Left-sided infective endocarditis in patients with liver cirrhosis.

OBJECTIVE: To evaluate the course of left-sided infective endocarditis (LsIE) in patients with liver cirrhosis (LC) analyzing its influence on mortality and the impact of surgery. METHODS: Prospective cohort study, conducted from 1984 to 2013 in 26 Spanish hospitals. RESULTS: A total of 3.136 patients with LsIE were enrolled and 308 had LC: 151 Child-Pugh A, 103 B, 34 C and 20 were excluded because of unknown stage. Mortality was significantly higher in the patients with LsIE and LC (42.5% vs. 28.4%; p < 0.01) and this condition was in general an independent worse factor for outcome (HR 1.51, 95% CI: 1.23-1.85; p < 0.001). However, patients in stage A had similar mortality to patients without cirrhosis (31.8% vs. 28.4% p = NS) and in this stage heart surgery had a protective effect (28% in operated patients vs. 60% in non-operated when it was indicated). Mortality was significantly higher in stages B (52.4%) and C (52.9%) and the prognosis was better for patients in stage B who underwent surgery immediately (mortality 50%) compared to those where surgery was delayed (58%) or not performed (74%). Only one patient in stage C underwent surgery. CONCLUSIONS: Patients with liver cirrhosis and infective endocarditis have a poorer prognosis only in stages B and C. Early surgery must be performed in stages A and although in selected patients in stage B when indicated.

Probing the biophysical interplay between a viral genome and its capsid.

The interaction between a viral capsid and its genome governs crucial steps in the life cycle of a virus, such as assembly and genome uncoating. Tuning cargo-capsid interactions is also essential for successful design and cargo delivery in engineered viral systems. Here we investigate the interplay between cargo and capsid for the picorna-like Triatoma virus using a combined native mass spectrometry and atomic force microscopy approach. We propose a topology and assembly model in which heterotrimeric pentons that consist of five copies of structural proteins VP1, VP2 and VP3 are the free principal units of assembly. The interpenton contacts are established primarily by VP2. The dual role of the genome is first to stabilize the densely packed virion and, second, on an increase in pH to trigger uncoating by relaxing the stabilizing interactions with the capsid. Uncoating occurs through a labile intermediate state of the virion that reversibly disassembles into pentons with the concomitant release of protein VP4.

Cryo-electron microscopy reconstructions of triatoma virus particles: a clue to unravel genome delivery and capsid disassembly.

Triatoma virus (TrV) is a member of the insect virus family Dicistroviridae and consists of a small, non-enveloped capsid that encloses its positive-sense ssRNA genome. Using cryo-transmission electron microscopy and three-dimensional reconstruction techniques combined with fitting of the available crystallographic models, this study analysed the capsids corresponding to mature and several RNA-empty TrV particles. After genome release, the resulting reconstruction of the empty capsids displayed no prominent conformational changes with respect to the full virion capsid. The results showed that RNA delivery led to empty capsids with an apparent overall intact protein shell and suggested that, in a subsequent step, empty capsids disassemble into small symmetrical particles. Contrary to what is observed upon genome release in mammalian picornaviruses, the empty TrV capsid maintained a protein shell thickness and size identical to that in full virions.

A plate holder for non-destructive testing of mesophase crystallization assays.

Here, we describe a goniometer holder to mount standard 96-well crystallization plates directly onto the goniometer head of an oscillation camera. This attachment was designed to check crystallization conditions straight from the crystallization plates under X-rays, and was proven to be useful for checking small crystals and solutions that destabilize monoolein-based lipidic cubic phase (LCP) crystallization experiments. A quick procedure for setting up LCP assays employing commercially available instruments is also reported.

[Mortality among steel workers of the Basque Country]. / Mortalidad en trabajadores de la siderurgia del País Vasco.

Most of mortality studies among steelworkers pointed out an increased frequency on cancer mortality, above all by lung cancer, and, in a lower proportion, by cancers of digestive and genitourinary systems. In Spain mortality rates are not published by occupation and economic activity to contrast these observations. It was carried out a proportionate mortality study among active or retired workers from an steel mill, Altos Hornos de Vizcaya, died from 1986 to 1993, to make a preliminary death risk assessment associated with job in the steel industry. A sample of 1553 men was drawn from the mortality register of a private Insurance Company. Death causes within the sample and in general population of the Autonomous Community of the Basque Country were compared using a proportionate analysis. Mortality odds ratios (OR) were also computed. The results show an excess of cancer mortality (OR = 1.26, IC: 1.11-1.42), stomach cancer (OR = 1.50, IC: 1.14-1.98) and renal cancer (OR = 1.89; IC: 1.14-3.14) as it has been stated by other authors. It has not been found an increased mortality risk from lung cancer (OR = 1.13, IC: 0.91-1.40), bladder cancer (OR = 1.13, IC: 0.74-1.72) and chronic respiratory disease (OR = 0.94, IC: 0.73-1.20). There is also an excess of liver cancer (OR = 1.56, IC: 1.06-2.28) and cancer of non specified location (OR = 1.85, IC: 1.45-2.36). This can be due to classification bias that affects the study. On the other hand, these and other selection bias, discussed in this paper, could underestimate the lung cancer mortality. We can not conclude that, among the workers of the study, the mortality from several kind of cancer is not associated to occupational exposure. Furthermore, this excess of stomach and kidney cancer mortality may lead us to pose the hypothesis of cause-effect relationship with some not well identified carcinogens present at the steel working place.