Clinical presentation, echocardiographic findings, treatment strategies, and prognosis of dogs with myxomatous mitral valve disease presented with pericardial effusion due to suspected left atrial tear: a retrospective case-control study.

INTRODUCTION/OBJECTIVES: Left atrial tear (LAT) is a life-threatening complication in dogs with myxomatous mitral valve disease (MMVD). The study objective was to describe clinical presentation, echocardiographic findings, treatment strategies, and survival in dogs with LAT compared to a control group of dogs with a similar stage of MMVD but no LAT. ANIMALS AND MATERIALS AND METHODS: Two-center retrospective case-controlled study including 15 dogs with and 15 dogs without LAT was conducted. Clinical and echocardiographic data were reviewed, and survival information were collected. RESULTS: Nine dogs in each group were in stage C of MMVD, while the remaining were in stage B2. No differences between groups were found regarding age, body weight, sex, kidney values, and echocardiography-derived cardiac dimensions. Most reported clinical signs associated with LAT included weakness, respiratory signs, and syncope. Treatment varied and was mainly focused on the management of congestive heart failure. Three dogs with LAT received a pericardiocentesis. All 15 dogs with LAT had died of cardiac causes, five dogs during the first seven days after admission. The median survival time for all 15 dogs with LAT was 52 days compared to 336 days in the control group (P=0.103). When excluding five dogs with LAT that died during the first seven days, the median survival increased to 407 days, not different compared to the control group (P=0.549). CONCLUSIONS: Dogs with MMVD and LAT have a high short-term mortality; however, when surviving the acute phase, the long-term prognosis may not differ from dogs with a similarly advanced degree of MMVD but without LAT.

Assessment of flax and hemp fibres in terms of their impact on the growth performance and health status of weaned piglets.

Weaning is a critical phase in intensive piglet production marked by the frequent occurrence of digestive disorders posing health and economic burden. To stave off such weaning-related problems, antibiotics and supplements containing high levels of ZnO are often used. In this study, we investigated whether natural fibres obtained from two plants known for their dietary fibre profile and antioxidant properties: flax (Linum usitatissimum L.) and hemp (Cannabis sativa L.), can serve as a health-promoting diet supplement. The study was conducted on a total of 191 Polish Large White piglets from 18 L, from their birth to 56 days of age. Piglets were divided by litters into six groups: W1.5, F1.5, H1.5, W2.0, F2.0, and H2.0. Groups W1.5, F1.5, and H1.5 received feed supplemented with 1.5% fibre from wood cellulose (W), flax (F), and hemp (H), respectively, while groups W2.0, F2.0, and H2.0 received feed with a higher 2.0% content of the same fibres. Flax and hemp fibres were characterised by a complex composition, antioxidant properties due to the presence of phenolic acids, and low risk of mycotoxin contamination. Flax fibre resulted in best weight gains and feed conversion ratio (P ≤ 0.05) of piglets, while hemp fibre had higher positive effect on antioxidant status (P ≤ 0.05) compared to the other two fibre additives. Neither flax nor hemp fibres had any adverse effect on the haematological and biochemical blood parameters. Piglets receiving a diet with 1.5% added fibre showed better growth performance, while diet supplementation with 2% fibre had a beneficial effect on the content of butyric acid in the small intestinal chyme (P ≤ 0.05). The results suggested that both flax and hemp fibres can be innovative feed additives for weaned piglets. However, further studies should be conducted in commercial farms, as the effects of dietary fibre could vary in more challenging environmental conditions.

Prenatal acrylamide exposure results in time-dependent changes in liver function and basal hematological, and oxidative parameters in weaned Wistar rats.

Acrylamide (ACR) is a toxic compound commonly found in fried, baked and heat-processed starchy foods. The current study investigated the time-dependent effects of maternal exposure to non-toxic ACR doses on the oxidative stress, liver function, and basal blood morphology of the rat offspring. Pregnant, Wistar rats were randomly divided into the control group or the groups administrated with ACR (3 mg/kg b.w./day): long exposure for 15 days, medium exposure for 10 days and short exposure for 5 days during pregnancy. Body mass, blood morphology and hematology, serum concentrations of growth hormone, IGF-1, TNF-α, IL-1ß, IL-6 and insulin, liver histomorphometry, liver activity of beclin1, LC2B and caspase3, markers of oxidative stress and the activity of antioxidative enzymes in blood serum and the liver were measured in offspring at weaning (postnatal day 21). Even short prenatal exposure to ACR led to oxidative stress and resulted in changes in liver histomorphometry and upregulation of autophagy/apoptosis. However, the most significant changes were observed following the long period of ACR exposure. This study has shown for the first time that ACR is responsible for changes in body mass in a time-dependent manner, which could lead to more serious illnesses like overweight and diabetes later in life.

[Clinical, radiological, and histopathological features of pulmonary post-COVID syndrome : A form of autoimmune-mediated interstitial lung disease?] / Klinische, radiologische und histopathologische Merkmale des pulmonalen Post-COVID-Syndroms : Eine Form der autoimmunvermittelten interstitiellen Lungenerkrankung?

BACKGROUND: About 10% of patients develop persistent symptoms after mild/moderate COVID-19. We have previously reported detection of antinuclear autoantibodies/extractable nuclear antigens (ANA/ENA) in patients with severe COVID-19. OBJECTIVES: The aim of this small pilot study was to characterize long-/post-COVID and to evaluate possible similarities between lung involvement in long-/post-COVID and connective tissue disease (CTD). METHODS: We prospectively enrolled 33 previously healthy patients with persistent pulmonal symptoms after mild/moderate COVID-19 without hospitalization (median age, 39 years). We performed clinical evaluation including pulmonary function tests, computed tomography (CT), and serology for ANA/ENA. In 29 of 33 patients, transbronchial biopsies (TBBs) were taken for histopathological assessment. RESULTS: Most patients presented with disturbed oxygen pulse in spiroergometry and slight lymphocytosis in bronchoalveolar lavage (BAL) fluid. The CT pattern showed bronchial wall thickening and increased low-attenuation volume. Autoantibodies were detected in 13 of 33 patients (39.4%). Histopathological assessment showed interstitial lymphocytosis with alveolar fibrin and organizing pneumonia. Ultrastructural analyses revealed interstitial collagen deposition. CONCLUSION: While histopathology of pulmonary long-/post-COVID alone is unspecific, the combination with clinical and radiological features together with detection of autoantibodies would allow for a diagnosis of interstitial pneumonia with autoimmune features (IPAF). Since we observe interstitial collagen deposition and since IPAF/CTD-ILD might progress to fibrosis, the persistence of autoantibodies and possible fibrotic change should be closely monitored in autoantibody-positive long-/post-COVID patients.

A multicentre prospective cohort study of the accuracy of conventional landmark technique for cricoid localisation using ultrasound scanning.

Cricoid pressure is employed during rapid sequence induction to reduce the risk of pulmonary aspiration. Correct application of cricoid pressure depends on knowledge of neck anatomy and precise identification of surface landmarks. Inaccurate localisation of the cricoid cartilage during rapid sequence induction risks incomplete oesophageal occlusion, with potential for pulmonary aspiration of gastric contents. It may also compromise the laryngeal view for the anaesthetist. Accurate localisation of the cricoid cartilage therefore has relevance for the safe conduct of rapid sequence induction. We conducted a multicentre, prospective cohort study to determine the accuracy of cricoid cartilage identification in 100 patients. The cranio-caudal midpoint of the cricoid cartilage was identified by a qualified anaesthetic assistant using the conventional landmark technique and marked. While maintaining the patient in the same position, a second mark was made by identifying the midpoint of the cricoid cartilage using ultrasound scanning. The mean (SD) distance between the two marks was 2.07 (8.49) mm. In 41% of patients the midpoint was incorrectly identified by a margin greater than 5 mm. This error was uniformly distributed both above and below the midpoint of the cricoid cartilage. The Pearson correlation coefficient of this error with respect to body mass index was 0.062 (p = 0.539) and with age was -0.020 (p = 0.843). There were also no significant differences in error between male and female patients. Identification of cricoid position using a landmark technique has a high degree of variability and has little correlation with age, sex or body mass index. These findings have significant implications for the safe application of cricoid pressure in the context of rapid sequence induction.

The effect of feeding system and sex on the performance and selected gastrointestinal features of fattening pigs.

The aim of the study was to evaluate the efficiency of two feeding systems for fattening pigs (wet and dry), taking into account their sex, on performance, nutrient digestibility, and some histological and microbiological parameters of the gut. The study was conducted on 450 fattening pigs, divided into 6 groups (n = 75) and housed in pens with 15 pigs per pen. The first three groups, divided according to sex, i.e. gilts, barrows and boars subjected to immunocastration (B-I), received complete dry feed, while the next three, divided in the same manner according to sex, were fed a fermented liquid diet. The nutritional value of the feeds, calculated on a dry weight basis, was similar for the two feeding systems in both stages of the fattening period. The best weight gains were observed in the group B-I pigs which received the liquid diet, and the poorest in the gilts fed the dry feeds. The best feed conversion ratio (FCR) was observed in the boars treated with Improvac®, especially those receiving the liquid diet. The feeding system significantly influenced the digestibility of nutrients, with higher apparent digestibility coefficients for crude protein, fat and fibre noted in the animals fed in the wet system. The liquid feeding system caused an increase in crypt depth in the colon in all groups of pigs, as well as an increase in the width of the muscular layer. A significant decrease in the total bacterial count was observed in the calcium, especially in the animals fed in the wet system.

Modification of the lipid profile and antioxidant status of the blood plasma of turkey hens fed mixtures with raw or extruded linseed.

The aim of the study was to determine the most beneficial proportion of raw linseed in complete feed mixtures for turkey hens on the basis of lipid and redox indicators in the blood. In experiment 1, the turkey hens received the complete mixture with 2%, 4% or 6% linseed. On the basis of the results obtained in experiment 1, we selected the most effective proportion of linseed, which was given to the birds in the group receiving a 4% linseed additive. In experiment 2, the birds were fed mixtures with a 4% addition of raw or extruded linseed. The use of 4% raw linseed was found to improve production effects (improvement of weight gain, and lower feed conversion ratios), while extruded linseed in the diet of turkey hens did not affect growth performance. The use of linseed (4% and 6%) as a feed component for turkey hens led to an increase in indicators of antioxidant potential, that is the total antioxidant potential of the plasma, vitamins E and C, bilirubin and creatinine. A benefit resulting from the use of linseed, particularly in the amounts of 2% and 4% was a marked improvement in lipid indicators in the blood. The reduced percentage of unsaturated fatty acids (n-3) following the use of extruded linseed resulted in a decrease in lipid peroxidation (lower content of malondialdehyde, superoxide and vitamins C and E in the blood). The most effective dose and form of linseed in the diet of turkey hens is 4% raw linseed.

The effect of DL-, L-isomers and DL-hydroxy analog administered at 2 levels as dietary sources of methionine on the metabolic and antioxidant parameters and growth performance of turkeys.

A hypothesis was verified that dietary methionine (Met) improves the growth and antioxidant status of turkeys, and that its effects depend on dietary inclusion levels and sources. A total of 816 female Hybrid Converter turkeys was fed wheat-soybean meal-based diets supplemented with 3 sources of Met: DL-, L-isomers and DL-hydroxy analog (DLM, LM, and MHA, respectively). In 4 4-week periods (from one to 16 wk of age), dietary Met content corresponded to NRC (1994) recommendations or was increased by approximately 50% (in one to 8 wk by 44 to 46% and in 9 to 16 wk by 55 to 56% vs. the NRC guidelines) to match the recommendations of some breeding companies. Increased Met content resulted in higher final body weights of turkeys (P = 0.002), an improved feed conversion ratio (P = 0.049), increased total glutathione concentration and ferric reducing ability of plasma (FRAP) values, and decreased malondialdehyde (MDA) concentration (all P < 0.001) in the blood plasma of turkeys. In comparison with DLM, LM and MHA contributed to an increase in plasma glutathione concentration (P = 0.001), a decrease in plasma triacylglycerol (P = 0.003) and uric acid (P = 0.001) concentrations, and a decrease in liver MDA (P = 0.001) levels. A decrease in plasma MDA (vs. DLM) and lipid peroxides (LOOH) (vs. DLM and LM) concentrations as well as a decrease in plasma superoxide dismutase (SOD) activity (vs. DLM and LM) also were noted in the MHA treatment (P = 0.016, P = 0.001 and P = 0.011, respectively). In conclusion, the results of the study indicate that the antioxidant status of turkeys could be affected by dietary Met levels and sources. The dietary Met content increased by 50% relative to NRC recommendations, improved the growth performance of turkeys, and strengthened their antioxidant defense system. In comparison with DLM, LM and MHA could be considered positive nutritional factors as manifested by a beneficial decrease in plasma and hepatic MDA concentrations as well as an increase in plasma glutathione levels, and the effect of MHA was more pronounced.

Effect of different dietary methionine levels on the growth performance and tissue redox parameters of turkeys.

A total of 630 8-week-old female Hybrid Converter turkeys were divided (based on their body weights) into 6 groups, with 7 replicates per group and 15 birds per replicate. All birds were fed identical isocaloric and isonitrogenous wheat-soybean meal-based diets without (group 1) or with (groups 2 to 6) increasing levels of supplemental methionine (Met). The total content of Met in diets 1 to 6 was as follows (%): 0.29, 0.32, 0.40, 0.47, 0.56, and 0.61 at 9 to 12 wk of age and 0.24, 0.28, 0.34, 0.42, 0.47, and 0.55 at 13 to 16 wk of age. In both feeding phases, dietary Met levels in group 3 corresponded to those recommended by the National Research Council (NRC) (1994). Different dietary Met concentrations had no influence on feed intake, the final body weights of turkeys or carcass dressing percentage. Only in the first experimental feeding period (9 to 12 wk), the lowest dietary Met content significantly deteriorated the feed conversion ratio (FCR), whereas the highest Met content led to a significant improvement in FCR. After 8 wk of experimental feeding, dietary treatment 1 contributed to a significant increase in the activity of catalase (CAT) (blood and breast muscles) and superoxide dismutase (liver), an increase in lipid peroxides concentrations (blood, breast muscle) and a decrease in total glutathione (GSH+GSSG) content (breast muscles), in comparison to treatment 3 which is comparable to NRC recommendations. The highest level of dietary Met significantly increased blood total antioxidant potential (FRAP) values and glutathione content in the liver. To sum up, in the final feeding period between 9 and 16 wk of age, the growth performance of female turkeys was not deteriorated by dietary Met deficiency or excess (-30% and up to +50% relative to NRC recommendations, respectively). The total antioxidant potential can be effectively increased by dietary Met supplementation, but the highest Met level may lead to unbalanced oxidative changes in the body as indicated by lower FRAP values and a lower GSH/GSSG ratio in the liver.

Two unusual cases: vulvar lipoma - description of the largest case in literature. Developing myoma with the longest pedicle.

The authors present two cases of benign tumors one located on the outer surface of the vulva, and the second extending beyond the vagina. The first, originating from the right pudendal lip, a lipoma measuring 23 cm in greatest diameter, weighing 6.6 kg, and the second a pedunculated, uterine smooth muscle myoma with a pedicle of 6.5 cm, maximum diameter 18 cm, weight 700 grams, which caused significant metroptosis. Operative procedures in each case were free of complications.

Influenza virus surveillance in Argentina during the 2012 season: antigenic characterization, genetic analysis and antiviral susceptibility.

The activity and circulation of influenza viruses in Argentina was studied during 2012 as part of the Argentinean Surveillance for Influenza and other Respiratory Viruses, in the context of Global Influenza Surveillance. The antigenicity and molecular characteristics of haemagglutinins (HA) of circulating influenza A and B viruses were analysed to assess the emergence of virus variants. Susceptibility to oseltamivir and zanamivir was evaluated by enzymatic assay and results were backed-up by sequencing of the neuraminidase (NA) genes. During the 2012 season, influenza virus circulation in Argentina was detected from weeks 24 to 51. The HA sequences of the studied A(H1N1)pdm09 subtype viruses segregated in a different genetic group compared to those identified during the 2009 pandemic, although they were still closely related antigenically to the vaccine virus A/California/07/2009. The HA sequences of the A(H3N2) viruses analysed fell into the A/Victoria/208/2009 clade, genetic group 3C. A mixed circulation of virus variants belonging to B/Victoria and B/Yamagata lineages was detected, with B/Victoria being dominant. All viruses tested were sensitive to oseltamivir and zanamivir except one. This isolate, an A(H1N1)pdm09 virus possessing the substitution NA-N295S, showed highly reduced inhibition by oseltamivir and reduced inhibition by zanamivir. Virological and epidemiological surveillance remains critical for detection of evolving influenza viruses.

Pregnant women infected with pandemic influenza A(H1N1)pdm09 virus showed differential immune response correlated with disease severity.

BACKGROUND: During pregnancy, immunological and hormonal alterations place women at increased risk for influenza-related severe illnesses including hospitalization and death. Although A(H1N1) pdm09 infection resulted in increased disease severity in pregnant women, the precise mechanisms responsible for this risk have yet to be established. OBJECTIVES: The present study was aimed to investigate the role of host chemokines and cytokine profiles in A(H1N1) pdm09 infection regarding disease severity in pregnant women. STUDY DESIGN: This retrospective survey examined 41 pregnant women with confirmed A(H1N1) pdm09 infection. Of them, 12 died (D), 29 survived (S), and 17 remained uninfected and served as controls (C). Antiviral response was evaluated for IFN-ß expression and gene expression profiles of cytokines (TNF-α, IL-6, IL-12, TGF-ß) and chemokines (IL-8, RANTES, MCP-1, IP-10), and the viral Matrix (M1) gene was quantified and normalized using the housekeeping gene product ß-actin mRNA. RESULTS: Higher IL-8 and TNF-α mRNA expression were found in D and S compared with C, while IL-6 showed higher expression in D. Interestingly, these results were associated with a decrease in the anti-inflammatory response of TGF-ß mRNA and IFN-ß. These alterations would lead to an imbalance in the immune response of those patients. CONCLUSIONS: Pregnancy-related reductions in IFN-ß and TGF-ß expression levels and elevated levels of pro-inflammatory cytokines could explain the increased severity of infection and death of pregnant women. These findings may help improve the understanding of the high susceptibility and disease severity to influenza virus infection during pregnancy.

The effect of yeast Yarrowia lipolytica on the antioxidant indices and macro-and microelements in blood plasma of turkey hens.

The aim of the study was to assess the effect of different amounts of Yarrowia lipolytica yeast on the redox response and content of macro- and microelements in the blood plasma of turkey hens. The experiment was carried out on 240 turkey hens aged from 1 to 16 weeks. The birds were randomly assigned to 3 experimental groups of 80 birds each. Group I served as a control (K) and did not receive any experimental compounds. The turkey hens from the experimental groups (YL3 and YL6) were administered dried Yarrowia lipolytica yeast in their feed mixtures in the amount of 3% (YL3) or 6% (YL6). Yarrowia lipolytica yeast in the feed mixtures for the turkey hens did not induce oxidation reactions in the organism of the birds. However, an increase in catalase activity and a reduction in the level of LOOH, MDA and vitamin C were observed in the blood plasma of the turkey hens whose diet was supplemented with YL yeast. In the case of other indices, such as superoxide dismutase activity and total antioxidant potential (FRAP), the additive caused no significant changes. Administering Yarrowia lipolytica yeast to turkey hens may stimulate the enzymatic response of the antioxidant system (e.g. increasing catalase activity), mainly by increasing the concentration of iron in the plasma.

The effect of different dietary levels of vitamin E and selenium on antioxidant status and immunological markers in serum of laying hens.

The effect of different dietary levels of selenium (Se) and vitamin E on egg production, the antioxidant status and the immune system response of hens was investigated in the current study. A total of 32 Lohman Brown hens were divided into four groups and were fed diets with 5% of soybean oil and two levels of Se (0.15 and 0.30 mg/kg) and vitamin E (30 and 60 mg/kg). During 10 weeks of experimental feeding, the body weights of hens and egg production were similar in all dietary treatments, but a higher Se content of diets contributed to a significant increase in egg weight. A higher vitamin E level significantly increased alpha-tocopherol concentrations (2.71 vs. 2.05 microg/mL, p = 0.001), superoxide dismutase (SOD) activity (43.3 vs. 39.9 U/mL, p = 0.049) and the ferric reducing ability of serum (FRAP) (123.0 vs. 105.7 micromol/L, p = 0.029). A higher Se content increased the concentrations of ascorbic acid (0.309 vs. 0.073 microg/L, p = 0.001), retinol (1.48 vs. 1.15 microg/mL, p = 0.001) and alpha-tocopherol (2.86 vs. 1.90 microg/mL, p = 0.001), the activity levels of catalase (3.40 vs. 2.98 U/L,p = 0.010) and SOD (43.4 vs. 30.8 U/mL, p = 0.040) as well as the total antioxidant status (TAS) of serum (0.38 vs. 0.28 mmol/L, p = 0.026). There were no significant differences in the concentrations of tumor necrosis factor-alpha (TNF-a) and interleukin-6 (IL-6) between treatments, while a higher vitamin E content of diets increased serum immunoglobulin A (IgA) concentrations (370.6 vs. 321.3 microg/mL, p = 0.026). Higher dietary levels of vitamin E and Se increased the serum concentrations of retinol (1.66 vs. 2.20 microg/mL, p = 0.013) and a-tocopherol (3.33 vs. 1.71, p = 0.014), but they had no effect on the other physiological parameters. It is recommended that the levels of both supplements, Se and vitamin E, be increased in laying hen diets as they have a beneficial effect on the serum concentrations of retinol and alpha-tocopherol.

Efficacy of mannanoligosaccharides additive to sows diets on colostrum, blood immunoglobulin content and production parameters of piglets.

The present results suggest that mannanoligosaccharides (MOS) included in a sow nutrition may affect its immune system and humoral antibody production in colostrum and milk, and thus increase the piglet immunity at the postnatal period. The studies involved sows of the Polish Landrace breed mated with boars (Hampshire x Duroc). In each experiment, the sows were assigned to two groups: control and experimental (MOS). Each group consisted of 16 sows managed in pens (2 animals in each) during pregnancy, whereas at farrowing and lactation period they were placed in individual pens. The basal diet during pregnancy (PR-S) and lactation (LC-S) period contained wheat (40% in experiment I--groups 1 and 2) or triticale (40% in experiment II--groups 3 and 4), as well as barley, soybean meal, soybean oil and mineral-vitamin premix. Throughout both experiments, the sows from the experimental group had a dietary supplement of mannanoligosaccharides (MOS) preparation for 4 of weeks prepartum and 4 weeks of post partum period. A level of the MOS supplementation (8 g of MOS per sow daily) based on the recommendations of the manufacturer. Blood samples were collected from the sows on days 84 (the start of trial) and 110 of pregnancy, after farrowing, and on day 21 of lactation period, while from the piglets at birth and on day 21 of age. Colostrum was collected between 1-3, 12, 24 and 48 h after farrowing. The blood samples taken from sows and piglets as well as the samples of sow colostrum and milk were evaluated for the presence of IgG, IgA and IgM antibodies. The present study has provided considerable evidence that MOS supplementation of sows feedstuff before and after farrowing (4 weeks before and 4 weeks after) exerts a positive effect on IgG content in the colostrum and plasma of sows and following this on serum IgG level in the suckling piglets. Higher level of colostral (passive) immunity influences positively body weight gain and survival rate of the piglets at weaning.

Some physicochemical bone parameters of sows fed microbial phytase-supplemented diet.

The aim of the present study was to determine the effect of microbial phytase addition to sow diets on a mineral content, mineralization level and geometric parameters of femoral and humeral bone. The studies were done on 75 sows assigned to 3 feeding groups. The animals from group I (positive control) were fed a diet of standard calcium and phosphorus dietary contents which complied with the requirements of the Polish Norms for Pig Nutrition (1993). The sows from group II (negative control) received a diet without an inorganic phosphorus content and finally, group III was provided with a diet without an inorganic phosphorus additive, but supplemented with microbial phytase (500 PU kg(-1)) and formic acid. After lactation completion and piglet weaning, 4 sows were selected from each group for slaughter and laboratory evaluation of femoral and humeral bone samples. The bone samples were examined for a content of dry matter, crude ash and minerals (phosphorus, Ca+2, Mg+2, Mn+2, Zn+2, Cu+2). The isolated femurs were analyzed for a mineralization degree and geometric parameters. A combined microbial phytase with formic acid supplementation significantly increased manganese and zinc concentration in femoral bone and a level of phosphorus, calcium, zinc and iron in humeral bone of sows. There was also observed significantly higher trabecular bone mineral density (Td) in the femoral bone as well as the bone volume. The evaluation of geometric parameters and bone cortical indices showed a significant influence of the sow feedstuff supplementation with microbial phytase and formic acid on the parameters studied.

Prevalence of Rho-inactivating epidermal cell differentiation inhibitor toxins in clinical Staphylococcus aureus isolates.

Staphylococcus aureus produces exotoxins of the epidermal cell differentiation inhibitor (EDIN) family that ADP-ribosylate and inactivate Rho GTPases. The prevalence of genes encoding EDIN in clinical and nasal isolates of S. aureus was investigated. Of the 196 clinical S. aureus isolates tested, 15 (7.8%) were positive for 1 edin gene, whereas of 81 nasal isolates tested, only 3 (3.7%) were edin positive. Of the total 18 edin-positive isolates, 16 (90%) carried edin-B and 2 (10%) carried edin-C, but none was positive for edin-A. All edin-positive strains could produce the respective EDIN protein. Pulsed-field gel electrophoresis analysis suggested that the edin-B-positive S. aureus isolates are derived from one clone, and the edin-C-positive isolates are derived from another clone. Given that toxins acting on Rho GTPases are considered to be important for bacterial virulence, the EDIN toxins of S. aureus should receive more attention in future studies.

How recombinant insulin analogs improve insulin therapy of diabetes mellitus: pathophysiology, clinical practice and recommendations.

According to the latest prognoses, 300 million people are expected to suffer from diabetes (particularly type 2) in 2025; diabetes will become a new epidemics of the coming century. Therefore it is so important to get acquainted with the pathomechanism of diabetes-related disorders and the possibilities of effective treatment. During the last decade, numerous prospective epidemiological studies have been completed, which have considerably extended our knowledge of the pathomechanism of disturbances and their effect on late complications of diabetes. Resistance to insulin has an important role in the etiology of type 2 diabetes. However, there is substantial evidence indicating that impairment or regression of rapid insulin secretion phase at the early stage of the disease is a factor of no lesser importance. The lack of appropriate insulin concentration after the stimulation by food ingestion (first 30 min after the meal), leads to permanent, treatment-resistant hyperglycemia. The postulated attempts to obtain a 'nearly normoglycemic' condition, as well as the results of prospective epidemiological studies proving that achieving this aim improves the prognosis of diabetic patients, prompt the researchers to search for the drugs or treatment schedules, which could effectively restore the impaired insulin secretion, and its early phase in particular, in type 2 diabetes. Human insulin analogs and their pre-formulated commercially available mixtures seem very promising in this respect.