulse therapy alone. Her condition improved, and she did not present sequelae. Our study shows that corticosteroids appear to be effective for the treatment of some patients with HUS encephalopathy.

Habitat Evaluation Procedures Report; Graves Property - Yakama Nation.

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Ashley, Paul; Muse, Anthony

2008-02-01

A habitat evaluation procedures (HEP) analysis was conducted on the Graves property (140 acres) in June 2007 to determine the number of habitat units to credit Bonneville Power Administration (BPA) for providing funds to acquire the property as partial mitigation for habitat losses associated with construction of McNary Dam. HEP surveys also documented the general ecological condition of the property. The Graves property was significantly damaged from past/present livestock grazing practices. Baseline HEP surveys generated 284.28 habitat units (HUs) or 2.03 HUs per acre. Of these, 275.50 HUs were associated with the shrubsteppe/grassland cover type while 8.78 HUs were tied to the riparian shrub cover type.

West Foster Creek 2007 Follow-up Habitat Evaluation Procedures (HEP) Report.

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Ashley, Paul R.

2008-02-01

A follow-up habitat evaluation procedures (HEP) analysis was conducted on the West Foster Creek (Smith acquisition) wildlife mitigation site in May 2007 to determine the number of additional habitat units to credit Bonneville Power Administration (BPA) for providing funds to enhance and maintain the project site as partial mitigation for habitat losses associated with construction of Grand Coulee Dam. The West Foster Creek 2007 follow-up HEP survey generated 2,981.96 habitat units (HU) or 1.51 HUs per acre for a 34% increase (+751.34 HUs) above baseline HU credit (the 1999 baseline HEP survey generated 2,230.62 habitat units or 1.13 HUs per acre). The 2007 follow-up HEP analysis yielded 1,380.26 sharp-tailed grouse (Tympanuchus phasianellus) habitat units, 879.40 mule deer (Odocoileus hemionus) HUs, and 722.29 western meadowlark (Sturnella neglecta) habitat units. Mule deer and sharp-tailed grouse habitat units increased by 346.42 HUs and 470.62 HUs respectively over baseline (1999) survey results due largely to cessation of livestock grazing and subsequent passive restoration. In contrast, the western meadowlark generated slightly fewer habitat units in 2007 (-67.31) than in 1999, because of increased shrub cover, which lowers habitat suitability for that species.

A novel strategy for hemolytic uremic syndrome: successful treatment with thrombomodulin α.

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Honda, Takashi; Ogata, Shohei; Mineo, Eri; Nagamori, Yukako; Nakamura, Shinya; Bando, Yuki; Ishii, Masahiro

2013-03-01

Hemolytic uremic syndrome (HUS) is a life-threatening infectious disease in childhood for which there is no confirmed therapeutic strategy. Endothelial inflammation leading to microthrombosis formation via complement activation is the main pathology of HUS. Thrombomodulin is an endothelial membrane protein that has anticoagulation and anti-inflammatory effects, including the suppression of complement activity. Recombinant human soluble thrombomodulin (rTM) is a novel therapeutic medicine for disseminated intravascular coagulation. We administered rTM to 3 patients with HUS for 7 days and investigated the outcomes in view of the patients' prognoses, changes in biochemical markers, complications, and adverse effects of rTM. Symptoms and laboratory data improved after initiation of rTM in all 3 patients. Abnormal activation of complements was also dramatically suppressed in 1 patient. The patients recovered without any complications or adverse effects of rTM. They were discharged having normal neurologic status and with no renal dysfunction. To our knowledge, this is the first report of rTM being used to treat HUS. These case reports show the positive effect of rTM in patients with HUS. Randomized controlled studies should be performed to assess the efficacy and safety of rTM for children with HUS.

Habitat Evaluation Procedures (HEP) Report : Ladd Marsh Wildlife Area, 2004-2006 Technical Report.

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Ashley, Paul; Wagoner, Sara

2006-05-01

The Regional HEP Team (RHT) and Oregon Department of Fish and Wildlife (ODFW) staff conducted a follow-up habitat evaluation procedures (HEP) analysis on the Ladd Marsh Wildlife Management Area (LMWA) in May 2005. The 2005 HEP assessment resulted in a total of 647.44 HUs, or 0.76 HUs/acre. This is an increase of 420.34 HUs (0.49 HUs/acre) over 2001 HEP survey results. The most significant increase in HUs occurred on the Wallender and Simonis parcels which increased by 214.30 HUs and 177.49 HUs respectively. Transects were established at or near 2001 HEP analysis transect locations whenever possible. ODFW staff biologists assisted the RHT re-establish transect locations and/or suggested areas for new surveys. Since 2001, significant changes in cover type acreage and/or structural conditions have occurred due to conversion of agriculture cover types to emergent wetland and grassland cover types. Agricultural lands were seeded to reestablish grasslands and wetlands were restored through active management and manipulation of extant water sources including natural stream hydrology/flood regimes and available irrigation. Grasslands increased on the Wallender parcel by 21% (65 acres), 23% (71 acres) at the Simonis site, and 39% (62 acres) at Conley Lake. The emergent wetland cover type also changed significantly increasing 60% (184 acres) at Wallender and 59% (184 acres) on the Simonis tract. Today, agriculture lands (crop and grazed pasture) have been nearly eliminated from Bonneville Power Administration (BPA) mitigation project lands located on the LMWA.

Epidemiological and Ecological Characterization of the EHEC O104:H4 Outbreak in Hamburg, Germany, 2011.

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Maike Tahden

Full Text Available In 2011, a large outbreak of entero-hemorrhagic E. coli (EHEC and hemolytic uremic syndrome (HUS occurred in Germany. The City of Hamburg was the first focus of the epidemic and had the highest incidences among all 16 Federal States of Germany. In this article, we present epidemiological characteristics of the Hamburg notification data. Evaluating the epicurves retrospectively, we found that the first epidemiological signal of the outbreak, which was in form of a HUS case cluster, was received by local health authorities when already 99 EHEC and 48 HUS patients had experienced their first symptoms. However, only two EHEC and seven HUS patients had been notified. Middle-aged women had the highest risk for contracting the infection in Hamburg. Furthermore, we studied timeliness of case notification in the course of the outbreak. To analyze the spatial distribution of EHEC/HUS incidences in 100 districts of Hamburg, we mapped cases' residential addresses using geographic information software. We then conducted an ecological study in order to find a statistical model identifying associations between local socio-economic factors and EHEC/HUS incidences in the epidemic. We employed a Bayesian Poisson model with covariates characterizing the Hamburg districts as well as incorporating structured and unstructured spatial effects. The Deviance Information Criterion was used for stepwise variable selection. We applied different modeling approaches by using primary data, transformed data, and preselected subsets of transformed data in order to identify socio-economic factors characterizing districts where EHEC/HUS outbreak cases had their residence.

Evaluation of lymph node perfusion using continuous mode harmonic ultrasonography with a second-generation contrast agent.

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Rubaltelli, Leopoldo; Khadivi, Yeganeh; Tregnaghi, Alberto; Stramare, Roberto; Ferro, Federica; Borsato, Simonetta; Fiocco, Ugo; Adami, Fausto; Rossi, Carlo Riccardo

2004-06-01

To evaluate the contribution of continuous mode contrast-enhanced harmonic ultrasonography (CE-HUS) with a second-generation contrast agent to the characterization of superficial lymphadenopathies with respect to conventional ultrasonographic techniques (B-mode and power Doppler). Fifty-six lymph nodes from 45 patients were studied both by conventional techniques and by CE-HUS. The dimensions, intranodal architecture, margins, and location of vessels were evaluated. Subsequently, all the lymph nodes were examined by CE-HUS, and enhancement of echogenicity was evaluated. The diagnoses obtained by means of fine-needle aspiration cytologic examination, surgical biopsy, or both were compared with those obtained by ultrasonography. Of the lymph nodes examined, 30 were benign and 26 were malignant (18 metastases and 8 non-Hodgkin lymphomas). The study using CE-HUS showed intense homogeneous enhancement in 28 of 30 reactive lymph nodes; perfusion defects in 17, of which 15 were neoplastic and 2 were inflammatory; intense but inhomogeneous speckled enhancement in the early arterial phase in 5 cases of lymphoma; and, last, scarce or absent intranodal enhancement in 4 metastases. The specificity, sensitivity, and accuracy of conventional techniques in differentiation between benign and malignant lymph nodes were 76%, 80%, and 78% versus 93%, 92%, and 92.8% for CE-HUS. The increase in correct diagnoses was significant (P = .05) when conventional ultrasonography was tested against CE-HUS. Superficial lymph nodes can be characterized as being neoplastic or benign with a high degree of diagnostic accuracy on the basis of the perfusion characteristics evaluated by CE-HUS. This technique has been shown to afford a higher degree of accuracy than currently obtainable by any other ultrasonographic technique.

Whole-Genome Characterization and Strain Comparison of VT2f-Producing Escherichia coli Causing Hemolytic Uremic Syndrome

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Michelacci, Valeria; Bondì, Roslen; Gigliucci, Federica; Franz, Eelco; Badouei, Mahdi Askari; Schlager, Sabine; Minelli, Fabio; Tozzoli, Rosangela; Caprioli, Alfredo; Morabito, Stefano

2016-01-01

Verotoxigenic Escherichia coli infections in humans cause disease ranging from uncomplicated intestinal illnesses to bloody diarrhea and systemic sequelae, such as hemolytic uremic syndrome (HUS). Previous research indicated that pigeons may be a reservoir for a population of verotoxigenic E. coli producing the VT2f variant. We used whole-genome sequencing to characterize a set of VT2f-producing E. coli strains from human patients with diarrhea or HUS and from healthy pigeons. We describe a phage conveying the vtx2f genes and provide evidence that the strains causing milder diarrheal disease may be transmitted to humans from pigeons. The strains causing HUS could derive from VT2f phage acquisition by E. coli strains with a virulence genes asset resembling that of typical HUS-associated verotoxigenic E. coli. PMID:27584691

Habitat Evaluation Procedures (HEP) Report : Priest River, 2004-2005 Technical Report.

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Entz, Ray

2005-02-01

On July 6, 2004, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Priest River property, an acquisition completed by the Kalispel Tribe of Indians in 2001. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, yellow warbler, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Priest River Project provides a total of 105.41 Habitat Units (HUs) for the species evaluated. Conifer forest habitat provides 26.95 HUs for bald eagle, black-capped chickadee, and white-tailed deer. Grassland habitat provides 23.78 HUs for Canada goose and mallard. Scmb-shrub vegetation provides 54.68 HUs for mallard, yellow warbler, and white-tailed deer.

A dual model HU conversion from MRI intensity values within and outside of bone segment for MRI-based radiotherapy treatment planning of prostate cancer

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Korhonen, Juha, E-mail: juha.p.korhonen@hus.fi [Clinical Research Institute Helsinki University Central Hospital Ltd., POB-700, 00029 HUS, Finland and Department of Oncology, Helsinki University Central Hospital, POB-180, 00029 HUS (Finland); Kapanen, Mika [Clinical Research Institute Helsinki University Central Hospital Ltd., POB-700, 00029 HUS (Finland); Department of Oncology, Helsinki University Central Hospital, POB-180, 00029 HUS (Finland); Department of Medical Physics, Tampere University Hospital, POB-2000, 33521 Tampere (Finland); Keyriläinen, Jani; Seppälä, Tiina; Tenhunen, Mikko [Department of Oncology, Helsinki University Central Hospital, POB-180, 00029 HUS (Finland)

2014-01-15

Purpose: The lack of electron density information in magnetic resonance images (MRI) poses a major challenge for MRI-based radiotherapy treatment planning (RTP). In this study the authors convert MRI intensity values into Hounsfield units (HUs) in the male pelvis and thus enable accurate MRI-based RTP for prostate cancer patients with varying tissue anatomy and body fat contents. Methods: T{sub 1}/T{sub 2}*-weighted MRI intensity values and standard computed tomography (CT) image HUs in the male pelvis were analyzed using image data of 10 prostate cancer patients. The collected data were utilized to generate a dual model HU conversion technique from MRI intensity values of the single image set separately within and outside of contoured pelvic bones. Within the bone segment local MRI intensity values were converted to HUs by applying a second-order polynomial model. This model was tuned for each patient by two patient-specific adjustments: MR signal normalization to correct shifts in absolute intensity level and application of a cutoff value to accurately represent low density bony tissue HUs. For soft tissues, such as fat and muscle, located outside of the bone contours, a threshold-based segmentation method without requirements for any patient-specific adjustments was introduced to convert MRI intensity values into HUs. The dual model HU conversion technique was implemented by constructing pseudo-CT images for 10 other prostate cancer patients. The feasibility of these images for RTP was evaluated by comparing HUs in the generated pseudo-CT images with those in standard CT images, and by determining deviations in MRI-based dose distributions compared to those in CT images with 7-field intensity modulated radiation therapy (IMRT) with the anisotropic analytical algorithm and 360° volumetric-modulated arc therapy (VMAT) with the Voxel Monte Carlo algorithm. Results: The average HU differences between the constructed pseudo-CT images and standard CT images of each

Associations Between Hydration Status, Intravenous Fluid Administration, and Outcomes of Patients Infected With Shiga Toxin-Producing Escherichia coli: A Systematic Review and Meta-analysis.

Science.gov (United States)

Grisaru, Silviu; Xie, Jianling; Samuel, Susan; Hartling, Lisa; Tarr, Phillip I; Schnadower, David; Freedman, Stephen B

2017-01-01

The associations between hydration status, intravenous fluid administration, and outcomes of patients infected with Shiga toxin-producing Escherichia coli (STEC) remain unclear. To determine the relationship between hydration status, the development and severity of hemolytic uremic syndrome (HUS), and adverse outcomes in STEC-infected individuals. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials via the OvidSP platform, PubMed via the National Library of Medicine, CINAHL Plus with full text, Scopus, Web of Science, ClinicalTrials.gov, reference lists, and gray literature were systematically searched. Two reviewers independently identified studies that included patients with hydration status documentation, proven or presumed STEC infection, and some form of HUS that developed. No language restrictions were applied. Two reviewers independently extracted individual study data, including study characteristics, population, and outcomes. Risk of bias was assessed using the Newcastle-Ottawa Scale; strength of evidence was adjudicated using the Grading of Recommendations Assessment, Development, and Evaluation method. Meta-analyses were conducted using random-effects models. Development of HUS, complications (ie, oligoanuric renal failure, involvement of the central nervous system, or death), and interventions (ie, renal replacement therapy). Eight studies comprising 1511 patients (all children) met eligibility criteria. Unpublished data were provided by the authors of 7 published reports. The median risk-of-bias score was 7.5 (range, 6-9). No studies evaluated the effect of hydration during STEC infections on the risk for HUS. A hematocrit value greater than 23% as a measure of hydration status at presentation with HUS was associated with the development of oligoanuric HUS (OR, 2.38 [95% CI, 1.30-4.35]; I2 = 2%), renal replacement therapy (OR, 1.90 [95% CI, 1.25-2.90]; I2 = 17%), and death (OR, 5.13 [95% CI, 1.50-17.57]; I2 = 55%). Compared with

Habitat Evaluation Procedures (HEP) Report; Beaver Lake, Technical Report 2005.

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Entz, Ray

2005-05-01

On August 14, 2003, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Beaver Lake property, an acquisition completed by the Kalispel Tribe of Indians in November 2002. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, muskrat, yellow warbler, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Beaver Lake Project provides a total of 232.26 Habitat Units (HUs) for the species evaluated. Conifer forest habitat provides 136.58 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. Forested wetland habitat provides 20.02 HUs for bald eagle, black-caped chickadee, mallard, and white-tailed deer. Scrub-shrub wetland habitat provides 7.67 HUs for mallard, yellow warbler, and white-tailed deer. Grassland meadow provides 22.69 HUs for Canada goose and mallard. Emergent wetlands provide 35.04 HUs for Canada goose, mallard, and muskrat. Open water provided 10.26 HUs for Canada goose, mallard, and muskrat. The objective of using HEP at the Beaver Lake Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

Habitat Evaluation Procedures (HEP) Report; Carey Creek, Technical Report 2005.

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Entz, Ray

2005-05-01

In August 2002, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Carey Creek property, an acquisition completed by the Kalispel Tribe of Indians in December 2001. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, yellow warbler, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Carey Creek Project provides a total of 172.95 Habitat Units (HUs) for the species evaluated. Conifer forest habitat provides 4.91 HUs for bald eagle, black-capped chickadee, and white-tailed deer. Forested wetlands provide 52.68 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. Scrub-shrub wetlands provide 2.82 HUs for mallard, yellow warbler and white-tailed deer. Wet meadow and grassland meadow provide 98.13 HUs for mallard and Canada goose. Emergent wetlands provide 11.53 HUs for mallard, muskrat, and Canada goose. Open water provides 2.88 HUs for Canada goose, mallard, and muskrat. The objective of using HEP at the Carey Creek Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

Plasmapheresis in thrombotic microangiopathy-associated syndromes: review of outcome data derived from clinical trials and open studies.

Science.gov (United States)

von Baeyer, Hans

2002-08-01

Current reimbursement policy of health insurance for therapeutic plasmapheresis requires proof of efficacy using the concept of evidence-based medicine. The aim of this paper is to review the outcome of plasmapheresis used to treat thrombotic microangiopathy (TMA)-associated syndromes in the last decade to provide scientific evidence to back up reimbursement applications. The strength of evidence of each reviewed study was assessed using the five levels of evidence criteria as defined by the American Society of Hematology in 1996 for assessment of the treatment of immune thrombocytopenia. The level Experimental indication was added for situations where only case reports or small series supported by pathophysiological reasoning are available. The definitions of evidence used in this paper are as follows: Level I, randomized clinical trial with low rates of error (p historical control group; Level V, case series without a control group or expert opinion; and Experimental, case reports and pathophysiological reasoning. The results of this analysis based on the published data is summarized as follows: The indication of plasmapheresis is assigned to Level IV evidence for thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS); cancer/chemotherapy-associated TTP/HUS is assigned to Level V evidence; and TTP/HUS refractory to standard plasma exchange and post-bone marrow transplantation TTP/HUS are assigned to Experimental indication. For both subsets, protein A immunoadsorption is reportedly successful. The other TMA-associated syndromes, hemolysis elevated liver enzymes low platelets and HUS in early childhood, are no indication of plasmapheresis. Two randomized clinical trials were performed in order to demonstrate the superiority of plasma exchange/fresh frozen plasma (PEX/FFP) over plasma transfusion in the management of TTP/HUS. The results prove the greater clinical success of the latter type of plasma administration. Standard PEX/FFP has reduced the

ADAMTS-13 level in children with severe diarrhea-associated hemolytic uremic syndrome: Unmasking new association

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Naglaa A Khalifa

2018-01-01

Full Text Available Severe deficiency of ADAMTS-13 leads to thrombotic thrombocytopenic purpura. Few studies have reported reduced activity of ADAMTS-13 in patients with atypical and typical hemolytic uremic syndrome (HUS. We hypothesized that ADAMTS-13 deficiency might play a role in the pathogenesis of severe HUS. This study aimed to evaluate the ADAMTS-13 level in severe typical HUS. This prospective case–control study was carried out in the Pediatric Nephrology Unit and Clinical Pathology Department, Faculty of Medicine, Zagazig University from February 2013 to February 2014. The study included 15 consecutive children with typical HUS as well as 15 healthy children as a control group. Routine laboratory investigations were performed. Assessment of serum ADAMTS-13 level was performed using the Quantikine human ADAMTS-13 ELISA kit. Data were analyzed using Statistical Package for Social Sciences version 16. Nonparametric values were expressed as median and range, and the median of two groups was tested by Mann–Whitney test. The serum ADAMTS-13 level was significantly lower in HUS patients when compared to the control group (P < 0.05. There were significant negative correlations between ADAMTS-13 level and duration on dialysis, as well as serum urea and creatinine. Furthermore, there were significant positive correlations between serum ADAMTS-13 level and both hemoglobin level and platelet count. Our study suggests that the ADAMTS-13 level was decreased in children with severe typical HUS and its deficiency correlated with disease severity.

Construction of a humanized antibody to hepatitis B surface antigen by specificity-determining residues (SDR)-grafting and de-immunization.

Science.gov (United States)

Kim, Keun-Soo; Kim, Hyun-Jung; Han, Byung Woo; Myung, Pyung-Keun; Hong, Hyo Jeong

2010-05-28

We previously constructed a humanized antibody, HuS10, by grafting the complementarity-determining regions (CDRs) of a parental murine monoclonal antibody into the homologous human antibody sequences. This process is termed CDR grafting. Some residues that were thought to affect the CDR loops and stabilize the structure of the variable regions were retained in the framework region. HuS10 exhibited in vivo virus-neutralizing activity, but its murine content had the potential to elicit immune responses in patients. In this study, to minimize the immunogenic potential of HuS10, we replaced 17 mouse residues in HuS10 with the comparable human residues using specificity-determining residue (SDR)-grafting and de-immunization methods. The resultant humanized antibody, HzS-III, had the same affinity and epitope specificity as HuS10 and had reduced immunogenic potential, as assessed by T-cell epitope analysis. Thus, SDR grafting in combination with de-immunization may be a useful strategy for minimizing the immunogenicity of humanized antibodies. In addition, HzS-III may be a good candidate for immunoprophylaxis of HBV infection. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Escherichia coli Shiga Toxin Mechanisms of Action in Renal Disease

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Tom G. Obrig

2010-12-01

Full Text Available Shiga toxin-producing Escherichia coli is a contaminant of food and water that in humans causes a diarrheal prodrome followed by more severe disease of the kidneys and an array of symptoms of the central nervous system. The systemic disease is a complex referred to as diarrhea-associated hemolytic uremic syndrome (D+HUS. D+HUS is characterized by thrombocytopenia, microangiopathic hemolytic anemia, and acute renal failure. This review focuses on the renal aspects of D+HUS. Current knowledge of this renal disease is derived from a combination of human samples, animal models of D+HUS, and interaction of Shiga toxin with isolated renal cell types. Shiga toxin is a multi-subunit protein complex that binds to a glycosphingolipid receptor, Gb3, on select eukaryotic cell types. Location of Gb3 in the kidney is predictive of the sites of action of Shiga toxin. However, the toxin is cytotoxic to some, but not all cell types that express Gb3. It also can cause apoptosis or generate an inflammatory response in some cells. Together, this myriad of results is responsible for D+HUS disease.

Eculizumab Therapy Leads to Rapid Resolution of Thrombocytopenia in Atypical Hemolytic Uremic Syndrome

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Han-Mou Tsai

2014-01-01

Full Text Available Eculizumab is highly effective in controlling complement activation in patients with the atypical hemolytic uremic syndrome (aHUS. However, the course of responses to the treatment is not well understood. We reviewed the responses to eculizumab therapy for aHUS. The results show that, in patients with aHUS, eculizumab therapy, when not accompanied with concurrent plasma exchange therapy, led to steady increase in the platelet count and improvement in extra-renal complications within 3 days. By day 7, the platelet count was normal in 15 of 17 cases. The resolution of hemolytic anemia and improvement in renal function were less predictable and were not apparent for weeks to months in two patients. The swift response in the platelet counts was only observed in one of five cases who received concurrent plasma exchange therapy and was not observed in a case of TMA due to gemcitabine/carboplatin. In summary, eculizumab leads to rapid increase in the platelet counts and resolution of extrarenal symptoms in patients with aHUS. Concurrent plasma exchange greatly impedes the response of aHUS to eculizumab therapy. Eculizumab is ineffective for gemcitabine/carboplatin associated TMA.

Dormaier and Chester Butte 2007 Follow-up Habitat Evaluation Procedures Report.

Energy Technology Data Exchange (ETDEWEB)

Ashley, Paul R.

2008-01-01

Follow-up habitat evaluation procedures (HEP) analyses were conducted on the Dormaier and Chester Butte wildlife mitigation sites in April 2007 to determine the number of additional habitat units to credit Bonneville Power Administration (BPA) for providing funds to enhance, and maintain the project sites as partial mitigation for habitat losses associated with construction of Grand Coulee Dam. The Dormaier follow-up HEP survey generated 482.92 habitat units (HU) or 1.51 HUs per acre for an increase of 34.92 HUs over baseline credits. Likewise, 2,949.06 HUs (1.45 HUs/acre) were generated from the Chester Butte follow-up HEP analysis for an increase of 1,511.29 habitat units above baseline survey results. Combined, BPA will be credited with an additional 1,546.21 follow-up habitat units from the Dormaier and Chester Butte parcels.

Atypical hemolytic uremic syndrome triggered by varicella infection

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Pauline Condom

2017-01-01

The current case describes an aHUS associated to varicella infection as demonstrated by the simultaneous occurrence of the viral infection and aHUS manifestations. Apart from typical Hemolytic Uremic Syndrome which is triggered by bacteria mostly Shiga toxin producing Echerichia coli and Streptococcus pneumoniae or Shigella, aHUS may be linked to viral infections such as HIV, EBV and enteroviruses, but very rarely by varicella. This case highlights a possible even rare complication of varicella infection a very common childhood disease. This complication could be avoided by to anti-VZV vaccination.

Hemolytic uremic syndrome associated with Plasmodium vivax malaria successfully treated with plasma exchange

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V S Keskar

2014-01-01

Full Text Available We report a case of hemolytic uremic syndrome (HUS in an adult patient with Plasmodium vivax malaria. The patient presented with worsening anemia, persistent thrombocytopenia and acute kidney injury. HUS was diagnosed based on the high serum lactate dehydrogenase, elevated reticulocyte count and presence of schistocytes on peripheral blood smear. Kidney biopsy showed features of thrombotic microangiopathy. Complete hematological remission was achieved after five sessions of therapeutic plasma exchange. Renal function partially recovered and stabilized at discharge. Vivax malaria, generally considered benign, may be rarely associated with HUS.

Differential CT Attenuation of Metabolically Active and Inactive Adipose Tissues — Preliminary Findings

Science.gov (United States)

Hu, Houchun H.; Chung, Sandra A.; Nayak, Krishna S.; Jackson, Hollie A.; Gilsanz, Vicente

2010-01-01

This study investigates differences in CT Hounsfield units (HUs) between metabolically active (brown fat) and inactive adipose tissues (white fat) due to variations in their densities. PET/CT data from 101 pediatric and adolescent patients were analyzed. Regions of metabolically active and inactive adipose tissues were identified and standard uptake values (SUVs) and HUs were measured. HUs of active brown fat were more positive (p<0.001) than inactive fat (−62.4±5.3 versus −86.7±7.0) and the difference was observed in both males and females. PMID:21245691

Indflydelse. Hvide evangelister er inde i varmen

DEFF Research Database (Denmark)

Olsen, Gorm Rye

2016-01-01

ANALYSE De hvide evangelister bar Trump ind i Det Hvide Hus. Det vil få stor betydning for USA's udenrigspolitik.......ANALYSE De hvide evangelister bar Trump ind i Det Hvide Hus. Det vil få stor betydning for USA's udenrigspolitik....

Fulltext PDF

Indian Academy of Sciences (India)

ART

1998-06-26

Jun 26, 1998 ... captain and his team of ... T hus, strong w inds and level playing grounds do not go together! Som e ..... exotic features unim aginable w ithout spin. D epending .... T hus, aerodynam ic view of sports furnishes a deeper.

Anticardiolipin antibodies in D+ hemolytic uremic syndrome.

NARCIS (Netherlands)

Loo, D.M.W.M. te; Alfen-van der Velden, J. van; Onland, W.; Heuvel, L.P.W.J. van den; Monnens, L.A.H.

2002-01-01

The diarrhea-associated form of the hemolytic uremic syndrome (D+ HUS) is characterized by a triad of symptoms, namely thrombocytopenia, hemolytic anemia, and acute renal failure. Histopathological studies of patients with D+ HUS show microthrombi in arterioles and glomeruli of the kidney. Recently,

Estimation of community-level influenza-associated illness in a low resource rural setting in India.

Science.gov (United States)

Saha, Siddhartha; Gupta, Vivek; Dawood, Fatimah S; Broor, Shobha; Lafond, Kathryn E; Chadha, Mandeep S; Rai, Sanjay K; Krishnan, Anand

2018-01-01

To estimate rates of community-level influenza-like-illness (ILI) and influenza-associated ILI in rural north India. During 2011, we conducted household-based healthcare utilization surveys (HUS) for any acute medical illness (AMI) in preceding 14days among residents of 28villages of Ballabgarh, in north India. Concurrently, we conducted clinic-based surveillance (CBS) in the area for AMI episodes with illness onset ≤3days and collected nasal and throat swabs for influenza virus testing using real-time polymerase chain reaction. Retrospectively, we applied ILI case definition (measured/reported fever and cough) to HUS and CBS data. We attributed 14days of risk-time per person surveyed in HUS and estimated community ILI rate by dividing the number of ILI cases in HUS by total risk-time. We used CBS data on influenza positivity and applied it to HUS-based community ILI rates by age, month, and clinic type, to estimate the community influenza-associated ILI rates. The HUS of 69,369 residents during the year generated risk-time of 3945 person-years (p-y) and identified 150 (5%, 95%CI: 4-6) ILI episodes (38 ILI episodes/1,000 p-y; 95% CI 32-44). Among 1,372 ILI cases enrolled from clinics, 126 (9%; 95% CI 8-11) had laboratory-confirmed influenza (A (H3N2) = 72; B = 54). After adjusting for age, month, and clinic type, overall influenza-associated ILI rate was 4.8/1,000 p-y; rates were highest among children value of influenza vaccination among target groups.

Complement Activation Induces Neutrophil Adhesion and Neutrophil-Platelet Aggregate Formation on Vascular Endothelial Cells

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Magdalena Riedl

2017-01-01

Discussion: Therefore, our findings of (i neutrophils adhering to complement-activated endothelial cells, (ii the formation of neutrophil-platelet aggregates on endothelial cells, and (iii the ability of aHUS serum to induce similar effects identify a possible role for neutrophils in aHUS manifestation.

Management of hemolytic-uremic syndrome in children.

Science.gov (United States)

Grisaru, Silviu

2014-01-01

Acute renal failure associated with a fulminant, life-threatening systemic disease is rare in previously healthy young children; however, when it occurs, the most common cause is hemolytic-uremic syndrome (HUS). In most cases (90%), this abrupt and devastating illness is a result of ingestion of food or drink contaminated with pathogens that produce very potent toxins. Currently, there are no proven treatment options that can directly inactivate the toxin or effectively interfere with the cascade of destructive events triggered by the toxin once it gains access to the bloodstream and binds its receptor. However, HUS is self-limited, and effective supportive management during the acute phase is proven to be a life saver for children affected by HUS. A minority of childhood HUS cases, approximately 5%, are caused by various genetic mutations causing uncontrolled activation of the complement system. These children, who used to have a poor prognosis leading to end-stage renal disease, now have access to exciting new treatment options that can preserve kidney function and avoid disease recurrences. This review provides a summary of the current knowledge on the epidemiology, pathophysiology, and clinical presentation of childhood HUS, focusing on a practical approach to best management measures.

Dehydration at admission increased the need for dialysis in hemolytic uremic syndrome children.

Science.gov (United States)

Balestracci, Alejandro; Martin, Sandra Mariel; Toledo, Ismael; Alvarado, Caupolican; Wainsztein, Raquel Eva

2012-08-01

Oligoanuric forms of postdiarrheal hemolytic uremic syndrome (D+ HUS) usually have more severe acute stage and higher risk of chronic sequelae than nonoligoanuric forms. During the diarrheal phase, gastrointestinal losses could lead to dehydration with pre-renal injury enhancing the risk of oligoanuric D+ HUS. Furthermore, it had been shown that intravenous volume expansion during the prodromal phase could decrease the frequency of oligoanuric renal failure. Thus, we performed this retrospective study to determine whether dehydration on admission is associated with increased need for dialysis in D+ HUS patients. Data from 137 children was reviewed, which were divided into two groups according to their hydration status at admission: normohydrated (n = 86) and dehydrated (n = 51). Laboratory parameters of the dehydrated patients reflected expected deteriorations (higher urea, higher hematocrit and lower sodium, bicarbonate, and pH) than normohydrated ones. Likewise, the dehydrated group had a higher rate of vomiting and need for dialysis (70.6 versus 40.7 %, p = 0.0007). Our data suggests that dehydration at hospital admission might represent a concomitant factor aggravating the intrinsic renal disease in D+ HUS patients increasing the need for dialysis. Therefore, the early recognition of patients at risk of D+ HUS is encouraged to guarantee a well-hydrated status.

Microbiological and serological control of Escherichia coli O157: H7 in kindergarten staff in Buenos Aires city and suburban areas

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Romina J. Fernández-Brando

2017-06-01

Full Text Available Shiga toxin (Stx-producing Escherichia coli (STEC infections are implicated in the development of the life-threatening hemolytic-uremic syndrome (HUS. Despite the magnitude of the social and economic problems caused by HUS, no licensed vaccine or effective therapy is currently available for human use. Prevention of STEC infections continues being the most important measure to reduce HUS incidence. This is especially true for Argentina where HUS incidence among children is extremely high and shows an endemic pattern. The aim of this work was to investigate serologically adult staff of kindergartens in Buenos Aires city and suburban areas in order to detect possible carriers, and to educate personnel about good practices to reduce HUS transmission. We also assessed the microbiological quality of water and meal samples from the same kindergartens. We tested 67 healthy adults, 13 water supplies and 6 meals belonging to 6 public kindergartens. We analysed hand swabs for isolation of STEC and serum samples for the presence of antibodies against Stx and lipopolysaccharide (LPS of O157 serogroup. We identified 46 Stx2-positive individuals, but only 7 for O157 LPS. No presence of STEC pathogens was detected in hands of staff, water or meal samples

Shiga Toxin in Enterohemorrhagic E.coli: regulation and novel antivirulence strategies

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Vanessa eSperandio

2012-06-01

Full Text Available Enterohemorrhagic Escherichia coli O157:H7 infects about 73,000 people annually in the USA and is a major cause of outbreaks of bloody diarrhea worldwide, and. In 5 to 7% of the cases, the person infected develops the potentially fatal sequelae hemolytic uremic syndrome (HUS, characterized by acute kidney failure. A hallmark of EHEC pathogenesis and cause of HUS is the production of Shiga toxin (Stx. Stx was first described by Kiyoshi Shiga in Shigella dysenterae serotype I and later discovered in EHEC, and it has been linked to HUS since 1983. Many factors regulate the production of Stx, including temperature, growth phase, antibiotics, reactive oxygen species and quorum sensing. Currently, there is no effective treatment or prophylaxis for HUS. Since the use of antibiotics is not advised to treat EHEC infections because it triggers Stx production, alternative antibacterial strategies need to be developed. Quorum sensing inhibitors represent a novel class of antibacterial compounds, which have the advantage of not interfering on bacterial growth, thereby without selective pressure that can lead to appearance of resistant strains. In this review, we discuss factors that regulate Stx production in EHEC as well as novel strategies to fight Stx and minimize development to HUS in EHEC-infected patients.

Atypical relapse of hemolytic uremic syndrome after transplantation

NARCIS (Netherlands)

Olie, Karolien H.; Florquin, Sandrine; Groothoff, Jaap W.; Verlaak, René; Strain, Lisa; Goodship, Timothy H. J.; Weening, Jan J.; Davin, Jean-Claude

2004-01-01

Atypical hemolytic uremic syndrome (HUS) frequently leads to end-stage renal failure and can relapse after transplantation. A 12-year-old girl presenting with familial atypical HUS with a factor H mutation was successfully transplanted 6 years after a first transplant that had failed because of

Verocytotoxin inhibits mitogenesis and protein synthesis in purified human glomerular mesangial cells without affecting cell viability: Evidence for two distinct mechanisms

NARCIS (Netherlands)

Setten, P.A. van; Hinsbergh, V.W.M. van; Heuvel, L.P.W.J. van den; Velden, T.J.A.N. van der; Kar, N.C.A.J. van de; Krebbers, R.J.M.; Karmali, M.A.; Monnens, L.A.H.

1997-01-01

Acute renal failure is one of the hallmarks of the hemolytic uremic syndrome (HUS). Infection with a verocytotoxin (VT)- or Shiga-like toxin (SLT)-producing Escherichia coli has been strongly implicated in the etiology of the epidemic form of HUS. The functional receptor for these closely related

Familial Atypical Hemolytic Uremic Syndrome: A Review of Its Genetic and Clinical Aspects

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Fengxiao Bu

2012-01-01

Full Text Available Atypical hemolytic uremic syndrome (aHUS is a rare renal disease (two per one million in the USA characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Both sporadic (80% of cases and familial (20% of cases forms are recognized. The study of familial aHUS has implicated genetic variation in multiple genes in the complement system in disease pathogenesis, helping to define the mechanism whereby complement dysregulation at the cell surface level leads to both sporadic and familial disease. This understanding has culminated in the use of Eculizumab as first-line therapy in disease treatment, significantly changing the care and prognosis of affected patients. However, even with this bright outlook, major challenges remain to understand the complexity of aHUS at the genetic level. It is possible that a more detailed picture of aHUS can be translated to an improved understanding of disease penetrance, which is highly variable, and response to therapy, both in the short and long terms.

Severe pneumococcal hemolytic uremic syndrome in an 8-month-old girl

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Tahar Gargah

2012-01-01

Full Text Available The hemolytic uremic syndrome (HUS, characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure, represents one of the major causes of acute renal failure in infancy and childhood. The typical form occurring after an episode of diarrhea caused by Escherichia coli is the most frequent in children. Other microorganisms also may be responsible for HUS, such as Streptococcus pneumoniae, which causes more severe forms of the disease. We report an 8-month-old girl who presented with pneumonia and subsequently developed HUS. Renal biopsy showed characteristic lesion of thrombotic microangiopathy and extensive cortical necrosis. She was managed with peritoneal dialysis but did not improve and developed severe sepsis due to staphylococcal peritonitis, resulting in the death of the patient. Streptococcus pneumoniae-induced HUS is uncommon, but results in severe disease in the young. There is a high risk of these patients developing end-stage kidney disease in the long term.

Estimation of community-level influenza-associated illness in a low resource rural setting in India.

Directory of Open Access Journals (Sweden)

Siddhartha Saha

Full Text Available To estimate rates of community-level influenza-like-illness (ILI and influenza-associated ILI in rural north India.During 2011, we conducted household-based healthcare utilization surveys (HUS for any acute medical illness (AMI in preceding 14days among residents of 28villages of Ballabgarh, in north India. Concurrently, we conducted clinic-based surveillance (CBS in the area for AMI episodes with illness onset ≤3days and collected nasal and throat swabs for influenza virus testing using real-time polymerase chain reaction. Retrospectively, we applied ILI case definition (measured/reported fever and cough to HUS and CBS data. We attributed 14days of risk-time per person surveyed in HUS and estimated community ILI rate by dividing the number of ILI cases in HUS by total risk-time. We used CBS data on influenza positivity and applied it to HUS-based community ILI rates by age, month, and clinic type, to estimate the community influenza-associated ILI rates.The HUS of 69,369 residents during the year generated risk-time of 3945 person-years (p-y and identified 150 (5%, 95%CI: 4-6 ILI episodes (38 ILI episodes/1,000 p-y; 95% CI 32-44. Among 1,372 ILI cases enrolled from clinics, 126 (9%; 95% CI 8-11 had laboratory-confirmed influenza (A (H3N2 = 72; B = 54. After adjusting for age, month, and clinic type, overall influenza-associated ILI rate was 4.8/1,000 p-y; rates were highest among children <5 years (13; 95% CI: 4-29 and persons≥60 years (11; 95%CI: 2-30.We present a novel way to use HUS and CBS data to generate estimates of community burden of influenza. Although the confidence intervals overlapped considerably, higher point estimates for burden among young children and older adults shows the utility for exploring the value of influenza vaccination among target groups.

76 FR 13191 - Agency Forms Undergoing Paperwork Reduction Act Review

Science.gov (United States)

2011-03-10

.... Proposed Project FoodNet Non-O157 Shiga toxin-Producing E. coli Study: Assessment of Risk Factors for... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [30-Day-11-11BI... cases, life-threatening hemolytic uremic syndrome (HUS). HUS occurs most frequently following infection...

Et lille hus i byen

DEFF Research Database (Denmark)

. Bebyggelserne, der blev opført som billige arbejderkvarterer, er i dag eftertragtede enklaver for velstillede københavnere. Populariteten bunder ikke alene husenes historie, men også i en række andre forhold, som arkitekter og planlæggere kan lære af i dag. I en tid med et stort behov for billige boliger, er...

Grib muligheden - i mulighedernes hus

DEFF Research Database (Denmark)

Nøttrup, Jonna

2007-01-01

Metodeudvikling på Bostedet Orion, Hillerød. Et socialpsykiatrisk bosted for sindslidende med multiple problemstillinger. Støttet af SL´s udviklingsfond.......Metodeudvikling på Bostedet Orion, Hillerød. Et socialpsykiatrisk bosted for sindslidende med multiple problemstillinger. Støttet af SL´s udviklingsfond....

Management of hemolytic-uremic syndrome in children

Directory of Open Access Journals (Sweden)

Grisaru S

2014-06-01

Full Text Available Silviu GrisaruUniversity of Calgary, Alberta Children's Hospital, Calgary, Alberta, CanadaAbstract: Acute renal failure associated with a fulminant, life-threatening systemic disease is rare in previously healthy young children; however, when it occurs, the most common cause is hemolytic-uremic syndrome (HUS. In most cases (90%, this abrupt and devastating illness is a result of ingestion of food or drink contaminated with pathogens that produce very potent toxins. Currently, there are no proven treatment options that can directly inactivate the toxin or effectively interfere with the cascade of destructive events triggered by the toxin once it gains access to the bloodstream and binds its receptor. However, HUS is self-limited, and effective supportive management during the acute phase is proven to be a life saver for children affected by HUS. A minority of childhood HUS cases, approximately 5%, are caused by various genetic mutations causing uncontrolled activation of the complement system. These children, who used to have a poor prognosis leading to end-stage renal disease, now have access to exciting new treatment options that can preserve kidney function and avoid disease recurrences. This review provides a summary of the current knowledge on the epidemiology, pathophysiology, and clinical presentation of childhood HUS, focusing on a practical approach to best management measures.Keywords: hemolytic, uremic, E.coli O157:H7, thrombotic, microangiopathy, complement system

Long-term health-related quality of life and psychological adjustment in children after haemolytic-uraemic syndrome.

Science.gov (United States)

Werner, Helene; Buder, Kathrin; Landolt, Markus A; Neuhaus, Thomas J; Laube, Guido F; Spartà, Giuseppina

2017-05-01

In children after haemolytic-uraemic syndrome (HUS), little is known about long-term health-related quality of life (HRQoL) and psychological adjustment as defined by behavioural problems, depressive symptoms and post-traumatic stress symptoms. Sixty-two paediatric patients with a history of HUS were included in this study. Medical data of the acute HUS episode were retrieved retrospectively from hospital records. Data on the clinical course at study investigation were assessed by clinical examination and laboratory evaluation. HRQoL and psychological adjustment data were measured by standardised, parent- and self-reported questionnaires. Haemolytic-uraemic syndrome was diagnosed at a mean of 6.5 years before the initiation of the study (standard deviation 2.9, range 0.1-15.7) years. Among the preschool children, parents reported that their child was less lively and energetic (HRQoL emotional dimension), while no increased behavioural problems were reported. In the school-age children, self- and proxy-reported HRQoL was well within or even above the norms, while increased total behavioural problems were found. The school-age children reported no increased depression scores. Also none of the children met the criteria for full or partial HUS-associated posttraumatic stress disorder. Healthcare providers should be particularly alert to behavioural problems in school-age children with a history of HUS and to lower HRQoL in preschool children.

Ouabain Protects Human Renal Cells against the Cytotoxic Effects of Shiga Toxin Type 2 and Subtilase Cytotoxin

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María M. Amaral

2017-07-01

Full Text Available Hemolytic uremic syndrome (HUS is one of the most common causes of acute renal failure in children. The majority of cases are associated with Shiga toxin (Stx-producing Escherichia coli (STEC. In Argentina, HUS is endemic and presents the highest incidence rate in the world. STEC strains expressing Stx type 2 (Stx2 are responsible for the most severe cases of this pathology. Subtilase cytotoxin (SubAB is another STEC virulence factor that may contribute to HUS pathogenesis. To date, neither a licensed vaccine nor effective therapy for HUS is available for humans. Considering that Ouabain (OUA may prevent the apoptosis process, in this study we evaluated if OUA is able to avoid the damage caused by Stx2 and SubAB on human glomerular endothelial cells (HGEC and the human proximal tubule epithelial cell (HK-2 line. HGEC and HK-2 were pretreated with OUA and then incubated with the toxins. OUA protected the HGEC viability from Stx2 and SubAB cytotoxic effects, and also prevented the HK-2 viability from Stx2 effects. The protective action of OUA on HGEC and HK-2 was associated with a decrease in apoptosis and an increase in cell proliferation. Our data provide evidence that OUA could be considered as a therapeutic strategy to avoid the renal damage that precedes HUS.

Factor H C-Terminal Domains Are Critical for Regulation of Platelet/Granulocyte Aggregate Formation

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Adam Z. Blatt

2017-11-01

Full Text Available Platelet/granulocyte aggregates (PGAs increase thromboinflammation in the vasculature, and PGA formation is tightly controlled by the complement alternative pathway (AP negative regulator, Factor H (FH. Mutations in FH are associated with the prothrombotic disease atypical hemolytic uremic syndrome (aHUS, yet it is unknown whether increased PGA formation contributes to the thrombosis seen in patients with aHUS. Here, flow cytometry assays were used to evaluate the effects of aHUS-related mutations on FH regulation of PGA formation and characterize the mechanism. Utilizing recombinant fragments of FH spanning the entire length of the protein, we mapped the regions of FH most critical for limiting AP activity on the surface of isolated human platelets and neutrophils, as well as the regions most critical for regulating PGA formation in human whole blood stimulated with thrombin receptor-activating peptide (TRAP. FH domains 19–20 were the most critical for limiting AP activity on platelets, neutrophils, and at the platelet/granulocyte interface. The role of FH in PGA formation was attributed to its ability to regulate AP-mediated C5a generation. AHUS-related mutations in domains 19–20 caused differential effects on control of PGA formation and AP activity on platelets and neutrophils. Our data indicate FH C-terminal domains are key for regulating PGA formation, thus increased FH protection may have a beneficial impact on diseases characterized by increased PGA formation, such as cardiovascular disease. Additionally, aHUS-related mutations in domains 19–20 have varying effects on control of TRAP-mediated PGA formation, suggesting that some, but not all, aHUS-related mutations may cause increased PGA formation that contributes to excessive thrombosis in patients with aHUS.

Blood urea nitrogen to serum creatinine ratio is an accurate predictor of outcome in diarrhea-associated hemolytic uremic syndrome, a preliminary study.

Science.gov (United States)

Keenswijk, Werner; Vanmassenhove, Jill; Raes, Ann; Dhont, Evelyn; Vande Walle, Johan

2017-03-01

Diarrhea-associated hemolytic uremic syndrome (D+HUS) is a common thrombotic microangiopathy during childhood and early identification of parameters predicting poor outcome could enable timely intervention. This study aims to establish the accuracy of BUN-to-serum creatinine ratio at admission, in addition to other parameters in predicting the clinical course and outcome. Records were searched for children between 1 January 2008 and 1 January 2015 admitted with D+HUS. A complicated course was defined as developing one or more of the following: neurological dysfunction, pancreatitis, cardiac or pulmonary involvement, hemodynamic instability, and hematologic complications while poor outcome was defined by death or development of chronic kidney disease. Thirty-four children were included from which 11 with a complicated disease course/poor outcome. Risk of a complicated course/poor outcome was strongly associated with oliguria (p = 0.000006) and hypertension (p = 0.00003) at presentation. In addition, higher serum creatinine (p = 0.000006) and sLDH (p = 0.02) with lower BUN-to-serum creatinine ratio (p = 0.000007) were significantly associated with development of complications. A BUN-to-sCreatinine ratio ≤40 at admission was a sensitive and highly specific predictor of a complicated disease course/poor outcome. A BUN-to-serum Creatinine ratio can accurately identify children with D+HUS at risk for a complicated course and poor outcome. What is Known: • Oliguria is a predictor of poor long-term outcome in D+HUS What is New: • BUN-to-serum Creatinine ratio at admission is an entirely novel and accurate predictor of poor outcome and complicated clinical outcome in D+HUS • Early detection of the high risk group in D+HUS enabling early treatment and adequate monitoring.

Habitat Evaluation Procedures (HEP) Report; Tacoma Creek South Project, Technical Report 2003-2005.

Energy Technology Data Exchange (ETDEWEB)

Entz, Ray

2005-02-01

On July 6, 2004, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Tacoma Creek South property, an acquisition completed by the Kalispel Tribe of Indians in June 2004. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, muskrat, yellow warbler, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Tacoma Creek South Project provides a total of 190.79 Habitat Units (HUs) for the species evaluated. Emergent wetlands provide 20.51 HUs for Canada goose, mallard, and muskrat. Grassland provides 1.65 HUs for Canada goose and mallard. Scrub-shrub vegetation provides 11.76 HUs for mallard, yellow warbler, and white-tailed deer. Conifer forest habitat provides 139.92 HUs for bald eagle, black-capped chickadee, and white-tailed deer. Deciduous forest also provides 19.15 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. The objective of using HEP at the Tacoma Creek South Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

EVALUATION OF BONE MINERALIZATION BY COMPUTED TOMOGRAPHY IN WILD AND CAPTIVE EUROPEAN COMMON SPADEFOOTS (PELOBATES FUSCUS), IN RELATION TO EXPOSURE TO ULTRAVIOLET B RADIATION AND DIETARY SUPPLEMENTS.

Science.gov (United States)

van Zijll Langhout, Martine; Struijk, Richard P J H; Könning, Tessa; van Zuilen, Dick; Horvath, Katalin; van Bolhuis, Hester; Maarschalkerweerd, Roelof; Verstappen, Frank

2017-09-01

Captive rearing programs have been initiated to save the European common spadefoot (Pelobates fuscus), a toad species in the family of Pelobatidae, from extinction in The Netherlands. Evaluating whether this species needs ultraviolet B (UVB) radiation and/or dietary supplementation for healthy bone development is crucial for its captive management and related conservation efforts. The bone mineralization in the femurs and the thickest part of the parietal bone of the skulls of European common spadefoots (n = 51) was measured in Hounsfield units (HUs) by computed tomography. One group, containing adults (n = 8) and juveniles (n = 13), was reared at ARTIS Amsterdam Royal Zoo without UVB exposure. During their terrestrial lifetime, these specimens received a vitamin-mineral supplement. Another group, containing adults (n = 8) and juveniles (n = 10), was reared and kept in an outdoor breeding facility in Münster, Germany, with permanent access to natural UVB light, without vitamin-mineral supplementation. The HUs in the ARTIS and Münster specimens were compared with those in wild specimens (n = 12). No significant difference was found between the HUs in the femurs of both ARTIS and Münster adults and wild adults (P = 0.537; P = 0.181). The HUs in the skulls of both captive-adult groups were significantly higher than in the skulls of wild specimens (P = 0.020; P = 0.005). The HUs in the femurs of the adult ARTIS animals were significantly higher than the HUs in the femurs of the adult Münster animals (P = 0.007). The absence of UVB radiation did not seem to have a negative effect on the bone development in the terrestrial stage. This suggests that this nocturnal, subterrestrial amphibian was able to extract sufficient vitamin D 3 from its diet and did not rely heavily on photobiosynthesis through UVB exposure.

Hellsgate Big Game Winter Range Wildlife Mitigation Project : Annual Report 2008.

Energy Technology Data Exchange (ETDEWEB)

Whitney, Richard P.; Berger, Matthew T.; Rushing, Samuel; Peone, Cory

2009-01-01

The Hellsgate Big Game Winter Range Wildlife Mitigation Project (Hellsgate Project) was proposed by the Confederated Tribes of the Colville Reservation (CTCR) as partial mitigation for hydropower's share of the wildlife losses resulting from Chief Joseph and Grand Coulee Dams. At present, the Hellsgate Project protects and manages 57,418 acres (approximately 90 miles2) for the biological requirements of managed wildlife species; most are located on or near the Columbia River (Lake Rufus Woods and Lake Roosevelt) and surrounded by Tribal land. To date we have acquired about 34,597 habitat units (HUs) towards a total 35,819 HUs lost from original inundation due to hydropower development. In addition to the remaining 1,237 HUs left unmitigated, 600 HUs from the Washington Department of Fish and Wildlife that were traded to the Colville Tribes and 10 secure nesting islands are also yet to be mitigated. This annual report for 2008 describes the management activities of the Hellsgate Big Game Winter Range Wildlife Mitigation Project (Hellsgate Project) during the past year.

Influenza-associated thrombotic microangiopathies.

Science.gov (United States)

Bitzan, Martin; Zieg, Jakub

2017-09-07

Thrombotic microangiopathy (TMA) refers to phenotypically similar disorders, including hemolytic uremic syndromes (HUS) and thrombotic thrombocytopenic purpura (TTP). This review explores the role of the influenza virus as trigger of HUS or TTP. We conducted a literature survey in PubMed and Google Scholar using HUS, TTP, TMA, and influenza as keywords, and extracted and analyzed reported epidemiological and clinical data. We identified 25 cases of influenza-associated TMA. Five additional cases were linked to influenza vaccination and analyzed separately. Influenza A was found in 83%, 10 out of 25 during the 2009 A(H1N1) pandemic. Two patients had bona fide TTP with ADAMTS13 activity rational treatment approaches.

Shillapoo Wildlife Area 2007 Follow-up HEP Report.

Energy Technology Data Exchange (ETDEWEB)

Ashley, Paul R.

2008-03-01

In April and May 2007 the Regional HEP Team (RHT) conducted a follow-up HEP analysis on the Egger (612 acres) and Herzog (210 acres) parcels located at the north end of the Shillapoo Wildlife Area. The Egger and Herzog parcels have been managed with Bonneville Power Administration funds since acquired in 1998 and 2001 respectively. Slightly more than 936 habitat units (936.47) or 1.14 HUs per acre was generated as an outcome of the 2007 follow-up HEP surveys. Results included 1.65 black-capped chickadee HUs, 280.57 great blue heron HUs, 581.45 Canada goose HUs, 40 mallard HUs, and 32.80 mink HUs. Introduction A follow-up Habitat Evaluation Procedures (HEP) (USFWS 1980) analysis was conducted by the Columbia Basin Fish and Wildlife Authority's (CBFWA) Regional HEP Team (RHT) during April and May 2007 to document changes in habitat quality and to determine the number of habitat units (HUs) to credit Bonneville Power Administration (BPA) for providing operation and maintenance (O&M) funds since WDFW acquired the parcels. The 2007 follow-up HEP evaluation was limited to Shillapoo Wildlife Area (SWA) parcels purchased with Bonneville Power Administration funds. D. Budd (pers. comm.) reported WDFW purchased the 612 acre Egger Farms parcel on November 2, 1998 for $1,737,0001 and the 210 acre Herzog acquisition on June 21, 2001 for $500,000 with Memorandum of Agreement funds (BPA and WDFW 1996) as partial fulfillment of BPA's wildlife mitigation obligation for construction of Bonneville and John Day Dams (Rasmussen and Wright 1989). Anticipating the eventual acquisition of the Egger and Herzog properties, WDFW conducted HEP surveys on these lands in 1994 to determine the potential number of habitat units to be credited to BPA. As a result, HEP surveys and habitat unit calculations were completed as much as seven years prior to acquiring the sites. The term 'Shillapoo Wildlife Area' will be used to describe only the Herzog and Egger parcels in this

Ocular involvement in paediatric haemolytic uraemic syndrome.

Science.gov (United States)

Sturm, Veit; Menke, Marcel N; Landau, Klara; Laube, Guido F; Neuhaus, Thomas J

2010-11-01

The aim of this study was to estimate the frequency and severity of ocular involvement in paediatric patients with haemolytic uraemic syndrome (HUS). The study was designed as an institutional, retrospective, observational case series. Charts for all 87 paediatric patients with HUS treated at the University Children's Hospital Zurich between 1995 and 2007 were reviewed. Patients with ocular involvement were identified and clinical findings presented. Three of 69 examined patients with HUS showed ocular involvement. Ophthalmic findings in two children were consistent with bilateral Purtscher retinopathy, showing multiple haemorrhages, exudations and superficial retinal whitening. The third child presented with bilateral isolated central intraretinal haemorrhages as a milder form of ocular involvement. In one of the children with Purtscher retinopathy, laser photocoagulation was required for bilateral rubeosis irides and development of disc neovascularization. Longterm outcomes in the two severely affected children showed decreased visual acuity caused by partial atrophy of the optic nerves. In the milder case visual acuity was not impaired at any time. A minority of paediatric patients with HUS developed ocular involvement. Acute ocular findings varied in severity from isolated intraretinal haemorrhages to Purtscher-like retinopathy with retinal ischaemia. Longterm complications included the development of neovascularizations and consecutive optic nerve atrophy. Although ocular involvement in HUS seems to be rare, physicians should be aware of this complication because of its possible vision-endangering consequences. © 2009 The Authors. Journal compilation © 2009 Acta Ophthalmol.

Hemolytic Uremic Syndrome: Late Renal Injury and Changing Incidence—A Single Centre Experience in Canada

Directory of Open Access Journals (Sweden)

Pierre Robitaille

2012-01-01

Full Text Available Aims. To assess trends in the incidence of pediatric diarrhea-associated hemolytic uremic syndrome (D+ HUS and document long-term renal sequelae. Methods. We conducted a retrospective cohort study of children with D+ HUS admitted to a tertiary care pediatric hospital in Montreal, Canada, from 1976 to 2010. In 2010, we recontacted patients admitted before 2000. Results. Of 337 cases, median age at presentation was 3.01 years (range 0.4–14. Yearly incidence peaked in 1988 and 1994-95, returning to near-1977 levels since 2003. Twelve patients (3.6% died and 19 (5.6% experienced long-term renal failure. Almost half (47% The patients required dialysis. Need for dialysis was the best predictor of renal sequelae, accounting for 100% of severe complications. Of children followed ≥1 year (, mean follow-up years, 19 had severe and 18 mild-to-moderate kidney injury, a total sequelae rate, of 18.6%. Ten years or more after-HUS (, mean follow-up years, 8 (9.4% patients demonstrated serious complications and 22 (25.9% mild-to-moderate, including 14 (16% microalbuminuria: total sequelae, 35.3%. Conclusions. Patients with D+ HUS should be monitored at least 5 years, including microalbuminuria testing, especially if dialysis was required. The cause of the declining incidence of D+HUS is elusive. However, conceivably, improved public health education may have played an important role in the prevention of food-borne disease.

Hemolytic uremic syndrome

Directory of Open Access Journals (Sweden)

Faruk Öktem

2011-12-01

Full Text Available Haemolytic uremic syndrome (HUS is a severe disease with microangiopathic anemia, thrombocytopenia and leading cause of acute renal failure in children. Several etiological factors causing to HUS have been identified, like infections, genetic mutations, drugs, systemic diseases. In this review, we present the new classification of the disease, detailed information about pathogenesis, diagnostic methods and therapeutic approaches.

En isoleret verden er en bedre verden

DEFF Research Database (Denmark)

Enrum, Nils

2014-01-01

Man skal ikke kaste med sten, hvis man bor i et hus med energimærke D ... Men problemet med varmetab fra danske boliger er til at løse......Man skal ikke kaste med sten, hvis man bor i et hus med energimærke D ... Men problemet med varmetab fra danske boliger er til at løse...

West Foster Creek Expansion Project 2007 HEP Report.

Energy Technology Data Exchange (ETDEWEB)

Ashley, Paul R.

2008-02-01

During April and May 2007, the Columbia Basin Fish and Wildlife Authority's (CBFWA) Regional HEP Team (RHT) conducted baseline Habitat Evaluation Procedures (HEP) (USFWS 1980, 1980a) analyses on five parcels collectively designated the West Foster Creek Expansion Project (3,756.48 acres). The purpose of the HEP analyses was to document extant habitat conditions and to determine how many baseline/protection habitat units (HUs) to credit Bonneville Power Administration (BPA) for funding maintenance and enhancement activities on project lands as partial mitigation for habitat losses associated with construction of Grand Coulee and Chief Joseph Dams. HEP evaluation models included mule deer (Odocoileus hemionus), western meadowlark (Sturnella neglecta), sharp-tailed grouse, (Tympanuchus phasianellus), Bobcat (Lynx rufus), mink (Neovison vison), mallard (Anas platyrhynchos), and black-capped chickadee (Parus atricapillus). Combined 2007 baseline HEP results show that 4,946.44 habitat units were generated on 3,756.48 acres (1.32 HUs per acre). HEP results/habitat conditions were generally similar for like cover types at all sites. Unlike crediting of habitat units (HUs) on other WDFW owned lands, Bonneville Power Administration received full credit for HUs generated on these sites.

C3 Glomerulopathy and Atypical Hemolytic Uremic Syndrome: Two Important Manifestations of Complement System Dysfunction

Directory of Open Access Journals (Sweden)

Ravneet Bajwa

2018-02-01

Full Text Available The advances in our understanding of the alternative pathway have emphasized that uncontrolled hyperactivity of this pathway causes 2 distinct disorders that adversely impact the kidney. In the so-called atypical hemolytic uremic syndrome (aHUS, renal dysfunction occurs along with thrombocytopenia, anemia, and target organ injury to multiple organs, most commonly the kidney. On the other hand, in the so-termed C3 glomerulopathy, kidney involvement is not associated with thrombocytopenia, anemia, or other system involvement. In this report, we present 2 cases of alternative pathway dysfunction. The 60-year-old female patient had biopsy-proven C3 glomerulopathy, while the 32-year-old female patient was diagnosed with aHUS based on renal dysfunction, thrombocytopenia, anemia, and normal ADAMTS-13 level. The aHUS patient was successfully treated with the monoclonal antibody (eculizumab for complement blockade. The patient with C3 glomerulopathy did not receive the monoclonal antibody. In this patient, management focused on blood pressure and proteinuria control with an angiotensin-converting enzyme inhibitor. This article focuses on the clinical differences, pathophysiology, and treatment of aHUS and C3 glomerulopathy.

Velkommen til gældens hus

DEFF Research Database (Denmark)

Lunde, Jens

2015-01-01

De amerikanske professorer, Atif Mian og Amir Sufi, udgav i år den udmærkede og noget oversete bog »House of Debt«, der vender fortællingen om finanskrisen på hovedet. Anmeldelse af: Atif Mian og Amir Sufi: "House of Debt. How They (and You) Caused the Great Recession, and How We Can Prevent...

Litteraturens hus, livets værksted

DEFF Research Database (Denmark)

Munk, Kasper Green

2016-01-01

W.G. Sebalds ’Campo Santo’ er et vildt katalog over litteraturens pligt til at bringe lys og lindring i mørke tider. Forfatterens ukuelige tro på skrivekunstens nytte står tilsyneladende kun i modsætning til hans pessimistiske historiefilosofi . Nu udkommer Sebalds posthume bog også på dansk...

Habitat Evaluation Procedures (HEP) Report; Priest River Project, Technical Report 2005.

Energy Technology Data Exchange (ETDEWEB)

Entz, Ray

2005-05-01

On July 6, 2004, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Priest River property, an acquisition completed by the Kalispel Tribe of Indians in 2001. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, yellow warbler, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Priest River Project provides a total of 140.73 Habitat Units (HUs) for the species evaluated. Conifer forest habitat provides 60.05 HUs for bald eagle, black-capped chickadee, and white-tailed deer. Grassland meadow habitat provides 7.39 HUs for Canada goose and mallard. Scrub-shrub vegetation provides 71.13 HUs for mallard, yellow warbler, and white-tailed deer. Open water habitat provides 2.16 HUs for Canada goose and mallard. The objective of using HEP at the Priest River Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

Habitat Evaluation Procedures (HEP) Report; North Eaton Lake, Technical Report 2005.

Energy Technology Data Exchange (ETDEWEB)

Entz, Ray

2005-11-01

On July 6, 2005, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the North Eaton Lake property, an acquisition completed by the Kalispel Tribe of Indians in November 2004. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, muskrat, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The North Eaton Lake Project provides a total of 235.05 Habitat Units (HUs) for the species evaluated. Open water habitat provides 9.38 HUs for Canada goose, mallard and muskrat. Emergent wetland habitat provides 11.36 HUs for Canada goose, mallard and muskrat. Forested wetland provides 10.97 HUs for bald eagle, black-capped chickadee, mallard and white-tailed deer. Conifer forest habitat provides 203.34 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. The objective of using HEP at the North Eaton Lake Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

Habitat Evaluation Procedures (HEP) Report; Gamblin Lake, Technical Report 2005.

Energy Technology Data Exchange (ETDEWEB)

Entz, Ray

2005-05-01

On August 12, 2003, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Gamblin Lake property, an acquisition completed by the Kalispel Tribe of Indians in December 2002. Evaluation species and appropriate models include bald eagle, black-capped chickadee, mallard, muskrat, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Gamblin Lake Project provides a total of 273.28 Habitat Units (HUs) for the species evaluated. Conifer forest habitat provides 127.92 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. Forested wetland habitat provides 21.06 HUs for bald eagle, black-caped chickadee, mallard, and white-tailed deer. Wet meadow provides 78.05 HUs for Canada goose and mallard. Emergent wetland habitat provides 46.25 HUs for mallard, muskrat, and Canada goose. The objective of using HEP at the Gamblin Lake Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

Efficacy of rituximab and plasmapharesis in an adult patient with antifactor H autoantibody-associated hemolytic uremic syndrome

Science.gov (United States)

Deville, Clemence; Garrouste, Cyril; Coppo, Paul; Evrard, Bertrand; Lautrette, Alexandre; Heng, Anne Elisabeth

2016-01-01

Abstract Antifactor H antibody (anti-CFHAb) is found in 6% to 25% cases of atypical hemolytic uremic syndrome (aHUS) in children, but has been only exceptionally reported in adults. There is no consensus about the best treatment for this type of aHUS. We report the case of an adult patient treated successfully with plasma exchange (PE), steroids, and rituximab. A 27-year-old Caucasian male presented to hospital with anemia, thrombocytopenia, and acute renal failure. One week earlier, he had digestive problems with diarrhea. The diagnosis of anti-CFHAb-associated aHUS (82,000 AU/mL) without CFHR gene mutations was established. He received Rituximab 375 mg/m2 (4 pulses) with PE and steroids. This treatment achieved renal and hematological remission at day (D) 31 and negative anti-CFHAb at D45 (<100 AU/mL). At D76, a fifth rituximab pulse was performed while CD19 was higher than 10/mm3. Steroids were stopped at month (M) 9. The patient has not relapsed during long-term follow-up (M39). Rituximab therapy can be considered for anti-CFHAb-associated aHUS. Monitoring of anti-CFHAb titer may help to guide maintenance therapeutic strategies including Rituximab infusion. PMID:27684863

Efficacy of rituximab and plasmapharesis in an adult patient with antifactor H autoantibody-associated hemolytic uremic syndrome: A case report and literature review.

Science.gov (United States)

Deville, Clemence; Garrouste, Cyril; Coppo, Paul; Evrard, Bertrand; Lautrette, Alexandre; Heng, Anne Elisabeth

2016-09-01

Antifactor H antibody (anti-CFHAb) is found in 6% to 25% cases of atypical hemolytic uremic syndrome (aHUS) in children, but has been only exceptionally reported in adults. There is no consensus about the best treatment for this type of aHUS. We report the case of an adult patient treated successfully with plasma exchange (PE), steroids, and rituximab.A 27-year-old Caucasian male presented to hospital with anemia, thrombocytopenia, and acute renal failure. One week earlier, he had digestive problems with diarrhea. The diagnosis of anti-CFHAb-associated aHUS (82,000 AU/mL) without CFHR gene mutations was established.He received Rituximab 375 mg/m (4 pulses) with PE and steroids. This treatment achieved renal and hematological remission at day (D) 31 and negative anti-CFHAb at D45 (<100 AU/mL). At D76, a fifth rituximab pulse was performed while CD19 was higher than 10/mm. Steroids were stopped at month (M) 9. The patient has not relapsed during long-term follow-up (M39).Rituximab therapy can be considered for anti-CFHAb-associated aHUS. Monitoring of anti-CFHAb titer may help to guide maintenance therapeutic strategies including Rituximab infusion.

Antibiotic treatment of verocytotoxin-producing Escherichia coli (VTEC) infection

DEFF Research Database (Denmark)

Agger, Morten; Scheutz, Flemming; Villumsen, Steen

2015-01-01

OBJECTIVES: A consensus has existed on not to treat verocytotoxin-producing Escherichia coli (VTEC)-infected individuals with antibiotics because of possible subsequent increased risk of developing haemolytic uraemic syndrome (HUS). The aim of this systematic review is to clarify the risk...... associated with antibiotic treatment during acute VTEC infection and in chronic VTEC carrier states. METHODS: A systematic search in PubMed identified 1 meta-analysis, 10 clinical studies and 22 in vitro/in vivo studies. RESULTS: Four clinical studies found an increased risk of HUS, four studies found...... no altered risk of HUS and two studies found a protective effect of antibiotics. In vitro and clinical studies suggest that DNA synthesis inhibitors should be avoided, whereas evidence from in vitro studies indicates that certain protein and cell wall synthesis inhibitors reduce the release of toxins from...

Targeting renin-angiotensin system in malignant hypertension in atypical hemolytic uremic syndrome

Directory of Open Access Journals (Sweden)

V Raghunathan

2017-01-01

Full Text Available Hypertension is common in hemolytic uremic syndrome (HUS and often difficult to control. Local renin-angiotensin activation is believed to be an important part of thrombotic microangiopathy, leading to a vicious cycle of progressive renal injury and intractable hypertension. This has been demonstrated in vitro via enhanced tissue factor expression on glomerular endothelial cells which is enhanced by angiotensin II. We report two pediatric cases of atypical HUS with severe refractory malignant hypertension, in which we targeted the renin-angiotensin system by using intravenous (IV enalaprilat, oral aliskiren, and oral enalapril with quick and dramatic response of blood pressure. Both drugs, aliskiren and IV enalaprilat, were effective in controlling hypertension refractory to multiple antihypertensive medications. These appear to be promising alternatives in the treatment of severe atypical HUS-induced hypertension and hypertensive emergency.

Vandrefalken i Sydgrønland

DEFF Research Database (Denmark)

Falk, Knud; Møller, Søren

2009-01-01

Præsentation i forbindelse med overrækkelse af Bodil Pedersen Fondens Natur- og Miljøpris, Fuglenes hus, 11. juni 2009. Se http://www.dof.dk/index.php?id=nyheder&s=nyheder&m=visning&nyhed_id=638......Præsentation i forbindelse med overrækkelse af Bodil Pedersen Fondens Natur- og Miljøpris, Fuglenes hus, 11. juni 2009. Se http://www.dof.dk/index.php?id=nyheder&s=nyheder&m=visning&nyhed_id=638...

Atypical haemolytic uraemic syndrome associated with a hybrid complement gene.

Directory of Open Access Journals (Sweden)

Julian P Venables

2006-10-01

Full Text Available BACKGROUND: Sequence analysis of the regulators of complement activation (RCA cluster of genes at chromosome position 1q32 shows evidence of several large genomic duplications. These duplications have resulted in a high degree of sequence identity between the gene for factor H (CFH and the genes for the five factor H-related proteins (CFHL1-5; aliases CFHR1-5. CFH mutations have been described in association with atypical haemolytic uraemic syndrome (aHUS. The majority of the mutations are missense changes that cluster in the C-terminal region and impair the ability of factor H to regulate surface-bound C3b. Some have arisen as a result of gene conversion between CFH and CFHL1. In this study we tested the hypothesis that nonallelic homologous recombination between low-copy repeats in the RCA cluster could result in the formation of a hybrid CFH/CFHL1 gene that predisposes to the development of aHUS. METHODS AND FINDINGS: In a family with many cases of aHUS that segregate with the RCA cluster we used cDNA analysis, gene sequencing, and Southern blotting to show that affected individuals carry a heterozygous CFH/CFHL1 hybrid gene in which exons 1-21 are derived from CFH and exons 22/23 from CFHL1. This hybrid encodes a protein product identical to a functionally significant CFH mutant (c.3572C>T, S1191L and c.3590T>C, V1197A that has been previously described in association with aHUS. CONCLUSIONS: CFH mutation screening is recommended in all aHUS patients prior to renal transplantation because of the high risk of disease recurrence post-transplant in those known to have a CFH mutation. Because of our finding it will be necessary to implement additional screening strategies that will detect a hybrid CFH/CFHL1 gene.

Diffusion-weighted imaging of the kidneys in haemolytic uraemic syndrome

International Nuclear Information System (INIS)

Herrmann, Jochen; Wenzel, Ulrich; Galler, Stephanie; Schoennagel, Bjoern P.; Bannas, Peter; Yamamura, Jin; Groth, Michael; Adam, Gerhard; Busch, Jasmin D.; Tozakidou, Magdalini; Petersen, Kay U.; Joekel, Michaela; Habermann, Christian R.

2017-01-01

To evaluate the kidneys of patients with haemolytic uraemic syndrome (HUS) using diffusion-weighted imaging (DWI) and Doppler ultrasound (US) compared with healthy controls. Fifteen patients (mean age 33.3 years; three male; 12 female) with diarrhoea-positive HUS and 15 healthy volunteers were prospectively evaluated with DWI and Doppler US. A total apparent diffusion coefficient (ADC TOT ), and ADCs predominantly reflecting microperfusion (ADC LOW ) and diffusion (ADC HIGH ) were calculated. Doppler US evaluated renal vascularity and flow. When compared with controls, kidneys affected by HUS showed reduced cortical ADC values (ADC TOT 1.79±0.22 vs. 2.04±0.1x10 -3 mm 2 /s, P 0.001), resulting in either low corticomedullary differences (11/15 patients) or an inverted corticomedullary pattern (4/15 patients). Reduction of cortical ADC values was associated with a decrease of cortical vascularity on Doppler US (ADC TOT , P<0.001; ADC LOW , P 0.047). Kidneys with complete absence of the cortical vasculature on Doppler US (four patients) also demonstrated limited diffusion (ADC HIGH , P 0.002). Low glomerular filtration rate, requirement for haemodialysis during hospitalization, and longer duration of haemodialysis were associated with decreased cortical diffusivity (ADC TOT: P 0.04, 0.007, and <0.001, respectively). DWI shows qualitative and quantitative abnormalities in kidneys affected by HUS, thereby extending the non-invasive assessment of renal parenchymal damage. (orig.)

Pneumococcal Induced T-activation with Resultant Thrombotic Microangiopathy

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J.W. Oliver

2010-01-01

Full Text Available Thrombotic microangiopathies are disorders resulting from platelet thromboses forming in the microvasculature with resultant schistocyte forms. Hemolytic uremic syndrome (HUS is a microangiopathic hemolytic anemia often complicated by acute renal failure in children. HUS is typically caused by bacterial infection, most commonly enterohemorrhagic Escherichia coli. Neuraminidase-producing organisms, such as Streptococcus pneumoniae have also been reported as potential etiologies. The pathogenesis in these cases involves cleavage of sialic acid residues from the surfaces of erythrocytes, platelets, and glomerular capillary endothelial cells, exposing the Thomsen-Friedenreich antigen, a process known as T-activation. We describe a 2-year-old girl who presented with pneumococcal pneumonia and sepsis ultimately resulting in a thrombotic microangiopathy with acute renal failure, most consistent with HUS. The patient's direct antiglobulin test was positive. Polyagglutination was observed with human adult serum, but not with umbilical cord serum. Her red blood cells (RBCs were reactive against peanut and soybean lectins, but not Salvia sclarea or Salvia horminum lectins. These findings are consistent with T-activation. Clinicians should be cognizant of the possibility of T-activation with resultant HUS in patients infected with neuraminidase-producing bacteria. Such patients may be difficult to identify using monoclonal typing antisera, as these typically do not have anti-T antibodies. Whether such patients are at risk for transfusion-associated hemolysis is debatable.

Chronic type B aortic dissection in association with Hemolyticuremic syndrome in a child

OpenAIRE

Gera, D. N.; Ghuge, P. P.; Gandhi, S.; Vanikar, A. V.; Shrimali, J. D.; Kute, V. B.; Trivedi, H. L.

2013-01-01

Aortic dissection (AD) is a potentially life-threatening medical emergency usually encountered in the elderly. Here, we report a 9-year-old child who was incidentally detected to have asymptomatic chronic type B dissecting aneurysm of aorta when he presented with relapse of Hemolytic uremic syndrome (HUS) without any genetic abnormalities like Marfan or Ehler-Danlos syndrome. To the best of our knowledge, this is the first case of AD associated with HUS in a child without any known associated...

Late Onset Cobalamin Disorder and Hemolytic Uremic Syndrome: A Rare Cause of Nephrotic Syndrome

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Gianluigi Ardissino

2017-01-01

Full Text Available Hemolytic uremic syndrome (HUS is an unrare and severe thrombotic microangiopathy (TMA caused by several pathogenetic mechanisms among which Shiga toxin-producing Escherichia coli infections and complement dysregulation are the most common. However, very rarely and particularly in neonates and infants, disorders of cobalamin metabolism (CblC can present with or be complicated by TMA. Herein we describe a case of atypical HUS (aHUS related to CblC disease which first presented in a previously healthy boy at age of 13.6 years. The clinical picture was initially dominated by nephrotic range proteinuria and severe hypertension followed by renal failure. The specific treatment with high dose of hydroxycobalamin rapidly obtained the remission of TMA and the complete recovery of renal function. We conclude that plasma homocysteine and methionine determinations together with urine organic acid analysis should be included in the diagnostic work-up of any patient with TMA and/or nephrotic syndrome regardless of age.

Quiescent complement in nonhuman primates during E coli Shiga toxin-induced hemolytic uremic syndrome and thrombotic microangiopathy.

Science.gov (United States)

Lee, Benjamin C; Mayer, Chad L; Leibowitz, Caitlin S; Stearns-Kurosawa, D J; Kurosawa, Shinichiro

2013-08-01

Enterohemorrhagic Escherichia coli (EHEC) produce ribosome-inactivating Shiga toxins (Stx1, Stx2) responsible for development of hemolytic uremic syndrome (HUS) and acute kidney injury (AKI). Some patients show complement activation during EHEC infection, raising the possibility of therapeutic targeting of complement for relief. Our juvenile nonhuman primate (Papio baboons) models of endotoxin-free Stx challenge exhibit full spectrum HUS, including thrombocytopenia, hemolytic anemia, and AKI with glomerular thrombotic microangiopathy. There were no significant increases in soluble terminal complement complex (C5b-9) levels after challenge with lethal Stx1 (n = 6) or Stx2 (n = 5) in plasma samples from T0 to euthanasia at 49.5 to 128 hours post-challenge. d-dimer and cell injury markers (HMGB1, histones) confirmed coagulopathy and cell injury. Thus, complement activation is not required for the development of thrombotic microangiopathy and HUS induced by EHEC Shiga toxins in these preclinical models, and benefits or risks of complement inhibition should be studied further for this infection.

Hemolytic uremic syndrome after bone marrow transplantation

Energy Technology Data Exchange (ETDEWEB)

Arai, Ayako; Sakamaki, Hisashi; Tanikawa, Shu [Tokyo Metropolitan Komagome Hospital (Japan)] [and others

1998-06-01

One hundred and thirteen patients who underwent autologous or allogeneic bone marrow transplantation (BMT) were investigated for the subsequent development of hemolytic uremic syndrome (HUS). HUS developed in seven patients (four males and three females, five acute lymphocytic leukemia (ALL), one acute myelogenous leukemia, one non-Hodgkin`s lymphoma) between 36-196 days after BMT. Four patients were recipients of autologous BMT and three were those of allogeneic BMT. Six patients were preconditioned with the regimens including fractionated total body irradiation (TBI). ALL and preconditioning regimen with TBI were suspected to be the risk factors for the development of HUS. Cyclosporin A (CSP) administration was discontinued in three patients who had been given CSP for graft-versus-host disease prophylaxis. Predonisolone was given to the three patients and plasma exchange was performed in one patient. Both hemolytic anemia and thrombocytopenia were resolved in virtually all patients, while creatinine elevation has persisted along with hypertension in one patient. (author)

Hemolytic Uremic Syndrome: New Developments in Pathogenesis and Treatment

Directory of Open Access Journals (Sweden)

Olivia Boyer

2011-01-01

Full Text Available Hemolytic uremic syndrome is defined by the characteristic triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. In children, most cases of HUS are caused by Shiga-toxin-producing bacteria, especially Escherichia coli O157:H7. Common vehicles of transmission include ground beef, unpasteurized milk, and municipal or swimming water. Shiga-toxin-associated HUS is a main cause of acute renal failure in young children. Management remains supportive as there is at present no specific therapy to ameliorate the prognosis. Immediate outcome is most often favourable but long-term renal sequelae are frequent due to nephron loss. Atypical HUS represents 5% of cases. In the past 15 years, mutations in complement regulators of the alternative pathway have been identified in almost 60% of cases, leading to excessive complement activation. The disease has a relapsing course and more than half of the patients either die or progress to end-stage renal failure. Recurrence after renal transplantation is frequent.

Chronic type B aortic dissection in association with Hemolyticuremic syndrome in a child.

Science.gov (United States)

Gera, D N; Ghuge, P P; Gandhi, S; Vanikar, A V; Shrimali, J D; Kute, V B; Trivedi, H L

2013-11-01

Aortic dissection (AD) is a potentially life-threatening medical emergency usually encountered in the elderly. Here, we report a 9-year-old child who was incidentally detected to have asymptomatic chronic type B dissecting aneurysm of aorta when he presented with relapse of Hemolytic uremic syndrome (HUS) without any genetic abnormalities like Marfan or Ehler-Danlos syndrome. To the best of our knowledge, this is the first case of AD associated with HUS in a child without any known associated genetic or inherited risk factors.

Diffusion-weighted imaging of the kidneys in haemolytic uraemic syndrome

Energy Technology Data Exchange (ETDEWEB)

Herrmann, Jochen [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg (Germany); University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Section of Pediatric Radiology, Hamburg (Germany); Wenzel, Ulrich [University Medical Center Hamburg-Eppendorf, III. Department of Internal Medicine, Hamburg (Germany); Galler, Stephanie; Schoennagel, Bjoern P.; Bannas, Peter; Yamamura, Jin; Groth, Michael; Adam, Gerhard [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg (Germany); Busch, Jasmin D.; Tozakidou, Magdalini [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Section of Pediatric Radiology, Hamburg (Germany); Petersen, Kay U. [University Hospital of Tuebingen, Department for Psychiatry and Psychotherapy, Section for Addiction Research and Therapy, Tuebingen (Germany); Joekel, Michaela [Siemens AG Healthcare, Hamburg (Germany); Habermann, Christian R. [Katholisches Marienkrankenhaus Hamburg, Department of Diagnostic and Interventional Radiology, Hamburg (Germany)

2017-11-15

To evaluate the kidneys of patients with haemolytic uraemic syndrome (HUS) using diffusion-weighted imaging (DWI) and Doppler ultrasound (US) compared with healthy controls. Fifteen patients (mean age 33.3 years; three male; 12 female) with diarrhoea-positive HUS and 15 healthy volunteers were prospectively evaluated with DWI and Doppler US. A total apparent diffusion coefficient (ADC{sub TOT}), and ADCs predominantly reflecting microperfusion (ADC{sub LOW}) and diffusion (ADC{sub HIGH}) were calculated. Doppler US evaluated renal vascularity and flow. When compared with controls, kidneys affected by HUS showed reduced cortical ADC values (ADC{sub TOT} 1.79±0.22 vs. 2.04±0.1x10{sup -3} mm{sup 2}/s, P 0.001), resulting in either low corticomedullary differences (11/15 patients) or an inverted corticomedullary pattern (4/15 patients). Reduction of cortical ADC values was associated with a decrease of cortical vascularity on Doppler US (ADC{sub TOT}, P<0.001; ADC{sub LOW}, P 0.047). Kidneys with complete absence of the cortical vasculature on Doppler US (four patients) also demonstrated limited diffusion (ADC{sub HIGH}, P 0.002). Low glomerular filtration rate, requirement for haemodialysis during hospitalization, and longer duration of haemodialysis were associated with decreased cortical diffusivity (ADC{sub TOT:} P 0.04, 0.007, and <0.001, respectively). DWI shows qualitative and quantitative abnormalities in kidneys affected by HUS, thereby extending the non-invasive assessment of renal parenchymal damage. (orig.)

[Microalbuminuria in pediatric patients diagnosed with hemolytic uremic syndrome].

Science.gov (United States)

Cubillos C, María Paz; Del Salas, Paulina; Zambrano, Pedro O

2015-01-01

Hemolytic uremic syndrome (HUS) is characterized by the presence of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney failure. It is the leading cause of acute kidney failure in children under 3 years of age. A variable number of patients develop proteinuria, hypertension, and chronic renal failure. To evaluate the renal involvement in pediatric patients diagnosed with HUS using the microalbumin/creatinine ratio. Descriptive concurrent cohort study that analyzed the presence of microalbuminuria in patients diagnosed with HUS between January 2001 and March 2012, who evolved without hypertension and normal renal function (clearance greater than 90ml/min using Schwartz formula). Demographic factors (age, sex), clinical presentation at time of diagnosis, use of antibiotics prior to admission, and need for renal replacement therapy were evaluated. Of the 24 patients studied, 54% were male. The mean age at diagnosis was two years. Peritoneal dialysis was required in 45%, and 33% developed persistent microalbuminuria. Antiproteinuric treatment was introduce in 4 patients, with good response. The mean follow-up was 6 years (range 6 months to 11 years). The serum creatinine returned to normal in all patients during follow up. The percentage of persistent microalbuminuria found in patients with a previous diagnosis of HUS was similar in our group to that described in the literature. Antiproteinuric treatment could delay kidney damage, but further multicenter prospective studies are necessary. Copyright © 2015. Publicado por Elsevier España, S.L.U.

Aortic and hepatic enhancement at multidetector CT: Evaluation of optimal iodine dose determined by lean body weight

International Nuclear Information System (INIS)

Kondo, Hiroshi; Kanematsu, Masayuki; Goshima, Satoshi; Watanabe, Haruo; Onozuka, Minoru; Moriyama, Noriyuki; Bae, Kyongtae T.

2011-01-01

Purpose: To determine the optimal iodine dose for aortic and hepatic enhancement at MDCT by comparing lean body weight (LBW) with total body weight (TBW). Materials and methods: This study was approved by our institutional review committee. One hundred and thirty-six patients were randomized into four groups: 550, 650, 750 mg iodine/(kg of LBW) and 600 mgI/(kg of TBW). The aortic and hepatic contrast enhancements (ΔHUs) during the portal venous-phase and variances of ΔHUs were compared. Results: Mean ΔHUs for 550, 650, 750 mgI/kg LBW and 600 mgI/kg TBW were: 95.1, 109.9, 122.4, and 131.2 HU, respectively, for the aorta. For the liver, 43.1, 55.4, 60.8, and 63.5 HU. Mean ΔHUs increased with iodine dose per kg LBW (p < 0.01), but no significant difference between 750 mgI/kg LBW and 600 mgI/kg TBW groups. Hepatic enhancement increased by ≥50 HU in 94% of patients with 750 mg/kg LBW. Variance of hepatic enhancement was marginally greater in the 600 mgI/kg TBW than in the 550 and 750 mgI/kg LBW. Conclusion: Hepatic enhancement variation was reduced with iodine doses based on LBW. Iodine dose of 750 mg iodine/kg LBW was appropriate to achieve hepatic enhancement ≥50 HU in 94% of patients.

Aortic and hepatic enhancement at multidetector CT: evaluation of optimal iodine dose determined by lean body weight.

Science.gov (United States)

Kondo, Hiroshi; Kanematsu, Masayuki; Goshima, Satoshi; Watanabe, Haruo; Onozuka, Minoru; Moriyama, Noriyuki; Bae, Kyongtae T

2011-12-01

To determine the optimal iodine dose for aortic and hepatic enhancement at MDCT by comparing lean body weight (LBW) with total body weight (TBW). This study was approved by our institutional review committee. One hundred and thirty-six patients were randomized into four groups: 550, 650, 750 mg iodine/(kg of LBW) and 600 mgI/(kg of TBW). The aortic and hepatic contrast enhancements (Δ HUs) during the portal venous-phase and variances of ΔHUs were compared. Mean ΔHUs for 550, 650, 750 mgI/kg LBW and 600 mgI/kg TBW were: 95.1, 109.9, 122.4, and 131.2HU, respectively, for the aorta. For the liver, 43.1, 55.4, 60.8, and 63.5 HU. Mean Δ HUs increased with iodine dose per kg LBW (p<0.01), but no significant difference between 750 mgI/kg LBW and 600 mgI/kg TBW groups. Hepatic enhancement increased by ≥50 HU in 94% of patients with 750 mg/kg LBW. Variance of hepatic enhancement was marginally greater in the 600 mgI/kg TBW than in the 550 and 750 mgI/kg LBW. Hepatic enhancement variation was reduced with iodine doses based on LBW. Iodine dose of 750 mg iodine/kg LBW was appropriate to achieve hepatic enhancement≥50 HU in 94% of patients. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Habitat Evaluation Procedures (HEP) Report; Calispell Creek Project, Technical Report 2004-2005.

Energy Technology Data Exchange (ETDEWEB)

Entz, Ray

2005-02-01

On July 13, 2004, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Calispell Creek property, an acquisition completed by the Kalispel Tribe of Indians in February 2004. Evaluation species and appropriate models include Canada goose, mallard, muskrat, yellow warbler, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Calispell Creek Project provides a total of 138.17 Habitat Units (HUs) for the species evaluated. Emergent wetland habitat provides 5.16 HUs for mallard and muskrat. Grassland provides 132.02 HUs for mallard and Canada goose. Scrub-shrub vegetation provides 0.99 HUs for yellow warbler and white-tailed deer. The objective of using HEP at the Calispell Creek Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

Dangerous drug interactions leading to hemolytic uremic syndrome following lung transplantation

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Parissis Haralabos

2010-09-01

Full Text Available Abstract Background To report our experience of a rather uncommon drug interaction, resulting in hemolytic uremic syndrome (HUS. Methods Two consecutive cases of hemolytic uremic syndrome were diagnosed in our service. In both patients the use of macrolides in patients taking Tacrolimus, resulted in high levels of Tacrolimus. Results The first patient was a 48 years old female with Bilateral emphysema. She underwent Single Sequential Lung Transplantation. She developed reperfusion injury requiring prolonged stay. Tacrolimus introduced (Day 51. The patient remained well up till 5 months later; Erythromycin commenced for chest infection. High Tacrolimus levels and a clinical diagnosis of HUS were made. She was treated with plasmapheresis successfully. The second case was a 57 years old female with Emphysema & A1 Antithrypsin deficiency. She underwent Right Single Lung Transplantation. A2 rejection with mild Obliterative Bronchiolitis diagnosed 1 year later and she switched to Tacrolimus. She was admitted to her local Hospital two and a half years later with right middle lobe consolidation. The patient commenced on amoxicillin and clarithromycin. Worsening renal indices, high Tacrolimus levels, hemolytic anemia & low Platelets were detected. HUS diagnosed & treated with plasmapheresis. Conclusions There are 21 cases of HUS following lung transplantation in the literature that may have been induced by high tacrolimus levels. Macrolides in patients taking Cyclosporin or Tacrolimus lead to high levels. Mechanism of action could be glomeruloconstrictor effect with reduced GFR increased production of Endothelin-1 and increased Platelet aggregation.

Soluble CD40 Ligand and Oxidative Response Are Reciprocally Stimulated during Shiga Toxin-Associated Hemolytic Uremic Syndrome

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Maria J. Abrey Recalde

2017-10-01

Full Text Available Shiga toxin (Stx, produced by Escherichia coli, is the main pathogenic factor of diarrhea-associated hemolytic uremic syndrome (HUS, which is characterized by the obstruction of renal microvasculature by platelet-fibrin thrombi. It is well known that the oxidative imbalance generated by Stx induces platelet activation, contributing to thrombus formation. Moreover, activated platelets release soluble CD40 ligand (sCD40L, which in turn contributes to oxidative imbalance, triggering the release of reactive oxidative species (ROS on various cellular types. The aim of this work was to determine if the interaction between the oxidative response and platelet-derived sCD40L, as consequence of Stx-induced endothelium damage, participates in the pathogenic mechanism during HUS. Activated human glomerular endothelial cells (HGEC by Stx2 induced platelets to adhere to them. Although platelet adhesion did not contribute to endothelial damage, high levels of sCD40L were released to the medium. The release of sCD40L by activated platelets was inhibited by antioxidant treatment. Furthermore, we found increased levels of sCD40L in plasma from HUS patients, which were also able to trigger the respiratory burst in monocytes in a sCD40L-dependent manner. Thus, we concluded that platelet-derived sCD40L and the oxidative response are reciprocally stimulated during Stx2-associated HUS. This process may contribute to the evolution of glomerular occlusion and the microangiopathic lesions.

Soluble CD40 Ligand and Oxidative Response Are Reciprocally Stimulated during Shiga Toxin-Associated Hemolytic Uremic Syndrome

Science.gov (United States)

Abrey Recalde, Maria J.; Alvarez, Romina S.; Alberto, Fabiana; Mejias, Maria P.; Ramos, Maria V.; Fernandez Brando, Romina J.; Bruballa, Andrea C.; Exeni, Ramon A.; Alconcher, Laura; Ibarra, Cristina A.; Amaral, María M.; Palermo, Marina S.

2017-01-01

Shiga toxin (Stx), produced by Escherichia coli, is the main pathogenic factor of diarrhea-associated hemolytic uremic syndrome (HUS), which is characterized by the obstruction of renal microvasculature by platelet-fibrin thrombi. It is well known that the oxidative imbalance generated by Stx induces platelet activation, contributing to thrombus formation. Moreover, activated platelets release soluble CD40 ligand (sCD40L), which in turn contributes to oxidative imbalance, triggering the release of reactive oxidative species (ROS) on various cellular types. The aim of this work was to determine if the interaction between the oxidative response and platelet-derived sCD40L, as consequence of Stx-induced endothelium damage, participates in the pathogenic mechanism during HUS. Activated human glomerular endothelial cells (HGEC) by Stx2 induced platelets to adhere to them. Although platelet adhesion did not contribute to endothelial damage, high levels of sCD40L were released to the medium. The release of sCD40L by activated platelets was inhibited by antioxidant treatment. Furthermore, we found increased levels of sCD40L in plasma from HUS patients, which were also able to trigger the respiratory burst in monocytes in a sCD40L-dependent manner. Thus, we concluded that platelet-derived sCD40L and the oxidative response are reciprocally stimulated during Stx2-associated HUS. This process may contribute to the evolution of glomerular occlusion and the microangiopathic lesions. PMID:29068360

Chronic type B aortic dissection in association with Hemolyticuremic syndrome in a child

Directory of Open Access Journals (Sweden)

D N Gera

2013-01-01

Full Text Available Aortic dissection (AD is a potentially life-threatening medical emergency usually encountered in the elderly. Here, we report a 9-year-old child who was incidentally detected to have asymptomatic chronic type B dissecting aneurysm of aorta when he presented with relapse of Hemolytic uremic syndrome (HUS without any genetic abnormalities like Marfan or Ehler-Danlos syndrome. To the best of our knowledge, this is the first case of AD associated with HUS in a child without any known associated genetic or inherited risk factors.

Relationship between Hounsfield Unit in CT Scan and Gray Scale in CBCT

Directory of Open Access Journals (Sweden)

Tahmineh Razi

2014-06-01

Full Text Available Background and aims. Cone-beam computed tomography (CBCT is an imaging system which has many advantages over computed tomography (CT. In CT scan, Hounsfield Unit (HU is proportional to the degree of x-ray attenuation by the tissue. In CBCT, the degree of x-ray attenuation is shown by gray scale (voxel value. The aim of the present study was to investigate the relationship between gray scale in CBCT and Hounsfield Unit (HU in CT scan. Materials and methods. In this descriptive study, the head of a sheep was scanned with 3 CBCT and one medical CT scanner. Gray scales and HUs were detected on images. Reconstructed data were analyzed to investigate relationship between CBCT gray scales and HUs. Results. A strong correlation between gray scales of CBCT and HUs of CT scan was determined. Conclusion. Considering the fact that gray scale in CBCT is the criteria in measurement of bone density before implant treatments, it is recommended because of the lower dose and cost compared to CT scan.

Clinical characteristics of hemolytic uremic syndrome secondary to cobalamin C disorder in Chinese children.

Science.gov (United States)

Li, Qi-Liang; Song, Wen-Qi; Peng, Xiao-Xia; Liu, Xiao-Rong; He, Le-Jian; Fu, Li-Bing

2015-08-01

The present study was undertaken to investigate the clinical characteristics of hemolytic uremic syndrome (HUS) secondary to cobalamin C disorder (cbl-C disorder). We reviewed retrospectively the medical records of 3 children with HUS secondary to cbl-C disorder who had been treated between April 1, 2009 and October 31, 2013. The 3 patients with HUS secondary to cbl-C disorder presented with progressive hemolytic anemia, acute renal failure, thrombocytopenia, poor feeding, and failure to thrive. Two of the 3 patients once had high blood pressure. The mutations of c.609G>A (p.W203X), c.217C>T (p.R73X) and c.365A>T (p.H122L) in the methylmalonic aciduria (cobalamin deficiency) cbl-C type, with homocystinuria gene were detected in the 3 patients. In these patients the levels of lactate dehydrogenase and homocysteine in serum were elevated and the level of methylmalonic acid (MMA) in urine was also elevated. After treatment with hydroxocobalamin, 2 patients were discharged with no obvious abnormal growth and neurological development and 1 patient died of multiple organ failure. The results of this study demonstrated that cbl-C disorder should be investigated in any child presenting with HUS. The high concentrations of homocysteine and MMA could be used for timely recognization of the disease. Once the high levels of plasma homocystein and/or plasma or urine MMA are detected, the treatment with parenteral hydroxocobalamin should be prescribed immediately. The early diagnosis and treatment would contribute to the good prognosis of the disease.

Habitat Evaluation Procedures (HEP) Report; West Beaver Lake Project, Technical Report 2005

Energy Technology Data Exchange (ETDEWEB)

Entz, Ray

2005-05-01

On September 7, 2004, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the West Beaver Lake property, an acquisition completed by the Kalispel Tribe of Indians in September 2004. Evaluation species and appropriate models include bald eagle, black-capped chickadee, mallard, muskrat, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The West Beaver Lake Project provides a total of 82.69 Habitat Units (HUs) for the species evaluated. Emergent wetland habitat provides 8.80 HUs for mallard, muskrat, and Canada goose. Conifer forest habitat provides 70.33 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. Open water provides 3.30 HUs for mallard, muskrat, and Canada goose. The objective of using HEP at the West Beaver Lake Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

Habitat Evaluation Procedures (HEP) Report; Upper Trimble Project, Technical Report 2004-2005.

Energy Technology Data Exchange (ETDEWEB)

Entz, Ray

2005-02-01

On July 13, 2004, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Upper Trimble property, an acquisition completed by the Kalispel Tribe of Indians in March 2004. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, muskrat, yellow warbler, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Upper Trimble Project provides a total of 250.67 Habitat Units (HUs) for the species evaluated. Wet meadow provides 136.92 HUs for mallard, muskrat, and Canada goose. Mixed forest habitat provides 111.88 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. Scrub-shrub vegetation provides 1.87 HUs for yellow warbler, and white-tailed deer. The objective of using HEP at the Upper Trimble Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

Analysis of decrease in lung perfusion blood volume with occlusive and non-occlusive pulmonary embolisms

International Nuclear Information System (INIS)

Ikeda, Yohei; Yoshimura, Norihiko; Hori, Yoshiro; Horii, Yosuke; Ishikawa, Hiroyuki; Yamazaki, Motohiko; Noto, Yoshiyuki; Aoyama, Hidefumi

2014-01-01

Highlights: • The proportion of preserved PE lesions in the non-occlusive group was 76.7% (33/43). • HUs of the iodine map were significantly higher in the non-occlusive group than in the occlusive group. • There was no significant difference in HUs between the non-occlusive and corresponding normal group. - Abstract: Purpose: The aim of this study was to determine if lung perfusion blood volume (lung PBV) with non-occlusive pulmonary embolism (PE) differs quantitatively and visually from that with occlusive PE and to investigate if lung PBV with non-occlusive PE remains the same as that without PE. Materials and methods: Totally, 108 patients suspected of having acute PE underwent pulmonary dual-energy computed tomography angiography (DECTA) between April 2011 and January 2012. Presence of PE on DECTA was evaluated by one radiologist. Two radiologists visually evaluated the PE distribution (segmental or subsegmental) and its nature (occlusive or non-occlusive) on DECTA and classified perfusion in lung PBV as “decreased,” “slightly decreased,” and “preserved”. Two radiologists used a lung PBV application to set a region of interest (ROI) in the center of the lesion and measured HU values of an iodine map. In the same slice as the ROI of the lesion and close to the lesion, another ROI was set in the normal perfusion area without PE, and HUs were measured. The proportion of lesions was compared between the occlusive and non-occlusive groups. HUs were compared among the occlusive, non-occlusive, and corresponding normal groups. Results: Twenty-five patients had 80 segmental or subsegmental lesions. There were 37 and 43 lesions in the occlusive and non-occlusive groups, respectively. The proportion of decreased lesions was 73.0% (27/37) in the occlusive group, while that of preserved lesions in the non-occlusive group was 76.7% (33/43). There was a significant difference in the proportion of lesions (P < 0.001) between the two groups. HUs of the

Molecular characterisation of human Shiga toxin-producing Escherichia coli O26 strains: results of an outbreak investigation, Romania, February to August 2016.

Science.gov (United States)

Usein, Codruţa-Romaniţa; Ciontea, Adriana Simona; Militaru, Cornelia Mãdãlina; Condei, Maria; Dinu, Sorin; Oprea, Mihaela; Cristea, Daniela; Michelacci, Valeria; Scavia, Gaia; Zota, Lavinia Cipriana; Zaharia, Alina; Morabito, Stefano

2017-11-01

IntroductionAt the beginning of 2016, an increase in paediatric haemolytic uremic syndrome (HUS) cases was observed in Romania. The microbiological investigations allowed isolation of Shiga toxin-producing Escherichia coli (STEC) O26 as the causative agent from most cases. Methods: An enhanced national surveillance of HUS and severe diarrhoea was established across the country following the identification of the first cases and was carried out until August 2016. A total of 15 strains were isolated from 10 HUS and five diarrhoea cases. Strains were characterised by virulence markers (i.e. stx type/subtype, eae , ehxA genes), phylogroup, genetic relatedness and clonality using PCR-based assays, PFGE and multilocus sequence typing (MLST). The first six strains were further characterised by whole genome sequencing (WGS). Results: Five PCR-defined genotypes were distinguished. All strains from HUS cases harboured stx2a and eae , with or without stx1a , while strains from diarrhoea cases carried exclusively stx1a and eae genes. PFGE resolved strains into multiple pulsotypes, compatible with a certain geographic segregation of the cases, and strains were assigned to phylogroup B1 and sequence type (ST) 21. WGS confirmed the results of conventional molecular methods, brought evidence of O26:H11 serotype, and complemented the virulence profiles. Discussion/conclusion: This first description of STEC O26 strains from cases in Romania showed that the isolates belonged to a diverse population. The virulence content of most strains highlighted a high risk for severe outcome in infected patients. Improving the national surveillance strategy for STEC infections in Romania needs to be further considered.

Shiga toxin-converting phages and the emergence of new pathogenic Escherichia coli: a world in motion

Science.gov (United States)

Tozzoli, Rosangela; Grande, Laura; Michelacci, Valeria; Ranieri, Paola; Maugliani, Antonella; Caprioli, Alfredo; Morabito, Stefano

2014-01-01

Shiga toxin (Stx)-producing Escherichia coli (STEC) are pathogenic E. coli causing diarrhea, hemorrhagic colitis (HC) and hemolytic uremic syndrome (HUS). STEC are characterized by a constellation of virulence factors additional to Stx and have long been regarded as capable to cause HC and HUS when possessing the ability of inducing the attaching and effacing (A/E) lesion to the enterocyte, although strains isolated from such severe infections sometimes lack this virulence feature. Interestingly, the capability to cause the A/E lesion is shared with another E. coli pathogroup, the Enteropathogenic E. coli (EPEC). In the very recent times, a different type of STEC broke the scene causing a shift in the paradigm for HUS-associated STEC. In 2011, a STEC O104:H4 caused a large outbreak with more than 800 HUS and 50 deaths. Such a strain presented the adhesion determinants of Enteroaggregative E. coli (EAggEC). We investigated the possibility that, besides STEC and EAggEC, other pathogenic E. coli could be susceptible to infection with stx-phages. A panel of stx2-phages obtained from STEC isolated from human disease was used to infect experimentally E. coli strains representing all the known pathogenic types, including both diarrheagenic E. coli (DEC) and extra-intestinal pathogenic E. coli (ExPEC). We observed that all the E. coli pathogroups used in the infection experiments were susceptible to the infection. Our results suggest that the stx2-phages used may not have specificity for E. coli adapted to the intestinal environment, at least in the conditions used. Additionally, we could only observe transient lysogens suggesting that the event of stable stx2-phage acquisition occurs rarely. PMID:24999453

Reconstruction of the forehead acoustic properties in an Indo-Pacific humpback dolphin (Sousa chinensis), with investigation on the responses of soft tissue sound velocity to temperature.

Science.gov (United States)

Song, Zhongchang; Zhang, Yu; Berggren, Per; Wei, Chong

2017-02-01

Computed tomography (CT) imaging and ultrasound experimental measurements were combined to reconstruct the acoustic properties (density, velocity, and impedance) of the head from a deceased Indo-Pacific humpback dolphin (Sousa chinensis). The authors extracted 42 soft forehead tissue samples to estimate the sound velocity and density properties at room temperature, 25.0  °C. Hounsfield Units (HUs) of the samples were read from CT scans. Linear relationships between the tissues' HUs and velocity, and HUs and density were revealed through regression analyses. The distributions of the head acoustic properties at axial, coronal, and sagittal cross sections were reconstructed, suggesting that the forehead soft tissues were characterized by low-velocity in the melon, high-velocity in the muscle and connective tissues. Further, the sound velocities of melon, muscle, and connective tissue pieces were measured under different temperatures to investigate tissues' velocity response to temperature. The results demonstrated nonlinear relationships between tissues' sound velocity and temperature. This study represents a first attempt to provide general information on acoustic properties of this species. The results could provide meaningful information for understanding the species' bioacoustic characteristics and for further investigation on sound beam formation of the dolphin.

[Historical stages of Hemolytic Uremic Syndrome in Argentina (1964-2009)].

Science.gov (United States)

Belardo, Marcela

2012-10-01

The aim is to present an historical time frame of Hemolytic Uremic Syndrome (HUS) in Argentina. From a public policy approach, the history of the disease is analyzed as an object of health policy and seeks to contribute in understanding the multiple dimensions of illness. As a medical and scientific issue, as a social problem and a matter of health policy, the article describes three phases ranging from its discovery up to the national program of HUS adopted in 2009. This article aims to provide an overview of developments in biomedical knowledge and the emergence of the issue in both social and political problem.

Commensal E. coli Stx2 lysogens produce high levels of phages after spontaneous prophage induction

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Hildegunn eIversen

2015-02-01

Full Text Available Enterohemorrhagic E. coli (EHEC is a food-borne pathogen that causes disease ranging from uncomplicated diarrhea to life-threatening hemolytic uremic syndrome (HUS and nervous system complications. Shiga toxin 2 (Stx2 is the major virulence factor of EHEC and is critical for development of HUS. The genes encoding Stx2 are carried by lambdoid bacteriophages and the toxin production is tightly linked to the production of phages during lytic cycle. It has previously been suggested that commensal E. coli could amplify the production of Stx2-phages and contribute to the severity of disease. In this study we examined the susceptibility of commensal E. coli strains to the Stx2-converting phage ϕ734, isolated from a highly virulent EHEC O103:H25 (NIPH-11060424. Among 38 commensal E. coli strains from healthy children below five years, 15 were lysogenized by the ϕ734 phage, whereas lytic infection was not observed. Three of the commensal E. coli ϕ734 lysogens were tested for stability, and appeared stable and retained the phage for at least 10 cultural passages. When induced to enter lytic cycle by H2O2 treatment, 8 out of 13 commensal lysogens produced more ϕ734 phages than NIPH-11060424. Strikingly, five of them even spontaneously (non-induced produced higher levels of phage than the H2O2 induced NIPH-11060424. An especially high frequency of HUS (60% was seen among children infected by NIPH-11060424 during the outbreak in 2006. Based on our findings, a high Stx2 production by commensal E. coli lysogens cannot be ruled out as a contributor to the high frequency of HUS during this outbreak.

MO-C-17A-05: A Three-Dimensional Head-And-Neck Phantom for Validation of Kilovoltage- and Megavoltage-Based Deformable Image Registration

International Nuclear Information System (INIS)

Kirby, N; Singhrao, K; Pouliot, J

2014-01-01

Purpose: To develop a three-dimensional (3D) deformable head-and-neck (H and N) phantom with realistic tissue contrast for both kilovoltage and megavoltage computed tomography and use it to objectively evaluate deformable image registration (DIR) algorithms. Methods: The phantom represents H and N patient anatomy. It is constructed from thermoplastic, which becomes pliable in boiling water, and hardened epoxy resin. Using a system of additives, the Hounsfield unit (HU) values of these materials were tuned to mimic anatomy for both kilovoltage (kV) and megavoltage (MV) imaging. The phantom opened along a sagittal midsection to reveal nonradiopaque markers, which were used to characterize the phantom deformation. The deformed and undeformed phantom was scanned with kV and MV computed tomography. Additionally, a calibration curve was created to change the HUs of the MV scans to be similar to kV HUs, (MC). The extracted ground-truth deformation was then compared to the results of two commercially available DIR algorithms, from Velocity Medical Solutions and MIM Software. Results: The phantom produced a 3D deformation, representing neck flexion, with a magnitude of up to 8 mm and was able represent tissue HUs for both kV and MV imaging modalities. The two tested deformation algorithms yielded vastly different results. For kV-kV registration, MIM made the lowest mean error, and Velocity made the lowest maximum error. For MV-MV, kV-MV, and kV-MC Velocity produced both the lowest mean and lowest maximum errors. Conclusion: The application of DIR across different imaging modalities is particularly difficult, due to differences in tissue HUs and the presence of imaging artifacts. For this reason, DIR algorithms must be validated specifically for this purpose. The developed H and N phantom is an effective tool for this purpose

Dehydration upon admission is a risk factor for incomplete recovery of renal function in children with haemolytic uremic syndrome.

Science.gov (United States)

Ojeda, José M; Kohout, Isolda; Cuestas, Eduardo

2013-01-01

Haemolytic uremic syndrome (HUS) is the most common cause of acute renal failure and the second leading cause of chronic renal failure in children. The factors that affect incomplete renal function recovery prior to hospital admission are poorly understood. To analyse the risk factors that determine incomplete recovery of renal function prior to hospitalisation in children with HUS. A retrospective case-control study. age, sex, duration of diarrhoea, bloody stools, vomiting, fever, dehydration, previous use of antibiotics, and incomplete recovery of renal function (proteinuria, hypertension, reduced creatinine clearance, and chronic renal failure during follow-up). Patients of both sexes under 15 years of age were included. Of 36 patients, 23 were males (65.3%; 95%CI: 45.8 to 80.9), with an average age of 2.5 ± 1.4 years. Twenty-one patients required dialysis (58%; 95% CI: 40.8 to 75.8), and 13 (36.1%; 95% CI: 19.0 to 53.1) did not recover renal function. In the bivariate model, the only significant risk factor was dehydration (defined as weight loss >5%) [(OR: 5.3; 95% CI: 1.4 to 12.3; P=.0220]. In the multivariate analysis (Cox multiple regression), only dehydration was marginally significant (HR: 95.823; 95% CI: 93.175 to 109.948; P=.085). Our data suggest that dehydration prior to admission may be a factor that increases the risk of incomplete recovery of renal function during long-term follow-up in children who develop HUS D+. Consequently, in patients with diarrhoea who are at risk of HUS, dehydration should be strongly avoided during outpatient care to preserve long-term renal function. These results must be confirmed by larger prospective studies.

Patterns in early diffusion-weighted MRI in children with haemolytic uraemic syndrome and CNS involvement

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Donnerstag, Frank; Ding, Xiaoqi; Bueltmann, Eva; Zajaczek, Jan; Lanfermann, Heinrich [Hannover Medical School, Institute of Diagnostic and Therapeutic Neuroradiology, Hannover (Germany); Pape, Lars; Das, Anibh Martin; Ehrich, Jochen; Hartmann, Hans [Hannover Medical School, Clinic for Pediatric Kidney, Liver and Metabolic Diseases, Hannover (Germany); Luecke, Thomas [Hannover Medical School, Clinic for Pediatric Kidney, Liver and Metabolic Diseases, Hannover (Germany); University of Bochum, Department of Neuropediatrics, Pediatric Hospital, Bochum (Germany); Hoy, Ludwig [Hannover Medical School, Institute of Biometrics, Hannover (Germany)

2012-03-15

Diffusion-weighted imaging (DWI) in children with diarrhoea associated haemolytic uraemic syndrome (D+HUS) and cerebral involvement was evaluated retrospectively. DWI within 24 h of onset of neurological symptoms. The apparent diffusion coefficient (ADC) was measured in grey/white matter and correlated with clinical and laboratory findings. DWI was abnormal in all. Abnormal ADC was detected in the supratentorial white matter (6/12) and cortex (1/12), the basal ganglia (5/12), the thalami (4/12), and the cerebellum (1/12). ADC was reduced in 5/12, increased in 4/12, and both in 3/12. Mean serum sodium was lower in patients with DWI abnormalities affecting the white matter (6/12), than in those with basal ganglia/thalamic involvement (6/12). Neurological outcome was normal in 4/11 and abnormal in 7/11, and 1 patient died, outcome did not correlate to either localisation or type of DWI abnormality. In D+HUS with neurological symptoms, early DWI may reveal abnormal ADC not only in the basal ganglia/thalami, but also in the white matter/cortex. Besides thrombotic microangiopathy, toxic effects of shiga toxin, azotaemia and hyponatraemia / hypoosmolality may be involved in cerebral involvement in children with D+HUS. Findings on early MRI seem not to predict clinical course or outcome. (orig.)

Patterns in early diffusion-weighted MRI in children with haemolytic uraemic syndrome and CNS involvement

International Nuclear Information System (INIS)

Donnerstag, Frank; Ding, Xiaoqi; Bueltmann, Eva; Zajaczek, Jan; Lanfermann, Heinrich; Pape, Lars; Das, Anibh Martin; Ehrich, Jochen; Hartmann, Hans; Luecke, Thomas; Hoy, Ludwig

2012-01-01

Diffusion-weighted imaging (DWI) in children with diarrhoea associated haemolytic uraemic syndrome (D+HUS) and cerebral involvement was evaluated retrospectively. DWI within 24 h of onset of neurological symptoms. The apparent diffusion coefficient (ADC) was measured in grey/white matter and correlated with clinical and laboratory findings. DWI was abnormal in all. Abnormal ADC was detected in the supratentorial white matter (6/12) and cortex (1/12), the basal ganglia (5/12), the thalami (4/12), and the cerebellum (1/12). ADC was reduced in 5/12, increased in 4/12, and both in 3/12. Mean serum sodium was lower in patients with DWI abnormalities affecting the white matter (6/12), than in those with basal ganglia/thalamic involvement (6/12). Neurological outcome was normal in 4/11 and abnormal in 7/11, and 1 patient died, outcome did not correlate to either localisation or type of DWI abnormality. In D+HUS with neurological symptoms, early DWI may reveal abnormal ADC not only in the basal ganglia/thalami, but also in the white matter/cortex. Besides thrombotic microangiopathy, toxic effects of shiga toxin, azotaemia and hyponatraemia / hypoosmolality may be involved in cerebral involvement in children with D+HUS. Findings on early MRI seem not to predict clinical course or outcome. (orig.)

Sex steroids do not affect shigatoxin cytotoxicity on human renal tubular or glomerular cells

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Kohan Donald E

2002-08-01

Full Text Available Abstract Background The greater susceptibility of children to renal injury in post-diarrheal hemolytic-uremic syndrome (HUS may be related, at least in part, to heightened renal cell sensitivity to the cytotoxic effect of Shiga toxin (Stx, the putative mediator of kidney damage in HUS. We hypothesized that sexual maturation, which coincides with a falling incidence of HUS, may induce a relatively Stx-resistant state in the renal cells. Methods Cultured human glomerular endothelial (HGEN, human glomerular visceral epithelial (HGEC and human proximal tubule (HPT cells were exposed to Stx-1 after pre-incubation with progesterone, β-estradiol or testosterone followed by determination of cytotoxicity. Results Under basal conditions, Stx-1 potently and dose-dependently killed HPT and HGEC, but had relatively little effect on HGEN. Pre-incubation for 1, 2 or 7 days with physiologic or pharmacologic concentrations of progesterone, β-estradiol or testosterone had no effect on Stx-1 cytotoxicity dose-response on any cell type. In addition, no steroid altered Gb3 expression (Stx receptor by any cell type at any time point. Conclusion These data do not support the notion that hormonal changes associated with puberty induce an Stx-resistant state within kidney cells.

Severe form of hemolytic-uremic syndrome with multiple organ failure in a child: a case report [v1; ref status: indexed, http://f1000r.es/24q

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Dino Mijatovic

2014-03-01

Full Text Available Introduction: Hemolytic-uremic syndrome (HUS is a leading cause of acute renal failure in infants and young children. It is traditionally defined as a triad of acute renal failure, hemolytic anemia and thrombocytopenia that occur within a week after prodromal hemorrhagic enterocolitis. Severe cases can also be presented by acute respiratory distress syndrome (ARDS, toxic megacolon with ileus, pancreatitis, central nervous system (CNS disorders and multiple organ failure (MOF. Case presentation: A previously healthy 4-year old Caucasian girl developed acute renal failure, thrombocytopenia and hemolytic anemia following a short episode of abdominal pain and bloody diarrhea. In the next week of, what initially appeared as typical HUS, she developed MOF, including ileus, pancreatitis, hepatitis, coma and ARDS, accompanied by hemodynamic instability and extreme leukocytosis. Nonetheless, the girl made a complete recovery after one month of the disease. She was successfully treated in the intensive care unit and significant improvement was noticed after plasmapheresis and continuous veno-venous hemodialysis. Conclusions: Early start of plasmapheresis and meticulous supportive treatment in the intensive care unit, including renal placement therapy, may be the therapy of choice in severe cases of HUS presented by MOF. Monitoring of prognostic factors is important for early performance of appropriate diagnostic and therapeutical interventions.

Acute Systolic Heart Failure Associated with Complement-Mediated Hemolytic Uremic Syndrome

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John L. Vaughn

2015-01-01

Full Text Available Complement-mediated hemolytic uremic syndrome (otherwise known as atypical HUS is a rare disorder of uncontrolled complement activation that may be associated with heart failure. We report the case of a 49-year-old female with no history of heart disease who presented with microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. Given her normal ADAMSTS13 activity, evidence of increased complement activation, and renal biopsy showing evidence of thrombotic microangiopathy, she was diagnosed with complement-mediated HUS. She subsequently developed acute hypoxemic respiratory failure secondary to pulmonary edema requiring intubation and mechanical ventilation. A transthoracic echocardiogram showed evidence of a Takotsubo cardiomyopathy with an estimated left ventricular ejection fraction of 20%, though ischemic cardiomyopathy could not be ruled out. Treatment was initiated with eculizumab. After several failed attempts at extubation, she eventually underwent tracheotomy. She also required hemodialysis to improve her uremia and hypervolemia. After seven weeks of hospitalization and five doses of eculizumab, her renal function and respiratory status improved, and she was discharged in stable condition on room air and independent of hemodialysis. Our case illustrates a rare association between acute systolic heart failure and complement-mediated HUS and highlights the potential of eculizumab in stabilizing even the most critically-ill patients with complement-mediated disease.

Acute Renal Replacement Therapy in Children with Diarrhea-Associated Hemolytic Uremic Syndrome: A Single Center 16 Years of Experience

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Silviu Grisaru

2011-01-01

Full Text Available Acute kidney injury (AKI is becoming more prevalent among hospitalized children, its etiologies are shifting, and new treatment modalities are evolving; however, diarrhea-associated hemolytic uremic syndrome (D+HUS remains the most common primary disease causing AKI in young children. Little has been published about acute renal replacement therapy (ARRT and its challenges in this population. We describe our single center's experience managing 134 pediatric patients with D+HUS out of whom 58 (43% required ARRT over the past 16 years. In our cohort, all but one patient were started on peritoneal dialysis (PD. Most patients, 47 (81%, received acute PD on a pediatric inpatient ward. The most common recorded complications in our cohort were peritoneal fluid leaks 13 (22%, peritonitis 11 (20%, and catheter malfunction 5 (9%. Nine patients (16% needed surgical revision of their PD catheters. There were no bleeding events related to PD despite a mean platelets count of 40.9 (±23.5 × 103/mm3 and rare use of platelets infusions. Despite its methodological limitations, this paper adds to the limited body of evidence supporting the use of acute PD as the primary ARRT modality in children with D+HUS.

Kardinální ctnosti v Husově Komentáři Sentencí

Czech Academy of Sciences Publication Activity Database

Machula, Tomáš

2015-01-01

Roč. 17, č. 4 (2015), s. 185-194 ISSN 1212-8570 Institutional support: RVO:67985955 Keywords : Hus * cardinal virtues * moral virtues * commentary on the Sentences * ethics Subject RIV: AA - Philosophy ; Religion

Fatty degeneration of the rotator cuff muscles on pre- and postoperative CT arthrography (CTA): is the Goutallier grading system reliable?

International Nuclear Information System (INIS)

Lee, Eugene; Choi, Jung-Ah; Kang, Heung Sik; Oh, Joo Han; Ahn, Soyeon; Hong, Sung Hwan; Chai, Jee Won

2013-01-01

To retrospectively evaluate fatty degeneration (FD) of rotator cuff muscles on CTA using Goutallier's grading system and quantitative measurements with comparison between pre- and postoperative states. IRB approval was obtained for this study. Two radiologists independently reviewed pre- and postoperative CTAs of 43 patients (24 males and 19 females, mean age, 58.1 years) with 46 shoulders confirmed as full-thickness tears with random distribution. FD of supraspinatus, infraspinatus/teres minor, and subscapularis was assessed using Goutallier's system and by quantitative measurements of Hounsfield units (HUs) on sagittal images. Changes in FD grades and HUs were compared between pre- and postoperative CTAs and analyzed with respect to preoperative tear size and postoperative cuff integrity. The correlations between qualitative grades and quantitative measurements and their inter-observer reliabilities were also assessed. There was statistically significant correlation between FD grades and HU measurements of all muscles on pre- and postoperative CTA (p 0.05). The average dose-length product (DLP, mGy . cm) was 365.2 mGy . cm (range, 323.8-417.2 mGy . cm) and estimated average effective dose was 5.1 mSv. Goutallier grades correlated well with HUs of rotator cuff muscles. Reliability was excellent for both systems, except for FD grade of IST/TM muscles, which may be more reliably assessed using quantitative measurements. (orig.)

Kehv tuukritöö ja pasane maa märgivad ajastu vaimu / Andres Laasik

Index Scriptorium Estoniae

Laasik, Andres, 1960-2016

2009-01-01

PÖFFi alafestivalil Animated Dreams linastunud neljast uuest filmist: Olga ja Priit Pärna "Tuukrid vihmas", Kaspar Jancise "Krokodill", Martinus Daane Klemeti "Õhus" ja Girlin Bassovskaja (Jelena Girlin, Mari-Liis Bassovskaja) "Oranus"

Eesti animafilm külvab uusi seemneid / Mari-Liis Rebane

Index Scriptorium Estoniae

Rebane, Mari-Liis

2009-01-01

PÖFFi alafestivalil Animated Dreams linastunud neljast uuest filmist: Olga ja Priit Pärna "Tuukrid vihmas", Kaspar Jancise "Krokodill", Martinus Daane Klemeti "Õhus" ja Girlin Bassovskaja (Jelena Girlin, Mari-Liis Bassovskaja) "Oranus"

Neli tuttuut Eesti animafilmi

Index Scriptorium Estoniae

2009-01-01

PÖFFi alafestivalil Animated Dreams linastus neli uut filmi: Olga ja Priit Pärna "Tuukrid vihmas", Kaspar Jancise "Krokodill", Martinus Daane Klemeti "Õhus" ja Girlin Bassovskaja (Jelena Girlin, Mari-Liis Bassovskaja) "Oranus"

A three-dimensional head-and-neck phantom for validation of multimodality deformable image registration for adaptive radiotherapy

International Nuclear Information System (INIS)

Singhrao, Kamal; Kirby, Neil; Pouliot, Jean

2014-01-01

Purpose: To develop a three-dimensional (3D) deformable head-and-neck (H and N) phantom with realistic tissue contrast for both kilovoltage (kV) and megavoltage (MV) imaging modalities and use it to objectively evaluate deformable image registration (DIR) algorithms. Methods: The phantom represents H and N patient anatomy. It is constructed from thermoplastic, which becomes pliable in boiling water, and hardened epoxy resin. Using a system of additives, the Hounsfield unit (HU) values of these materials were tuned to mimic anatomy for both kV and MV imaging. The phantom opens along a sagittal midsection to reveal radiotransparent markers, which were used to characterize the phantom deformation. The deformed and undeformed phantoms were scanned with kV and MV imaging modalities. Additionally, a calibration curve was created to change the HUs of the MV scans to be similar to kV HUs, (MC). The extracted ground-truth deformation was then compared to the results of two commercially available DIR algorithms, from Velocity Medical Solutions and MIM software. Results: The phantom produced a 3D deformation, representing neck flexion, with a magnitude of up to 8 mm and was able to represent tissue HUs for both kV and MV imaging modalities. The two tested deformation algorithms yielded vastly different results. For kV–kV registration, MIM produced mean and maximum errors of 1.8 and 11.5 mm, respectively. These same numbers for Velocity were 2.4 and 7.1 mm, respectively. For MV–MV, kV–MV, and kV–MC Velocity produced similar mean and maximum error values. MIM, however, produced gross errors for all three of these scenarios, with maximum errors ranging from 33.4 to 41.6 mm. Conclusions: The application of DIR across different imaging modalities is particularly difficult, due to differences in tissue HUs and the presence of imaging artifacts. For this reason, DIR algorithms must be validated specifically for this purpose. The developed H and N phantom is an effective tool

Foodborne Illnesses

Science.gov (United States)

... paralysis, severe dehydration, and HUS. Eating, Diet, and Nutrition The following steps may help relieve the symptoms ... sugary foods, dairy products, caffeine, and alcohol until recovery is complete Infants and children present special concerns. ...

Leiomyoma: a rare cause of adrenal incidentaloma

African Journals Online (AJOL)

2012-09-19

Sep 19, 2012 ... tomography (CT) imaging, malignancy is suggested by a diameter ... Hounsfield units (HUs) (> 10) and limited washout of contrast after .... Hounsfield units. Air ... in a child with acquired immunodeficiency syndrome. Pediatr ...

ADAMTS-13 deficiency following Hemiscorpius lepturus scorpion sting

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Ehsan Valavi

2011-01-01

Full Text Available Hemiscorpius lepturus is a lethal scorpion with potentially cytotoxic venom. Various degrees of local and systemic toxicity have been observed after its envenomation ranging from local erythema to disseminated intravascular coagulation, renal failure and severe pulmonary hemorrhage. In this case report, we report on a seven-year-old patient who developed the hemolytic uremic syndrome (HUS after being stung by the scorpion H. lepturus. This condition is characterized by microangiopathic hemolytic anemia, thrombocytopenia, increased serum levels of lactate dehydrogenase and uremia. We evaluated the causes of HUS and found that the levels of C3, C4, CH50 and H factors were normal, but the activity of Von Willebrand factor cleaving protease was decreased (less than 5% of the normal activity. The patient improved after administering therapy with plasma exchange.

Středověká vyobrazení Jana Husa – teologické interpretace historických událostí

Czech Academy of Sciences Publication Activity Database

Studničková, Milada

2013-01-01

Roč. 53, č. 1 (2013), s. 79-92 ISSN 0323-0562 Institutional support: RVO:68378033 Keywords : Jan Hus * Martinitz Bible * Gradual of Leitmeritz * biblical exegesis * typological parallelism Subject RIV: AL - Art, Architecture, Cultural Heritage

Microangiopatias trombóticas: púrpura trombocitopênica trombótica e síndrome hemolítico-urêmica Thrombotic microangiopathies: thrombotic thrombocytopenic purpura / hemolytic uremic syndrome

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Maria Goretti Polito

2010-09-01

complemento. Uma série de mutações e polimorfismo em genes que codificam proteínas reguladoras do complemento sozinhas ou em combinação podem levar a SHU atípica. Aproximadamente 60% dos casos de SHU atípica têm mutações do tipo "perda da função" em genes que codificam as proteínas reguladoras do complemento, as quais protegem as células hospedeiras da ativação do complemento: fator H do complemento (FHC, fator I (FIC e proteína cofator de membrana (PCM ou CD46, ou mutações do tipo "ganho da função" em genes que codificam o FHC ou C3. Além disso, aproximadamente 10% dos pacientes com SHU atípica têm deficiência na função do FHC devido a anticorpos anti-FHC. Mesmo que as MATs sejam condições altamente heterogêneas, um terço dos pacientes tem deficiência severa da ADA-MTS13. Transfusões de plaquetas são contraindicadas nesses pacientes. Infusão de plasma ou plasma exchange (PE é o único tratamento eficiente.Thrombotic microangiopathies (TMAs are pathological conditions characterized by generalized microvascular occlusion by platelet thrombi, thrombocytopenia, and microangiopathic hemolytic anemia. Two typical phenotypes of TMAs are hemolytic- uremic syndrome (HUS and thrombotic thrombocytopenic purpura (TTP. Other disorders occasionally present with similar manifestations. Depending on whether renal or brain lesions prevail, two pathologically indistinguishable but somehow clinically different disorders have been described: HUS and TTP. Injury to the endothelial cell is the central and likely inciting factor in the sequence of events leading to TMA. Loss of physiological thromboresistance, leukocyte adhesion to damaged endothelium, complement consumption, abnormal von Willebrand factor release and fragmentation, and increased vascular shear stress may then sustain and amplify the microangiopathic process. Intrinsic abnormalities of the complement system and of the von Willebrand factor pathway may account for a genetic predisposition to the

New generation in Estonian animation / Mari-Liis Rebane

Index Scriptorium Estoniae

Rebane, Mari-Liis, 1988-

2010-01-01

Eesti animafilmide loojate uuest põlvkonnast, animafilmide tegemise võimalustest, uute animafilmide tasemest. Martinus Daane Klemeti animafilmidest "Furry Flurry" (2006) ja "Light My Fire" (2007) ning joonisfilmist "Õhus" (Eesti Joonisfilm, 2009, kunstnik Gerda Märtens)

Epidemiological analysis of a cluster within the outbreak of Shiga toxin-producing Escherichia coli serotype O104:H4 in Northern Germany, 2011.

Science.gov (United States)

Scharlach, Martina; Diercke, Michaela; Dreesman, Johannes; Jahn, Nicola; Krieck, Manuela; Beyrer, Konrad; Claußen, Katja; Pulz, Matthias; Floride, Regina

2013-06-01

In May 2011 one of the worldwide largest outbreaks of haemolytic uraemic syndrome (HUS) and bloody diarrhoea caused by Shiga toxin-producing Escherichia coli (STEC) serotype O104:H4 occurred in Germany. One of the most affected federal states was Lower Saxony. We present the investigation of a cluster of STEC and HUS cases within this outbreak by means of a retrospective cohort study. After a 70th birthday celebration which took place on 7th of May 2011 among 72 attendants seven confirmed cases and four probable cases were identified, two of them developed HUS. Median incubation period was 10 days. Only 35 persons (48.6%) definitely answered the question whether they had eaten the sprouts that were used for garnishing the salad. Univariable analysis revealed different food items, depending on the case definition, with Odds Ratio (OR)>1 indicating an association with STEC infection, but multivariable logistic regression showed no increased risk for STEC infection for any food item and any case definition. Sprouts as the source for the infection had to be assumed based on the results of a tracing back of the delivery ways from the catering company to the sprouts producer who was finally identified as the source of the entire German outbreak. In this large outbreak several case-control studies failed to identify the source of infection. Copyright © 2012 Elsevier GmbH. All rights reserved.

Two cases of urinary tract infection caused by Shiga toxin-producing Escherichia coli 0157:H7 strains Dos casos de infección del tracto urinario causados por cepas de Escherichia coli 0157:H7 productoras de toxina Shiga.

Directory of Open Access Journals (Sweden)

María Del P. Gadea

2012-06-01

Full Text Available ABSTRACT STEC strains can infect extra-intestinal sites such as the human urinary tract and sometimes cause severe complications. We report two cases of urinary tract infection caused by STEC in two elderly women with comorbidities. Although both strains belonged to the 0157:H7 serotype and carried genes associated with severe illness, none of the patients developed hemolytic uremic syndrome (HUS. These findings provide additional evidence for the presence of these agents in our country and in the region, and highlight the need to maintain an active surveillance system of HUS cases, placing special emphasis on the study of other sites of infection in patients with non-diarrheal HUS.En los seres humanos, las cepas STEC pueden producir infección en sitios extraintestinales, como el tracto urinario, y causar complicaciones graves. Comunicamos dos casos de infección urinaria por STEC en dos mujeres ancianas con comorbilidades. Aunque ambas cepas correspondieron al serotipo 0157:H7 y portaban los genes asociados con enfermedad grave, ninguna de las pacientes desarrolló síndrome urémico hemolítico (SUH. Estos hallazgos constituyen una evidencia adicional de la presencia de estos agentes en nuestro país y en la región, y destacan la necesidad de mantener un sistema activo de vigilancia, con especial énfasis en el estudio de otros sitios de Infección en pacientes que presentan SUH no asociado a diarrea.

Habitat Evaluation Procedures (HEP) Report : West Beaver Lake, 2004-2005 Technical Report.

Energy Technology Data Exchange (ETDEWEB)

Entz, Ray

2005-02-01

On September 7, 2004, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the West Beaver Lake property, an acquisition completed by the Kalispel Tribe of Indians in September 2004. Evaluation species and appropriate models include bald eagle, black-capped chickadee, mallard, muskrat, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The West Beaver Lake Project provides a total of 103.08 Habitat Units (HUs) for the species evaluated. Emergent wetland habitat provides 7.17 HUs for mallard and muskrat. Conifer forest habitat provides 95.91 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. The objective of using HEP at the West Beaver Lake Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

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tions as quantum field theories with certain kinds of embedded internal symmetries called 'gauge ... field theories and gauge symmetries to the unini- tiated. 1. ..... photon also suffers from the same factor. hus, if we think that the solid lines in.

Whole-Genome Characterization and Strain Comparison of VT2f-Producing Escherichia coli Causing Hemolytic Uremic Syndrome.

NARCIS (Netherlands)

Grande, Laura; Michelacci, Valeria; Bondì, Roslen; Gigliucci, Federica; Franz, Eelco; Badouei, Mahdi Askari; Schlager, Sabine; Minelli, Fabio; Tozzoli, Rosangela; Caprioli, Alfredo; Morabito, Stefano

2016-01-01

Verotoxigenic Escherichia coli infections in humans cause disease ranging from uncomplicated intestinal illnesses to bloody diarrhea and systemic sequelae, such as hemolytic uremic syndrome (HUS). Previous research indicated that pigeons may be a reservoir for a population of verotoxigenic E. coli

Победа над солнцем / Николай Караев

Index Scriptorium Estoniae

Караев, Николай, 1978-

2009-01-01

PÖFFi alafestivalil Animated Dreams linastus neli uut filmi: Olga ja Priit Pärna "Tuukrid vihmas", Kaspar Jancise "Krokodill", Martinus Daane Klemeti "Õhus" ja Girlin Bassovskaja (Jelena Girlin, Mari-Liis Bassovskaja) "Oranus". Lisaks sõnum animafilmifestivali võitjate kohta

The Execution of the Miners of Kutná Hora at Poděbrady and in Křivoklát in 1496. On the Veneration of the Miners of Poděbrady in the Sixteenth Century

Czech Academy of Sciences Publication Activity Database

Šárovcová, Martina

Suppl., č. 2 (2015), s. 259-278 ISSN 0015-1831 Institutional support: RVO:68378033 Keywords : music manuscripts * Utraquism * Bohemian Reformation * illuminated fragments * Jan Hus * Fabián Puléř * early modern illuminated manuscripts Subject RIV: AL - Art, Architecture, Cultural Heritage

Health utility scores from EQ-5D and health-related quality of life in patients with esophageal cancer: a real-world cross-sectional study.

Science.gov (United States)

Doherty, M K; Leung, Y; Su, J; Naik, H; Patel, D; Eng, L; Kong, Q Q; Mohsin, F; Brown, M C; Espin-Garcia, O; Vennettilli, A; Renouf, D J; Faluyi, O O; Knox, J J; MacKay, H; Wong, R; Howell, D; Mittmann, N; Darling, G E; Cella, D; Xu, W; Liu, G

2018-06-14

Esophageal cancer and its treatment can cause serious morbidity/toxicity. These effects on health-related quality of life (HRQOL) can be measured using disease-specific scales such as FACT-E, generic scales such as EQ-5D-3L, or through symptoms. In a two-year cross-sectional study, we compared HRQOL across esophageal cancer patients treated in an ambulatory clinic and across multiple disease states, among patients with all stages of esophageal cancer. Consenting patients completed FACT-E, EQ-5D, a visual analog scale, and patient reported (PR)-ECOG. Symptom complexes were constructed from FACT-E domains. Responses were categorized by disease state: pre-, during, and post-treatment, surveillance, progression, and palliative chemotherapy. Spearman correlation and multivariable linear regression characterized these associations. In total, 199 patients completed 317 questionnaires. Mean FACT-E and subscale scores dropped from baseline through treatment and recovered during post-treatment surveillance (P < 0.001); EQ-5D health utility scores (HUS) displayed a similar pattern but with smaller differences (P = 0.07), and with evidence of ceiling effect. Among patients with stage II/III esophageal cancer, mean EQ-5D HUS varied across disease states (P < 0.001), along with FACT-E and subscales (P < 0.001). Among patients with advanced disease, there was no significant difference between baseline and on-treatment total scores, but improved esophageal cancer-specific scales were noted (P = 0.003). Strong correlation was observed between EQ-5D and FACT-E (R = 0.73), along with physical and functional subscales. In addition, the association between FACT-E and EQ-5D HUS was maintained in a multivariable model (P < 0.001). We interpret these results to suggest that in a real-world clinic setting, FACT-E, EQ-5D HUS, and symptoms were strongly correlated. Most HRQOL and symptom parameters suggested that patients had worse HRQOL and symptoms during curative therapy

Epidemiology of Shiga toxin producing Escherichia coli in Australia, 2000-2010

Directory of Open Access Journals (Sweden)

Vally Hassan

2012-01-01

Full Text Available Abstract Background Shiga toxin-producing Escherichia coli (STEC are an important cause of gastroenteritis in Australia and worldwide and can also result in serious sequelae such as haemolytic uraemic syndrome (HUS. In this paper we describe the epidemiology of STEC in Australia using the latest available data. Methods National and state notifications data, as well as data on serotypes, hospitalizations, mortality and outbreaks were examined. Results For the 11 year period 2000 to 2010, the overall annual Australian rate of all notified STEC illness was 0.4 cases per 100,000 per year. In total, there were 822 STEC infections notified in Australia over this period, with a low of 1 notification in the Australian Capital Territory (corresponding to a rate of 0.03 cases per 100,000/year and a high of 413 notifications in South Australia (corresponding to a rate of 2.4 cases per 100,000/year, the state with the most comprehensive surveillance for STEC infection in the country. Nationally, 71.2% (504/708 of STEC infections underwent serotype testing between 2001 and 2009, and of these, 58.0% (225/388 were found to be O157 strains, with O111 (13.7% and O26 (11.1% strains also commonly associated with STEC infections. The notification rate for STEC O157 infections Australia wide between 2001-2009 was 0.12 cases per 100,000 per year. Over the same 9 year period there were 11 outbreaks caused by STEC, with these outbreaks generally being small in size and caused by a variety of serogroups. The overall annual rate of notified HUS in Australia between 2000 and 2010 was 0.07 cases per 100,000 per year. Both STEC infections and HUS cases showed a similar seasonal distribution, with a larger proportion of reported cases occurring in the summer months of December to February. Conclusions STEC infections in Australia have remained fairly steady over the past 11 years. Overall, the incidence and burden of disease due to STEC and HUS in Australia appears

Teknologi med arkitektonisk kvalitet

DEFF Research Database (Denmark)

Sørensen, Peter

2001-01-01

Kortfattet artikel om forholdet mellem arkitektonisk fremtræden og den valgte teknologi. Der beskrives to principielt forskellige tilgange til teknologi som redskab for arkitektur: den anonyme teknologi og den synonyme teknologi. Disse to begreber relateres til den aktuelle Projekt-Hus debat om...

Teknologi med arkitektonisk kvalitet

DEFF Research Database (Denmark)

Sørensen, Peter

2001-01-01

Kortfattet artikel om forholdet mellem arkitektonisk fremtræden og den valgte teknologi. Der beskrives to principielt forskellige tilgange til teknologi som redskab for arkitektur: den anonyme teknologi og den synonyme teknologi. Disse to begrebet relateres til den aktuelle Projekt-Hus debat om...

An international consensus approach to the management of atypical hemolytic uremic syndrome in children

NARCIS (Netherlands)

Loirat, C.; Fakhouri, F.; Ariceta, G.; Besbas, N.; Bitzan, M.; Bjerre, A.; Coppo, R.; Emma, F.; Johnson, S.; Karpman, D.; Landau, D.; Langman, C.B.; Lapeyraque, A.L.; Licht, C.; Nester, C.; Pecoraro, C.; Riedl, M.; Kar, N.C.A.J. van de; Walle, J. Vande; Vivarelli, M.; Fremeaux-Bacchi, V.

2016-01-01

Atypical hemolytic uremic syndrome (aHUS) emerged during the last decade as a disease largely of complement dysregulation. This advance facilitated the development of novel, rational treatment options targeting terminal complement activation, e.g., using an anti-C5 antibody (eculizumab). We review

Středověká vyobrazení Jana Husa – teologické interpretace historických událostí

Czech Academy of Sciences Publication Activity Database

Studničková, Milada

2013-01-01

Roč. 53, č. 1 (2013), s. 79-92 ISSN 0323-0562 R&D Projects: GA ČR(CZ) GBP405/12/G148 Keywords : Jan Hus * Martinitz Bible * Gradual of Leitmeritz * biblical exegesis * typological parallelism Subject RIV: AL - Art, Architecture, Cultural Heritage

Forskerland.dk

DEFF Research Database (Denmark)

2009-01-01

Valg af materiale/medie/form: Digital materiale på internettet med emner inden for Naturområder, Livets udvikling, Forskernes hus, Himmelrummet, Ekspeditioner og Naturkatastrofer. Valg af arbejdsform: Internet-udgave, som giver elever mulighed for at arbejde individuelt med forskellige emner. Beg...

Human Serum is as Efficient as Fetal Bovine Serum in Supporting Proliferation and Differentiation of Human Multipotent Stromal (Mesenchymal) Stem Cells In Vitro and In Vivo

DEFF Research Database (Denmark)

Aldahmash, Abdullah; Haack-Sørensen, Mandana; Al-Nbaheen, May

2011-01-01

BACKGROUND: Human multipotent stromal (skeletal, mesenchymal) stem cells (hMSC) are employed in an increasing number of clinical trials for tissue regeneration of age-related degenerative diseases. However, routine use of fetal bovine sera (FBS) for their in vitro expansion is not optimal and may......) or adipocytic markers (PPAR-gamma2, lipoprotein lipase (LPL), aP2), respectively. In order to test for the functional capacity of hMSC-TERT that have been maintained in long-term cultures in the presence of HuS vs. FBS, the cells were mixed with hydroxyapatite/tricalcium phosphate (HA/TCP) and implanted...... subcutaneously in immune deficient mice. hMSC maintained in HuS vs. FBS formed comparable heterotopic bone. DISCUSSION: Human serum can support proliferation and differentiation of hMSC in vitro and can maintain their bone forming capacity in vivo. The use of human serum in cell cultures of hMSC intended...

Recurrent atypical hemolytic uremic syndrome after renal transplantation: treatment with eculizumab

Directory of Open Access Journals (Sweden)

Ana B. Latzke

2018-04-01

Full Text Available Atypical hemolytic uremic syndrome (aHUS is a rare entity. It is characterized by a thrombotic microangiopathy (nonimmune hemolytic anemia, thrombocytopenia, and acute renal failure, with a typical histopathology of thickening of capillary and arteriolar walls and an obstructive thrombosis of the vascular lumen. The syndrome is produced by a genetic or acquired deregulation of the alternative pathway of the complement system, with high rates of end stage renal disease, post-transplant recurrence, and high mortality. Mutations associated with factor H, factor B and complement C3 show the worst prognosis. Even though plasma therapy is occasionally useful, eculizumab is effective both for treatment and prevention of post-transplant recurrence. We describe here an adult case of congenital aHUS (C3 mutation under preventive treatment with eculizumab after renal transplantation, with neither disease recurrence nor drug-related adverse events after a 36-months follow-up.

Belatacept for Maintenance Immunosuppression in Lung Transplantation

Directory of Open Access Journals (Sweden)

Christine Hui PharmD

2014-06-01

Full Text Available Belatacept is a novel immunosuppressant that blocks a T-cell costimulation pathway and is approved for use in adult kidney transplant recipients. Its safety and efficacy have not been established after lung transplantation. We present a case of a lung transplant recipient treated with belatacept. A 56-year-old man underwent bilateral lung retransplantation for bronchiolitis obliterans syndrome (BOS. In the third year posttransplant, he developed hemolytic uremic syndrome (HUS attributed to tacrolimus. Tacrolimus was changed to sirolimus. One month later, he presented with worsening renal function and HUS attributed to sirolimus. Plasmapheresis and steroid pulse were initiated with clinical improvement, and sirolimus was switched to belatacept. He experienced no episodes of cellular rejection but developed recurrent BOS. Complications during treatment included anemia and recurrent pneumonias. The safety and efficacy of belatacept in lung transplantation remains unclear; further studies are needed.

Circulating microRNAs in patients with Shiga-Toxin-producing E. coli O104:H4 induced hemolytic uremic syndrome.

Directory of Open Access Journals (Sweden)

Johan M Lorenzen

Full Text Available BACKGROUND: In early May 2011, an outbreak of hemorrhagic colitis associated with hemolytic-uremic syndrome (HUS first developed in Northern Germany and spread to 15 other countries in Europe. The outbreak-strain O104:H4, which combined virulence factors of typical enteroaggregative and Shiga-Toxin-producing E. coli was associated with an unusual high rate of hemolytic uremic syndrome. Also an unexpected high rate of coma and seizures leading to mechanical ventilation and ICU treatment was observed. MicroRNAs are small ribonucleotides orchestrating gene expression. We tested whether circulating microRNAs in serum of HUS patients during the 2011 epidemics are altered in this patient cohort and related to clinical manifestations. METHODOLOGY/PRINCIPAL FINDINGS: We profiled microRNAs using RNA isolated from serum of patients and healthy age-matched controls. The results were validated in 38 patients at baseline, 29 patients during follow-up and 21 age-matched healthy controls by miRNA-specific quantitative RT-PCR. Circulating levels of miR-24, miR-126 were increased in HUS patients versus controls. There was no association between these microRNAs and renal function or the need for renal replacement therapy. In contrast, levels of miR-126 were associated with neurological symptoms at baseline and during follow-up. In addition, miR-126 (on admission and miR-24 (on admission and during follow-up were associated with platelet count. CONCLUSIONS/SIGNIFICANCE: Circulating microRNAs are strongly altered in this patient cohort and associated with neurological symptoms as well as platelet count.

Shiga toxin 1 induces on lipopolysaccharide-treated astrocytes the release of tumor necrosis factor-alpha that alter brain-like endothelium integrity.

Directory of Open Access Journals (Sweden)

Verónica I Landoni

Full Text Available The hemolytic uremic syndrome (HUS is characterized by hemolytic anemia, thrombocytopenia and renal dysfunction. The typical form of HUS is generally associated with infections by Gram-negative Shiga toxin (Stx-producing Escherichia coli (STEC. Endothelial dysfunction induced by Stx is central, but bacterial lipopolysaccharide (LPS and neutrophils (PMN contribute to the pathophysiology. Although renal failure is characteristic of this syndrome, neurological complications occur in severe cases and is usually associated with death. Impaired blood-brain barrier (BBB is associated with damage to cerebral endothelial cells (ECs that comprise the BBB. Astrocytes (ASTs are inflammatory cells in the brain and determine the BBB function. ASTs are in close proximity to ECs, hence the study of the effects of Stx1 and LPS on ASTs, and the influence of their response on ECs is essential. We have previously demonstrated that Stx1 and LPS induced activation of rat ASTs and the release of inflammatory factors such as TNF-α, nitric oxide and chemokines. Here, we demonstrate that rat ASTs-derived factors alter permeability of ECs with brain properties (HUVECd; suggesting that functional properties of BBB could also be affected. Additionally, these factors activate HUVECd and render them into a proagregant state promoting PMN and platelets adhesion. Moreover, these effects were dependent on ASTs secreted-TNF-α. Stx1 and LPS-induced ASTs response could influence brain ECs integrity and BBB function once Stx and factors associated to the STEC infection reach the brain parenchyma and therefore contribute to the development of the neuropathology observed in HUS.

Psychiatric features in perpetrators of homicide-unsuccessful-suicide at Weskoppies Hospital in a 5-year period

Directory of Open Access Journals (Sweden)

Paul Sussman

2013-03-01

Full Text Available Background. In the absence of medical literature reporting on homicide-unsuccessful-suicide (HUS cases in which the perpetrator is referred for forensic psychiatric observation present an opportunity to explore psychiatric features pertaining to the event. Objective. To identify possible contributing psychiatric features in HUS cases. Method. A retrospective, single-centre, descriptive study was conducted, in which were reviewed clinical records of HUS subjects referred for observation to Weskoppies Hospital from December 2005 to January 2011. Socio-demographic and psychiatric information was obtained. Results. Nine cases were reviewed. The median age of the subjects was 29 years and 7 subjects were male. Five cases involved family members. Cases involving couples demonstrated male subjects and cases involving filicide demonstrated female subjects. Only 1 case involved the use of a firearm. At the time of the incident, 4 of the cases had no psychiatric diagnosis but notable interpersonal difficulties. Psychotic disorders were diagnosed in 3 subjects, a depressive disorder in 1 subject and a depressive and anxiety disorder in 1 subject. Conclusion. Subjects commonly used less lethal methods than shooting. The high rate of psychiatric disorders diagnosed is in keeping with court referrals occurring when a mental illness is suspected. Some cases may require specialised probing before psychosis becomes apparent. Identification of psychosocial stressors and failure of coping mechanisms during periods of strife within an intimate relationship may be a focus of future research in homicide-suicide cases. Separation should possibly be investigated as an independent factor which promotes the interpersonal difficulty associated with homicide-suicide.

Shiga Toxin 1 Induces on Lipopolysaccharide-Treated Astrocytes the Release of Tumor Necrosis Factor-alpha that Alter Brain-Like Endothelium Integrity

Science.gov (United States)

Landoni, Verónica I.; Schierloh, Pablo; de Campos Nebel, Marcelo; Fernández, Gabriela C.; Calatayud, Cecilia; Lapponi, María J.; Isturiz, Martín A.

2012-01-01

The hemolytic uremic syndrome (HUS) is characterized by hemolytic anemia, thrombocytopenia and renal dysfunction. The typical form of HUS is generally associated with infections by Gram-negative Shiga toxin (Stx)-producing Escherichia coli (STEC). Endothelial dysfunction induced by Stx is central, but bacterial lipopolysaccharide (LPS) and neutrophils (PMN) contribute to the pathophysiology. Although renal failure is characteristic of this syndrome, neurological complications occur in severe cases and is usually associated with death. Impaired blood-brain barrier (BBB) is associated with damage to cerebral endothelial cells (ECs) that comprise the BBB. Astrocytes (ASTs) are inflammatory cells in the brain and determine the BBB function. ASTs are in close proximity to ECs, hence the study of the effects of Stx1 and LPS on ASTs, and the influence of their response on ECs is essential. We have previously demonstrated that Stx1 and LPS induced activation of rat ASTs and the release of inflammatory factors such as TNF-α, nitric oxide and chemokines. Here, we demonstrate that rat ASTs-derived factors alter permeability of ECs with brain properties (HUVECd); suggesting that functional properties of BBB could also be affected. Additionally, these factors activate HUVECd and render them into a proagregant state promoting PMN and platelets adhesion. Moreover, these effects were dependent on ASTs secreted-TNF-α. Stx1 and LPS-induced ASTs response could influence brain ECs integrity and BBB function once Stx and factors associated to the STEC infection reach the brain parenchyma and therefore contribute to the development of the neuropathology observed in HUS. PMID:22479186

International comparative studies of education and large scale change

NARCIS (Netherlands)

Howie, Sarah; Plomp, T.; Bascia, Nina; Cumming, Alister; Datnow, Amanda; Leithwood, Kenneth; Livingstone, David

2005-01-01

The development of international comparative studies of educational achievements dates back to the early 1960s and was made possible by developments in sample survey methodology, group testing techniques, test development, and data analysis (Husén & Tuijnman, 1994, p. 6). The studies involve

Human mannose-binding lectin inhibitor prevents Shiga toxin-induced renal injury

DEFF Research Database (Denmark)

Ozaki, Masayuki; Kang, Yulin; Tan, Ying Siow

2016-01-01

Hemolytic uremic syndrome caused by Shiga toxin-producing Escherichia coli (STEC HUS) is a worldwide endemic problem, and its pathophysiology is not fully elucidated. Here we tested whether the mannose-binding lectin (MBL2), an initiating factor of lectin complement pathway activation, plays a cr...

Několik textů z odpustkové aféry aneb co je nového v roce 1412

Czech Academy of Sciences Publication Activity Database

Soukup, Pavel

2015-01-01

Roč. 7, č. 2 (2015), s. 249-288 ISSN 1804-0977 R&D Projects: GA ČR(CZ) GBP405/12/G148 Institutional support: RVO:67985955 Keywords : indulgences * Hussitism * Wycliffism * religious polemics * medieval theology * John XXIII (antipope) * Jan Hus Subject RIV: AB - History

fruits cterizat (Ziziph tion of hus ma f ascor auri

African Journals Online (AJOL)

SAM

presented in Table 3 shows that DEPC, DTT, NaBH4 and mercaptoethanol inhibited ... reducing agents such as mercaptoethanol and DTT could inhibit APX activity via hydrolysis of the disulphide bridges in the structure. DEPC inhibited the ...

haemolytic-uraemic syndrome in children from south India

African Journals Online (AJOL)

Though rare in children, D- HUS is an important disorder in paediatric .... in three (Fig. 2). Glomerular changes included focal seg mental ... has been linked to 40% of cases. Drugs, .... Characterization of the cytokine immune response in ... system abnormalities in patients with atypical hemolytic uremic syndrome. Clin.

Verocytotoxin producing E. Coli O157 on farms : prevalences, risk factors and transmission

NARCIS (Netherlands)

Schouten, J.M.

2005-01-01

Infection with verocytotoxin producing Escherichia coli (VTEC) O157 in humans can lead to mild or bloody diarrhoea, with e.g. the haemolytic uraemic syndrome (HUS) as possible complication. Cattle appear to be important reservoirs of O157 VTEC. The main

Biblické a patristické zdroje Husova Kázání o pokoji a Komenského irénismu

Czech Academy of Sciences Publication Activity Database

Beneš, Jiří

2015-01-01

Roč. 45, 93/94 (2015), s. 33-45 ISSN 0323-2220 R&D Projects: GA ČR(CZ) GBP401/12/G168 Institutional support: RVO:67985955 Keywords : Jan Hus * J. A. Comenius * Bohemian reformation * thinking of peace * patristic tradition Subject RIV: AA - Philosophy ; Religion

Materials Research Society Spring Meeting Symposium KK: Microbial Life on Surfaces: Biofilm-Material Interactions: Life at Interfaces. Held in San Francisco, California on 25-27 April 2011 (Abstracts)

Science.gov (United States)

2012-05-24

cases, virulent strains can cause for haemolytic-uremic syndrome (HUS), peritonitis, mastitis , septicemia and gram-negative pneumonia. E. coli...and betaine-modified rods exposed to 50% fetal bovine serum for 1, 30, 60, or 90 days were tested for antimicrobial/antibiofilm activity using the mCDC

Yeast Interacting Proteins Database: YDR311W, YLR288C [Yeast Interacting Proteins Database

Lifescience Database Archive (English)

Full Text Available f a heterotrimeric complex (Rad17p-Mec3p-Ddc1p) that forms a sliding clamp, loaded onto partial duplex...liding clamp, loaded onto partial duplex DNA by a clamp loader complex; homolog of human and S. pombe Hus1 R

Mistr Jakoubek ze Stříbra a testimonia Husovy mučednické smrti z let 1415-1417

Czech Academy of Sciences Publication Activity Database

Šmahel, František

2015-01-01

Roč. 62, č. 1 (2015), s. 313-323 ISSN 1803-7429 Institutional support: RVO:67985955 Keywords : Jacob of Mies * Jan Hus * Jerome of Prague * University of Prague * Council of Constance * communion under both kinds Subject RIV: AB - History http://hdl.handle.net/11222.digilib/134677

Prevention of chemotherapy-induced nephrotoxicity in children with cancer

Directory of Open Access Journals (Sweden)

Fatemeh Ghane Sharbaf

2017-01-01

Full Text Available Children with cancer treated with cytotoxic drugs are frequently at risk of developing renal dysfunction. The cytotoxic drugs that are widely used for cancer treatment in children are cisplatin (CPL, ifosfamide (IFO, carboplatin, and methotrexate (MTX. Mechanisms of anticancer drug-induced renal disorders are different and include acute kidney injury (AKI, tubulointerstitial disease, vascular damage, hemolytic uremic syndrome (HUS, and intrarenal obstruction. CPL nephrotoxicity is dose-related and is often demonstrated with hypomagnesemia, hypokalemia, and impaired renal function with rising serum creatinine and blood urea nitrogen levels. CPL, mitomycin C, and gemcitabine treatment cause vascular injury and HUS. High-dose IFO, streptozocin, and azacitidine cause renal tubular dysfunction manifested by Fanconi syndrome, rickets, and osteomalacia. AKI is a common adverse effect of MTX, interferon-alpha, and nitrosourea compound treatment. These strategies to reduce the cytotoxic drug-induced nephrotoxicity should include adequate hydration, forced diuresis, and urinary alkalization. Amifostine, sodium thiosulfate, and diethyldithiocarbamate provide protection against CPL-induced renal toxicity.

Clostridium sordellii as a Cause of Fatal Septic Shock in a Child with Hemolytic Uremic Syndrome

Directory of Open Access Journals (Sweden)

Rebekah Beyers

2014-01-01

Full Text Available Clostridium sordellii is a toxin producing ubiquitous gram-positive anaerobe, mainly associated with trauma, soft tissue skin infections, and gynecologic infection. We report a unique case of a new strain of Clostridium sordellii (not present in the Center for Disease Control (CDC database infection induced toxic shock syndrome in a previously healthy two-year-old male with colitis-related hemolytic uremic syndrome (HUS. The patient presented with dehydration, vomiting, and bloody diarrhea. He was transferred to the pediatric critical care unit (PICU for initiation of peritoneal dialysis (PD. Due to increased edema and intolerance of PD, he was transitioned to hemodialysis through a femoral vascular catheter. He subsequently developed severe septic shock with persistent leukocytosis and hypotension, resulting in subsequent death. Stool culture confirmed Shiga toxin producing Escherichia coli 0157:H7. A blood culture was positively identified for Clostridium sordellii. Clostridium sordelli is rarely reported in children; to our knowledge this is the first case described in a pediatric patient with HUS.

Hounsfield unit recovery in clinical cone beam CT images of the thorax acquired for image guided radiation therapy

DEFF Research Database (Denmark)

Thing, Rune Slot; Bernchou, Uffe; Mainegra-Hing, Ernesto

2016-01-01

-correspondence with the planning CT images, and total volume HU error. Artefacts are reduced and CT-like HUs are recovered in the artefact corrected CBCT images. Visual inspection confirms that artefacts are indeed suppressed by the proposed method, and the HU root mean square difference between reconstructed CBCTs...

Characterization of free lytic bacteriophages isolated from compost against O145 Shiga toxin-producing Escherichia coli (STEC) as a potential biocontrol agent

Science.gov (United States)

Shiga toxin-producing E. coli (STEC), one of the most prevalent foodborne pathogens, are notorious for hemolytic uremic syndrome (HUS) and causing high mortality among children and the elder population after infection. Besides O157 STEC, non-O157 STEC—particularly serogroup O145—is commonly associat...

Unit 1A: General Approach to the Teaching of Architecture

DEFF Research Database (Denmark)

Gammelgaard Nielsen, Anders

2011-01-01

An ideal course Ever since the founding of the Aar- hus School of Architecture in 1965 there has been a tradition for lively discussion surrounding the content of the architecture program. The discussion has often been con- ducted from ideological or norma- tive positions, with the tendency to st...

Zprávy o smrti Jana Husa ve Starých letopisech českých

Czech Academy of Sciences Publication Activity Database

Černá, Alena M.

2016-01-01

Roč. 87, č. 1 (2016), s. 45-61 ISSN 1211-7617 R&D Projects: GA ČR(CZ) GBP405/12/G148 Institutional support: RVO:68378092 Keywords : 15th century * Old Czech language * Jan Hus * Petr of Mladoňovice * Old Czech Annals Subject RIV: AI - Linguistics

Quantitative risk assessment for Escherichia coli O157:H7 in frozen ground beef patties consumed by young children in French households.

Science.gov (United States)

Delignette-Muller, M L; Cornu, M

2008-11-30

A quantitative risk assessment for Escherichia coli O157:H7 in frozen ground beef patties consumed by children under 10 years of age in French households was conducted by a national study group describing an outbreak which occurred in France in 2005. Our exposure assessment model incorporates results from French surveys on consumption frequency of ground beef patties, serving size and consumption preference, microbial destruction experiments and microbial counts on patties sampled from the industrial batch which were responsible for the outbreak. Two different exposure models were proposed, respectively for children under the age of 5 and for children between 5 and 10 years. For each of these two age groups, a single-hit dose-response model was proposed to describe the probability of hemolytic and uremic syndrome (HUS) as a function of the ingested dose. For each group, the single parameter of this model was estimated by Bayesian inference, using the results of the exposure assessment and the epidemiological data collected during the outbreak. Results show that children under 5 years of age are roughly 5 times more susceptible to the pathogen than children over 5 years. Exposure and dose-response models were used in a scenario analysis in order to validate the use of the model and to propose appropriate guidelines in order to prevent new outbreaks. The impact of the cooking preference was evaluated, showing that only a well-done cooking notably reduces the HUS risk, without annulling it. For each age group, a relation between the mean individual HUS risk per serving and the contamination level in a ground beef batch was proposed, as a tool to help French risk managers.

Comparative Genomics of Recent Shiga Toxin-Producing Escherichia coli O104:H4: Short-Term Evolution of an Emerging Pathogen

Science.gov (United States)

Grad, Yonatan H.; Godfrey, Paul; Cerquiera, Gustavo C.; Mariani-Kurkdjian, Patricia; Gouali, Malika; Bingen, Edouard; Shea, Terrence P.; Haas, Brian J.; Griggs, Allison; Young, Sarah; Zeng, Qiandong; Lipsitch, Marc; Waldor, Matthew K.; Weill, François-Xavier; Wortman, Jennifer R.; Hanage, William P.

2013-01-01

ABSTRACT The large outbreak of diarrhea and hemolytic uremic syndrome (HUS) caused by Shiga toxin-producing Escherichia coli O104:H4 in Europe from May to July 2011 highlighted the potential of a rarely identified E. coli serogroup to cause severe disease. Prior to the outbreak, there were very few reports of disease caused by this pathogen and thus little known of its diversity and evolution. The identification of cases of HUS caused by E. coli O104:H4 in France and Turkey after the outbreak and with no clear epidemiological links raises questions about whether these sporadic cases are derived from the outbreak. Here, we report genome sequences of five independent isolates from these cases and results of a comparative analysis with historical and 2011 outbreak isolates. These analyses revealed that the five isolates are not derived from the outbreak strain; however, they are more closely related to the outbreak strain and each other than to isolates identified prior to the 2011 outbreak. Over the short time scale represented by these closely related organisms, the majority of genome variation is found within their mobile genetic elements: none of the nine O104:H4 isolates compared here contain the same set of plasmids, and their prophages and genomic islands also differ. Moreover, the presence of closely related HUS-associated E. coli O104:H4 isolates supports the contention that fully virulent O104:H4 isolates are widespread and emphasizes the possibility of future food-borne E. coli O104:H4 outbreaks. PMID:23341549

Using DRG to analyze hospital production: a re-classification model based on a linear tree-network topology

Directory of Open Access Journals (Sweden)

Achille Lanzarini

2014-09-01

Full Text Available Background: Hospital discharge records are widely classified through the Diagnosis Related Group (DRG system; the version currently used in Italy counts 538 different codes, including thousands of diagnosis and procedures. These numbers reflect the considerable effort of simplification, yet the current classification system is of little use to evaluate hospital production and performance.Methods: As the case-mix of a given Hospital Unit (HU is driven by its physicians’ specializations, a grouping of DRGs into a specialization-driven classification system has been conceived through the analysis of HUs discharging and the ICD-9-CM codes. We propose a three-folded classification, based on the analysis of 1,670,755 Hospital Discharge Cards (HDCs produced by Lombardy Hospitals in 2010; it consists of 32 specializations (e.g. Neurosurgery, 124 sub-specialization (e.g. skull surgery and 337 sub-sub-specialization (e.g. craniotomy.Results: We give a practical application of the three-layered approach, based on the production of a Neurosurgical HU; we observe synthetically the profile of production (1,305 hospital discharges for 79 different DRG codes of 16 different MDC are grouped in few groups of homogeneous DRG codes, a more informative production comparison (through process-specific comparisons, rather than crude or case-mix standardized comparisons and a potentially more adequate production planning (considering the Neurosurgical HUs of the same city, those produce a limited quote of the whole neurosurgical production, because the same activity can be realized by non-Neurosugical HUs.Conclusion: Our work may help to evaluate the hospital production for a rational planning of available resources, blunting information asymmetries between physicians and managers. 

The Autism Diagnostic Observation Schedule, Module 4: Application of the Revised Algorithms in an Independent, Well-Defined, Dutch Sample (N = 93)

Science.gov (United States)

de Bildt, Annelies; Sytema, Sjoerd; Meffert, Harma; Bastiaansen, Jojanneke A. C. J.

2016-01-01

This study examined the discriminative ability of the revised Autism Diagnostic Observation Schedule module 4 algorithm (Hus and Lord in "J Autism Dev Disord" 44(8):1996-2012, 2014) in 93 Dutch males with Autism Spectrum Disorder (ASD), schizophrenia, psychopathy or controls. Discriminative ability of the revised algorithm ASD cut-off…

Genotype/phenotype correlations in complement factor h deficiency arising from uniparental isodisomy

DEFF Research Database (Denmark)

Wilson, Valerie; Darlay, Rebecca; Wong, William

2013-01-01

We report a male infant who presented at 8 months of age with atypical hemolytic uremic syndrome (aHUS) responsive to plasma therapy. Investigation showed him to have complement factor H (CFH) deficiency associated with a homozygous CFH mutation (c.2880delT [p.Phe960fs]). Mutation screening of th...

Postdiarrheal Shiga Toxin-Mediated Hemolytic Uremic Syndrome Similar to Septic Shock Síndrome urémico hemolítico símil shock séptico, posterior a diarrea mediada por toxina shiga

Directory of Open Access Journals (Sweden)

Patricia G. Valles

2005-10-01

Full Text Available The inflammatory response of host endothelial cells is included in the development of vascular damage observed in enterohemorrhagic Escherichia coli (EHEC infection, resulting in hemolytic uremic syndrome (HUS. The response to a non-conventional treatment for a group of D+ HUS (diarrhea positive HUS patients, with clinical hemodynamic parameters of septic shock was evaluated in this prospective study (1999-2003. Twelve children 2.8 ± 0.6 years old, with D+ HUS produced by E. coli infection with serological evidence of Shiga toxin, presenting severe unstable hemodynamic parameters and neurological dysfunction at onset, were studied. The protocol included fresh frozen plasma infusions, methylprednisolone pulses (10mg/k/day for three consecutive days and plasma exchange for five days, starting after admission to the intensive care unit (ICU. The twelve patients with increased pediatric risk of mortality (PRISM score: 18 ± 2 after admission to intensive care unit (ICU, required dialysis for 17.4 ± 4 days, mechanical ventilator assistance for 10 ± 1 days and early inotropic drugs support for 10.5 ± 1 days. Neurological dysfunction included generalized tonic-clonic seizures lasting for 5.4 ± 1 days, n:8. Focal seizures were present in the remaining patients. Dilated cardiomyopathy was present in 6 children. Eight children suffered hemorrhagic colitis. Nine patients survived. Within one year of the injury, neurological sequelae, Glasgow outcome scale (GOS 3 and 4, were present in two patients, chronic renal failure in one patient. We suggest that early introduction of this protocol could benefit D+ HUS patients with hemodynamic instability and neurological dysfunction at onset. Further studies are likely to elucidate the mechanisms involved in this early adverse clinical presentation of D+ HUS patients.La respuesta inflamatoria de la célula endotelial se incluye en el desarrollo del daño vascular observado en la infección por Escherichia coli

Haemolytic Uraemic Syndrome: An Unusual Cause of Jaundice ...

African Journals Online (AJOL)

HUS should be considered in patients presenting with jaundice to the emergency room in the setting of the above mentioned triad. Case Report: This case report is about a 41 year old lady who presented with jaundice, thrombocytopenia, anemia and renal failure. In the course of investigating the cause of her symptoms, ...

The role of gallery forests in maintaining Phlebotominae populations: potential Leishmania spp. vectors in the Brazilian savanna

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Tâmara Dias Oliveira Machado

Full Text Available BACKGROUND Knowledge on synanthropic phlebotomines and their natural infection by Leishmania is necessary for the identification of potential areas for leishmaniasis occurrence. OBJECTIVE To analyse the occurrence of Phlebotominae in gallery forests and household units (HUs in the city of Palmas and to determine the rate of natural infection by trypanosomatids. METHODS Gallery forests and adjacent household areas were sampled on July (dry season and November (rainy season in 2014. The total sampling effort was 960 HP light traps and eight Shannon traps. Trypanosomatids were detected in Phlebotominae females through the amplification of the SSU rDNA region, and the positive samples were used in ITS1-PCR. Trypanosomatid species were identified using sequencing. FINDINGS A total of 1,527 sand flies representing 30 species were captured in which 949 (28 spp. and 578 (22 spp. were registered in July and November, respectively. In July, more specimens were captured in the gallery forests than in the HUs, and Nyssomyia whitmani was particularly frequent. In November, most of the specimens were found in the HUs, and again, Ny. whitmani was the predominant species. Lutzomyia longipalpis was commonly found in domestic areas, while Bichromomyia flaviscutellata was most frequent in gallery forests. Molecular analysis of 154 pools of females (752 specimens identified Leishmania amazonensis, L. infantum, and Crithidia fasciculata in Ny. whitmani, as well as L. amazonensis in Lu. longipalpis, Trypanosoma sp. and L. amazonensis in Pintomyia christenseni, and L. amazonensis in both Psathyromyia hermanlenti and Evandromyia walkeri. MAIN CONCLUSIONS These results show the importance of gallery forests in maintaining Phlebotominae populations in the dry month, as well as their frequent occurrence in household units in the rainy month. This is the first study to identify Leishmania, Trypanosoma, and Crithidia species in Phlebotominae collected in Palmas, Tocantins

Clonal Diversity of Chilean Isolates of Enterohemorrhagic Escherichia coli from Patients with Hemolytic-Uremic Syndrome, Asymptomatic Subjects, Animal Reservoirs, and Food Products

Science.gov (United States)

Rios, Maritza; Prado, Valeria; Trucksis, Michele; Arellano, Carolina; Borie, Consuelo; Alexandre, Marcela; Fica, Alberto; Levine, Myron M.

1999-01-01

To determine clonal relationship among Chilean enterohemorrhagic Escherichia coli (EHEC) strains from different sources (clinical infections, animal reservoirs, and food), 54 EHEC isolates (44 of E. coli O157, 5 of E. coli O111, and 5 of E. coli O26) were characterized for virulence genes by colony blot hybridization and by pulsed-field gel electrophoresis (PFGE). By colony blotting, 12 different genotypes were identified among the 44 E. coli O157 isolates analyzed, of which the genetic profile stx1+ stx2+ hly+ eae+ was the most prevalent. All human O157 strains that were associated with sporadic cases of hemolytic-uremic syndrome (HUS) carried both the stx1 and stx2 toxin-encoding genes and were eaeA positive. Only 9 of 13 isolates from human controls were stx1+ stx2+, and 8 carried the eaeA gene. Comparison of profiles obtained by PFGE of XbaI-digested genomic DNA showed a great diversity among the E. coli O157 isolates, with 37 different profiles among 39 isolates analyzed. Cluster analysis of PFGE profiles showed a wide distribution of clinical isolates obtained from HUS cases and asymptomatic individuals and a clonal relationship among O157 isolates obtained from HUS cases and pigs. Analysis of virulence genes showed that a correlation exists among strains with the genotype stx1+ stx2+ eae+ and pathogenic potential. A larger difference in the PFGE restriction patterns was observed among the EHEC strains of serogroups O26 and O111. These results indicate that several different EHEC clones circulate in Chile and suggest that pigs are an important animal reservoir for human infections by EHEC. Guidelines have been proposed for better practices in the slaughter of animals in Chile. PMID:9986852

Critical congenital heart disease--utility of routine screening for chromosomal and other extracardiac malformations.

Science.gov (United States)

Baker, Kimberly; Sanchez-de-Toledo, Joan; Munoz, Ricardo; Orr, Richard; Kiray, Shareen; Shiderly, Dana; Clemens, Michele; Wearden, Peter; Morell, Victor O; Chrysostomou, Constantinos

2012-01-01

Objective.  Infants with critical congenital heart disease (CHD) can have genetic and other extracardiac malformations, which add to the short- and long-term risk of morbidity and perhaps mortality. We sought to examine our center's practice of screening for extracardiac anomalies and to determine the yield of these tests among specific cardiac diagnostic categories. Design.  Retrospective review of infants admitted to the cardiac intensive care unit with a new diagnosis of CHD. Subjects were categorized into six groups: septal defects (SD), conotruncal defects (CTD), single-ventricle physiology (SV), left-sided obstructive lesions (LSO), right-sided obstructive lesions (RSO), and "other" (anomalous pulmonary venous return, Ebstein's anomaly). Screening modalities included genetic testing (karyotype and fluorescent in situ hybridization for 22q11.2 deletion), renal ultrasound (RUS), and head ultrasound (HUS). Results.  One hundred forty-one patients were identified. The incidence of cardiac anomalies was: CTD (36%), SD (18%), SV (18%), LSO (14%), RSO (3%), and "other" (8%). Overall 14% had an abnormal karyotype, 5% had a deletion for 22q11.2, 28% had an abnormal RUS and 22% had abnormal HUS. Patients in SD and SV had the highest incidence of abnormal karyotype (36% and 17%); 22q11.2 deletion was present only in CTD and LSO groups (9% and 7%, respectively); abnormal RUS and HUS were seen relatively uniformly in all categories. Premature infants had significantly higher incidence of renal 43% vs. 24%, and intracranial abnormalities 46% vs. 16%. Conclusion.  Infants with critical CHD and particularly premature infants have high incidence of genetic and other extracardiac anomalies. Universal screening for these abnormalities with ultrasonographic and genetic testing maybe warranted because early detection could impact short and long-term outcomes. © 2011 Wiley Periodicals, Inc.

The role of gallery forests in maintaining Phlebotominae populations: potential Leishmania spp. vectors in the Brazilian savanna.

Science.gov (United States)

Machado, Tâmara Dias Oliveira; Minuzzi-Souza, Thaís Tâmara Castro; Ferreira, Tauana de Sousa; Freire, Luciana Pereira; Timbó, Renata Velôzo; Vital, Tamires Emanuele; Nitz, Nadjar; Silva, Mariana Neiva; Santos, Alcinei de Souza; Sales, Nathyla Morgana Cunha; Obara, Marcos Takashi; Andrade, Andrey José de; Gurgel-Gonçalves, Rodrigo

2017-10-01

Knowledge on synanthropic phlebotomines and their natural infection by Leishmania is necessary for the identification of potential areas for leishmaniasis occurrence. To analyse the occurrence of Phlebotominae in gallery forests and household units (HUs) in the city of Palmas and to determine the rate of natural infection by trypanosomatids. Gallery forests and adjacent household areas were sampled on July (dry season) and November (rainy season) in 2014. The total sampling effort was 960 HP light traps and eight Shannon traps. Trypanosomatids were detected in Phlebotominae females through the amplification of the SSU rDNA region, and the positive samples were used in ITS1-PCR. Trypanosomatid species were identified using sequencing. A total of 1,527 sand flies representing 30 species were captured in which 949 (28 spp.) and 578 (22 spp.) were registered in July and November, respectively. In July, more specimens were captured in the gallery forests than in the HUs, and Nyssomyia whitmani was particularly frequent. In November, most of the specimens were found in the HUs, and again, Ny. whitmani was the predominant species. Lutzomyia longipalpis was commonly found in domestic areas, while Bichromomyia flaviscutellata was most frequent in gallery forests. Molecular analysis of 154 pools of females (752 specimens) identified Leishmania amazonensis, L. infantum, and Crithidia fasciculata in Ny. whitmani, as well as L. amazonensis in Lu. longipalpis, Trypanosoma sp. and L. amazonensis in Pintomyia christenseni, and L. amazonensis in both Psathyromyia hermanlenti and Evandromyia walkeri. These results show the importance of gallery forests in maintaining Phlebotominae populations in the dry month, as well as their frequent occurrence in household units in the rainy month. This is the first study to identify Leishmania, Trypanosoma, and Crithidia species in Phlebotominae collected in Palmas, Tocantins, Brazil.

The efficacy and safety of oral Tamsulosin controlled absorption system (OCAS for the treatment of lower urinary tract symptoms due to bladder outlet obstruction associated with benign prostatic hyperplasia: an open-label preliminary study

Directory of Open Access Journals (Sweden)

Bannakij Lojanapiwat

2011-08-01

Full Text Available AIMS: Tamsulosin, a superselective subtype alpha 1a and 1d blocker, is used for the treatment of male lower urinary tract symptoms (LUTS commonly caused by benign prostatic hyperplasia (BPH. This prospective study evaluated the efficacy and safety of a new formulation, Tamsulosin OCAS® (Oral Controlled Absorption System, for LUTS associated with BPH in Thai patients. MATERIALS AND METHODS: Fifty one patients over 40 years old with complaints of LUTS associated with BPH were recruited. Patients received an 8 week course of once daily 0.4 mg tamsulosin OCAS®, and were followed up at 2 (visit 3, 4 (visit 4 and 8 (visit 5 weeks post-treatment. At each visit, patients were assessed using the International Prostate Symptom Score (IPSS, Nocturia Quality of Life (N-QoL Questionnaire, QoL Assessment Index (IPSS-QoL, and International Index of Erectile Function (IIEF. The primary outcome was efficacy of Tamsulosin. The secondary outcomes included change in the mean number of nocturia episodes, hours of undisturbed sleep (HUS and uroflowmetry measurements. RESULTS: Total IPSS significantly decreased at week 8 from baseline (from 19.52 to 6.08; p < 0.001. Similarly, the voiding and storage subscores of IPSS also continued to improve significantly starting from the second and third visits, respectively (p < 0.001 versus baseline. The IPSS-QoL and N-QoL scores significantly improved at visit 3 through end of study. In addition, we observed significant nocturia and HUS improvement in their last clinic visit. Uroflowmetry parameters, Qmax and Qave, improved significantly at 3rd clinic visit . Three patients experienced mild dizziness. CONCLUSION: Tamsulosin OCAS® treatment led to significant improvements in LUTS, HUS and QoL in Thai patients with bladder outlet obstruction from BPH with few side effects.

A study on CT attenuation and MR signal intensity of protein solution

International Nuclear Information System (INIS)

Kim, Joung Hae; Choi, Dae Seob; Kim, Soon; Lee, Hyeon Kyeong; Oh, Hyeon Hee; Kim, Seung Hyeon; Lee, Sung Woo; Chang, Kee Hyun; Chung, Jun Ho

2001-01-01

To correlate CT attenuation and MR signal intensity with concentration of protein solution. CT and MR examinations of a phantom containing bovine serum albumin solutions of various concentrations ranging from 0 to 55% were performed. CT Hounsfield units(HUs), MR signal intensities, and apparent diffusion coefficients (ADCs) of each albumin solution were measured, and CT HUs and MR signal intensities of the solutions were compared with those of cerebrospinal fluid (CSF), white matter, and cortical gray matter. CT HU increased gradually with increasing albumin concentration. On T1-weighted images(T1WI), signal intensity increased with increasing albumin concentrations of up to 35% but then decreased. On T2-weighted images(T2Wl), gradually decreasing signal intensity and increasing albumin concentration were observed Fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted images (DWls) showed that signal intensity peaked at a concentration of 10% and then gradually decreased. The ADC of the solution gradually decreased as concentration increased. Compared with those of normal brain structures, the CT HUs of solutions at concentrations of over 20% were higher than those of white and gray matter. At T1WI, the signal intensities of 10-45% solutions were similar to or higher than that of the gray matter. At T2Wl, the signal intensities of solutions above 25, 35, and 40% were lower than those of CSF, gray matter, and white matter, respectively. FLAIR images showed that the signal intensities of 5-35% solutions were higher than that of gray matter. The CT attenuation of albumin solution increased gradually with increasing concentration. MR signal intensities peaked at 35% concentration on T1WI and at 10% on FLAIR and DW images, respectively, and then gradually decreased. T2Wl and ADC map images showed gradually decreasing signal intensity and ADC as albumin concentration increased

Actualización en el tratamiento del síndrome urémico hemolítico endémico: Patogénesis y tratamiento de la complicación sistémica más grave de las infecciones por Escherichia coli productor de toxina Shiga Update on the treatment of endemic hemolytic uremic syndrome: Pathogenesis and treatment of the most severe systemic complication of infections by Shiga toxin-producing Escherichia coli

Directory of Open Access Journals (Sweden)

Romina J. Fernández-Brando

2011-08-01

Full Text Available La forma típica o post-diarreica del síndrome urémico hemolítico (SUH es la complicación más grave de las infecciones por cepas de Escherichia coli productoras de toxina Shiga (STEC. En la Argentina el SUH es un problema crítico de salud pública, ya que representa la principal causa de falla renal aguda en la infancia, la segunda causa de falla renal crónica, y aporta el 20% de los casos de transplante renal durante la infancia y la adolescencia. A pesar de los avances en el conocimiento de su patogénesis, el único tratamiento actual de los pacientes con SUH es de sostén, y no existen terapias específicas ni preventivas. En la presente revisión expondremos los conocimientos básicos de los mecanismos patogénicos y discutiremos los enfoques terapéuticos tradicionales e innovadores, con especial foco en la situación nacional y los aportes hechos por grupos de la Argentina.The typical form of hemolytic uremic syndrome (HUS is the major complication of Shiga toxin-producing Escherichia coli (STEC infections. HUS is a critical health problem in Argentina since it is the main cause of acute renal failure in children and the second cause of chronic renal failure, giving account for 20% of renal transplants in children and adolescents in our country. In spite of the extensive research in the field, the mainstay of treatment for patients with HUS is supportive therapy, and there are no specific therapies preventing or ameliorating the disease course. In this review, we present the current knowledge about pathogenic mechanisms and discuss traditional and innovative therapeutic approaches, with special focus in national status and contributions made by Argentinean groups.

Kina

DEFF Research Database (Denmark)

Nørup Sørensen, Camilla Tenna

2017-01-01

udvikling er kun blevet yderligere fremskyndet efter, at Donald Trump har indtaget Det Hvide Hus og med „America First” har varslet et mere isolationistisk USA. Det åbner nye muligheder og giver et større internationalt handlerum for Kina. Kapitlet har til formål at give baggrunden og konteksten for Kinas...

Filosoficko-teologické základy myšlení Jana Husa: Univerzálie a některá s nimi spojená témata

Czech Academy of Sciences Publication Activity Database

Pavlíček, Ota

2015-01-01

Roč. 63, č. 6 (2015), s. 859-892 ISSN 0015-1831 R&D Projects: GA ČR(CZ) GBP405/12/G148 Institutional support: RVO:67985955 Keywords : Jan Hus * John Wyclif * Prague University * universals * philosophical theology * creation * ideas in God's mind * first matter * analogical being * formal distinction Subject RIV: AA - Philosophy ; Religion

Zuzana Husárová: lyrika lidská i technologická

Czech Academy of Sciences Publication Activity Database

Piorecký, Karel

2016-01-01

Roč. 8, č. 38 (2016), s. 40-43 ISSN 1336-9644 R&D Projects: GA ČR GPP406/12/P603 Institutional support: RVO:68378068 Keywords : electronic literature * technology * sound poetry * perfomance * transmediality Subject RIV: AJ - Letters, Mass-media, Audiovision

Pathogenic Potential to Humans of Bovine Escherichia coli O26, Scotland

Science.gov (United States)

Rosser, Tracy; Allison, Lesley J.; Courcier, Emily; Evans, Judith; McKendrick, Iain J.; Pearce, Michael C.; Handel, Ian; Caprioli, Alfredo; Karch, Helge; Hanson, Mary F.; Pollock, Kevin G.J.; Locking, Mary E.; Woolhouse, Mark E.J.; Matthews, Louise; Low, J. Chris; Gally, David L.

2012-01-01

Escherichia coli O26 and O157 have similar overall prevalences in cattle in Scotland, but in humans, Shiga toxin–producing E. coli O26 infections are fewer and clinically less severe than E. coli O157 infections. To investigate this discrepancy, we genotyped E. coli O26 isolates from cattle and humans in Scotland and continental Europe. The genetic background of some strains from Scotland was closely related to that of strains causing severe infections in Europe. Nonmetric multidimensional scaling found an association between hemolytic uremic syndrome (HUS) and multilocus sequence type 21 strains and confirmed the role of stx2 in severe human disease. Although the prevalences of E. coli O26 and O157 on cattle farms in Scotland are equivalent, prevalence of more virulent strains is low, reducing human infection risk. However, new data on E. coli O26–associated HUS in humans highlight the need for surveillance of non-O157 enterohemorrhagic E. coli and for understanding stx2 phage acquisition. PMID:22377426

Thrombotic Microangiopathic Hemolytic Anemia without Evidence of Hemolytic Uremic Syndrome

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Şinasi Özsoylu

2016-03-01

Full Text Available In a recent issue of this journal Dr. Oymak and her colleagues presented a clinically and genetically well-studied 5-year-old boy who was seen with severe microangiopathic hemolytic anemia without laboratory findings of renal involvement despite complement factor H gene mutations [1]. Because of Yeneral’s extensive review [2] on atypical hemolytic uremic syndrome (aHUS published recently in the Turkish Journal of Hematology, I brought it to readers’ attention that more recently some authors do not use ‘aHUS’, which was historically used to distinguish heterogeneous uncharacterized syndromes from Shiga toxin-related HUS, since the term lacks both specificity and suggested causes [3]. Though in our patient with thrombotic thrombocytopenic purpura renal involvement was documented at the beginning but not in the last two recurrences, neither serum nor urinary findings indicated kidney involvement [4]. Although the discussions of Dr. Oymak et al. are well taken, the term ‘microangiopathic hemolytic anemia’ is covering the syndrome to a large extent as suggested by George and Nester

Brief Report: Relationship Between ADOS-2, Module 4 Calibrated Severity Scores (CSS) and Social and Non-Social Standardized Assessment Measures in Adult Males with Autism Spectrum Disorder (ASD)

Science.gov (United States)

Morrier, Michael J.; Ousley, Opal Y.; Caceres-Gamundi, Gabriella A.; Segall, Matthew J.; Cubells, Joseph F.; Young, Larry J.; Andari, Elissar

2017-01-01

The ADOS-2 Modules 1-3 now include a standardized calibrated severity score (CSS) from 1 to 10 based on the overall total raw score. Subsequent research published CSS for Module 4 (Hus, Lord, "Journal of Autism and Developmental Disorders" 44(8):1996-2012, 2014); however more research is needed to examine the psychometric properties of…

East Europe Report, Political, Sociological and Military Affairs, No. 2150

Science.gov (United States)

1983-06-09

Trup Voi Muntilor," Zoltan Jekely; "The Poet," Peter Zirkuli); I. Vinea—7 ("War," "A Remembrance," Janos Szasz ); I. Barbu—4 ("Miss Hus," Erno...Zoltan Jekely, Jozsef Meliusz, Kanyadi Sandor, Domokos Szilagyi, Janos Szasz and so forth. But, as any antholo- gy, it can be improved. First, by

Quantitative risk assessment of hemolytic uremic syndrome associated with consumption of bulk milk sold directly from producer to consumer in South Africa

DEFF Research Database (Denmark)

Ntuli, Victor; Njage, Patrick Murigu Kamau; Bonilauri, Paolo

2018-01-01

,000 servings consumed, the expected median numbers of HUS cases per year from raw PDBM were 52 for 5 years and younger and 3.2 for older than 5 years. The median numbers of cases per year for pasteurized PDBM were 47 for 5 years and younger and 2.9 for older than 5 years. Sensitivity analysis revealed...

Fatal case of hemolytic-uremic syndrome in an adult due to a rare serogroup O91 Entero hemorrhagic Escherichia coli associated with a Clostridium difficile infection. More than meets the eye

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Thomas Guillard

2015-08-01

Full Text Available Hemolytic-uremic syndrome due to enterohemorrhagic Escherichia coli, belonging to serogroup O91 has rarely been described. We report here a case of post-diarrheal HUS due to EHEC O91 in an elderly patient for whom diagnosis was delayed given a previously diagnosed C. difficile infection. This case highlights the usefulness of Shiga-toxin detection.

The Establishment of Barnahus in Denmark

DEFF Research Database (Denmark)

Søbjerg, Lene Mosegaard

2017-01-01

I 2013 blev fem børnehuse oprettet i Danmark med det formål at kvalificere og koordinere den indsats, der tilbydes børn og unge, der har været udsat for overgreb. Hensigten var at give børn og unge en helhedsorienteret indsats ved at samle flere offentlige instanser i et fælles hus. Kapitlet disk...

Mangelfuld radonsikring kan koste dyrt

DEFF Research Database (Denmark)

Kirkeskov, Jesper

2012-01-01

Hvad gør man for at undgå regningen for at skulle rive et nyt hus ned til fundamentet pga. mangelfuld radonsikring? Bygningsreglement 2010 kræver, at radonindholdet i nye bygninger højst er 100 Bq/m³. Særligt i områder med meget radon i jorden kan dette give udfordringer. Hvis bygningen er opført...

Quantitative MRI shows cerebral microstructural damage in hemolytic-uremic syndrome patients with severe neurological symptoms but no changes in conventional MRI

Energy Technology Data Exchange (ETDEWEB)

Weissenborn, Karin; Worthmann, Hans; Heeren, Meike [Hannover Medical School, Clinic for Neurology, Hannover (Germany); Bueltmann, Eva; Donnerstag, Frank; Giesemann, Anja M.; Goetz, Friedrich; Lanfermann, Heinrich; Ding, Xiao-Qi [Hannover Medical School, Institute of Diagnostic and Interventional Neuroradiology, Hannover (Germany); Kielstein, Jan; Schwarz, Anke [Hannover Medical School, Clinic for Nephrology and Hypertension, Hannover (Germany)

2013-07-15

Severe neurological symptoms in Shiga toxin-producing Escherichia coli infection associated hemolytic-uremic syndrome (STEC-HUS) are often accompanied by none or only mild alterations of cerebral magnetic resonance imaging (MRI). This study aims to analyze if quantitative MRI is able to reveal cerebral pathological alterations invisible for conventional MRI. In nine patients with STEC-HUS associated severe neurological symptoms but inconspicuous cerebral MRI findings maps of the parameters T2 relaxation time, relative proton density (PD), apparent diffusion coefficient (ADC), and fractional anisotropy (FA) were generated. Quantitative values of these parameters were measured at the basal ganglia, thalamus, and white matter of the frontal and parietal lobe and compared to those of nine age- and sex-matched controls. Significant T2 prolongation (p < 0.01) was found in the basal ganglia of all patients compared to controls. PD and ADC were not significantly altered. A significant reduction of FA in patients was seen at caput nuclei caudati (p < 0.01). Prolonged T2 relaxation time indicates cerebral microstructural damages in these patients despite their inconspicuous MRI findings. T2 relaxometry could be used as a complementary tool for the assessment of metabolic-toxic brain syndromes. (orig.)

Real-time genomic investigation underlying the public health response to a Shiga toxin-producing Escherichia coli O26:H11 outbreak in a nursery.

Science.gov (United States)

Moran-Gilad, J; Rokney, A; Danino, D; Ferdous, M; Alsana, F; Baum, M; Dukhan, L; Agmon, V; Anuka, E; Valinsky, L; Yishay, R; Grotto, I; Rossen, J W A; Gdalevich, M

2017-10-01

Shiga toxin-producing Escherichia coli (STEC) is a significant cause of gastrointestinal infection and the haemolytic-uremic syndrome (HUS). STEC outbreaks are commonly associated with food but animal contact is increasingly being implicated in its transmission. We report an outbreak of STEC affecting young infants at a nursery in a rural community (three HUS cases, one definite case, one probable case, three possible cases and five carriers, based on the combination of clinical, epidemiological and laboratory data) identified using culture-based and molecular techniques. The investigation identified repeated animal contact (animal farming and petting) as a likely source of STEC introduction followed by horizontal transmission. Whole genome sequencing (WGS) was used for real-time investigation of the incident and revealed a unique strain of STEC O26:H11 carrying stx2a and intimin. Following a public health intervention, no additional cases have occurred. This is the first STEC outbreak reported from Israel. WGS proved as a useful tool for rapid laboratory characterization and typing of the outbreak strain and informed the public health response at an early stage of this unusual outbreak.

Effect of ultra-low doses, ASIR and MBIR on density and noise levels of MDCT images of dental implant sites

Energy Technology Data Exchange (ETDEWEB)

Widmann, Gerlig; Schullian, Peter [Medical University of Innsbruck, Department of Radiology, Innsbruck (Austria); Al-Shawaf, Reema; Al-Sadhan, Ra' ed; Al-Ekrish, Asma' a A. [King Saud University, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, Riyadh (Saudi Arabia); Hoermann, Romed [Medical University of Innsbruck, Division of Clinical and Functional Anatomy, Innsbruck (Austria)

2017-05-15

Differences in noise and density values in MDCT images obtained using ultra-low doses with FBP, ASIR, and MBIR may possibly affect implant site density analysis. The aim of this study was to compare density and noise measurements recorded from dental implant sites using ultra-low doses combined with FBP, ASIR, and MBIR. Cadavers were scanned using a standard protocol and four low-dose protocols. Scans were reconstructed using FBP, ASIR-50, ASIR-100, and MBIR, and either a bone or standard reconstruction kernel. Density (mean Hounsfield units [HUs]) of alveolar bone and noise levels (mean standard deviation of HUs) was recorded from all datasets and measurements were compared by paired t tests and two-way ANOVA with repeated measures. Significant differences in density and noise were found between the reference dose/FBP protocol and almost all test combinations. Maximum mean differences in HU were 178.35 (bone kernel) and 273.74 (standard kernel), and in noise, were 243.73 (bone kernel) and 153.88 (standard kernel). Decreasing radiation dose increased density and noise regardless of reconstruction technique and kernel. The effect of reconstruction technique on density and noise depends on the reconstruction kernel used. (orig.)

Effect of ultra-low doses, ASIR and MBIR on density and noise levels of MDCT images of dental implant sites

International Nuclear Information System (INIS)

Widmann, Gerlig; Schullian, Peter; Al-Shawaf, Reema; Al-Sadhan, Ra'ed; Al-Ekrish, Asma'a A.; Hoermann, Romed

2017-01-01

Differences in noise and density values in MDCT images obtained using ultra-low doses with FBP, ASIR, and MBIR may possibly affect implant site density analysis. The aim of this study was to compare density and noise measurements recorded from dental implant sites using ultra-low doses combined with FBP, ASIR, and MBIR. Cadavers were scanned using a standard protocol and four low-dose protocols. Scans were reconstructed using FBP, ASIR-50, ASIR-100, and MBIR, and either a bone or standard reconstruction kernel. Density (mean Hounsfield units [HUs]) of alveolar bone and noise levels (mean standard deviation of HUs) was recorded from all datasets and measurements were compared by paired t tests and two-way ANOVA with repeated measures. Significant differences in density and noise were found between the reference dose/FBP protocol and almost all test combinations. Maximum mean differences in HU were 178.35 (bone kernel) and 273.74 (standard kernel), and in noise, were 243.73 (bone kernel) and 153.88 (standard kernel). Decreasing radiation dose increased density and noise regardless of reconstruction technique and kernel. The effect of reconstruction technique on density and noise depends on the reconstruction kernel used. (orig.)

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Indian Academy of Sciences (India)

user

In this section of Resonance, we invite readers to pose questions likely to be raised in a classroom situation. ... bias towards either gender is intended. ... people. W e w illreturn to this scenario later,let us tackle the present problem ¯rst. W e claim that the .... T hus, it is easy to see that w hen w e interchange their p osition s,it ...

Postoperatiivisen tetraplegiapotilaan asento-hoito Töölön sairaalan Traumatologisella Teho- ja Tehostetun valvonnan osastolla – Ohjeistus uusille sairaanhoitajille ja opiskelijoille

OpenAIRE

Suominen, Terhi; Pyrhönen, Niina

2011-01-01

Postoperatiivisen tetraplegiapotilaan asentohoito Töölön sairaalan Traumatologisella Teho- ja Tehostetun valvonnan osastolla – ohjeistus uusille sairaanhoitajille ja opiskelijoille Tämä projektiraportti on osa Laurea-ammattikorkeakoulun sekä Helsingin ja Uudenmaan sai-raanhoitopiirin (HUS) Helsingin yliopistollisen keskussairaalan (HYKS) operatiivisen tulosyksikön laadunkehittämishanketta. Hoitotyönlaadun kehittämishanke sijoittuu vuosille 2007–2012. Hankkeen pyrkimyksenä on parantaa näyt...

Mistr Jan Hus v díle J. A. Komenského

Czech Academy of Sciences Publication Activity Database

Steiner, Martin

2015-01-01

Roč. 45, 93/94 (2015), s. 25-32 ISSN 0323-2220 R&D Projects: GA ČR GB14-37038G Institutional support: RVO:67985955 Keywords : J. A. Comenius * John Huss * The Unity of the Brethren * The Reformation Subject RIV: AA - Philosophy ; Religion

Radon som sporgas for jordluftindtrængning til hus ved forurenet renserigrund

DEFF Research Database (Denmark)

Andersen, C.E.

2001-01-01

udeluftens koncentration, og selv en meget lille indtrængning af jordluft til huset kan derfor have stor betydning for dets radonkoncentration. Undersøgelsen bygger bl.a. på kontinuerte målinger af radon,differenstryk, atmosfæretryk, og temperaturer i indeklimaet samt spotmålinger af radon under terrændækket...... slukket. Denne vurdering er dog behæftet med stor usikkerhed, og der er formodentlig tale om et overestimat, idet det eksempelvis er forudsat, atder ikke forekommer diffusion igennem betondækket. Rapporten beskriver desuden en ny metode, hvor radonmålinger anvendes til at vurdere influenszonen for et...

Fatty degeneration of the rotator cuff muscles on pre- and postoperative CT arthrography (CTA): is the Goutallier grading system reliable?

Energy Technology Data Exchange (ETDEWEB)

Lee, Eugene; Choi, Jung-Ah; Kang, Heung Sik [Seoul National University Bundang Hospital, Department of Radiology, Seongnam-si, Gyeongi-do (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, 28 Yeongon-dong, Chongno-gu, Seoul (Korea, Republic of); Oh, Joo Han [Seoul National University Bundang Hospital, Department of Orthopedic Surgery, Seongnam-si, Gyeongi-do (Korea, Republic of); Ahn, Soyeon [Seoul National University Bundang Hospital, Medical Research Collaborating Center, Seongnam-si, Gyeongi-do (Korea, Republic of); Hong, Sung Hwan [Seoul National University College of Medicine, Department of Radiology, 28 Yeongon-dong, Chongno-gu, Seoul (Korea, Republic of); Chai, Jee Won [SMG-SNU Boramae Medical Center, Department of Radiology, 425 Shindaebang-dong, Dongjak-gu, Seoul (Korea, Republic of)

2013-09-15

To retrospectively evaluate fatty degeneration (FD) of rotator cuff muscles on CTA using Goutallier's grading system and quantitative measurements with comparison between pre- and postoperative states. IRB approval was obtained for this study. Two radiologists independently reviewed pre- and postoperative CTAs of 43 patients (24 males and 19 females, mean age, 58.1 years) with 46 shoulders confirmed as full-thickness tears with random distribution. FD of supraspinatus, infraspinatus/teres minor, and subscapularis was assessed using Goutallier's system and by quantitative measurements of Hounsfield units (HUs) on sagittal images. Changes in FD grades and HUs were compared between pre- and postoperative CTAs and analyzed with respect to preoperative tear size and postoperative cuff integrity. The correlations between qualitative grades and quantitative measurements and their inter-observer reliabilities were also assessed. There was statistically significant correlation between FD grades and HU measurements of all muscles on pre- and postoperative CTA (p < 0.05). Inter-observer reliability of fatty degeneration grades were excellent to substantial on both pre- and postoperative CTA in supraspinatus (0.8685 and 0.8535) and subscapularis muscles (0.7777 and 0.7972), but fair in infraspinatus/teres minor muscles (0.5791 and 0.5740); however, quantitative Hounsfield units measurements showed excellent reliability for all muscles (ICC: 0.7950 and 0.9346 for SST, 0.7922 and 0.8492 for SSC, and 0.9254 and 0.9052 for IST/TM). No muscle showed improvement of fatty degeneration after surgical repair on qualitative and quantitative assessments; there was no difference in changes of fatty degeneration after surgical repair according to preoperative tear size and post-operative cuff integrity (p > 0.05). The average dose-length product (DLP, mGy . cm) was 365.2 mGy . cm (range, 323.8-417.2 mGy . cm) and estimated average effective dose was 5.1 mSv. Goutallier grades

SU-E-J-218: Evaluation of CT Images Created Using a New Metal Artifact Reduction Reconstruction Algorithm for Radiation Therapy Treatment Planning

Energy Technology Data Exchange (ETDEWEB)

Niemkiewicz, J; Palmiotti, A; Miner, M; Stunja, L; Bergene, J [Lehigh Valley Health Network, Allentown, PA (United States)

2014-06-01

Purpose: Metal in patients creates streak artifacts in CT images. When used for radiation treatment planning, these artifacts make it difficult to identify internal structures and affects radiation dose calculations, which depend on HU numbers for inhomogeneity correction. This work quantitatively evaluates a new metal artifact reduction (MAR) CT image reconstruction algorithm (GE Healthcare CT-0521-04.13-EN-US DOC1381483) when metal is present. Methods: A Gammex Model 467 Tissue Characterization phantom was used. CT images were taken of this phantom on a GE Optima580RT CT scanner with and without steel and titanium plugs using both the standard and MAR reconstruction algorithms. HU values were compared pixel by pixel to determine if the MAR algorithm altered the HUs of normal tissues when no metal is present, and to evaluate the effect of using the MAR algorithm when metal is present. Also, CT images of patients with internal metal objects using standard and MAR reconstruction algorithms were compared. Results: Comparing the standard and MAR reconstructed images of the phantom without metal, 95.0% of pixels were within ±35 HU and 98.0% of pixels were within ±85 HU. Also, the MAR reconstruction algorithm showed significant improvement in maintaining HUs of non-metallic regions in the images taken of the phantom with metal. HU Gamma analysis (2%, 2mm) of metal vs. non-metal phantom imaging using standard reconstruction resulted in an 84.8% pass rate compared to 96.6% for the MAR reconstructed images. CT images of patients with metal show significant artifact reduction when reconstructed with the MAR algorithm. Conclusion: CT imaging using the MAR reconstruction algorithm provides improved visualization of internal anatomy and more accurate HUs when metal is present compared to the standard reconstruction algorithm. MAR reconstructed CT images provide qualitative and quantitative improvements over current reconstruction algorithms, thus improving radiation

Overexpressed Proteins in Hypervirulent Clade 8 and Clade 6 Strains of Escherichia coli O157:H7 Compared to E. coli O157:H7 EDL933 Clade 3 Strain.

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Natalia Amigo

Full Text Available Escherichia coli O157:H7 is responsible for severe diarrhea and hemolytic uremic syndrome (HUS, and predominantly affects children under 5 years. The major virulence traits are Shiga toxins, necessary to develop HUS and the Type III Secretion System (T3SS through which bacteria translocate effector proteins directly into the host cell. By SNPs typing, E. coli O157:H7 was separated into nine different clades. Clade 8 and clade 6 strains were more frequently associated with severe disease and HUS. In this study, we aimed to identify differentially expressed proteins in two strains of E. coli O157:H7 (clade 8 and clade 6, obtained from cattle and compared them with the well characterized reference EDL933 strain (clade 3. Clade 8 and clade 6 strains show enhanced pathogenicity in a mouse model and virulence-related properties. Proteins were extracted and analyzed using the TMT-6plex labeling strategy associated with two dimensional liquid chromatography and mass spectrometry in tandem. We detected 2241 proteins in the cell extract and 1787 proteins in the culture supernatants. Attention was focused on the proteins related to virulence, overexpressed in clade 6 and 8 strains compared to EDL933 strain. The proteins relevant overexpressed in clade 8 strain were the curli protein CsgC, a transcriptional activator (PchE, phage proteins, Stx2, FlgM and FlgD, a dienelactone hydrolase, CheW and CheY, and the SPATE protease EspP. For clade 6 strain, a high overexpression of phage proteins was detected, mostly from Stx2 encoding phage, including Stx2, flagellin and the protease TagA, EDL933_p0016, dienelactone hydrolase, and Haemolysin A, amongst others with unknown function. Some of these proteins were analyzed by RT-qPCR to corroborate the proteomic data. Clade 6 and clade 8 strains showed enhanced transcription of 10 out of 12 genes compared to EDL933. These results may provide new insights in E. coli O157:H7 mechanisms of pathogenesis.

Disease-linked mutations in factor H reveal pivotal role of cofactor activity in self-surface-selective regulation of complement activation.

Science.gov (United States)

Kerr, Heather; Wong, Edwin; Makou, Elisavet; Yang, Yi; Marchbank, Kevin; Kavanagh, David; Richards, Anna; Herbert, Andrew P; Barlow, Paul N

2017-08-11

Spontaneous activation enables the complement system to respond very rapidly to diverse threats. This activation is efficiently suppressed by complement factor H (CFH) on self-surfaces but not on foreign surfaces. The surface selectivity of CFH, a soluble protein containing 20 complement-control protein modules (CCPs 1-20), may be compromised by disease-linked mutations. However, which of the several functions of CFH drives this self-surface selectivity remains unknown. To address this, we expressed human CFH mutants in Pichia pastoris We found that recombinant I62-CFH (protective against age-related macular degeneration) and V62-CFH functioned equivalently, matching or outperforming plasma-derived CFH, whereas R53H-CFH, linked to atypical hemolytic uremic syndrome (aHUS), was defective in C3bBb decay-accelerating activity (DAA) and factor I cofactor activity (CA). The aHUS-linked CCP 19 mutant D1119G-CFH had virtually no CA on (self-like) sheep erythrocytes ( E S ) but retained DAA. The aHUS-linked CCP 20 mutant S1191L/V1197A-CFH (LA-CFH) had dramatically reduced CA on E S but was less compromised in DAA. D1119G-CFH and LA-CFH both performed poorly at preventing complement-mediated hemolysis of E S PspCN, a CFH-binding Streptococcus pneumoniae protein domain, binds CFH tightly and increases accessibility of CCPs 19 and 20. PspCN did not improve the DAA of any CFH variant on E S Conversely, PspCN boosted the CA, on E S , of I62-CFH, R53H-CFH, and LA-CFH and also enhanced hemolysis protection by I62-CFH and LA-CFH. We conclude that CCPs 19 and 20 are critical for efficient CA on self-surfaces but less important for DAA. Exposing CCPs 19 and 20 with PspCN and thus enhancing CA on self-surfaces may reverse deficiencies of some CFH variants. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

Molecular Characterization of Human Atypical Sorbitol-Fermenting Enteropathogenic Escherichia coli O157 Reveals High Diversity.

Science.gov (United States)

Kossow, Annelene; Zhang, Wenlan; Bielaszewska, Martina; Rhode, Sophie; Hansen, Kevin; Fruth, Angelika; Rüter, Christian; Karch, Helge; Mellmann, Alexander

2016-05-01

Alongside the well-characterized enterohemorrhagic Escherichia coli (EHEC) O157:H7, serogroup O157 comprises sorbitol-fermenting typical and atypical enteropathogenic E. coli (EPEC/aEPEC) strains that carry the intimin-encoding gene eae but not Shiga toxin-encoding genes (stx). Since little is known about these pathogens, we characterized 30 clinical isolates from patients with hemolytic uremic syndrome (HUS) or uncomplicated diarrhea with respect to their flagellin gene (fliC) type and multilocus sequence type (MLST). Moreover, we applied whole-genome sequencing (WGS) to determine the phylogenetic relationship with other eae-positive EHEC serotypes and the composition of the rfbO157 region. fliC typing resulted in five fliC types (H7, H16, H34, H39, and H45). Isolates of each fliC type shared a unique ST. In comparison to the 42 HUS-associated E. coli (HUSEC) strains, only the stx-negative isolates with fliCH7 shared their ST with EHEC O157:H7/H(-) strains. With the exception of one O157:H(-) fliCH16 isolate, HUS was exclusively associated with fliCH7. WGS corroborated the separation of the fliCH7 isolates, which were closely related to the EHEC O157:H7/H(-) isolates, and the diverse group of isolates exhibiting different fliC types, indicating independent evolution of the different serotypes. This was also supported by the heterogeneity within the rfbO157 region that exhibited extensive recombinations. The genotypic subtypes and distribution of clinical symptoms suggested that the stx-negative O157 strains with fliCH7 were originally EHEC strains that lost stx The remaining isolates form a distinct and diverse group of atypical EPEC isolates that do not possess the full spectrum of virulence genes, underlining the importance of identifying the H antigen for clinical risk assessment. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

SU-E-J-218: Evaluation of CT Images Created Using a New Metal Artifact Reduction Reconstruction Algorithm for Radiation Therapy Treatment Planning

International Nuclear Information System (INIS)

Niemkiewicz, J; Palmiotti, A; Miner, M; Stunja, L; Bergene, J

2014-01-01

Purpose: Metal in patients creates streak artifacts in CT images. When used for radiation treatment planning, these artifacts make it difficult to identify internal structures and affects radiation dose calculations, which depend on HU numbers for inhomogeneity correction. This work quantitatively evaluates a new metal artifact reduction (MAR) CT image reconstruction algorithm (GE Healthcare CT-0521-04.13-EN-US DOC1381483) when metal is present. Methods: A Gammex Model 467 Tissue Characterization phantom was used. CT images were taken of this phantom on a GE Optima580RT CT scanner with and without steel and titanium plugs using both the standard and MAR reconstruction algorithms. HU values were compared pixel by pixel to determine if the MAR algorithm altered the HUs of normal tissues when no metal is present, and to evaluate the effect of using the MAR algorithm when metal is present. Also, CT images of patients with internal metal objects using standard and MAR reconstruction algorithms were compared. Results: Comparing the standard and MAR reconstructed images of the phantom without metal, 95.0% of pixels were within ±35 HU and 98.0% of pixels were within ±85 HU. Also, the MAR reconstruction algorithm showed significant improvement in maintaining HUs of non-metallic regions in the images taken of the phantom with metal. HU Gamma analysis (2%, 2mm) of metal vs. non-metal phantom imaging using standard reconstruction resulted in an 84.8% pass rate compared to 96.6% for the MAR reconstructed images. CT images of patients with metal show significant artifact reduction when reconstructed with the MAR algorithm. Conclusion: CT imaging using the MAR reconstruction algorithm provides improved visualization of internal anatomy and more accurate HUs when metal is present compared to the standard reconstruction algorithm. MAR reconstructed CT images provide qualitative and quantitative improvements over current reconstruction algorithms, thus improving radiation

Technical Note: Radiation properties of tissue- and water-equivalent materials formulated using the stoichiometric analysis method in charged particle therapy

Energy Technology Data Exchange (ETDEWEB)

Yohannes, Indra; Vasiliniuc, Stefan [Radiation Oncology, University Hospital Erlangen, Erlangen 91054 (Germany); Hild, Sebastian [Faculty of Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany and Department of Biophysics, GSI - Helmholtz Centre for Heavy Ion Research, Darmstadt 64291 (Germany); Langner, Oliver [QRM - Quality Assurance in Radiology and Medicine GmbH, Möhrendorf 91096 (Germany); Graeff, Christian [Department of Biophysics, GSI - Helmholtz Centre for Heavy Ion Research, Darmstadt 64291 (Germany); Bert, Christoph, E-mail: christoph.bert@uk-erlangen.de [Radiation Oncology, University Hospital Erlangen, Erlangen 91054 (Germany); Faculty of Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054 (Germany); Department of Biophysics, GSI - Helmholtz Centre for Heavy Ion Research, Darmstadt 64291 (Germany)

2016-01-15

Purpose: Five tissue- and water-equivalent materials (TEMs) mimicking ICRU real tissues have been formulated using a previously established stoichiometric analysis method (SAM) to be applied in charged particle therapy. The purpose of this study was an experimental verification of the TEMs-SAM against charged particle beam measurements and for different computed tomography (CT) scanners. The potential of the TEMs-SAM to be employed in the dosimetry was also investigated. Methods: Experimental verification with three CT scanners was carried out to validate the calculated Hounsfield units (HUs) of the TEMs. Water-equivalent path lengths (WEPLs) of the TEMs for proton (106.8 MeV/u), helium (107.93 MeV/u), and carbon (200.3 MeV/u) ions were measured to be compared with the computed relative stopping powers. HU calibration curves were also generated. Results: Differences between the measured HUs of the TEMs and the calculated HUs of the ICRU real tissues for all CT scanners were smaller than 4 HU except for the skeletal tissues which deviated up to 21 HU. The measured WEPLs verified the calculated WEPLs of the TEMs (maximum deviation was 0.17 mm) and were in good agreement with the calculated WEPLs of the ICRU real tissues (maximum deviation was 0.23 mm). Moreover, the relative stopping powers converted from the measured WEPLs differed less than 0.8% and 1.3% from the calculated values of the SAM and the ICRU, respectively. Regarding the relative nonelastic cross section per unit of volume for 200 MeV protons, the ICRU real tissues were generally well represented by the TEMs except for adipose which differed 3.8%. Further, the HU calibration curves yielded the mean and the standard deviation of the errors not larger than 0.5% and 1.9%, respectively. Conclusions: The results of this investigation implied the potential of the TEMs formulated using the SAM to be employed for both, beam dosimetry and HU calibration in charged particle therapy.

Early Assessment of Treatment Responses During Radiation Therapy for Lung Cancer Using Quantitative Analysis of Daily Computed Tomography

Energy Technology Data Exchange (ETDEWEB)

Paul, Jijo; Yang, Cungeng [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Wu, Hui [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou (China); Tai, An [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Dalah, Entesar [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Department of Medical Diagnostic Imaging, College of Health Science, University of Sharjah (United Arab Emirates); Zheng, Cheng [Biostatistics, Joseph. J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (United States); Johnstone, Candice [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Kong, Feng-Ming [Department of Radiation Oncology, Indiana University, Indianapolis, Indiana (United States); Gore, Elizabeth [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Li, X. Allen, E-mail: ali@mcw.edu [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States)

2017-06-01

Purpose: To investigate early tumor and normal tissue responses during the course of radiation therapy (RT) for lung cancer using quantitative analysis of daily computed tomography (CT) scans. Methods and Materials: Daily diagnostic-quality CT scans acquired using CT-on-rails during CT-guided RT for 20 lung cancer patients were quantitatively analyzed. On each daily CT set, the contours of the gross tumor volume (GTV) and lungs were generated and the radiation dose delivered was reconstructed. The changes in CT image intensity (Hounsfield unit [HU]) features in the GTV and the multiple normal lung tissue shells around the GTV were extracted from the daily CT scans. The associations between the changes in the mean HUs, GTV, accumulated dose during RT delivery, and patient survival rate were analyzed. Results: During the RT course, radiation can induce substantial changes in the HU histogram features on the daily CT scans, with reductions in the GTV mean HUs (dH) observed in the range of 11 to 48 HU (median 30). The dH is statistically related to the accumulated GTV dose (R{sup 2} > 0.99) and correlates weakly with the change in GTV (R{sup 2} = 0.3481). Statistically significant increases in patient survival rates (P=.038) were observed for patients with a higher dH in the GTV. In the normal lung, the 4 regions proximal to the GTV showed statistically significant (P<.001) HU reductions from the first to last fraction. Conclusion: Quantitative analysis of the daily CT scans indicated that the mean HUs in lung tumor and surrounding normal tissue were reduced during RT delivery. This reduction was observed in the early phase of the treatment, is patient specific, and correlated with the delivered dose. A larger HU reduction in the GTV correlated significantly with greater patient survival. The changes in daily CT features, such as the mean HU, can be used for early assessment of the radiation response during RT delivery for lung cancer.

Technical Note: Radiation properties of tissue- and water-equivalent materials formulated using the stoichiometric analysis method in charged particle therapy

International Nuclear Information System (INIS)

Yohannes, Indra; Vasiliniuc, Stefan; Hild, Sebastian; Langner, Oliver; Graeff, Christian; Bert, Christoph

2016-01-01

Purpose: Five tissue- and water-equivalent materials (TEMs) mimicking ICRU real tissues have been formulated using a previously established stoichiometric analysis method (SAM) to be applied in charged particle therapy. The purpose of this study was an experimental verification of the TEMs-SAM against charged particle beam measurements and for different computed tomography (CT) scanners. The potential of the TEMs-SAM to be employed in the dosimetry was also investigated. Methods: Experimental verification with three CT scanners was carried out to validate the calculated Hounsfield units (HUs) of the TEMs. Water-equivalent path lengths (WEPLs) of the TEMs for proton (106.8 MeV/u), helium (107.93 MeV/u), and carbon (200.3 MeV/u) ions were measured to be compared with the computed relative stopping powers. HU calibration curves were also generated. Results: Differences between the measured HUs of the TEMs and the calculated HUs of the ICRU real tissues for all CT scanners were smaller than 4 HU except for the skeletal tissues which deviated up to 21 HU. The measured WEPLs verified the calculated WEPLs of the TEMs (maximum deviation was 0.17 mm) and were in good agreement with the calculated WEPLs of the ICRU real tissues (maximum deviation was 0.23 mm). Moreover, the relative stopping powers converted from the measured WEPLs differed less than 0.8% and 1.3% from the calculated values of the SAM and the ICRU, respectively. Regarding the relative nonelastic cross section per unit of volume for 200 MeV protons, the ICRU real tissues were generally well represented by the TEMs except for adipose which differed 3.8%. Further, the HU calibration curves yielded the mean and the standard deviation of the errors not larger than 0.5% and 1.9%, respectively. Conclusions: The results of this investigation implied the potential of the TEMs formulated using the SAM to be employed for both, beam dosimetry and HU calibration in charged particle therapy

Technical Note: Radiation properties of tissue- and water-equivalent materials formulated using the stoichiometric analysis method in charged particle therapy.

Science.gov (United States)

Yohannes, Indra; Hild, Sebastian; Vasiliniuc, Stefan; Langner, Oliver; Graeff, Christian; Bert, Christoph

2016-01-01

Five tissue- and water-equivalent materials (TEMs) mimicking ICRU real tissues have been formulated using a previously established stoichiometric analysis method (SAM) to be applied in charged particle therapy. The purpose of this study was an experimental verification of the TEMs-SAM against charged particle beam measurements and for different computed tomography (CT) scanners. The potential of the TEMs-SAM to be employed in the dosimetry was also investigated. Experimental verification with three CT scanners was carried out to validate the calculated Hounsfield units (HUs) of the TEMs. Water-equivalent path lengths (WEPLs) of the TEMs for proton (106.8 MeV/u), helium (107.93 MeV/u), and carbon (200.3 MeV/u) ions were measured to be compared with the computed relative stopping powers. HU calibration curves were also generated. Differences between the measured HUs of the TEMs and the calculated HUs of the ICRU real tissues for all CT scanners were smaller than 4 HU except for the skeletal tissues which deviated up to 21 HU. The measured WEPLs verified the calculated WEPLs of the TEMs (maximum deviation was 0.17 mm) and were in good agreement with the calculated WEPLs of the ICRU real tissues (maximum deviation was 0.23 mm). Moreover, the relative stopping powers converted from the measured WEPLs differed less than 0.8% and 1.3% from the calculated values of the SAM and the ICRU, respectively. Regarding the relative nonelastic cross section per unit of volume for 200 MeV protons, the ICRU real tissues were generally well represented by the TEMs except for adipose which differed 3.8%. Further, the HU calibration curves yielded the mean and the standard deviation of the errors not larger than 0.5% and 1.9%, respectively. The results of this investigation implied the potential of the TEMs formulated using the SAM to be employed for both, beam dosimetry and HU calibration in charged particle therapy.

Management of hemolytic-uremic syndrome in children

OpenAIRE

Grisaru, Silviu

2014-01-01

Silviu GrisaruUniversity of Calgary, Alberta Children's Hospital, Calgary, Alberta, CanadaAbstract: Acute renal failure associated with a fulminant, life-threatening systemic disease is rare in previously healthy young children; however, when it occurs, the most common cause is hemolytic-uremic syndrome (HUS). In most cases (90%), this abrupt and devastating illness is a result of ingestion of food or drink contaminated with pathogens that produce very potent toxins. Currently, there ...

Beretning for Bulbrogård 2012 (BU2012), aristokratisk kompleks. NM I journalnr. 7701/94 Store Fuglede sogn, Ars herred, (Holbæk Amt) Region Sjælland. Sted nr. 03.01.06 – sb. nr. 102 Kort nr. 1413 III NØ Beretning for undersøgelse aristokratisk kompleks fra det 6. – 7. årh. ved Bulbrogård ved Tissø

DEFF Research Database (Denmark)

Bican, Josefine Franck

De afsluttende undersøgelser på Bulbrogård 2012 bød på nye og overraskende resultater: Bulbrogård har fået en ny fase. Som det nogle gange sker, bliver man mere forvirret end oplyst ved at få mere viden – dette er også tilfældet her. Den ny hal (hus 7) kan være det manglende arkitektoniske bindel...

Acute Kidney Injury in Pregnancy.

Science.gov (United States)

Jim, Belinda; Garovic, Vesna D

2017-07-01

Pregnancy-related acute kidney injury (AKI) has declined in incidence in the last three decades, although it remains an important cause of maternal and fetal morbidity and mortality. Pregnancy-related causes of AKI such as preeclampsia, acute fatty liver of pregnancy, HELLP (Hemolysis, Elevated Liver function tests, Low Platelets) syndrome, and the thrombotic microangiopathies (thrombotic thrombocytopenic purpura, atypical hemolytic-uremic syndrome [HUS]) exhibit overlapping features and often present as diagnostic dilemmas. Differentiating among these conditions may be difficult or impossible based on clinical criteria only. In difficult and rare cases, a renal biopsy may need to be considered for the exact diagnosis and to facilitate appropriate treatment, but the risks and benefits need to be carefully weighed. The use of eculizumab for the treatment of atypical HUS has demonstrated efficacy in early case reports. Non-pregnancy related causes such as volume depletion and pyelonephritis require early and aggressive resuscitative as well as antibiotic measures respectively. We will discuss in this review the various etiologies of AKI in pregnancy, current diagnostic approaches, and the latest treatment strategies. Given the recent trends of increasing maternal age at the time of pregnancy, and the availability of modern reproductive methods increase the risks of AKI in pregnancy in the coming years. Copyright © 2017 Elsevier Inc. All rights reserved.

A novel mechanism of bacterial toxin transfer within host blood cell-derived microvesicles.

Directory of Open Access Journals (Sweden)

Anne-lie Ståhl

2015-02-01

Full Text Available Shiga toxin (Stx is the main virulence factor of enterohemorrhagic Escherichia coli, which are non-invasive strains that can lead to hemolytic uremic syndrome (HUS, associated with renal failure and death. Although bacteremia does not occur, bacterial virulence factors gain access to the circulation and are thereafter presumed to cause target organ damage. Stx was previously shown to circulate bound to blood cells but the mechanism by which it would potentially transfer to target organ cells has not been elucidated. Here we show that blood cell-derived microvesicles, shed during HUS, contain Stx and are found within patient renal cortical cells. The finding was reproduced in mice infected with Stx-producing Escherichia coli exhibiting Stx-containing blood cell-derived microvesicles in the circulation that reached the kidney where they were transferred into glomerular and peritubular capillary endothelial cells and further through their basement membranes followed by podocytes and tubular epithelial cells, respectively. In vitro studies demonstrated that blood cell-derived microvesicles containing Stx undergo endocytosis in glomerular endothelial cells leading to cell death secondary to inhibited protein synthesis. This study demonstrates a novel virulence mechanism whereby bacterial toxin is transferred within host blood cell-derived microvesicles in which it may evade the host immune system.

Water Quality Management Studies. Postimpoundment Study of R.E. ’Bob’ Woodruff Lake, Alabama River, Alabama.

Science.gov (United States)

1984-08-01

species richness and density. Such changes are easy to see if stresses are severe. However, subtle stresses can result in subtle changes in community...1976). This clogging of canals is possible because the channels are relatively narrow and the decumbent stems growing from I each side can- come into...CL.) Grisebach CE) Sacgittaria latifolia Willd. POACEAE CE) Fri,2n t hus giganteus (Walt.) Muhl. CFl-lv) Hydrochloa carotini’nsis Beauvois (E) Leersia

Fulltext PDF

Indian Academy of Sciences (India)

Academy of Sciences, Bangalore 560 080. Items illustrating ideas and concepts will generally be chosen. Keywords. Riemann integral, unit ball, Eu- ... 1g is called the unit ball in n -space. It is the set of all points w ithin a distance ofone unit from the origin. T hus S 1 is the line segm ent [¡ 1;+ 1]in R. 1. ,S 2 is th e u n it d isc f(x ...

Glycan Encapsulated Gold Nanoparticles Selectively Inhibit Shiga Toxins 1 and 2

OpenAIRE

Kulkarni, Ashish A.; Fuller-Schaefer, Cynthia; Korman, Henry; Weiss, Alison A.; Iyer, Suri S.

2010-01-01

Shiga toxins (Stx) released by Escherichia coli O157:H7 and Shigella dysentriae, cause life-threatening conditions that include hemolytic-uremic syndrome (HUS), kidney failure and neurological complications. Cellular entry is mediated by the B subunit of the AB5 toxin, which recognizes cell surface glycolipids present in lipid raft like structures. We developed gold glyconanoparticles that present a multivalent display similar to the cell surface glycolipids to compete for these toxins. These...

Urban Chickens as a Pathway for Human Illness: An Examination of Knowledge, Behavior and Risk

OpenAIRE

Stella Capoccia; Michael Masters; Scott Risser

2018-01-01

This research investigates the relationships between human knowledge, behavior and risk as they relate to urban chicken husbandry in the United States. Concern over zoonotic diseases has been on the rise, especially with increasing contact between birds and humans. In particular, avian influenza—or bird flu—and Salmonella enterica (Salmonella) and Escherichia coli (E. coli) can all cross species lines between people and poultry. This study analyzed knowledge and practices in urban chicken hus...

Exploration of sequence alterations of the vitamin D receptor gene in regard to hypocalcemia and periparturient paresis in dairy cows

OpenAIRE

Reiche, Maria Agnes

2012-01-01

Periparturient hypocalcemia belongs to the most important mineral metabolism dysfunctions in dairy cows. The incidence of subclinical hypocalcemia in the USA is given with 25% in heifers and up to 40 to 50 % in older cows (Reinhardt et al. 2010), the incidence of clinical symptoms (downer cow syndrome) is given with 5-10% (DeGaris und Lean 2008; Goff 2008). Hence manifold prophylaxis and therapy concepts to prevent periparturient paresis are established in current practice in dairy cattle hus...

Ti år med formidlingspligt

DEFF Research Database (Denmark)

Meyer, Gitte

2014-01-01

Jubilæet blev markeret ved et symposium - men hvor var journalisterne, og hvor var forskerne? For få uger siden lagde TV 2 hus til et symposium om videnskab, formidling, journalistik og spin. Danske Videnskabsjournalister og Akademiet for de Tekniske Videnskaber tog med arrangementet et behjertet...... initiativ. De ville gøre status efter ti år med lovfæstet formidlingspligt på universiteterne. Samtidig lagde de op til et kritisk blik på universitetsverdenens kommunikationsafdelinger...

Muutoksen johtamisen malli palveluntarjoajalle

OpenAIRE

Kivimäki, Heidi

2017-01-01

Opinnäytetyön kohdeorganisaationa on HUS-Tietohallinto. Kyseessä on asiantuntijaorganisaatio, jossa pääsääntöisesti oman alan asiantuntijat vastaavat itsenäisesti palveluista. Tietohallinto on palveluntarjoaja, joka tuottaa sisäisille ja ulkoisille asiakkaille palveluja. Ohjelmistot ja niiden ylläpito tilataan ulkoisilta toimittajilta. Opinnäytetyön tavoitteena on kehittää muutoksen johtamisen malli palveluntarjoajan roolissa työskentelevälle asiantuntijalle. Muutosmallin kehittäminen on ...

Wafer-Scale Integration of Systolic Arrays,

Science.gov (United States)

1985-10-01

hus wtha rbaiith hig robabili, e aubrbe orutysta mostck b(e)adstotoefwsi the cenofther cnnel thati are connted to (g.The kery ato the alevel of t...problems considered heretofore in this paper also have an interpretation in a purely graph theoretic model. Suppose we are given a two-dimensional...graphs," Magyar 7Td. Akad. Math . Kut. Int. Kozl, Vol. 5, 1960, pp. 17-61. [6] D. Fussell and P. Varman, "Fault-tolerant wafer-scale architectures for

Opiskelijoita ohjaavien sairaanhoitajien kokemuksia organisaation tuesta opiskelijaohjauksessa

OpenAIRE

Heinilä, Päivi; Penttinen, Nina; Sillman, Outi

2014-01-01

Tämän opinnäytetyön tarkoituksena oli kuvailla, minkälaisia kokemuksia opiskelijoita ohjaavilla sairaanhoitajilla oli organisaatiolta saamastaan tuesta opiskelijaohjauksessa. Tavoitteena on, että saatua tietoa hyödynnetään opiskelijoita ohjaavien sairaanhoitajien tukemiseen. Opinnäytetyö toteutettiin laadullisena tutkimuksena. Aineisto kerättiin toukokuussa 2014 ryhmähaastattelulla käyttämällä teemahaastattelun menetelmää. Haastatteluihin osallistui yhteensä yhdeksän sairaanhoitajaa HUS/H...

Evaluation of Environmental and Hydraulic Performance of Bio-Composite Revetment Blocks

OpenAIRE

Thamer A.  Ahmeed; Nor A.  Alias; Abdul H.  Ghazali; Mohd. S.  Jaafar

2006-01-01

It is necessary to develop a concrete revetment block which can cater for environment and at the same time it will be effective in protecting river banks (stabilize the slope of banks) from scouring during flood. In the present study, the environmental and hydraulic performance of the proposed revetment block was evaluated through laboratory and field tests. The tested revetment block is called bio-composite because it is composed of concrete, plastic mesh and biological material (coconut hus...

Detection of Shiga toxin-producing Escherichia coli by sandwich enzyme-linked immunosorbent assay using chicken egg yolk IgY antibodies

OpenAIRE

Parma, Y. R.; Chacana, P. A.; Lucchesi, P. M. A.; Rogé, A.; Granobles Velandia, C. V.; Krüger, A.; Parma, A. E.; Fernández-Miyakawa, M. E.

2012-01-01

Enterohemorrhagic Escherichia coli (EHEC), a subset of Shiga toxin producing E. coli (STEC) is associated with a spectrum of diseases that includes diarrhea, hemorrhagic colitis and a life-threatening hemolytic-uremic syndrome (HUS). Regardless of serotype, Shiga toxins (Stx1 and/or Stx2) are uniformly expressed by all EHEC, and so exploitable targets for laboratory diagnosis of these pathogens. In this study, a sandwich ELISA for determination of Shiga toxin (Stx) was developed using anti-St...

Detection of Shiga toxin-producing Escherichia coli by sandwich enzyme-linked immunosorbent assay using chicken egg yolk IgY antibodies

OpenAIRE

Yanil R Parma; Pablo A Chacana; Paula María Alejandra Lucchesi; Ariel eRoge; Claudia V Granobles Velandia; Alejandra eKrüger; Alejandra eKrüger; Alberto E. Parma; Mariano Enrique Fernandez Miyakawa

2012-01-01

Enterohemorrhagic Escherichia coli (EHEC), a subset of Shiga toxin producing E. coli (STEC) is associated with a spectrum of diseases that includes diarrhea, hemorrhagic colitis and a life-threatening hemolytic uremic syndrome (HUS). Regardless of serotype, Shiga toxins (Stx1 and/or Stx2) are uniformly expressed by all EHEC, and so exploitable targets for laboratory diagnosis of these pathogens. In this study, a sandwich ELISA for determination of Shiga toxin (Stx) was developed using anti-St...

Multimodal ultrasound tomography for breast imaging: a prospective study of clinical feasibility.

Science.gov (United States)

Forte, S; Dellas, S; Stieltjes, B; Bongartz, B

2017-01-01

To describe the clinical set-up and evaluate the feasibility of multimodal ultrasound tomography (MUT) for breast imaging. Thirty-two consecutive patients referred for breast imaging and 24 healthy volunteers underwent MUT. In the 32 patients, the examination discomfort was compared to that of mammography (n = 31), handheld ultrasound (HUS) (n = 27) and magnetic resonance imaging (MRI) (n = 4) on a scale from 1 (lowest discomfort) to 10 (highest discomfort). MUT investigation time was recorded. Findings automatically detected by MUT were correlated with conventional imaging and biopsy results. Breast MUT was well tolerated by all 56 participants; 55 bilateral exams were uneventful. During one exam, the digitalisation card failed and the exam was successfully repeated within three days. Mean examination discomfort was 1.6 (range = 1-5) for MUT, 1.5 (range = 1-5) for HUS, 5.3 (range = 3-7) for MRI, and 6.3 (range = 1-10) for mammography. MUT examination time was 38 ± 6 min (mean ± standard deviation). In the patients referred for breast imaging, MUT detected four lesions and indicated malignancy in three of these cases. These findings were confirmed by additional imaging and biopsy. MUT is feasible in a clinical context considering examination time and patient acceptance. These interesting initial diagnostic findings warrant further studies.

Raskaana oleville sekä synnyttäneille äideille Bella Mamma -pilates : -helppoja lantionpohjaa vahvistavia pilates-liikkeitä yhdessä vauvan kanssa

OpenAIRE

Hakala, Suvi; Wennerström, Annika

2010-01-01

Opinnäyteprojekti oli osa Laurean ja HYKS- naistentautien ja synnytysten tulosyksikön (NALA) hoitotyön laadunkehittämishanketta 2007–2012. Yksi hankkeen tavoitteista oli kehittää hoitotyötä HUS:n laadunkehittämistarpeiden pohjalta sekä hyödyntää Laurean ammattikorkeakoulun opiskelijoiden Learning by Developing –kehittämistyön strategiaa. Opinnäyteprojekti tehtiin osittain yhteistyössä Naistenklinikan lapsivuodeosastojen sekä fysioterapiaosaston kanssa. Projektiryhmä kokoontui suunnitelmavaihe...

Early Detection of Amyloid Plaque in Alzheimer’s Disease via X-ray Phase CT

Science.gov (United States)

2016-08-01

Geraghty, J. A. Seibert, and S. L. Wootton-Gorges, “Dose reduction in pediatric CT : A rational approach,” Radiology 228, 352–360 (2003). Medical...improvement in image quality can be quantified as large as 450 [Fig. 6(c)] and 350 [Fig. 6(d)] Hounsfield units (HUs), where the Hounsfield unit is defined...AWARD NUMBER: W81XWH-12-1-0138 TITLE: Early Detection of Amyloid Plaque in Alzheimer’s Disease via X-ray Phase CT PRINCIPAL INVESTIGATOR

Limited Evaluation of Image Quality Produced by a Portable Head CT Scanner (CereTom) in a Neurosurgery Centre

Science.gov (United States)

Abdullah, Ariz Chong; Adnan, Johari Siregar; Rahman, Noor Azman A.; Palur, Ravikant

2017-01-01

Introduction Computed tomography (CT) is the preferred diagnostic toolkit for head and brain imaging of head injury. A recent development is the invention of a portable CT scanner that can be beneficial from a clinical point of view. Aim To compare the quality of CT brain images produced by a fixed CT scanner and a portable CT scanner (CereTom). Methods This work was a single-centre retrospective study of CT brain images from 112 neurosurgical patients. Hounsfield units (HUs) of the images from CereTom were measured for air, water and bone. Three assessors independently evaluated the images from the fixed CT scanner and CereTom. Streak artefacts, visualisation of lesions and grey–white matter differentiation were evaluated at three different levels (centrum semiovale, basal ganglia and middle cerebellar peduncles). Each evaluation was scored 1 (poor), 2 (average) or 3 (good) and summed up to form an ordinal reading of 3 to 9. Results HUs for air, water and bone from CereTom were within the recommended value by the American College of Radiology (ACR). Streak artefact evaluation scores for the fixed CT scanner was 8.54 versus 7.46 (Z = −5.67) for CereTom at the centrum semiovale, 8.38 (SD = 1.12) versus 7.32 (SD = 1.63) at the basal ganglia and 8.21 (SD = 1.30) versus 6.97 (SD = 2.77) at the middle cerebellar peduncles. Grey–white matter differentiation showed scores of 8.27 (SD = 1.04) versus 7.21 (SD = 1.41) at the centrum semiovale, 8.26 (SD = 1.07) versus 7.00 (SD = 1.47) at the basal ganglia and 8.38 (SD = 1.11) versus 6.74 (SD = 1.55) at the middle cerebellar peduncles. Visualisation of lesions showed scores of 8.86 versus 8.21 (Z = −4.24) at the centrum semiovale, 8.93 versus 8.18 (Z = −5.32) at the basal ganglia and 8.79 versus 8.06 (Z = −4.93) at the middle cerebellar peduncles. All results were significant with P-value < 0.01. Conclusions Results of the study showed a significant difference in image quality produced by the fixed CT scanner and

Biodistribution and elimination kinetics of systemic Stx2 by the Stx2A and Stx2B subunit-specific human monoclonal antibodies in mice

Directory of Open Access Journals (Sweden)

Sheoran Abhineet

2012-06-01

Full Text Available Abstract Background Hemolytic uremic syndrome (HUS leading to acute kidney failure, is a condition linked to the production of primarily Shiga toxin 2 (Stx2 by some E. coli serotypes. We have previously shown that Stx2 A subunit-specific human monoclonal antibody (HuMAb 5C12, and B subunit-specific HuMAb 5H8 inhibit cultured cell death, and protect mice and piglets from fatal Stx2-intoxication. We have also shown that 5H8 blocks binding of Stx2 to its cell-surface receptor globotriaosyl ceramide (Gb3, whereas Stx2 when complexed with 5C12 binds Gb3 with higher affinity than Stx2. The mechanism by which 5C12 neutralizes Stx2 in vitro involves trapping of Stx2 in the recycling endosomes and releasing it into the extracellular environment. Because of the clinical implications associated with the formation of Stx2/antibody complexes and the potential for trapping and clearance through a severely damaged kidney associated with HUS, we investigated the likely site(s of Stx2/antibody localization and clearance in intoxicated mice treated with antibody or placebo. Results Mice were injected with radiolabeled Stx2 (125I-Stx2 4 hours after administration of 5C12, 5H8, or phosphate buffered saline (PBS and the sites of localization of labeled Stx2, were investigated 3, 24 and 48 hours later. The liver recorded statistically much higher concentrations of labeled Stx2 for groups receiving 5C12 and 5H8 antibodies after 3, 24 and 48 hours, as compared with the PBS group. In contrast, highest levels of labeled Stx2 were detected in the kidneys of the PBS group at all 3 sampling times. Mice receiving either of the two HuMAbs were fully protected against the lethal effect of Stx2, as compared with the fatal outcome of the control group. Conclusions The results suggest that HuMAbs 5C12 and 5H8 promoted hepatic accumulation and presumably clearance of toxin/antibody complexes, significantly diverting Stx2 localization in the kidneys, the target of Stx2 and the

Protection of Human Podocytes from Shiga Toxin 2-Induced Phosphorylation of Mitogen-Activated Protein Kinases and Apoptosis by Human Serum Amyloid P Component

Science.gov (United States)

Dettmar, Anne K.; Binder, Elisabeth; Greiner, Friederike R.; Liebau, Max C.; Kurschat, Christine E.; Jungraithmayr, Therese C.; Saleem, Moin A.; Schmitt, Claus-Peter; Feifel, Elisabeth; Orth-Höller, Dorothea; Kemper, Markus J.; Pepys, Mark; Würzner, Reinhard

2014-01-01

Hemolytic uremic syndrome (HUS) is mainly induced by Shiga toxin 2 (Stx2)-producing Escherichia coli. Proteinuria can occur in the early phase of the disease, and its persistence determines the renal prognosis. Stx2 may injure podocytes and induce proteinuria. Human serum amyloid P component (SAP), a member of the pentraxin family, has been shown to protect against Stx2-induced lethality in mice in vivo, presumably by specific binding to the toxin. We therefore tested the hypothesis that SAP can protect against Stx2-induced injury of human podocytes. To elucidate the mechanisms underlying podocyte injury in HUS-associated proteinuria, we assessed Stx2-induced activation of mitogen-activated protein kinases (MAPKs) and apoptosis in immortalized human podocytes and evaluated the impact of SAP on Stx2-induced damage. Human podocytes express Stx2-binding globotriaosylceramide 3. Stx2 applied to cultured podocytes was internalized and then activated p38α MAPK and c-Jun N-terminal kinase (JNK), important signaling steps in cell differentiation and apoptosis. Stx2 also activated caspase 3, resulting in an increased level of apoptosis. Coincubation of podocytes with SAP and Stx2 mitigated the effects of Stx2 and induced upregulation of antiapoptotic Bcl2. These data suggest that podocytes are a target of Stx2 and that SAP protects podocytes against Stx2-induced injury. SAP may therefore be a useful therapeutic option. PMID:24566618

Acute dialysis-associated peritonitis in children with D+ hemolytic uremic syndrome.

Science.gov (United States)

Adragna, Marta; Balestracci, Alejandro; García Chervo, Laura; Steinbrun, Silvina; Delgado, Norma; Briones, Liliana

2012-04-01

Acute peritoneal dialysis (PD) is the preferred therapy for renal replacement in children with post-diarrheal hemolytic uremic syndrome (D+ HUS), but peritonitis remains a frequent complication of this procedure. We reviewed data from 149 patients with D+ HUS who had undergone acute PD with the aim of determining the prevalence and risk factors for the development of peritonitis. A total of 36 patients (24.2%) presented peritonitis. The median onset of peritonitis manifestations was 6 (range 2-18) days after the initiation of dialysis treatment, and Gram-positive microorganisms were the predominant bacterial type isolated (15/36 patients). The patients were divided into two groups: with or without peritonitis, respectively. Univariate analysis revealed that a longer duration of the oligoanuric period, more days of dialysis, catheter replacement, stay in the intensive care unit, and hypoalbuminemia were significantly associated to the development of peritonitis. The multivariate analysis, controlled by duration of PD, identified the following independent risk factors for peritonitis: catheter replacement [p = 0.037, odds ratio (OR) 1.33, 95% confidence interval (CI) 1.02-1.73], stay in intensive care unit (p = 0.0001, OR 2.62, 95% CI 1.65-4.19), and hypoalbuminemia (p = 0.0076, OR 1.45, 95% CI 1.10-1.91). Based on these findings, we conclude that the optimization of the aseptic technique during catheter manipulation and early nutritional support are targets for the prevention of peritonitis, especially in critically ill patients.

Asiakaslähtöisen hoidon toteutuminen nuorisopsykiatriassa

OpenAIRE

Ruotsalo, Heli

2015-01-01

Tämän kehittämistyön tarkoituksena oli kartoittaa eräässä nuorisopsykiatrisessa yksikössä asiakaslähtöisyyden toteutumista valmiin HUS-asiakastyytyväisyyskyselyn avulla ja kuvata fokusryhmähaastattelun avulla nuorisopsykiatrisen hoitohenkilökunnan näkemyksiä, toiveita ja tarpeita asiakaslähtöisyyden toteutumiselle. Kehittämistyön tavoitteena oli tuottaa tietoa tietojohtamisen avuksi psykiatrisen hoidon muutostilanteessa kohti avohoidon lisäämistä ja kehittämistä. Tavoitteena oli myös aktivoid...

Kirjallisuuskatsaus tiimityöstä

OpenAIRE

Uimi, Jutta

2012-01-01

Laurea-ammattikorkeakoulu Tiivistelmä Laurea Lohja Hoitotyön koulutusohjelma Uimi Jutta Kirjallisuuskatsaus tiimityöstä Vuosi 2012 Sivumäärä 43 Tämän opinnäytetyön tavoitteena oli kuvata kirjallisuuskatsauksen muodossa, miten tiimityö määritellään terveydenhuollon organisaatiossa ja tiimityön käytettävyyttä sekä millaisissa yhteyksissä tiimityötä käytetään. Tarkoituksena oli tuottaa tutkittua tietoa tiimityöstä Helsingin ja Uudenmaan sairaanhoitopiiriin (HUS) kuulu...

Castillos, poder feudal y reorganización espacial en la Transierra madrileña (siglos XII-XIII

Directory of Open Access Journals (Sweden)

Iñaki Martín Viso

2000-01-01

Full Text Available Algunos castillos de la Transierra madrileña en los siglos xii y xiii son herederos de los husün musulmanes, pero se convierten en esa época en centros de poder señorial sobre unas débiles comunidades. No obstante, sólo su transformación en concejos permitirá la supervivencia de algunos de ellos, aunque se observa también un desplazamiento del habitat hacia el llano, resultado de la formación de un nuevo sistema productivo basado en la agricultura cerealfstica y la propiedad feudal, por lo que el papel de los castillos es limitado. En las zonas serranas su relevancia es aún menor y nunca estructuraron el paisaje, labor que ejercieran los sexmos de la Tierra de Segovia.Some castles of the Madrid's Transierra in the xii"" and xiif" centuries are inheritors of the muslim husün, but they viere converted during this age in centres of a lordship power which was imposed to the weak communities. However, only some of them could survive through their conversión In town counciis (concejos, although there is also an habitat's displacement to the plain, that is the result of the new producing system based on the grain agrículture and the feudal property, so the role of the castles was reduced. In the mountain áreas the landscape was never structured by castles, but by the rural distrícts (sexmos ofthe Segovia's Land.

Heterogeneity in Induction Level, Infection Ability, and Morphology of Shiga Toxin-Encoding Phages (Stx Phages) from Dairy and Human Shiga Toxin-Producing Escherichia coli O26:H11 Isolates

Science.gov (United States)

Bonanno, Ludivine; Petit, Marie-Agnès; Loukiadis, Estelle; Michel, Valérie

2016-01-01

Shiga toxin (Stx)-producing Escherichia coli (STEC) bacteria are foodborne pathogens responsible for diarrhea and hemolytic-uremic syndrome (HUS). Shiga toxin, the main STEC virulence factor, is encoded by the stx gene located in the genome of a bacteriophage inserted into the bacterial chromosome. The O26:H11 serotype is considered to be the second-most-significant HUS-causing serotype worldwide after O157:H7. STEC O26:H11 bacteria and their stx-negative counterparts have been detected in dairy products. They may convert from the one form to the other by loss or acquisition of Stx phages, potentially confounding food microbiological diagnostic methods based on stx gene detection. Here we investigated the diversity and mobility of Stx phages from human and dairy STEC O26:H11 strains. Evaluation of their rate of in vitro induction, occurring either spontaneously or in the presence of mitomycin C, showed that the Stx2 phages were more inducible overall than Stx1 phages. However, no correlation was found between the Stx phage levels produced and the origin of the strains tested or the phage insertion sites. Morphological analysis by electron microscopy showed that Stx phages from STEC O26:H11 displayed various shapes that were unrelated to Stx1 or Stx2 types. Finally, the levels of sensitivity of stx-negative E. coli O26:H11 to six Stx phages differed among the 17 strains tested and our attempts to convert them into STEC were unsuccessful, indicating that their lysogenization was a rare event. PMID:26826235

Effect of ultra-low doses, ASIR and MBIR on density and noise levels of MDCT images of dental implant sites.

Science.gov (United States)

Widmann, Gerlig; Al-Shawaf, Reema; Schullian, Peter; Al-Sadhan, Ra'ed; Hörmann, Romed; Al-Ekrish, Asma'a A

2017-05-01

Differences in noise and density values in MDCT images obtained using ultra-low doses with FBP, ASIR, and MBIR may possibly affect implant site density analysis. The aim of this study was to compare density and noise measurements recorded from dental implant sites using ultra-low doses combined with FBP, ASIR, and MBIR. Cadavers were scanned using a standard protocol and four low-dose protocols. Scans were reconstructed using FBP, ASIR-50, ASIR-100, and MBIR, and either a bone or standard reconstruction kernel. Density (mean Hounsfield units [HUs]) of alveolar bone and noise levels (mean standard deviation of HUs) was recorded from all datasets and measurements were compared by paired t tests and two-way ANOVA with repeated measures. Significant differences in density and noise were found between the reference dose/FBP protocol and almost all test combinations. Maximum mean differences in HU were 178.35 (bone kernel) and 273.74 (standard kernel), and in noise, were 243.73 (bone kernel) and 153.88 (standard kernel). Decreasing radiation dose increased density and noise regardless of reconstruction technique and kernel. The effect of reconstruction technique on density and noise depends on the reconstruction kernel used. • Ultra-low-dose MDCT protocols allowed more than 90 % reductions in dose. • Decreasing the dose generally increased density and noise. • Effect of IRT on density and noise varies with reconstruction kernel. • Accuracy of low-dose protocols for interpretation of bony anatomy not known. • Effect of low doses on accuracy of computer-aided design models unknown.

Bare Nouns in Danish with Special Reference to the Object Position

DEFF Research Database (Denmark)

Müller, Henrik Hoeg

2017-01-01

in subject position, function as both generic and existential arguments, and appear with all aspectual verb classes. However, BPs and BSS expressing a non-generic, modificational meaning concur in object position of activity verbs and stative verbs with a possession relation implicature. These V+BP and V......+BS structures, it is suggested, form a progressive continuum of three different subtypes of pseudo-incorporation (PI), namely (i) PI of BPs (low integration as in spise æbler 'eat apples'), (ii) PI of type 1 BSS (medium integration as in male hus 'paint house'), and (iii) PI of type 2 BSS (maximum integration...

Calculating the number of shock waves, expulsion time, and optimum stone parameters based on noncontrast computerized tomography characteristics.

Science.gov (United States)

Foda, Khaled; Abdeldaeim, Hussein; Youssif, Mohamed; Assem, Akram

2013-11-01

To define the parameters that accompanied a successful extracorporeal shock wave lithotripsy (ESWL), namely the number of shock waves (SWs), expulsion time (ET), mean stone density (MSD), and the skin-to-stone distance (SSD). A total of 368 patients diagnosed with renal calculi using noncontrast computerized tomography had their MSD, diameter, and SSD recorded. All patients were treated using a Siemens lithotripter. ESWL success meant a stone-free status or presence of residual fragments 934 HUs and SSD >99 mm. The required number of SWs and the expected ET can be anticipated. Copyright © 2013 Elsevier Inc. All rights reserved.

Renoscintigraphy in assessment of renal lesions in children after hemolytic-uremic syndrome

International Nuclear Information System (INIS)

Lass, P.; Marczak, E.; Romanowicz, G.; and others.

1994-01-01

The aim of the study was to assess the role of renoscintigraphic examination in monitoring of patients after the hemolytic-uremic syndrome. 27 children mean 9 years the hemolytic-uremic syndrome underwent the complex of biochemical, ultrasound and renoscintigraphic examinations. The abnormal renoscintigraphic was seen in 85.1% of children, while the alternative test described the renal lesion in 29-66%. Renoscintigraphic examination seems to be the most sensitive in monitoring of remote sequel in patients after HUS. Those patients should undergone long-lasting observation, for the sake of possibility of development of renal insufficiency. (author). 14 refs

Kätilön ammatillinen osaaminen naistentautien hoitotyössä : kysely valmistuville kätilöopiskelijoille : taustatietojen yhteys ammatilliseen osaamiseen

OpenAIRE

Jerrman, Anne; Kokkonen, Saija

2008-01-01

Opinnäytetyön tarkoituksena oli kartoittaa eri taustamuuttujien yhteyttä kätilöopiskelijoiden ammatilliseen osaamiseen. Opinnäytetyö on osa Näyttöön perustuva kätilötyö -hanketta. Hanke toteutetaan yhteistyössä HUS Naistensairaalan kanssa, ja sen tavoitteena on tuottaa näyttöön perustuvaa tietoa toiminnan kehittämiseksi. Tämä työ on jatkoa opinnäytetyölle Kätilön ammatillinen osaaminen naistentautien hoitotyössä - kysely valmistuville kätilöopiskelijoille. Opinnäytetyön aineisto kerä...

Escherichia coli enterohemorrágica y síndrome urémico hemolítico en Argentina Enterohemorrhagic Escherichia coli and hemolytic-uremic syndrome in Argentina

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Mariana A. Rivero

2004-08-01

Full Text Available El síndrome urémico hemolítico (SUH.es un desorden multisistémico caracterizado por presentar insuficiencia renal aguda, anemia hemolítica microangiopática y trombocitopenia. Constituye la principal causa de insuficiencia renal aguda y la segunda causa de insuficiencia renal crónica y de transplante renal en niños en la Argentina. Actualmente, nuestro país presenta el registro más alto de SUH en todo el mundo, con aproximadamente 420 casos nuevos declarados anualmente y una incidencia de 12.2/100 000 niños menores de 5 años de edad. Se reconocen múltiples agentes etiológicos, aunque se considera a la infección por Escherichia coli enterohemorrágica (EHEC como la principal etiología de SUH. La gran mayoría de brotes epidémicos y casos esporádicos en humanos se han asociado con el serotipo O157:H7, aunque otros serotipos han sido también aislados, y éstos son un subgrupo de E. coli verocitotoxigénico (VTEC..El bovino es considerado el principal reservorio de VTEC. El contagio al hombre frecuentemente se debe al consumo de alimentos cárneos y lácteos contaminados, deficientemente cocidos o sin pasteurizar, o al contacto directo con los animales o con sus heces, consumo de agua, frutas o verduras contaminadas. También puede producirse contagio mediante el contacto interhumano.The hemolytic-uremic syndrome (HUS is a multisystemic disorder that is characterized by the onset of acute renal failure, microangiopathic hemolytic anemia and thrombocytopenia. It is the most common cause of acute renal failure and the second cause of chronic renal failure and renal transplantation in children in Argentina. Our country has the highest incidence of HUS in the world, with approximately 420 new cases observed each year with an incidence of 12.2 cases per 100 000 children in the age group 0-5 years. Numerous etiologic factors have been associated with HUS but the infection with enterohemorrhagic Escherichia coli (EHEC is considered the

Heme acquisition mechanisms of Porphyromonas gingivalis - strategies used in a polymicrobial community in a heme-limited host environment.

Science.gov (United States)

Smalley, J W; Olczak, T

2017-02-01

Porphyromonas gingivalis, a main etiologic agent and key pathogen responsible for initiation and progression of chronic periodontitis requires heme as a source of iron and protoporphyrin IX for its survival and the ability to establish an infection. Porphyromonas gingivalis is able to accumulate a defensive cell-surface heme-containing pigment in the form of μ-oxo bisheme. The main sources of heme for P. gingivalis in vivo are hemoproteins present in saliva, gingival crevicular fluid, and erythrocytes. To acquire heme, P. gingivalis uses several mechanisms. Among them, the best characterized are those employing hemagglutinins, hemolysins, and gingipains (Kgp, RgpA, RgpB), TonB-dependent outer-membrane receptors (HmuR, HusB, IhtA), and hemophore-like proteins (HmuY, HusA). Proteins involved in intracellular heme transport, storage, and processing are less well characterized (e.g. PgDps). Importantly, P. gingivalis may also use the heme acquisition systems of other bacteria to fulfill its own heme requirements. Porphyromonas gingivalis displays a novel paradigm for heme acquisition from hemoglobin, whereby the Fe(II)-containing oxyhemoglobin molecule must first be oxidized to methemoglobin to facilitate heme release. This process not only involves P. gingivalis arginine- and lysine-specific gingipains, but other proteases (e.g. interpain A from Prevotella intermedia) or pyocyanin produced by Pseudomonas aeruginosa. Porphyromonas gingivalis is then able to fully proteolyze the more susceptible methemoglobin substrate to release free heme or to wrest heme from it directly through the use of the HmuY hemophore. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Taxonomy Meets Public Health: The Case of Shiga Toxin-Producing Escherichia coli.

Science.gov (United States)

Scheutz, Flemming

2014-06-01

To help assess the clinical and public health risks associated with different Shiga toxin-producing Escherichia coli (STEC) strains, an empirical classification scheme was used to classify STEC into five "seropathotypes" (seropathotype A [high risk] to seropathotypes D and E [minimal risk]). This definition is of considerable value in cases of human infection but is also problematic because not all STEC infections are fully characterized and coupled to reliable clinical information. Outbreaks with emerging hybrid strains continuously challenge our understanding of virulence potential and may result in incorrect classification of specific pathotypes; an example is the hybrid strain that caused the 2011 outbreak in Germany, STEC/EAggEC O104:H4, which may deserve an alternative seropathotype designation. The integration of mobile virulence factors in the stepwise and parallel evolution of pathogenic lineages of STEC collides with the requirements of a good taxonomy, which separates elements of each group into subgroups that are mutually exclusive, unambiguous, and, together, include all possibilities. The concept of (sero)-pathotypes is therefore challenged, and the need to identify factors of STEC that absolutely predict the potential to cause human disease is obvious. Because the definition of hemolytic-uremic syndrome (HUS) is distinct, a basic and primary definition of HUS-associated E. coli (HUSEC) for first-line public health action is proposed: stx2 in a background of an eae- or aggR-positive E. coli followed by a second-line subtyping of stx genes that refines the definition of HUSEC to include only stx2a and stx2d. All other STEC strains are considered "low-risk" STEC.

Acute kidney injury in Hemiscorpius lepturus scorpion stung children: Risk factors and clinical features

Directory of Open Access Journals (Sweden)

Ehsan Valavi

2016-01-01

Full Text Available Acute kidney injury (AKI is frequently seen in Hemiscorpius lepturus scorpion stung children. We have previously reported several victims with hemolytic uremic syndrome (HUS and a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 deficiency. Hence, we conducted this study to identify predictive factors and clinical features of AKI in H. lepturus scorpion stung patients. We included all 215 H. lepturus scorpion stung children with no previous renal diseases in two groups (with and without AKI and compared them based on their clinical and laboratory findings. AKI was found in 27.4% of patients, they were significantly younger and with lower body weight (P = 0.006, P = 0.011, respectively. There was a significant difference between groups with and without AKI in findings such as fever (P = 0.003, hypertension (P <0.001, hemolytic anemia (P <0.001, thrombocytopenia (P <0.001, massive proteinuria (P <0.001, hemoglobinuria (P <0.001, pyuria (P <0.001, and hematuria (P = 0.004. HUS was in 5.5% and disseminated intravascular coagulation in 14.6% which had a significant association with AKI (P <0.001.There were several independent predictors for AKI in a multivariate regression model including thrombocytopenia (P = 0.002, pyuria (P = 0.01, proteinuria (P =0.01, and fever (P = 0.02. Hemodialysis was performed in four patients but kidney function improved in all patients and there was no findings of renal impairment after three months follow-up. We found several predictors for AKI in children following H. lepturus scorpion sting including younger age, delay in receiving medical care, pigmenturia, microangiopathic hemolytic anemia, proteinuria, and pyuria.

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African Journals Online (AJOL)

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Mitomycin-C-Induced TTP/HUS Treated Successfully with Rituximab: Case Report and Review of the Literature

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Gunjan Shah

2013-01-01

Full Text Available Microangiopathic hemolytic anemia (MAHA, thrombocytopenia, fever, renal failure, and neurologic symptoms comprise the cardinal features of thrombotic thrombocytopenic purpura and hemolytic uremic syndrome. Etiologies can include medications, infections, cancers, or transplantation. We present a patient with a history of rectal cancer treated with mitomycin-C who developed MAHA, acute kidney injury, and thrombocytopenia 6 months after completing therapy and to did not respond the plasmapheresis or steroids. She was treated with four weekly doses of rituximab with full recovery.

Engineering i skolen

DEFF Research Database (Denmark)

Auner, Suzie; Daugbjerg, Peer; Nielsen, Keld

Denne didaktik er udarbejdet i forbindelse med projektet “Engineering i skolen” (EiS), som har til formål at bringe engineering ind i naturfagsundervisningen i grundskolen. EiS er et samarbejde mellem Engineer the future, VIA University College, Astra og Naturvidenskabernes Hus, UCC samt lærere fra...... grundskolen ligeledes kan have glæde af at læse med. Didaktikken er blevet til på grundlag af en række forarbejder. Et indledende litteraturstudium dannede udgangspunkt for at opstille nogle principper for en engineering-didaktik, der kan fungere i dansk grundskolekontekst. Sideløbende blev der gennemført en...

Cerebral Hemodynamics in Patients with Hemolytic Uremic Syndrome Assessed by Susceptibility Weighted Imaging and Four-Dimensional Non-Contrast MR Angiography.

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Ulrike Löbel

Full Text Available Conventional magnetic resonance imaging (MRI of patients with hemolytic uremic syndrome (HUS and neurological symptoms performed during an epidemic outbreak of Escherichia coli O104:H4 in Northern Europe has previously shown pathological changes in only approximately 50% of patients. In contrast, susceptibility-weighted imaging (SWI revealed a loss of venous contrast in a large number of patients. We hypothesized that this observation may be due to an increase in cerebral blood flow (CBF and aimed to identify a plausible cause.Baseline 1.5T MRI scans of 36 patients (female, 26; male, 10; mean age, 38.2±19.3 years were evaluated. Venous contrast was rated on standard SWI minimum intensity projections. A prototype four-dimensional (time resolved magnetic resonance angiography (4D MRA assessed cerebral hemodynamics by global time-to-peak (TTP, as a surrogate marker for CBF. Clinical parameters studied were hemoglobin, hematocrit, creatinine, urea levels, blood pressure, heart rate, and end-tidal CO2.SWI venous contrast was abnormally low in 33 of 36 patients. TTP ranged from 3.7 to 10.2 frames (mean, 7.9 ± 1.4. Hemoglobin at the time of MRI (n = 35 was decreased in all patients (range, 5.0 to 12.6 g/dL; mean, 8.2 ± 1.4; hematocrit (n = 33 was abnormally low in all but a single patient (range, 14.3 to 37.2%; mean, 23.7 ± 4.2. Creatinine was abnormally high in 30 of 36 patients (83% (range, 0.8 to 9.7; mean, 3.7 ± 2.2. SWI venous contrast correlated significantly with hemoglobin (r = 0.52, P = 0.0015, hematocrit (r = 0.65, P < 0.001, and TTP (r = 0.35, P = 0.036. No correlation of SWI with blood pressure, heart rate, end-tidal CO2, creatinine, and urea level was observed. Findings suggest that the loss of venous contrast is related to an increase in CBF secondary to severe anemia related to HUS. SWI contrast of patients with pathological conventional MRI findings was significantly lower compared to patients with normal MRI (mean SWI score, 1

A rapid procedure for the detection and isolation of enterohaemorrhagic Escherichia coli (EHEC) serogroup O26, O103, O111, O118, O121, O145 and O157 strains and the aggregative EHEC O104:H4 strain from ready-to-eat vegetables.

Science.gov (United States)

Tzschoppe, Markus; Martin, Annett; Beutin, Lothar

2012-01-03

Human infections with Enterohaemorrhagic Escherichia coli strains (EHEC) as agents of Haemorrhagic Colitis (HC) and Haemolytic Uraemic Syndrome (HUS) are frequently associated with the consumption of EHEC contaminated foodstuffs of different origins. EHEC O26, O103, O111, O118, O121, O145 and O157 strains are responsible for the majority of HC and HUS cases worldwide. In May 2011, the emerging aggregative EHEC O104:H4 strain caused a large outbreak with high HUS incidence in northern Germany. Contaminated sprouted seeds were suspected to be the vehicles of transmission. The examination of vegetables retailed for raw consumption revealed low numbers of E. coli (vegetables are not yet published. Therefore, we have developed a rapid and sensitive method for detecting low EHEC contamination in vegetables (1-10 cfu/25 g) with artificially EHEC contaminated ready-to-eat salads. A 6-hour enrichment period in BRILA-broth was sufficient to detect 1-10 EHEC from spiked samples after plating 0.1 ml portions of enrichment culture on selective TBX-agar and CHROMagar STEC plates that were incubated at 44 °C overnight. Unlike EHEC strains, the growth of bacteria of the plant flora was substantially inhibited at 44 °C. DNA for real-time PCR detection of EHEC characteristic genes (stx(1), stx(2), eae, ehxA, and O-antigen associated) was prepared with bacteria grown on TBX-agar plates. The storage of EHEC inoculated salad samples for 72 h at 6 °C resulted in a significant reduction (mean value 14.6%) of detectable EHEC, suggesting interference of EHEC with the resident plant microflora. CHROMagar STEC was evaluated as a selective medium for the detection of EHEC strains. Growth on CHROMagar STEC was closely associated with EHEC O26:[H11], O111:[H8], O118:H16, O121:[H19], O145:[H28], O157:[H7] and aggregative EHEC O104:H4 strains and with the presence of the terB gene (tellurite resistance). TerB sequences were found in 87.2% of 235 EHEC but only in only 12.5% of 567 non

Basal ganglia perfusion using dynamic color Doppler sonography in infants with hypoxic ischemic encephalopathy receiving therapeutic hypothermia: a pilot study.

Science.gov (United States)

Faingold, Ricardo; Cassia, Guilherme; Morneault, Linda; Saint-Martin, Christine; Sant'Anna, Guilherme

2016-10-01

The objective of this study was to evaluate the cerebral perfusion of the basal ganglia in infants with hypoxic-ischemic encephalopathy (HIE) receiving hypothermia using dynamic color Doppler sonography (CDS) and investigate for any correlation between these measurements and survival. Head ultrasound (HUS) was performed with a 9S4 MHz sector transducer in HIE infants submitted to hypothermia as part of their routine care. Measurements of cerebral perfusion intensity (CPI) with an 11LW4 MHz linear array transducer were performed to obtain static images and DICOM color Doppler videos of the blood flow in the basal ganglia area. Clinical and radiological data were evaluated retrospectively. The video images were analyzed by two radiologists using dedicated software, which allows automatic quantification of color Doppler data from a region of interest (ROI) by dynamically assessing color pixels and flow velocity during the heart cycle. CPI is expressed in cm/sec and is calculated by multiplying the mean velocity of all pixels divided by the area of the ROI. Three videos of 3 seconds each were obtained of the ROI, in the coronal plane, and used to calculate the CPI. Data are presented as mean ± SEM or median (quartiles). A total of 28 infants were included in this study: 16 male, 12 female. HUS was performed within the first 48 hours of therapeutic hypothermia treatment. CPI values were significantly higher in the seven non-survivors when compared to survivors (0.226±0.221 vs . 0.111±0.082 cm/sec; P=0.02). Increased perfusion intensity of the basal ganglia area within the first 48 of therapeutic hypothermia treatment was associated with poor outcome in neonates with HIE.

Cerebral Hemodynamics in Patients with Hemolytic Uremic Syndrome Assessed by Susceptibility Weighted Imaging and Four-Dimensional Non-Contrast MR Angiography.

Science.gov (United States)

Löbel, Ulrike; Forkert, Nils Daniel; Schmitt, Peter; Dohrmann, Thorsten; Schroeder, Maria; Magnus, Tim; Kluge, Stefan; Weiler-Normann, Christina; Bi, Xiaoming; Fiehler, Jens; Sedlacik, Jan

2016-01-01

Conventional magnetic resonance imaging (MRI) of patients with hemolytic uremic syndrome (HUS) and neurological symptoms performed during an epidemic outbreak of Escherichia coli O104:H4 in Northern Europe has previously shown pathological changes in only approximately 50% of patients. In contrast, susceptibility-weighted imaging (SWI) revealed a loss of venous contrast in a large number of patients. We hypothesized that this observation may be due to an increase in cerebral blood flow (CBF) and aimed to identify a plausible cause. Baseline 1.5T MRI scans of 36 patients (female, 26; male, 10; mean age, 38.2±19.3 years) were evaluated. Venous contrast was rated on standard SWI minimum intensity projections. A prototype four-dimensional (time resolved) magnetic resonance angiography (4D MRA) assessed cerebral hemodynamics by global time-to-peak (TTP), as a surrogate marker for CBF. Clinical parameters studied were hemoglobin, hematocrit, creatinine, urea levels, blood pressure, heart rate, and end-tidal CO2. SWI venous contrast was abnormally low in 33 of 36 patients. TTP ranged from 3.7 to 10.2 frames (mean, 7.9 ± 1.4). Hemoglobin at the time of MRI (n = 35) was decreased in all patients (range, 5.0 to 12.6 g/dL; mean, 8.2 ± 1.4); hematocrit (n = 33) was abnormally low in all but a single patient (range, 14.3 to 37.2%; mean, 23.7 ± 4.2). Creatinine was abnormally high in 30 of 36 patients (83%) (range, 0.8 to 9.7; mean, 3.7 ± 2.2). SWI venous contrast correlated significantly with hemoglobin (r = 0.52, P = 0.0015), hematocrit (r = 0.65, P effect of blood transfusions in patients with HUS and neurological symptoms.

Intestinal Pathogenic Escherichia coli: Insights for Vaccine Development

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Maricarmen Rojas-Lopez

2018-03-01

Full Text Available Diarrheal diseases are one of the major causes of mortality among children under five years old and intestinal pathogenic Escherichia coli (InPEC plays a role as one of the large causative groups of these infections worldwide. InPECs contribute significantly to the burden of intestinal diseases, which are a critical issue in low- and middle-income countries (Asia, Africa and Latin America. Intestinal pathotypes such as enteropathogenic E. coli (EPEC and enterotoxigenic E. coli (ETEC are mainly endemic in developing countries, while ETEC strains are the major cause of diarrhea in travelers to these countries. On the other hand, enterohemorrhagic E. coli (EHEC are the cause of large outbreaks around the world, mainly affecting developed countries and responsible for not only diarrheal disease but also severe clinical complications like hemorrhagic colitis and hemolytic uremic syndrome (HUS. Overall, the emergence of antibiotic resistant strains, the annual cost increase in the health care system, the high incidence of traveler diarrhea and the increased number of HUS episodes have raised the need for effective preventive treatments. Although the use of antibiotics is still important in treating such infections, non-antibiotic strategies are either a crucial option to limit the increase in antibiotic resistant strains or absolutely necessary for diseases such as those caused by EHEC infections, for which antibiotic therapies are not recommended. Among non-antibiotic therapies, vaccine development is a strategy of choice but, to date, there is no effective licensed vaccine against InPEC infections. For several years, there has been a sustained effort to identify efficacious vaccine candidates able to reduce the burden of diarrheal disease. The aim of this review is to summarize recent milestones and insights in vaccine development against InPECs.

Detección y caracterización de Escherichia coli productor de toxina Shiga a partir de casos clínicos y de alimentos en Uruguay Detection and characterization of Shiga toxin - producing Escherichia coli from clinical cases and food in Uruguay

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G. Varela

2008-06-01

Full Text Available Establecimos la frecuencia de aislamiento de Escherichia coli productor de toxina Shiga (STEC a partir de muestras clínicas y de alimentos, así como las características fenotípicas y genotípicas de las cepas recuperadas. Se analizaron 198 muestras fecales de niños con diarrea sanguinolenta (DS, 14 muestras fecales de niños con síndrome urémico hemolítico (SUH y 220 muestras de carne picada. También se estudiaron 4 cepas STEC aisladas de alimentos embutidos. Se recuperó STEC de 3 (1,5% de los niños con DS, de 1 (7% niño con SUH y de 4 (1,8% de las muestras de carne picada. Todas las cepas fueron eae y ehxA positivas. Los serotipos detectados fueron: O157:H7 (9 cepas, O26:H11 (2 cepas, O111:NM (1 cepa y O145:HNT (1 cepa. Todas las cepas O157:H7 portaron el subtipo eae-g1; las cepas O26:H11 y O145:HNT portaron el subtipo eae-b1 y la cepa O111:NM portó el subtipo eae-g2/q. Las cepas STEC del mismo serogrupo mostraron alta diversidad genética. En Uruguay STEC no sería agente frecuente de diarrea con sangre en niños. Sin embargo, las cepas recuperadas presentaron los genes asociados con enfermedad severa y 2 de los 3 niños infectados con STEC evolucionaron a SUH. La carne picada y otros alimentos serían vehículos importantes de O157:H7.We have assessed the frequency of Shiga toxin-producing Escherichia coli (STEC in clinical and food samples as well as studied the genotypic and phenotypic characteristics of the recovered strains. One hundred ninety eight fecal samples from children with bloody diarrhea (BD, 14 from children with hemolytic uremic syndrome (HUS, 220 ground beef samples and 4 STEC isolates from other beef-derived products were analyzed. The STEC strains were isolated from 3 (1.5% children with bloody diarrhea, 1 (7% from a child with HUS and 4 (1.8% from ground beef samples. All strains were eae and ehxA positive. The serotypes found were: O157:H7 (9 strains, O26:H11 (2, O111: NM (1 and O145:HNT (1. All O157:H7 STEC

Professor om brexit-åbning: Det bliver sværere i næste fase

DEFF Research Database (Denmark)

Wind, Marlene

2017-01-01

Professor og centerleder, Marlene Wind, var den 8. december i Vejle Amts Folkeblad, hvor hun kommenterede på udviklingen i Brexit-forhandlingerne i forlængelse af udmeldingen om, at forhandlingerne er klar til den næste fase. Professor Wind kalder dette for et gennembrud, men pointerer også at de...... videre forhandlinger vil være på EU’s præmisser. De videre forhandlinger vil blandt andet handle om en kommende handelsaftale mellem de to parter, til hvilket professor Wind påpeger, at det kan tage mange år, før man har en sådan i hus. Samtidig vurderer Wind også, at nogle leave-vælgere måske vil blive...

Síndrome urémico hemolítico. Tratamiento de la glomerulopatía secundaria Hemolytic uremic syndrome. Treatment of secondary glomerulopathy

Directory of Open Access Journals (Sweden)

María G. Caletti

2005-12-01

Full Text Available La insuficiencia renal crónica es la complicación más grave del síndrome urémico hemolítico (SUH. En el año 1996 se publicó la secuencia histológica de su evolución en pacientes con períodos oligoanúricos prolongados. En los últimos años se han propuesto diferentes esquemas terapéuticos para enlentecer la evolución a la insuficiencia renal crónica terminal en distintas nefropatías, diabéticas y no diabéticas, cuya expresión puede comenzar aun en la adolescencia. En este trabajo se comenta la respuesta a dos esquemas terapéuticos de dos grupos de pacientes con SUH que presentaron proteinuria con o sin hipertensión arterial e insuficiencia renal. Se enfatiza la indicación de la dieta hiposódica y controlada en proteínas en el mismo momento del alta del paciente y la incorporación de un inhibidor de la enzima de conversión de angiotensina II, iECA, (enalapril al comienzo de la aparición de la proteinuria.Chronic renal failure (CRF is the most severe complication of hemolytic uremic syndrome (HUS. In 1996, the histological sequence of changes in patients with long lasting oligoanuric periods was clarified. In the last years different therapeutic schemes have been proposed in order to slacken the development of terminal CRF in different renal conditions secondary to diabetes and other diseases. Some of these cases can suffer the onset of renal failure at adolescence. In this review, response to two treatment schemes in different patients with HUS and proteinuria with or without hypertension or renal failure is commented. Early indication of poor sodium diet and strict control of protein intake at the very moment of hospital discharge is strongly recommended, as well as angiotensin II conversion inhibiting enzymes (iACE at the appearance of proteinuria.

Exhaled volatile substances mirror clinical conditions in pediatric chronic kidney disease.

Directory of Open Access Journals (Sweden)

Juliane Obermeier

Full Text Available Monitoring metabolic adaptation to chronic kidney disease (CKD early in the time course of the disease is challenging. As a non-invasive technique, analysis of exhaled breath profiles is especially attractive in children. Up to now, no reports on breath profiles in this patient cohort are available. 116 pediatric subjects suffering from mild-to-moderate CKD (n = 48 or having a functional renal transplant KTx (n = 8 and healthy controls (n = 60 matched for age and sex were investigated. Non-invasive quantitative analysis of exhaled breath profiles by means of a highly sensitive online mass spectrometric technique (PTR-ToF was used. CKD stage, the underlying renal disease (HUS; glomerular diseases; abnormalities of kidney and urinary tract or polycystic kidney disease and the presence of a functional renal transplant were considered as classifiers. Exhaled volatile organic compound (VOC patterns differed between CKD/ KTx patients and healthy children. Amounts of ammonia, ethanol, isoprene, pentanal and heptanal were higher in patients compared to healthy controls (556, 146, 70.5, 9.3, and 5.4 ppbV vs. 284, 82.4, 49.6, 5.30, and 2.78 ppbV. Methylamine concentrations were lower in the patient group (6.5 vs 10.1 ppbV. These concentration differences were most pronounced in HUS and kidney transplanted patients. When patients were grouped with respect to degree of renal failure these differences could still be detected. Ammonia accumulated already in CKD stage 1, whereas alterations of isoprene (linked to cholesterol metabolism, pentanal and heptanal (linked to oxidative stress concentrations were detectable in the breath of patients with CKD stage 2 to 4. Only weak associations between serum creatinine and exhaled VOCs were noted. Non-invasive breath testing may help to understand basic mechanisms and metabolic adaptation accompanying progression of CKD. Our results support the current notion that metabolic adaptation occurs early during the time

Occurrence and characterization of stx and/or eae-positive Escherichia coli isolated from wildlife, including a typical EPEC strain from a wild boar.

Science.gov (United States)

Alonso, Carla Andrea; Mora, Azucena; Díaz, Dafne; Blanco, Miguel; González-Barrio, David; Ruiz-Fons, Francisco; Simón, Carmen; Blanco, Jorge; Torres, Carmen

2017-08-01

Shiga toxin-producing E. coli (STEC) and enteropathogenic E. coli (EPEC) strains are food-borne pathogens associated with acute diarrhea. Haemolytic-uremic syndrome (HUS) is often a complication of STEC infection. In order to examine the occurrence, serotypes, virulence and antimicrobial-resistance profiles of STEC and EPEC in wildlife, 326 faecal E. coli strains from 304 clinically healthy animals were analyzed. For this approach stx 1 , stx 2 and eae genes, as well as accessory virulence determinants (ehx, hlyA, saa, tia, bfp, subAB) were PCR-screened and sequenced. Serotyping was performed employing all available O (O1-O185) and H (H1-H56) antisera. Genetic diversity was analyzed by XbaI-PFGE and phylotyping. Thirteen STEC (4.3%) and 10 EPEC (3.3%) were identified among 12 deer, 3 mouflon, 6 wild boars and 2 birds. Nine STEC showed seropathotypes B (O145:[H28]) and C (O22:H8, O128:[H2]) associated with HUS, and D (O110:H28, O146:H21, O146:[H28], ONT:H8) associated with human diarrhea. Although most isolates harbored stx 2b and stx 1c variants, stx 2a and stx 1a (related with severe disease) were also detected. Additionally, the eae gene was present in one stx 2a -positive O145:[H28] STEC from a deer and 11 STEC harbored subAB genes (mainly the subAB 2 variant). EPEC isolates showed 7 different intimin variants (β1, β2, γ1, ε1, ζ1, ι1-A, κ). Interestingly, the O49:[H10] eae-κ EPEC isolated from a wild boar was bfpA-positive showing a combination of serotype/virulence profile previously detected among human clinical tEPEC. Based on present results, wild ruminants, wild boars and to a lesser extent birds would be carriers of potentially pathogenic STEC and EPEC strains. Copyright © 2017 Elsevier B.V. All rights reserved.

Infection in burn patients in a referral center in Colombia.

Science.gov (United States)

Ramirez-Blanco, Carlos Enrique; Ramirez-Rivero, Carlos Enrique; Diaz-Martinez, Luis Alfonso; Sosa-Avila, Luis Miguel

2017-05-01

Worldwide, burns are responsible for more than 300,000 deaths annually; infection is a major cause of morbidity and mortality in these patients. Early identification and treatment of infection improves outcome. Toward this end it's necessary to identify the institutions flora and organisms that most frequently produces infection. To characterize infections developed by burn patients hospitalized at the University Hospital of Santander (HUS). Burn patients hospitalized in the HUS from January 1 to December 2014 were followed. Medical information regarding infections, laboratory and pathology reports were obtained. Statistical analysis with measures of central tendency, proportions, global and specific incidence density plus overall and specific incidence was obtained. For the microbiological profile proportions were established. 402 burn patients were included, 234 (58.2%) men and 168 (41.8%) women, aged between 6 days and 83 years, median 12.5 years. The burn agents include scald (52.5%), fire (10.0%), gasoline (9.2%), electricity (7.5%), among others. Burn area ranged from 1% to 80% TBS. Cumulative mortality was 1.5%. 27.8% of burned patients had one or more infections. Identified infections include folliculitis (27.0%), urinary tract infection (19.0%), infection of the burn wound (10.4%), pneumonia (8.6%), Central venous catheter (7.4%), bloodstream infection (7.4%) and skin grafts infection (4.3%) among others. Bacteria were responsible for 88.5% of the cases and fungi 11.5%. The most frequently isolated germs were P. aeruginosa, A. baumannii, E. coli, S. aureus and K. pneumoniae. Most gram-negative bacteria were sensitive to Amikacin, gram positive bacteria were sensitive to multiple antibiotics. Burns is a severe trauma that occurs in adult and pediatric patients, has several causative agents and can compromise the patient's life. The burned patient is at risk for a variety of infections. According to the type of infection it is possible to infer the most

Protection from hemolytic uremic syndrome by eyedrop vaccination with modified enterohemorrhagic E. coli outer membrane vesicles.

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Kyoung Sub Choi

Full Text Available We investigated whether eyedrop vaccination using modified outer membrane vesicles (mOMVs is effective for protecting against hemolytic uremic syndrome (HUS caused by enterohemorrhagic E. coli (EHEC O157:H7 infection. Modified OMVs and waaJ-mOMVs were prepared from cultures of MsbB- and Shiga toxin A subunit (STxA-deficient EHEC O157:H7 bacteria with or without an additional waaJ mutation. BALB/c mice were immunized by eyedrop mOMVs, waaJ-mOMVs, and mOMVs plus polymyxin B (PMB. Mice were boosted at 2 weeks, and challenged peritoneally with wild-type OMVs (wtOMVs at 4 weeks. As parameters for evaluation of the OMV-mediated immune protection, serum and mucosal immunoglobulins, body weight change and blood urea nitrogen (BUN/Creatinin (Cr were tested, as well as histopathology of renal tissue. In order to confirm the safety of mOMVs for eyedrop use, body weight and ocular histopathological changes were monitored in mice. Modified OMVs having penta-acylated lipid A moiety did not contain STxA subunit proteins but retained non-toxic Shiga toxin B (STxB subunit. Removal of the polymeric O-antigen of O157 LPS was confirmed in waaJ-mOMVs. The mice group vaccinated with mOMVs elicited greater humoral and mucosal immune responses than did the waaJ-mOMVs and PBS-treated groups. Eyedrop vaccination of mOMVs plus PMB reduced the level of humoral and mucosal immune responses, suggesting that intact O157 LPS antigen can be a critical component for enhancing the immunogenicity of the mOMVs. After challenge, mice vaccinated with mOMVs were protected from a lethal dose of wtOMVs administered intraperitoneally, conversely mice in the PBS control group were not. Collectively, for the first time, EHEC O157-derived mOMV eyedrop vaccine was experimentally evaluated as an efficient and safe means of vaccine development against EHEC O157:H7 infection-associated HUS.

Síndrome hemolítico-urêmica esporádica pós-parto Sporadic postpartum hemolytic uremic syndrome

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Elza M. Moreira

2008-08-01

Full Text Available Anemia hemolítica microangiopática associado à trombocitopenia participa de um grupo de doenças que freqüentemente apresentam suas características clínicas muito semelhantes, sendo difícil distingui-las. A síndrome hemolítico-urêmica é dividida em duas apresentações: a forma não esporádica, que acomete comumente crianças após infecção bacteriana causando diarréia sanguinolenta, possui bom prognóstico; e a forma esporádica, que acomete adultos, sendo bem descritos casos em mulheres pósparto, é a forma sistêmica de trombocitopenia microangiopática de pior prognóstico com alta morbidade e mortalidade, cuja falência renal é o distúrbio predominante. Relatamos um caso de síndrome hemolítico-urêmica pós-parto em paciente previamente sadia, que apresentou quadro de insuficiência renal, anemia hemolítica e trombocitopenia. Instituída a terapêutica de suporte adequada e precocemente, a paciente evoluiu satisfatoriamente com normalização dos níveis pressóricos e recuperação da função renal.Microangiopathic hemolytic associated with thrombocytopenia is part of a disease group that frequently show likeness and that's why become difficult to separate them. There are two types of hemolytic uremic syndrome (HUS; the non sporadic type and the epidemic or "typical" type that is common on childreen that is associated with diarrhea and infection caused by verotoxinaproducing E. coli with a good prognostic; and the sporadic postpartum period. It is the systemic type of mocroangiophatic thrombocytopenia of poor prognostic with high morbidity and mortality which renal failure is the main disturb. We reported a case of HUS occuring in postpartum previously healthy, that showed abrupt renal failure, hemolytic anemia and thrombocytopenia. After proper therapy the patient developed a normal blood pressure and recovery renal function.

Charpy impact test results on five materials and NIST verification specimens using instrumented 2-mm and 8-mm strikers

International Nuclear Information System (INIS)

Nanstad, R.K.; Sokolov, M.A.

1995-01-01

The Heavy-Section Steel Irradiation Program at Oak Ridge National Laboratory is involved in two cooperative projects, with international participants, both of which involve Charpy V-notch impact tests with instrumented strikers of 2mm and 8mm radii. Two heats of A 533 grade B class I pressure vessel steel and a low upper-shelf (LUS) submerged-arc (SA) weld were tested on the same Charpy machine, while one heat of a Russian Cr-Mo-V forging steel and a high upper-shelf (HUS) SA weld were tested on two different machines. The number of replicate tests at any one temperature ranged from 2 to 46 specimens. Prior to testing with each striker, verification specimens at the low, high, and super high energy levels from the National Institute of Standards and Technology (NIST) were tested. In the two series of verification tests, the tests with the 2mm striker met the requirements at the low and high energy levels but not at the super high energy. For one plate, the 2mm striker showed somewhat higher average absorbed energies than those for the 8-mm striker at all three test temperatures. For the second plate and the LUS weld, however, the 2mm striker showed somewhat lower energies at both test temperatures. For the Russian forging steel and the HUS weld, tests were conducted over a range of temperatures with tests at one laboratory using the 8mm striker and tests at a second laboratory using the 2mm striker. Lateral expansion was measured for all specimens and the results are compared with the absorbed energy results. The overall results showed generally good agreement (within one standard deviation) in energy measurements by the two strikers. Load-time traces from the instrumented strikers were also compared and used to estimate shear fracture percentage. Four different formulas from the European Structural Integrity Society draft standard for instrumented Charpy test are compared and a new formula is proposed for estimation of percent shear from the force-time trace

Catalog of databases and reports

International Nuclear Information System (INIS)

Burtis, M.D.

1997-04-01

This catalog provides information about the many reports and materials made available by the US Department of Energy's (DOE's) Global Change Research Program (GCRP) and the Carbon Dioxide Information Analysis Center (CDIAC). The catalog is divided into nine sections plus the author and title indexes: Section A--US Department of Energy Global Change Research Program Research Plans and Summaries; Section B--US Department of Energy Global Change Research Program Technical Reports; Section C--US Department of Energy Atmospheric Radiation Measurement (ARM) Program Reports; Section D--Other US Department of Energy Reports; Section E--CDIAC Reports; Section F--CDIAC Numeric Data and Computer Model Distribution; Section G--Other Databases Distributed by CDIAC; Section H--US Department of Agriculture Reports on Response of Vegetation to Carbon Dioxide; and Section I--Other Publications

Catalog of databases and reports

Energy Technology Data Exchange (ETDEWEB)

Burtis, M.D. [comp.

1997-04-01

This catalog provides information about the many reports and materials made available by the US Department of Energy`s (DOE`s) Global Change Research Program (GCRP) and the Carbon Dioxide Information Analysis Center (CDIAC). The catalog is divided into nine sections plus the author and title indexes: Section A--US Department of Energy Global Change Research Program Research Plans and Summaries; Section B--US Department of Energy Global Change Research Program Technical Reports; Section C--US Department of Energy Atmospheric Radiation Measurement (ARM) Program Reports; Section D--Other US Department of Energy Reports; Section E--CDIAC Reports; Section F--CDIAC Numeric Data and Computer Model Distribution; Section G--Other Databases Distributed by CDIAC; Section H--US Department of Agriculture Reports on Response of Vegetation to Carbon Dioxide; and Section I--Other Publications.

Escherichia coli verocitotoxigénico: varias cuestiones... y los tambos también Verocytotoxigenic Escherichia coli: several aspects... and also the dairy farms

Directory of Open Access Journals (Sweden)

Daniel Fernández

2012-12-01

Full Text Available Escherichia coli verocitotoxigénico (VTEC es causante de brotes y casos esporádicos de colitis hemorrágica (CH y síndrome urémico hemolítico (SUH. En Argentina el SUH es endémico, con 500 nuevos casos por ano y una incidencia de 17/100 000 ninos menores de 5 anos. El serotipo aislado con mayor frecuencia es el O157:H7, aunque hay serotipos no-O157 que están asociados con la enfermedad en el hombre. VTEC produce verocitotoxinas y factores de virulencia accesorios como intimina, enterohemolisina y una proteína autoaglutinante llamada Saa. Diversos estudios realizados en varios países han confirmado que los bovinos de diferente edad son los principales reservorios de VTEC, y han demostrado altas prevalencias tanto de serotipos O157:H7 como no-O157, muchos de ellos involucrados en brotes de SUH y CH a nivel mundial. La transmisión de VTEC al hombre se produce por el consumo de carne mal cocida, de verduras y agua contaminadas por heces de portadores, así como por el contacto persona-persona y con el medio ambiente contaminado. Los tambos pueden contribuir al riesgo de infección por VTEC en humanos mediante el consumo de leche cruda, de productos lácteos o carne contaminada proveniente de bovinos lecheros, y también a través del propio medio ambiente del tambo. Existe una amplia distribución y una alta prevalencia de serotipos VTEC en bovinos lecheros de Argentina, por lo cual es importante aplicar medidas de control y manejo que eviten la transmisión de cepas entre animales, ambiente y humanos.Verocytotoxigenic Escherichia coli (VTEC is associated with outbreaks and sporadic cases of hemorrhagic colitis (HC and hemolytic-uremic syndrome (HUS, the most severe form of these human diseases. In Argentina HUS is endemic, with 500 new cases per year and an incidence of 17/100,000 in children under 5 years of age. VTEC O157:H7 is the most frequently isolated serotype, although there are non-O157 serotypes that have been associated with

Reduced service of the “IT Service Desk” (Computing Helpdesk) on the after noon of Friday 8 October 2010

CERN Multimedia

IT Department

2010-01-01

Please note that due to relocation, the “IT Service Desk” will be operating a reduced service on Friday 8th October from 12-30. In particular, the telephone line 78888 will not be available and users will be invited to submit their requests by e-mail (Computing.Helpdesk@cern.ch). E-mail requests will be treated as normal, but some delays are possible. In the event of urgent problems you may call the IT Manager on Duty on 163013. We also take this opportunity to remind you about the “IT Service Status Board” where all computing incidents and scheduled interventions are updated online. Please see: http://cern.ch/it-servicestatus. Normal service will be resumed at 8-30 a.m on Monday 11 October. Thank you in advance for your understanding. The CERN “User Support” Team (IT-UDS-HUS)

Late complications following total-body irradiation and bone marrow rescue in mice: predominance of glomerular nephropathy and hemolytic anemia

International Nuclear Information System (INIS)

Down, J.D.; Berman, A.J.; Mauch, P.; Warhol, M.

1990-01-01

Late mortality and pathology were assessed in various mouse strains following total-body irradiation (TBI) and bone marrow transplantation. Long-term survival data revealed both radiation dose- and strain-dependent onset of mortality between 1 and 2 years post-treatment. Renal damage appeared to have contributed to the late mortality in most treatment groups as shown by glomerular lesions, elevated blood urea nitrogen and an accompanying fall in hematocrit. Hemolysis was deduced to be the major cause of anemia, as concluded from results of 51 Cr-labeled erythrocyte survival. No decrease in erythropoiesis was evident as seen from spleen and bone marrow 59 Fe uptake. These findings are together consistent with the manifestation of a hemolytic uremic syndrome (HUS) with kidney glomeruli representing the principal sites of injury responsible for both renal dysfunction and microangiopathic hemolysis. (author)

Late complications following total-body irradiation and bone marrow rescue in mice: predominance of glomerular nephropathy and hemolytic anemia

Energy Technology Data Exchange (ETDEWEB)

Down, J.D.; Berman, A.J.; Mauch, P. (Harvard Medical School, Boston, MA (USA)); Warhol, M. (Pennsylvania Hospital, Philadelphia, PA (USA). Dept. of Pathology); Yeap, B. (Dana Farber Cancer Inst., Boston, MA (USA))

1990-03-01

Late mortality and pathology were assessed in various mouse strains following total-body irradiation (TBI) and bone marrow transplantation. Long-term survival data revealed both radiation dose- and strain-dependent onset of mortality between 1 and 2 years post-treatment. Renal damage appeared to have contributed to the late mortality in most treatment groups as shown by glomerular lesions, elevated blood urea nitrogen and an accompanying fall in hematocrit. Hemolysis was deduced to be the major cause of anemia, as concluded from results of {sup 51}Cr-labeled erythrocyte survival. No decrease in erythropoiesis was evident as seen from spleen and bone marrow {sup 59}Fe uptake. These findings are together consistent with the manifestation of a hemolytic uremic syndrome (HUS) with kidney glomeruli representing the principal sites of injury responsible for both renal dysfunction and microangiopathic hemolysis. (author).

Microangiopatia trombótica en adultos Thrombotic microangiopathy in adults

Directory of Open Access Journals (Sweden)

Gonzalo J. Barrientos

2006-08-01

Full Text Available Las microangiopatías trombóticas (MAT incluyen la púrpura trombótica trombocitopénica (PTT, el síndrome urémico hemolítico (SUH y las microangiopatías del embarazo. Se describen ocho pacientes adultos con cuadros de microangiopatía trombótica, que fueron atendidos en el Hospital Italiano de Buenos Aires entre 2003 y 2004. El promedio de edad fue de 40 años, con igual proporción de hombres y mujeres. En cuatro de los ocho pacientes descriptos el diagnóstico se realizó al ingreso. Cuatro pacientes evolucionaron con características de SUH, tres como PTT y uno como MAT del embarazo. Todos los pacientes presentaron trombocitopenia y anemia hemolítica microangiopática. La insuficiencia renal fue la tercera característica más frecuente. Aquellos con diagnóstico de PTT presentaron los cuadros de mayor gravedad. Todos los pacientes fueron tratados con plasmaféresis. El tratamiento inmunosupresor también fue utilizado. Cuatro pacientes se recuperaron completamente, 2 fallecieron, 1 permanece con insuficiencia renal crónica con requerimiento de hemodiálisis y 1 fue colectomizado. Las MAT son desórdenes oclusivos de la microcirculación, con repercusión sistémica y/o renal. Existe superposición de los cuadros de PTT/SUH, y éstos pueden ser idiopáticos o secundarios. La importancia de un diagnóstico y tratamiento precoz radica en su elevada morbimortalidad. Entre los diagnósticos diferenciales figuran la sepsis, las enfermedades oncológicas, las vasculitis sistémicas, la eclampsia y otros. La infusión del plasma y principalmente la plasmaféresis son los tratamientos fundamentales. Aún se requiere mejorar el manejo y la evolución de estos síndromes, dada la elevada morbimortalidad que conllevan.Thrombotic microangiopathic hemolytic anemias include thrombotic thrombocytopenic purpura (TTP, hemolytic uremic syndrome (HUS and pregnancy associated thrombotic microangiopathy (TMA. Eight adult patients (four males and four

Emerging types of Shiga toxin-producing E. coli (STEC O178 present in cattle, deer and humans from Argentina and Germany

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Angelika eMiko

2014-06-01

Full Text Available More than 400 serotypes of Shiga toxin-producing Escherichia coli (STEC have been implicated in outbreaks and sporadic human diseases. In recent years STEC strains belonging to serogroup O178 have been commonly isolated from cattle and food of bovine origin in South America and Europe. In order to explore the significance of these STEC strains as potential human pathogens, 74 German and Argentinean E. coli O178 strains from animals, food and humans were characterized phenotypically and investigated for their serotypes, stx-genotypes and forty-three virulence-associated markers by a real-time PCR-microarray. The majority (n=66 of the O178 strains belonged to serotype O178:H19. The remaining strains divided into O178:H7 (n=6, O178:H10 (n=1 and O178:H16 (n=1. STEC O178:H19 strains were mainly isolated from cattle and food of bovine origin, but one strain was from a patient with hemolytic uremic syndrome (HUS. Genotyping of the STEC O178:H19 strains by pulsed-field gel electrophoresis revealed two major clusters of genetically highly related strains which differ in their stx-genotypes and non-Stx putative virulence traits, including adhesins, toxins and serine-proteases. Cluster A-strains including the HUS-strain (n=35 carried genes associated with severe disease in humans (stx2a, stx2d, ehxA, saa, subAB1, lpfAO113, terE combined with stx1a, espP, iha. Cluster B-strains (n=26 showed a limited repertoire of virulence genes (stx2c, pagC, lpfAO113, espP, iha. Among O178:H7 strains isolated from deer meat and patients with uncomplicated disease a new STEC variant was detected that is associated with the genotype stx1c/stx2b/ehxA/subAB2/espI/[terE]/espP/iha. None of the STEC O178 strains was positive for locus of enterocyte effacement (LEE- and nle-genes. Results indicate that STEC O178:H19 strains belong to the growing group of LEE-negative STEC that should be considered with respect to their potential to cause diseases in humans.

Efecto citotóxico de la toxina shiga tipo 2 y su subunidad b en células epiteliales tubulares renales humanas en cultivo Cytotoxic effect of Shiga toxin type 2 and its B subunit on human renal tubular epithelial cell cultures

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Virginia Pistone Creydt

2005-04-01

Full Text Available Escherichia coli enterohemorrágica productora de toxina Shiga (Stx causa diarrea acuosa, colitis hemorrágica y síndrome urémico hemolítico (SUH. En Argentina, el SUH es la principal causa de insuficiencia renal en niños. El objetivo de este trabajo fue estudiar la toxicidad de Stx tipo 2 (Stx2 y su subunidad B (Stx2B en células epiteliales tubulares renales humanas (CERH, en presencia y ausencia de factores inflamatorios. Los efectos citotóxicos se evaluaron como alteración de la funcionalidad del epitelio; daños histológicos; viabilidad celular; síntesis de proteínas y apoptosis celular. Los resultados muestran que Stx2 regula el pasaje de agua a través de CERH a tiempos menores de 1h de incubación. A tiempos mayores, hasta 72 hs, el estudio de la morfología, la viabilidad, la síntesis de proteínas y la apoptosis demostró que las CERH fueron sensibles a la acción citotóxica de Stx2 y Stx2B de una manera dosis y tiempo dependiente. Estos efectos fueron potenciados por lipopolisacáridos bacterianos (LPS, IL-1b, y butirato.Shiga toxin (Stx-producing E.coli causing watery diarrhea, hemorrhagic colitis and hemolytic-uremic syndrome (HUS. In Argentina, HUS is the most common cause of acute renal failure in children. The purpose of the present study was to examine the cytotoxicity of Stx type 2 (Stx2 and its B subunit (Stx2B on human renal tubular epithelial cells (HRTEC, in the presence and absence of inflammatory factors. Cytotoxic effects were assessed in terms of functionality of the epithelium, histological damage, cell viability, protein synthesis and cellular apoptosis. Results show that Stx2 regulates the passage of water through the HRTEC within an incubation period of 1h. Within longer periods, up to 72 hours, the study of morphology, viability, protein synthesis and apoptosis shows that HRTEC were sensitive to the cytotoxic action of Stx2 and Stx2B in a dose- and time-dependent manner. These effects were potentiated by

In-silico design, expression, and purification of novel chimeric Escherichia coli O157:H7 OmpA fused to LTB protein in Escherichia coli.

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Aytak Novinrooz

Full Text Available E. coli O157:H7, one of the major EHEC serotypes, is capable of developing bloody diarrhea, hemorrhagic colitis (HC, and fatal hemolytic uremic syndrome (HUS and is accompanied by high annual economic loss worldwide. Due to the increased risk of HC and HUS development following antibiotic therapy, the prevention of infections caused by this pathogen is considered to be one of the most effective ways of avoiding the consequences of this infection. The main aim of the present study was to design, express, and purify a novel chimeric protein to develope human vaccine candidate against E. coli O157:H7 containing loop 2-4 of E. coli O157:H7, outer membrane protein A (OmpA, and B subunit of E. coli heat labile enterotoxin (LTB which are connected by a flexible peptide linker. Several online databases and bioinformatics software were utilized to choose the peptide linker among 537 analyzed linkers, design the chimeric protein, and optimize the codon of the relative gene encoding this protein. Subsequently, the recombinant gene encoding OmpA-LTB was synthesized and cloned into pET-24a (+ expression vector and transferred to E. coli BL21(DE3 cells. The expression of OmpA-LTB chimeric protein was then carried out by induction of cultured E. coli Bl21 (DE3 cells with 1mM isopropyl-β-D-thiogalactopyranoside (IPTG. The purification of OmpA-LTB was then performed by nickel affinity chromatography. Expression and purification were analyzed by sodium dodecyl sulphate poly acrylamide gel electrophoresis. Moreover, the identity of the expressed protein was analyzed by western blotting. SDS-PAGE and western immunoblotting confirmed the successful expression of a 27 KDa recombinant protein after 24 hours at 37°C post-IPTG induction. OmpA-LTB was then successfully purified, using nickel affinity chromatography under denaturing conditions. The yield of purification was 12 mg per liter of culture media. Ultimately, we constructed the successful design and efficient

Shiga toxin-producing Escherichia coli (STEC: principal virulence factors and epidemiology Escherichia coli produtora de toxina shiga (STEC: principais fatores de virulência e dados epidemiológicos

Directory of Open Access Journals (Sweden)

Halha Ostrensky Saridakis

2007-10-01

Full Text Available Shiga toxin producing Escherichia coli is an important food borne pathogen, mainly beef products, and is associated to mild and severe bloody diarrhea. In some individuals, STEC infection can progress to hemolytic-uremic syndrome (HUS, a sequela characterized by renal failure, and thrombotic thrombocytopenic purpura (TTP, with possible central nervous system involvement. Cattle, usually healthy, is the principal reservoir of STEC, although these strains have also been isolated from other domestic animals: sheep, goats, dogs, cats and pigs. The principal virulence feature, the production of Shiga toxins, is not enough to cause diseases, and other factors are considered important, as enterohemolysin and fimbrial and afimbrial adhesions production. Although human diseases associated to STEC have not been frequently reported in Brazil, their presence is frequent in cattle, as well as the correlation between serotypes found in these animals and human patients. Escherichia coli produtora de toxina Shiga (STEC é um importante patógeno veiculado por alimentos, principalmente produtos derivados de carne bovina e está associado a quadros de diarréias leves a severas e sanguinolentas. Em alguns indivíduos, a infecção por STEC pode progredir para a síndrome hemolítico-urêmica (HUS, seqüela caracterizada pela falência renal e a púrpura trombocitopênica trombótica (TTP, com possível envolvimento do sistema nervoso central. O gado bovino, geralmente saudável, é o principal reservatório de STEC, embora estas cepas também tenham sido isoladas de outros animais domésticos: ovelhas, cabras, cães, gatos e suínos. A principal característica de virulência, a produção de toxinas Shiga, não é suficiente para causar doenças e outros fatores são considerados relevantes, como a produção de enterohemolisina e de adesinas fimbriais e afimbriais. Embora as doenças humanas associadas a STEC sejam pouco descritas no Brasil, podemos observar

INFLUENCE OF SUPPLY AND DEMAND FACTORS AT THE DEVELOPMENT OF ENVIRONMENTALLY RESPONSIBLE HOUSING AND UTILITIES SECTOR IN THE RUSSIAN FEDERATION

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Natalia B. Safronova

2016-11-01

Full Text Available Empirical marketing regional research on supply and demand factors of housing and communal services (HCS revealed determinants of customer loyalty and satisfaction with the service level and factors influencing on willingness to purchase additional services. Specific features of housing and utilities sector (HUS as a social significant industry determine requirements to models reflecting reciprocal influence of indices of satisfaction, loyalty and economic indices of operation. The article presents definition of requirements along with development of techniques for modeling influence of satisfaction and loyalty on consumer behaviour of clients. The authors demonstrate trustworthy statistical results of correlative interrelationship of different factors. There have been designed regression models for taking management solutions by executives of management company housing and communal services at the development environmental responsibility. The causes that lead and hamper development of socially oriented services in different regions of the Russian Federation have been identified.

Vertebral body trabecular density at the thoracolumbar junction using quantitative computed tomography

International Nuclear Information System (INIS)

Singer, K.P.; Breidahl, P.D.; Royal Perth Hospital

1990-01-01

Quantitative computed tomography was used to assess vertebral trabecular density in 26 post-mortem spines from individuals aged between 14 and 80 years. All vertebrae from T10 to L1 were scanned transversely near the mid-vertebral level with calculations of trabecular density in HUs averaged and referenced to a mineral equivalent phantom. An age-related decline in trabecular density was recorded (r=0.55, p<0.0001). Density measures from the anterior aspect of the vertebral body were significantly greater than from postero-lateral regions. From T10 to L1, there was a significant decrease in trabecular density, whereas density measures multiplied by vertebral body cross-sectional area were constant. Predictions of vertebral compressive strength using quantitative computed tomography may become more accurate by increasing the sampling area per scan and including vertebral body cross-sectional area as part of the radiologic assessment. (orig.)

Role of the Checkpoint Clamp in DNA Damage Response

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Mihoko Kai

2013-01-01

Full Text Available DNA damage occurs during DNA replication, spontaneous chemical reactions, and assaults by external or metabolism-derived agents. Therefore, all living cells must constantly contend with DNA damage. Cells protect themselves from these genotoxic stresses by activating the DNA damage checkpoint and DNA repair pathways. Coordination of these pathways requires tight regulation in order to prevent genomic instability. The checkpoint clamp complex consists of Rad9, Rad1 and Hus1 proteins, and is often called the 9-1-1 complex. This PCNA (proliferating cell nuclear antigen-like donut-shaped protein complex is a checkpoint sensor protein that is recruited to DNA damage sites during the early stage of the response, and is required for checkpoint activation. As PCNA is required for multiple pathways of DNA metabolism, the checkpoint clamp has also been implicated in direct roles in DNA repair, as well as in coordination of the pathways. Here we discuss roles of the checkpoint clamp in DNA damage response (DDR.

Life after acquired thrombotic thrombocytopenic purpura: morbidity, mortality, and risks during pregnancy.

Science.gov (United States)

Vesely, S K

2015-06-01

Patients who have recovered from their acute episode of acquired ADAMTS13-deficient thrombotic thrombocytopenic purpura (TTP) were once thought to have complete recovery except for risk of relapse. Data from previous publications from the Oklahoma TTP-hemolytic uremic syndrome (HUS) Registry are summarized. Patients have decreased cognitive function and increased prevalence of hypertension, systemic lupus erythematosus, major depression, and albuminuria as compared to the expected values from the US population. The proportion of patients that died during the follow-up period was greater than expected based on the US population reference population. Among women who had a pregnancy following recovery from TTP, relapse during pregnancy or postpartum is uncommon, but the occurrence of preeclampsia may be increased. Thirteen of 16 pregnancies in these women resulted in healthy children. Increased morbidity and mortality in TTP patients following recovery suggest that TTP may be more of a chronic disorder than a disorder with acute episodes and complete recovery. © 2015 International Society on Thrombosis and Haemostasis.

Mechanosensing regulates virulence in Escherichia coli O157:H7.

Science.gov (United States)

Islam, Md Shahidul; Krachler, Anne Marie

2016-01-01

Enterohemorrhagic Escherichia coli O157:H7 is a food-borne pathogen transmitted via the fecal-oral route, and can cause bloody diarrhea and hemolytic uremic syndrome (HUS) in the human host. Although a range of colonization factors, Shiga toxins and a type III secretion system (T3SS) all contribute to disease development, the locus of enterocyte effacement (LEE) encoded T3SS is responsible for the formation of lesions in the intestinal tract. While a variety of chemical cues in the host environment are known to up-regulate LEE expression, we recently demonstrated that changes in physical forces at the site of attachment are required for localized, full induction of the system and thus spatial regulation of virulence in the intestinal tract. Here, we discuss our findings in the light of other recent studies describing mechanosensing of the host and force-dependent induction of virulence mechanisms. We discuss potential mechanisms of mechanosensing and mechanotransduction, and the level of conservation across bacterial species.

Red River Wildlife Management Area HEP Report, Habitat Evaluation Procedures, Technical Report 2004.

Energy Technology Data Exchange (ETDEWEB)

Ashley, Paul

2004-11-01

A habitat evaluation procedures (HEP) analysis conducted on the 314-acre Red River Wildlife Management Area (RRWMA) managed by the Idaho Department of Fish and Game resulted in 401.38 habitat units (HUs). Habitat variables from six habitat suitability index (HSI) models, comprised of mink (Mustela vison), mallard (Anas platyrhynchos), common snipe (Capella gallinago), black-capped chickadee (Parus altricapillus), yellow warbler (Dendroica petechia), and white-tailed deer (Odocoileus virginianus), were measured by Regional HEP Team (RHT) members in August 2004. Cover types included wet meadow, riverine, riparian shrub, conifer forest, conifer forest wetland, and urban. HSI model outputs indicate that the shrub component is lacking in riparian shrub and conifer forest cover types and that snag density should be increased in conifer stands. The quality of wet meadow habitat, comprised primarily of introduced grass species and sedges, could be improved through development of ephemeral open water ponds and increasing the amount of persistent wetland herbaceous vegetation e.g. cattails (Typha spp.) and bulrushes (Scirpus spp.).

From passive houses to healthy houses: architecture, environment and a overall solution; Fra passivhus til sunne hus: arkitektur, miljoe og helhet

Energy Technology Data Exchange (ETDEWEB)

Butters, Chris; Leland, Bente Nuth

2012-11-01

Energy and climate are key issues, but sustainable architecture involves much more: nature's cycles, materials, resilience over time, health. The trend towards passive house standard is positive, but tends to become dogmatic and far too narrowly focused on energy - and on theory rather than on real people. Buildings should be healthy, both for people and for the planet. Without a holistic approach, passive houses can introduce new risks, both technical, inefficient use of money, and risks to indoor environment. And if built in energy-intensive materials transported from far away, they can have just as large climate emissions as old buildings. Researchers, argue the authors, sometimes ignore the human ecological dimensions of sustainability, in their obsession with technical details. This book raises two types of critique of the passive house concept: one concerns technical differences, in particular a very sceptical look at mechanical ventilation; the other relates to people. For it is not only immigrants or the elderly who often fail to maintain buildings correctly, but many ordinary people too. Passive houses must be built with a high degree of precision, and operated correctly. In addition, builders often make errors; and technology fails quite often. In contrast to this, older buildings are 'forgiving' - they tolerate small leaks, amateur repairs, minor neglect. Simplicity is a key feature of good solutions. The authors argue that sustainable architecture must have real robustness. For sustainability depends on ordinary, fallible people. Beginning with a short history of ecological or 'green' architecture, and of the principles behind it, the book reminds us that the first houses to achieve passive standard were built and tested in Canada over 30 years ago. The book is illustrated with 14 buildings from Norway and Europe, many of them groundbreaking; about half are signed by the GAIA network of architects. These include houses designed especially for allergy-prone people, constructions with entirely non-toxic materials, old urban blocks refurbished to zero energy standard, and a school which achieves passive energy standard using no mechanical ventilation - something Norwegian researchers have declared {sup i}s impossible{sup .} The book is written for specialists as well as a general public. A key message is that passive buildings are not the only or necessarily best solution - there are many approaches. This, say the authors, is very important at a time when building regulations and research funds are being almost exclusively channelled towards the passive house approach. This is both politically risky, and it is bad science. The GAIA network in Scandinavia and beyond has pioneered the field of sustainable architecture for over 30 years. Their holistic approach is gaining increasing recognition. Beyond the theoretical research - and the greenwashing -- this book shows the way forward from the 'passive' era towards genuinely 'deep green' architecture.(Author)

Predisposing, enabling, and need factors associated with high service use in a public mental health system.

Science.gov (United States)

Lindamer, Laurie A; Liu, Lin; Sommerfeld, David H; Folsom, David P; Hawthorne, William; Garcia, Piedad; Aarons, Gregory A; Jeste, Dilip V

2012-05-01

The purpose of this study was twofold: (1) To investigate the individual- and system-level characteristics associated with high utilization of acute mental health services according to a widely-used theory of service use-Andersen's Behavioral Model of Health Service Use -in individuals enrolled in a large, public-funded mental health system; and (2) To document service utilization by high use consumers prior to a transformation of the service delivery system. We analyzed data from 10,128 individuals receiving care in a large public mental health system from fiscal years 2000-2004. Subjects with information in the database for the index year (fiscal year 2000-2001) and all of the following 3 years were included in this study. Using logistic regression, we identified predisposing, enabling, and need characteristics associated with being categorized as a single-year high use consumer (HU: >3 acute care episodes in a single year) or multiple-year HU (>3 acute care episodes in more than 1 year). Thirteen percent of the sample met the criteria for being a single-year HU and an additional 8% met the definition for multiple-year HU. Although some predisposing factors were significantly associated with an increased likelihood of being classified as a HU (younger age and female gender) relative to non-HUs, the characteristics with the strongest associations with the HU definition, when controlling for all other factors, were enabling and need factors. Homelessness was associated with 115% increase in the odds of ever being classified as a HU compared to those living independently or with family and others. Having insurance was associated with increased odds of being classified as a HU by about 19% relative to non-HUs. Attending four or more outpatient visits was an enabling factor that decreased the chances of being defined as a HU. Need factors, such as having a diagnosis of schizophrenia, bipolar disorder or other psychotic disorder or having a substance use disorder

Characteristics of Metastatic Mediastinal Lymph Nodes of Non-Small Cell Lung Cancer on Preoperative F-18 FDG PET/CT

International Nuclear Information System (INIS)

Lee, Ah Young; Choi, Su Jung; Jung, Kyung Pyo; Park, Ji Sun; Lee, Seok Mo; Bae, Sang Kyun

2014-01-01

The aim of this study was to evaluate the characteristics of PET and CT features of mediastinal metastatic lymph nodes on F-18 FDG PET/CT and to determine the diagnostic criteria in nodal staging of non-small cell lung cancer. One hundred four non-small cell lung cancer patients who had preoperative F-18 FDG PET/CT were included. For quantitative analysis, the maximum SUV of the primary tumor, maximum SUV of the lymph nodes (SUVmax), size of the lymph nodes, and average Hounsfield units (aHUs) and maximum Hounsfield units (mHUs) of the lymph nodes were measured. The SUVmax, SUV ratio of the lymph node to blood pool (LN SUV/blood pool SUV), SUV ratio of the lymph node to primary tumor (LN SUV/primary tumor SUV), size, aHU, and mHU were compared between the benign and malignant lymph nodes. Among 372 dissected lymph node stations that were pathologically diagnosed after surgery, 49 node stations were malignant and 323 node stations benign. SUVmax, LN SUV/blood pool SUV, and size were significantly different between the malignant and benign lymph node stations (P <0.0001). However, there was no significant difference in LN SUV/primary tumor SUV (P =0.18), mHU (P =0.42), and aHU (P =0.98). Using receiver-operating characteristic curve analyses, there was no significant difference among these three variables (SUVmax, LN SUV/blood pool SUV, and size). The optimal cutoff values were 2.9 for SUVmax, 1.4 for LN SUV/blood pool SUV, and 5 mm for size. When the cutoff value of SUVmax≥2.9 and size≥5 mm were used in combination, the positive predictive value was 44.2%, and the negative predictive value was 90.9 %. When we evaluated the results based on the histology of the primary tumor, the negative predictive value was 92.3 % in adenocarcinoma (cutoff values of SUVmax≥2.3 and size≥5 mm) and 97.2 % in squamous cell carcinoma (cutoff values of SUVmax≥3.6 and size≥8 mm), separately. In the lymph node staging of non-small cell lung cancer, SUVmax, LN SUV/blood pool SUV

Immunization of pregnant cows with Shiga toxin-2 induces high levels of specific colostral antibodies and lactoferrin able to neutralize E. coli O157:H7 pathogenicity.

Science.gov (United States)

Albanese, Adriana; Sacerdoti, Flavia; Seyahian, E Abril; Amaral, Maria Marta; Fiorentino, Gabriela; Fernandez Brando, Romina; Vilte, Daniel A; Mercado, Elsa C; Palermo, Marina S; Cataldi, Angel; Zotta, Elsa; Ibarra, Cristina

2018-03-20

E. coli O157:H7 is a foodborne pathogen responsible for bloody diarrhea, hemorrhagic colitis and hemolytic uremic syndrome (HUS). The objective of the present work was to evaluate the ability of colostral IgG obtained from Stx2-immunized cows to prevent against E. coli O157:H7 infection and Stx2 cytotoxicity. Hyperimmune colostrum (HC) was obtained from cows intramuscularly immunized with inactivated Stx2 or vehicle for controls. Colostral IgG was purified by affinity chromatography. Specific IgG antibodies against Stx2 and bovine lactoferrin (bLF) levels in HC and the corresponding IgG (HC-IgG/bLF) were determined by ELISA. The protective effects of HC-IgG/bLF against Stx2 cytotoxicity and adhesion of E. coli O157:H7 and its Stx2-negative mutant were analyzed in HCT-8 cells. HC-IgG/bLF prevention against E. coli O157:H7 was studied in human colon and rat colon loops. Protection against a lethal dose of E. coli O157:H7 was evaluated in a weaned mice model. HC-IgG/bLF showed high anti-Stx2 titers and high bLF levels that were able to neutralize the cytotoxic effects of Stx2 in vitro and in vivo. Furthermore, HC-IgG/bLF avoided the inhibition of water absorption induced by E. coli O157:H7 in human colon and also the pathogenicity of E. coli O157:H7 and E. coli O157:H7Δstx2 in rat colon loops. Finally, HC-IgG/bLF prevented in a 100% the lethality caused by E. coli O157:H7 in a weaned mice model. Our study suggests that HC-IgG/bLF have protective effects against E. coli O157:H7 infection. These beneficial effects may be due to specific anti-Stx2 neutralizing antibodies in combination with high bLF levels. These results allow us to consider HC-IgG/bLF as a nutraceutical tool which could be used in combination with balanced supportive diets to prevent HUS. However further studies are required before recommendations can be made for therapeutic and clinical applications. Copyright © 2018 Elsevier Ltd. All rights reserved.

Comparison of clinical and immunological findings in gnotobiotic piglets infected with Escherichia coli O104:H4 outbreak strain and EHEC O157:H7.

Science.gov (United States)

Wöchtl, Bettina; Gunzer, Florian; Gerner, Wilhelm; Gasse, Hagen; Koch, Michaela; Bagó, Zoltán; Ganter, Martin; Weissenböck, Herbert; Dinhopl, Nora; Coldewey, Sina M; von Altrock, Alexandra; Waldmann, Karl-Heinz; Saalmüller, Armin; Zimmermann, Kurt; Steinmann, Jörg; Kehrmann, Jan; Klein-Hitpass, Ludger; Blom, Jochen; Ehricht, Ralf; Engelmann, Ines; Hennig-Pauka, Isabel

2017-01-01

Shiga toxin (Stx) producing Escherichia coli ( E. coli ) (STEC) is the most frequent cause of diarrhoea-positive haemolytic uraemic syndrome (D + HUS) in humans. In 2011, a huge outbreak with an STEC O104:H4 strain in Germany highlighted the limited possibilities for causative treatment of this syndrome. The responsible STEC strain was found to combine Stx production with adherence mechanisms normally found in enteroaggregative E. coli (EAEC). Pathotypes of E. coli evolve and can exhibit different adhesion mechanisms. It has been shown previously that neonatal gnotobiotic piglets are susceptible for infection with STEC, such as STEC O157:H7 as well as for EAEC, which are considered to be the phylogenetic origin of E. coli O104:H4. This study was designed to characterise the host response to infection with the STEC O104:H4 outbreak strain in comparison to an STEC O157:H7 isolate by evaluating clinical parameters (scoring) and markers of organ dysfunction (biochemistry), as well as immunological (flow cytometry, assessment of cytokines/chemokines and acute phase proteins) and histological alterations (light- and electron microscopy) in a gnotobiotic piglet model of haemolytic uraemic syndrome. We observed severe clinical symptoms, such as diarrhoea, dehydration and neurological disorders as well as attaching-and-effacing lesions (A/E) in the colon in STEC O157:H7 infected piglets. In contrast, STEC O104:H4 challenged animals exhibited only mild clinical symptoms including diarrhoea and dehydration and HUS-specific/severe histopathological, haematological and biochemical alterations were only inconsistently presented by individual piglets. A specific adherence phenotype of STEC O104:H4 could not be observed. Flow cytometric analyses of lymphocytes derived from infected animals revealed an increase of natural killer cells (NK cells) during the course of infection revealing a potential role of this subset in the anti-bacterial activity in STEC disease. Unexpectedly, E

Distinguishing infected from noninfected abdominal fluid collections after surgery: an imaging, clinical, and laboratory-based scoring system.

Science.gov (United States)

Gnannt, Ralph; Fischer, Michael A; Baechler, Thomas; Clavien, Pierre-Alain; Karlo, Christoph; Seifert, Burkhardt; Lesurtel, Mickael; Alkadhi, Hatem

2015-01-01

Mortality from abdominal abscesses ranges from 30% in treated cases up to 80% to 100% in patients with undrained or nonoperated abscesses. Various computed tomographic (CT) imaging features have been suggested to indicate infection of postoperative abdominal fluid collections; however, features are nonspecific and substantial overlap between infected and noninfected collections exists. The purpose of this study was to develop and validate a scoring system on the basis of CT imaging findings as well as laboratory and clinical parameters for distinguishing infected from noninfected abdominal fluid collections after surgery. The score developmental cohort included 100 consecutive patients (69 men, 31 women; mean age, 58 ± 17 years) who underwent portal-venous phase CT within 24 hours before CT-guided intervention of postoperative abdominal fluid collections. Imaging features included attenuation (Hounsfield unit [HU]), volume, wall enhancement and thickness, fat stranding, as well as entrapped gas of fluid collections. Laboratory and clinical parameters included diabetes, intake of immunosuppressive drugs, body temperature, C-reactive protein, and leukocyte blood cell count. The score was validated in a separate cohort of 30 consecutive patients (17 men, 13 women; mean age, 51 ± 15 years) with postoperative abdominal fluid collections. Microbiologic analysis from fluid samples served as the standard of reference. Diabetes, body temperature, C-reactive protein, attenuation of the fluid collection (in HUs), wall enhancement and thickness of the wall, adjacent fat stranding, as well as entrapped gas within the fluid collection were significantly different between infected and noninfected collections (P collection (in HUs), as well as entrapped gas as significant independent predictors of infection (P collection, ≥ 20 HU: 4 points; entrapped gas: 3 points). The model was well calibrated (Hosmer-Lemeshow test, P = 0.36). In the validation cohort, scores of 2 or lower

Õhus on elu : barokkmuusika ja nüüdistants Nikkolo peadisaineri loodud kostüümides. Väärtmuusika elamus pealinnast

Index Scriptorium Estoniae

2008-01-01

15.-24. augustini annab kontserdisarjas "Eesti mõisad 2008" kuus kontsertetendust barokkmuusika ansambel Corelli Consort (vt. www.corelli.ee), kontsertetenduste kostüümid on loonud Ivo Nikkolo brändi naisteriiete peadisainer Eve Hanson. 17.-23. augustini toimub Tallinna Raekojas, Rootsi Mihkli kirikus ja Jaani kirikus Tallinna Kammermuusika festival (vt. www.plmf.ee)

STUDY OF ACUTE KIDNEY INJURY IN CHILDREN: ITS AETIOLOGY, CLINICAL PROFILE AND OUTCOME

Directory of Open Access Journals (Sweden)

Garuda

2015-03-01

Full Text Available OBJECTIVES : To determine the incidence , age & sex ratio , analyse the spectrum of Acute Kidney Injury (AKI in its aetiopathology , complications including mortality , prognostic factors and the role of dialysis in the management. METHODS : This prospective observational study was conducted on serial cases of 30 patients a dmitted in Paediatrics department from Feb 2012 - Aug 2014 (30 months. RESULTS : The incidence of AKI was 0.44%. Children in age group of 0 - 4 yrs were affected most , predominantly males. Distribution of AKI according to aetiopathogenesis was Acute Tubular Necrosis (ATN 50% , Haemolytic Uraemic Syndrome (HUS 19.8% , Glomerulonephritis (GN 13.2% , Obstructive uropathy 9.9% and Acute on Chronic renal failure (CRF 6.6%. Dialysis was required in 53.3% of patients. Mortality was 57%. Patients with complications of sepsis , neurological & respiratory problems , hyperkalemia , metabolic acidosis and gastrointestinal bleeding were associated with high mortality. CONCLUSIONS : AKI is a common life threatening condition seen in childhood. Early referral , proper assessment , adequate & timely treatment and prompt institution of dialysis helps in decreasing mortality.

Gerdas råd

DEFF Research Database (Denmark)

Evron, Lotte Orr

2017-01-01

I den her blogpost vil jeg præsentere det, som Gerda kalder et eksemplarisk fald og fortælle om, hvordan hun lever med fald. Posten er udarbejdet ud fra en løbende samtale jeg havde sammen med ti mennesker, der var faldet. Samtalerne var slået op som et tilbud om en individuel samtale om fald, men...... medarbejderne, andre var mødt op på eget initiativ. Workshoppen foregik i august 2014. Seks af deltagerne var til stede hele seancen, fire gik til og fra undervejs. Gerda var en af dem, som valgte at blive under hele seancen. Et par af deltagerne ønskede ikke at samtalerne blev optaget, derfor blev der taget...... noter undervejs og efter workshoppen. Alle gav mundtlig tilladelse til, at jeg måtte bruge mine noter i min forskning og faldforebyggelsesarbejde. Gerda er 82 år og bor alene med sin hund i et stort hus. Ud over lidt hjælp til rengøring hver 14. dag klarer hun selv alt andet i sin dagligdag. Ca. tre...

Feasibility of MRI-only treatment planning for proton therapy in brain and prostate cancers: Dose calculation accuracy in substitute CT images

International Nuclear Information System (INIS)

Koivula, Lauri

2016-01-01

Purpose: Magnetic resonance imaging (MRI) is increasingly used for radiotherapy target delineation, image guidance, and treatment response monitoring. Recent studies have shown that an entire external x-ray radiotherapy treatment planning (RTP) workflow for brain tumor or prostate cancer patients based only on MRI reference images is feasible. This study aims to show that a MRI-only based RTP workflow is also feasible for proton beam therapy plans generated in MRI-based substitute computed tomography (sCT) images of the head and the pelvis. Methods: The sCTs were constructed for ten prostate cancer and ten brain tumor patients primarily by transforming the intensity values of in-phase MR images to Hounsfield units (HUs) with a dual model HU conversion technique to enable heterogeneous tissue representation. HU conversion models for the pelvis were adopted from previous studies, further extended in this study also for head MRI by generating anatomical site-specific conversion models (a new training data set of ten other brain patients). This study also evaluated two other types of simplified sCT: dual bulk density (for bone and water) and homogeneous (water only). For every clinical case, intensity modulated proton therapy (IMPT) plans robustly optimized in standard planning CTs were calculated in sCT for evaluation, and vice versa. Overall dose agreement was evaluated using dose–volume histogram parameters and 3D gamma criteria. Results: In heterogeneous sCTs, the mean absolute errors in HUs were 34 (soft tissues: 13, bones: 92) and 42 (soft tissues: 9, bones: 97) in the head and in the pelvis, respectively. The maximum absolute dose differences relative to CT in the brain tumor clinical target volume (CTV) were 1.4% for heterogeneous sCT, 1.8% for dual bulk sCT, and 8.9% for homogenous sCT. The corresponding maximum differences in the prostate CTV were 0.6%, 1.2%, and 3.6%, respectively. The percentages of dose points in the head and pelvis passing 1% and 1 mm

Feasibility of MRI-only treatment planning for proton therapy in brain and prostate cancers: Dose calculation accuracy in substitute CT images

Energy Technology Data Exchange (ETDEWEB)

Koivula, Lauri [Department of Radiation Oncology, Comprehensive Cancer Center, Helsinki University Central Hospital, P.O. Box 180, Helsinki 00029 HUS (Finland)

2016-08-15

Purpose: Magnetic resonance imaging (MRI) is increasingly used for radiotherapy target delineation, image guidance, and treatment response monitoring. Recent studies have shown that an entire external x-ray radiotherapy treatment planning (RTP) workflow for brain tumor or prostate cancer patients based only on MRI reference images is feasible. This study aims to show that a MRI-only based RTP workflow is also feasible for proton beam therapy plans generated in MRI-based substitute computed tomography (sCT) images of the head and the pelvis. Methods: The sCTs were constructed for ten prostate cancer and ten brain tumor patients primarily by transforming the intensity values of in-phase MR images to Hounsfield units (HUs) with a dual model HU conversion technique to enable heterogeneous tissue representation. HU conversion models for the pelvis were adopted from previous studies, further extended in this study also for head MRI by generating anatomical site-specific conversion models (a new training data set of ten other brain patients). This study also evaluated two other types of simplified sCT: dual bulk density (for bone and water) and homogeneous (water only). For every clinical case, intensity modulated proton therapy (IMPT) plans robustly optimized in standard planning CTs were calculated in sCT for evaluation, and vice versa. Overall dose agreement was evaluated using dose–volume histogram parameters and 3D gamma criteria. Results: In heterogeneous sCTs, the mean absolute errors in HUs were 34 (soft tissues: 13, bones: 92) and 42 (soft tissues: 9, bones: 97) in the head and in the pelvis, respectively. The maximum absolute dose differences relative to CT in the brain tumor clinical target volume (CTV) were 1.4% for heterogeneous sCT, 1.8% for dual bulk sCT, and 8.9% for homogenous sCT. The corresponding maximum differences in the prostate CTV were 0.6%, 1.2%, and 3.6%, respectively. The percentages of dose points in the head and pelvis passing 1% and 1 mm

Interpreting neonatal nursing care from the parents' experiences viewpoint Interpretación del cuidado de enfermería neonatal desde las experiencias y vivencias de los padres; Interpretação do cuidado da enfermagem neonatal partindo das experiências e vivências dos pais

Directory of Open Access Journals (Sweden)

RUIZ DE CÁRDENAS CARMEN HELENA

2008-12-01

Full Text Available The objective is "to interpret the experiences of the new-born's parents about nursing care received by their children in the newborn unit (UCIN of la Samaritana University Hospital (HUS". In a quantitative, descriptive and exploratory study, a semi structured interview was used which served as guide to obtain testimonies of fathers and mothers of hospitalized newborns. From the analysis of the information obtained from each one of the questions substantive codes were identified, which were grouped to form categories. The result was five categories: 1. Difficulties in the performance of the parents' role. 2. Impact due to the newborn hospitalization. 3. Expectations from the parents in relation with the newborn's care. 4. Assertive communication. 5. Parents learn from female/male nurse(s. The testimonies and analysis of each one of these strategies allow an approach to the interpretation of nursing care for parents of hospitalized newborns, based on their experiences. In the authors' opinion, the rise of two categories which are very important for nursing, can be highlighted, these have to continue being explored in other type of research: "parents learn from the nurses" and "assertive communication".El objetivo es "interpretar las experiencias y vivencias de los padres de los neonatos acerca del cuidado de enfermería que reciben sus hijos en la unidad de neonatos (UCIN del Hospital Universitario de la Samaritana (HUS". Es un estudio cualitativo, descriptivo, exploratorio. Se utilizó una entrevista semiestructurada la cual sirvió como guía para obtener los testimonios de los padres y madres de los neonatos hospitalizados. Del análisis de la información obtenida de cada una de las preguntas se identificaron códigos sustantivos, los cuales se agruparon con el fin de formar las categorías. Surgieron cinco categorías: 1. Dificultades en el desempeño del rol de padres. 2. Impacto ante la

Interpretación del cuidado de enfermería neonatal desde las experiencias y vivencias de los padres do cuidado da enfermagem neonatal partindo das experiências e vivências dos pais Interpreting neonatal nursing care from the parents' experiences viewpoint

Directory of Open Access Journals (Sweden)

JUAN CLEMENTE GUERRA GUERRA

2008-12-01

Full Text Available El objetivo es "interpretar las experiencias y vivencias de los padres de los neonatos acerca del cuidado de enfermería que reciben sus hijos en la unidad de neonatos (UCIN del Hospital Universitario de la Samaritana (HUS". Es un estudio cualitativo, descriptivo, exploratorio. Se utilizó una entrevista semiestructurada la cual sirvió como guía para obtener los testimonios de los padres y madres de los neonatos hospitalizados. Del análisis de la información obtenida de cada una de las preguntas se identificaron códigos sustantivos, los cuales se agruparon con el fin de formar las categorías. Surgieron cinco categorías: 1. Dificultades en el desempeño del rol de padres. 2. Impacto ante la hospitalización del neonato. 3. Expectativas de los padres frente al cuidado del neonato. 4. Comunicación asertiva. 5. Los padres aprenden de las(os enfermeras(os. Los testimonios y el análisis de cada una de estas categorías permiten un acercamiento a la interpretación de lo que es el cuidado de enfermería para los padres de los neonatos hospitalizados, a partir de sus experiencias y vivencias. En opinión de los autores, resalta el surgimiento de dos categorías muy importantes para enfermería, que se deben seguir explorando en otro tipo de investigaciones: "los padres aprenden de las enfermeras" y "comunicación asertiva".O objetivo é "interpretar as experiências e vivências dos pais dos neonatos em torno ao cuidado de enfermagem fornecido aos filhos na unidade de cuidado intensivo neonatal (UCIN do Hospital Universitário da Samaritana (HUS". Esse é um levantamento qualitativo, descritivo e experimental. Utilizou-se uma entrevista semi-estruturada que serviu como orientação para obter os testemunhos dos pais e mães dos neonatos hospitalizados. Da análise da informação coletada com base em cada uma das perguntas, identificamos códigos substantivos, que foram compilados objetivando a formação de categorias. Dessa compilação sa

Relationship between Infill patterns in 3D printing and Hounsfield Unit

International Nuclear Information System (INIS)

Savi, M.; Cechinel, C.M.; Silveira, L.C.; Soares, F.A.P.; Potiens, M.P.A.

2017-01-01

Introduction: One of the requirements for a phantom to correctly simulate the human body is that the radiation attenuation of the material used is compatible with the values of its corresponding tissues. The aim of this study is to evaluate the values of Hounsfield Unit (HU) in a 3D printed material in order to verify its compatibility, on tomography, with human tissues, so that it can be used as feedstock for simulators constructed in 3D printers. Methods: Cubes with 2cm of edge were printed using ABS filament with 8 different forms of internal filling. The samples were irradiated by a CT scanner, the measured HUs and their results compared to the literature. Results: Modification of the filling form as well as its percentage influenced the HU values that ranged from -133 to -451. Conclusion: The specific variations of internal fill patterns directly influence the interaction of the material used with the radiation, thus altering the HU values. Despite the variation found, the HU values were sufficient to simulate few tissues in the human body, which requires future studies with new materials that further attenuate the radiation and the range of tissues to be expanded. (author)

The highly virulent 2006 Norwegian EHEC O103:H25 outbreak strain is related to the 2011 German O104:H4 outbreak strain.

Directory of Open Access Journals (Sweden)

Trine M L'Abée-Lund

Full Text Available In 2006, a severe foodborne EHEC outbreak occured in Norway. Seventeen cases were recorded and the HUS frequency was 60%. The causative strain, Esherichia coli O103:H25, is considered to be particularly virulent. Sequencing of the outbreak strain revealed resemblance to the 2011 German outbreak strain E. coli O104:H4, both in genome and Shiga toxin 2-encoding (Stx2 phage sequence. The nucleotide identity between the Stx2 phages from the Norwegian and German outbreak strains was 90%. During the 2006 outbreak, stx(2-positive O103:H25 E. coli was isolated from two patients. All the other outbreak associated isolates, including all food isolates, were stx-negative, and carried a different phage replacing the Stx2 phage. This phage was of similar size to the Stx2 phage, but had a distinctive early phage region and no stx gene. The sequence of the early region of this phage was not retrieved from the bacterial host genome, and the origin of the phage is unknown. The contaminated food most likely contained a mixture of E. coli O103:H25 cells with either one of the phages.

Relationship between Infill patterns in 3D printing and Hounsfield Unit

Energy Technology Data Exchange (ETDEWEB)

Savi, M.; Cechinel, C.M.; Silveira, L.C.; Soares, F.A.P., E-mail: Matheus.savi@ifsc.edu.br [Instituo Federal de Santa Catarina (IFSC), Florianópolis (Brazil). Departamento Acadêmico de Saúde e Serviços; Potiens, M.P.A. [Instituto de Pesquisas Energéticas Nucleares (IPEN/CNEN-SP), São Paulo, SP (Brazil). Lab. de Calibração de Instrumentos

2017-07-01

Introduction: One of the requirements for a phantom to correctly simulate the human body is that the radiation attenuation of the material used is compatible with the values of its corresponding tissues. The aim of this study is to evaluate the values of Hounsfield Unit (HU) in a 3D printed material in order to verify its compatibility, on tomography, with human tissues, so that it can be used as feedstock for simulators constructed in 3D printers. Methods: Cubes with 2cm of edge were printed using ABS filament with 8 different forms of internal filling. The samples were irradiated by a CT scanner, the measured HUs and their results compared to the literature. Results: Modification of the filling form as well as its percentage influenced the HU values that ranged from -133 to -451. Conclusion: The specific variations of internal fill patterns directly influence the interaction of the material used with the radiation, thus altering the HU values. Despite the variation found, the HU values were sufficient to simulate few tissues in the human body, which requires future studies with new materials that further attenuate the radiation and the range of tissues to be expanded. (author)

Role of bacteriophages in STEC infections: new implications for the design of prophylactic and treatment approaches [v2; ref status: indexed, http://f1000r.es/437

Directory of Open Access Journals (Sweden)

Jaime H. Amorim

2014-08-01

Full Text Available Shiga toxin (Stx is considered the main virulence factor in Shiga toxin-producing Escherichia coli (STEC infections. Previously we reported the expression of biologically active Stx by eukaryotic cells in vitro and in vivo following transfection with plasmids encoding Stx under control of the native bacterial promoter1,2. Since stx genes are present in the genome of lysogenic bacteriophages, here we evaluated the relevance of bacteriophages during STEC infection. We used the non-pathogenic E. coli C600 strain carrying a lysogenic 933W mutant bacteriophage in which the stx operon was replaced by a gene encoding the green fluorescent protein (GFP. Tracking GFP expression using an In Vivo Imaging System (IVIS, we detected fluorescence in liver, kidney, and intestine of mice infected with the recombinant E. coli strain after treatment with ciprofloxacin, which induces the lytic replication and release of bacteriophages. In addition, we showed that chitosan, a linear polysaccharide composed of d-glucosamine residues and with a number of commercial and biomedical uses, had strong anti-bacteriophage effects, as demonstrated at in vitro and in vivo conditions. These findings bring promising perspectives for the prevention and treatment of haemolytic uremic syndrome (HUS cases.

An Adjusted Likelihood Ratio Approach Analysing Distribution of Food Products to Assist the Investigation of Foodborne Outbreaks

Science.gov (United States)

Norström, Madelaine; Kristoffersen, Anja Bråthen; Görlach, Franziska Sophie; Nygård, Karin; Hopp, Petter

2015-01-01

In order to facilitate foodborne outbreak investigations there is a need to improve the methods for identifying the food products that should be sampled for laboratory analysis. The aim of this study was to examine the applicability of a likelihood ratio approach previously developed on simulated data, to real outbreak data. We used human case and food product distribution data from the Norwegian enterohaemorrhagic Escherichia coli outbreak in 2006. The approach was adjusted to include time, space smoothing and to handle missing or misclassified information. The performance of the adjusted likelihood ratio approach on the data originating from the HUS outbreak and control data indicates that the adjusted approach is promising and indicates that the adjusted approach could be a useful tool to assist and facilitate the investigation of food borne outbreaks in the future if good traceability are available and implemented in the distribution chain. However, the approach needs to be further validated on other outbreak data and also including other food products than meat products in order to make a more general conclusion of the applicability of the developed approach. PMID:26237468

The effect of tributyltin chloride on Caenorhabditis elegans germline is mediated by a conserved DNA damage checkpoint pathway.

Science.gov (United States)

Cheng, Zhe; Tian, Huimin; Chu, Hongran; Wu, Jianjian; Li, Yingying; Wang, Yanhai

2014-03-21

Tributyltin (TBT), one of the environmental pollutants, has been shown to impact the reproduction of animals. However, due to the lack of appropriate animal model, analysis of the affected molecular pathways in germ cells is lagging and has been particularly challenging. In the present study, we investigated the effects of tributyltin chloride (TBTCL) on the nematode Caenorhabditis elegans germline. We show that exposure of C. elegans to TBTCL causes significantly elevated level of sterility and embryonic lethality. TBTCL exposure results in an increased number of meiotic DNA double-strand breaks in germ cells, subsequently leading to activated DNA damage checkpoint. Exposing C. elegans to TBTCL causes dose- and time-dependent germline apoptosis. This apoptotic response was blocked in loss-of-function mutants of hus-1 (op241), mrt-2 (e2663) and p53/cep-1 (gk138), indicating that checkpoints and p53 are essential for mediating TBTCL-induced germ cell apoptosis. Moreover, TBTCL exposure can inhibit germ cell proliferation, which is also mediated by the conserved checkpoint pathway. We thereby propose that TBT exhibits its effects on the germline by inducing DNA damage and impaired maintenance of genomic integrity. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

[Survival of VTEC O157 and non-O157 in water troughs and bovine feces].

Science.gov (United States)

Polifroni, Rosana; Etcheverría, Analía I; Arroyo, Guillermo H; Padola, Nora L

2014-01-01

Verotoxin-producing Escherichia coli (VTEC) is the etiologic agent of hemolytic-uremic syndrome (HUS), which typically affects children ranging in age from six months to five years old. Transmission is produced by consumption of contaminated food, by direct contact with animals or the environment and from person to person. In previous studies we determined that the environment of a dairy farm is a non-animal reservoir; thus, we proposed to study the survival of 4 VTEC isolates (O20:H19; O91:H21; O157:H7 and O178:H19) in sterile water troughs and bovine feces by viable bacteria count and detection of virulence genes by PCR. It was demonstrated that the survival of different VTEC isolates (O157 and non-O157) varied in terms of their own characteristics as well as of the environmental conditions where they were found. The main differences between isolates were their survival time and the maximal counts reached. The competitive and adaptive characteristics of some isolates increase the infection risk for people that are visiting or working on a farm, as well as the risk for reinfection of the animals and food contamination. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Contrast timing in computed tomography: Effect of different contrast media concentrations on bolus geometry

International Nuclear Information System (INIS)

Mahnken, Andreas H.; Jost, Gregor; Seidensticker, Peter; Kuhl, Christiane; Pietsch, Hubertus

2012-01-01

Objective: To assess the effect of low-osmolar, monomeric contrast media with different iodine concentrations on bolus shape in aortic CT angiography. Materials and methods: Repeated sequential computed tomography scanning of the descending aorta of eight beagle dogs (5 male, 12.7 ± 3.1 kg) was performed without table movement with a standardized CT scan protocol. Iopromide 300 (300 mg I/mL), iopromide 370 (370 mg I/mL) and iomeprol 400 (400 mg I/mL) were administered via a foreleg vein with an identical iodine delivery rate of 1.2 g I/s and a total iodine dose of 300 mg I/kg body weight. Time-enhancement curves were computed and analyzed. Results: Iopromide 300 showed the highest peak enhancement (445.2 ± 89.1 HU), steepest up-slope (104.2 ± 17.5 HU/s) and smallest full width at half maximum (FWHM; 5.8 ± 1.0 s). Peak enhancement, duration of FWHM, enhancement at FWHM and up-slope differed significantly between iopromide 300 and iomeprol 400 (p 0.05). Conclusions: Low viscous iopromide 300 results in a better defined bolus with a significantly higher peak enhancement, steeper up-slope and smaller FWHM when compared to iomeprol 400. These characteristics potentially affect contrast timing.

The role of aortic wall CT attenuation measurements for the diagnosis of acute aortic syndromes

Energy Technology Data Exchange (ETDEWEB)

Knollmann, Friedrich D., E-mail: friedrich.knollmann@ucdmc.ucdavis.edu [Department of Radiology, University of California, Davis, 4860 Y Street, Sacramento, CA 95817 (United States); Departments of Radiology and Cardiothoracic Surgery, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213 (United States); Lacomis, Joan M.; Ocak, Iclal; Gleason, Thomas [Department of Radiology, University of California, Davis, 4860 Y Street, Sacramento, CA 95817 (United States); Departments of Radiology and Cardiothoracic Surgery, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213 (United States)

2013-12-01

Objectives: To determine if measurements of aortic wall attenuation can improve the CT diagnosis of acute aortic syndromes. Methods: CT reports from a ten year period were searched for acute aortic syndromes (AAS). Studies with both an unenhanced and a contrast enhanced (CTA) series that had resulted in the diagnosis of intramural hematoma (IMH) were reviewed. Diagnoses were confirmed by medical records. The attenuation of aortic wall abnormalities was measured. The observed attenuation threshold was validated using studies from 39 new subjects with a variety of aortic conditions. Results: The term “aortic dissection” was identified in 1206, and IMH in 124 patients’ reports. IMH was confirmed in 31 patients, 21 of whom had both unenhanced and contrast enhanced images. All 21 had pathologic CTA findings, and no CTA with IMH was normal. Attenuation of the aortic wall was greater than 45 HUs on the CTA images in all patients with IMH. When this threshold was applied to the new group, sensitivity for diagnosing AAS was 100% (19/19), and specificity 94% (16/17). Addition of unenhanced images did not improve accuracy. Conclusions: Measurements of aortic wall attenuation in CTA have a high negative predictive value for the diagnosis of acute aortic syndromes.

Assessment of the increased calcification of the jaw bone with CT-Scan after dental implant placement.

Science.gov (United States)

Yunus, Barunawaty

2011-06-01

This study was performed to evaluate the changes of jaw bone density around the dental implant after placement using computed tomography scan (CT-Scan). This retrospective study consisted of 30 patients who had lost 1 posterior tooth in maxilla or mandible and installed dental implant. The patients took CT-Scan before and after implant placement. Hounsfield Unit (HU) was measured around the implants and evaluated the difference of HU before and after implant installation. The mean HU of jaw bone was 542.436 HU and 764.9 HU before and after implant placement, respectively (p<0.05). The means HUs for male were 632.3 HU and 932.2 HU and those for female 478.2 HU and 645.5 HU before and after implant placement, respectively (p<0.05). Also, the jaw bone with lower density needed longer period for implant procedure and the increased change of HU of jaw bone was less in the cases which needed longer period for osseointegration. CT-Scan could be used to assess the change of bone density around dental implants. Bone density around dental implant was increased after placement. The increased rate of bone density could be determined by the quality of jaw bone before implant placement.

Assessment of the increased calcification of the jaw bone with CT-Scan after dental implant placement

Energy Technology Data Exchange (ETDEWEB)

Yunus, Barunawaty [Faculty of Dentistry, Hasanuddin University, Makassar (Malaysia)

2011-06-15

This study was performed to evaluate the changes of jaw bone density around the dental implant after placement using computed tomography scan (CT-Scan). This retrospective study consisted of 30 patients who had lost 1 posterior tooth in maxilla or mandible and installed dental implant. The patients took CT-Scan before and after implant placement. Hounsfield Unit (HU) was measured around the implants and evaluated the difference of HU before and after implant installation. The mean HU of jaw bone was 542.436 HU and 764.9 HU before and after implant placement, respectively (p<0.05). The means HUs for male were 632.3 HU and 932.2 HU and those for female 478.2 HU and 645.5 HU before and after implant placement, respectively (p<0.05). Also, the jaw bone with lower density needed longer period for implant procedure and the increased change of HU of jaw bone was less in the cases which needed longer period for osseointegration. CT-Scan could be used to assess the change of bone density around dental implants. Bone density around dental implant was increased after placement. The increased rate of bone density could be determined by the quality of jaw bone before implant placement.

Assessment of the increased calcification of the jaw bone with CT-Scan after dental implant placement

International Nuclear Information System (INIS)

Yunus, Barunawaty

2011-01-01

This study was performed to evaluate the changes of jaw bone density around the dental implant after placement using computed tomography scan (CT-Scan). This retrospective study consisted of 30 patients who had lost 1 posterior tooth in maxilla or mandible and installed dental implant. The patients took CT-Scan before and after implant placement. Hounsfield Unit (HU) was measured around the implants and evaluated the difference of HU before and after implant installation. The mean HU of jaw bone was 542.436 HU and 764.9 HU before and after implant placement, respectively (p<0.05). The means HUs for male were 632.3 HU and 932.2 HU and those for female 478.2 HU and 645.5 HU before and after implant placement, respectively (p<0.05). Also, the jaw bone with lower density needed longer period for implant procedure and the increased change of HU of jaw bone was less in the cases which needed longer period for osseointegration. CT-Scan could be used to assess the change of bone density around dental implants. Bone density around dental implant was increased after placement. The increased rate of bone density could be determined by the quality of jaw bone before implant placement.

An epigenetic signal encoded protection mechanism is activated by graphene oxide to inhibit its induced reproductive toxicity in Caenorhabditis elegans.

Science.gov (United States)

Zhao, Yunli; Wu, Qiuli; Wang, Dayong

2016-02-01

Although many studies have suggested the adverse effects of engineered nanomaterials (ENMs), the self-protection mechanisms for organisms against ENMs toxicity are still largely unclear. Using Caenorhabditis elegans as an in vivo assay system, our results suggest the toxicity of graphene oxide in reducing reproductive capacity by inducing damage on gonad development. The observed reproductive toxicity of GO on gonad development was due to the combinational effect of germline apoptosis and cell cycle arrest, and DNA damage activation might act as an inducer for this combinational effect. For the underlying molecular mechanism of reproductive toxicity of GO, we raised a signaling cascade of HUS-1/CLK-2-CEP-1-EGL-1-CED-4-CED-3 to explain the roles of core apoptosis signaling pathway and DNA damage checkpoints. Moreover, we identified a miRNA regulation mechanism activated by GO to suppress its induced reproductive toxicity. A mir-360 regulation mechanism was activated by GO to suppress its induced DNA damage-apoptosis signaling cascade through affecting component of CEP-1. Our identified epigenetic signal encoded protection mechanism activated by GO suggests a novel self-protection mechanism for organisms against the ENMs toxicity. Copyright © 2015 Elsevier Ltd. All rights reserved.

The role of aortic wall CT attenuation measurements for the diagnosis of acute aortic syndromes

International Nuclear Information System (INIS)

Knollmann, Friedrich D.; Lacomis, Joan M.; Ocak, Iclal; Gleason, Thomas

2013-01-01

Objectives: To determine if measurements of aortic wall attenuation can improve the CT diagnosis of acute aortic syndromes. Methods: CT reports from a ten year period were searched for acute aortic syndromes (AAS). Studies with both an unenhanced and a contrast enhanced (CTA) series that had resulted in the diagnosis of intramural hematoma (IMH) were reviewed. Diagnoses were confirmed by medical records. The attenuation of aortic wall abnormalities was measured. The observed attenuation threshold was validated using studies from 39 new subjects with a variety of aortic conditions. Results: The term “aortic dissection” was identified in 1206, and IMH in 124 patients’ reports. IMH was confirmed in 31 patients, 21 of whom had both unenhanced and contrast enhanced images. All 21 had pathologic CTA findings, and no CTA with IMH was normal. Attenuation of the aortic wall was greater than 45 HUs on the CTA images in all patients with IMH. When this threshold was applied to the new group, sensitivity for diagnosing AAS was 100% (19/19), and specificity 94% (16/17). Addition of unenhanced images did not improve accuracy. Conclusions: Measurements of aortic wall attenuation in CTA have a high negative predictive value for the diagnosis of acute aortic syndromes

Scan Quality and Entrance Skin Dose in Thoracic CT: A Comparison between Bismuth Breast Shield and Posteriorly Centered Partial CT Scans

International Nuclear Information System (INIS)

Tappouni, Rafel; Mathers, Bradley

2012-01-01

Objectives. To compare the effectiveness of the bismuth breast shield and partial CT scan in reducing entrance skin dose and to evaluate the effect of the breast shield on image quality (IQ). Methods. Nanodots were placed on an adult anthropomorphic phantom. Standard chest CT, CT with shield, and partial CT were performed. Nanodot readings and effective doses were recorded. 50 patients with chest CTs obtained both with and without breast shields were reviewed. IQ was evaluated by two radiologists and by measuring Hounsfield units (HUs) and standard deviation (SD) of HU in anterior subcutaneous region. Results. Breast shield and the partial CT scans reduced radiation to the anterior chest by 38% and 16%, respectively. Partial CT increased dose to the posterior chest by 37% and effective dose by 8%. Change in IQ in shield CT was observed in the anterior chest wall. Significant change in IQ was observed in 5/50 cases. The shield caused an increase of 20 HU (P = 0.021) and a 1.86 reduction in SD of HU (P = 0.027) in the anterior compared to posterior subcutaneous regions. Summary. Bismuth breast shield is more effective than the partial CT in reducing entrance skin dose while maintaining image quality

Lysine residue 185 of Rad1 is a topological but not a functional counterpart of lysine residue 164 of PCNA.

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Niek Wit

Full Text Available Monoubiquitylation of the homotrimeric DNA sliding clamp PCNA at lysine residue 164 (PCNA(K164 is a highly conserved, DNA damage-inducible process that is mediated by the E2/E3 complex Rad6/Rad18. This ubiquitylation event recruits translesion synthesis (TLS polymerases capable of replicating across damaged DNA templates. Besides PCNA, the Rad6/Rad18 complex was recently shown in yeast to ubiquitylate also 9-1-1, a heterotrimeric DNA sliding clamp composed of Rad9, Rad1, and Hus1 in a DNA damage-inducible manner. Based on the highly similar crystal structures of PCNA and 9-1-1, K185 of Rad1 (Rad1(K185 was identified as the only topological equivalent of PCNA(K164. To investigate a potential role of posttranslational modifications of Rad1(K185 in DNA damage management, we here generated a mouse model with a conditional deletable Rad1(K185R allele. The Rad1(K185 residue was found to be dispensable for Chk1 activation, DNA damage survival, and class switch recombination of immunoglobulin genes as well as recruitment of TLS polymerases during somatic hypermutation of immunoglobulin genes. Our data indicate that Rad1(K185 is not a functional counterpart of PCNA(K164.

E.coli O157:H7

Directory of Open Access Journals (Sweden)

Treor Francis Fernandez

2008-06-01

Full Text Available The serious nature of the symptoms of haemorrhagic colitis and HUS and the apparent low infectious dose (<100 cells of E.coli O157:H7 places this food borne pathogen a most serious of known food borne pathogens. Persuasive evidence suggests that healthy cattle are a reservoir of O157 and they can enter the food chain to provide a source of exposure for humans. A possible route of transmission of O157 VTEC may involve infections initially in calves that shed their organism into faecal slurry that may be used on grazing grass. This provides potential for infection of other animals from which the organism may contaminate milk or carcasses at slaughter. Possible sources of VTEC in healthy animals other E.coli O157:H7 than cattle and a wider range of foodstuffs require further investigation. Many features of E.coli O157:H7 strains remain poorly understood. It includes: (i Role of virulent genes in the animal, (ii Mechanism of evolution of the organism, (iii The progress of individual cases of E.coli O157:H7 infection, and (iv The difference in incidence of infection in different geographical areas. [Veterinary World 2008; 1(3.000: 83-87

Habitat Evaluation Procedures (HEP) Report; Steigerwald Lake National Wildlife Refuge, Technical Report 2000-2001.

Energy Technology Data Exchange (ETDEWEB)

Allard, Donna

2001-09-01

Steigenvald Lake National Wildlife Refuge (NWR, refuge) was established as a result of the U. S. Army Corps of Engineers (COE) transferring ownership of the Stevenson tract located in the historic Steigerwald Lake site to the U.S. Fish and Wildlife Service (FWS, Service) for the mitigation of the fish and wildlife losses associated with the construction of a second powerhouse at the Bonneville Dam on the Columbia River and relocation of the town of North Bonneville (Public Law 98-396). The construction project was completed in 1983 and resulted in the loss of approximately 577 acres of habitat on the Washington shore of the Columbia River (USFWS, 1982). The COE determined that acquisition and development of the Steigenvald Lake area, along with other on-site project management actions, would meet their legal obligation to mitigate for these impacts (USCOE, 1985). Mitigation requirements included restoration and enhancement of this property to increase overall habitat diversity and productivity. From 1994 to 1999, 317 acres of additional lands, consisting of four tracts of contiguous land, were added to the original refuge with Bonneville Power Administration (BPA) funds provided through the Washington Wildlife Mitigation Agreement. These tracts comprised Straub (191 acres), James (90 acres), Burlington Northern (27 acres), and Bliss (9 acres). Refer to Figure 1. Under this Agreement, BPA budgeted $2,730,000 to the Service for 'the protection, mitigation, and enhancement of wildlife and wildlife habitat that was adversely affected by the construction of Federal hydroelectric dams on the Columbia River or its tributaries' in the state of Washington (BPA, 1993). Lands acquired for mitigation resulting from BPA actions are evaluated using the habitat evaluation procedures (HEP) methodology, which quantifies how many Habitat Units (HUs) are to be credited to BPA. HUs or credits gained lessen BPA's debt, which was formally tabulated in the Federal Columbia

Habitat Evaluation Procedures (HEP) Report : Oleson Tracts of the Tualatin River National Wildlife Refuge, 2001-2002 Technical Report.

Energy Technology Data Exchange (ETDEWEB)

Allard, Donna; Smith, maureen; Schmidt, Peter

2004-09-01

Located in the northern Willamette River basin, Tualatin River National Wildlife Refuge (Refuge) was established in 1992 with an approved acquisition boundary to accommodate willing sellers with potentially restorable holdings within the Tualatin River floodplain. The Refuge's floodplain of seasonal and emergent wetlands, Oregon ash riparian hardwood, riparian shrub, coniferous forest, and Garry oak communities are representative of remnant plant communities historically common in the Willamette River valley and offer an opportunity to compensate for wildlife habitat losses associated with the Willamette River basin federal hydroelectric projects. The purchase of the Oleson Units as additions to the Refuge using Bonneville Power Administration (BPA) funds will partially mitigate for wildlife habitat and target species losses incurred as a result of construction and inundation activities at Dexter and Detroit Dams. Lands acquired for mitigation of Federal Columbia River Power System (FCRPS) impacts to wildlife are evaluated using the Habitat Evaluation Procedures (HEP) methodology, which quantifies how many Habitat Units (HUs) are to be credited to BPA. HUs or credits gained lessen BPA's debt, which was formally tabulated in the FCRPS Loss Assessments and adopted as part of the Northwest Power and Conservation Council's Fish and Wildlife Program as a BPA obligation (NWPCC, 1994 and 2000). There are two basic management scenarios to consider for this evaluation: (1) Habitats can be managed without restoration activities to benefit wildlife populations, or (2) Habitats can be restored using a number of techniques to improve habitat values more quickly. Without restoration, upland and wetland areas may be periodically mowed and disced to prevent invasion of exotic vegetation, volunteer trees and shrubs may grow to expand forested areas, and cooperative farming may be employed to provide forage for migrating and wintering waterfowl. Abandoned cropland

Fitness of Enterohemorrhagic Escherichia coli (EHEC)/Enteroaggregative E. coli O104:H4 in Comparison to That of EHEC O157: Survival Studies in Food and In Vitro.

Science.gov (United States)

Böhnlein, Christina; Kabisch, Jan; Meske, Diana; Franz, Charles M A P; Pichner, Rohtraud

2016-11-01

In 2011, one of the world's largest outbreaks of hemolytic-uremic syndrome (HUS) occurred, caused by a rare Escherichia coli serotype, O104:H4, that shared the virulence profiles of Shiga toxin-producing E. coli (STEC)/enterohemorrhagic E. coli (EHEC) and enteroaggregative E. coli (EAEC). The persistence and fitness factors of the highly virulent EHEC/EAEC O104:H4 strain, grown either in food or in vitro, were compared with those of E. coli O157 outbreak-associated strains. The log reduction rates of the different EHEC strains during the maturation of fermented sausages were not significantly different. Both the O157:NM and O104:H4 serotypes could be shown by qualitative enrichment to be present after 60 days of sausage storage. Moreover, the EHEC/EAEC O104:H4 strain appeared to be more viable than E. coli O157:H7 under conditions of decreased pH and in the presence of sodium nitrite. Analysis of specific EHEC strains in experiments with an EHEC inoculation cocktail showed a dominance of EHEC/EAEC O104:H4, which could be isolated from fermented sausages for 60 days. Inhibitory activities of EHEC/EAEC O104:H4 toward several E. coli strains, including serotype O157 strains, could be determined. Our study suggests that EHEC/EAEC O104:H4 is well adapted to the multiple adverse conditions occurring in fermented raw sausages. Therefore, it is strongly recommended that STEC strain cocktails composed of several serotypes, instead of E. coli O157:H7 alone, be used in food risk assessments. The enhanced persistence of EHEC/EAEC O104:H4 as a result of its robustness, as well as the production of bacteriocins, may account for its extraordinary virulence potential. In 2011, a severe outbreak caused by an EHEC/EAEC serovar O104:H4 strain led to many HUS sequelae. In this study, the persistence of the O104:H4 strain was compared with those of other outbreak-relevant STEC strains under conditions of fermented raw sausage production. Both O157:NM and O104:H4 strains could survive

T. G. Masaryk, Václav Havel a heslo „pravda vítězí“ z československé prezidentské standarty

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Jaroslaw Kilias

2017-06-01

Full Text Available The paper deals with the motto written on the flag of the president of Czechoslovakia, “Truth Prevails”. It is usually associated with T. G. Masaryk, the first president of Czechoslovakia, and Václav Havel, its last president and the first president of Czech Republic. For Masaryk the truth was an ethical ideal and an imperative which obliged him to fight for what he believed to be true. In his writings on the meaning of Czech history he gave it religious connotation, presenting it as a fulfillment of the humanitarian ideal, a heritage of the Czech reformation started by Jan Hus and the Hussites (who used the slogan “God’s truth prevails”. However, the meaning of the motto was in fact polyphonic, as most of the Czech public treated it as a generalized nationalist, perhaps anti-German symbol. For the Communists it symbolized a highly prized, domestic revolutionary tradition. Another meaning the motto received under Václav Havel, a former dissident whose truth aimed against “deceitful” Communism, losing its meaning after the fall of the Communist regime when it turned into an obstacle for critical self-reflection. The history of the motto gives the impression that the idea of truth may be a viable basis for the political ethics of conviction, but it hardly forms a basis for the ethics of responsibility.

Milk Fat Globules Hamper Adhesion of Enterohemorrhagic Escherichia coli to Enterocytes: In Vitro and in Vivo Evidence

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Thomas Douëllou

2018-05-01

Full Text Available Enterohemorrhagic Escherichia coli (EHEC; E. coli are food-borne agents associated with gastroenteritis, enterocolitis, bloody diarrhea and the hemolytic-uremic syndrome (HUS. Bovine milk glycans have been shown to contain oligosaccharides which are similar to host epithelial cell receptors and can therefore prevent bacterial adhesion. This study aimed to describe interactions between EHEC O157:H7 EDL933 and O26:H11 21765 and milk fat globules (MFGs in raw milk and raw milk cheese, and the impact of MFGs on EHEC strains adhesion to the intestinal tract in vitro and in vivo. Both EHEC serotypes clearly associated with native bovine MFGs and significantly limited their adhesion to a co-culture of intestinal cells. The presence of MFGs in raw milk cheese had two effects on the adhesion of both EHEC serotypes to the intestinal tracts of streptomycin-treated mice. First, it delayed and reduced EHEC excretion in mouse feces for both strains. Second, the prime implantation site for both EHEC strains was 6 cm more proximal in the intestinal tracts of mice fed with contaminated cheese containing less than 5% of fat than in those fed with contaminated cheese containing 40% of fat. Feeding mice with 40% fat cheese reduced the intestinal surface contaminated with EHEC and may therefore decrease severity of illness.

Mouse in Vivo Neutralization of Escherichia coli Shiga Toxin 2 with Monoclonal Antibodies

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Larry H. Stanker

2013-10-01

Full Text Available Shiga toxin-producing Escherichia coli (STEC food contaminations pose serious health concerns, and have been the subject of massive food recalls. STEC has been identified as the major cause of the life-threatening complication of hemolytic uremic syndrome (HUS. Besides supportive care, there currently are no therapeutics available. The use of antibiotics for combating pathogenic E. coli is not recommended because they have been shown to stimulate toxin production. Clearing Stx2 from the circulation could potentially lessen disease severity. In this study, we tested the in vivo neutralization of Stx2 in mice using monoclonal antibodies (mAbs. We measured the biologic half-life of Stx2 in mice and determined the distribution phase or t1/2 α to be 3 min and the clearance phase or t1/2 β to be 40 min. Neutralizing mAbs were capable of clearing Stx2 completely from intoxicated mouse blood within minutes. We also examined the persistence of these mAbs over time and showed that complete protection could be passively conferred to mice 4 weeks before exposure to Stx2. The advent of better diagnositic methods and the availability of a greater arsenal of therapeutic mAbs against Stx2 would greatly enhance treatment outcomes of life threatening E. coli infections.

Eder Acquisition 2007 Habitat Evaluation Procedures Report.

Energy Technology Data Exchange (ETDEWEB)

Ashley, Paul R.

2008-01-01

A habitat evaluation procedures (HEP) analysis was conducted on the Eder acquisition in July 2007 to determine how many protection habitat units to credit Bonneville Power Administration (BPA) for providing funds to acquire the project site as partial mitigation for habitat losses associated with construction of Grand Coulee and Chief Joseph Dams. Baseline HEP surveys generated 3,857.64 habitat units or 1.16 HUs per acre. HEP surveys also served to document general habitat conditions. Survey results indicated that the herbaceous plant community lacked forbs species, which may be due to both livestock grazing and the late timing of the surveys. Moreover, the herbaceous plant community lacked structure based on lower than expected visual obstruction readings (VOR); likely a direct result of livestock impacts. In addition, introduced herbaceous vegetation including cultivated pasture grasses, e.g. crested wheatgrass and/or invader species such as cheatgrass and mustard, were present on most areas surveyed. The shrub element within the shrubsteppe cover type was generally a mosaic of moderate to dense shrubby areas interspersed with open grassland communities while the 'steppe' component was almost entirely devoid of shrubs. Riparian shrub and forest areas were somewhat stressed by livestock. Moreover, shrub and tree communities along the lower reaches of Nine Mile Creek suffered from lack of water due to the previous landowners 'piping' water out of the stream channel.

Comparison of Tissue Density in Hounsfield Units in Computed Tomography and Cone Beam Computed Tomography.

Science.gov (United States)

Varshowsaz, Masoud; Goorang, Sepideh; Ehsani, Sara; Azizi, Zeynab; Rahimian, Sepideh

2016-03-01

Bone quality and quantity assessment is one of the most important steps in implant treatment planning. Different methods such as computed tomography (CT) and recently suggested cone beam computed tomography (CBCT) with lower radiation dose and less time and cost are used for bone density assessment. This in vitro study aimed to compare the tissue density values in Hounsfield units (HUs) in CBCT and CT scans of different tissue phantoms with two different thicknesses, two different image acquisition settings and in three locations in the phantoms. Four different tissue phantoms namely hard tissue, soft tissue, air and water were scanned by three different CBCT and a CT system in two thicknesses (full and half) and two image acquisition settings (high and low kVp and mA). The images were analyzed at three sites (middle, periphery and intermediate) using eFilm software. The difference in density values was analyzed by ANOVA and correction coefficient test (P<0.05). There was a significant difference between density values in CBCT and CT scans in most situations, and CBCT values were not similar to CT values in any of the phantoms in different thicknesses and acquisition parameters or the three different sites. The correction coefficients confirmed the results. CBCT is not reliable for tissue density assessment. The results were not affected by changes in thickness, acquisition parameters or locations.

Feasibility of CBCT-based dose calculation: Comparative analysis of HU adjustment techniques

International Nuclear Information System (INIS)

Fotina, Irina; Hopfgartner, Johannes; Stock, Markus; Steininger, Thomas; Lütgendorf-Caucig, Carola; Georg, Dietmar

2012-01-01

Background and purpose: The aim of this work was to compare the accuracy of different HU adjustments for CBCT-based dose calculation. Methods and materials: Dose calculation was performed on CBCT images of 30 patients. In the first two approaches phantom-based (Pha-CC) and population-based (Pop-CC) conversion curves were used. The third method (WAB) represents override of the structures with standard densities for water, air and bone. In ROI mapping approach all structures were overridden with average HUs from planning CT. All techniques were benchmarked to the Pop-CC and CT-based plans by DVH comparison and γ-index analysis. Results: For prostate plans, WAB and ROI mapping compared to Pop-CC showed differences in PTV D median below 2%. The WAB and Pha-CC methods underestimated the bladder dose in IMRT plans. In lung cases PTV coverage was underestimated by Pha-CC method by 2.3% and slightly overestimated by the WAB and ROI techniques. The use of the Pha-CC method for head–neck IMRT plans resulted in difference in PTV coverage up to 5%. Dose calculation with WAB and ROI techniques showed better agreement with pCT than conversion curve-based approaches. Conclusions: Density override techniques provide an accurate alternative to the conversion curve-based methods for dose calculation on CBCT images.

Transcriptomic analysis of Portunus trituberculatus reveals a critical role for WNT4 and WNT signalling in limb regeneration.

Science.gov (United States)

Liu, Lei; Fu, Yuanyuan; Zhu, Fang; Mu, Changkao; Li, Ronghua; Song, Weiwei; Shi, Ce; Ye, Yangfang; Wang, Chunlin

2018-06-05

The swimming crab (Portunus trituberculatus) is among the most economically important seawater crustacean species in Asia. Despite its commercial importance and being well-studied status, genomic and transcriptomic data are scarce for this crab species. In the present study, limb bud tissue was collected at different developmental stages post amputation for transcriptomic analysis. Illumina RNA-sequencing was applied to characterise the limb regeneration transcriptome and identify the most characteristic genes. A total of 289,018 transcripts were obtained by clustering and assembly of clean reads, producing 150,869 unigenes with an average length of 956 bp. Subsequent analysis revealed WNT signalling as the key pathway involved in limb regeneration, with WNT4 a key mediator. Overall, limb regeneration appears to be regulated by multiple signalling pathways, with numerous cell differentiation, muscle growth, moult, metabolism, and immune-related genes upregulated, including WNT4, LAMA, FIP2, FSTL5, TNC, HUS1, SWI5, NCGL, SLC22, PLA2, Tdc2, SMOX, GDH, and SMPD4. This is the first experimental study done on regenerating claws of P. trituberculatus. These findings expand existing sequence resources for crab species, and will likely accelerate research into regeneration and development in crustaceans, particularly functional studies on genes involved in limb regeneration. Copyright © 2018 Elsevier B.V. All rights reserved.

PCR Based Detection of Shiga Toxin Producing E. coli in Commercial Poultry and Related Environments

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Homaira Anzum Himi

2015-02-01

Full Text Available Shiga toxin (Stx-producing E. coli (STEC is the most important foodborne pathogen which is the causal agent of mild diarrhea, bloody diarrhea, hemolytic-uremic syndrome (HUS in human. The present study was designed to determine the prevalence and identification of Shiga toxin (Stx-producing E. coli in poultry, detection of its source of infection in poultry and transmission pattern to human. For this purpose a total of 150 samples (cloacal swab-60, feed -15, water-15 and egg -60 were collected and analyzed in bacteriology laboratory by cultured in different bacteriological media followed by gram’s staining, biochemical tests and Polymerase Chain reaction (PCR. The PCR was performed by targeting 16s rRNA gene and shiga toxin producing gene in E. coli. Out of 150 collected samples, E. coli was found in 81 (54% samples. Presence of E. coli was 100% in both feed (n=15 and egg (n=60, whereas 10% in cloacal swab (n=6. Water samples were totally free of E. coli. The stx2 gene was detected in all samples whether all samples were negative for stx1 gene. The study revealed that, poultry feed acts as a source of E. coli infection in poultry, which may be transmitted to environment and human via meat or eggs. Antibiotic sensitivity test revealed that isolated bacteria were highly sensitive to Ciprofloxacin.

IND UCTION OF SPAW NING IN THE TR OPICAL WALKING CATFISH (C la rias b atr ac hus BY CONTROLLI NG WATER L EVEL AND T EMPERAT URE

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M. ZAIRIN JR.

2001-01-01

Full Text Available This experiment was carried out t o confirm the rol e of water level and w ater temperature i n indu cing t he s pawning o f tr opical walking catfi sh . Ma ture mal es an d females reared un de r 23 - 2 5 °C, were paired and in duced to spa wn by cont rolling w ater level and w ater temperature. Decr easi ng water level and returni ng it to its original level r esulted i n a low spawni ng r ate (l es s t han 6. 7 % at 23 °C . Decreasing water level with simultaneous increase in water temperature, followed by returning the respective levels to their originals gave high spa wning rates ( 41.7 — 50 %; whereas the s ame treatment but without a ny water temperature decrea sed when t he wate r le vel was return ed t o t he initial level, gave a lo w spawning rate (16 .7 %. In creasin g water level only, fail ed to ind uce spa wning . A high spawning rate was obtained also when changes in water level were ca rried out under high t emperature of 28 °C. No fish spawned in the ab sence of the environmental stimulation. From the results, i t is confirmed that water le vel and t emperature play important r oles i n i nducin g spaw ning of tropical walki ng catfish. Changes i n water t emperature probably increas e the sensitivity of fish to th e change in water level. Prolo nged exposure to high water tem perature c ould also improve the sensitivity of fish.

Esforços de inovação organizacional e qualidade do serviço: um estudo empírico sobre unidades hospitalares Esfuerzos de innovación organizacional y calidad de los servicios: una investigación empírica sobre unidades hospitalarias Organizational innovation and service quality: an empirical analysis on hospital units

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Marcelino José Jorge

2013-04-01

health system pays little attention to organizational innovation in Hospital Units (HUs. Calling upon the analytical framework proposed by Economic Analysis to investigate asymmetric information and innovation, this paper analyzes the connections among effectiveness of rules, routines and protocols, staff training, and service quality in HUs with the help of statistical analysis of Hospital Accreditation reports. The convenience sample consisted of ten reports containing perceived assessment data. As a theoretical contribution, the proposed model analyzes the dynamic relationship between organizational innovation, service quality and growth in HU and development of the market for healthcare services. Empirical findings show that the effect of organizational innovation in Referral Hospital Units is stronger than the effect of staff training.

Radon as a tracer for soil-gas entry into a house located next to a contaminated dry-cleaning property; Radon som sporgas for jordluftindtraengning til hus ved forurenet renserigrund

Energy Technology Data Exchange (ETDEWEB)

Andersen, C.E

2001-07-01

This study applies the naturally occurring radioactive gas radon-222 as a tracer for soil-gas entry into a house located next to a dry-cleaners shop. This is possible because the concentration of radon in the soil below the house is about 1000 times higher than the concentration in outdoor air. The study is based on continuous indoor measurement of radon, differential pressures, barometric pressure and temperatures and grab samples of radon below the slab and in the soil in the vicinity of the house. During the investigation, vacuum extraction were used to remove chlorinated solvents (perchloroethylene, PCE) from the unsaturated zone. The study shows that the vacuum extraction influences the radon concentration in and below the house. When the vacuum pump is on, the indoor radon concentration is only 10 Bq/m{sup 3} corresponding to the contribution from radon in outdoor air and exhalation from building materials. When the vacuum pump is set off, the average indoor radon concentration increases to 30 Bq/m{sup 3}. It is believed that the increase is caused by radon entry from the soil. Regression analysis demonstrates that changes in the indoor radon concentration can be explained by changes in indoor-outdoor pressure differences and changes in the atmospheric pressure. This suggests that advection is the primary mode of entry. Under some highly simplifying assumptions the soil-gas entry is found to be around 1 m{sup 3}/h. This, however, is most likely an overestimate. Based on the measured radon concentration in the exhaust air from the vacuum system and a typical radon emanation rate for Danish soil, it is estimated that the soil vapor extraction system ventilates about 10000 m{sup 3} of soil. The investigation is supported by numerical model calculations with the finite-volume model Rnmod3d. (au)

The KYxxL motif in Rad17 protein is essential for the interaction with the 9–1–1 complex

Energy Technology Data Exchange (ETDEWEB)

Fukumoto, Yasunori, E-mail: fukumoto@faculty.chiba-u.jp [Laboratory of Molecular Cell Biology, Graduate School of Pharmaceutical Sciences, Chiba University, Chiba 260-8675 (Japan); Ikeuchi, Masayoshi; Nakayama, Yuji [Department of Biochemistry & Molecular Biology, Kyoto Pharmaceutical University, Kyoto 607-8414 (Japan); Yamaguchi, Naoto, E-mail: nyama@faculty.chiba-u.jp [Laboratory of Molecular Cell Biology, Graduate School of Pharmaceutical Sciences, Chiba University, Chiba 260-8675 (Japan)

2016-09-02

ATR-dependent DNA damage checkpoint is the major DNA damage checkpoint against UV irradiation and DNA replication stress. The Rad17–RFC and Rad9–Rad1–Hus1 (9–1–1) complexes interact with each other to contribute to ATR signaling, however, the precise regulatory mechanism of the interaction has not been established. Here, we identified a conserved sequence motif, KYxxL, in the AAA+ domain of Rad17 protein, and demonstrated that this motif is essential for the interaction with the 9–1–1 complex. We also show that UV-induced Rad17 phosphorylation is increased in the Rad17 KYxxL mutants. These data indicate that the interaction with the 9–1–1 complex is not required for Rad17 protein to be an efficient substrate for the UV-induced phosphorylation. Our data also raise the possibility that the 9–1–1 complex plays a negative regulatory role in the Rad17 phosphorylation. We also show that the nucleotide-binding activity of Rad17 is required for its nuclear localization. - Highlights: • We have identified a conserved KYxxL motif in Rad17 protein. • The KYxxL motif is crucial for the interaction with the 9–1–1 complex. • The KYxxL motif is dispensable or inhibitory for UV-induced Rad17 phosphorylation. • Nucleotide binding of Rad17 is required for its nuclear localization.

Effects of computed tomography contrast medium factors on contrast enhancement

International Nuclear Information System (INIS)

Terasawa, Kazuaki; Hatcho, Atsushi; Okuda, Itsuko

2011-01-01

The various nonionic iodinated contrast media used in contrast computed tomography (CT) studies differ in terms of their composition, characteristics, and iodine concentration (mgI/ml), as well as the volume injected (ml). Compared with ionic iodinated contrast media, nonionic iodinated contrast media are low-osmolar agents, with different agents having different osmotic pressures. Using a custom-made phantom incorporating a semipermeable membrane, the osmotic flow rate (hounsfield unit (HU)/s) could easily be measured based on the observed increase in CT numbers, and the relationship between the osmotic pressure and the osmotic flow rate could be obtained (r 2 =0.84). In addition, taking the effects of patient size into consideration, the levels of contrast enhancement in the abdominal aorta (AA) and inferior vena cava (IVC) were compared among four types of CT contrast medium. The results showed differences in contrast enhancement in the IVC during the equilibrium phase depending on the type of contrast medium used. It was found that the factors responsible for the differences observed in enhancement in the IVC were the osmotic flow rate and the volume of the blood flow pathways in the circulatory system. It is therefore considered that the reproducibility of contrast enhancement is likely to be reduced in the examination of parenchymal organs, in which scanning must be performed during the equilibrium phase, even if the amount of iodine injected per unit body weight (mgI/kg) is maintained at a specified level. (author)

Carboxyhemoglobin - the forgotten parameter of neonatal hyperbilirubinemia.

Science.gov (United States)

Bailey, Douggl G N; Fuchs, Hans; Hentschel, Roland

2017-07-26

Neonatal hyperbilirubinemia is influenced by a wide variety of factors, one of which is hemolysis. Serious hyperbilirubinemia may lead to a kernicterus with detrimental neurologic sequelae. Patients suffering from hemolytic disease have a higher risk of developing kernicterus. Carbon monoxide (CO), a byproduct of hemolysis or heme degradation, was described by Sjöstrand in the 1960s. It is transported as carboxyhemoglobin (COHb) and exhaled through the lungs. We were interested in a potential correlation between COHb and total serum bilirubin (TSB) and the time course of both parameters. We used a point of care (POC) blood gas analyzer and did a retrospective analysis of bilirubin and COHb data collected over a 60-day period. An arbitrary cut-off point set at 2% COHb identified four patients with hemolytic disease of different origins who required phototherapy. In one patient with atypical hemolytic uremic syndrome (aHUS), COHb preceded the rise in bilirubin by about 2 days. Despite this displacement, there was a moderately good correlation of COHb with TSB levels <15 mg/dL (257 μmol/L) (r2: 0.80) and direct bilirubin (r2: 0.78) in the first patient. For all the four patients and all time points the correlation was slightly lower (r2: 0.59). COHb might be useful as a marker for high hemoglobin turnover to allow an earlier identification of newborns at risk to a rapid rise in bilirubin.

Interpretación del cuidado de enfermería neonatal desde las experiencias y vivencias de los padres

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JUAN CLEMENTE GUERRA GUERRA

2008-12-01

Full Text Available El objetivo es "interpretar las experiencias y vivencias de los padres de los neonatos acerca del cuidado de enfermería que reciben sus hijos en la unidad de neonatos (UCIN del Hospital Universitario de la Samaritana (HUS". Es un estudio cualitativo, descriptivo, exploratorio. Se utilizó una entrevista semiestructurada la cual sirvió como guía para obtener los testimonios de los padres y madres de los neonatos hospitalizados. Del análisis de la información obtenida de cada una de las preguntas se identificaron códigos sustantivos, los cuales se agruparon con el fin de formar las categorías. Surgieron cinco categorías: 1. Dificultades en el desempeño del rol de padres. 2. Impacto ante la hospitalización del neonato. 3. Expectativas de los padres frente al cuidado del neonato. 4. Comunicación asertiva. 5. Los padres aprenden de las(os enfermeras(os. Los testimonios y el análisis de cada una de estas categorías permiten un acercamiento a la interpretación de lo que es el cuidado de enfermería para los padres de los neonatos hospitalizados, a partir de sus experiencias y vivencias. En opinión de los autores, resalta el surgimiento de dos categorías muy importantes para enfermería, que se deben seguir explorando en otro tipo de investigaciones: "los padres aprenden de las enfermeras" y "comunicación asertiva".

Trabajando a gusto en Enfermería Working with pleasure in Nursing

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Martha Isabel Camargo Ramírez

2012-04-01

Full Text Available Introducción: la atención a personas hospitalizadas, amerita de parte de sus cuidadores contar además de sus conocimientos con la estabilidad emocional y calidad en las relaciones humanas; lo cual puede ser fortalecido a través del desarrollo de aptitudes personales. Objetivo: describir los resultados de la intervención educativa "Trabajando a gusto" dirigida al personal de enfermería de un hospital de tercer nivel, orientada al fortalecimiento de la dimensión personal. Metodología: estudio descriptivo resultado de un proyecto de extensión desarrollado en el Hospital Universitario de Santander (HUS. Se utilizaron tres instrumentos: Comunicación asertiva, Control de emociones, Prevención y manejo del estrés, los cuales se aplicaron antes y después de la intervención. Resultados: en el Eje temático de Comunicación Asertiva las personas aumentaron el nivel de asertividad pasando de un 39,17% en el pretest a un 45,48% en el postest. En el eje de Control de Emociones, la claridad definida como la buena comprensión pasó de un 25,37% antes de la intervención a un 32,14% en el nivel clasificado como excelente; en la reparación definida como la capacidad de regular los estados emocionales correctamente, los participantes pasaron en el nivel excelente de un 26,47% a un 38%. En la prevención y manejo del estrés no se evidenciaron cambios. Conclusiones: la intervención fue positiva en algunos aspectos de la comunicación y el control de emociones. Si bien las actitudes son aprendidas y posibles de ser modificadas, se requieren procesos formativos a largo plazo para mayores y mejores resultados, con un acompañamiento posterior y nuevas mediciones. Salud UIS 2012; 44 (1: 29-38Introduction: the care provided to patients who are hospitalized, requires from the caregivers not only their knowledge, also their emotional stability and interpersonal skills, which can be strenghtened trought the development of their personality. Objective: to

Sekuen Nukleotida Gene Shiga like toxin-2 dari Isolat Lokal Escherichia coli O157:H7 asal Hewan dan Manusia (NUCLEOTIDES SQUENCES OF SHIGA-LIKE TOXIN 2 GENES OF ESCHERICHIA COLI O157:H7 LOCAL ISOLATES ORIGINATED FROM ANIMALS AND HUMAN

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I Wayan Suardana

2017-04-01

Full Text Available Animals/livestock, especially cattle, are known as the main reservoir of Escherichia coli O157: H7. As the only one of zoonotic E. coli, the pathogenicity of these bacteria is determined by its ability to produce one or more very potent cytotoxin known as Shiga-like toxin (Stx or verocytotoxin, particularly of the Stx2 type that is closely related to the incidence of hemolytic uremic syndrome (HUS in humans. This study analyzed the nucleotide sequences of stx2 gene between isolates from animals and humans in an effort to assess the potential zoonoses of the agent. The research activity was initiated by cultivating 20 isolates of E. coli O157:H7 collection based on result in the previous study i.e. 2 isolates originated from cattle feces, 2 isolates originated from beef, 2 isolates originated from chicken feces, 2 isolates originated from human feces, and 12 non-clinical isolates originated from human fecal who were suffering with renal failure. All isolates were confirmed on selective medium Sorbitol MacConkey Agar (SMAC followed by testing on aglutination O157 latex test, and H7 antisera. Molecular analysis of stx2 gene covering open reading frame (ORF of the stx2 gene was performed using the primer which was designed by researcher i.e. Stx2 (F/Stx2 (R. The results showed, there were 2 isolates i.e. KL-48 (2 originated from human feces and SM-25 (1 originated from cattle feces were positive for carrying a stx2 gene, which was marked by the 1587 bp PCR product. Analysis of sequencing showed both isolates had identical to stx2 nucleotide squences with E. phaga 933 as well as E. coli ATCC 933. These results indicate the both local isolates are potential as zoonotic agents with clinical effects similar to E. phaga 933 and E. coli ATCC 43894. ABSTRAK Hewan ternak khususnya sapi, dikenal sebagai reservoir utama Escherichia coli O157:H7. Sebagai satu-satunya serotipe E. coli yang bersifat zoonosis, patogenitas bakteri ini ditentukan oleh kemampuannya

¿Conocen los usuarios sus deberes y derechos?: Una evaluación posterior a una intervención Do the users know their rights and responsibilities?: A post-intervention evaluation

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Fabio Alberto Camargo Figuera

2011-04-01

Full Text Available Introducción: Los derechos y deberes de los enfermos son un factor fundamental en un sistema de salud y un indicador de la calidad del servicio, por tal motivo, las instituciones prestadoras de servicios de salud tienen la responsabilidad de promover su conocimiento, no sólo en el personal asistencial y administrativo, sino también en sus usuarios, a fin de que ellos puedan exigir el cumplimiento de los mismos. Objetivos: Determinar el nivel de conocimiento de los usuarios sobre sus derechos y deberes en una institución de salud de Tercer Nivel de atención. Materiales y métodos: Se realizó un estudio descriptivo de corte trasversal luego de la implementación de un proyecto educativo que buscaba socializar entre los usuarios sus derechos y deberes. Se calculó un tamaño muestral de 369 usuarios, con un nivel de confianza del 95,0%, poder estadístico del 80,0%, prevalencia esperada de buenos conocimientos del 50,0%, y un IC 95% (45,0-55,0%. Se realizó muestreo aleatorio simple. Se solicito consentimiento informado a todos los participantes. Resultados: El 54,7% de los usuarios tenía un nivel de conocimiento bueno, el 40,5% regular y el 4,8% deficiente. El nivel de conocimientos fue mayor, con respecto a una encuesta anterior. El 10,9% de los usuarios manifestaron que habían recibido información sobre sus derechos y deberes, y de estos el 40,4% la recibieron en la ESE-HUS. Conclusiones: En su mayoría, los usuarios tenían un buen nivel de conocimientos sobre derechos y deberes de los enfermos, a pesar de no haber recibido información sobre el tema. Salud UIS 2011; 43(1: 11-19Introduction: Patients rights and responsibilities are a fundamental factor in on health system and a service quality indicator of the service, for that reason, health-care institutions have the responsibility to promote ther awareness not only among health-care and management staff, but also in their users, so that these could demond their compliance

"Det är inte mig det är fel på, det är huset" : en studie av prognosfaktorer och bemötande med fokus på sjuka hus-syndromet

OpenAIRE

Edvardsson, Berit

2015-01-01

Bakgrund: Sick Building Syndrome, SBS, är fortfarande 2015 ett tillstånd som vållar mycket diskussion. Symtomen kan grupperas i slemhinnesymtom, hudsymtom och allmänna symtom. I definitionen ingår att personen/ personerna som fått symtom har exponerats för dålig inomhusluft i en speciell byggnad. När personen inte är i byggnaden så förbättras eller försvinner symtomen. Många olika faktorer kan orsaka eller medverka till uppkomst eller försämringar av SBS-symtom, som t.ex. luftens innehåll av ...

Columbia River wildlife mitigation habitat evaluation procedures report: Scotch Creek Wildlife Area, Berg Brothers, and Douglas County pygmy rabbit projects

International Nuclear Information System (INIS)

Ashley, P.R.; Ratassepp, J.; Berger, M.; Judd, S.L.

1997-01-01

This Habitat Evaluation Procedure study was conducted to determine baseline habitat units (HUs) on the Scotch Creek, Mineral Hill, Pogue Mountain, Chesaw and Tunk Valley Habitat Areas (collectively known as the Scotch Creek Wildlife Area) in Okanogan County, Sagebrush Flat and the Dormaler property in Douglas County, and the Berg Brothers ranch located in Okanogan County within the Colville Reservation. A HEP team comprised of individuals from the Washington Department of Fish and Wildlife, the Confederated Tribes of the Colville Reservation, and the Natural Resources Conservation Service (Appendix A) conducted baseline habitat surveys using the following HEP evaluation species: mule deer (Odocoileus hemionus), sharp-tailed grouse (Tympanuchus phasianellus), pygmy rabbit (Brachylagus idahoensis), white-tailed deer (Odocoileus virginiana), mink (Mustela vison), Canada goose (Branta canadensis), downy woodpecker (Picoides pubescens), Lewis woodpecker (Melanerpes lewis), and Yellow warbler (Dendroica petechia). Results of the HEP analysis are listed below. General ratings (poor, marginal, fair, etc.,) are described in Appendix B. Mule deer habitat was marginal lacking diversity and quantify of suitable browse species. Sharp-tailed grouse habitat was marginal lacking residual nesting cover and suitable winter habitat Pygmy rabbit habitat was in fair condition except for the Dormaier property which was rated marginal due to excessive shrub canopy closure at some sites. This report is an analysis of baseline habitat conditions on mitigation project lands and provides estimated habitat units for mitigation crediting purposes. In addition, information from this document could be used by wildlife habitat managers to develop management strategies for specific project sites

Impacts of Verotoxigenic and Enterohaemorrhagic Escherichia Coli (Vtec and Ehec on Animal, Human and Food

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Widodo Suwito

2009-06-01

Full Text Available Verotoxigenic and enterohaemorrhagic Escherichia coli, VTEC and EHEC are strains that produce a toxin on the Vero cells in vitro, therefore the toxin called verotoxin. Strain VTEC and EHEC have been isolated from human and various animal species, mainly ruminants and pigs. The prevalence of VTEC in cattle is 35%, milk 10%, cheese 1.5%. In beef meat, pork, poultry, goat and sheep is 3.7, 1.5, 1.5, 2 and 2.5%, respectively. In contrast, the human prevalence in United States, Spain and France 5 – 10, 2.5 and 3.4%, respectively. In Indonesia, nine cases of VTEC were reported by Ciptomangunkusumo Hospital and four out of nine cases were died. The verotoxin also named Shiga toxins (Stx, is active in vivo as a pathogen on the endothelial cells of the blood vessels of the gastro intestinal mucosa, kidneys, brain and other tissues of human and piglets. Verotoxin in human, ruminants and piglets causes bloody diarrhea so with ruminants. In the adult ruminants, verotoxin results in clinical signs and they act as asymptomatic carriers of VTEC and EHEC strains but in human, it produced haemorrhagic colitis (HC, haemolytic uremic syndrome (HUS and thrombocytopenia purpura (TPP. Infection in human by the most famous EHEC strain belongs to the O157:H7 serotype, through faecal contamination or environment of either food of animal origin, or other foodstuffs (fruits and vegetables. Infection from EHEC strains could be prevented by avoiding food of animal origin and unpasteurized milk, and by taking care of food hygiene for comsumption.

Columbia River Wildlife Mitigation Habitat Evaluation Procedures Report / Scotch Creek Wildlife Area, Berg Brothers, and Douglas County Pygmy Rabbit Projects.

Energy Technology Data Exchange (ETDEWEB)

Ashley, Paul R.

1997-01-01

This Habitat Evaluation Procedure study was conducted to determine baseline habitat units (HUs) on the Scotch Creek, Mineral Hill, Pogue Mountain, Chesaw and Tunk Valley Habitat Areas (collectively known as the Scotch Creek Wildlife Area) in Okanogan County, Sagebrush Flat and the Dormaler property in Douglas County, and the Berg Brothers ranch located in Okanogan County within the Colville Reservation. A HEP team comprised of individuals from the Washington Department of Fish and Wildlife, the Confederated Tribes of the Colville Reservation, and the Natural Resources Conservation Service (Appendix A) conducted baseline habitat surveys using the following HEP evaluation species: mule deer (Odocoileus hemionus), sharp-tailed grouse (Tympanuchus phasianellus), pygmy rabbit (Brachylagus idahoensis), white-tailed deer (Odocoileus virginiana), mink (Mustela vison), Canada goose (Branta canadensis), downy woodpecker (Picoides pubescens), Lewis woodpecker (Melanerpes lewis), and Yellow warbler (Dendroica petechia). Results of the HEP analysis are listed below. General ratings (poor, marginal, fair, etc.,) are described in Appendix B. Mule deer habitat was marginal lacking diversity and quantify of suitable browse species. Sharp-tailed grouse habitat was marginal lacking residual nesting cover and suitable winter habitat Pygmy rabbit habitat was in fair condition except for the Dormaier property which was rated marginal due to excessive shrub canopy closure at some sites. This report is an analysis of baseline habitat conditions on mitigation project lands and provides estimated habitat units for mitigation crediting purposes. In addition, information from this document could be used by wildlife habitat managers to develop management strategies for specific project sites.

The roles of DNA damage-dependent signals and MAPK cascades in tributyltin-induced germline apoptosis in Caenorhabditis elegans.

Science.gov (United States)

Wang, Yun; Wang, Shunchang; Luo, Xun; Yang, Yanan; Jian, Fenglei; Wang, Xuemin; Xie, Lucheng

2014-08-01

The induction of apoptosis is recognized to be a major mechanism of tributyltin (TBT) toxicity. However, the underlying signaling pathways for TBT-induced apoptosis remain unclear. In this study, using the nematode Caenorhabditis elegans, we examined whether DNA damage response (DDR) pathway and mitogen-activated protein kinase (MAPK) signaling cascades are involved in TBT-induced germline apoptosis and cell cycle arrest. Our results demonstrated that exposing worms to TBT at the dose of 10nM for 6h significantly increased germline apoptosis in N2 strain. Germline apoptosis was absent in strains that carried ced-3 or ced-4 loss-of-function alleles, indicating that both caspase protein CED-3 and Apaf-1 protein CED-4 were required for TBT-induced apoptosis. TBT-induced apoptosis was blocked in the Bcl-2 gain-of-function strain ced-9(n1950), whereas TBT induced a minor increase in the BH3-only protein EGL-1 mutated strain egl-1(n1084n3082). Checkpoint proteins HUS-1 and CLK-2 exerted proapoptotic effects, and the null mutation of cep-1, the homologue of tumor suppressor gene p53, significantly inhibited TBT-induced apoptosis. Apoptosis in the loss-of-function strains of ERK, JNK and p38 MAPK signaling pathways were completely or mildly suppressed under TBT stress. These results were supported by the results of mRNA expression levels of corresponding genes. The present study indicated that TBT-induced apoptosis required the core apoptotic machinery, and that DDR genes and MAPK pathways played essential roles in signaling the processes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Maqâsid al-Qur’ân dan Deradikalisasi Penafsiran dalam Konteks Keindonesiaan

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Ulya Fikriyati

2015-09-01

Full Text Available This article deals with the viewpoint that the reading of the Qur’ân by a certain generation is subject to criticism by the following generation. The article seeks to offer, as an example, the deradicalization of interpreting the so-called ‘radical’ verses of the Qur’ân in Indonesian context. Islam in Indonesia always interact with various races, ethnicities, religions and beliefs, and therefore requires a type of exegesis different from other regions such as the Middle East. For the radicalization of interpretation, this article offers what is called the maqâsid al-Qur’ân as its parameter. The maqâsid al-Qur’ân consists of seven points: 1 Hifz al-dîn wa tatwîr wasâilih, 2 Hifz al-nafs wa tatwîruhâ, 3 Hifz al-‘aql wa tatwîruh, 4 Hifz al-mâl wa tanmîyat wasâilih, 5 Hifz al-‘ird wa tatwîr al-wasâil li al-husûl ‘alayh, 6 Tahqîq al-huqûq al-insânîyah wa mâ yandarij tahtahâ, 7 Hifz al-‘âlam wa ‘imâratuhâ. As spirit and parameter, the maqâsid al-Qur’ân necessitates the dialectics of dynamic interpretation without any judgment of infidelity or heresy. If a certain reading of the Qur’anic verses deviates from these seven maqâsid al-Qur’ân above, it deserves to be examined further, but not to be immediately suppressed.

An outbreak of Vero cytotoxin producing Escherichia coli O157 infection associated with takeaway sandwiches.

LENUS (Irish Health Repository)

McDonnell, R J

1997-12-12

An outbreak of food poisoning due to Escherichia coli O157 phage type 2 Vero cytotoxin 2 affected 26 people in southern counties of England in May and June 1995. The organism was isolated from faecal specimens from 23 patients, 16 of whom lived in Dorset and seven in Hampshire. Isolates were indistinguishable by phage typing, Vero cytotoxin gene typing, restriction fragment length polymorphism, and pulsed field gel electrophoresis. Three associated cases, linked epidemiologically to the outbreak, were confirmed serologically by detection of antibodies to E. coli O157 lipopolysaccharide. Twenty-two of the 26 patients were adults: four were admitted to hospital with haemorrhagic colitis. Four cases were children: two were admitted to hospital with haemolytic uraemic syndrome (HUS). There were no deaths. Although E. coli O157 was not isolated from any food samples, illness was associated with having eaten cold meats in sandwiches bought from two sandwich producers, in Weymouth and in Portsmouth. Both shops were supplied by the same wholesaler, who kept no records and obtained cooked meats from several sources in packs that did not carry adequate identification marks. It was, therefore, impossible to trace back to the original producer or to investigate further to determine the origin of contamination with E. coli O157. To protect the public health it is essential that all wholesale packs of ready-to-eat food carry date codes and the producer\\'s identification mark. Detailed record keeping should be part of hazard analysis critical control point (HACCP) systems and should be maintained throughout the chain of distribution from the producer to retail outlets.

Comparison of Iohexol-380 and Iohexol-350 for coronary CT angiography: A multicenter, randomized, double-blind phase 3 trial

Energy Technology Data Exchange (ETDEWEB)

Park, Eun Ah; Lee, Whal [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Kang, Doo Kyoung [Dept. of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of); and others

2016-06-15

This multi-center, randomized, double-blind, phase 3 trial was conducted to compare the safety and efficacy of contrast agents iohexol-380 and iohexol-350 for coronary CT angiography in healthy subjects. Volunteers were randomized to receive 420 mgI/kg of either iohexol-350 or iohexol-380 using a flow rate of 4 mL/sec. All adverse events were recorded. Two blinded readers independently reviewed the CT images and conflicting results were resolved by a third reader. Luminal attenuations (ascending aorta, left main coronary artery, and left ventricle) in Hounsfield units (HUs) and image quality on a 4-point scale were calculated. A total of 225 subjects were given contrast media (115 with iohexol-380 and 110 with iohexol-350). There was no difference in number of adverse drug reactions between groups: 75 events in 56 (48.7%) of 115 subjects in the iohexol-380 group vs. 74 events in 51 (46.4%) of 110 subjects in the iohexol-350 group (p = 0.690). No severe adverse drug reactions were recorded. Neither group showed an increase in serum creatinine. Significant differences in mean density between the groups was found in the ascending aorta: 375.8 ± 71.4 HU with iohexol-380 vs. 356.3 ± 61.5 HU with iohexol-350 (p = 0.030). No significant differences in image quality scores between both groups were observed for all three anatomic evaluations (all, p > 0.05). Iohexol-380 provides improved enhancement of the ascending aorta and similar attenuation of the coronary arteries without any increase in adverse drug reactions, as compared with iohexol-350 using an identical amount of total iodine.

Comparison of Iohexol-380 and Iohexol-350 for coronary CT angiography: A multicenter, randomized, double-blind phase 3 trial

International Nuclear Information System (INIS)

Park, Eun Ah; Lee, Whal; Kang, Doo Kyoung

2016-01-01

This multi-center, randomized, double-blind, phase 3 trial was conducted to compare the safety and efficacy of contrast agents iohexol-380 and iohexol-350 for coronary CT angiography in healthy subjects. Volunteers were randomized to receive 420 mgI/kg of either iohexol-350 or iohexol-380 using a flow rate of 4 mL/sec. All adverse events were recorded. Two blinded readers independently reviewed the CT images and conflicting results were resolved by a third reader. Luminal attenuations (ascending aorta, left main coronary artery, and left ventricle) in Hounsfield units (HUs) and image quality on a 4-point scale were calculated. A total of 225 subjects were given contrast media (115 with iohexol-380 and 110 with iohexol-350). There was no difference in number of adverse drug reactions between groups: 75 events in 56 (48.7%) of 115 subjects in the iohexol-380 group vs. 74 events in 51 (46.4%) of 110 subjects in the iohexol-350 group (p = 0.690). No severe adverse drug reactions were recorded. Neither group showed an increase in serum creatinine. Significant differences in mean density between the groups was found in the ascending aorta: 375.8 ± 71.4 HU with iohexol-380 vs. 356.3 ± 61.5 HU with iohexol-350 (p = 0.030). No significant differences in image quality scores between both groups were observed for all three anatomic evaluations (all, p > 0.05). Iohexol-380 provides improved enhancement of the ascending aorta and similar attenuation of the coronary arteries without any increase in adverse drug reactions, as compared with iohexol-350 using an identical amount of total iodine

Identification, characterization and structure analysis of a type I ribosome-inactivating protein from Sapium sebiferum (Euphorbiaceae)

Energy Technology Data Exchange (ETDEWEB)

Wu, Ying [Key Laboratory of Ion Beam Bioengineering and Bioenergy Forest Research Center of State Forestry Administration, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, Anhui (China); School of Life Sciences, University of Science and Technology of China, Hefei 230027, Anhui (China); College of Food and Bioengineering, Henan University of Science and Technology, Luoyang 471023, Henan (China); Mao, Yingji [Key Laboratory of Ion Beam Bioengineering and Bioenergy Forest Research Center of State Forestry Administration, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, Anhui (China); School of Life Sciences, University of Science and Technology of China, Hefei 230027, Anhui (China); Jin, Shan; Hou, Jinyan; Du, Hua [Key Laboratory of Ion Beam Bioengineering and Bioenergy Forest Research Center of State Forestry Administration, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, Anhui (China); Yang, Minglei, E-mail: yml888@mail.ustc.edu.cn [Key Laboratory of Ion Beam Bioengineering and Bioenergy Forest Research Center of State Forestry Administration, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, Anhui (China); Wu, Lifang, E-mail: lfwu@ipp.ac.cn [Key Laboratory of Ion Beam Bioengineering and Bioenergy Forest Research Center of State Forestry Administration, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, Anhui (China); School of Life Sciences, University of Science and Technology of China, Hefei 230027, Anhui (China)

2015-08-07

Ribosome-inactivating proteins (RIPs) are N-glycosidases (EC3.2.2.22) that universally inactivate the ribosome, thereby inhibiting protein biosynthesis. In this study, a novel type I RIPs named SEBIN was identified in Sapium sebiferum. Nuclear acid depurine experiment showed that SEBIN had rRNA N-Glycosidase activity. Further experiment indicated that SEBIN significantly inhibited Caenorhabditis elegans development as well as resulted in worm cell apoptosis. This is the first report to evaluate RIPs toxicity using C. elegans. We proposed that SEBIN may impaire C. elegans reproduction in a DNA-damage manner besides traditional protein synthesis inhibition approach. The predicted 3D structure was modeled using threading and ab initio modeling, and the r-RNA binding residue of SEBIN was identified through the protein-ligand docking approach. It showed the amino acid residues, Glu195, Asn81, Ala82, Tyr83, Glu164, Ser163, Ile159 and Arg167, played critical roles in catalytic process. Our results provided the theoretical foundation of structure–function relationships between enzymatic properties, toxicity and structural characterization of SEBIN. - Graphical abstract: Superposition of main chains of ricin (cyan) and SEBIN (brown), and adenine binding site residues of SEBIN. - Highlights: • A Ribosome-inactivating proteins gene (SEBIN) was isolated from Sapium sebiferum. • SEBIN had DNase activity besides widely reported ribosome inactivation via N-glycosidases activity. • SEBIN significantly inhibited Caenorhabditis elegans development in vivo. • SEBIN may impaire C. elegans reproduction in a DNA-damage manner with the aid of mutant strains hus-1 and clk-2. • The possible active sites between SEBIN and the adenine of rRNA were predicted.

Renal vascular lesions as a marker of poor prognosis in patients with lupus nephritis. Gruppo Italiano per lo Studio della Nefrite Lupica (GISNEL).

Science.gov (United States)

Banfi, G; Bertani, T; Boeri, V; Faraggiana, T; Mazzucco, G; Monga, G; Sacchi, G

1991-08-01

The frequency of renal vascular lesions (RVL) and their relevance in the progression of renal damage were evaluated by the Pathology Group of the "Gruppo Italiano per lo Studio della Nefrite Lupica" (GISNEL). Of 285 patients with lupus nephritis collected from 20 nephrology centers in Italy and classified according to World Health Organization (WHO) criteria, 79 cases (27.7%) with RVL were identified and classified as follows: (1) lupus vasculopathy (n = 27); (2) hemolytic-uremic syndrome/thrombotic thrombocytopenic purpura (HUS/TTP) malignant hypertension-like lesions (n = 24); (3) vasculitis (n = 8); (4) arterio-arteriosclerosis (n = 20). At the time of renal biopsy, patients with RVL had mean serum creatinine levels significantly higher than patients without RVL (201.8 +/- 195.9 mumol/L [2.2 +/- 2.2 mg/dL] v 108.1 +/- 108.0 mumol/L [1.2 +/- 1.2 mg/dL]; P less than 0.01). Hypertension was more frequent in patients with RVL than in those without (68.4% v 30.5%; P less than 0.01). The probability of kidney survival assessed according to the Kaplan-Meier method at 5 and 10 years was, respectively, 74.3% +/- 5.9% and 58.0% +/- 8.9% in patients with RVL, compared with 89.6% +/- 2.7% and 85.9% +/- 3.7% in patients without RVL. However, the two groups did not differ significantly as regards overall survival, the probability of survival at 5 and 10 years being 86.5% +/- 4.5% and 78.8% +/- 6.6% in patients with RVL and 92.2% +/- 2.2% and 83.3% +/- 4.4% in patients without RVL.(ABSTRACT TRUNCATED AT 250 WORDS)

A tool based on Ligation Detection Reaction-Universal Array (LDR-UA) for the characterization of VTEC by identification of virulence-associated and serogroup-specific genes.

Science.gov (United States)

Lauri, Andrea; Castiglioni, Bianca; Morabito, Stefano; Tozzoli, Rosangela; Consolandi, Clarissa; Mariani, Paola

2011-02-01

Verocytoxigenic Escherichia coli (VTEC) are zoonotic pathogens whose natural reservoir is represented by ruminants, particularly cattle. Infections are mainly acquired by consumption of undercooked contaminated food of animal origin, contact with infected animals and contaminated environment. VTEC O157 is the most frequently isolated serogroup from cases of human disease, however, other VTEC serogroups, such as O26, O111, O145 and O103, are increasingly reported as causing Hemolytic Uremic Syndrome (HUS) worldwide. The identification of VTEC is troublesome, hindering the development of effective prevention strategies. In fact, VTEC are morphologically indistinguishable from harmless E. coli and their pathogenic potential is not strictly dependent on the serogroup, but relies on the presence of a collection of virulence genes. We developed a diagnostic tool for VTEC based on the Ligation Detection Reaction coupled to Universal Array (LDR-UA) for the simultaneous identification of virulence factors and serogroup-associated genes. The method includes the investigation of 40 sites located in 13 fragments from 12 genes (sodCF1/F2, adfO, terB, ehxA, eae, vtx1, vtx2, ihp1, wzx, wbdI, rfbE, dnaK) and was evaluated by performing a trial on a collection of 67 E. coli strains, both VTEC and VT-negative E. coli, as well as on 25 isolates belonging to other related species. Results of this study showed that the LDR-UA technique was specific in identifying the target microorganism. Moreover, due to its higher throughput, the LDR-UA can be a valid and cheaper alternative to real time PCR-based (rt-PCR) methods for VTEC identification. Copyright © 2010 Elsevier Ltd. All rights reserved.

Detection of E.Coli Strains Containing Shiga Toxin (Stx1/2 Gene in Diarrheal Specimens from Children Less than 5 Years Old by PCR Technique and Study of the Patterns of Antibiotic Resistance

Directory of Open Access Journals (Sweden)

MR Pourmand

2009-10-01

Full Text Available Introduction: Shiga toxin- producing Escherichia coli (STEC is an emerging bacterial pathogen in developing countries that causes several diseases such as diarrhea, hemorrhagic colitis (HC and hemolytic uremic syndrome (HUS, particularly in children. Aim of the research was detection of STEC in diarrheal specimens from under 5 year olds and study of the patterns of antibiotic resistance of these strains. Methods: In the study,300 fecal samples were collected from children with diarrhea referring to Ali Asghar Hospital. E.coli species were isolated by standard bacteriological and biochemical tests. Presence of shiga toxin genes (stx1/2 was investigated by PCR technique (Qiagen. Antibiogram test for strains containing the toxin gene was performed using 16 different antibiotic discs (MAST by disc diffusion agar (Kirby-Bauer method. Results: From 39 E.coli isolates, 9(23.1% strains were detected by PCR to contain stx1/2 gene. One strain was resistant to all 16 antibiotics. All the STEC strains were sensitive to meropenem (MRP, imipenem (IMI, gentamycin (GEN and nitrofurantoin (NI. 4(44.44% strains showed multi-drug resistant pattern. All these 4strains were resistant to cotrimoxazole(SxT. Also, 6(66.66% strains were resistant to at least one antibiotic. Conclusion: In Iran, shiga toxin- producing Escherichia coli (STEC may be a commonly bacterial pathogen causing diarrhea, particularly in children. Therefore, we should use new techniques for investigation of these strains. Increase in number of emerging and new strains that could be resistant to classic antibiotics such as cotrimoxazole may be foreseen. It is suggested that antibiotics prescription programs in treatment of diarrhea causing E.coli strains be updated.

Identification, characterization and structure analysis of a type I ribosome-inactivating protein from Sapium sebiferum (Euphorbiaceae)

International Nuclear Information System (INIS)

Wu, Ying; Mao, Yingji; Jin, Shan; Hou, Jinyan; Du, Hua; Yang, Minglei; Wu, Lifang

2015-01-01

Ribosome-inactivating proteins (RIPs) are N-glycosidases (EC3.2.2.22) that universally inactivate the ribosome, thereby inhibiting protein biosynthesis. In this study, a novel type I RIPs named SEBIN was identified in Sapium sebiferum. Nuclear acid depurine experiment showed that SEBIN had rRNA N-Glycosidase activity. Further experiment indicated that SEBIN significantly inhibited Caenorhabditis elegans development as well as resulted in worm cell apoptosis. This is the first report to evaluate RIPs toxicity using C. elegans. We proposed that SEBIN may impaire C. elegans reproduction in a DNA-damage manner besides traditional protein synthesis inhibition approach. The predicted 3D structure was modeled using threading and ab initio modeling, and the r-RNA binding residue of SEBIN was identified through the protein-ligand docking approach. It showed the amino acid residues, Glu195, Asn81, Ala82, Tyr83, Glu164, Ser163, Ile159 and Arg167, played critical roles in catalytic process. Our results provided the theoretical foundation of structure–function relationships between enzymatic properties, toxicity and structural characterization of SEBIN. - Graphical abstract: Superposition of main chains of ricin (cyan) and SEBIN (brown), and adenine binding site residues of SEBIN. - Highlights: • A Ribosome-inactivating proteins gene (SEBIN) was isolated from Sapium sebiferum. • SEBIN had DNase activity besides widely reported ribosome inactivation via N-glycosidases activity. • SEBIN significantly inhibited Caenorhabditis elegans development in vivo. • SEBIN may impaire C. elegans reproduction in a DNA-damage manner with the aid of mutant strains hus-1 and clk-2. • The possible active sites between SEBIN and the adenine of rRNA were predicted

Detection of Shiga toxin-producing Escherichia coli by sandwich enzyme-linked immunosorbent assay using chicken egg yolk IgY antibodies

Science.gov (United States)

Parma, Y. R.; Chacana, P. A.; Lucchesi, P. M. A.; Rogé, A.; Granobles Velandia, C. V.; Krüger, A.; Parma, A. E.; Fernández-Miyakawa, M. E.

2012-01-01

Enterohemorrhagic Escherichia coli (EHEC), a subset of Shiga toxin producing E. coli (STEC) is associated with a spectrum of diseases that includes diarrhea, hemorrhagic colitis and a life-threatening hemolytic-uremic syndrome (HUS). Regardless of serotype, Shiga toxins (Stx1 and/or Stx2) are uniformly expressed by all EHEC, and so exploitable targets for laboratory diagnosis of these pathogens. In this study, a sandwich ELISA for determination of Shiga toxin (Stx) was developed using anti-Stx2B subunit antibodies and its performance was compared with that of the Vero cell assay and a commercial immunoassay kit. Chicken IgY was used as capture antibody and a HRP-conjugated rabbit IgG as the detection antibody. The anti-Stx2B IgY was harvested from eggs laid by hens immunized with a recombinant protein fragment. Several parameters were tested in order to optimize the sandwich ELISA assay, including concentration of antibodies, type and concentration of blocking agent, and incubation temperatures. Supernatants from 42 STEC strains of different serotypes and stx variants, including stx2EDL933, stx2vha, stx2vhb, stx2g, stx1EDL933, and stx1d were tested. All Stx variants were detected by the sandwich ELISA, with a detection limit of 115 ng/ml Stx2. Twenty three strains negative for stx genes, including different bacteria species, showed no activity in Vero cell assay and produced negative results in ELISA, except for two strains. Our results show that anti-Stx2B IgY sandwich ELISA could be used in routine diagnosis as a rapid, specific and economic method for detection of Shiga toxin-producing E. coli. PMID:22919675

Production of biologically active recombinant human factor H in Physcomitrella.

Science.gov (United States)

Büttner-Mainik, Annette; Parsons, Juliana; Jérôme, Hanna; Hartmann, Andrea; Lamer, Stephanie; Schaaf, Andreas; Schlosser, Andreas; Zipfel, Peter F; Reski, Ralf; Decker, Eva L

2011-04-01

The human complement regulatory serum protein factor H (FH) is a promising future biopharmaceutical. Defects in the gene encoding FH are associated with human diseases like severe kidney and retinal disorders in the form of atypical haemolytic uremic syndrome (aHUS), membranoproliferative glomerulonephritis II (MPGN II) or age-related macular degeneration (AMD). There is a current need to apply intact full-length FH for the therapy of patients with congenital or acquired defects of this protein. Application of purified or recombinant FH (rFH) to these patients is an important and promising approach for the treatment of these diseases. However, neither protein purified from plasma of healthy individuals nor recombinant protein is currently available on the market. Here, we report the first stable expression of the full-length human FH cDNA and the subsequent production of this glycoprotein in a plant system. The moss Physcomitrella patens perfectly suits the requirements for the production of complex biopharmaceuticals as this eukaryotic system not only offers an outstanding genetical accessibility, but moreover, proteins can be produced safely in scalable photobioreactors without the need for animal-derived medium compounds. Transgenic moss lines were created, which express the human FH cDNA and target the recombinant protein to the culture supernatant via a moss-derived secretion signal. Correct processing of the signal peptide and integrity of the moss-produced rFH were verified via peptide mapping by mass spectrometry. Ultimately, we show that the rFH displays complement regulatory activity comparable to FH purified from plasma. © 2010 The Authors. Plant Biotechnology Journal © 2010 Society for Experimental Biology, Association of Applied Biologists and Blackwell Publishing Ltd.

Escherichia coli O157:H7 outbreak associated with consumption of ground beef, June-July 2002.

Science.gov (United States)

Vogt, Richard L; Dippold, Laura

2005-01-01

A case-control and environmental study tested the hypothesis that purchasing and eating ground beef from a specific source was the cause of a cluster of cases of hemolytic uremic syndrome (HUS) and Escherichia coli (E. coli) O157:H7 gastroenteritis. A case-control study comparing risk factors was conducted over the telephone on nine case-patients with 23 selected controls. An environmental investigation was conducted that consisted of reviewing beef handling practices at a specific local supermarket and obtaining ground beef samples from the store and two households with case-patients. The analysis of the case-control study showed that eight case-patients (89%) purchased ground beef at Grocery Chain A compared with four controls who did not develop illness (17%) (matched odds ratio=undefined; 95% confidence interval 2.8, infinity; p=0.006). The environmental investigation showed that Grocery Chain A received meat from Meatpacker A. Laboratory analysis of meat samples from Meatpacker A and Grocery Chain A and stool samples from some patients recovered an identical strain of E. coli O157:H7 according to pulse-field gel electrophoresis. Both the case-control and environmental studies showed that purchasing ground beef at Grocery Chain A, which received ground beef from Meatpacker A, was the major risk factor for illness in eight case-patients; the ninth case-patient was found to be unrelated to the outbreak. Furthermore, meat from Meatpacker A was associated with a nationwide outbreak of E. coli O157:H7 illness that resulted in the second largest recall of beef in U.S. history at the time.

[EHEC carriage in ruminants and probiotic effects].

Science.gov (United States)

Forano, Evelyne; Chaucheyras-Durand, Frédérique; Bertin, Yolande; Martin, Christine

2013-01-01

Enterohaemorrhagic Escherichia coli (EHEC) are Shiga-Toxin producing E. coli (STEC) that cause human outbreaks which can lead to a severe illness such as haemolytic-uraemic syndrome (HUS), particularly in young children. The gastrointestinal tract of cattle and other ruminants is the principal reservoir of EHEC strains and outbreaks have been associated with direct contact with the farm environment, and with the consumption of meat, dairy products, water and fruit or vegetable contaminated with ruminant manure. Several outbreaks occurred these last years in France. In Brazil, although STEC carriage in ruminants is important, human cases due to EHEC are fairly rare. In order to reduce EHEC survival in the ruminant gastrointestinal tract and thus limit contamination of food products, it is necessary to determine the mechanisms underlying EHEC persistence in this ecosystem with the aim of developing nutritional or ecological strategies. The effect of probiotics has been tested in vitro on the growth and survival of EHEC strains and in vivo on the animal carriage of these strains. Various studies have then shown that lactic bacteria or non-pathogenic E. coli strains were able to limit EHEC fecal shedding. In addition, understanding EHEC physiology in the ruminant gut is also critical for limiting EHEC shedding. We found that EHEC O157:H7 is able to use ethanolamine and mucus-derived sugars as nitrogen and carbon sources, respectively. Thus, these substrates represent an ecological niche for EHEC and their utilization confers a competitive growth advantage to these pathogens as they use them more rapidly than the bacteria belonging to the resident intestinal microbiota. Understanding EHEC metabolism and ecology in the bovine intestinal tract will allow proposing probiotic strains to compete with EHEC for nutrients and thus decrease the sanitary risk. © Société de Biologie, 2014.

A study on a pedicle-screw-based reduction method for artificially reduced artifacts

Science.gov (United States)

Kim, Hyun-Ju; Lee, Hae-Kag; Cho, Jae-Hwan

2017-09-01

The purpose of this study is a quantitative analysis of the degree of the reduction of the artifacts that are induced by pedicle screws through the application of the recently developed iterative metallic artifact reduction (I MAR) software. Screw-type implants that are composed of 4.5 g/cm3 titanium (Ti) with an approximate average computed tomography (CT) value of 6500 Hounsfield units (HUs) that are used for the treatment of spinal diseases were placed in paraffin, a tissueequivalent material, and then dried. After the insertion, the scanning conditions were fixed as 120 kVp and 250 mA using multidetector computed tomography (MDCT) (Enlarge, Siemens, Germany). The slice thickness and the increment were set at the fields of view (FOVs) of 3 mm and 120 mm, respectively; the pitch is 0.8; the rotation time is 1 s; and the I MAR software was applied to the raw data of the acquired images to compare the CT-value changes of the posterior images. When the I MAR software was applied to animal vertebrae, it was possible to reduce the 65.7% image loss of the black-hole-effect image through the application of the I MAR software. When the I MAR image loss (%) was compared with the white-streak-effect image, the high-intensity image type with the white-streak effect could be reduced by 91.34% through the application of the I MAR software. In conclusion, a metal artifact that is due to a high-density material can be reduced more effectively when the I MAR algorithm is applied compared with that from the application of the conventional MAR algorithm. The I MAR can provide information on the various tissues that form around the artifact and the reduced metal structures, which can be helpful for radiologists and clinicians in their determination of an accurate diagnosis.

Genetic variation in PNPLA3 (adiponutrin) confers sensitivity to weight loss-induced decrease in liver fat in humans.

Science.gov (United States)

Sevastianova, Ksenia; Kotronen, Anna; Gastaldelli, Amalia; Perttilä, Julia; Hakkarainen, Antti; Lundbom, Jesper; Suojanen, Laura; Orho-Melander, Marju; Lundbom, Nina; Ferrannini, Eleuterio; Rissanen, Aila; Olkkonen, Vesa M; Yki-Järvinen, Hannele

2011-07-01

The rs738409 C→G single nucleotide polymorphism in the patatin-like phospholipase domain-containing 3 (PNPLA3; adiponutrin) leads to a missense mutation (I148M), which is associated with increased liver fat but not insulin resistance. The I148M mutation impedes triglyceride hydrolysis in vitro, and its carriers have an increased risk of developing severe liver disease. We explored whether the rs738409 PNPLA3 G allele influences the ability of weight loss to decrease liver fat or change insulin sensitivity. We recruited 8 subjects who were homozygous for the rs738409 PNPLA3 G allele (PNPLA3-148MM) and 10 who were homozygous for the rs738409 PNPLA3 C allele (PNPLA3-148II). To allow comparison of changes in liver fat, the groups were matched with respect to baseline age, sex, body mass index, and liver fat. The subjects were placed on a hypocaloric low-carbohydrate diet for 6 d. Liver fat content (proton magnetic resonance spectroscopy), whole-body insulin sensitivity of glucose metabolism (euglycemic clamp technique), and lipolysis ([(2)H(5)]glycerol infusion) were measured before and after the diet. At baseline, fasting serum insulin and C-peptide concentrations were significantly lower in the PNPLA3-148MM group than in the PNPLA3-148II group, as predicted by study design. Weight loss was not significantly different between groups (PNPLA3-148MM: -3.1 ± 0.5 kg; PNPLA3-148II: -3.1 ± 0.4 kg). Liver fat decreased by 45% in the PNPLA3-148MM group (P loss is effective in decreasing liver fat in subjects who are homozygous for the rs738409 PNPLA3 G or C allele. This trial was registered at www.hus.fi as 233775.

Effect of short-term carbohydrate overfeeding and long-term weight loss on liver fat in overweight humans.

Science.gov (United States)

Sevastianova, Ksenia; Santos, Alexandre; Kotronen, Anna; Hakkarainen, Antti; Makkonen, Janne; Silander, Kaisa; Peltonen, Markku; Romeo, Stefano; Lundbom, Jesper; Lundbom, Nina; Olkkonen, Vesa M; Gylling, Helena; Fielding, Barbara A; Rissanen, Aila; Yki-Järvinen, Hannele

2012-10-01

Cross-sectional studies have identified a high intake of simple sugars as an important dietary factor predicting nonalcoholic fatty liver disease (NAFLD). We examined whether overfeeding overweight subjects with simple sugars increases liver fat and de novo lipogenesis (DNL) and whether this is reversible by weight loss. Sixteen subjects [BMI (kg/m²): 30.6 ± 1.2] were placed on a hypercaloric diet (>1000 kcal simple carbohydrates/d) for 3 wk and, thereafter, on a hypocaloric diet for 6 mo. The subjects were genotyped for rs739409 in the PNPLA3 gene. Before and after overfeeding and after hypocaloric diet, metabolic variables and liver fat (measured by proton magnetic resonance spectroscopy) were measured. The ratio of palmitate (16:0) to linoleate (18:2n-6) in serum and VLDL triglycerides was used as an index of DNL. Carbohydrate overfeeding increased weight (±SEM) by 2% (1.8 ± 0.3 kg; P fat by 27% from 9.2 ± 1.9% to 11.7 ± 1.9% (P = 0.005). DNL increased in proportion to the increase in liver fat and serum triglycerides in subjects with PNPLA3-148IIbut not PNPLA3-148MM. During the hypocaloric diet, the subjects lost 4% of their weight (3.2 ± 0.6 kg; P fat content (from 11.7 ± 1.9% to 8.8 ± 1.8%; P Carbohydrate overfeeding for 3 wk induced a >10-fold greater relative change in liver fat (27%) than in body weight (2%). The increase in liver fat was proportional to that in DNL. Weight loss restores liver fat to normal. These data indicate that the human fatty liver avidly accumulates fat during carbohydrate overfeeding and support a role for DNL in the pathogenesis of NAFLD. This trial was registered at www.hus.fi as 235780.

Subperiosteal Drainage versus Subdural Drainage in the management of Chronic Subdural Hematoma (A Comparative Study).

Science.gov (United States)

Chih, Adrian Ng Wei; Hieng, Albert Wong Sii; Rahman, Noor Azman A; Abdullah, Jafri Malin

2017-03-01

Symptomatic chronic subdural hematomas (CSDH) remain one of the most frequent diagnoses in current neurosurgical practice. Burr-hole craniostomy with irrigation and placement of close-system drainage is the current recommended surgery for symptomatic CSDH. The aim of this study is to perform a direct comparison between two surgical techniques in the treatment of symptomatic CSDH, which have been proven in previous studies to be efficient. Our main objective was to compare the efficacy of placement of a subperiosteal drain (SPD) and a subdural drain (SDD) following single burr-hole craniostomy and irrigation, and to demonstrate any significant differences in terms of overall surgical complications, functional outcome at three months and mortality rate. The study was carried out in two local neurosurgical centres. The SPD group was performed in Hospital Umum Sarawak (HUS) and the SDD group was performed in Hospital Sultanah Aminah Johor Bahru (HSAJB), from 1 January 2012 till 30 January 2014 with a total of 30 patients in both treatment groups. Overall, there were no statistically significant difference in terms of patient general characteristics, pre-operative and post-operative symptoms, Markwalder grades, post-operative hematoma volume and recurrence, mortality and functional outcome at discharge and at three month follow-up between both groups. Albeit not achieving statistical significance, we observed a lower rate of surgical complication especially for post-operative intracranial hematoma with placement of the SPD system. Our study concludes that both treatment methods proved to be highly effective in the treatment of CSDH. However, with a lower overall surgical complication rate, treatment with single burr-hole craniostomy, irrigation and placement of the SPD system can be considered a treatment of choice for the management of symptomatic CSDH.

Ex vivo validation of a stoichiometric dual energy CT proton stopping power ratio calibration

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Xie, Yunhe; Ainsley, Christopher; Yin, Lingshu; Zou, Wei; McDonough, James; Solberg, Timothy D.; Lin, Alexander; Teo, Boon-Keng Kevin

2018-03-01

A major source of uncertainty in proton therapy is the conversion of Hounsfield unit (HU) to proton stopping power ratio relative to water (SPR). In this study, we measured and quantified the accuracy of a stoichiometric dual energy CT (DECT) SPR calibration. We applied a stoichiometric DECT calibration method to derive the SPR using CT images acquired sequentially at 80 kVp and 140 kVp . The dual energy index was derived based on the HUs of the paired spectral images and used to calculate the effective atomic number (Z eff), relative electron density ({{ρ }e} ), and SPRs of phantom and biological materials. Two methods were used to verify the derived SPRs. The first method measured the sample’s water equivalent thicknesses to deduce the SPRs using a multi-layer ion chamber (MLIC) device. The second method utilized Gafchromic EBT3 film to directly compare relative ranges between sample and water after proton pencil beam irradiation. Ex vivo validation was performed using five different types of frozen animal tissues with the MLIC and three types of fresh animal tissues using film. In addition, the residual ranges recorded on the film were used to compare with those from the treatment planning system using both DECT and SECT derived SPRs. Bland-Altman analysis indicates that the differences between DECT and SPR measurement of tissue surrogates, frozen and fresh animal tissues has a mean of 0.07% and standard deviation of 0.58% compared to 0.55% and 1.94% respectively for single energy CT (SECT) and SPR measurement. Our ex vivo study indicates that the stoichiometric DECT SPR calibration method has the potential to be more accurate than SECT calibration under ideal conditions although beam hardening effects and other image artifacts may increase this uncertainty.

Lessons learned from a textbook outbreak: EHEC-O157:H7 infections associated with the consumption of raw meat products, June 2012, Limburg, Belgium.

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Braeye, Toon; Denayer, Sarah; De Rauw, Klara; Forier, Anmarie; Verluyten, Jurgen; Fourie, Ludo; Dierick, Katelijne; Botteldoorn, Nadine; Quoilin, Sophie; Cosse, Pascale; Noyen, Jeannine; Pierard, Denis

2014-01-01

On 5 June 2012 several enterohemorrhagic Escherichia coli, EHEC, O157:H7 infections were reported to the public health authorities of Limburg. We performed a case-control study, a trace back/forward investigation and compared strains isolated from human cases and food samples. A case was defined as anyone with a laboratory-confirmed E. coli O157:H7-infection in North-East Limburg from May 30 2012 till July 15 2012. Family members with bloody diarrhea were also included as cases. E. coli O157 was isolated by culture and the presence of the virulence genes was verified using (q)PCR. Isolates were genotyped and compared by Pulsed Field Gel Electrophoresis (PFGE) and insertion sequence 629-printing (IS629-printing). The outbreak involved 24 cases, of which 17 were laboratory-confirmed. Five cases developed Hemolytic Uremic Syndrome (HUS) and fifteen were hospitalized. Cases reported a significantly higher consumption of "steak tartare", a raw meat product (OR 48.12; 95% CI; 5.62- 416.01). Cases were also more likely to buy meat-products at certain butcheries (OR 11.67; 95% CI; 1.41 - 96.49). PFGE and IS629-printing demonstrated that the vtx1a vtx2a eae ehxA positive EHEC O157:H7 strains isolated from three meat products and all seventeen human stool samples were identical. In a slaughterhouse, identified by the trace-back investigation, a carcass infected with a different EHEC strain was found and confiscated. We present a well described and effectively investigated foodborne outbreak associated with meat products. Our main recommendations are the facilitation and acceleration of the outbreak detection and the development of a communication plan to reaches all persons at risk. Foodborne diseases, Shiga-toxigenic Escherichia coli, Enterohemorrhagic Escherichia coli, Meat products, Case control studies, Electrophoresis, Gel, Pulsed-Field.

When whole-genome alignments just won't work: kSNP v2 software for alignment-free SNP discovery and phylogenetics of hundreds of microbial genomes.

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Gardner, Shea N; Hall, Barry G

2013-01-01

Effective use of rapid and inexpensive whole genome sequencing for microbes requires fast, memory efficient bioinformatics tools for sequence comparison. The kSNP v2 software finds single nucleotide polymorphisms (SNPs) in whole genome data. kSNP v2 has numerous improvements over kSNP v1 including SNP gene annotation; better scaling for draft genomes available as assembled contigs or raw, unassembled reads; a tool to identify the optimal value of k; distribution of packages of executables for Linux and Mac OS X for ease of installation and user-friendly use; and a detailed User Guide. SNP discovery is based on k-mer analysis, and requires no multiple sequence alignment or the selection of a single reference genome. Most target sets with hundreds of genomes complete in minutes to hours. SNP phylogenies are built by maximum likelihood, parsimony, and distance, based on all SNPs, only core SNPs, or SNPs present in some intermediate user-specified fraction of targets. The SNP-based trees that result are consistent with known taxonomy. kSNP v2 can handle many gigabases of sequence in a single run, and if one or more annotated genomes are included in the target set, SNPs are annotated with protein coding and other information (UTRs, etc.) from Genbank file(s). We demonstrate application of kSNP v2 on sets of viral and bacterial genomes, and discuss in detail analysis of a set of 68 finished E. coli and Shigella genomes and a set of the same genomes to which have been added 47 assemblies and four "raw read" genomes of H104:H4 strains from the recent European E. coli outbreak that resulted in both bloody diarrhea and hemolytic uremic syndrome (HUS), and caused at least 50 deaths.

Shiga toxin-producing Escherichia coli (STEC) O22:H8 isolated from cattle reduces E. coli O157:H7 adherence in vitro and in vivo.

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Martorelli, L; Albanese, A; Vilte, D; Cantet, R; Bentancor, A; Zolezzi, G; Chinen, I; Ibarra, C; Rivas, M; Mercado, E C; Cataldi, A

2017-09-01

Shiga toxin-producing Escherichia coli (STEC) are a group of bacteria responsible for food-associated diseases. Clinical features include a wide range of symptoms such as diarrhea, hemorrhagic colitis and the hemolytic uremic syndrome (HUS), a life-threatening condition. Our group has observed that animals naturally colonized with STEC strains of unknown serotype were not efficiently colonized with E. coli O157:H7 after experimental infection. In order to assess the basis of the interference, three STEC strains were isolated from STEC persistently-colonized healthy cattle from a dairy farm in Buenos Aires, Argentina. The three isolated strains are E. coli O22:H8 and carry the stx1 and stx2d genes. The activatable activity of Stx2d was demonstrated in vitro. The three strains carry the adhesins iha, ehaA and lpf O113 . E. coli O22:H8 formed stronger biofilms in abiotic surface than E. coli O157:H7 (eae+, stx2+) and displayed a more adherent phenotype in vitro towards HeLa cells. Furthermore, when both serotypes were cultured together O22:H8 could reduce O157:H7 adherence in vitro. When calves were intragastrically pre-challenged with 10 8 CFU of a mixture of the three STEC strains and two days later challenged with the same dose of the strain E. coli O157:H7 438/99, the shedding of the pathogen was significantly reduced. These results suggest that E. coli O22:H8, a serotype rarely associated with human illness, might compete with O157:H7 at the bovine recto-anal junction, making non-O157 carrying-calves less susceptible to O157:H7 colonization and shedding of the bacteria to the environment. Copyright © 2017 Elsevier B.V. All rights reserved.

Ekiri syndrome: a report of 13 cases

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Rahbarimanesh AA

2009-02-01

Full Text Available "nBackground: Ekiri syndrome or lethal toxic encephalopathy is a complication of shigellosis with dysentery, hyperpyrexia, seizures, headache and altered level of consiousness, which rapidly progresses to death. These children die at the beginning of the disease (8-48 hours from the beginning of symptoms, from brain edema. However they had no symptoms or signs of sepsis, dehydration, DIC or Hemolytic Uremic Syndrome (HUS. "nMethods: This survey is a case series study of children with Ekiri syndrome in Bahrami hospital from October 1998-2008 presented with loss of consciousness, colitis and high fever shortly after admission. Information about the patients was gathered from the documents according to physical signs and symptoms, lab data of those whom Ekiri syndrome had been diagnosed for them. Studied variables in this assessment were age, sex, fever, convulsions and loss of consciousness. Headache, encephalopathy, dehydration, elevated ICP, colitis, underline disease, stool, blood and CSF cultures. "nResults: The subjects contain 13 cases (10 male, 3 female, averaged 30/5 months of age. All had seizure, elevated ICP, encephalopathy and coma. All of the patients had fever between 39 and 40, averaged 39.5 degree of centigrade. Seven patients had headache and three ones was dehydrated. The first presentation symptom in three patients was gastroenteritis, in 9 was siezure and in 1 patient was headache. Stool culture in all patients was positive, but blood culture was positive in only one of them. CSF culture was negative in all of the patients. Mortality was 100%. "nConclusion: Symptoms, signs and presentation of Ekiri syndrome, a rare complication of infection with shigella, in the patients in Bahrami hospital was similar with the other studies beforehand in other countries. In this study, all the patients were died and supportive treatments were ineffective.

The influence of a telehealth project on healthcare professional recruitment and retention in remote areas in Mali: A longitudinal study

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Gisèle Irène Claudine Mbemba

2016-05-01

Full Text Available Objectives: The telehealth project EQUI-ResHuS (in French, Les TIC pour un accès Équitable aux Ressources Humaines en Santé aimed to contribute to more equitable access to care and support practice in remote regions in Mali. This study explored the evolution of perceptions concerning telehealth among healthcare professionals in the four district health centres that participated in the EQUI-ResHus project and identified variables influencing their perceptions of telehealth impact on recruitment and retention of health professionals. Methods: One year after a first survey (T1, a second data collection (T2 was carried out among healthcare professionals using a 91-item questionnaire. Questions assessing telehealth use and perceptions and perceived impact on recruitment and retention of healthcare professionals were rated on a 5-point Likert scale. A total of 10 independent variables were considered for the analyses. A Wilcoxon signed-rank test was performed to detect differences between T1 and T2, and a bivariate linear regression model for repeated measures was carried out to assess the impact of independent variables on dependent variables. Results: There were no noticeable changes in perceptions related to telehealth influence on recruitment and retention. Only access to information and communication technology significantly differed between T1 and T2 according the Wilcoxon rank test (p = 0.001. Perceived influence of telehealth on recruitment and retention was mostly explained by attitude towards telehealth, perceived effect on recruitment and retention and barriers to recruitment and retention. Conclusion: Based on our results, telehealth was perceived as having a positive influence but mostly indirect influence on healthcare professional recruitment and retention. Also, there were no major changes after 1 year of telehealth use.

Checkpoint responses to replication stalling: inducing tolerance and preventing mutagenesis

Energy Technology Data Exchange (ETDEWEB)

Kai, Mihoko; Wang, Teresa S.-F

2003-11-27

Replication mutants often exhibit a mutator phenotype characterized by point mutations, single base frameshifts, and the deletion or duplication of sequences flanked by homologous repeats. Mutation in genes encoding checkpoint proteins can significantly affect the mutator phenotype. Here, we use fission yeast (Schizosaccharomyces pombe) as a model system to discuss the checkpoint responses to replication perturbations induced by replication mutants. Checkpoint activation induced by a DNA polymerase mutant, aside from delay of mitotic entry, up-regulates the translesion polymerase DinB (Pol{kappa}). Checkpoint Rad9-Rad1-Hus1 (9-1-1) complex, which is loaded onto chromatin by the Rad17-Rfc2-5 checkpoint complex in response to replication perturbation, recruits DinB onto chromatin to generate the point mutations and single nucleotide frameshifts in the replication mutator. This chain of events reveals a novel checkpoint-induced tolerance mechanism that allows cells to cope with replication perturbation, presumably to make possible restarting stalled replication forks. Fission yeast Cds1 kinase plays an essential role in maintaining DNA replication fork stability in the face of DNA damage and replication fork stalling. Cds1 kinase is known to regulate three proteins that are implicated in maintaining replication fork stability: Mus81-Eme1, a hetero-dimeric structure-specific endonuclease complex; Rqh1, a RecQ-family helicase involved in suppressing inappropriate recombination during replication; and Rad60, a protein required for recombinational repair during replication. These Cds1-regulated proteins are thought to cooperatively prevent mutagenesis and maintain replication fork stability in cells under replication stress. These checkpoint-regulated processes allow cells to survive replication perturbation by preventing stalled replication forks from degenerating into deleterious DNA structures resulting in genomic instability and cancer development.

Checkpoint responses to replication stalling: inducing tolerance and preventing mutagenesis

International Nuclear Information System (INIS)

Kai, Mihoko; Wang, Teresa S.-F.

2003-01-01

Replication mutants often exhibit a mutator phenotype characterized by point mutations, single base frameshifts, and the deletion or duplication of sequences flanked by homologous repeats. Mutation in genes encoding checkpoint proteins can significantly affect the mutator phenotype. Here, we use fission yeast (Schizosaccharomyces pombe) as a model system to discuss the checkpoint responses to replication perturbations induced by replication mutants. Checkpoint activation induced by a DNA polymerase mutant, aside from delay of mitotic entry, up-regulates the translesion polymerase DinB (Polκ). Checkpoint Rad9-Rad1-Hus1 (9-1-1) complex, which is loaded onto chromatin by the Rad17-Rfc2-5 checkpoint complex in response to replication perturbation, recruits DinB onto chromatin to generate the point mutations and single nucleotide frameshifts in the replication mutator. This chain of events reveals a novel checkpoint-induced tolerance mechanism that allows cells to cope with replication perturbation, presumably to make possible restarting stalled replication forks. Fission yeast Cds1 kinase plays an essential role in maintaining DNA replication fork stability in the face of DNA damage and replication fork stalling. Cds1 kinase is known to regulate three proteins that are implicated in maintaining replication fork stability: Mus81-Eme1, a hetero-dimeric structure-specific endonuclease complex; Rqh1, a RecQ-family helicase involved in suppressing inappropriate recombination during replication; and Rad60, a protein required for recombinational repair during replication. These Cds1-regulated proteins are thought to cooperatively prevent mutagenesis and maintain replication fork stability in cells under replication stress. These checkpoint-regulated processes allow cells to survive replication perturbation by preventing stalled replication forks from degenerating into deleterious DNA structures resulting in genomic instability and cancer development

Role of climate in the spread of shiga toxin-producing Escherichia coli infection among children

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Acquaotta, Fiorella; Ardissino, Gianluigi; Fratianni, Simona; Perrone, Michela

2017-09-01

Haemolytic-uraemic syndrome (HUS) is a rare disease mainly affecting children that develops as a complication of shiga toxin-producing Escherichia coli (STEC) infection. It is characterised by acute kidney injury, platelet consumption and mechanical destruction of red blood cells (haemolysis). In order to test the working hypothesis that the spread of the infection is influenced by specific climatic conditions, we analysed all of the identified cases of infection occurring between June 2010 and December 2013 in four provinces of Lombardy, Italy (Milano, Monza Brianza, Varese and Brescia), in which a STEC surveillance system has been developed as part of a preventive programme. In the selected provinces, we recorded in few days a great number of cases and clusters which are unrelated for spatially distant or for the disease are caused by different STEC serotypes. In order to investigate a common factor that favoured the onset of infection, we have analysed in detail the weather conditions of the areas. The daily series of temperature, rain and relative humidity were studied to show the common climate peculiarities whilst the correlation coefficient and the principal component analysis (PCA) were used to point out the meteorological variable, maximum temperature, as the principal climate element in the onset of the infection. The use of distributed lag non-linear models (DLNM) and the climate indices characterising heat waves (HWs) has allowed to identify the weather conditions associated with STEC infection. The study highlighted a close temporal correlation between STEC infection in children and the number, duration and frequency of heat waves. In particular, if the maximum temperature is greater than 90th percentile, days classified as very hot, for 3 or more consecutive days, the risk of infection is increasing.

Protection against Shiga-Toxigenic Escherichia coli by Non-Genetically Modified Organism Receptor Mimic Bacterial Ghosts.

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Paton, Adrienne W; Chen, Austen Y; Wang, Hui; McAllister, Lauren J; Höggerl, Florian; Mayr, Ulrike Beate; Shewell, Lucy K; Jennings, Michael P; Morona, Renato; Lubitz, Werner; Paton, James C

2015-09-01

Shiga-toxigenic Escherichia coli (STEC) causes severe gastrointestinal infections in humans that may lead to life-threatening systemic sequelae, such as the hemolytic uremic syndrome (HUS). Rapid diagnosis of STEC infection early in the course of disease opens a window of opportunity for therapeutic intervention, for example, by administration of agents that neutralize Shiga toxin (Stx) in the gut lumen. We previously developed a recombinant bacterium that expresses a mimic of the Stx receptor globotriaosyl ceramide (Gb3) on its surface through modification of the lipopolysaccharide (A. W. Paton, R. Morona, and J. C. Paton, Nat Med 6:265-270, 2000, http://dx.doi.org/10.1038/73111). This construct was highly efficacious in vivo, protecting mice from otherwise fatal STEC disease, but the fact that it is a genetically modified organism (GMO) has been a barrier to clinical development. In the present study, we have overcome this issue by development of Gb3 receptor mimic bacterial ghosts (BGs) that are not classified as GMOs. Gb3-BGs neutralized Stx1 and Stx2 in vitro with high efficiency, whereas alternative Gb3-expressing non-GMO subbacterial particles (minicells and outer membrane blebs) were ineffective. Gb3-BGs were highly efficacious in a murine model of STEC disease. All mice (10/10) treated with Gb3-BGs survived challenge with a highly virulent O113:H21 STEC strain and showed no pathological signs of renal injury. In contrast, 6/10 mice treated with control BGs succumbed to STEC challenge, and survivors exhibited significant weight loss, neutrophilia, and histopathological evidence of renal damage. Thus, Gb3-BGs offer a non-GMO approach to treatment of STEC infection in humans, particularly in an outbreak setting. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

A two-stage genome-wide association study of sporadic amyotrophic lateral sclerosis.

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Chiò, Adriano; Schymick, Jennifer C; Restagno, Gabriella; Scholz, Sonja W; Lombardo, Federica; Lai, Shiao-Lin; Mora, Gabriele; Fung, Hon-Chung; Britton, Angela; Arepalli, Sampath; Gibbs, J Raphael; Nalls, Michael; Berger, Stephen; Kwee, Lydia Coulter; Oddone, Eugene Z; Ding, Jinhui; Crews, Cynthia; Rafferty, Ian; Washecka, Nicole; Hernandez, Dena; Ferrucci, Luigi; Bandinelli, Stefania; Guralnik, Jack; Macciardi, Fabio; Torri, Federica; Lupoli, Sara; Chanock, Stephen J; Thomas, Gilles; Hunter, David J; Gieger, Christian; Wichmann, H Erich; Calvo, Andrea; Mutani, Roberto; Battistini, Stefania; Giannini, Fabio; Caponnetto, Claudia; Mancardi, Giovanni Luigi; La Bella, Vincenzo; Valentino, Francesca; Monsurrò, Maria Rosaria; Tedeschi, Gioacchino; Marinou, Kalliopi; Sabatelli, Mario; Conte, Amelia; Mandrioli, Jessica; Sola, Patrizia; Salvi, Fabrizio; Bartolomei, Ilaria; Siciliano, Gabriele; Carlesi, Cecilia; Orrell, Richard W; Talbot, Kevin; Simmons, Zachary; Connor, James; Pioro, Erik P; Dunkley, Travis; Stephan, Dietrich A; Kasperaviciute, Dalia; Fisher, Elizabeth M; Jabonka, Sibylle; Sendtner, Michael; Beck, Marcus; Bruijn, Lucie; Rothstein, Jeffrey; Schmidt, Silke; Singleton, Andrew; Hardy, John; Traynor, Bryan J

2009-04-15

The cause of sporadic amyotrophic lateral sclerosis (ALS) is largely unknown, but genetic factors are thought to play a significant role in determining susceptibility to motor neuron degeneration. To identify genetic variants altering risk of ALS, we undertook a two-stage genome-wide association study (GWAS): we followed our initial GWAS of 545 066 SNPs in 553 individuals with ALS and 2338 controls by testing the 7600 most associated SNPs from the first stage in three independent cohorts consisting of 2160 cases and 3008 controls. None of the SNPs selected for replication exceeded the Bonferroni threshold for significance. The two most significantly associated SNPs, rs2708909 and rs2708851 [odds ratio (OR) = 1.17 and 1.18, and P-values = 6.98 x 10(-7) and 1.16 x 10(-6)], were located on chromosome 7p13.3 within a 175 kb linkage disequilibrium block containing the SUNC1, HUS1 and C7orf57 genes. These associations did not achieve genome-wide significance in the original cohort and failed to replicate in an additional independent cohort of 989 US cases and 327 controls (OR = 1.18 and 1.19, P-values = 0.08 and 0.06, respectively). Thus, we chose to cautiously interpret our data as hypothesis-generating requiring additional confirmation, especially as all previously reported loci for ALS have failed to replicate successfully. Indeed, the three loci (FGGY, ITPR2 and DPP6) identified in previous GWAS of sporadic ALS were not significantly associated with disease in our study. Our findings suggest that ALS is more genetically and clinically heterogeneous than previously recognized. Genotype data from our study have been made available online to facilitate such future endeavors.

GROWTH RATE AND IDENTIFICATION OF YEASTS IN THREE DIFFERENT MEDIA: FLOUR, SPROUT OF CEREALS AND COMMERCIAL MEDIA

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P DEHGHAN

2002-12-01

Full Text Available Introduction. The yeasts are a large group of fungi. In addition to their different uses in food industries and pharmacology they can also cause human and animal infections under predisposing factors. For investigating the yeast"s growth phases and diagnosis of the species, they should culture in media from natural sources like the seeds on the commercial media. According to yeast"s nutritinal requierments and considering the various nutritional materials of seeds like wheat, rice, barney and better use of these seed"s compounds during sprouting, this research was done with the aim of measurment of growth rate and yeasts characterization in such media. Methods. For making seeds media, a fixed quantity of seed"s flour or sprout"s flour was added to a certain amount of agar in acidotic condition (pH=5.8. The germination of seeds was done by Hus method and for colony counting Mc, Farland tubes were used and microscopic and macroscopic characteristics were investigated and compared in both synthetic and seed media Results. The results showed that the rate of yeasts growth in all germinated seeds was more than the seeds themeselves. Statistical analysis showed no significal difference between the growth rate of yeasts in both wheat and barney sprout compared to the commercial media. In the microscopic studies, the species of Candida albicans in wheat flour has produced more chlamydoconidia than the synthetic medium of corn meal agar. Also production of the capsule in C.neoformans in the seed"s media has been better than the synthetic media. Discussion. According to the promising results obtained from the present study regard to the growth rate and differentiation of the fungal species in such media, standardization and mass production of them in our country would seem to be an productive step towards self sufficiency.

SU-E-J-136: Investigation Into Robustness of Stopping Power Calculated by DECT and SECT for Proton Therapy Treatment Planning

Energy Technology Data Exchange (ETDEWEB)

Zhu, J [University of Adelaide, Adelaide, SA (Australia); Penfold, S [University of Adelaide, Adelaide, SA (Australia); Royal Adelaide Hospital, Adelaide, SA (Australia)

2015-06-15

Purpose: To investigate the robustness of dual energy CT (DECT) and single energy CT (SECT) proton stopping power calibration techniques and quantify the associated errors when imaging a phantom differing in chemical composition to that used during stopping power calibration. Methods: The CIRS tissue substitute phantom was scanned in a CT-simulator at 90kV and 140kV. This image set was used to generate a DECT proton SPR calibration based on a relationship between effective atomic number and mean excitation energy. A SECT proton SPR calibration based only on Hounsfield units (HUs) was also generated. DECT and SECT scans of a second phantom of known density and chemical composition were performed. The SPR of the second phantom was calculated with the DECT approach (SPR-DECT),the SECT approach (SPR-SECT) and finally the known density and chemical composition of the phantom (SPR-ref). The DECT and SECT image sets were imported into the Pinnacle{sup 3} research release of proton therapy treatment planning. The difference in dose when exposed to a common pencil beam distribution was investigated. Results: SPR-DECT was found to be in better agreement with SPR-ref than SPR- SECT. The mean difference in SPR for all materials was 0.51% for DECT and 6.89% for SECT. With the exception of Teflon, SPR-DECT was found to agree with SPR-ref to within 1%. Significant differences in calculated dose were found when using the DECT image set or the SECT image set. Conclusion: The DECT calibration technique was found to be more robust to situations in which the physical properties of the test materials differed from the materials used during SPR calibration. Furthermore, it was demonstrated that the DECT and SECT SPR calibration techniques can Result in significantly different calculated dose distributions.

Acute kidney injury in pregnancy-specific disorders

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J Prakash

2017-01-01

Full Text Available The incidence of acute kidney injury in pregnancy (P-AKI has declined significantly over the last three decades in developing countries. However, it is still associated with significant fetomaternal mortality and morbidity. The diagnosis of P-AKI is based on the serum creatinine increase. The usual formulas for estimating glomerular filtration rate (GFR are not validated in this population. The incidence of P-AKI with respect to total AKI cases has decreased in the last three decades from 25% in 1980s to 9% in 2000s at our centre. During the first trimester of gestation, AKI develops most often due to septic abortion or hyperemesis gravidarum. Septic abortion related AKI with respect to total AKI decreased from 9% to 5% in our study. Prevention of unwanted pregnancy and avoidance of septic abortion are keys to eliminate abortion associated AKI in early pregnancy. However, we have not seen AKI on account of hyperemesis gravidarum over a period of 33 years at our center. In the third trimester, the differential diagnosis of AKI in association with pregnancy specific conditions namely preeclampsia/HELLP syndrome, acute fatty liver of pregnancy and thrombotic microangiopathies of pregnancy (P-TMA is more challenging, because these 3 conditions share several clinical features of thrombotic microangiopathy which makes the diagnosis very difficult on clinical grounds. It is imperative to distinguish these conditions to make appropriate therapeutic decisions. Typically, AFLP and HELLP syndrome improve after delivery of the fetus, whereas plasma exchange is the first-line treatment for pregnancy associated thrombotic microangioathies (P-TMA. We observed that preclampsia/eclampsia is the most common cause of AKI in late third trimester and postpartum periods followed by puerperal sepsis and postpartum hemorrhage. Pregnancy-associated thrombotic microangiopathies (aHUS/TTP and AFLP are rare causes of AKI during pregnancy in developing countries.

Acute Kidney Injury in Pregnancy-specific Disorders.

Science.gov (United States)

Prakash, J; Ganiger, V C

2017-01-01

The incidence of acute kidney injury in pregnancy (P-AKI) has declined significantly over the last three decades in developing countries. However, it is still associated with significant fetomaternal mortality and morbidity. The diagnosis of P-AKI is based on the serum creatinine increase. The usual formulas for estimating glomerular filtration rate (GFR) are not validated in this population. The incidence of P-AKI with respect to total AKI cases has decreased in the last three decades from 25% in 1980s to 9% in 2000s at our centre. During the first trimester of gestation, AKI develops most often due to septic abortion or hyperemesis gravidarum. Septic abortion related AKI with respect to total AKI decreased from 9% to 5% in our study. Prevention of unwanted pregnancy and avoidance of septic abortion are keys to eliminate abortion associated AKI in early pregnancy. However, we have not seen AKI on account of hyperemesis gravidarum over a period of 33 years at our center. In the third trimester, the differential diagnosis of AKI in association with pregnancy specific conditions namely preeclampsia/HELLP syndrome, acute fatty liver of pregnancy and thrombotic microangiopathies of pregnancy (P-TMA) is more challenging, because these 3 conditions share several clinical features of thrombotic microangiopathy which makes the diagnosis very difficult on clinical grounds. It is imperative to distinguish these conditions to make appropriate therapeutic decisions. Typically, AFLP and HELLP syndrome improve after delivery of the fetus, whereas plasma exchange is the first-line treatment for pregnancy associated thrombotic microangioathies (P-TMA). We observed that preclampsia/eclampsia is the most common cause of AKI in late third trimester and postpartum periods followed by puerperal sepsis and postpartum hemorrhage. Pregnancy-associated thrombotic microangiopathies (aHUS/TTP) and AFLP are rare causes of AKI during pregnancy in developing countries.

Prevalence, quantification and isolation of pathogenic shiga toxin Escherichia coli O157:H7 along the production and supply chain of pork around Hubei Province of China.

Science.gov (United States)

Khan, Sher Bahadar; Zou, Geng; Xiao, Ran; Cheng, Yuting; Rehman, Zia Ur; Ali, Sher; Memon, Atta Muhammad; Fahad, Shah; Ahmad, Irshad; Zhou, Rui

2018-02-01

Shiga toxin Escherichia coli (STEC) O157:H7 is an important zoonotic food borne pathogen causing gastroenteritis that may lead to life threatening hemorragic colitis (HC) and hemorrhagic uremic syndrome (HUS). 325 meat and tissue samples were tested for enumeration of O157:H7 strains using most probable number (MPN)-PCR targeting their specific genes flicH7 and rfbO157 followed by isolation, sereotyping and pathogenicity testing. The overall prevalence of O157:H7 was 41.3% (134/325) along the production and supply chain of pork (PSCP), being higher in supply chain (59%, 118/200) as compared to pig farms (12.8%, 16/125). Along the PSCP, the highest prevalence was found in slaughter houses (86.25%, 69/80) followed by wet- (53.3%, 32/60) and super-markets (28.3%, 17/60). The MPN values ranged from 3 to 1100 MPN/g in overall positive samples, being higher in slaughter houses followed by wet and super markets. Except from intestine and meat samples of slaughter house, the MPN was found higher in summer as compared to winter samples. Eight STEC O157:H7 isolated from meat and liver samples were tested in Balb/C mice for pathogenicity. After development of clinical signs and symptoms, 50-83.3% mortality was produced in the infected mice. Histopathological investigations revealed visible necrosis of intestinal epithelial cells, shedding of cellular debris in the intestine, while in the kidney, necrosis of renal cortical portion of tubular epithelial cells was observed. STEC O157:H7 is prevalent along PSCP around Hubei of China in different proportions being alarmingly higher in supply chain and markets which is a matter of concern for public health. Copyright © 2017. Published by Elsevier Ltd.

Occurrence of verotoxigenic E.coli in cow feces and antimicrobial resistance of the isolates in cattle farms in Shahrekord area

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Mojtaba Bonyadian

2017-09-01

Full Text Available Introduction:Escherichia coli is a common bacterium in the intestinal microflora of warm-blooded animals. They are routinely shed into the environment through feces and can contaminate water and soil, and, consequently fruits and vegetables .Enterohemorrhagic E. coli strains are recently emerged group of food-borne pathogens that are a significant public health threat. This group causes bloody diarrhea and hemolytic uremic syndrome (HUS, and the disease is prevalent in developed countries. The purpose of this study was to isolate and identify the E.coli O157: H7 and other verotoxigenic ones and major virulence genes (rfbE, eaeA, stx1, stx2 in fecal swab samples by PCR in Shahrekord area. Materials and methods: In Spring and Summer 2015, 400 cow fecal swab samples were collected from farms in Shahrekord area. Bacteriological and biochemical examinations were done for detection of E.coli. PCR assay was done for identification of O157:H7 serotype and other verotoxigenic E. coli using rfbE, eae, stx1 and stx2 genes. Results: E. coli O157:H7 was not detected in any strains tested. But PCR showed that out of 384 E.coli strain, 104(27/08% isolates carried stx1 gene, 36(9/37% carried stx2 gene and 16 (4.16% carried both stx1 and stx2 genes. Intimin (eaeA gene was detected in 280(72/91% of the isolates. Among verotoxigenic strain antibiotic resistance to Tetracycline 87/1%, Ampiciline 51/62%, Cefotaxime 48/38%, Gentamycin 25/81%,, Ciprofeloxacin 3/22% and Sulfamethoxazol 3/22% were observed. Discussion and conclusion: According to the results, although the serotype O157: H7 did not isolate from the feces of cattle but other verotoxigenic strains that showed high resistance  to antibiotic were isolated so it is a risk for human health.

Tousled-like kinase-dependent phosphorylation of Rad9 plays a role in cell cycle progression and G2/M checkpoint exit.

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Ryan Kelly

Full Text Available Genomic integrity is preserved by checkpoints, which act to delay cell cycle progression in the presence of DNA damage or replication stress. The heterotrimeric Rad9-Rad1-Hus1 (9-1-1 complex is a PCNA-like clamp that is loaded onto DNA at structures resulting from damage and is important for initiating and maintaining the checkpoint response. Rad9 possesses a C-terminal tail that is phosphorylated constitutively and in response to cell cycle position and DNA damage. Previous studies have identified tousled-like kinase 1 (TLK1 as a kinase that may modify Rad9. Here we show that Rad9 is phosphorylated in a TLK-dependent manner in vitro and in vivo, and that T355 within the C-terminal tail is the primary targeted residue. Phosphorylation of Rad9 at T355 is quickly reduced upon exposure to ionizing radiation before returning to baseline later in the damage response. We also show that TLK1 and Rad9 interact constitutively, and that this interaction is enhanced in chromatin-bound Rad9 at later stages of the damage response. Furthermore, we demonstrate via siRNA-mediated depletion that TLK1 is required for progression through S-phase in normally cycling cells, and that cells lacking TLK1 display a prolonged G2/M arrest upon exposure to ionizing radiation, a phenotype that is mimicked by over-expression of a Rad9-T355A mutant. Given that TLK1 has previously been shown to be transiently inactivated upon phosphorylation by Chk1 in response to DNA damage, we propose that TLK1 and Chk1 act in concert to modulate the phosphorylation status of Rad9, which in turn serves to regulate the DNA damage response.

Detection of Shiga toxin-producing Escherichia coli by sandwich enzyme-linked immunosorbent assay using chicken egg yolk IgY antibodies

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Yanil R Parma

2012-06-01

Full Text Available Enterohemorrhagic Escherichia coli (EHEC, a subset of Shiga toxin producing E. coli (STEC is associated with a spectrum of diseases that includes diarrhea, hemorrhagic colitis and a life-threatening hemolytic uremic syndrome (HUS. Regardless of serotype, Shiga toxins (Stx1 and/or Stx2 are uniformly expressed by all EHEC, and so exploitable targets for laboratory diagnosis of these pathogens. In this study, a sandwich ELISA for determination of Shiga toxin (Stx was developed using anti-Stx2 B subunit antibodies and its performance was compared with that of the Vero cell assay and a commercial immunoassay kit. Chicken IgY was used as capture antibody and a HRP-conjugated rabbit IgG as the detection antibody. The anti-Stx2B IgY was harvested from eggs laid by hens immunized with a recombinant protein fragment. Several parameters were tested in order to optimize the sandwich ELISA assay, including concentration of antibodies, type and concentration of blocking agent, and incubation temperatures. Supernatants from 42 STEC strains of different serotypes and stx variants, including stx2EDL933, stx2vha, stx2vhb, stx2g, stx1EDL933 and stx1d were tested. All Stx variants were detected by the sandwich ELISA, with a detection limit of 400 ng /ml Stx2. Twenty three strains negative for stx genes, including different bacteria species, showed no activity in Vero cell assay and produced negative results in ELISA, except for 2 strains. Our results show that anti-Stx2B IgY sandwich ELISA could be used in routine diagnosis as a rapid, specific and economic method for detection of Shiga toxin-producing E. coli.

Ultralow dose dentomaxillofacial CT imaging and iterative reconstruction techniques: variability of Hounsfield units and contrast-to-noise ratio

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Bischel, Alexander; Stratis, Andreas; Kakar, Apoorv; Bosmans, Hilde; Jacobs, Reinhilde; Gassner, Eva-Maria; Puelacher, Wolfgang; Pauwels, Ruben

2016-01-01

Objective: The aim of this study was to evaluate whether application of ultralow dose protocols and iterative reconstruction technology (IRT) influence quantitative Hounsfield units (HUs) and contrast-to-noise ratio (CNR) in dentomaxillofacial CT imaging. Methods: A phantom with inserts of five types of materials was scanned using protocols for (a) a clinical reference for navigated surgery (CT dose index volume 36.58 mGy), (b) low-dose sinus imaging (18.28 mGy) and (c) four ultralow dose imaging (4.14, 2.63, 0.99 and 0.53 mGy). All images were reconstructed using: (i) filtered back projection (FBP); (ii) IRT: adaptive statistical iterative reconstruction-50 (ASIR-50), ASIR-100 and model-based iterative reconstruction (MBIR); and (iii) standard (std) and bone kernel. Mean HU, CNR and average HU error after recalibration were determined. Each combination of protocols was compared using Friedman analysis of variance, followed by Dunn's multiple comparison test. Results: Pearson's sample correlation coefficients were all >0.99. Ultralow dose protocols using FBP showed errors of up to 273 HU. Std kernels had less HU variability than bone kernels. MBIR reduced the error value for the lowest dose protocol to 138 HU and retained the highest relative CNR. ASIR could not demonstrate significant advantages over FBP. Conclusions: Considering a potential dose reduction as low as 1.5% of a std protocol, ultralow dose protocols and IRT should be further tested for clinical dentomaxillofacial CT imaging. Advances in knowledge: HU as a surrogate for bone density may vary significantly in CT ultralow dose imaging. However, use of std kernels and MBIR technology reduce HU error values and may retain the highest CNR. PMID:26859336

SU-E-T-470: Importance of HU-Mass Density Calibration Technique in Proton Pencil Beam Dose Calculation

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Penfold, S; Miller, A [University of Adelaide, Adelaide, SA (Australia)

2015-06-15

Purpose: Stoichiometric calibration of Hounsfield Units (HUs) for conversion to proton relative stopping powers (RStPs) is vital for accurate dose calculation in proton therapy. However proton dose distributions are not only dependent on RStP, but also on relative scattering power (RScP) of patient tissues. RScP is approximated from material density but a stoichiometric calibration of HU-density tables is commonly neglected. The purpose of this work was to quantify the difference in calculated dose of a commercial TPS when using HU-density tables based on tissue substitute materials and stoichiometric calibrated ICRU tissues. Methods: Two HU-density calibration tables were generated based on scans of the CIRS electron density phantom. The first table was based directly on measured HU and manufacturer quoted density of tissue substitute materials. The second was based on the same CT scan of the CIRS phantom followed by a stoichiometric calibration of ICRU44 tissue materials. The research version of Pinnacle{sup 3} proton therapy was used to compute dose in a patient CT data set utilizing both HU-density tables. Results: The two HU-density tables showed significant differences for bone tissues; the difference increasing with increasing HU. Differences in density calibration table translated to a difference in calculated RScP of −2.5% for ICRU skeletal muscle and 9.2% for ICRU femur. Dose-volume histogram analysis of a parallel opposed proton therapy prostate plan showed that the difference in calculated dose was negligible when using the two different HU-density calibration tables. Conclusion: The impact of HU-density calibration technique on proton therapy dose calculation was assessed. While differences were found in the calculated RScP of bony tissues, the difference in dose distribution for realistic treatment scenarios was found to be insignificant.

Štrasburská hus v Kodani: Náčrt pojmu irónie u Sørena Kierkegaarda (Strasbourg goose in Copenhagen: An outline to the concept of irony in Søren Kierkegaard’s work

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Česlav Peter Šajda

2006-09-01

Full Text Available The author of this text makes clear the circumstances of origin, structure, and content of Kierkegaard´ s master dissertation thesis. He analyses understanding of irony, his relation to Socrates and irony in totality of Kierkegaard’s understanding. The conclusion of this text points to irony of Kierkegaard’s destiny.

Synanthropic rodents as possible reservoirs of shigatoxigenic Escherichia coli strains

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Ximena eBlanco Crivelli

2012-11-01

Full Text Available Shigatoxigenic Escherichia coli (STEC strains are worldwide zoonotic pathogen responsible for different cases of human disease including hemolytic uremic syndrome (HUS. Transmission of STEC to humans occurs through the consumption of food and water contaminated by faeces of carriers and by person-to-person contact.The objective of this study was twofold: (a to investigate whether synanthropic rodents are possible reservoirs of STEC in the urban area and (b whether a particular genus out of synanthropic rodent is the principal carrier of STEC.One hundred forty-five rodents were captured in Buenos Aires City. Screening for stx1/stx2 and rfbO157 was done by PCR from the confluence zone. STEC isolates were further characterized with biochemical tests by standard methods. Additional virulence factors (eae, ehxA and saa were also determined by PCR. Forty-one of the rodents were necropsied and sample of kidney and small and large intestine were taken for histopathological diagnosis. The samples sections were stained with hematoxylin-eosin, and observed by light microscopy to evaluate the systemic involvement of these species in natural infections. STEC was isolated from seven out of twenty seven suspect animals at screening. The following genotypes were found in the STEC strains: stx1/stx2/ehxA (1, stx2 (4, stx2/ehxA (1, stx2/ehxA/eae (1. Neither gross nor microscopic lesions compatible with those produced by Shiga toxin were observed in the studied organs of necropsied rodents.The bivariate analysis including the hundred forty-five rodents data showed that the isolation of STEC is associated positively to Rattus genus. This synanthropic species may play a role in the transmissibility of the agent thus being a risk to the susceptible population. Their control should be included specifically in actions to dismiss the contamination of food and water by STEC in the urban area, as additional strategies for epidemiological control.

Natural killer T (NKT cells accelerate Shiga toxin type 2 (Stx2 pathology in mice

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Fumiko eObata

2015-04-01

Full Text Available Shiga toxin-producing Escherichia coli (STEC is a leading cause of childhood renal disease He-molytic Uremic Syndrome (HUS. The involvement of renal cytokines and chemokines is sus-pected to play a critical role in disease progression. In current article, we tested the hypothesis that NKT cells are involved in Stx2-induced pathology in vivo. To address this hypothesis we compared Stx2 toxicity in WT and CD1 knockout (KO mice. In CD1KO mice, which lack nat-ural killer T (NKT cells, Stx2-induced pathologies such as weight loss, renal failure, and death were delayed. In WT mice, Stx2-specific selective increase in urinary albumin occurs in later time points, and this was also delayed in NKT cell deficient mice. NKT cell-associated cytokines such as IL-2, IL-4, IFN-γ and IL-17 were detected in kidney lysates of Stx2-injected WT mice with the peak around 36 h after Stx2 injection. In CD1KO, there was a delay in the kinetics, and increases in these cytokines were observed 60 h post Stx2 injection. These data suggest that NKT cells accelerate Stx2-induced pathology in mouse kidneys. To determine the mechanism by which NKT cells promote Stx2-associated disease, in vitro studies were performed using murine renal cells. We found that murine glomerular endothelial cells and podocytes express functional CD1d molecules and can present exogenous antigen to NKT cells. Moreover, we observed the direct interaction between Stx2 and the receptor Gb3 on the surface of mouse renal cells by 3D STORM-TIRF which provides single molecule imaging. Collectively, these data suggest that Stx2 binds to Gb3 on renal cells and leads to aberrant CD1d-mediated NKT cell activation. Therefore, strategies targeting NKT cells could have a significant impact on Stx2-associated renal pathology in STEC disease.

Natural killer T (NKT) cells accelerate Shiga toxin type 2 (Stx2) pathology in mice.

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Obata, Fumiko; Subrahmanyam, Priyanka B; Vozenilek, Aimee E; Hippler, Lauren M; Jeffers, Tynae; Tongsuk, Methinee; Tiper, Irina; Saha, Progyaparamita; Jandhyala, Dakshina M; Kolling, Glynis L; Latinovic, Olga; Webb, Tonya J

2015-01-01

Shiga toxin-producing Escherichia coli (STEC) is a leading cause of childhood renal disease Hemolytic Uremic Syndrome (HUS). The involvement of renal cytokines and chemokines is suspected to play a critical role in disease progression. In current article, we tested the hypothesis that NKT cells are involved in Stx2-induced pathology in vivo. To address this hypothesis we compared Stx2 toxicity in WT and CD1 knockout (KO) mice. In CD1KO mice, which lack natural killer T (NKT) cells, Stx2-induced pathologies such as weight loss, renal failure, and death were delayed. In WT mice, Stx2-specific selective increase in urinary albumin occurs in later time points, and this was also delayed in NKT cell deficient mice. NKT cell-associated cytokines such as IL-2, IL-4, IFN-γ, and IL-17 were detected in kidney lysates of Stx2-injected WT mice with the peak around 36 h after Stx2 injection. In CD1KO, there was a delay in the kinetics, and increases in these cytokines were observed 60 h post Stx2 injection. These data suggest that NKT cells accelerate Stx2-induced pathology in mouse kidneys. To determine the mechanism by which NKT cells promote Stx2-associated disease, in vitro studies were performed using murine renal cells. We found that murine glomerular endothelial cells and podocytes express functional CD1d molecules and can present exogenous antigen to NKT cells. Moreover, we observed the direct interaction between Stx2 and the receptor Gb3 on the surface of mouse renal cells by 3D STORM-TIRF which provides single molecule imaging. Collectively, these data suggest that Stx2 binds to Gb3 on renal cells and leads to aberrant CD1d-mediated NKT cell activation. Therefore, strategies targeting NKT cells could have a significant impact on Stx2-associated renal pathology in STEC disease.

SU-E-J-210: Characterizing Tissue Equivalent Materials for the Development of a Dual MRI-CT Heterogeneous Anthropomorphic Phantom Designed Specifically for MRI Guided Radiotherapy Systems

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Steinmann, A; Stafford, R; Yung, J; Followill, D [UT MD Anderson Cancer Center, Houston, TX (United States)

2015-06-15

Purpose: MRI guided radiotherapy (MRIgRT) is an emerging technology which will eventually require a proficient quality auditing system. Due to different principles in which MR and CT acquire images, there is a need for a multi-imaging-modality, end-to-end QA phantom for MRIgRT. The purpose of this study is to identify lung, soft tissue, and tumor equivalent substitutes that share similar human-like CT and MR properties (i.e. Hounsfield units and relaxation times). Methods: Materials of interested such as common CT QA phantom materials, and other proprietary gels/silicones from Polytek, SmoothOn, and CompositeOne were first scanned on a GE 1.5T Signa HDxT MR. Materials that could be seen on both T1-weighted and T2-weighted images were then scanned on a GE Lightspeed RT16 CT simulator and a GE Discovery 750HD CT scanner and their HU values were then measured. The materials with matching HU values of lung (−500 to −700HU), muscle (+40HU) and soft tissue (+100 to +300HU) were further scanned on GE 1.5T Signa HDx to measure their T1 and T2 relaxation times from varying parameters of TI and TE. Results: Materials that could be visualized on T1-weighted and T2-weighted images from a 1.5T MR unit and had an appropriate average CT number, −650, −685, 46,169, and 168 HUs were: compressed cork saturated with water, Polytek Platsil™ Gel-00 combined with mini styrofoam balls, radiotherapy bolus material, SmoothOn Dragon-Skin™ and SmoothOn Ecoflex™, respectively. Conclusion: Post processing analysis is currently being performed to accurately map T1 and T2 values for each material tested. From previous MR visualization and CT examinations it is expected that Dragon-Skin™, Ecoflex™ and bolus will have values consistent with tissue and tumor substitutes. We also expect compressed cork statured with water, and Polytek™-styrofoam combination to have approximate T1 and T2 values suitable for lung-equivalent materials.

Upright CBCT: A novel imaging technique

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Xenia J Fave

2014-03-01

Full Text Available Purpose: We present a method for acquiring and correcting upright images using the on board CBCT imager. An upright imaging technique would allow for the introduction of upright radiation therapy treatments, which would benefit a variety of patients including those with thoracic cancers whose lung volumes are increased in an upright position and those who experience substantial discomfort during supine treatment positions.Methods: To acquire upright CBCT images, the linac head was positioned at 0 degrees, the KV imager and detector arms extended to their lateral positions, and the couch placed at 270 degrees. The KV imager was programmed to begin taking continuous fluoroscopic projections as the couch rotated from 270 to 90 degrees. The FOV was extended by performing this procedure twice, once with the detector shifted 14.5 cm towards the gantry and once with it shifted 14.5 cm away from the gantry. The two resulting sets of images were stitched together prior to reconstruction. The imaging parameters were chosen to deliver the some dose as that delivered during a simulation CT. A simulation CT was deformably registered to an upright CBCT reconstruction in order to evaluate the possibility of correcting the HU values via mapping.Results: Both spatial linearity and high contrast resolution were maintained in upright CBCT when compared to a simulation CT. Low contrast resolution and HU linearity decreased. Streaking artifacts were caused by the limited 180 degree arc angle and a sharp point artifact in the center of the axial slices resulted at the site of the stitching. A method for correcting the HUs was shown to be robust against these artifacts.Conclusion: Upright CBCT could be of great benefit to many patients. This study demonstrates its feasibility and presents solutions to some of its first hurdles before clinical implementation.--------------------------Cite this article as:Fave X, Yang J, Balter P, Court L. Upright CBCT: A novel imaging

Characterization of 3D printing techniques: Toward patient specific quality assurance spine-shaped phantom for stereotactic body radiation therapy.

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Min-Joo Kim

Full Text Available Development and comparison of spine-shaped phantoms generated by two different 3D-printing technologies, digital light processing (DLP and Polyjet has been purposed to utilize in patient-specific quality assurance (QA of stereotactic body radiation treatment. The developed 3D-printed spine QA phantom consisted of an acrylic body phantom and a 3D-printed spine shaped object. DLP and Polyjet 3D printers using a high-density acrylic polymer were employed to produce spine-shaped phantoms based on CT images. Image fusion was performed to evaluate the reproducibility of our phantom, and the Hounsfield units (HUs were measured based on each CT image. Two different intensity-modulated radiotherapy plans based on both CT phantom image sets from the two printed spine-shaped phantoms with acrylic body phantoms were designed to deliver 16 Gy dose to the planning target volume (PTV and were compared for target coverage and normal organ-sparing. Image fusion demonstrated good reproducibility of the developed phantom. The HU values of the DLP- and Polyjet-printed spine vertebrae differed by 54.3 on average. The PTV Dmax dose for the DLP-generated phantom was about 1.488 Gy higher than that for the Polyjet-generated phantom. The organs at risk received a lower dose for the 3D printed spine-shaped phantom image using the DLP technique than for the phantom image using the Polyjet technique. Despite using the same material for printing the spine-shaped phantom, these phantoms generated by different 3D printing techniques, DLP and Polyjet, showed different HU values and these differently appearing HU values according to the printing technique could be an extra consideration for developing the 3D printed spine-shaped phantom depending on the patient's age and the density of the spinal bone. Therefore, the 3D printing technique and materials should be carefully chosen by taking into account the condition of the patient in order to accurately produce 3D printed

A STUDY ON ASYMPTOMATIC CARDIAC CHANGES IN TYPE 2 DIABETES PATIENTS

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Ramchandra Rao

2015-06-01

Full Text Available INTRODUCTION: Majority of the time the patient of Diabetes presents with complications like Myocardial infarction, heart failure, being end stages of cardiovascular 2 disease associated with other macro and microvascular complications. If patients are screened at an early stage of Diabetes before the onset of symptoms the cardiovascular complications can be delayed and mortality can be reduced . There are only few studies in India done to screen asymptomatic diabetic individuals for cardiovascular compli cations. This study is done in view of screening the asymptomatic individuals in our area to prevent complications. With the available infrastructure, ECG, 2D ECHO were done in 50 patients who met inclusion, exclusion criterias, the changes were noted and the cardiac status was evaluated. AIM AND OBJECTIVES : “To study the asymptomatic cardiac changes in type2 Diabetes patients”. To observe the ECG changes in patients of type2 Diabetes without any symptoms of cardiac disease. To evaluate the ECG changes along with 2DECHO findings in asymptomatic cardiac patients of type 2 Diabetes. To study the correlation between these two investigations and evaluate the cardiac status of the individual. CONCLUSIONS : M ost of the patients in study group belong to 5 th decade , Males with Diabetes were almost double that of females , Most of the patients had duration of Diabetes as 5yrs , Less than half of patients had family history of Diabetes , Half of the group had alcohol, smoking habits , More than half of patients were overweight , Only 20% had good control of Diabetes , Total cholesterol is above normal in almost all of the patients, LDL is elevated in half of the patients, triglycerides in most of them, there is significant dyslipidemia in patients of Diabetes , Only 6 had normal ECG. Rest of them have LVH, ischemia , 18 patients had changes in echo including LVD, regional and global hypokinesias , t hus the present study shows patients with type 2

Proton range shift analysis on brain pseudo-CT generated from T1 and T2 MR.

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Pileggi, Giampaolo; Speier, Christoph; Sharp, Gregory C; Izquierdo Garcia, David; Catana, Ciprian; Pursley, Jennifer; Amato, Francesco; Seco, Joao; Spadea, Maria Francesca

2018-05-29

In radiotherapy, MR imaging is only used because it has significantly better soft tissue contrast than CT, but it lacks electron density information needed for dose calculation. This work assesses the feasibility of using pseudo-CT (pCT) generated from T1w/T2w MR for proton treatment planning, where proton range comparisons are performed between standard CT and pCT. MR and CT data from 14 glioblastoma patients were used in this study. The pCT was generated by using conversion libraries obtained from tissue segmentation and anatomical regioning of the T1w/T2w MR. For each patient, a plan consisting of three 18 Gy beams was designed on the pCT, for a total of 42 analyzed beams. The plan was then transferred onto the CT that represented the ground truth. Range shift (RS) between pCT and CT was computed at R 80 over 10 slices. The acceptance threshold for RS was according to clinical guidelines of two institutions. A γ-index test was also performed on the total dose for each patient. Mean absolute error and bias for the pCT were 124 ± 10 and -16 ± 26 Hounsfield Units (HU), respectively. The median and interquartile range of RS was 0.5 and 1.4 mm, with highest absolute value being 4.4 mm. Of the 42 beams, 40 showed RS less than the clinical range margin. The two beams with larger RS were both in the cranio-caudal direction and had segmentation errors due to the partial volume effect, leading to misassignment of the HU. This study showed the feasibility of using T1w and T2w MRI to generate a pCT for proton therapy treatment, thus avoiding the use of a planning CT and allowing better target definition and possibilities for online adaptive therapies. Further improvements of the methodology are still required to improve the conversion from MRI intensities to HUs.

The appearance and effects of metallic implants in CT images

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Kairn, T.; Crowe, S.B.; Trapp, J.V.; Fogg, P.

2013-01-01

The computed tomography (CT) imaging artefacts that metallic medical implants produce in surrounding tissues are usually contoured and over-ridden during radiotherapy treatment planning. In cases where radiotherapy treatment beams unavoidably pass though implants, it is especially important to understand the imaging artefacts that may occur within the implants themselves. This study examines CT images of a set of simple metallic objects, immersed in water, in order to evaluate reliability and variability of CT numbers (Hounsfield units, HUs) within medical implants. Model implants with a range of sizes (heights from 2.2 to 49.6 mm), electron densities (from 2.3 to 7.7 times the electron density of water) and effective atomic numbers (from 3.9 to 9.0 times the effective atomic number of water in a CT X-ray beam) were created by stacking metal coins from several currencies. These 'implants' were CT scanned within a large (31.0 cm across) and a small (12.8 cm across) water phantom. Resulting HU values are as much as 50 % lower than the result of extrapolating standard electron density calibration data (obtained for tissue and bone densities) up to the metal densities and there is a 6 % difference between the results obtained by scanning with 120 and 140 kVp tube potentials. Profiles through the implants show localised cupping artefacts, within the implants, as well as a gradual decline in HU outside the implants that can cause the implants' sizes to be over estimated by 1.3–9.0 mm. These effects are exacerbated when the implants are scanned in the small phantom or at the side of the large phantom, due to reduced pre-hardening of the X-ray beam in these configurations. These results demonstrate the necessity of over-riding the densities of metallic implants, as well as their artefacts in tissue, in order to obtain accurate radiotherapy dose calculations.

Image quality and absorbed dose comparison of single- and dual-source cone-beam computed tomography.

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Miura, Hideharu; Ozawa, Shuichi; Okazue, Toshiya; Kawakubo, Atsushi; Yamada, Kiyoshi; Nagata, Yasushi

2018-04-17

Dual-source cone-beam computed tomography (DCBCT) is currently available in the Vero4DRT image-guided radiotherapy system. We evaluated the image quality and absorbed dose for DCBCT and compared the values with those for single-source CBCT (SCBCT). Image uniformity, Hounsfield unit (HU) linearity, image contrast, and spatial resolution were evaluated using a Catphan phantom. The rotation angle for acquiring SCBCT and DCBCT images is 215° and 115°, respectively. The image uniformity was calculated using measurements obtained at the center and four peripheral positions. The HUs of seven materials inserted into the phantom were measured to evaluate HU linearity and image contrast. The Catphan phantom was scanned with a conventional CT scanner to measure the reference HU for each material. The spatial resolution was calculated using high-resolution pattern modules. Image quality was analyzed using ImageJ software ver. 1.49. The absorbed dose was measured using a 0.6-cm 3 ionization chamber with a 16-cm-diameter cylindrical phantom, at the center and four peripheral positions of the phantom, and calculated using weighted cone-beam CT dose index (CBCTDI w ). Compared with that of SCBCT, the image uniformity of DCBCT was slightly reduced. A strong linear correlation existed between the measured HU for DCBCT and the reference HU, although the linear regression slope was different from that of the reference HU. DCBCT had poorer image contrast than did SCBCT, particularly with a high-contrast material. There was no significant difference between the spatial resolutions of SCBCT and DCBCT. The absorbed dose for DCBCT was higher than that for SCBCT, because in DCBCT, the two x-ray projections overlap between 45° and 70°. We found that the image quality was poorer and the absorbed dose was higher for DCBCT than for SCBCT in the Vero4DRT. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of

Presence of Staphylococcus aureus and Shiga Toxigenic Escherichia coli O157:H7 in Raw Meat in Ağrı, Turkey

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Naim Deniz Ayaz

2016-08-01

Full Text Available Background: Staphylococcus aureus and Shiga toxin producing Escherichia coli O157:H7 (EHEC are significant foodborne pathogens worldwide. While S. aureus can cause mild superficial skin infections or life-threatening bacteremia and endocarditis, as well as toxininduced cases such as toxic shock syndrome; E. coli O157:H7 can cause symptoms from mild diarrhea to severe hemorrhagic colitis (HC, hemolytic uremic syndrome (HUS, thrombotic thrombocytopenic purpura (TTP. Objectives: The objectives of this study were to find out the prevalence and seasonal distribution of S. aureus in 214 frozen raw meat (turkey, chicken and beef and the prevalence of E. coli O157:H7 in 70 raw beef with the characterization of the E. coli O157:H7 isolate by multiplex polymerase chain reaction (PCR. Materials and Methods: For the detection of S. aureus, a total of 214 frozen raw meat samples including 74 turkey meat, 70 chicken meat and 70 beef cuts (approximately 2 × 3 cm cubic parts; and for the detection of E. coli O157:H7, a total of 70 frozen raw beef samples that all were produced from national companies and consumed in Ağrı, Turkey were analyzed. Results: Out of 214 meat samples, 25.7 % (18/70 of the beef, 11.4 % (8/74 of the chicken meat, and 5.4 % (4/70 of the turkey meat samples were contaminated with S. aureus. Out of 70 frozen raw beef samples, only 1 (1.4% was identified as both Shiga toxin 1 and 2producing E. coli O157:H7 by the detection of stx1, stx2, eaeA, hly, and fliCh7 according to multiplex PCR analysis. Conclusion: Our findings demonstrate that occurrence frequency of S. aureus was higher in frozen raw beef than in raw chicken and turkey meat samples. Although the prevalence of E. coli O157:H7 was low in beef, the presence of virulence genes, especially toxin genesrema in a significant public health concern.

SU-E-J-210: Characterizing Tissue Equivalent Materials for the Development of a Dual MRI-CT Heterogeneous Anthropomorphic Phantom Designed Specifically for MRI Guided Radiotherapy Systems

International Nuclear Information System (INIS)

Steinmann, A; Stafford, R; Yung, J; Followill, D

2015-01-01

Purpose: MRI guided radiotherapy (MRIgRT) is an emerging technology which will eventually require a proficient quality auditing system. Due to different principles in which MR and CT acquire images, there is a need for a multi-imaging-modality, end-to-end QA phantom for MRIgRT. The purpose of this study is to identify lung, soft tissue, and tumor equivalent substitutes that share similar human-like CT and MR properties (i.e. Hounsfield units and relaxation times). Methods: Materials of interested such as common CT QA phantom materials, and other proprietary gels/silicones from Polytek, SmoothOn, and CompositeOne were first scanned on a GE 1.5T Signa HDxT MR. Materials that could be seen on both T1-weighted and T2-weighted images were then scanned on a GE Lightspeed RT16 CT simulator and a GE Discovery 750HD CT scanner and their HU values were then measured. The materials with matching HU values of lung (−500 to −700HU), muscle (+40HU) and soft tissue (+100 to +300HU) were further scanned on GE 1.5T Signa HDx to measure their T1 and T2 relaxation times from varying parameters of TI and TE. Results: Materials that could be visualized on T1-weighted and T2-weighted images from a 1.5T MR unit and had an appropriate average CT number, −650, −685, 46,169, and 168 HUs were: compressed cork saturated with water, Polytek Platsil™ Gel-00 combined with mini styrofoam balls, radiotherapy bolus material, SmoothOn Dragon-Skin™ and SmoothOn Ecoflex™, respectively. Conclusion: Post processing analysis is currently being performed to accurately map T1 and T2 values for each material tested. From previous MR visualization and CT examinations it is expected that Dragon-Skin™, Ecoflex™ and bolus will have values consistent with tissue and tumor substitutes. We also expect compressed cork statured with water, and Polytek™-styrofoam combination to have approximate T1 and T2 values suitable for lung-equivalent materials

SU-F-T-398: Improving Radiotherapy Treatment Planning Using Dual Energy Computed Tomography Based Tissue Characterization

Energy Technology Data Exchange (ETDEWEB)

Tomic, N; Bekerat, H; Seuntjens, J; Forghani, R; DeBlois, F; Devic, S [McGill University, Montreal, QC (Canada)

2016-06-15

Purpose: Both kVp settings and geometric distribution of various materials lead to significant change of the HU values, showing the largest discrepancy for high-Z materials and for the lowest CT scanning kVp setting. On the other hand, the dose distributions around low-energy brachytherapy sources are highly dependent on the architecture and composition of tissue heterogeneities in and around the implant. Both measurements and Monte Carlo calculations show that improper tissue characterization may lead to calculated dose errors of 90% for low energy and around 10% for higher energy photons. We investigated the ability of dual-energy CT (DECT) to characterize more accurately tissue equivalent materials. Methods: We used the RMI-467 heterogeneity phantom scanned in DECT mode with 3 different set-ups: first, we placed high electron density (ED) plugs within the outer ring of the phantom; then we arranged high ED plugs within the inner ring; and finally ED plugs were randomly distributed. All three setups were scanned with the same DECT technique using a single-source DECT scanner with fast kVp switching (Discovery CT750HD; GE Healthcare). Images were transferred to a GE Advantage workstation for DECT analysis. Spectral Hounsfield unit curves (SHUACs) were then generated from 50 to 140-keV, in 10-keV increments, for each plug. Results: The dynamic range of Hounsfield units shrinks with increased photon energy as the attenuation coefficients decrease. Our results show that the spread of HUs for the three different geometrical setups is the smallest at 80 keV. Furthermore, among all the energies and all materials presented, the largest difference appears at high Z tissue equivalent plugs. Conclusion: Our results suggest that dose calculations at both megavoltage and low photon energies could benefit in the vicinity of bony structures if the 80 keV reconstructed monochromatic CT image is used with the DECT protocol utilized in this work.

Growth advantage of Escherichia coli O104:H4 strains on 5-N-acetyl-9-O-acetyl neuraminic acid as a carbon source is dependent on heterogeneous phage-Borne nanS-p esterases.

Science.gov (United States)

Saile, Nadja; Schwarz, Lisa; Eißenberger, Kristina; Klumpp, Jochen; Fricke, Florian W; Schmidt, Herbert

2018-06-01

Enterohemorrhagic E. coli (EHEC) are serious bacterial pathogens which are able to cause a hemorrhagic colitis or the life-threatening hemolytic-uremic syndrome (HUS) in humans. EHEC strains can carry different numbers of phage-borne nanS-p alleles that are responsible for acetic acid release from mucin from bovine submaxillary gland and 5-N-acetyl-9-O-acetyl neuraminic acid (Neu5,9Ac 2 ), a carbohydrate present in mucin. Thus, Neu5,9Ac 2 can be transformed to 5-N-acetyl neuraminic acid, an energy source used by E. coli strains. We hypothesize that these NanS-p proteins are involved in competitive growth of EHEC in the gastrointestinal tract of humans and animals. The aim of the current study was to demonstrate and characterize the nanS-p alleles of the 2011 E. coli O104:H4 outbreak strain LB226692 and analyze whether the presence of multiple nanS-p alleles in the LB226692 genome causes a competitive growth advantage over a commensal E. coli strain. We detected and characterized five heterogeneous phage-borne nanS-p alleles in the genome of E. coli O104:H4 outbreak strain LB226692 by in silico analysis of its genome. Furthermore, successive deletion of all nanS-p alleles, subsequent complementation with recombinant NanS-p13-His, and in vitro co-culturing experiments with the commensal E. coli strain AMC 198 were conducted. We could show that nanS-p genes of E. coli O104:H4 are responsible for growth inhibition of strain AMC 198, when Neu5,9Ac 2 was used as sole carbon source in co-culture. The results of this study let us suggest that multiple nanS-p alleles may confer a growth advantage by outcompeting other E. coli strains in Neu5,9Ac 2 rich environments, such as mucus in animal and human gut. Copyright © 2018 Elsevier GmbH. All rights reserved.

Structural and functional characterization of the product of disease-related factor H gene conversion.

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Herbert, Andrew P; Kavanagh, David; Johansson, Conny; Morgan, Hugh P; Blaum, Bärbel S; Hannan, Jonathan P; Barlow, Paul N; Uhrín, Dušan

2012-03-06

Numerous complement factor H (FH) mutations predispose patients to atypical hemolytic uremic syndrome (aHUS) and other disorders arising from inadequately regulated complement activation. No unifying structural or mechanistic consequences have been ascribed to these mutants beyond impaired self-cell protection. The S1191L and V1197A mutations toward the C-terminus of FH, which occur in patients singly or together, arose from gene conversion between CFH encoding FH and CFHR1 encoding FH-related 1. We show that neither single nor double mutations structurally perturbed recombinant proteins consisting of the FH C-terminal modules, 19 and 20 (FH19-20), although all three FH19-20 mutants were poor, compared to wild-type FH19-20, at promoting hemolysis of C3b-coated erythrocytes through competition with full-length FH. Indeed, our new crystal structure of the S1191L mutant of FH19-20 complexed with an activation-specific complement fragment, C3d, was nearly identical to that of the wild-type FH19-20:C3d complex, consistent with mutants binding to C3b with wild-type-like affinity. The S1191L mutation enhanced thermal stability of module 20, whereas the V1197A mutation dramatically decreased it. Thus, although mutant proteins were folded at 37 °C, they differ in conformational rigidity. Neither single substitutions nor double substitutions increased measurably the extent of FH19-20 self-association, nor did these mutations significantly affect the affinity of FH19-20 for three glycosaminoglycans, despite critical roles of module 20 in recognizing polyanionic self-surface markers. Unexpectedly, FH19-20 mutants containing Leu1191 self-associated on a heparin-coated surface to a higher degree than on surfaces coated with dermatan or chondroitin sulfates. Thus, potentially disease-related functional distinctions between mutants, and between FH and FH-related 1, may manifest in the presence of specific glycosaminoglycans.

Characterization of 3D printing techniques: Toward patient specific quality assurance spine-shaped phantom for stereotactic body radiation therapy.

Science.gov (United States)

Kim, Min-Joo; Lee, Seu-Ran; Lee, Min-Young; Sohn, Jason W; Yun, Hyong Geon; Choi, Joon Yong; Jeon, Sang Won; Suh, Tae Suk

2017-01-01

Development and comparison of spine-shaped phantoms generated by two different 3D-printing technologies, digital light processing (DLP) and Polyjet has been purposed to utilize in patient-specific quality assurance (QA) of stereotactic body radiation treatment. The developed 3D-printed spine QA phantom consisted of an acrylic body phantom and a 3D-printed spine shaped object. DLP and Polyjet 3D printers using a high-density acrylic polymer were employed to produce spine-shaped phantoms based on CT images. Image fusion was performed to evaluate the reproducibility of our phantom, and the Hounsfield units (HUs) were measured based on each CT image. Two different intensity-modulated radiotherapy plans based on both CT phantom image sets from the two printed spine-shaped phantoms with acrylic body phantoms were designed to deliver 16 Gy dose to the planning target volume (PTV) and were compared for target coverage and normal organ-sparing. Image fusion demonstrated good reproducibility of the developed phantom. The HU values of the DLP- and Polyjet-printed spine vertebrae differed by 54.3 on average. The PTV Dmax dose for the DLP-generated phantom was about 1.488 Gy higher than that for the Polyjet-generated phantom. The organs at risk received a lower dose for the 3D printed spine-shaped phantom image using the DLP technique than for the phantom image using the Polyjet technique. Despite using the same material for printing the spine-shaped phantom, these phantoms generated by different 3D printing techniques, DLP and Polyjet, showed different HU values and these differently appearing HU values according to the printing technique could be an extra consideration for developing the 3D printed spine-shaped phantom depending on the patient's age and the density of the spinal bone. Therefore, the 3D printing technique and materials should be carefully chosen by taking into account the condition of the patient in order to accurately produce 3D printed patient-specific QA

The appearance and effects of metallic implants in CT images.

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Kairn, T; Crowe, S B; Fogg, P; Trapp, J V

2013-06-01

The computed tomography (CT) imaging artefacts that metallic medical implants produce in surrounding tissues are usually contoured and over-ridden during radiotherapy treatment planning. In cases where radiotherapy treatment beams unavoidably pass though implants, it is especially important to understand the imaging artefacts that may occur within the implants themselves. This study examines CT images of a set of simple metallic objects, immersed in water, in order to evaluate reliability and variability of CT numbers (Hounsfield units, HUs) within medical implants. Model implants with a range of sizes (heights from 2.2 to 49.6 mm), electron densities (from 2.3 to 7.7 times the electron density of water) and effective atomic numbers (from 3.9 to 9.0 times the effective atomic number of water in a CT X-ray beam) were created by stacking metal coins from several currencies. These 'implants' were CT scanned within a large (31.0 cm across) and a small (12.8 cm across) water phantom. Resulting HU values are as much as 50 % lower than the result of extrapolating standard electron density calibration data (obtained for tissue and bone densities) up to the metal densities and there is a 6 % difference between the results obtained by scanning with 120 and 140 kVp tube potentials. Profiles through the implants show localised cupping artefacts, within the implants, as well as a gradual decline in HU outside the implants that can cause the implants' sizes to be over estimated by 1.3-9.0 mm. These effects are exacerbated when the implants are scanned in the small phantom or at the side of the large phantom, due to reduced pre-hardening of the X-ray beam in these configurations. These results demonstrate the necessity of over-riding the densities of metallic implants, as well as their artefacts in tissue, in order to obtain accurate radiotherapy dose calculations.

Technical Note: Multipurpose CT, ultrasound, and MRI breast phantom for use in radiotherapy and minimally invasive interventions

Energy Technology Data Exchange (ETDEWEB)

Ruschin, Mark, E-mail: Mark.Ruschin@sunnybrook.ca; Chin, Lee; Ravi, Ananth; McCann, Claire [Department of Medical Physics, Sunnybrook Odette Cancer Centre, Toronto, Ontario M4N 3M5, Canada and Department of Radiation Oncology, University of Toronto, Toronto, Ontario M4N 3M5 (Canada); Davidson, Sean R. H. [Techna Institute, University Health Network, Toronto, Ontario M5G 1P5 (Canada); Phounsy, William [Department of Physics, Ryerson University, Toronto, Ontario M5B 2K3 (Canada); Yoo, Tae Sun [Institute of Health Policy, University of Toronto, Toronto, Ontario M5T 3M6 (Canada); Pignol, Jean-Philippe [Department of Radiation Oncology, Erasmus MC Cancer Institute, 3075 EA Rotterdam (Netherlands)

2016-05-15

Purpose: To develop a multipurpose gel-based breast phantom consisting of a simulated tumor with realistic imaging properties in CT, ultrasound and MRI, or a postsurgical cavity on CT. Applications for the phantom include: deformable image registration (DIR) quality assurance (QA), autosegmentation validation, and localization testing and training for minimally invasive image-guided procedures such as those involving catheter or needle insertion. Methods: A thermoplastic mask of a typical breast patient lying supine was generated and then filled to make an array of phantoms. The background simulated breast tissue consisted of 32.4 g each of ballistic gelatin (BG) powder and Metamusil™ (MM) dissolved in 800 ml of water. Simulated tumors were added using the following recipe: 12 g of barium sulfate (1.4% v/v) plus 0.000 14 g copper sulfate plus 0.7 g of MM plus 7.2 g of BG all dissolved in 75 ml of water. The phantom was evaluated quantitatively in CT by comparing Hounsfield units (HUs) with actual breast tissue. For ultrasound and MRI, the phantoms were assessed based on subjective image quality and signal-difference to noise (SDNR) ratio, respectively. The stiffness of the phantom was evaluated based on ultrasound elastography measurements to yield an average Young’s modulus. In addition, subjective tactile assessment of phantom was performed under needle insertion. Results: The simulated breast tissue had a mean background value of 24 HU on CT imaging, which more closely resembles fibroglandular tissue (40 HU) as opposed to adipose (−100 HU). The tumor had a mean CT number of 45 HU, which yielded a qualitatively realistic image contrast relative to the background either as an intact tumor or postsurgical cavity. The tumor appeared qualitatively realistic on ultrasound images, exhibiting hypoechoic characteristics compared to background. On MRI, the tumor exhibited a SDNR of 3.7. The average Young’s modulus was computed to be 15.8 ± 0.7 kPa (1 SD

On the Legitimacy of Popper's “Open Society”%论波普“开放社会”的正当性问题

Institute of Scientific and Technical Information of China (English)

赵伟

2014-01-01

Normally in the political philosophy ,legitimacy refers to moral justification .But according to Karl Popper's critical rationalism , its value and facts are dualistic . T hus in Popper's theories , the justification of open society goes to be a problem . As for this , Popper thought that the open society is the logic extension of his critical rationalism . Popper tried to justify the open society with non-moral method . T his paper points out that the essence of the critical rationalism is some kind of faith . T herefore , the open society is a sort of choice of value and has to be justified with his own effectiveness and extrinsic purposes . From this sense , Popper can be considered as a utilitarian .%正当性就是在道德上被证成。由于波普坚持事实与价值两分的“二元论”，波普“开放社会”的证成性就成为问题，即不能以设定某种外在目的的方式来论证“开放社会”的合理。波普“开放社会”理论是其批判理性主义在社会政治领域的逻辑引申，并以非道德评价的方式来论证“开放社会”的正当性。波普的批判理性主义的实质依然是信仰，“开放社会”本身就是一种价值选择的结果，波普论证“开放社会”的正当性也只能诉诸外在的目的与自身的效用，这就意味着被其所批判的功利主义的“效果原则”依然构成波普“开放社会”的正当性依据。

Study of Variation in Dose Calculation Accuracy Between kV Cone-Beam Computed Tomography and kV fan-Beam Computed Tomography

Science.gov (United States)

Kaliyaperumal, Venkatesan; Raphael, C. Jomon; Varghese, K. Mathew; Gopu, Paul; Sivakumar, S.; Boban, Minu; Raj, N. Arunai Nambi; Senthilnathan, K.; Babu, P. Ramesh

2017-01-01

Cone-beam computed tomography (CBCT) images are presently used for geometric verification for daily patient positioning. In this work, we have compared the images of CBCT with the images of conventional fan beam CT (FBCT) in terms of image quality and Hounsfield units (HUs). We also compared the dose calculated using CBCT with that of FBCT. Homogenous RW3 plates and Catphan phantom were scanned by FBCT and CBCT. In RW3 and Catphan phantom, percentage depth dose (PDD), profiles, isodose distributions (for intensity modulated radiotherapy plans), and calculated dose volume histograms were compared. The HU difference was within ± 20 HU (central region) and ± 30 HU (peripheral region) for homogeneous RW3 plates. In the Catphan phantom, the difference in HU was ± 20 HU in the central area and peripheral areas. The HU differences were within ± 30 HU for all HU ranges starting from −1000 to 990 in phantom and patient images. In treatment plans done with simple symmetric and asymmetric fields, dose difference (DD) between CBCT plan and FBCT plan was within 1.2% for both phantoms. In intensity modulated radiotherapy (IMRT) treatment plans, for different target volumes, the difference was <2%. This feasibility study investigated HU variation and dose calculation accuracy between FBCT and CBCT based planning and has validated inverse planning algorithms with CBCT. In our study, we observed a larger deviation of HU values in the peripheral region compared to the central region. This is due to the ring artifact and scatter contribution which may prevent the use of CBCT as the primary imaging modality for radiotherapy treatment planning. The reconstruction algorithm needs to be modified further for improving the image quality and accuracy in HU values. However, our study with TG-119 and intensity modulated radiotherapy test targets shows that CBCT can be used for adaptive replanning as the recalculation of dose with the anisotropic analytical algorithm is in full accord

TU-FG-BRB-01: Dual Energy CT Proton Stopping Power Ratio Calibration and Validation with Animal Tissues

Energy Technology Data Exchange (ETDEWEB)

Xie, Y; Yin, L; Ainsley, C; McDonough, J; Solberg, T; Lin, A; Teo, B [University of Pennsylvania, Philadelphia, PA (United States)

2016-06-15

Purpose: The conversion of Hounsfield Unit (HU) to proton stopping power ratio (SPR) is a main source of uncertainty in proton therapy. In this study, the SPRs of animal tissues were measured and compared with prediction from dual energy CT (DECT) and single energy CT (SECT) calibrations. Methods: A stoichiometric calibration method for DECT was applied to predict the SPR using CT images acquired at 80 kVp and 140 kVp. The dual energy index was derived based on the HUs of the paired spectral images and used to calculate the SPRs of the materials. Tissue surrogates with known chemical compositions were used for calibration, and animal tissues (pig brain, liver, kidney; veal shank, muscle) were used for validation. The materials were irradiated with proton pencil beams, and SPRs were deduced from the residual proton range measured using a multi-layer ion chamber device. In addition, Gafchromic EBT3 films were used to measure the distal dose profiles after irradiation through the tissue samples and compared with those calculated by the treatment planning system using both DECT and SECT predicted SPRs. Results: The differences in SPR between DECT prediction and measurement were −0.31±0.36% for bone, 0.47±0.42% for brain, 0.67±0.15% for liver, 0.51±0.52% for kidney, and −0.96±0.15% for muscle. The corresponding results using SECT were 3.1±0.12%, 1.90±0.45%, −0.66±0.11%, 2.33±0.21%, and −1.70±0.17%. In the film measurements, average distances between film and calculated distal dose profiles were 0.35±0.12 mm for DECT calibration and −1.22±0.12 mm for SECT calibration for a beam with a range of 15.79 cm. Conclusion: Our study indicates that DECT is superior to SECT for proton SPR prediction and has the potential to reduce the range uncertainty to less than 2%. DECT may permit the use of tighter distal and proximal range uncertainty margins for treatment, thereby increasing the precision of proton therapy.

Electromagnetically Driven Plasma-Field Dynamics in Modified Ionosphere

Science.gov (United States)

Kochetov, Andrey; Terina, Galina

Under sounding of an artificial ionospheric turbulence by short probing radio pulses of ordinary polarization the two types of scattered signals were observed: a "caviton" signal (CS) and a "plasma" signal (PS), which appeared with the heating transmitter switching on and disap-peared after its switching off (G.I. Terina J. Atm. Terr. Phys, 57, 1995, 273, Izv. VUZov, Radiofizika, 39, 1998, 203). The scattered signal of PS type was revealed also after the heating switching off. It was called an "aftereffect plasma signal" (AEPS) (G.I. Terina Izv .VUZov, Radiofizika, 43, 2000, 958). This signal had large time and spatial delays and appeared mostly when corresponding PS had envelope fluctuations. The aftereffect phenomenon was expressed at time on CS by amplitude increasing at once after the heating transmitter turning off. The theoretical model of this phenomenon is proposed in and some peculiarities of the aftereffect phenomena of the scattered signals in modified ionospheric plasma are considered and discussed. For theoretical interpretation of the characteristics of CS and AEPS the numerical solution of nonlinear Shrüdinger equation (NSE) with driven extension were carried out in inhomogeneous plasma layer with linear electron density profile (A.V. Kochetov, V.A. Mironov, G.I. Terina, Adv. Space Reseacrh, 29, 2002, 1369) and for the one with prescribed density depletion (and A.V. Kochetov, G.I. Terina, Adv. Space Reseacrh, 38, 2006, 2490). The simulation results obtained for linear inhomogeneous plasma layer and for plasma one with density depletion al-low us to interpret the aftereffect of CS and PS qualitatively. The field amplitude increase at relaxation stage displayed at calculations allows us to interpret of CS aftereffect. The large time delays of AEPS can be explained as a result of powerful radio waves trapping in the forming at the plasma resonance regions density depletions (E. Mjøhus, J. Geophys. Res. 103, 1998, 14711; B. Eliasson and L. Stenflo, J

Investigation of an Escherichia coli O145 outbreak in a child day-care centre - extensive sampling and characterization of eae- and stx1-positive E. coli yields epidemiological and socioeconomic insight

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Bruheim Torkjel

2011-09-01

Full Text Available Abstract Background On October 29th 2009 the health authorities in the city of Trondheim, Norway were alerted about a case of Shiga toxin-positive E. coli (STEC O145 in a child with bloody diarrhoea attending a day-care centre. Symptomatic children in this day-care centre were sampled, thereby identifying three more cases. This initiated an outbreak investigation. Methods A case was defined as a child attending the day-care centre, in whom eae- and stx1- but not stx2-positive E. coli O145:H28 was diagnosed from a faecal sample, with multilocus variable number of tandem repeat analysis (MLVA profile identical to the index isolate. All 61 children, a staff of 14 in the day-care centre, and 74 close contacts submitted faecal samples. Staff and parents were interviewed about cases' exposure to foods and animals. Faecal samples from 31 ewes from a sheep herd to which the children were exposed were analyzed for E. coli O145. Results Sixteen cases were identified, from which nine presented diarrhoea but not haemolytic uremic syndrome (HUS. The attack rate was 0.26, and varied between age groups (0.13-0.40 and between the three day-care centre departments (0.20-0.50, and was significantly higher amongst the youngest children. Median duration of shedding was 20 days (0-71 days. Children were excluded from the day-care centre during shedding, requiring parents to take compassionate leave, estimated to be a minimum total of 406 days for all cases. Atypical enteropathogenic E. coli (aEPEC were detected among 14 children other than cases. These isolates were genotypically different from the outbreak strain. Children in the day-care centre were exposed to faecal pollution from a sheep herd, but E. coli O145 was not detected in the sheep. Conclusions We report an outbreak of stx1- and eae-positive STEC O145:H28 infection with mild symptoms among children in a day-care centre. Extensive sampling showed occurrence of the outbreak strain as well as other STEC and

The effect of 50% compared to 100% inspired oxygen fraction on brain oxygenation and post cardiac arrest mitochondrial function in experimental cardiac arrest.

Science.gov (United States)

Nelskylä, Annika; Nurmi, Jouni; Jousi, Milla; Schramko, Alexey; Mervaala, Eero; Ristagno, Giuseppe; Skrifvars, Markus B

2017-07-01

arrest disturbs cardiac mitochondrial respiration, but it is not alleviated with the use of 50% compared to 100% oxygen (Ethical and hospital approvals ESAVI/1077/04.10.07/2016 and HUS/215/2016, §7 30.3.2016, Funding Helsinki University and others). Copyright © 2017 Elsevier B.V. All rights reserved.

Performance evaluation of iterative reconstruction algorithms for achieving CT radiation dose reduction — a phantom study

Science.gov (United States)

Dodge, Cristina T.; Tamm, Eric P.; Cody, Dianna D.; Liu, Xinming; Jensen, Corey T.; Wei, Wei; Kundra, Vikas

2016-01-01

The purpose of this study was to characterize image quality and dose performance with GE CT iterative reconstruction techniques, adaptive statistical iterative reconstruction (ASiR), and model‐based iterative reconstruction (MBIR), over a range of typical to low‐dose intervals using the Catphan 600 and the anthropomorphic Kyoto Kagaku abdomen phantoms. The scope of the project was to quantitatively describe the advantages and limitations of these approaches. The Catphan 600 phantom, supplemented with a fat‐equivalent oval ring, was scanned using a GE Discovery HD750 scanner at 120 kVp, 0.8 s rotation time, and pitch factors of 0.516, 0.984, and 1.375. The mA was selected for each pitch factor to achieve CTDIvol values of 24, 18, 12, 6, 3, 2, and 1 mGy. Images were reconstructed at 2.5 mm thickness with filtered back‐projection (FBP); 20%, 40%, and 70% ASiR; and MBIR. The potential for dose reduction and low‐contrast detectability were evaluated from noise and contrast‐to‐noise ratio (CNR) measurements in the CTP 404 module of the Catphan. Hounsfield units (HUs) of several materials were evaluated from the cylinder inserts in the CTP 404 module, and the modulation transfer function (MTF) was calculated from the air insert. The results were confirmed in the anthropomorphic Kyoto Kagaku abdomen phantom at 6, 3, 2, and 1 mGy. MBIR reduced noise levels five‐fold and increased CNR by a factor of five compared to FBP below 6 mGy CTDIvol, resulting in a substantial improvement in image quality. Compared to ASiR and FBP, HU in images reconstructed with MBIR were consistently lower, and this discrepancy was reversed by higher pitch factors in some materials. MBIR improved the conspicuity of the high‐contrast spatial resolution bar pattern, and MTF quantification confirmed the superior spatial resolution performance of MBIR versus FBP and ASiR at higher dose levels. While ASiR and FBP were relatively insensitive to changes in dose and pitch, the spatial

[A cranium relates].

Science.gov (United States)

Lithner, K

1994-01-01

In 1987 the Swedish zoologist Karl Georg Wingstrand, (1919-92), who was professor of comparative anatomy at the University of Copenhagen, was going to retire. In that connection he handed over as a gift to the Historical Museum of Malmö a cranium, which he had inherited after his paternal grandfather's brother, Fr. august Wingstrand. It had been found, when the latter's home was emptied in the beginning of the 1910's after his death. On the inside of the sawed-off top of the cranium was written "Housewife Elsa Nilsdotter from Bäsinge, hanged on the Castle of Malmö in 1882". According to family tradition August Wingstrand had acquired it when serving as a prison doctor in Malmö. August Wingstrand was born in 1855 and started his medical studies at the University of Lund in 1878. After studies there and at the Medical School of Stockholm he took his degree as Licentiate of Medicine in 1897. The exceptionally long study period of 40 semesters can partly be explained through his active participation in the student life of his "Nation". After taking his degree he became a psychiatrist in mental hospitals and died in 1910. The background of the cranium was that in 1881 a farmer, Månsson, in the province of Skåne was shot and killed. The reason was that his wife, Else Nilsdotter, and the hired man, Sjöstedt, were in love with each other and had instigated the hired man's uncle, Eld, to shoot him. The crime was immediately solved and Else Nilsdotter, Sjöstedt and Eld were sentenced to death on January 7, 1882. Before the sentence had been submitted to the Court of Appeal Else Nilsdotter committed suicide on January 25, 1882, through hanging or rather strangling herself in her cell at the Prison in Malmm, the old fortress Malmöhus, where the Historical Museum now is situated. According to regulations her body was handed over to the Anatomical Institution of the University of Lund for use in dissection and afterwards she was buried there. The probable reason why the

Halveti-Şâbânî Şeyhi Mustafa Kemâleddîn Bekrî ve Hediyyetü’l-Ahbâb Adlı Eseri

Directory of Open Access Journals (Sweden)

Halim Gül

2013-03-01

Full Text Available AbstractThis article studies the life and woks of Kemaleddin Bekrî, who affiliated himself to Khalvati-Shabani Sheikh Abdullatîf b. Hüsameddîn el-Halebî, and who was growed up under Abd al-Ghani al-Nabulsi’s control. His work “Hadiyyat al-Ahbab fi ma li’l-Khalveti min al-Şuruti va’l-Adab”, which explains the conditions and rules of “khalvet” was also studied. The work consists of preface, eight parts and an epilogue and all parts examined in detail.ÖzetBu makalede, Abdülganî Nablusî’nin (ö.1143/1730 gözetiminde yetişen, halvetî-Şabânî şeyhi Abdullatîf b. Hüsameddîn el-Halebî’ye intisap eden Mustafa Kemaleddin Bekrî’nin hayatı ve eserleri incelenmiştir. Bu çerçevede onun tasavvufi bir kavram olan halvetin âdab ve şartlarını izah eden “Hediyyetü’l ahbâb fî mâ li’l-halveti mine’ş-şurûti ve’l-âdâb” adlı risalesinin incelenmesi ve değerlendirmesi üzerinde durulmuştur. Söz konusu eser, mukaddime sekiz bölüm ve bir hatimeden oluşmaktadır.Le Shaykh Khalwatî-Sha‘bânî Mustafâ Kamâl al-Dîn Bakrî et son Traité qui s’intitule Hadiyya al-ahbâbRésuméDans cet article, on va étudier d’abord la vie et les œuvres du Shaykh Khalwatî-Sha‘bânî Mustafâ Kamâl al-Dîn Bakrî qui a été éduqué par le célèbre soufi ‘Abd al-Ghanî Nablûsî (m. 1143/1730 et a été initié par ‘Abd al-Latîf b. Husâm al-Dîn al-Halabî. Puis, plus particulièrement, on va analyser son traité qui s’intitule ‘Hadiyya al-ahbâb fî mâ li’l-khalwatî min al-shurût wa’l-âdâb’. Ce traité – qui a été composé de dix-huit chapitres et d’une conclusion – étudie les convenances et les conditions de la retraite spirituelle, khalwa, une des notions soufies importantes

Validación de una técnica de PCR múltiple para la detección de Escherichia coli productor de toxina Shiga Validation of a multiplex PCR for detection of Shiga toxin-producing Escherichia coli

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G.A. Leotta

2005-03-01

Full Text Available La infección por Escherichia coli productor de toxina Shiga (STEC es causa de diarrea con o sin sangre, colitis hemorrágica y síndrome urémico hemolítico (SUH en humanos. El objetivo de este trabajo fue validar una técnica de PCR múltiple para el diagnóstico de STEC basado en la detección de los genes stx1, stx2 y rfbO157. La validación de la técnica se realizó en dos laboratorios independientes, en forma paralela. Se determinó rango de trabajo, selectividad y robustez. Se evaluó el desempeño de la técnica al combinar distintas concentraciones de dos cepas con diferentes factores de virulencia. El rango de trabajo dependió de la cepa analizada, los valores máximos y mínimos fueron 6,6 x 107 y 1,0 x 104 UFC/50 µl. El límite de detección fue de 1,0 x 104 UFC/50 µl y el límite de corte de 1,0 x 105 UFC/50 µl. La robustez fue óptima al modificar diferentes variables. Se obtuvo 100% de inclusividad, exclusividad, precisión analítica, valor predictivo positivo y valor predictivo negativo. No se observó interferencia al combinar distintas concentraciones de los factores de virulencia blanco de la reacción. La técnica validada es una alternativa apropiada para la detección y confirmación de STEC O157 y no-O157 a partir de cultivos bacterianos.Shiga toxin-producing Escherichia coli (STEC cause non-bloody or bloody diarrhea, hemorrhagic colitis and hemolytic uremic syndrome (HUS in humans. The aim of the present study was to validate a multiplex PCR for the STEC diagnosis based on the detection of stx1, stx2 and rfbO157 genes. The multiplex PCR validation was carried out in two independent laboratories in a parallel way. Work range, selectivity and robustness were established. The PCR performance was evaluated using different concentrations of two STEC strains harboring different target genes. The work range depended on the strain analyzed, the maximum and the minimum values were 6.6 x 107 and 1.0 x 104 CFU/50 µl. The

Multiplex real-time PCR assay for detection of Escherichia coli O157:H7 and screening for non-O157 Shiga toxin-producing E. coli.

Science.gov (United States)

Li, Baoguang; Liu, Huanli; Wang, Weimin

2017-11-09

Shiga toxin-producing Escherichia coli (STEC), including E. coli O157:H7, are responsible for numerous foodborne outbreaks annually worldwide. E. coli O157:H7, as well as pathogenic non-O157:H7 STECs, can cause life-threating complications, such as bloody diarrhea (hemolytic colitis) and hemolytic-uremic syndrome (HUS). Previously, we developed a real-time PCR assay to detect E. coli O157:H7 in foods by targeting a unique putative fimbriae protein Z3276. To extend the detection spectrum of the assay, we report a multiplex real-time PCR assay to specifically detect E. coli O157:H7 and screen for non-O157 STEC by targeting Z3276 and Shiga toxin genes (stx1 and stx2). Also, an internal amplification control (IAC) was incorporated into the assay to monitor the amplification efficiency. The multiplex real-time PCR assay was developed using the Life Technology ABI 7500 System platform and the standard chemistry. The optimal amplification mixture of the assay contains 12.5 μl of 2 × Universal Master Mix (Life Technology), 200 nM forward and reverse primers, appropriate concentrations of four probes [(Z3276 (80 nM), stx1 (80 nM), stx2 (20 nM), and IAC (40 nM)], 2 μl of template DNA, and water (to make up to 25 μl in total volume). The amplification conditions of the assay were set as follows: activation of TaqMan at 95 °C for 10 min, then 40 cycles of denaturation at 95 °C for 10 s and annealing/extension at 60 °C for 60 s. The multiplex assay was optimized for amplification conditions. The limit of detection (LOD) for the multiplex assay was determined to be 200 fg of bacterial DNA, which is equivalent to 40 CFU per reaction which is similar to the LOD generated in single targeted PCRs. Inclusivity and exclusivity determinants were performed with 196 bacterial strains. All E. coli O157:H7 (n = 135) were detected as positive and all STEC strains (n = 33) were positive for stx1, or stx2, or stx1 and stx2 (Table 1). No cross reactivity was detected with Salmonella

Detección, aislamiento y caracterización de Escherichia coli productor de toxina Shiga a partir de carne molida fresca proveniente de carnicerías de Concepción, provincia de Tucumán Detection, isolation and characterization of Shiga toxin-producing Escherichia coli (STEC in fresh ground beef from butcher shops in Concepción, Tucumán Province

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M. A. Jure

2010-12-01

Full Text Available Escherichia coli productor de toxina Shiga (STEC es un patógeno emergente transmitido por alimentos. Existen numerosos serotipos de STEC asociados a enfermedad en humanos, entre los cuales prevalece el serotipo O157:H7. La carne molida es el principal vehículo de transmisión. En la ciudad de Concepción, provincia de Tucumán, entre setiembre y diciembre de 2004 se diagnosticaron dos casos de síndrome urémico hemolítico (SUH. El objetivo de este trabajo fue detectar, aislar y caracterizar STEC O157 y no-O157 a partir de muestras de carne molida fresca obtenidas en las bocas de expendio. Entre los meses de setiembre y diciembre de 2004 se recolectaron 53 muestras de carne molida fresca en carnicerías de la ciudad de Concepción. Para la detección, el aislamiento y la caracterización de STEC O157:H7 se utilizó la metodología USDA-FSIS 2002. Para la detección de E. coli no-O157 se utilizaron dos técnicas de PCR; para el aislamiento y la caracterización se utilizó una metodología previamente validada en una etapa intralaboratorio. Siete muestras fueron positivas para el gen stx2, de las cuales 4 también fueron positivas para el gen rfbO157. Sin embargo, solo se aisló una cepa de E. coli O157:H7 biotipo C, portadora de los genes eae, stx2 y ehxA. El presente trabajo refleja la importancia de implementar técnicas que permitan detectar este grupo de patógenos emergentes a partir de productos cárnicos.Shiga toxin-producing Escherichia coli is an emerging foodborne pathogen. There are many STEC serotypes associated with human diseases, being the O157:H7 serotype the most prevalent. Ground beef is the main transmission vehicle. In Concepción city, Tucumán Province, between September and December 2004, two hemolytic uremic syndrome (HUS cases were diagnosed. The main objective of this work was to detect, isolate and characterize STEC O157 and non-O157 strains in fresh ground beef. Between September and December 2004, 53 fresh ground

A comparison of the compositional differences between humic fractions isolated by the IHSS and exhaustive extraction procedures

Science.gov (United States)

Chang, R. R.; Mylotte, R.; Hayes, M. H. B.; Mclnerney, R.; Tzou, Y. M.

2014-03-01

highly ordered hydrocarbon structures that would be expected to have closer associations with the mineral colloids. Although the SEE procedure isolated all of the HAs and FAs from the Yangmingshan soil, extractability of the Hu from the volcanic soil in the DMSO/acid solvent was low (21 %), and contrasted with the much higher yields from temperate and tropical regions. The decreased Hu extraction may arise from its associations with the extensive iron and aluminium hydroxide mineral colloids in the soil. The Hu from this sub-tropical soil was different from the Hus isolated from other soil types, indicating the need to isolate and characterise these recalcitrant organic material in order to understand the organic carbon components in soils in greater detail. Such results would indicate that more attention should be given to mineral colloids in soils, and to the organo/mineral associations that will have an important role in the stabilities of OM in the soil environment.

Single-energy computed tomography-based pulmonary perfusion imaging: Proof-of-principle in a canine model

Energy Technology Data Exchange (ETDEWEB)

Yamamoto, Tokihiro, E-mail: toyamamoto@ucdavis.edu [Department of Radiation Oncology, University of California Davis School of Medicine, Sacramento, California 95817 (United States); Kent, Michael S.; Wisner, Erik R. [Department of Surgical and Radiological Sciences, University of California Davis School of Veterinary Medicine, Davis, California 95616 (United States); Johnson, Lynelle R.; Stern, Joshua A. [Department of Medicine and Epidemiology, University of California Davis School of Veterinary Medicine, Davis, California 95616 (United States); Qi, Lihong [Department of Public Health Sciences, University of California Davis, Davis, California 95616 (United States); Fujita, Yukio [Department of Radiation Oncology, Tokai University, Isehara, Kanagawa 259-1193 (Japan); Boone, John M. [Department of Radiology, University of California Davis School of Medicine, Sacramento, California 95817 (United States)

2016-07-15

Purpose: Radiotherapy (RT) that selectively avoids irradiating highly functional lung regions may reduce pulmonary toxicity, which is substantial in lung cancer RT. Single-energy computed tomography (CT) pulmonary perfusion imaging has several advantages (e.g., higher resolution) over other modalities and has great potential for widespread clinical implementation, particularly in RT. The purpose of this study was to establish proof-of-principle for single-energy CT perfusion imaging. Methods: Single-energy CT perfusion imaging is based on the following: (1) acquisition of end-inspiratory breath-hold CT scans before and after intravenous injection of iodinated contrast agents, (2) deformable image registration (DIR) for spatial mapping of those two CT image data sets, and (3) subtraction of the precontrast image data set from the postcontrast image data set, yielding a map of regional Hounsfield unit (HU) enhancement, a surrogate for regional perfusion. In a protocol approved by the institutional animal care and use committee, the authors acquired CT scans in the prone position for a total of 14 anesthetized canines (seven canines with normal lungs and seven canines with diseased lungs). The elastix algorithm was used for DIR. The accuracy of DIR was evaluated based on the target registration error (TRE) of 50 anatomic pulmonary landmarks per subject for 10 randomly selected subjects as well as on singularities (i.e., regions where the displacement vector field is not bijective). Prior to perfusion computation, HUs of the precontrast end-inspiratory image were corrected for variation in the lung inflation level between the precontrast and postcontrast end-inspiratory CT scans, using a model built from two additional precontrast CT scans at end-expiration and midinspiration. The authors also assessed spatial heterogeneity and gravitationally directed gradients of regional perfusion for normal lung subjects and diseased lung subjects using a two-sample two-tailed t

Protocolo POG 9061 en la recaída aislada a sistema nervioso central en pacientes con diagnóstico de leucemia linfoide aguda. Resultados de una serie de casos en el Hospital Universitario de Santander POG 9061 protocol to treat isolated central nervous system recurrence in patients with acute lymphoid leukemia at Hospital Universitario de Santander

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Ernesto Rueda

2010-04-01

Full Text Available Introducción: La leucemia linfoide aguda (LLA es la neoplasia más común en niños; el 5-10 % presentan recaídas a sistema nervioso central (SNC, un factor de mal pronóstico. Objetivo: Describir los resultados obtenidos en una unidad de oncología pediátrica con el protocolo POG 9061 modificado, en pacientes con LLA y recaída aislada a SNC. Metodología: Cohorte de los pacientes atendidos en el Hospital Universitario de Santander (HUS. Se estimó la sobrevida libre de evento (SLE y la sobrevida total (ST, así como las alteraciones resultantes del protocolo. Se incluyeron 15 pacientes atendidos entre enero/93 y marzo/07; el último diagnóstico de recaída al SNC se hizo en noviembre/04. Resultados: El 66,6 % de las recaídas se dieron antes de 18 meses luego de remitir la LLA. Dos pacientes abandonaron el protocolo, uno de los cuales falleció; dos o más fallecieron luego de terminar el protocolo. La ST a cinco años fue de 85,6 % (IC95 % 53,3-96,2, mientras que la SLE de 84,9 % (IC95 % 51,2-96,0 %. La complicación más frecuente fue mielosupresión; no hubo alteraciones de la función renal y solo una ligera elevación de las pruebas de función hepática. Las causas de hospitalización fueron principalmente infecciones. El coeficiente intelectual de los pacientes posterior a la aplicación del protocolo indicaba deficiencia leve en el 45,4 % de ellos. Conclusiones: La sobrevida, el tipo y la frecuencia de complicaciones, son similares a las encontradas a nivel mundial, lo que es relevante dada la alta proporción de pacientes con recaída precoz luego de remisión de la LLA. Salud UIS 2010; 42: 7-17Introduction: Acute lymphoblastic leukemia (ALL is the most frequent neoplasm in children. Relapses to central nervous system (CNS Appears in 5-10 % of the ALL patients and is a bad prognostic factor. Objective: To describe the results obtained with modified POG 9061 protocol in a pediatric oncology unit. Methodology: Survival analysis was

Single-energy computed tomography-based pulmonary perfusion imaging: Proof-of-principle in a canine model.

Science.gov (United States)

Yamamoto, Tokihiro; Kent, Michael S; Wisner, Erik R; Johnson, Lynelle R; Stern, Joshua A; Qi, Lihong; Fujita, Yukio; Boone, John M

2016-07-01

Radiotherapy (RT) that selectively avoids irradiating highly functional lung regions may reduce pulmonary toxicity, which is substantial in lung cancer RT. Single-energy computed tomography (CT) pulmonary perfusion imaging has several advantages (e.g., higher resolution) over other modalities and has great potential for widespread clinical implementation, particularly in RT. The purpose of this study was to establish proof-of-principle for single-energy CT perfusion imaging. Single-energy CT perfusion imaging is based on the following: (1) acquisition of end-inspiratory breath-hold CT scans before and after intravenous injection of iodinated contrast agents, (2) deformable image registration (DIR) for spatial mapping of those two CT image data sets, and (3) subtraction of the precontrast image data set from the postcontrast image data set, yielding a map of regional Hounsfield unit (HU) enhancement, a surrogate for regional perfusion. In a protocol approved by the institutional animal care and use committee, the authors acquired CT scans in the prone position for a total of 14 anesthetized canines (seven canines with normal lungs and seven canines with diseased lungs). The elastix algorithm was used for DIR. The accuracy of DIR was evaluated based on the target registration error (TRE) of 50 anatomic pulmonary landmarks per subject for 10 randomly selected subjects as well as on singularities (i.e., regions where the displacement vector field is not bijective). Prior to perfusion computation, HUs of the precontrast end-inspiratory image were corrected for variation in the lung inflation level between the precontrast and postcontrast end-inspiratory CT scans, using a model built from two additional precontrast CT scans at end-expiration and midinspiration. The authors also assessed spatial heterogeneity and gravitationally directed gradients of regional perfusion for normal lung subjects and diseased lung subjects using a two-sample two-tailed t-test. The mean TRE

Single-energy computed tomography-based pulmonary perfusion imaging: Proof-of-principle in a canine model

International Nuclear Information System (INIS)

Yamamoto, Tokihiro; Kent, Michael S.; Wisner, Erik R.; Johnson, Lynelle R.; Stern, Joshua A.; Qi, Lihong; Fujita, Yukio; Boone, John M.

2016-01-01

Purpose: Radiotherapy (RT) that selectively avoids irradiating highly functional lung regions may reduce pulmonary toxicity, which is substantial in lung cancer RT. Single-energy computed tomography (CT) pulmonary perfusion imaging has several advantages (e.g., higher resolution) over other modalities and has great potential for widespread clinical implementation, particularly in RT. The purpose of this study was to establish proof-of-principle for single-energy CT perfusion imaging. Methods: Single-energy CT perfusion imaging is based on the following: (1) acquisition of end-inspiratory breath-hold CT scans before and after intravenous injection of iodinated contrast agents, (2) deformable image registration (DIR) for spatial mapping of those two CT image data sets, and (3) subtraction of the precontrast image data set from the postcontrast image data set, yielding a map of regional Hounsfield unit (HU) enhancement, a surrogate for regional perfusion. In a protocol approved by the institutional animal care and use committee, the authors acquired CT scans in the prone position for a total of 14 anesthetized canines (seven canines with normal lungs and seven canines with diseased lungs). The elastix algorithm was used for DIR. The accuracy of DIR was evaluated based on the target registration error (TRE) of 50 anatomic pulmonary landmarks per subject for 10 randomly selected subjects as well as on singularities (i.e., regions where the displacement vector field is not bijective). Prior to perfusion computation, HUs of the precontrast end-inspiratory image were corrected for variation in the lung inflation level between the precontrast and postcontrast end-inspiratory CT scans, using a model built from two additional precontrast CT scans at end-expiration and midinspiration. The authors also assessed spatial heterogeneity and gravitationally directed gradients of regional perfusion for normal lung subjects and diseased lung subjects using a two-sample two-tailed t

Reflexiones metodológicas en torno al trabajo de campo antropológico en el terreno de la historia reciente Reflexões metodológicas em relaçao ao trabalho antropológico de campo no terreno da historia recente Methodological reflections around anthropological fieldwork in the area of recent history

Directory of Open Access Journals (Sweden)

María José Sarrabayrouse Oliveira

2009-07-01

methodological problems that arose in the development of my dissertation, in which I carry out an ethnographic work about the practices and proceedings of penal justice during the last military dictatorship in Argentina. The research was structured around the analysis of a judicial trial. This led, on the one hand, to the question about what these documents say and which are the possibilities that anthropology offer for its analysis. The research implied, at the same time, the carrying out of interviews to the social actors that officiated as witnesses and protagonists of the story recounted. T hus, written records and testimonies of the period were available for carrying out this research work, both elements that constitute an important part of the fieldwork on the specific area of the penal justice in the 1970s.

Análise multivariada da divergência genética de genótipos de arroz sob estresse salino durante a fase vegetativa Multivariate analysis of genetic divergence of genotypes of rice under salt stress during the vegetative phase

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Letícia Carvalho Benitez

2011-06-01

of varieties with tolerance to high salinity. Hus the aim of this work is to evaluate genetic divergence among rice genotypes, aiming at the selection of genotypes tolerant to salinity during the vegetative phase. Seeds of 10 rice genotypes were grown in vitro on MS medium supplemented with 0 and 136 mM NaCl. After 21 days, six morphological characters were evaluated and the results subjected to multivariate analysis. The methods of Tocher, based on Mahalanobis distance, and graphic dispersion of canonic variables followed the same pattern of clustering structure, forming six groups. The characteristic of shoot fresh weight was the largest contributor to the genetic dissimilarity between genotypes by the method of Singh, while the other two canonic variables were sufficient to account for 91.27% of observed variation. Under the experimental conditions tested, the genotypes showed different degrees of salinity tolerance, while Colossus BRS, BRS Bojuru and BR IRGA 410, belonging to the groups three and four, were those who were more tolerant genotype and Moti, belonging to two what was more sensitive to salt stress.

Habitat Evaluation Procedures (HEP) Report; Precious Lands Wildlife Management Area, Technical Report 2000-2003.

Energy Technology Data Exchange (ETDEWEB)

Kozusko, Shana

2003-12-01

The Nez Perce Tribe (NPT) currently manages a 15,325 acre parcel of land known as the Precious Lands Wildlife Management Area that was purchased as mitigation for losses incurred by construction of the four lower Snake River dams. The Management Area is located in northern Wallowa County, Oregon and southern Asotin County, Washington (Figure 1). It is divided into three management parcels--the Buford parcel is located on Buford Creek and straddles the WA-OR state line, and the Tamarack and Basin parcels are contiguous to each other and located between the Joseph Creek and Cottonwood Creek drainages in Wallowa County, OR. The project was developed under the Pacific Northwest Electric Power Planning and Conservation Act of 1980 (P.L. 96-501), with funding from the Bonneville Power Administration (BPA). The acreage protected under this contract will be credited to BPA as habitat permanently dedicated to wildlife and wildlife mitigation. A modeling strategy known as Habitat Evaluation Procedure (HEP) was developed by the U.S. Fish and Wildlife Service and adopted by BPA as a habitat equivalency accounting system. Nine wildlife species models were used to evaluate distinct cover type features and provide a measure of habitat quality. Models measure a wide range of life requisite variables for each species and monitor overall trends in vegetation community health and diversity. One product of HEP is an evaluation of habitat quality expressed in Habitat Units (HUs). This HU accounting system is used to determine the amount of credit BPA receives for mitigation lands. After construction of the four lower Snake River dams, a HEP loss assessment was conducted to determine how many Habitat Units were inundated behind the dams. Twelve target species were used in that evaluation: Canada goose, mallard, river otter, downy woodpecker, song sparrow, yellow warbler, marsh wren, western meadowlark, chukar, ring-necked pheasant, California quail, and mule deer. The U.S. Army Corp of

Selected Abstracts of the 6th International Congress of UENPS; Valencia (Spain; November 23rd-25th 2016; Session “Gut, gastroenterology and nutrition”

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--- Various Authors

2016-11-01

. Aguar, A. Núñez-Ramiro, M. Cernada, M. Gormaz, M. VentoABS 12. DNA AND PROTEIN OXIDATIVE STRESS IN PRETERM INFANTS LESS THAN 32 WEEKS OF GESTATIONAL AGE FED WITH DONOR HUMAN MILK VERSUS OWN MOTHER’S MILK • A. Parra-Llorca, J. Kuligowski, A. Sánchez-Illana, M. Gormaz, M. Cernada, M. Aguar, A. Núñez-Ramiro, M. VentoABS 13. RELATIONSHIP BETWEEN ENTERAL NUTRITION GROWTH IN THE EARLY NEONATAL PERIOD AND PHYSICAL AND PSYCHOMOTOR DEVELOPMENT OF VERY PREMATURE INFANTS (VPI IN THE FIRST 8 CORRECTED MONTHS • A.V. Degtyareva, V. Talvirskaya, D. Amirhanova, M. NaroganABS 14. THE VERY EARLY DIFFERENCES IN THE BODY COMPOSITION BETWEEN PRETERM NEWBORNS FED WITH FORMULA OR BREAST MILK COMPARED TO THE GROUP OF FULL TERM NEWBORNS • N. Mól, M. Zasada, P. KwintaABS 15. ANALYSIS OF THE INFLUENCE OF DIFFERENT TYPES OF DELIVERY AT THE TIME OF FIRST BREASTFEEDING IN HEALTHY TERM NEWBORNS • A.F. Fontes, A. Barroso PereiraABS 16. HUMAN MILK BANK ESTABLISHMENT IN A NEONATAL UNIT IMPROVES BREASTFEEDING RATES • M. Gormaz, A. Parra-Llorca, M. Cernada, J. Kuligowski, A. Gimeno Navarro, A. Ramón Beltrán, S. Lázaro Beixer, M. Vento, I. MaciánABS 17. LONG-TERM DIFFERENCES IN METABOLIC PATTERN BETWEEN MILK FROM MOTHERS DELIVERING TERM AND PRETERM NEWBORNS: A METABOLOME STUDY • S. Perrone, M. Riccitelli, M. Longini, M.L. Tataranno, S. Negro, M. Tassini, A. Vivi, C. Bracciali, G. Olinda, M. Calderisi, G. BuonocoreABS 18. “NETINCARE” PROJECT: NETWORKING TO IMPROVE HEALTH CARE FOR MOTHERS AND PREMATURE INFANTS IN THE BALTIC REGION AND MOLDOVA • N. Revenco, O. Cirstea, S. Polberger, A. Valiulis, H. Varendi, A. Tiit, K. Abdul, A. Sandgren, K. Young-Keun (DaeHo, G. Husén StrömqvistABS 19. POSTNATAL GROWTH RATE IN PRETERM INFANTS HOSPITALIZED IN NICU • S. Heljic, S. Terzic, H. MaksicABS 20. HUMAN MILK BANKING IN GREECE; EXPERIENCE FROM A PUBLIC PERINATAL CENTRE: DATA FROM THE LAST DECADE • I. Ioannou, G. Liosis, G.Vourna, F. Sioubara, K. Dritsakou, A. Tsilia, M. Tzaki

Approach for Realization of Economic Development and Social Stability in Ethnic Region of Sichuan

Institute of Scientific and Technical Information of China (English)

WU Yousheng

2013-01-01

The stability of Sichuan ’ s ethnic regions cannot be separated from their economic development.Hence, the necessary conditions for promoting the development and stability of Si-chuan ’ s ethnic regions include: fully applying the “Scientific Concept of Development”; enhan-cing the integrative and comprehensive utilization of resources;developing resource -saving and en-vironment -friendly industries; and constructing an industrial system based upon the advantages of local characteristics . 1. Integrating Advantaged Resources and Constructing Advantaged Industrial Systems ( 1 ) Enhancing Resource Development and Resource Integration Firstly, we should strengthen geological ex-ploration , and especially strengthen the investiga-tion and evaluation of those mineral resources which have a national shortage , but also have both a large potential market and big development po-tential in Sichuan ’ s ethnic regions . Secondly , we should strengthen resource ac-cumulation and its sustainable utilization;insist on“Development in Protection , and Protection in De-velopment”;strengthen the saving and sustainable utilization of resources , especially land , energy and water resources; and actively develop renew-able resources, including solar energy , biogas, bi-omass energy and wind power . with the development of tourism resources as well as agricultural and husbandry resources . ( 2 ) Advance Agriculture and Husbandry with Traditional Characteristics towards Ones with Modern Characteristics If we want to develop an agriculture and hus-bandry with modern characteristics , and realize the transformation of traditional farming and animal husbandry to ones with modern characteristics in the Sichuan ethnic regions , then, we should take the lead in building a national -level demonstra-tion base of modern agriculture and husbandry in the ethnic regions .Taking the construction of the“Four Big Systems” into consideration , we should perfect the support system for

Rare Disease Patient Registry & Natural History Study - Coordination of Rare Diseases at Sanford

Science.gov (United States)

2017-09-28

Neoplasia Type 2; Multiple Endocrine Neoplasia, Type IV; Multiple Endocrine Neoplasia, Type 3; Multiple Endocrine Neoplasia (MEN) Syndrome; Multiple Endocrine Neoplasia Type 2B; Multiple Endocrine Neoplasia Type 2A; Atypical Hemolytic Uremic Syndrome; Atypical HUS; Wiedemann-Steiner Syndrome; Breast Implant-Associated Anaplastic Large Cell Lymphoma; Autoimmune/Inflammatory Syndrome Induced by Adjuvants (ASIA); Hemophagocytic Lymphohistiocytosis; Behcet's Disease