Molecular evidence of interhuman transmission of Pneumocystis pneumonia among renal transplant recipients hospitalized with HIV-infected patients.

Ten Pneumocystis jirovecii pneumonia (PCP) cases were diagnosed in renal transplant recipients (RTRs) during a 3-year period. Nosocomial transmission from HIV-positive patients with PCP was suspected because these patients shared the same hospital building, were not isolated, and were receiving suboptimal anti-PCP prophylaxis or none. P. jirovecii organisms were typed with the multitarget polymerase chain reaction-single-strand conformation polymorphism method. Among the 45 patients with PCP hospitalized during the 3-year period, 8 RTRs and 6 HIV-infected patients may have encountered at least 1 patient with active PCP within the 3 months before the diagnosis of their own PCP episode. In six instances (five RTRs, one HIV-infected patient), the patients harbored the same P. jirovecii molecular type as that found in the encountered PCP patients. The data suggest that part of the PCP cases observed in this building, particularly those observed in RTRs, were related to nosocomial interhuman transmission.

Risk factors, aetiology and outcome of ischaemic stroke in young adults: the Swiss Young Stroke Study (SYSS).

Ischaemic stroke (IS) in young adults has been increasingly recognized as a serious health condition. Stroke aetiology is different in young adults than in the older population. This study aimed to investigate aetiology and risk factors, and to search for predictors of outcome and recurrence in young IS patients. We conducted a prospective multicentre study of consecutive IS patients aged 16-55 years. Baseline demographic data, risk factors, stroke aetiology including systematic genetic screening for Fabry disease and severity were assessed and related to functional neurological outcome (modified Rankin Scale, mRS), case fatality, employment status, place of residence, and recurrent cerebrovascular events at 3 months. In 624 IS patients (60 % men), median age was 46 (IQR 39-51) years and median NIHSS on admission 3 (IQR 1-8). Modifiable vascular risk factors were found in 73 %. Stroke aetiology was mostly cardioembolism (32 %) and of other defined origin (24 %), including cervicocerebral artery dissection (17 %). Fabry disease was diagnosed in 2 patients (0.3 %). Aetiology remained unknown in 20 %. Outcome at 3 months was favourable (mRS 0-1) in 61 % and fatal in 2.9 %. Stroke severity (p < 0.001) and diabetes mellitus (p = 0.023) predicted unfavourable outcome. Stroke recurrence rate at 3 months was 2.7 %. Previous stroke or TIA predicted recurrent cerebrovascular events (p = 0.012). In conclusion, most young adults with IS had modifiable vascular risk factors, emphasizing the importance of prevention strategies. Outcome was unfavourable in more than a third of patients and was associated with initial stroke severity and diabetes mellitus. Previous cerebrovascular events predicted recurrent ones.

Neurophysiologic diagnosis, clinical symptoms and neuropathologic findings in polyneuropathies

Tausta: Polyneuropatia (PNP) on ääreishermoston sairaus, joka aiheuttaa laaja-alaisia, yleensä symmetrisiä vaurioita ääreishermostossa. PNP:aan johtavia syitä on satoja. Tavoitteet: Löytää parhaat neurofysiologiset menetelmät uremian, myelooman hoidossa käytettävän talidomidin sekä Fabryn taudin aiheuttaman PNP:n diagnosoimiseksi. Fabryn taudissa tutkin lisäksi ohutsäieneuropatian aiheuttamia neuropatologisia löydöksiä iholta otetusta koepalasta. Tutkimuksissa kartoitettiin lisäksi PNP:n aiheuttamien subjektiivisten oireiden korrelaatio neurofysiologisten ja neuropatologisten löydösten kanssa. Munuaisten vajaatoimintaa sairastavilla potilailla tavoitteena oli tutkia dialyysihoidon tehon vaikutusta autonomisen hermoston toimintaan sekä yhden dialyysikerran vaikutusta neurofysiologisiin löydöksiin. Aineisto ja menetelmät: I: Tutkittiin 21 uremiapotilaan sensoristen ja motoristen hermojen vasteet, värinä- sekä lämpötuntokynnykset ennen ja jälkeen hemodialyysin. Subjektiiviset PNP oireet kartoitettiin PNP oireita kysyvillä kaavakkeella. II:12 talidomidi hoitoa saavaa myeloomapotilasta, tutkimuksen menetelmät olivat samat kuin tutkimuksessa I. III: 12 Fabryn tautia sairastavaa potilasta, edellä mainittujen neurofysiologisten tutkimusten lisäksi potilailta otettiin ihobiopsia säären alueelta. Ihobiopsiasta laskettiin ohuiden hermosyiden määrä koepalan värjäyksen jälkeen. Subjektiiviset PNP oireet kartoitettiin kyselykaavakkeella. Sydämen sykevaihtelu tutkittiin levossa taajuustason analyysillä. IV: 32 uremiapotilaan autonomisen hermoston toimintaa tutkittiin sydämen sykevaihtelun aikatason analysillä, paksujen myelinoituneiden säikeiden toimintaa tutkittiin perifeeristen sensoristen hermojen mittauksilla toistetusti noin 2.9 vuoden aikana. Tulokset: Ureemisen PNP:n diagnostiikassa herkimmät tutkimukset ovat F-aaltojen parametrit alaraajojen motorisista hermoista, värinätuntokynnys alaraajoista sekä suralishermon amplitudi. Positiiviset PNP oireet uremiassa korreloivat värinätunto-kynnyksen sekä sensoristen hermojen neurografialöydösten kanssa. Neurofysiologisten tutkimusten ajankohdalla dialyysiajankohtaan nähden ei ole merkitystä. Talidomidi-PNP on pääasiassa sensorinen, mutta motoriset syyt ovat lievästi vaurioituneet. Talidomidi PNP:ssa subjektiiviset oireet korreloivat huonosti neurofysiologisten löydösten kanssa. Fabryn taudissa naisilla on oletettua enemmän ohutsäieneuropatian aiheuttamia oireita ja löydöksiä. Paksujen säikeiden löydöksiä ei tullut esiin. Ohutsäieneuropatian diagnostiikassa ihobiopsia ja kvantitatiiviset tuntokynnysmittaustestit täydentävät toisiaan. Tehokas dialyysi parantaa autonomisen hermoston toimintaa uremiapotilailla. Päätelmät: Erityyppisten polyneuropatioiden diagnostiikassa pitää etukäteen valita PNP tyypille oikeat tutkimusmenetelmät raskaiden tutkimuspatterien vähentämiseksi sekä diagnostiikan parantamiseksi. PNP:n aiheuttamat oireet ja kliiniset löydökset pitää aina tutkia, mutta yksin ne eivät ole herkkiä PNP:n diagnostiikassa.

Obtenção de bactérias para a o biocontrole de Meloidogyne javanica por meio de aquecimento de solo e tratamento com filtrado de raízes de plantas antagonistas a fitonematóides

Cinco amostras de solo com alto teor de matéria orgânica (10,14 dag/kg) de 1 kg cada foram autoclavadas (120 °C/1h), cinco foram aquecidas em forno de microondas a 660 watts e 2450 Hz por 4 min e cinco não foram aquecidas. Raízes de Mucuna aterrima, Crotalaria juncea, Tagetes erecta e Lycopersicon esculentum foram maceradas separadamente em liquidificador à baixa velocidade durante 30 s em 1000 mL de água e peneiradas. As suspensões resultantes foram adicionadas às amostras de solos as quais foram acondicionadas em saco plástico e submetidas aos três tratamentos térmicos e posteriormente mantidas a 28 ºC por 24 h. Setenta e oito isolados bacterianos foram obtidos das amostras de solo por diluição em série e submetidos à seleção para o biocontrole de M. javanica. Sementes de tomate foram microbiolizadas por imersão em suspensão de propágulos de cada uma das culturas e semeadas em substrato dentro de tubetes em casa de vegetação. As mudas resultantes foram inoculadas com 400 ovos do nematóide, cada. O isolado UFV-6 de Escherichia coli reduziu o número de galhas em maior magnitude (80%) ao passo que o isolado UFV-8 de Citrobacter freundii foi o mais eficiente na redução do número de ovos (83%). A identificação dos isolados foi feita por análise de ácidos graxos esteres de metil e testes bioquímicos.

Ação nematicida de extratos de alho, mostarda, pimenta malagueta, de óleo de mostarda e de dois produtos à base de capsainóides e alil isotiocianato sobre juvenis de Meloidogyne javanica, (treub) Chitwood, 1949, em casa de vegetação

Neves, W.S; Freitas, L.G.; Coutinho, M.M.; Giaretta-Dallemole, R.; Fabry, C.F.S.; Dhingra, O.D. & Ferraz, S. Atividade nematicida de extratos botânicos de pimenta malagueta (Capsicum frutescens), mostarda (Brassica campestris) e alho (Allium sativum) sobre o nematóide das galhas, Meloidogyne javanica, em casa de vegetação. Summa Phytopathologica, v.35, n.4, p.255-261, 2009 O experimento teve como objetivo avaliar a atividade nematicida de extratos botânicos dos frutos de pimenta malagueta (Capsicum frutescens), plantas de mostarda (Brassica campestris), de bulbos de alho (Allium sativum) e óleo de mostarda sobre o nematóide das galhas, Meloidogyne javanica, em tomateiro em casa de vegetação e posteriormente comparar os extratos que apresentassem maior redução de número de galhas e de ovos com dois produtos à base de capsaicina, capsainóides e alil isotiocianato. Uma mistura peneirada de solo e areia na proporção 1:1 (v:v) foi colocada em vasos de plástico e infestada com 4000 ovos de M. javanica. Quatro dias após 20 mL de cada extrato, na concentração de 1000 ppm, foram espalhados sobre o solo. Apenas água foi derramada sobre o solo infestado no tratamento testemunha. Mudas de tomate com 20 dias de idade foram transplantadas quatro dias após a colocação dos extratos ao solo. Após quarenta e cinco dias avaliou-se o número de ovos e o número de galhas do sistema radicular de cada planta. Os extratos clorofórmico e cetônico de pimenta malagueta e o óleo de mostarda apresentaram melhor controle do nematóide, diferindo estatisticamente da testemunha quanto ao número de galhas. Porém, somente o óleo de mostarda reduziu significativamente o número de ovos quando comparado com a testemunha. Os extratos cetônico e clorofórmico de pimenta e o óleo de mostarda reduziram em 34,5%, 40,4% e 99,9% o número de galhas, respectivamente e o óleo de mostarda reduziu em 99,9% o número de ovos. No experimento seguinte foram avaliados o extrato clorofórmico de pimenta, o óleo de mostarda, o produto comercial Champon® e um produto em desenvolvimento na UFV, chamado DS, a base de capsaicina, capsainóides e alil isotiocianato em diferentes concentrações. Os produtos Champon® e DS e o óleo de mostarda reduziram o número de ovos e galhas quando comparados à testemunha em todas as concentrações testadas. O extrato de pimenta apresentou o melhor resultado na concentração de 400 ppm, reduzindo o número de ovos e galhas em relação à testemunha, porém esse foi bem maior quando comparado com os demais produtos testados.

Magnetic Resocance Imaging Methods in the Follow-up of Multiple Sclerosis and in Farby Disease

Multiple sclerosis (MS) is a chronic immune-mediated inflammatory disorder of the central nervous system. MS is the most common disabling central nervous system (CNS) disease of young adults in the Western world. In Finland, the prevalence of MS ranges between 1/1000 and 2/1000 in different areas. Fabry disease (FD) is a rare hereditary metabolic disease due to mutation in a single gene coding α-galactosidase A (alpha-gal A) enzyme. It leads to multi-organ pathology, including cerebrovascular disease. Currently there are 44 patients with diagnosed FD in Finland. Magnetic resonance imaging (MRI) is commonly used in the diagnostics and follow-up of these diseases. The disease activity can be demonstrated by occurrence of new or Gadolinium (Gd)-enhancing lesions in routine studies. Diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) are advanced MR sequences which can reveal pathologies in brain regions which appear normal on conventional MR images in several CNS diseases. The main focus in this study was to reveal whether whole brain apparent diffusion coefficient (ADC) analysis can be used to demonstrate MS disease activity. MS patients were investigated before and after delivery and before and after initiation of diseasemodifying treatment (DMT). In FD, DTI was used to reveal possible microstructural alterations at early timepoints when excessive signs of cerebrovascular disease are not yet visible in conventional MR sequences. Our clinical and MRI findings at 1.5T indicated that post-partum activation of the disease is an early and common phenomenon amongst mothers with MS. MRI seems to be a more sensitive method for assessing MS disease activity than the recording of relapses. However, whole brain ADC histogram analysis is of limited value in the follow-up of inflammatory conditions in a pregnancy-related setting because the pregnancy-related physiological effects on ADC overwhelm the alterations in ADC associated with MS pathology in brain tissue areas which appear normal on conventional MRI sequences. DTI reveals signs of microstructural damage in brain white matter of FD patients before excessive white matter lesion load can be observed on conventional MR scans. DTI could offer a valuable tool for monitoring the possible effects of enzyme replacement therapy in FD.

Le Spectateur français au XIXme siècle, ou Variétés morales, politiques et littéraires, recueillies des meilleurs écrits périodiques

1810 (A08,T08).

Le Spectateur français au XIXme siècle, ou Variétés morales, politiques et littéraires, recueillies des meilleurs écrits périodiques

1810 (A09,T09).

Le Spectateur français au XIXme siècle, ou Variétés morales, politiques et littéraires, recueillies des meilleurs écrits périodiques

1812 (A12,T12).

Le Spectateur français au XIXme siècle, ou Variétés morales, politiques et littéraires, recueillies des meilleurs écrits périodiques

1805 (T2).

Le Spectateur français au XIXme siècle, ou Variétés morales, politiques et littéraires, recueillies des meilleurs écrits périodiques

1809 (A6,T6).

Le Spectateur français au XIXme siècle, ou Variétés morales, politiques et littéraires, recueillies des meilleurs écrits périodiques

Variante(s) de titre : Le Spectateur français au 19e siècle

Le Spectateur français au XIXme siècle, ou Variétés morales, politiques et littéraires, recueillies des meilleurs écrits périodiques

1806 (T3).