Paratricipital approach for distal humerus fractures.

OBJECTIVE: To report functional outcomes in a case series of distal shaft and distal humeral fractures (AO type 12 and 13) managed with open reduction and internal fixation using paratricipital approach. METHODS: Patients who were intervened between May 2006 and December 2015 were included in the analysis. The Mayo Elbow Performance Score (MEPS), the Disabilities of the Arm, Shoulder and Hand (DASH) score and the visual analogue scale (VAS) were used for functional assessment. RESULTS: Twelve patients were included in this case series, eight (67%) of them were women. The average age was 46 (SD 22). Regarding the type of fracture, three (25%) were classified as 12A1, two (17%) as 12B1, two (17%) as 12B2, three (25%) as 13C1 and two (17%) as 13C2. At most recent average follow-up of 3, 4 years (DS 1,62), the results were: elbow range of flexion-extension 138,3º (SD 15,18), MEPS reached 85,8 (DS 11,7), DASH of 11,8 (SD 10,6) and the mean VAS 1,3 (SD 1,1). At the final evaluation, all fractures had healed. One case presented radial nerve neuropraxia, three cases paresthesias at the ulnar nerve territory, and all of these evolved positively and spontaneously. CONCLUSIONS: In our experience, posterior paratricipital approach is useful and safe for managing the open reduction and internal fixation. It may provide preservation of the triceps and promote an earlier rehabilitation. Functional outcomes were satisfactory in this case series.

Aqueous extract of pomegranate enriched in ellagitannins prevents anxiety-like behavior and metabolic changes induced by cafeteria diet in an animal model of menopause.

Women around menopause are vulnerable to present psychiatric and metabolic disorders; thus, therapies that contribute to treat both pathologies are required. Previous reports showed that an aqueous extract of pomegranate (Punica granatum), enriched in ellagitannins, exerts an antidepressant-like effect in ovariectomized rats. We analyze whether this aqueous extract of P. granatum (AE-PG) prevents the anxiety-like behavior induced by a cafeteria diet (CAF) in middle-aged ovariectomized rats at the same time that it prevents an increase in body weight, glucose, lipids, and the changes on mRNA expression of the peroxisome proliferator-activated receptor-gamma (PPAR-γ) in the liver. Also, the effects of AE-PG on the protein levels of PPAR-γphospho-PPAR-γ, extracellular signal-regulated protein kinase (ERK1/2) and phospho-ERK1/2 were measured in the hippocampus and amygdala. CAF induced anxiety-like behavior, augmented lipids and glucose blood levels, body weight, visceral fat, insulin resistance, and decreased mRNA expression of PPAR-γ in the liver. In rats fed with the CAF, AE-PG prevented the anxiety-like behavior, reduced body weight, lowered lipid levels, reduced insulin resistance, and increased PPAR-γ mRNA expression in the liver. In the hippocampus, ERK1/2 but not PPAR-γ protein levels were decreased by CAF, while AE-PG prevented these effects. In the amygdala, CAF increased the phosphorylation of PPARγ, and AE-PG prevented it. In contrast, AE-PG rescued the decreased ERK1/2 protein level in the hippocampus caused by CAF. In conclusion, AE-PG treatment prevented anxiogenic and metabolic effects induced by CAF, and its effects appear to be mediated by ERK1/2 and PPARγ depending on the brain area studied.

Prevalence, antimicrobial resistance profile and comparison of selective plating media for the isolation of Salmonella spp. in free-ranging waterfowl from Entre Rios, Argentina.

The present study was conducted to estimate the apparent prevalence of Salmonella spp. in free-ranging waterfowl that inhabitant Entre Ríos, Argentina, determine the antimicrobial resistance of the isolated, and compare the performance of two selective plating media used for Salmonella isolation. Five hundred ninety nine free-living waterfowl were sampled one time by cloacal swab from April 2014 to July 2016. Only 6 samples from waterfowl belonged to all counties sampled were positive to Salmonella spp., so the apparent prevalence was 1%. Four serovars were isolated (Salmonella ser. Typhimurium, S. ser. Schwarzengrund, S. enterica subsp. I [4,12: i: -], S. enterica subsp. IIIb [60: r: e, n, x, z15]), which were susceptible to 15 antibiotics tested and resistant to erythromycin. Furthermore, some strains showed an intermediate resistant to neomycin, ciprofloxacin and/or streptomycin. The multiple antibiotic resistances index was 0.05. For Hektoen enteric agar and Salmonella Shigella agar, the relative accuracy, sensitivity, specificity, positive predictive value, and negative predictive value did not show any difference between them. The agreement was good between these two plating-media and the difference between these plating-media was not statistically significant. The low prevalence of Salmonella spp. in waterfowl in Entre Rios should not be discounted, since Salmonella ser. Typhimurium was the most prevalent serovar and some free-ranging waterfowl species studied can migrate from/to different countries, increasing the possibility to cross-contaminated Salmonella to resident or other migrant birds.

Prevalence, antimicrobial resistance profile and comparison of selective plating media for the isolation of Salmonella in backyard chickens from Entre Rios, Argentina.

This study was conducted to estimate the apparent prevalence of Salmonella spp. in birds kept under backyard system in Entre Ríos, Argentina, and determine the performance of two selective plating media used for Salmonella isolation, and the antimicrobial resistance of the isolated. Also, the association of farms characteristics with Salmonella presence was evaluated. A total of 657 backyard chickens and 15 gooses were sampled one time by cloacal swab, belonging to 51 and one family farms, respectively, and four counties in Entre Rios state from April 2014 to May 2015. Only four samples from backyard chickens belonged to three family farms from Uruguay County were positive to Salmonella spp., so the apparent prevalence was 0.6% for this kind of chicken. Four serovars were isolated (Salmonella ser. Lille, S. ser. Newport, S. ser. Enteritidis and S. ser. Rissen), which were susceptible to all antibiotics tested with the exception of erythromycin. For Hektoen enteric agar and brilliant green agar, relative specificity and positive predictive value were 1, and the relative sensitivity and negative predictive value did not show any difference between them. The agreement was very good between these two plating media. None of the variables studied could be selected to calculate the risk factors associated with Salmonella isolation because p > .15. Although the prevalence of Salmonella spp. is low in backyard birds in Entre Rios, the presence of S. ser. Enteritidis should not be discounted, because it is found in the county that concentrates a large population of intensive poultry production in the state.

The evidence base for healthcare related decision-making in Regional Health Authorities

OBJECTIVES: To evaluate the evidence base used in policy and healthcare decision making by the Regional Health Authorities in Trinidad. DESIGN AND METHODS: The study focused on the five Regional Health Authorities (RHAs) in Trinidad where senior administrative employees at each Regional Health Authority were purposively sampled and interviewed using a structured questionnaire. Responses were initially reviewed individually to determine types of evidence used within each RHA. All responses were secondly compared between the various RHAs. RESULTS: All RHAs participated; each had an observatory type unit which was responsible for data collection, collation and production of reports on an annual basis. Reports focused on the number of patients accessing services (e.g. specialist clinics and surgical procedures), patient demographics and patient access to health services. All RHAs had annual service agreements with the Ministry of Health which acted as a guide with targets and as a check on accountability of money spent. Decision making in each RHA was tiered by financial cap; most decisions were made by the Chief Executive Officer and/or Board of Directors within their caps; decisions requiring monetary investment over the RHA limit had to be approved by the Ministry of Health. CONCLUSION: This study revealed that RHAs had systems in place whereby they engaged in evidence-based practice utilising the Authority’s observatory data plus other information sources, ran trial periods and economic analyses for healthcare related decision making.

COD fractionation and biological treatability of mixed industrial wastewaters.

This study was conducted at a centralized wastewater treatment plant that receives discharges from nearly 160 industries. The chemical oxygen demand (COD) was fractionated for two objectives: delineation of the limits of the activated sludge process being used at the plant, and evaluation of the potential environmental impact of the treated effluent. Physico-chemical analyses, respirometric and biodegradation tests, as well as COD fractionation were carried out. Molasses-wastewaters were determined to be the major contribution to the plant. The influent was dark brown in color, with a relatively high content of both organics (2503 mg/L COD) and salts (5459 µS/cm conductivity), but a low biochemical oxygen demand (568 mg/L BOD(5)) and BOD(5)/COD ratio (0.24). The degradability of the organics was limited by the high content of inert soluble COD (S(I)). The COD fractionation pattern was 40-20-40% for S(I), X(I) (inerts) and S(H) (soluble hydrolyzable), respectively. More than 90% BOD(5) removal was obtained, which was sufficient for the plant to meet the national Standards. However, the effluent discharged into the river was intensely colored and polluted (>1000 mg/L COD, >5000 µS/cm), emphasizing the need for legislation regulating COD, color and salinity, and for upgraded treatment methods worldwide for molasses wastewaters.

Heartburn and other related symptoms are independent of body mass index in irritable bowel syndrome.

BACKGROUND: increasing body mass index (BMI) is a risk factor for GERD but little is known about this association in the irritable bowel syndrome (IBS). AIMS: to determine the presence of heartburn and other related symptoms in relation with BMI in IBS. METHODS: volunteers (n = 483) answered the Rome II-Modular Questionnaire, and were divided into IBS and non-IBS (controls) groups. The frequency of heartburn, chest pain, epigastric pain, nausea, vomiting and belching was compared between the groups in the study sample and within three BMI categories. RESULTS: the IBS (23.7%) and controls (76.3%) were similar in gender (females: 68.1%), age (32.2 +/- 12.7 years), and BMI (25.4 +/- 4.4). Raw associations analysis showed that heartburn: OR: 1.62 (95%CI: 1.04-2.53), chest pain: 1.77 (1.13-2.77), epigastric pain: 1.75 (1.03-2.98) and nausea: 2.45 (1.10-5.32) were more frequent in IBS vs. controls. Meanwhile, according to BMI, in those with obesity, heartburn was more frequent in IBS and among those with overweight, epigastric pain and nausea were also more frequent in IBS. However, in an adjusted log linear model, no significant interaction was found between BMI and any other studied symptom and heartburn was found to be independent of IBS: 1,4 (0.9, 4.7). Finally, a logistic regression model found no interaction between BMI and the presence of heartburn or IBS. CONCLUSIONS: while heartburn and other reflux-related symptoms are more frequent in IBS than in controls, these associations are independent of BMI.

Heartburn and other related symptoms are independent of body mass index in irritable bowel syndrome

Background: increasing body mass index (BMI) is a risk factor for GERD but little is known about this association in the irritable bowel syndrome (IBS). Aims: to determine the presence of heartburn and other related symptoms in relation with BMI in IBS. Methods: volunteers (n = 483) answered the Rome II-Modular Questionnaire, and were divided into IBS and non-IBS (controls) groups. The frequency of heartburn, chest pain, epigastric pain, nausea, vomiting and belching was compared between the groups in the study sample and within three BMI categories. Results: the IBS (23.7%) and controls (76.3%) were similar in gender (females: 68.1%), age (32.2 ± 12.7 years), and BMI (25.4 ± 4.4). Raw associations analysis showed that heartburn: OR: 1.62 (95%CI: 1.04-2.53), chest pain: 1.77 (1.13-2.77), epigastric pain: 1.75 (1.03-2.98) and nausea: 2.45 (1.10-5.32) were more frequent in IBS vs. controls. Meanwhile, according to BMI, in those with obesity, heartburn was more frequent in IBS and among those with overweight, epigastric pain and nausea were also more frequent in IBS. However, in an adjusted log linear model, no significant interaction was found between BMI and any other studied symptom and heartburn was found to be independent of IBS: 1,4 (0.9, 4.7). Finally, a logistic regression model found no interaction between BMI and the presence of heartburn or IBS. Conclusions: while heartburn and other reflux-related symptoms are more frequent in IBS than in controls, these associations are independent of BMI(AU)

[Impact of the anxiety characteristics and depression on clinical aspects and quality of life in patients with irritable bowel syndrome]. / Impacto de los rasgos de ansiedad y depresión sobre aspectos clínicos y calidad de vida en pacientes con síndrome de intestino irritable.

BACKGROUND: Anxiety and depression have been related with seeking medical care by IBS patients, however their impact over the clinical characteristics and health related quality of life (HRQOL) of the patients, is unknown. AIMS: To evaluate the impact of these traits over the symptoms, number of consultations and HRQOL in IBS. METHODS: Consecutive moderate to severe IBS-Rome I patients that consulted a reference center in Mexico City, answered the HAD, a Bowel Symptom Questionnaire and the SF-36. Patients were compared according to the presence or absence of anxiety or depression. RESULTS: Anxiety was found in 70%, depression in 46% and both traits among 40%. The majority of those with depression were single compared to a married majority in those without this trait (p = 0.03). Those with anxiety (p = 0.03) and depression (p = 0.006) reported more number of days with abdominal pain/ discomfort and both traits (p = 0.000) were associated with a higher frequency of fullness, distention, abdominal pain, incomplete evacuation, abnormal bowel movements and lower HRQOL. Patients with anxiety reported a more severe IBS and those with depression a higher frequency of diarrhea predominance (p = 0.047). CONCLUSIONS: Traits anxiety and depression negatively impacted over the number of days, symptom frequency and HRQOL of patients with moderate to severe IBS. More studies are needed to determine if these psychological symptoms are causing these outcomes or if the gastrointestinal symptoms and poor HRQOL are triggering anxiety and depression in IBS.

Cloning and characterization of a cDNA encoding a protein synthesis initiation factor-2alpha (eIF-2alpha) kinase from Drosophila melanogaster. Homology To yeast GCN2 protein kinase.

Phosphorylation of the alpha subunit of the eukaryotic initiation factor 2 (eIF-2alpha) is one of the best-characterized mechanisms for downregulating protein synthesis in mammalian cells in response to various stress conditions. In Drosophila, such a regulatory mechanism has not been elucidated. We report the molecular cloning and characterization of DGCN2, a Drosophila eIF-2alpha kinase related to yeast GCN2 protein kinase. DGCN2 contains all of the 12 catalytic subdomains characteristic of eukaryotic Ser/Thr protein kinases and the conserved sequence of eIF-2alpha kinases in subdomain V. A large insert of 94 amino acids, which is characteristic of eIF-2alpha kinases, is also present between subdomains IV and V. It is particularly notable that DGCN2 possesses an amino acid sequence related to class II aminoacyl-tRNA synthetases, a unique feature of yeast GCN2 protein kinase. DGCN2 expression is developmentally regulated. During embryogenesis, DGCN2 mRNA is dynamically expressed in several tissues. Interestingly, at later stages this expression becomes restricted to a few cells of the central nervous system. Affinity-purified antibodies, raised against a synthetic peptide based on the predicted DGCN2 sequence, specifically immunoprecipitated an eIF-2alpha kinase activity and recognized an approximately 175 kDa phosphoprotein in Western blots of Drosophila embryo extracts.

Multiple tyrosine protein kinases in rat hippocampal neurons: isolation of Ptk-3, a receptor expressed in proliferative zones of the developing brain.

Tyrosine protein kinases are likely to play an important role in the maintenance and/or development of the nervous system. In this study we have used the PCR cloning technique to isolate sequences derived from tyrosine kinase genes expressed in cultured hippocampal neurons obtained from 17.5-day-old rat embryos. Nucleotide sequence analysis of 209 independent clones revealed sequences derived from 25 tyrosine kinases, of which two corresponded to previously unreported genes. One of the PCR clones, ptk-2, belongs to the Jak family of cytoplasmic tyrosine kinases. The second clone, ptk-3, was derived from a gene encoding an additional class of tyrosine kinase receptors whose extracellular domains contain regions of homology with coagulation factors V and VIII and complement component C1. Transcripts encoding the Ptk-3 receptor are present in a variety of embryonic and adult tissues with highest levels observed in brain. During development, ptk-3 transcripts are most abundant in the proliferative neuroepithelial cells of the ventricular zone, raising the possibility that this receptor may play an important role in the generation of the mammalian nervous system.

Dtrk, a Drosophila gene related to the trk family of neurotrophin receptors, encodes a novel class of neural cell adhesion molecule.

We report the identification and molecular characterization of Dtrk, a Drosophila gene encoding a receptor tyrosine kinase highly related to the trk family of mammalian neurotrophin receptors. The product of the Dtrk gene, gp160Dtrk, is dynamically expressed during Drosophila embryogenesis in several areas of the developing nervous system, including neurons and fasciculating axons. gp160Dtrk has structural homology with neural cell adhesion molecules of the immunoglobulin superfamily and promotes cell adhesion in a homophilic, Ca2+ independent manner. More importantly, this adhesion process specifically activates its tyrosine protein kinase activity. These findings suggest that gp160Dtrk represents a new class of neural cell adhesion molecules that may regulate neuronal recognition and axonal guidance during the development of the Drosophila nervous system.

Loss of the amino-terminal helix-loop-helix domain of the vav proto-oncogene activates its transforming potential.

vav, a novel human oncogene, was originally generated in vitro by replacement of its normal 5' coding sequences with sequences from pSV2neo DNA, cotransfected as a selectable marker (S. Katzav, D. Martin-Zanca, and M. Barbacid, EMBO J. 8:2283-2290, 1989). The vav proto-oncogene is normally expressed in cells of hematopoietic origin. To determine whether the 5' rearrangement of vav or its ectopic expression in NIH 3T3 cells contributes to its transforming potential, we isolated murine and human proto-vav cDNA clones as well as human genomic clones corresponding to the 5' end of the gene. Normal proto-vav was poorly transforming in NIH 3T3 cells, whereas truncation of its 5' end greatly enhanced its transforming activity. The relative failure of full-length proto-vav cDNA clones to transform NIH 3T3 cells indicates that the transforming activity of vav is not simply due to ectopic expression. Analysis of the predicted amino terminus of the vav proto-oncogene shows that it contains a helix-loop-helix domain and a leucine zipper motif similar to that of myc family proteins, though it lacks a basic region that is usually found adjacent to helix-loop-helix domains. Loss of the helix-loop-helix domain of proto-vav, either by truncation or by rearrangement with pSV2neo sequences, activates its oncogenic potential.

Molecular analysis of the pac gene encoding a puromycin N-acetyl transferase from Streptomyces alboniger.

Nucleotide sequence of a 906-bp fragment of Streptomyces alboniger DNA containing the gene (pac), which encodes a puromycin N-acetyltransferase (PAC), has been determined. The pac gene contains a 600-nt open reading frame, starting with an ATG codon, which encodes a polypeptide of Mr 21,531; this is consistent with the 23 +/- 1.5 kDa size of the PAC enzyme. High-resolution S1 mapping indicates that transcription starts at or next to a C residue 35 bp upstream from the putative ATG start codon. A 263-bp DNA fragment from the 5' region of the pac gene has promoter activity in the promoter-probe plasmid pIJ486. Its -35 and -10 regions show significant structural homology to the corresponding regions of the hyg gene promoter, but they are different from the promoter sequences of other Streptomyces and Escherichia coli genes.

Two genes in Streptomyces alboniger puromycin biosynthesis pathway are closely linked.

Several recombinant plasmids, derived from the Streptomyces vector pIJ702 and carrying different stretches of Streptomyces alboniger DNA encoding the gene (pac) for puromycin N-acetyl transferase [Vara et al., Gene 33 (1985) 197-206] were found to also include the gene (dmpM) for the O-demethylpuromycin O-methyl transferase enzyme. Both genes are present on the same 2.4-kb DNA fragment. Coupled transcription-translation experiments suggested that the dmpM gene product is a 44-kDa polypeptide and that both dmpM and pac might belong to different transcriptional units. The level of expression of the dmpM gene was dependent upon the orientation of insertion in the vector.

The hyg gene promoter from Streptomyces hygroscopicus: a novel form of Streptomyces promoters.

A 207 bp DNA fragment from the 5' region of the hyg gene of Streptomyces hygroscopicus was located preceding a DNA sequence encoding the mature form of human interferon alpha 2. This gene fusion, inserted in the Streptomyces vector pIJ702, expressed interferon activity in Streptomyces lividans indicating that the 207 bp sequence has promoter activity. The transcription initiation site was located. No significant homology with previously described Streptomyces promoters could be found. It appears therefore, it represents a novel class of Streptomyces promoters.

Efficient transformation of mammalian cells with constructs containing a puromycin-resistance marker.

Recombinant plasmids have been obtained that lead to the accumulation of five- to ten-fold more puromycin-N-acetyl-transferase (PAC) mRNA and two- to three-fold more PAC activity than the already described plasmid pSV2pac [Vara et al., Nucl. Acids Res. 14 (1986) 4117-4124]. When these optimized recombinants were used for stable transformation to puromycin resistance, efficiencies up to 1 x 10(-2) were obtained, indicating that these pac-containing recombinants may be very useful dominant selectable markers for gene transfer in mammalian cells.

Optimization of gene expression in Streptomyces lividans by a transcription terminator.

The ability of an inverted repeat sequence (IRS) from the 3' end of the aph gene from Streptomyces fradiae to induce transcription termination in vivo has been examined. As a model system, a DNA fragment encoding the human interferon alpha 2 inserted in the Streptomyces plasmid pIJ702 was used. When the IRS was inserted downstream from this sequence and transcription assayed in Streptomyces lividans, highly efficient (approximately 90%) transcription termination was observed occurring immediately after the 3' terminus of the dyad. In contrast, gene constructions lacking the IRS transcribed longer mRNAs. Moreover, the IRS gave rise to increased amounts of the hIFN alpha 2 suggesting that the putative stem-loop structure stabilised the transcript.

[APH(3')-II phosphotransferase determination using protein transfer (western blotting)]. / Estudio de la fosfotransferasa APH(3')-II mediante trasferencia de proteínas ("western blotting").

The APH(3')-II aminoglycoside-phosphotransferase has been studied by protein blotting. This technique allowed the detection of the enzyme in the crude extracts from clinical isolates of Enterobacteriaceae, and the molecular weight determination of the APH(3')-II. The obtained molecular weight of 25,000 is coincident with the previously reported value determined by a different method. These results demonstrate that this technique is useful for the study of aminoglycoside-modifying enzymes.