Head and Neck Diseases by Alexandros G.Sfakianakis: 12/22/15

Τρίτη 22 Δεκεμβρίου 2015

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A Randomized Controlled Trial of the Effectiveness of Traditional and Mobile Public Health Communications With Health Care Providers

Research Articles
Janet Baseman, Debra Revere, Ian Painter, Mark Oberle, Jeffrey Duchin, Hanne Thiede, Randall Nett, Dorothy MacEachern, Andy Stergachis
Disaster Medicine and Public Health Preparedness, FirstView Article(s), 10 pages

Abstract

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A Randomized Controlled Trial of the Effectiveness of Traditional and Mobile Public Health Communications With Health Care Providers

Abstract

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Injured condylar cartilage leads to traumatic temporomandibular joint ankylosis

Publication date: Available online 21 December 2015
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Jiewen Dai, Ningjuan Ouyang, Xiaofang Zhu, Li Huang, Guofang Shen
PurposeThe exact mechanisms of traumatic temporomandibular joint ankylosis (TTMJA) are largely unknown. In this study, we explore the role of injured condylar cartilage in the development of TTMJA.Material and MethodsOne-month-old male mice were divided into two groups. In group 1, condylar cartilage was partially removed in the right joint using a small scissors to induce ankylosis. In group 2, condylar cartilage was completely removed in the same right joint using a small scissors to induce ankylosis. The phenotypes were observed using gross observation, micro-computed tomography scans and histological examination.ResultsThe results revealed a great deal of ectopic cartilage and bone formation in the right periarticular region in all mice in group 1, whereas there was only a small amount of ectopic cartilage present in 26.7% of the mice in group 2. Additionally, there was stronger expression of FGF9 and weaker expression of OPN in the right temporomandibular joint region in group 2 at 7 days after surgery.ConclusionsThese results suggest that the injured cartilage, not the injured bone, plays a crucial role in the development of TTMJA. In addition, it offers a useful TTMJA animal model to study the molecular mechanisms of TTMJA based on the gene manipulation technology, such as gene knock-out and knock-in as well as transgenic or gene mutation.

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Systematic Review of Oral Ulceration with Bone Sequestration

Publication date: Available online 22 December 2015
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Benjamin Palla, Egon Burian, John Richard Klecker, Riham Fliefel, Sven Otto
BackgroundThis article represents the first systematic review entirely dedicated toward a disease called oral ulceration with bone sequestration (OUBS). We performed this review in order to further define and outline this disease. A secondary interest was to recognize the prevalence and importance of OUBS in relation to other oral disorders accompanied by ulceration and bone exposure.Material and methodsThe systematic review was registered with PROSPERO (registration number CRD42015024294) and performed in cooperation with Harvard's Countway Library. Searches were built using MeSH terms and proximity operators previously mentioned in OUBS descriptions. Database searches were performed through EMBASE, Medline, and PubMed, followed by a handsearch of bibliographies for relevant articles. Articles were assessed against eligibility and inclusion criteria centering on bone exposure without known etiologic cause. We sought to gather information on patient age, sex, anatomical location, clinical presentation, and comorbidities. PRISMA guidelines were followed.ResultsThe searches identified 766 records total. Despite considerable inspection, we found only 8 articles qualifying for our review. In the 8 articles, there were a total of 24 patients fulfilling the criteria of OUBS. Although some abstracts mentioned idiopathic nature, most authors presented clinical cases with probable causes to ulceration and sequestration. The mean age of these patients was 43.21± 11.94 years. The male to female ratio was 3:1. The predominant area of occurrence was the mandible (n= 23, 95.8%)ConclusionThe representation of OUBS in the literature remains scarce. More data must be generated and gathered on the concept of OUBS so as to determine the true incidence and importance of this disease. Despite rare occurrences of conditions characterizing OUBS, the recent discussion of this topic in the scientific community calls for more knowledge to be brought forth, with great benefit to patients suffering from ulcerative diseases and osteonecrosis.

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Iterations of computer- and template assisted mandibular or maxillary reconstruction with free flaps containing the lateral scapular border – evolution of a biplanar plug-on cutting guide

Publication date: Available online 21 December 2015
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Carl-Peter Cornelius, Goetz Andreas Giessler, Frank Wilde, Marc Christian Metzger, Gerson Mast, Florian Andreas Probst
BackgroundComputer-assisted planning and intraoperative implementation using templates have become appreciated modalities in craniofacial reconstruction with fibula and DCIA flaps due to saving in operation time, improved accuracy of osteotomies and easy insetting. Up to now, a similar development for flaps from the subscapular vascular system, namely the lateral scapular border and tip, has not been addressed in the literature.Patients/MethodA cohort of 12 patients who underwent mandibular (n=10) or maxillary (n=2) reconstruction with free flaps containing the lateral scapular border and tip using computer-assisted planning, stereolithography (STL) models and selective laser sintered (SLS) templates for bone contouring and sub-segmentation osteotomies was reviewed focussing on iterations in the design of computer generated tools and templates.ResultsThe technical evolution migrated from hybrid STL models over SLS templates for cutout as well as sub-segmentation with a uniplanar framework to plug-on tandem template assemblies providing a biplanar access for the in toto cutout from the posterior aspect in succession with contouring into sub-segments from the medial side. Conclusion: The latest design version is the proof of concept that virtual planning of bone flaps from the lateral scapular border can be successfully transferred into surgery by appropriate templates.

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Increased Spontaneous Otoacoustic Emissions in Mice with a Detached Tectorial Membrane

Abstract

Mutations in genes encoding tectorial membrane (TM) proteins are a significant cause of human hereditary hearing loss (Hildebrand et al. 2011), and several mouse models have been developed to study the functional significance of this accessory structure in the mammalian cochlea. In this study, we use otoacoustic emissions (OAE), signals obtained from the ear canal that provide a measure of cochlear function, to characterize a mouse in which the TM is detached from the spiral limbus due to an absence of otoancorin (Otoa, Lukashkin et al. 2012). Our results demonstrate that spontaneous emissions (SOAE), sounds produced in the cochlea without stimulation, increase dramatically in mice with detached TMs even though their hearing sensitivity is reduced. This behavior is unusual because wild-type (WT) controls are rarely spontaneous emitters. SOAEs in mice lacking Otoa predominate around 7 kHz, which is much lower than in either WT animals when they generate SOAEs or in mutant mice in which the TM protein Ceacam16 is absent (Cheatham et al. 2014). Although both mutants lack Hensen's stripe, loss of this TM feature is only observed in regions coding frequencies greater than ~15 kHz in WT mice so its loss cannot explain the low–frequency, de novo SOAEs observed in mice lacking Otoa. The fact that ~80 % of mice lacking Otoa produce SOAEs even when they generate smaller distortion product OAEs suggests that the active process is still functioning in these mutants but the system(s) involved have become less stable due to alterations in TM structure.

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Ungeschützter Geschlechtsverkehr bringt E. coli daher

Ursachenforschung
Nach ungeschütztem Vaginalverkehr kann es zu einer Kolonisation der Vagina mit E. coli kommen. Dafür fanden sich Ursachen unterschiedlicher Art.

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Selective Inner Hair Cell Dysfunction in Chinchillas Impairs Hearing-in-Noise in the Absence of Outer Hair Cell Loss

Abstract

Poorer hearing in the presence of background noise is a significant problem for the hearing impaired. Ototoxic drugs, ageing, and noise exposure can damage the sensory hair cells of the inner ear that are essential for normal hearing sensitivity. The relationship between outer hair cell (OHC) loss and progressively poorer hearing sensitivity in quiet or in competing background noise is supported by a number of human and animal studies. In contrast, the effect of moderate inner hair cell (IHC) loss or dysfunction shows almost no impact on behavioral measures of hearing sensitivity in quiet, when OHCs remain intact, but the relationship between selective IHC loss and hearing in noise remains relatively unknown. Here, a moderately high dose of carboplatin (75 mg/kg) that produced IHC loss in chinchillas ranging from 40 to 80 % had little effect on thresholds in quiet. However, when tested in the presence of competing broadband (BBN) or narrowband noise (NBN), thresholds increased significantly. IHC loss >60 % increased signal-to-noise ratios (SNRs) for tones (500–11,300 Hz) in competing BBN by 5–10 dB and broadened the masking function under NBN. These data suggest that IHC loss or dysfunction may play a significant role in listening in noise independent of OHC integrity and that these deficits may be present even when thresholds in quiet are within normal limits.

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Excitation Patterns of Standard and Steered Partial Tripolar Stimuli in Cochlear Implants

Abstract

Current steering in partial tripolar (pTP) mode has been shown to improve pitch perception and spectral resolution with cochlear implants (CIs). In this mode, a fraction (σ) of the main electrode current is returned within the cochlea and steered between the basal and apical flanking electrodes (with a proportion of α and 1 − α, respectively). Pitch generally decreases when α increases from 0 to 1, although the salience of pitch change varies across CI users. This study aimed to identify the mechanism of pitch changes with pTP-mode current steering and the factors contributing to the intersubject variability in pitch-ranking sensitivity. The electrical fields were measured for steered pTP stimuli on the same main electrode with α = 0, 0.5, and 1 in five implanted ears using electrical field imaging (EFI). The related excitation patterns were also measured physiologically using evoked compound action potential (ECAP) and psychophysically using psychophysical forward masking (PFM). Consistent with the pitch-ranking results in this study, the EFI, ECAP, and PFM centroids shifted apically with increasing α. An apical shift was also observed for the PFM peak but not for the EFI or ECAP peak. The pattern width was similar with different α values within a given measure (e.g., EFI, ECAP, or PFM), but the ECAP patterns were broader than the EFI and PFM patterns, possibly because ECAP was measured with smaller σ values than EFI and PFM. The amount of pattern shift with α depended on σ (i.e., the total amount of current used for steering) but was not correlated with the pitch-ranking sensitivity across subjects. The results revealed that the pitch changes elicited by pTP-mode current steering were not only driven by the shifts of excitation centroid.

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Letter on the article “Head and neck sarcoma: Analysis of 29 cases”

Publication date: Available online 21 December 2015
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): M. Carifi, D. Dall'Olio

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Injured condylar cartilage leads to traumatic temporomandibular joint ankylosis

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Atypical Lemierre syndrome

Publication date: Available online 21 December 2015
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): M. Risoud, G. Mortuaire, D. Chevalier, B. Rysman
IntroductionLemierre syndrome is a complication of oropharyngeal infection and consists of a combination of internal jugular vein septic thrombophlebitis with septicaemia and distant septic emboli (mainly in the lungs). We describe an atypical case with facial vein and anterior jugular vein thrombophlebitis.Case summaryA 34-year-old woman attended the emergency room with tonsillitis, left head and neck cellulitis, left facial vein thrombosis and lung abscesses. A diagnosis of atypical Lemierre syndrome was proposed and the patient was treated surgically (neck incision and tonsillectomy) and medically (antibiotics, hyperbaric oxygen therapy and anticoagulation) allowing cure without sequelae.DiscussionLemierre syndrome, a rare but serious complication requiring immediate treatment, should be investigated (by blood cultures and chest CT scan) in the presence of neck vein thrombosis complicating oropharyngeal infection.

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Iterations of computer- and template assisted mandibular or maxillary reconstruction with free flaps containing the lateral scapular border – evolution of a biplanar plug-on cutting guide

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A Randomized Controlled Trial of the Effectiveness of Traditional and Mobile Public Health Communications With Health Care Providers

Abstract

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A Randomized Controlled Trial of the Effectiveness of Traditional and Mobile Public Health Communications With Health Care Providers

Abstract

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Injured condylar cartilage leads to traumatic temporomandibular joint ankylosis

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Systematic Review of Oral Ulceration with Bone Sequestration

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Iterations of computer- and template assisted mandibular or maxillary reconstruction with free flaps containing the lateral scapular border – evolution of a biplanar plug-on cutting guide

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Increased Spontaneous Otoacoustic Emissions in Mice with a Detached Tectorial Membrane

Abstract

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Ungeschützter Geschlechtsverkehr bringt E. coli daher

Ursachenforschung
Nach ungeschütztem Vaginalverkehr kann es zu einer Kolonisation der Vagina mit E. coli kommen. Dafür fanden sich Ursachen unterschiedlicher Art.

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Selective Inner Hair Cell Dysfunction in Chinchillas Impairs Hearing-in-Noise in the Absence of Outer Hair Cell Loss

Abstract

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Excitation Patterns of Standard and Steered Partial Tripolar Stimuli in Cochlear Implants

Abstract

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Letter on the article “Head and neck sarcoma: Analysis of 29 cases”

Publication date: Available online 21 December 2015
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): M. Carifi, D. Dall'Olio

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Injured condylar cartilage leads to traumatic temporomandibular joint ankylosis

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Atypical Lemierre syndrome

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Iterations of computer- and template assisted mandibular or maxillary reconstruction with free flaps containing the lateral scapular border – evolution of a biplanar plug-on cutting guide

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Tuberculose mammaire : à propos de quatre cas à l’hôpital d’instruction des armées Omar Bongo Ondimba (HIAOBO) de Libreville (Gabon)

Résumé

La tuberculose mammaire est une localisation rare de la tuberculose extrapulmonaire. Sa fréquence augmente de manière proportionnelle à la pandémie VIH. Nous rapportons quatre cas de tuberculose mammaire diagnostiquée dans le service de médecine polyvalente de l'HIAOBO, dont deux ayant une sérologie VIH positive. Il est nécessaire de connaître cette forme extrapulmonaire car le diagnostic différentiel avec les tumeurs mammaires est parfois difficile.

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Systematic Review of Oral Ulceration with Bone Sequestration

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Milk consumption in relation to incidence of nasopharyngeal carcinoma in 48 countries/regions

Abstract

Background

Decreasing trends of nasopharyngeal carcinoma (NPC) incidence have been consistently reported in endemic populations but the etiology of NPC remains unclear. The objective of our study was to assess the international and local (Hong Kong) correlations of milk and dairy products per capita consumption with NPC incidence.

Methods

We conducted an ecological study in 48 countries/regions. Age standardized incidence rates of NPC were obtained from the Cancer Incidence in Five Continents. Dairy product consumption and Human Development Index were obtained from the Food and Agriculture Organization of the United Nations and the United Nations Development Programme. Spearman correlation, multivariate analysis and time-lagged analysis were performed.

Results

The negative correlations between milk consumption and decreased age standardized incidence rates of NPC were observed in the 48 countries/regions adjusting for Human Development Index in endemic countries/regions. In Hong Kong, multivariate analysis, after adjusting for other potential confounders, including salted fish, cigarette, vegetable consumption and socioeconomic status, showed consistently negative and significant correlations between milk consumption and NPC incidence (The strongest coefficient (β) was observed at 10-year lag in males [β = −0.439; P < 0.01] and in females [β = −0.258; P < 0.01]).

Conclusions

Our study showed the correlations on milk consumption per capita and against lower risk of NPC in 48 countries/regions and in Hong Kong. These hypothesis-generating results could support further studies on individual exposures and the disease.

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Inter-comparison of dynamic models for radionuclide transfer to marine biota in a Fukushima accident scenario

Publication date: March 2016
Source:Journal of Environmental Radioactivity, Volume 153
Author(s): J. Vives i Batlle, N.A. Beresford, K. Beaugelin-Seiller, R. Bezhenar, J. Brown, J.-J. Cheng, M. Ćujić, S. Dragović, C. Duffa, B. Fiévet, A. Hosseini, K.T. Jung, S. Kamboj, D.-K. Keum, A. Kryshev, D. LePoire, V. Maderich, B.-I. Min, R. Periáñez, T. Sazykina, K.-S. Suh, C. Yu, C. Wang, R. Heling
We report an inter-comparison of eight models designed to predict the radiological exposure of radionuclides in marine biota. The models were required to simulate dynamically the uptake and turnover of radionuclides by marine organisms.Model predictions of radionuclide uptake and turnover using kinetic calculations based on biological half-life (TB1/2) and/or more complex metabolic modelling approaches were used to predict activity concentrations and, consequently, dose rates of 90Sr, 131I and 137Cs to fish, crustaceans, macroalgae and molluscs under circumstances where the water concentrations are changing with time. For comparison, the ERICA Tool, a model commonly used in environmental assessment, and which uses equilibrium concentration ratios, was also used. As input to the models we used hydrodynamic forecasts of water and sediment activity concentrations using a simulated scenario reflecting the Fukushima accident releases.Although model variability is important, the intercomparison gives logical results, in that the dynamic models predict consistently a pattern of delayed rise of activity concentration in biota and slow decline instead of the instantaneous equilibrium with the activity concentration in seawater predicted by the ERICA Tool. The differences between ERICA and the dynamic models increase the shorter the TB1/2 becomes; however, there is significant variability between models, underpinned by parameter and methodological differences between them.The need to validate the dynamic models used in this intercomparison has been highlighted, particularly in regards to optimisation of the model biokinetic parameters.

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Letter on the article “Head and neck sarcoma: Analysis of 29 cases”

Publication date: Available online 21 December 2015
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): M. Carifi, D. Dall'Olio

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Atypical Lemierre syndrome

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Artist afflicted with MS races against death to spread her light – Norwalk Reflector

Artist afflicted with MS races against death to spread her light
Norwalk Reflector
Then, one day, half of her tongue went numb. Hours of hospital tests revealed she had MS. "That was the first time my kids heard the word 'incurable,'" Emily says. "I'd had cancer and I'd gotten fixed; but when I had to explain what progressive MS was …

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Evaluation of the GenoType® MTBDRsl assay in Korean patients with MDR or XDR tuberculosis

10.3109/23744235.2015.1125999<br/>Hyun Yong Jeong

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Dermatophytosis in northern Africa

Summary

Infections caused by dermatophytes are a global problem and a major public health burden in the world today. In Africa, especially in the northern geographical zone, dermatophytic infections are being reported at an alarming rate. This is mostly because of some local but unique cultural practices, socioeconomic and environmental conditions, lack of reliable diagnostic personnel and facilities and ineffective treatment. Interestingly, the pathogen spectrum and the clinical manifestation are most times different from what is seen in other continents. Several epidemiological studies have been performed on the incidence and aetiology of dermatophytoses in northern Africa. However, there is currently no review article with up-to-date information on the relevant findings reported so far in this region. This information is necessary for clinicians who treat dermatophytic infections all over the world since agents of dermatophytes are no longer restricted because of the rapid mobility of humans from one part of the world to another. Moreover, the epidemiology of dermatophytoses is known to change over time, thus requiring the update of information from time to time. A review of relevant studies published on dermatophytoses in northern Africa is presented. This covers all of old Sudan, Algeria, Egypt, Libya, Tunisia and Morocco.

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Invasive pulmonary mycosis due to Chaetomium globosum with false-positive galactomannan test: a case report and literature review

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Summary

In this case, the authors report Chaetomium globosum as a cause of invasive pulmonary infection in a patient with Wegener's granulomatosis. Fungal hyphae (KOH and Calcofluor) were seen on direct microscopy of lung biopsy sample and bronchoalveolar lavage (BAL) sample. C. globosum isolated on culture clinched the diagnosis of invasive pulmonary infection by Chaetomium spp. A positive galactomannan of serum and BAL was repeatedly seen and was utilised for follow-up and as prognostic marker in patient management. The patient was successfully treated with liposomal amphotericin B followed by voriconazole. All the Chaetomium infections reported till date since 1980 are reviewed. Chaetomium spp. with its unique ecology has a hidden clinical potential to cause invasive mould infections.

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Thiamine antivitamins – an opportunity of therapy of fungal infections caused by Malassezia pachydermatis and Candida albicans

Summary

Severe skin diseases and systemic fungaemia are caused by Malassezia pachydermatis and Candida albicans respectively. Antifungal therapies are less effective because of chronic character of infections and high percentage of relapses. Therefore, there is a great need to develop new strategies of antifungal therapies. We previously found that oxythiamine decreases proliferation of yeast (Saccharomyces cerevisiae), therefore we suggest that thiamine antivitamins can be considered as antifungal agents. The aim of this study was the comparison of thiamine antivitamins (oxythiamine, amprolium, thiochrome, tetrahydrothiamine and tetrahydrooxythiamine) inhibitory effect on the growth rate and energetic metabolism efficiency in non-pathogenic S. cerevisiae and two potentially pathogenic species M. pachydermatis and C. albicans. Investigated species were cultured on a Sabouraud medium supplemented with trace elements in the presence (40 mg l⁻¹) or absence of each tested antivitamins to estimate their influence on growth rate, enzyme activity and kinetic parameters of pyruvate decarboxylase and malate dehydrogenase of each tested species. Oxythiamine was the only antivitamin with antifungal potential. M. pachydermatis and S. cerevisiae were the most sensitive, whereas C. albicans was the least sensitive to oxythiamine action. Oxythiamine can be considered as supportive agent in superficial mycoses treatment, especially those caused by species from the genus Malassezia.

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Fluorescent Pseudomonads in the Phyllosphere of Wheat: Potential Antagonists Against Fungal Phytopathogens

Abstract

Fluorescent pseudomonads isolated from wheat leaves were characterized regarding their antagonistic potential and taxonomy in relation to protect crop plants from infestation by Fusarium and Alternaria fungi causing diseases in wheat. Using a dual culture assay, inhibition of fungal growth was found for 40 isolates of 175 fluorescent pseudomonads. Twenty-two of the antagonists were able to suppress strains of Fusarium as well as Alternaria. By means of real-time qPCR, the phlD gene encoding the antibiotic 2,4-diacetylphloroglucinol was detected in 20 isolates. On the basis of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry spectral patterns, the isolates with antagonistic activity were assigned to the phylogenetic subgroup Pseudomonas fluorescens and the closely related Pseudomonas gessardii subgroup. The results of the study suggest that pseudomonads in the phyllosphere of crop plants may possibly contribute to natural plant protection.

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Lytic Action of the Truncated yncE Gene in Escherichia coli

Abstract

We recently found lytic action of the truncated yncE gene. When the truncated yncE gene of Salmonella enterica serovar Paratyphi A was expressed in Escherichia coli DH5α under the control of the Ara promoter, bacterial growth was markedly inhibited. In the present study, we characterized this lytic action. The N-terminal 103 aa of YncE, containing a signal peptide, was demonstrated to be essential for inhibition. Microscopic observation showed that the bacterial envelope of E. coli was damaged by the expression of truncated yncE, resulting in the release of cytoplasmic content and the formation of bacterial ghosts. The addition of MgSO₄ or spermine, which is the stabilizer of bacterial membrane structure, dramatically reversed the cell lysis induced by the toxic truncated YncE. In contrast, the lytic action was significantly enhanced by the addition of SDS or EDTA. Our data indicated that the toxic truncated YncE could cause cell lysis by the disruption of the bacterial membrane.

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Wenyingzhuangia aestuarii sp. nov., A Marine Bacterium of the Family Flavobacteriaceae Isolated from an Estuary

Abstract

A Gram-negative, strictly aerobic, chemoheterotrophic, pale-yellow pigmented, non-motile, rod-shaped bacterial strain, designated MN1-138^T, was isolated from water in the tidal zone at the estuary of Heita river, Iwate, Japan, using an in situ cultivation technique. Preliminary analysis based on the 16S rRNA gene sequence revealed that the novel isolate is affiliated with the family Flavobacteriaceae of the phylum Bacteroidetes, and the highest sequence similarities were found with the species Wenyingzhuangia heitensis H-MN17^T (97.3 %). The DNA–DNA relatedness between values between strains MN1-138^T and W. heitensis H-MN17^T was 34 %. The DNA G+C content of strain MN1-138^T was determined to be 33.1 mol%; MK-6 was identified as the major menaquinone; and the presence of iso-C15:0, iso-C15:0 3-OH, and iso-C17:0 3-OH as the major (>10 %) cellular fatty acids. A polar lipid profile was present consisting of phosphatidylethanolamine, two unidentified glycolipids, and two unidentified lipids. From the distinct phylogenetic position and combination of genotypic and phenotypic characteristics, the strain is considered to represent a novel species of the genus Wenyingzhuangia for which the name Wenyingzhuangia aestuarii sp. nov. is proposed. The type strain of W. aestuarii sp. nov. is MN1-138^T (=KCTC 42780^T = NBRC 111505^T).

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SDS-PAGE and Gel IEF: Tool for Differentiation of Methicillin-Resistant and Methicillin-Sensitive Strains of Staphylococcus aureus

Abstract

The methicillin-resistant Staphylococcus aureus causes difficult-to-treat healthcare-associated infections in humans. For fast and effective selection of an appropriate antibiotic therapy, it is essential to have rapid and reliable methods for differentiation of methicillin-resistant S. aureus from less dangerous methicillin-sensitive S. aureus. There have been many methods for the identification of methicillin-resistant S. aureus described but none has been accepted as an international standard. The most commonly used techniques such as phenotyping and genotyping have a few disadvantages, for instance, these techniques are not reproducible and stable. In addition, they are time-consuming, expensive, and they are not capable to distinguish all S. aureus strains. In this study, the methicillin-resistant and methicillin-sensitive S. aureus isolates obtained from patients were extracted in hot water. The released proteins were characterised by sodium dodecyl sulphate polyacrylamide gel electrophoresis and gel isoelectric focusing. These two methods were able to differentiate among tested bacterial strains. The proposed methods are time saving, they are applicable in standard biochemical laboratories, and they do not require any expensive equipment.

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The burden of serious human fungal infections in Brazil

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Summary

In Brazil, human fungal infections are prevalent, however, these conditions are not officially reportable diseases. To estimate the burden of serious fungal diseases in 1 year in Brazil, based on available data and published literature. Historical official data from fungal diseases were collected from Brazilian Unified Health System Informatics Department (DATASUS). For fungal diseases for which no official data were available, assumptions of frequencies were made by estimating based on published literature. The incidence (/1000) of hospital admissions for coccidioidomycosis was 7.12; for histoplasmosis, 2.19; and for paracoccidioidomycosis, 7.99. The estimated number of cryptococcal meningoencephalitis cases was 6832. Also, there were 4115 cases of Pneumocystis pneumonia in AIDS patients per year, 1 010 465 aspergillosis and 2 981 416 cases of serious Candida infections, including invasive and non-invasive diseases. In this study, we demonstrate that more than 3.8 million individuals in Brazil may be suffering from serious fungal infections, mostly patients with malignant cancers, transplant recipients, asthma, previous tuberculosis, HIV infection and those living in endemic areas for truly pathogenic fungi. The scientific community and the governmental agencies should work in close collaboration in order to reduce the burden of such complex, difficult-to-diagnose and hard to treat diseases.

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Safety and efficacy of phage therapy via the intravenous route

Increasing development of antimicrobial resistance is driving a resurgence in interest in phage therapy: the use of bacteriophages to treat bacterial infections. As the lytic action of bacteriophages is unaffected by the antibiotic resistance status of their bacterial target it is thought that phage therapy may have considerable potential in the treatment of a wide range of topical and localized infections. As yet this interest has not extended to intravenous (IV) use, which is surprising given that the historical record shows that phages are likely to be safe and effective when delivered by this route. Starting almost 100 years ago, phages were administered intravenously in treatment of systemic infections including typhoid, and Staphylococcal bacteremia. There was extensive IV use of phages in the 1940s to treat typhoid, reportedly with outstanding efficacy and safety. The safety of IV phage administration is also underpinned by the detailed work of Ochs and colleagues in Seattle who have over 4 decades experience with IV injection into human subjects of large doses of highly purified coliphage PhiX174. Though these subjects included a large number of immune deficient children no serious side effects were observed over this extended time period. The large and continuing global health problems of typhoid and Staphylococcus aureus are exacerbated by the increasing antibiotic resistance of these pathogens. We contend that these infections are excellent candidates for use of intravenous phage therapy.

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Monitoring Lysobacter capsici AZ78 using strain specific qPCR reveals the importance of the formulation for its survival in vineyards

Survival in the phyllosphere is a critical feature for biofungicides based on non-spore forming bacteria. Moreover, knowledge of their persistence on plants is important to design effective formulations and application techniques. With this scope, the aim of this work was to develop a specific method to monitor the fate in the environment of Lysobacter capsici AZ78, a biocontrol agent of Plasmopara viticola, and to evaluate the contribution of formulation in its persistence on grapevine leaves. A strain-specific primer pair derived from REP-PCR fingerprinting was used in quantitative PCR experiments to track the evolution of L. capsici AZ78 population in vineyards. The population reached between 5 and 6 log₁₀ cells gram of leaf^–1 after application and decreased by more than 100 times in one week. Multiple regression analysis showed that unfavourable temperature was the main environmental factor correlating with the decrease of L. capsici AZ78 persistence on grapevine leaves. Importantly, the use of formulation additives protected L. capsici AZ78 against environmental factors and improved its persistence on the leaves by more than 10 times compared to nude cells. Formulation and the knowledge about the persistence of L. capsici AZ78 in vineyards will be useful to develop commercial biofungicides for foliar application.

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Adding mucins to an in vitro batch fermentation model of the large intestine induces changes in microbial population isolated from porcine feces depending on the substrate

Adding mucus to in vitro fermentation models of the large intestine showed that some genera, namely lactobacilli, are dependent on host-microbiota interactions and that they rely on mucosa layers to increase their activity. This study investigates whether this dependence on mucus is substrate-dependent and to which extend other genera are impacted by the presence of mucus. Inulin and cellulose were fermented in vitro by a fecal inoculum from pig in the presence or not of mucin-beads in order to compare fermentation patterns and bacterial communities. Mucins increased final gas production with inulin and shifted short-chain fatty acids molar ratios (P < 0.001). QPCR analyses revealed that Lactobacillus spp. and Bifidobacterium spp. decreased with mucins, but Bacteroides spp. increased when inulin was fermented. A more in-depth community analysis indicated that the mucins increased Proteobacteria (0.55 vs. 0.25%, P = 0.013), Verrucomicrobia (5.25 vs. 0.03%, P = 0.032), Ruminococcaceae, Bacteroidaceae, and Akkermansia spp. Proteobacteria (5.67 vs. 0.55%, P < 0.001) and Lachnospiraceae (33 vs. 10.4%) were promoted in the mucuscompared to the broth, while Ruminococcaceae decreased. The introduction of mucins affected many microbial genera and fermentation patterns, but from PCA results, the impact of mucus was independent from the fermentation substrate.

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Supraglacial bacterial community structures vary across the Greenland ice sheet

The composition and spatial variability of microbial communities that reside within the extensive (>200 000 km²) biologically active area encompassing the Greenland ice sheet (GrIS) is hypothesised to be variable. We examined bacterial communities from cryoconite debris and surface ice across the GrIS, using sequence analysis and quantitative PCR of 16S rRNA genes from co-extracted DNA and RNA. Communities were found to differ across the ice sheet, with 82.8% of the total calculated variation attributed to spatial distribution on a scale of tens of kilometres separation. Amplicons related to Sphingobacteriaceae, Pseudanabaenaceae and WPS-2 accounted for the greatest portion of calculated dissimilarities. The bacterial communities of ice and cryoconite were moderately similar (global R = 0.360, p = 0.002) and the sampled surface type (ice versus cryoconite) did not contribute heavily towards community dissimilarities (2.3% of total variability calculated). The majority of dissimilarities found between cryoconite 16S rRNA gene amplicons from DNA and RNA was calculated to be the result of changes in three taxa; Pseudanabaenaceae, Sphingobacteriaceae and WPS-2, which together contributed towards 80.8 ± 12.6% of dissimilarities between samples. Bacterial communities across the GrIS are spatially variable active communities that are likely influenced by localised biological inputs and physicochemical conditions.

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Resilience of SAR11 bacteria to rapid acidification in the high latitude open ocean

Ubiquitous SAR11 Alphaproteobacteria numerically dominate marine planktonic communities. Because they are excruciatingly difficult to cultivate, there is comparatively little known about their physiology and metabolic responses to long- and short- term environmental changes. As surface oceans take up anthropogenic, atmospheric CO₂, the consequential process of ocean acidification could affect the global biogeochemical significance of SAR11. Shipping accidents or inadvertent release of chemicals from industrial plants can have strong short-term local effects on oceanic SAR11. This study investigated the effect of 2.5 fold acidification of seawater on the metabolism of SAR11 and other heterotrophic bacterioplankton along a natural temperature gradient crossing the North Atlantic Ocean, Norwegian and Greenland Seas. Uptake rates of the amino acid leucine by SAR11 cells as well as other bacterioplankton remained similar to controls despite an instant ~50% increase in leucine bioavailability upon acidification. This high physiological resilience to acidification even without acclimation, suggests that open ocean dominant bacterioplankton are able to cope even with sudden and therefore more likely with long-term acidification effects.

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Cowden Syndrome and Concomitant Pulmonary Neuroendocrine Tumor: A Presentation of Two Cases

Cowden Syndrome is a rare autosomal dominantly inherited disorder. Patients with Cowden Syndrome are at increased risk of various benign and malignant neoplasms in breast, endometrium, thyroid, gastrointestinal tract, and genitourinary system. Neuroendocrine tumors are ubiquitous neoplasms that may occur anywhere in the human body. Bronchopulmonary neuroendocrine tumors include four different histological subtypes, among these, typical and atypical pulmonary carcinoids. No association between Cowden Syndrome and neuroendocrine tumors has previously been described. We present two cases of Cowden Syndrome that were diagnosed with pulmonary carcinoids.

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A Comparison of Methods for Capturing Patient Preferences for Delivery of Mental Health Services to Low-Income Hispanics Engaged in Primary Care

Abstract

Background

Consideration of patient preferences regarding delivery of mental health services within primary care may greatly improve access and quality of care for the many who could benefit from those services.

Objectives

This project evaluated the feasibility and usefulness of adding a consumer-products design method to qualitative methods implemented within a community-based participatory research (CBPR) framework.

Research Design

Discrete-choice conjoint experiment (DCE) added to systematic focus group data collection and analysis.

Subjects

Focus group data were collected from 64 patients of a Federally-Qualified Health Center (FQHC) serving a predominantly low-income Hispanic population. A total of 604 patients in the waiting rooms of the FQHC responded to the DCE.

Measures

The DCE contained 15 choice tasks that each asked respondents to choose between three mental health services options described by the levels of two (of eight) attributes based on themes that emerged from focus group data.

Results

The addition of the DCE was found to be feasible and useful in providing distinct information on relative patient preferences compared with the focus group analyses alone. According to market simulations, the package of mental health services guided by the results of the DCE was preferred by patients.

Conclusions

Unique patterns of patient preferences were uncovered by the DCE and these findings were useful in identifying pragmatic solutions to better address the mental health service needs of this population. However, for this resource-intensive method to be adopted more broadly, the scale of the primary care setting and/or scope of the issue addressed have to be relatively large.

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Αρχειοθήκη ιστολογίου

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Η λίστα ιστολογίων μου

Τρίτη 22 Δεκεμβρίου 2015

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Αρχειοθήκη ιστολογίου