Neisseria gonorrhoeae culture growth rates from asymptomatic individuals with a positive nucleic acid amplification test.

Gonorrhoea infections are frequently diagnosed at extragenital locations in asymptomatic individuals and are historically related to poor recovery in culture, which hinders antimicrobial susceptibility testing. The aim of this study was to evaluate recovery rates of Neisseria gonorrhoeae by culture among asymptomatic individuals who tested positive by nucleic acid amplification tests between 2018 and 2019 in Barcelona (Spain). In total, 10 396 individuals were tested for N. gonorrhoeae on first-void urine, rectal, pharyngeal and/or vaginal swabs depending on sexual behaviour. Overall infection prevalence was 5·5% (95% confidence interval [CI] 5·0-5·9). Seven hundred and ten samples were positive corresponding to 567 individuals. The most common site of infection was the pharynx (71·3%), followed by rectum (23·1%) and genitals (4·7%) (P < 0·0001). The N. gonorrhoeae recovery rate in culture, time from positive screening to culture specimen and inoculation delay were calculated. Recovery rate was 21·7% in pharynx, 66·9% in rectum and 37·0% in genitals (25·0% vagina, 71·4% urethra) (P < 0·0001). Median culture collection time was 1 [0; 3] days, and median inoculation delay was 5·01 [4·99-7·99] h, with no impact on N. gonorrhoeae recovery, P = 0·8367 and P = 0·7670, respectively. Despite efforts towards optimizing pre-analytical conditions, the N. gonorrhoeae recovery rate in asymptomatic individuals is unacceptably low (especially for pharynx), representing a problem for monitoring antimicrobial-resistant infections.

Low frequency of cytomegalovirus (CMV) disease despite high prevalence of CMV viraemia in patients with advanced HIV infection: a clinical and immunological 48-week follow-up study.

OBJECTIVES: The aim of the study was to investigate the dynamics of cytomegalovirus (CMV) replication and CMV-specific immune response recovery after antiretroviral treatment (ART) initiation in patients with advanced HIV infection. METHODS: A prospective observational study of patients with HIV infection and CD4 counts of < 100 cells/µL was carried out (September 2015 to July 2018). HIV viral load (VL), CD4 count and CMV VL were determined by quantitative polymerase chain reaction (PCR) at baseline and at 4, 12, 24 and 48 weeks, and CMV-specific immune response was determined by QuantiFERON-CMV assay at baseline and 48 weeks. All patients were started on ART but only those with CMV end-organ disease (EOD) received anti-CMV treatment. RESULTS: Fifty-three patients with a median age of 43.6 [interquartile range (IQR) 36.7-52.4] years were included in the study. At baseline, the median CD4 count was 30 cells/µL (IQR 20-60 cells/µL) and the median HIV VL was 462 000 HIV-1 RNA copies/mL (IQR 186 000-1 300 000 copies/mL). At baseline, 32% patients had detectable CMV viraemia but none had detectable CMV viraemia at 48 weeks. Only one of 53 (1.9%) patients developed EOD during follow-up. Seven (13.2%) patients were lost to follow-up and six (11.3%) died; none of the deaths was related to CMV. Similar percentages of patients had a CMV-specific immune response at baseline (71.7%) and at 48 weeks (70.0%). The magnitude of this response tended to increase over time [median 1.63 (IQR 0.15-5.77) IU/mL at baseline vs. median 2.5 (IQR 0.1-8.325) IU/mL at 48 weeks; P = 0.11]. We did not find any risk factors associated with 48-week mortality. CONCLUSIONS: Although the prevalence of CMV viraemia in patients with advanced HIV infection remains high, achieving a good immunological recovery through ART is enough to suppress CMV viraemia, without an increased risk of CMV EOD. The prevalence of a CMV-specific immune response was high and endured over time.

Frontal fibrosing alopecia: a pathology on the rise / Alopecia frontal fibrosante: una enfermedad en auge.

Frontal fibrosing alopecia (FFA) is a scarring alopecia whose incidence is increasing significantly in our country. It is characterized by loss of frontotemporal hairline that mostly affects postmenopausal women, with a negative impact on quality of life. It is associated with early menopause in 14% of cases and hypothyroidism in 15%. With regard to treatment, 5α-reductase inhibitors are the drugs that have shown improvement of the disease in a larger number of cases. We report a new case of FFA in a woman of 77 years successfully treated with finasteride at doses of 2.5mg daily.

Tail artery blood flow measured by chronically implanted Doppler ultrasonic probes in unrestrained conscious rats.

We describe a surgical procedure for chronically implanting a Doppler ultrasonic probe around the tail artery of the rat to measure phasic flow velocity in the tail artery of the unrestrained conscious rat. The phasic tail flow signal is highly correlated with the simultaneously recorded superior mesenteric flow signal (range 0.70-0.89 in seven rats) during vasoconstriction induced by exposure to formaldehyde vapour. In response to two quick alerting taps on the cage, tail flow velocity fell from 20+/-2 to 7+/-1 cm/s (P<0.01) and mesenteric flow fell from 30+/-5 to 25+/-4 cm/s (P<0.05), with the fall in tail flow being significantly greater than the fall in mesenteric flow (P<0.05, n=7 rats). In anesthetized rats, the phasic tail flow signal was highly correlated with phasic arterial pressure (range 0.71-0.83 in seven rats). The ability to reliably measure phasic arterial tail flow in the conscious unrestrained rat should facilitate experimental studies of brain pathways regulating flow to this principally cutaneous vascular bed in different physiological situations.

Entamoeba histolytica contains a beta 1 integrin-like molecule similar to fibronectin receptors from eukaryotic cells.

Entamoeba histolytica trophozoites do interact with extracellular matrix components in order to invade and finally destroy tissue. An important step in this interaction involves the binding of a 140-kDa membrane protein that binds to fibronectin. The similarity of this amoebic receptor to fibronectin receptors from higher eukaryotic cells was defined by indirect immunofluorescence, western blot and immunohistochemistry, using polyclonal monospecific antibodies raised against the amoebic protein. These results suggest that lower eukaryotic cells have and use a beta 1 integrin-like molecule as well as mechanisms similar to those present in higher eukaryotic cells during interaction with extracellular matrix components.

Biomechanical study of canine spinal fracture fixation using pins or bone screws with polymethylmethacrylate.

Five configurations of pins or screws interconnected with polymethylmethacrylate (PMMA) were applied to isolated canine lumbar spines (L2 to L5) in which a complete fracture-luxation had been produced at L3 to L4. Twenty-five repaired spines and five intact control spines were subjected to four-point bending and tested once to failure in ventral flexion. The purpose of this study was to determine the effects of pin number, pin angle, and use of 3.5-mm cortical bone screws instead of smooth 3.2-mm diameter pins on rigidity and ultimate strength of spinal fractures repaired by the implant-PMMA fixation technique. Bending moment versus the angular deformation curves were recorded. Rigidity, bending moment at 10 degrees angular deformation, moment at failure, and deformation at failure of each type of fixation were compared using analysis of variance. Spinal segments stabilized with eight pin-PMMA fixation had significantly greater rigidity and strength at failure than four pin-PMMA fixations (P < .05). Furthermore, spinal segments stabilized with eight pins angled away from the fracture failed at significantly greater bending moment than those with eight pins angled toward the fracture (P < .05). However, for four-pin fixation, greater strength was achieved by angling pins in the bone toward the fracture site (P < .05). Screw-PMMA fixations failed by screw bending and were less rigid and weaker at failure than the corresponding configuration of pin-PMMA fixation (P < .05).

Possible role of calmodulin in the secretion of Entamoeba histolytica electron-dense granules containing collagenase.

Entamoeba histolytica cells secrete electron-dense granules (EDGs) that have collagenase activity. To study the possible involvement of calmodulin (CaM) on EDG secretion, the effect of several CaM antagonists (TFP, R24571, W-7, W-5, dibucaine and DL-propranolol) was tested on this cellular function. Except for W-5 and dibucaine, the rest of these compounds inhibited EDG secretion. Transmission electron microscopy of collagen-activated trophozoites showed numerous EDGs located in or near the surface membrane. In contrast, trophozoites incubated with TFP showed no EDGs. Protein kinase C inhibitors (H-7, ML-9) had no effect on EDG secretion, suggesting that CaM antagonists acted by selectively inhibiting CaM. These results suggest that a CaM-dependent process is involved in EDG secretion.