The effects of age on inflammatory and coagulation-fibrinolysis response in patients hospitalized for pneumonia

Objective

To determine whether inflammatory and hemostasis response in patients hospitalized for pneumonia varies by age and whether these differences explain higher mortality in the elderly.

Methods

In an observational cohort of subjects with community-acquired pneumonia (CAP) recruited from emergency departments (ED) in 28 hospitals, we divided subjects into 5 age groups (<50, 51–64, 65–74, 75–84, and ≥85). We measured circulating levels of inflammatory (TNF, IL-6, and IL-10), hemostasis (D-dimer, Factor IX, thrombin-antithrombin complex, antithrombin and plasminogen-activator inhibitor-1), and cell-surface markers (TLR-2, TLR-4, and HLA-DR) during the first week of hospitalization and at discharge and compared 90-day mortality. We used logistic regression to compare odds ratios (OR) for 90-day mortality between age groups, adjusting for differences in pre-infection factors alone and then additionally adjusting for immune markers.

Results

Of 2,183 subjects, 495, 444, 403, 583, and 258 subjects were <50, 51–64, 65–74, 75–84, and ≥85 years of age, respectively. Large age-related differences were observed in 90-day mortality (0.82% vs. 3.2% vs. 6.4% vs. 12.8% vs. 13.6%, p<0.01). No age-related differences in inflammatory and cell surface markers occurred during the first week. Older subjects had higher pro-coagulant markers on ED presentation and over first week (p≤0.03), but these differences were modest (1.0–1.7-fold differences). Odds of death for older adults changed minimally in models incorporating differences in hemostasis and inflammatory markers (for subjects ≥85 compared to those <50, OR = 4.36, when adjusted for pre-infection factors and OR = 3.49 when additionally adjusted for hemostasis markers). At discharge, despite clinical recovery as evidenced by normal vital signs in >85% subjects, older subjects had modestly increased hemostasis markers and IL-6 levels (p<0.01).

Conclusions

Modest age-related increases in coagulation response occur during hospitalization for CAP; however these differences do not explain the large differences in mortality. Despite clinical recovery, immune resolution may be delayed in older adults at discharge.     

Factors influencing in the response of <i>Schizolobium parahybum</i> (Vell) Blake to <i>Ceratocystis paradoxa</i> and <i>C. moniliformis</i>

In the Ecuadorian coast one of the most destructive diseases of the pachaco is vascular wilt or stem rot caused by Ceratocystis complex, so the aim of this study was to determine the factors that affect the efficiency of the reaction of bark pachaco to this disease. This research was conducted under laboratory conditions, using trees pachaco S38, S41, S98, AE-1, AE-2 and AE-3, and pathogenic species Ceratocystis paradoxa and C. moniliformis. The method utilized was tissue stem bark,with bark sections with 4.5 cm², and a suspension of 3x10⁴ units infection and remained in a humid chamber for 96 hours at 25 ± 5 °C. Were determined grades of resistance/ susceptibility using a scale from 0 to 4, depending on the amount of mycelia and peritecio in each plant sample. Three factors were used: four colonies obtained by several transfers from each fungal specie, four ages of colonies of each fungal specie and four volumes of inoculum applied (units of infection), using for each experiment separately Completely Randomized Design with 4 replications factorial arrangement. For comparison between treatment means was used Tukey test at 5% probability of error. For future trials using this technique, you could use 30-day colonies for C. paradoxa and 40 days for C. moniliformis, and an application volume of 100 μL/cm², it would improve the level of response for the formation of perithecium and mycelia in samples cortex.     

Isocitrate dehydrogenase 1 R132C mutation occurs exclusively in microsatellite stable colorectal cancers with the CpG island methylator phenotype

The CpG Island Methylator Phenotype (CIMP) is fundamental to an important subset of colorectal cancer; however, its cause is unknown. CIMP is associated with microsatellite instability but is also found in BRAF mutant microsatellite stable cancers that are associated with poor prognosis. The isocitrate dehydrogenase 1 (IDH1) gene causes CIMP in glioma due to an activating mutation that produces the 2-hydroxyglutarate oncometabolite. We therefore examined IDH1 alteration as a potential cause of CIMP in colorectal cancer. The IDH1 mutational hotspot was screened in 86 CIMP-positive and 80 CIMP-negative cancers. The entire coding sequence was examined in 81 CIMP-positive colorectal cancers. Forty-seven cancers varying by CIMP-status and IDH1 mutation status were examined using Illumina 450K DNA methylation microarrays. The R132C IDH1 mutation was detected in 4/166 cancers. All IDH1 mutations were in CIMP cancers that were BRAF mutant and microsatellite stable (4/45, 8.9%). Unsupervised hierarchical cluster analysis identified an IDH1 mutation-like methylation signature in approximately half of the CIMP-positive cancers. IDH1 mutation appears to cause CIMP in a small proportion of BRAF mutant, microsatellite stable colorectal cancers. This study provides a precedent that a single gene mutation may cause CIMP in colorectal cancer, and that this will be associated with a specific epigenetic signature and clinicopathological features.     

奥美拉唑联合法莫替丁治疗反流性食管炎的临床效果分析

目的：观察并分析奥关拉唑联合法莫替丁治疗反流性食管炎的临床效果。方法：选取2008年5月至2012年5月在本院确诊并治疗的反流性食管炎患者45例,随机平均分为三组。联合用药组（15例）：每日早餐前口服20mg奥关拉唑,睡前口服20mg法莫替丁;奥关拉唑组（15例）：每日口服两次奥美拉唑,每次20mg;法莫替丁组（15例）：每日口服两次法莫替丁,每次20mg。每组的治疗时间均为8周。在内镜指导下观察并比较三组患者的胸痛、反酸和烧心等主要病征的改善情况,综合评价三种治疗方法的临床疗效。结果：联合用药组较其他两组获得的疗效更明显,患者的症状得到较好的改善,差异有统计学意义（P〈0．05）。结论：奥美拉唑联合法莫替丁能够有效地抑制胃酸的分泌,对于反流性食管炎的,临床治疗具有良好的效果。     

Detection of QTL in Rainbow Trout Affecting Survival When Challenged with Flavobacterium psychrophilum

Bacterial cold water disease (BCWD) causes significant economic loss in salmonid aquaculture. We previously detected genetic variation in survival following challenge with Flavobacterium psychrophilum (Fp), the causative agent of BCWD in rainbow trout (Oncorhynchus mykiss). A family-based selection program to improve resistance was initiated in 2005 at the USDA National Center for Cool and Cold Water Aquaculture. Select crosses were made in 2007 and 2009 to evaluate family-based disease survival using Fp injection challenges. From each putative F₂/BC₁ family generated in 2009, 200–260 fish were challenged in 4–7 replicates per family. Whole genome QTL scans of three F₂/BC₁ families were conducted with about 270 informative microsatellite loci per family spaced at an average interval size of 6 cM throughout the rainbow trout genome. Markers on chromosomes containing QTL were further evaluated in three additional F₂/BC₁ families. The additional F₂/BC₁ families were sire or dam half-sibs (HS) of the initially genome scanned families. Overall, we identified nine major QTL on seven chromosomes that were significant or highly significant with moderate to large effects of at least 13 % of the total phenotypic variance. The largest effect QTL for BCWD resistance explaining up to 40 % of the phenotypic variance was detected on chromosome OMY8 in family 2009070 and in the combined dam HS family 2009069–070. The nine major QTL identified in this study are candidates for fine mapping to identify new markers that are tightly linked to disease resistance loci for using in marker assisted selection strategies.     

CO2 efflux from a Mediterranean semi-arid forest soil. II. Effects of soil fauna and surface stoniness

Many forest soils in the Mediterranean basin areshallow and contain high amounts of gravel in theorganic layers. Recent studies on soil organic matteraccumulation have shown high amounts of organic matteroccurring mainly in soils with high levels ofstoniness at the soil surface. The gravel layer mayaffect the microclimatic conditions of the soilsurface and probably the distribution and activity ofsoil fauna.In order to quantify the combined effects soil fauna(epigeic macrofauna and earthworms) and stoniness onthe release of soil CO₂, we performed a threefactor field experiment by using a series ofreconstructed soil profiles. Factors 1 and 2 consistedof the exclusion/presence of soil epigeic macrofaunaand earthworms, and factor 3 of the presence/absenceof a gravel layer intermingled with the H horizon. Weincubated ¹⁴C straw in the H horizon and carriedout three 40 mm rainfall simulations.Soil respiration primarily depended on the season. Theeffects of soil fauna were generally small and did notcoincide with periods of high faunal activity. Thelargest effects of both earthworms and soil epigeicfauna were found after wetting the soil in summer. Theeffects of the earthworms were concentrated in themineral soil while the effects of the epigeic faunawere concentrated in the H horizon and mainly arosetowards the end of the experiment. This suggests thatthe effects of epigeic fauna may have beenunderestimated due to the length of the experiment.The gravel layer increased the effect of faunaprobably by creating more favorable microclimaticconditions. The accumulation of organic matter insoils with high levels of stoniness cannot beexplained by the effect of gravel on soil microclimatenor by its effect on the activity of soil fauna.     

Characterization of Lipids and Proteins Associated to the Cell Wall of the Acapsular Mutant Cryptococcus neoformans Cap 67

Cryptococcus neoformans is an opportunistic human pathogen that causes life‐threatening meningitis. In this fungus, the cell wall is exceptionally not the outermost structure due to the presence of a surrounding polysaccharide capsule, which has been highly studied. Considering that there is little information about C. neoformans cell wall composition, we aimed at describing proteins and lipids extractable from this organelle, using as model the acapsular mutant C. neoformans cap 67. Purified cell wall preparations were extracted with either chloroform/methanol or hot sodium dodecyl sulfate. Total lipids fractionated in silica gel 60 were analyzed by electrospray ionization tandem mass spectrometry (ESI‐MS/MS), while trypsin digested proteins were analyzed by liquid chromatography coupled to tandem mass spectrometry (LC‐MS/MS). We detected 25 phospholipid species among phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine, phosphatidylinositol, and phosphatidic acid. Two glycolipid species were identified as monohexosyl ceramides. We identified 192 noncovalently linked proteins belonging to different metabolic processes. Most proteins were classified as secretory, mainly via nonclassical mechanisms, suggesting a role for extracellular vesicles (EV) in transwall transportation. In concert with that, orthologs from 86% of these proteins have previously been reported both in fungal cell wall and/or in EV. The possible role of the presently described structures in fungal–host relationship is discussed.     

Theory in motion

Modeling studies are now a significant part of mainstream research in motor control. Novel and classical modeling techniques used in recent work on small and large motor systems illustrate the different roles that models play in furthering our understanding of motor systems. The models presented reveal single neuron short-term memory, unexpected effects of reciprocal inhibition and methods for decoding activity in large populations of neurons.     

Foot internal stress distribution during impact in barefoot running as function of the strike pattern

The aim of the present study is to examine the impact absorption mechanism of the foot for different strike patterns (rearfoot, midfoot and forefoot) using a continuum mechanics approach. A three-dimensional finite element model of the foot was employed to estimate the stress distribution in the foot at the moment of impact during barefoot running. The effects of stress attenuating factors such as the landing angle and the surface stiffness were also analyzed. We characterized rear and forefoot plantar sole behavior in an experimental test, which allowed for refined modeling of plantar pressures for the different strike patterns. Modeling results on the internal stress distributions allow predictions of the susceptibility to injury for particular anatomical structures in the foot.