Altered GABAergic and glutamatergic activity within the rat hippocampus and amygdala in rats subjected to repeated corticosterone administration but not restraint stress.

We investigated the effect of two well characterized preclinical animal models of depression - repeated injections of corticosterone (CORT) and repeated restraint stress - on markers of GABAergic and glutamatergic activity in the hippocampus and amygdala. Stress is an identified risk factor for the onset of major depression, but the neurobiological mechanisms by which stress may produce depressogenic effects are not clear. Rats received one of the following four treatments for 21 consecutive days: daily single CORT injections (40mg/kg), daily single vehicle injections, daily 6h of restraint stress, or daily handling. After the 21-day stress period, all rats were sacrificed and hippocampal and amygdalar tissue was collected and prepared for Western blot analyses. We examined the effect of CORT and restraint stress on glutamate decarboxylase (GAD)-65 and GAD67, as well as the α1, α2, α3, and ß2-3 GABA(A) receptor subunits, and the vesicular glutamate transporter (VGLUT)-2. We found that CORT significantly decreased GAD65 and the α2 receptor subunit and increased VGLUT2 within the hippocampus. We also found that CORT decreased GAD67 and the α2 receptor subunit in the amygdala. However, restraint stress had no significant effect on protein expression in either the hippocampus or the amygdala. These findings parallel our previous results showing that repeated CORT injections, but not restraint stress, increase depression-like behavior in rats, and suggest that the depressogenic effects of CORT may be related to alterations in GABAergic and glutamatergic neurotransmission in stress-sensitive regions of the brain.

Influencia de la asistencia a las guarderías sobre la morbilidad y el consumo de recursos sanitarios en niños menores de 2 años / No disponible

Objetivo: evaluar la influencia de la asistencia a la guardería sobre la morbilidad y elconsumo de recursos sanitarios en los niños menores de 2 años.Material y métodos: diseño: estudio longitudinal prospectivo. Centros participantes: centrosde Atención Primaria, coordinados por el Grupo de Investigación de la Asociación Españolade Pediatría de Atención de Primaria (AEPap). Sujetos: niños menores de 2 años que acudena las consultas de pediatría de los centros de salud participantes. Muestra: niños nacidosentre el 1 de abril y el 30 de octubre de 2009 que cumplan los criterios de inclusión. Variables:la variable independiente será asistencia o no a la guardería. Como variables dependientes seanalizarán el número y el tipo de infecciones, los tratamientos recibidos y la asistencia a centrossanitarios. Se recogerán variables de caracterización familiares y personales que pudieranactuar como factores de confusión. Recogida de datos: entrevistas realizadas en la primera visitay a los 6, 12, 18 y 24 meses de edad. Análisis estadístico: para analizar las diferencias entreel número de infecciones dependiendo de la edad del niño al entrar en la guardería se realizaráun test de Anova. Para comparar el consumo de antibióticos y de broncodilatadores, asícomo la utilización de recursos sanitarios entre los niños que acuden a la guardería y aquellosque no lo hacen se aplicará el test de la T de Student o el test U de Mann-Whitney. Se realizaráun análisis multivariante de regresión lineal paso a paso para identificar factores personalesy familiares que pueden considerarse como variables predictoras del número de infecciones,controlando los posibles factores de confusión e interacciones(AU)

Objective: to evaluate the influence of child day-care centres on morbidity and consumptionof health resources in children younger than 2 years.Methods: design: prospective longitudinal study. Participating institutions: Primary HealthCare centers, coordinated by “Grupo de Investigación de la Asociación Española de Pediatríade Atención Primaria” (AEPap) (Research Group of the Spanish Primary Care PediatricsAssociation). Subjects: children aged 0 to 2 years attending pediatric appointments ofthe participating health centres. Sample: all children born between April 1st and October30th, 2009, that meet the inclusion criteria. Variables: independent variable will be Childday-care center or not. As dependent variables it will be analyzed the number and type ofinfection, treatments received and assistance to Health Care centers. Characterization personaland family variables that could act as confounding factors will be also collected. Datacollection: interviews conducted during the first visit and at 6, 12, 18 and 24 months of age.Statistical analysis: to analyze the differences between number of infections depending onage of child when entering child day-care center, an Anova test will be done. We will applyStudent’s T test or Mann-Whitney´s U test to compare antibiotic consumption, use of bronchodilators,health resource utilization among children attending child day-care center andthose who don’t. A multivariate lineal regression analysis will be done step by step to identifypersonal and family factors that may be considered as predictors of the number of infectionsafter controlling potential confounders and interaction factors(AU)

Temporal gene expression and probiotic attributes of Lactobacillus acidophilus during growth in milk.

Lactic acid bacteria have been used as starter strains in the production of fermented dairy products for centuries. Lactobacillus acidophilus is a widely recognized probiotic bacteria commonly added to yogurt and used in dietary supplements. In this study, a whole genome microarray was employed to monitor gene expression of L. acidophilus NCFM cells propagated in 11% skim milk during early, mid and late logarithmic phase, and stationary phase. Approximately 21% of 1,864 open reading frames were differentially expressed at least in one time point. Genes differentially expressed in skim milk included several members of the proteolytic enzyme system. Expression of prtP (proteinase precursor) and prtM (maturase) increased over time as well as several peptidases and transport systems. Expression of Opp1 (oligopeptide transport system 1) was highest at 4 h, whereas gene expression of Opp2 increased over time reaching its highest level at 12 h, suggesting that the 2 systems have different specificities. Expression of a 2-component regulatory system, previously shown to regulate acid tolerance and proteolytic activity, also increased during the early log and early stationary phases of growth. Expression of the genes involved in lactose utilization increased immediately (5 min) upon exposure to milk. The acidification activity, survival under storage conditions, and adhesion to mucin and Caco-2 tissue culture cells of selected mutants containing insertionally inactivated genes differentially expressed in the wild-type strain during growth in milk were examined for any potential links between probiotic properties and bacterial growth and survival in milk. Some of the most interesting genes found to be expressed in milk were correlated with signaling (autoinducer-2) and adherence to mucin and intestinal epithelial cells, in vitro.

Lactobacillus plantarum 299v surface-bound GAPDH: a new insight into enzyme cell walls location.

The aim of this study was to provide new insight into the mechanism whereby the housekeeping enzyme glyceraldehyde-3-phosphate dehydrogenase (GAPDH) locates to cell walls of Lactobacillus plantarum 299v. After purification, cytosolic and cell wall GAPDH (cw-GAPDH) forms were characterized and shown to be identical homotetrameric active enzymes. GAPDH concentration on cell walls was growth-time dependent. Free GAPDH was not observed on the culture supernatant at any time during growth, and provoked cell lysis was not concomitant with any reassociation of GAPDH onto the cell surface. Hence, with the possibility of cw-GAPDH resulting from autolysis being unlikely, entrapment of intracellular GAPDH on the cell wall after a passive efflux through altered plasma membrane was investigated. Flow cytometry was used to assess L. plantarum 299v membrane permeabilization after labeling with propidium iodide (PI). By combining PI uptake and cw-GAPDH activity measurements, we demonstrate here that the increase in cw-GAPDH concentration from the early exponential phase to the late stationary phase is closely related to an increase in plasma membrane permeability during growth. Moreover, we observed that increases in both plasma membrane permeability and cw-GAPDH activity were delayed when glucose was added during L. plantarum 299v growth. Using a double labeling of L. plantarum 299v cells with anti-GAPDH antibodies and propidium iodide, we established unambiguously that cells with impaired membrane manifest five times more cw-GAPDH than unaltered cells. Our results show that plasma membrane permeability appears to be closely related to the efflux of GAPDH on the bacterial cell surface, offering new insight into the understanding of the cell wall location of this enzyme.

Characterization of exopolysaccharides produced by three moderately halophilic bacteria belonging to the family Alteromonadaceae.

AIMS: To study the exopolysaccharides (EPSs) produced by three novel moderately halophilic species belonging to the family Alteromonadaceae to optimize EPS yields, characterize their physical and chemical properties and evaluate possible biotechnological applications for these polymers. METHODS AND RESULTS: EPSs synthesized by Idiomarina fontislapidosi F32(T), Idiomarina ramblicola R22(T) and Alteromonas hispanica F23(T) were collected and analysed under optimum conditions: MY medium supplemented with 7.5% (w/v) salts; 32 degrees C; and 1% (w/v) glucose. Polymers were synthesized mainly during the early stationary growth phase with yields ranging from 1 to 1.5 g l(-1). The Idiomarina species each produced an anionic EPS composed mainly of glucose, mannose and galactose. A. hispanica synthesized an anionic EPS composed mainly of glucose, mannose and xylose. Solutions of all the polymers were low in viscosity and pseudoplastic in their behaviour. They showed emulsifying activity and the capacity to bind some metals. CONCLUSIONS: The Alteromonadaceae species studied in this work produced EPSs with physical and chemical properties different from those produced by other halophilic and nonhalophilic bacteria, suggesting that the wide diversity of micro-organisms being encountered nowadays in hypersaline environments offers enormous potential resources for biotechnological applications. SIGNIFICANCE AND IMPACT OF THE STUDY: We have optimized the EPS production and analysed new biopolymers produced by some recently described, moderately halophilic bacteria. These biopolymers are chemically and physically different from others already in use in biotechnology and offer hopes for new applications, especially in the case of A. hispanica, which may prove to be a viable source of xylo-oligosaccharides.

Strain- and matrix-dependent adhesion of Lactobacillus plantarum is mediated by proteinaceous bacterial compounds.

AIMS: The ability of 31 Lactobacillus plantarum strains to adhere to biological matrixes was evaluated, and the molecules involved in adherence were studied. METHODS AND RESULTS: Mucin, basement membrane proteins and Caco-2 cells were used in adhesion tests. These in vitro assays, together with a yeast agglutination test, were found to be discriminative for screening Lact. plantarum strains for adhesion. Some strains, such as 299v, CBE, BMCM12, Col4S and T25, were shown to possess interesting adhesion properties in at least two models. The adhesion of these strains was strongly inhibited when the bacterial cells were pretreated with trypsin. Lithium chloride and methyl-alpha-D-mannoside also inhibited adhesion to a lower extent. CONCLUSIONS: The adhesion of Lact. plantarum depends on both the model and the strain used. The chemical and enzymatic pretreatments applied to the bacterial cells suggested that lectin-like adhesins and other proteinaceous cell-surface structures are involved in adhesion of these strains. SIGNIFICANCE AND IMPACT OF THE STUDY: We found a great diversity in the adhesion properties between Lact. plantarum strains. Based upon the adhesive property of these strains interesting candidates were identified, that will undergo further study as potential probiotics.

Infusion pumps.

Confluence in technologic advances in medical electronics, the availability of new intravenous pharmaceuticals, increasing sophistication of home care delivery systems and the economic motivations imposed by Diagnosis-Related Groups and capitated care payment mechanisms stimulated dramatic developments in intravenous delivery technologies, both for the hospital and the outpatient environment. Success in the use of these sophisticated drug delivery systems, however, depends on appropriate patient selection, optimal selection of a delivery alternative and careful patient monitoring for both desired therapeutic response, health delivery quality and patient safety.

Oximetry: state-of-the-art.

Measuring arterial hemoglobin saturation via traditional arterial blood gas testing or co-oximetry complements the fundamental physical examination process. Within the last two decades, advancements in diagnostic technologies made possible the dynamic, noninvasive assessment of hemoglobin saturation through pulse oximetry. Technology assessment teams must determine the relative cost-effectiveness of these techniques and their effect on patient outcome.

Wound care dressings.

Significant advances in wound healing technologies dramatically enhance the health provider's ability to achieve optimal wound healing. Maximal success in treating both pressure and skin ulcers, however, remains with the fundamental principles of moist wound healing, pressure relief, local and systemic infection control and adequate nutrition. Nurse executives are challenged to evaluate wound dressing technologies in the integrated clinical environment of comprehensive, scientifically validated, wound care clinical practice guidelines.

Support surfaces: therapeutic and performance insights.

Support surfaces (specially designed hospital mattresses) are becoming important aspects of a comprehensive patient care plan. However, their proper use requires a clear understanding of the relative advantages and disadvantages of different product types. Moreover, careful assessment of outcomes is essential as support surfaces represent a significant, incremental increase in the costs of care, and their misuse could actually contribute to patient morbidity.

Automated medication dispensing systems.

Threefold pressures to control hospital costs, improve professional staff performance and maximize medical quality motivate health systems managers to continually reassess the potential role of automated medication dispensing systems. Nurse managers become intimately involved in this assessment and reassessment process and must understand both the varied performance variables and the total health system implementation challenges presented by each of the available systems.

Electronic fetal monitoring.

Currently, recommendations regarding the marginal value of electronic fetal monitoring (EFM) to the standard practice management of the patient in labor must be couched in qualifications regarding both patient tolerance for risk and health team uncertainty about practice guidelines for intermittent auscultation during pregnancy. If stresses on a maternity unit's manpower prevent strict registered nurse or nurse mid-wife compliance with an auscultatory monitoring program, then EFM may make both quality and health outcomes sense. If, on the other hand, the unit employs stringent patient care quality monitoring guidelines, then a course of intermittent auscultation may make both safety and cost-effectiveness sense.

Chest pain observation units.

The key to technologic assessment of the chest pain unit lies in the recognition of the unit's ability to optimize outcomes of an illness with high incidence, high acute mortality and significant chronic morbidity. The chest pain observation unit, as an adjunct to the emergency department (ED), offers health managers and administrators the clinical tool, first envisioned by Dr. Lown in the 1960s, to achieve improved quality and cost-effectiveness of acute chest pain management as health care moves into a new century.

Laparoscopic cholecystectomy: a technologic assessment.

Laparoscopic cholecystectomy, despite its short clinical history, has clearly established itself as the preferred surgical therapy for gallbladder removal in symptomatic patients. Significant questions remain, however, regarding the appropriate credentialing criteria for surgeons performing these procedures, the potential incidence of long-term complications, therapeutic guidelines for the assessment and intervention with patients with common duct stones and those select patient subgroups that can be optimally managed with medical, rather than surgical, therapy. The technology assessment team plays a critical role in helping to design mechanisms to answer these important outcomes inquiries.

Computer-based patient records--hype versus reality.

Although growing in capacity, few of today's computer-based patient records (CPR) systems satisfy all the key requirements defined by the Institute of Medicine. This current vacuum, however, should not frustrate us but rather stimulate our personal interest and creativity as to ways to best accomplish an optimal CPR solution in a very dynamic health care environment.

Support surfaces--a technology review.

Technology assessment performed on the wide range of clinical support systems available highlights the potential difficulties encountered when already utilized clinical therapies become subject to careful scientific scrutiny. The technology assessment committee must look beyond tacitly accepted indications for technology use and instead focus their evaluations on current, published clinical outcomes research. Where this latter clinical research is lacking, the technology assessment committee's goal is to balance the best available evidence of clinical safety and efficacy of a technology against the relative costs of that therapy.

Technology assessment: analytical product research.

In this series on health technology assessment, not only will technology design, scientifically validated therapeutic efficacy and relative cost efficiency be evaluated, but also the medical ethical challenges of technology introduction will be explored. Ideally, these considerations can form the foundation for a technology assessment team's discussions.

Devising and delivering objectives for disease state management.

Comprehensive, objective plans of clinical care that reflect the optimal diagnosis and treatment must be developed. Standardized plans of patient care that are centered around a specific disease entity meet outcomes management and maximize health delivery quality. This integration is embodied in the philosophy of disease state management.

Cost-effective wound care: new priorities driven by outcomes.

International demands for optimizing the quality and cost effectiveness of health care requires the rethinking of traditional wound care paradigms. This essay defines cost effectiveness as the comparative measure of costs to achieve a given clinical outcome. Among some of the issues that need to be addressed are having more studies that compare the cost effectiveness of wound care modalities, defining what an acceptable outcome for a prescribed treatment program is, deciding who should define the significant outcome, and measuring the values of each therapy.