First application of a transcutaneous optical single-port glucose monitoring device in patients with type 1 diabetes mellitus.

The combination of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion can be used to improve the treatment of patients with diabetes. The aim of this study was to advance an existing preclinical single-port system for clinical application by integrating the sensors of a phosphorescence based CGM system into a standard insulin infusion set. The extracorporeal optical phase fluorimeter was miniaturised and is now comparable with commercial CGM systems regarding size, weight and wear comfort. Sensor chemistry was adapted to improve the adhesion of the sensor elements on the insulin infusion set. In-vitro tests showed a linear correlation of R2=0.998 between sensor values and reference glucose values in the range of 0-300mg/dl. Electrical and cytotoxicity tests showed no negative impact on human health. Two single-port devices were tested in each of 12 patients with type 1 diabetes mellitus in a clinical set-up for 12h. Without additional data processing, the overall median absolute relative difference (median ARD) was 22.5%. For some of the used devices the median ARD was even well below 10%. The present results show that individual glucose sensors performance of the single-port system is comparable with commercial CGM systems but further improvements are needed. The new system offers a high extent of safety and usability by combining insulin infusion and continuous glucose measurement in a single-port system which could become a central element in an artificial pancreas for an improved treatment of patients with type 1 diabetes mellitus.

Seroprevalence of Leishmania infection among asymptomatic renal transplant recipients from southern Spain.

BACKGROUND: The aim of this article is to assess the seroprevalence of Leishmania infection among asymptomatic renal transplant recipients in a population in the south of Spain. METHODS: Serum samples were screened for immunoglobulin-G antibodies against Leishmania with an indirect fluorescent antibody test. RESULTS: Of 625 examined serum samples, 30 (4.8%) samples were positive for Leishmania antibodies. Thirteen samples showed titers of 1:80, 15 samples showed titers of 1:160, and 2 samples showed titers of 1:320. None of the patients with positive serology to Leishmania showed signs or symptoms compatible with leishmaniasis. CONCLUSION: The prevalence of Leishmania infection found among asymptomatic renal transplant patients reinforces the need for attention in evaluation of these patients in endemic areas.

Open-lung biopsy in patients with undiagnosed lung lesions referred at a tertiary cancer center is safe and reveals noncancerous, noninfectious entities as the most common diagnoses.

We evaluated the diagnostic yield of open-lung biopsies (OLBs) in a large tertiary cancer center to determine the role of infectious diseases as causes of undiagnosed pulmonary lesions. All consecutive adult patients with either single or multiple pulmonary nodules or masses who underwent a diagnostic OLB over a period of 10 years (1998-2007) were retrospectively identified. Their risk factors for malignancy and clinical and radiological characteristics were reviewed, and their postoperative complications were assessed. We evaluated 155 patients with a median age of 57 years (range, 19-83 years). We identified infectious etiologies in 29 patients (19 %). The most common diagnosis in this group was histoplasmosis (12 [41 %]), followed by nontuberculous mycobacterial infection (7 [24 %]) and aspergillosis (4 [14 %]). The majority of the 126 remaining patients had nonmalignant diagnoses, the most prevalent being nonspecific granuloma (26 %), whereas only 17 % had malignant diagnoses. We observed no significant differences among the patients with infectious, malignant, or both noninfectious and nonmalignant final diagnoses regarding their demographic, laboratory, and clinical characteristics. Six percent of the patients had at least one post-OLB complication, and the post-OLB mortality rate was 1 %. OLB is a safe diagnostic procedure which frequently identifies a wide variety of infectious and inflammatory diseases.

Genetic diversity of Streptococcus agalactiae strains colonizing the same pregnant woman.

Pulsed-field gel electrophoresis (PFGE) of SmaI-DNA digests and serotyping was performed on 15 colonies of Streptococcus agalactiae (GBS) from each of 30 vaginal rectal colonized women. Five distinct GBS serotypes were observed among the 30 specimens (Ia, Ib, II, III and V). In 29 of the 30 samples, the same serotype was observed among all 15 colonies; in the remaining specimen, the 15 colonies yielded two serotypes (II and V). The PFGE profiles of all colonies in 27 of the 30 subjects were indistinguishable within each subject. In the remaining women, different DNA profiles were identified among the colonies in each specimen, one of whom carried two different serotypes. Furthermore, strains of the same serotype belonging to different women were genetically heterogeneous.

Cardiolipin synthase expression is essential for growth at elevated temperature and is regulated by factors affecting mitochondrial development.

Cardiolipin (CL) is a unique dimeric phospholipid localized primarily in the mitochondrial membrane. In eukaryotes, the enzyme CL synthase catalyses the synthesis of CL from two lipid substrates, CDP-diacylglycerol and phosphatidylglycerol. In earlier studies, we reported the purification of CL synthase from Saccharomyces cerevisiae and the cloning of the gene CRD1 (previously called CLS1) that encodes the enzyme. Because CL is an important component of the mitochondrial membrane, knowledge of its regulation will provide insight into the biogenesis of this organelle. To understand how CL synthesis is regulated, we analysed CRD1 expression by Northern blot analysis of RNA extracted from cells under a variety of growth conditions. CRD1 expression is regulated by mitochondrial development factors. CRD1 levels were 7- to 10-fold greater in stationary than in logarithmic growth phase, and threefold greater in wild-type than in rho 0 mutants. Expression was somewhat elevated during growth in glycerol/ethanol versus glucose media. In contrast, CRD1 expression was not regulated by the phospholipid precursors inositol and choline, and was not altered in the regulatory mutants ino2, ino4 and opi1. Mutations in cytochrome oxidase assembly, which led to reduced Crd1p enzyme activity, did not affect CRD1 expression. The crd1 null mutant makes a truncated CRD1 message. Although the null mutant can grow on both fermentable and non-fermentable carbon sources at lower temperatures, it cannot form colonies at 37 degrees C. In conclusion, CRD1 expression is controlled by factors affecting mitochondrial development, but not by the phospholipid precursors inositol and choline. Expression of CRD1 is essential for growth at elevated temperatures, suggesting that either CL or Crd1p is required for an essential cellular function.