Electronic equipment and appliances in special wards of hospitals as a source of azole-resistant Aspergillus fumigatus: a multi-centre study from Iran.

BACKGROUND: Azole-resistant Aspergillus fumigatus (ARAf), reported as a global public health concern, has been unexpectedly observed in different countries. AIM: To identify ARAf and detect azole resistance related to the CYP51A mutation in different hospital environmental samples. METHODS: In this multi-centre study from Iran, surfaces of electronic equipment and appliances from different hospitals in Iran were sampled using cotton swabs. All samples were cultured using azole-containing agar plates (ACAPs). Recovered Aspergillus isolates were identified at the species level using partial DNA sequencing of the ß-tubulin gene. The azole susceptibility testing of A. fumigatus isolates was performed using the Clinical and Laboratory Standards Institute M38-A3 guideline. The sequencing of the CYP51A gene was also performed to detect mutations related to resistance. FINDINGS: Out of the 693 collected samples, 89 (12.8%) Aspergillus species were recovered from ACAPs. Aspergillus fumigatus (41.6%) was the most prevalent, followed by A. tubingensis (23.6%) and A. niger (15.6%). Among 37 isolates of A. fumigatus, 19 (51.3%) showed high minimum inhibitory concentration (MIC) values to at least one of the three azoles, voriconazole, itraconazole, and posaconazole. CYP51A polymorphisms were detected in all 19 isolates, of which 52.6% showed the TR34/L98H mutation. Other detected mutations were G432C, G448S, G54E/G138C, F46Y, and Y121F/M220I/D255E. T289F and G432C were the first reported mutations in ARAf. CONCLUSION: There was a considerable level of azole resistance in hospital environmental samples, a serious warning for patients vulnerable to aspergillosis. Our findings have also revealed a different mutation pattern in the CYP51A gene.

The Needs of Orthopaedic Patients in Discharge Planning.

Introduction: Patients' transition from hospital to home could be challenging for patients and caregivers. This is of utmost importance for patients requiring special or long-term care such as post-orthopaedic surgery. Effective discharge planning is required to ensure that patients are prepared to and get continuous care after returning home to prevent complications. Patients' need assessment is essential to develop effective discharge planning to meet the patient's needs. Materials and methods: This mixed-method study aimed to determine the patient's needs to develop a discharge planning for total knee replacement surgery. The needs for 96 total knee replacement patients were assessed using the Needs Evaluation Questionnaire (NEQ). The in-depth interview primary focus was to explore the lived experience of the post-total knee replacement patients receiving care in the hospital. Results: A total of 96 participants (100%) completed the NEQ questionnaire. Most of the needs concerned by the participants were expressed by at least 70% of them except the financial need (59.4%). The semi-structured interview found two elements which were a support group and patients' needs in terms of emotional, physical and spiritual preparation in developing effective discharge planning. Conclusion: This study clarified that the patient needs assessment in the patient care plan.

Association of vitamin D, retinol and zinc deficiencies with stunting in toddlers: findings from a national study in Iran.

OBJECTIVE: The objective of this study was to investigate the association of serum levels of 25(OH)D3 (vitamin D), retinol (vitamin A) and zinc with stunting in a large sample of Iranian toddlers. STUDY DESIGN: This was a cross-sectional study. METHODS: A total of 4261 children, aged 10-36 months, who had Iranian birth certificates were included in the present study. Weight and height were measured by experienced professionals in accordance with standard protocols. Stunting was defined as a height-for-age z-score of <-1 standard deviation (SD) based on the World Health Organization (WHO) criteria (the WHO Child Growth Standards median). Serum levels of 25(OH)D3, retinol and zinc were examined based on standard methods. RESULTS: The mean age of the study participants was 19.2 ± 8.4 months. A significant inverse association was found between serum retinol concentrations and the odds of stunting such that after controlling for potential confounders, toddlers in the highest quartile of serum retinol levels had 29% lower odds of stunting than those in the lowest quartile (odds ratio [OR]: 0.71, 95% confidence interval [CI]: 0.53-0.97). Furthermore, a significant inverse association was found between serum levels of retinol and stunting in girls (OR: 0.57, 95% CI: 0.34-0.94), urban toddlers (OR: 0.66, 95% CI: 0.44-0.99) and those who did not use nutritional supplements (OR: 0.70, 95% CI: 0.52-0.95). Although serum 25(OH)D3 levels were not significantly associated with stunting in the overall study population, we found a positive association among toddlers who used nutritional supplements. No significant association was found between serum levels of zinc and stunting. CONCLUSION: We found a significant inverse association between serum levels of retinol and stunting in toddlers aged 10-36 months.

Experimental and theoretical study of rhenium radioisotopes production for manufacturing of new compositional radiopharmaceuticals.

Rhenium therapeutic radioisotopes, namely rhenium-186 and 188, are radionuclides that have been used in combination with various ligands to provide different radiopharmaceuticals for the treatment of different diseases for many years. Each of these radioisotopes has its own special attributes, which make it appropriate to destroy special-sized tumors. High energy, long range beta particles in 188Re can give this certainty that large tumors can be eradicated with high efficiency. On the other hand, 186Re with low energy, short range beta particles is adequate item to ruin small tumors with minimum side effects and high yield. Thus, each of these radioisotopes has features that can cover just part of the treatment individually. So we thought accompanying 186Re and 188Re must have the best outcome to treat tumors with various sizes. Irradiating natural rhenium with neutrons has this potential to produce parallel 186Re and 188R together. We are looking for investigating whether the natural rhenium irradiation, in addition the concurrent production of these radioisotopes, gives us the appropriate radioactivity values to produce compositional radiopharmaceuticals? In this research, the experimental and theoretical assessments of 186Re and 188R simultaneous production to reach compositional radiopharmaceutical by natural rhenium irradiation in the Tehran research reactor, as well as the type and amount of produced impurities have been investigated. The results showed that experimental data are in good agreement with theoretical calculations. The maximum relative error in data has been calculated 8%. The results showed that, in the simultaneous production 186Re and 188R via the natural rhenium irradiation method, the amounts of impurities are trivial compared to the main products, and the activities of main products are properly enough to produce compositional radiopharmaceuticals.

Effect of diets containing roasted soybean, extruded soybean or their combination on performance and milk fatty acid profile of lactating Holstein cows.

The aim of this study was to investigate the effect of diets containing roasted soybean (R), extruded soybean (E) or their combination (RE) on dairy cow performance and milk fatty acid (FA) profile. Nine multiparous lactating Holstein cows (680 ± 25 kg BW; 90 ± 10 DIM; means ± SD) were randomly assigned to a triple 3 × 3 Latin square design. Dry matter intake (DMI), apparent nutrient digestibility, milk yield, composition and FA profile and efficiency of nitrogen (N) utilization for milk production were measured. Cows fed R and RE had higher 4% fat corrected milk (FCM) yield and DMI compared to those fed the E (P<0.05). The efficiency of 4% FCM production per unit of DMI was not influenced by experimental diets (P>0.05). Experimental diets had no effect on milk fat and protein concentrations and nutrient digestibility (P>0.05). Milk fat concentrations of vaccenic acid (VA; C18:1 trans-11) and conjugated linoleic acid (CLA; C18:2 cis-9, trans-11) were higher for cows fed with RE compared to other groups (P<0.05). We concluded that cows fed with RE had similar milk production and fat content compared to those fed with R and a similar beneficial milk FA profile compared to those fed with E. Thus, feeding a diet with RE improved the quality and quantity of dairy cow milk.

Toxoplasma gondii infection among sheep and goats in Iran: a systematic review and meta-analysis.

Toxoplasmosis, a cosmopolitan parasitic infection caused by Toxoplasma gondii, is frequently found in meat-producing animals and human beings. This review and meta-analysis study was performed to evaluate the overall prevalence of T. gondii infection among sheep and goats in Iran. Data were systematically collected from 1977 to 2012 in Iran on the following electronic databases: PubMed, Google Scholar, Science Direct, Scopus, Web of Science, Magiran, Irandoc, IranMedex, and Scientific Information Database (SID). Additionally, abstracts of national scientific congresses and dissertations were included. A total of 34 articles in field of sheep and 18 articles about goat toxoplasmosis, totalizing to the examination of 14,372 sheep and 3,120 goats, reporting prevalence of toxoplasmosis from different regions of Iran fulfilled our eligibility criteria. The overall prevalence rate of toxoplasmosis in Iran was estimated to be 31% (95% confidence interval (CI) = 0.259825 to 0.352382) in sheep and 27% (95% CI = 0.140097 to 0.424782) in goats, respectively. There was no significant difference in infection rate between males and females among sheep (odds ratio (OR) = 1.002, 95% CI = 0.59 to 1.696) and goats (OR = 1.027, 95% CI = 0.685 to 1.541). Analysis revealed that infection rate in sheep over than 1 year old was 2.4 times more than that in less than 1 year old (OR = 2.396, 95% CI = 1.050 to 5.467). This systematic review and meta-analysis study revealed that infection is widespread in Iran. Further studies are required to improve strategies for controlling infection among flocks and consequently in human population.

Numerical correlation between nerve conduction velocity and compound nerve action potential of median nerve in patients with carpal tunnel syndrome and normal group.

BACKGROUND: Electrodiagnostic studies have a major role in the diagnosis of carpal tunnel syndrome (CTS). The parameters used in this regard include nerve conduction velocity (NCV) and compound nerve action potential (CNAP). In some individuals, recording sensory nerve action potential (SNAP) and as a result NCV is impossible. This study aims at determining the numerical correlation between CNAP and NCV calculated through SNAP METHODS: NCV and CNAP in 100 hands of 50 electrophysiologically and clinically asymptomatic individuals and 100 hands of 70 patients with CTS were surveyed. The correlation between NCV and CNAP was determined using independent t-test and regression model. RESULTS: The results indicated that there is a significant correlation between sex, group, CNAP and NCV statistically (P(value) < 0.05). Pearson correlation coefficient was -0.95. Agreement between NCV and CNAP was proved based on Bland Altman plot. CONCLUSIONS: There is numerical correlation between NCV and CNAP that we can use it when we are not able to calculate NCV through SNAP.

Cell and process design for targeting of recombinant protein into the culture medium of Escherichia coli.

This paper is a review of strategies to introduce protein into the liquid medium of Escherichia coli K-12 industrial production cells. The cell design strategies are generally based on one of two general mechanisms. The first strategy involves a two-stage translocation using active transporters in the cytoplasmic membrane followed by passive transport through the outer membrane. Passive transport is achieved through either external or internal destabilization of the E. coli structural components. The latter can be achieved by transplantation of destabilizing components (lysis proteins) that work by permeabilization of the outer membrane from the interior of the cell, or by using cells carrying mutations of structural components. Passive transport can also be achieved by a chemical, mechanical, or enzymatic permeabilization directed from outside the cell. The second strategy is realized through transplantation of proteins capable of active transport over one or both of the membranes. This involves the transplantation of secretion mechanisms into the K-12 cell from pathogenic E. coli as well as from other species. The process design strategies are dependent on environmental conditions and must take into account changes in physical parameters, medium design, and influx of limiting carbon source in fed-batch cultivation.

Growth rate-dependent changes in Escherichia coli membrane structure and protein leakage.

The phospholipid and fatty acid content of the Escherichia coli membrane were investigated during continuous cultivation. At low growth rates, there was an increase in cardiolipin produced at the expense of phosphatidylethanolamine. Phosphatidylglycerol had a maximum at a growth rate of 0.3 h(-1). The amount of cyclic fatty acids was markedly increased at lower growth rates, while there was an evident minimum at 0.3 h(-1). This was also the case for saturated fatty acids. At this point, the unsaturated fatty acids had a maximum depending mainly on changes in cis-vaccenic acid. The mechanical strength towards sonication and osmotic shock/enzymatic treatment showed that the cells were more rigid at low dilution rates. However, this was accompanied by a higher cell lysis, a reduced capacity for total and specific protein production and a lower yield of cells. The amount of lipid A in the medium (endotoxin) was constant and negligible at all growth rates. The leakage of periplasmic protein to the medium had an optimum at 0.3 h(-1), resulting in a transport of 20% of the total recombinant product. It is argued that this constitutes the point of highest membrane fluidity and thus an increase possibility for protein transport.

Identification of serine esterases in tissue homogenates.

Serine esterases react with [3H]diisopropylphosphofluoridate ([3H]DFP) to produce radioactive adducts that can be resolved by denaturing slab gel electrophoresis. To identify an esterase or its catalytic subunit, a potential substrate was included in the reaction mixture with the expectation that it would suppress the enzyme's reaction with [3H]DFP. The nature of the enzyme could be inferred from the character of the substrates that suppress labeling. The validity of this analytical method was tested with two serine proteases, trypsin and alpha-chymotrypsin, and two serine esterases, acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), and several of their natural or model substrates or inhibitors. Application of the method to complex biological systems was tested with chicken embryo brain microsomes. Trypsin labeling with [3H]DFP was suppressed by alpha-N-benzoyl-l-arginine ethyl ester (BAEE) and poly-l-lysine but not by benzoyl-l-tyrosine ethyl ester (BTEE). [3H]DFP labeling of chymotrypsin was suppressed by both BAEE and BTEE. Labeling of AChE and BuChE was suppressed by their natural and some related substrates and inhibitors. [3H]DFP reacted with brain microsomes to produce nine distinct radioactive bands. When the relevant substrates and inhibitors of AChE were included in the reaction mixtures, labeling of only the 95-kDa band was suppressed, implicating it as AChE. Labeling of the 85- and 79-kDa bands was inhibited by butyrylcholine, suggesting that these proteins have BuChE activity.

Antitubercular natural products: berberine from the roots of commercial Hydrastis canadensis powder. Isolation of inactive 8-oxotetrahydrothalifendine, canadine, beta-hydrastine, and two new quinic acid esters, hycandinic acid esters-1 and -2.

Berberine (4) is responsible for the activity of an extract of a commercial root sample of Hydrastis canadensis against multiply drug resistant Mycobacterium tuberculosis. Two new quinic acid feruloyl esters, compounds 2 and 3, have been isolated from the same source along with canadine (1c), 8-oxotetrahydrothalifendine (1), and beta-hydrastine (5). These were found to be inactive. The structures of the new compounds were elucidated from spectral (1H, 13C, HMQC, HMBC, and H-H COSY) and chemical evidences.

A simple, inexpensive apparatus for performance of preparative scale solution phase multiple parallel synthesis of drug analogs. II. Biological evaluation of a retrospective library of quinolone antiinfective agents.

A series of pure fluoroquinolone antiinfective agents was prepared by multiple parallel synthesis using a simple new apparatus. These compounds were evaluated biologically against Gram-positive and Gram-negative microorganisms and against a BCG strain transfected with luciferase in a fluorescence-based antitubercular assay. Activity against relatively fast growing, acid-fast Mycobacterium smegmatis was determined in part by agar-dilution streak assays. Data obtained against Escherichia coli-derived DNA gyrase does not correlate well with whole cell assays against E. coli. These compounds were assayed by a convenient glass-fiber filter binding method modified for high throughput screening. In these analogs, the results with a N-1 cyclopropyl substituent were often inferior to those obtained with a N-1 2',4'-difluorophenyl substituent. None of the new compounds prepared was superior in its antimycobacterial potency to ciprofloxacin or temafloxacin.