Phlebotomine sandflies (Diptera: Psychodidae) from Lábrea, state of Amazonas, Brazil, with a description of Evandromyia (Aldamyia) apurinan Shimabukuro, Figueira & Silva, sp. nov.

An entomological survey was conducted from July-December 2009 and September-December 2010, as part of the epidemiological monitoring of American cutaneous leishmaniasis (ACL) in the municipality of Lábrea, state of Amazonas (AM), Brazil. Sandflies were collected using CDC light traps installed in intra and peridomiciliary locations, as well as the border of forested areas around houses where autochthonous cases of ACL were recorded. A total of 510 sandflies belonging to 26 species were collected. The most abundant species was Nyssomyia antunesi (44.5%) followed by Evandromyia walkeri (10.6%) and Micropygomyia rorotaensis (9.8%). Here we also describe Evandromyia (Aldamyia) apurinan sp. nov. and report new records for Trichophoromyia flochi and Evandromyia sipani in AM and Brazil, respectively. Our results describe the composition of the sandfly fauna in the south of AM and suggest Ny. antunesi as the putative vector in the transmission of Leishmania in this area of the Amazon Region.

Application of colon capsule endoscopy (CCE) to evaluate the whole gastrointestinal tract: a comparative study of single-camera and dual-camera analysis.

BACKGROUND AND STUDY AIMS Colon capsule endoscopy (CCE) was developed for the evaluation of colorectal pathology. In this study, our aim was to assess if a dual-camera analysis using CCE allows better evaluation of the whole gastrointestinal (GI) tract compared to a single-camera analysis. PATIENTS AND METHODS We included 21 patients (12 males, mean age 56.20 years) submitted for a CCE examination. After standard colon preparation, the colon capsule endoscope (PillCam Colon™) was swallowed after reinitiation from its "sleep" mode. Four physicians performed the analysis: two reviewed both video streams at the same time (dual-camera analysis); one analyzed images from one side of the device ("camera 1"); and the other reviewed the opposite side ("camera 2"). We compared numbers of findings from different parts of the entire GI tract and level of agreement among reviewers. RESULTS A complete evaluation of the GI tract was possible in all patients. Dual-camera analysis provided 16% and 5% more findings compared to camera 1 and camera 2 analysis, respectively. Overall agreement was 62.7% (kappa = 0.44, 95% CI: 0.373-0.510). Esophageal (kappa = 0.611) and colorectal (kappa = 0.595) findings had a good level of agreement, while small bowel (kappa = 0.405) showed moderate agreement. CONCLUSION The use of dual-camera analysis with CCE for the evaluation of the GI tract is feasible and detects more abnormalities when compared with single-camera analysis.

Syphilis in HIV-infected patients: Predictors for serological failure and serofast state.

Purpose: HIV-infected patients treated for syphilis may be at increased risk for serological failure and serofast state. Our aim was to analyse serological response to treatment in HIV-infected patients diagnosed with syphilis, and factors associated with serological cure and serofast state. Methods: Open-label, no controlled study of a series of HIV- patients diagnosed with syphilis during 2004-2011. Patients were categorized by rapid plasma reagin titer (RPR) into success (4-fold decrease in RPR by 12 or 24 months after treatment of early or late syphilis), serofast (success with persistently stable reactive RPR), and failure/ re-infection ( failure to decrease 4-fold in RPR by 12 or 24 months after treatment or sustained 4-fold increase in RPR after treatment response). Results: 141 HIV- patients were diagnosed with syphilis during the study period (104 early syphilis, 36 late or indeterminate latent syphilis). The mean age was 36.3 years, 98.5% were male, and 87.2% homosexual men. In 46 (32.6%) cases, HIV and syphilis infection diagnosis were coincident (mean CD4 457/mm3 and HIV-VL 4.72 log10). Among patients with prior known HIV infection, 65 were on antiretroviral therapy (ART) at syphilis diagnosis (mean CD4 469/ mm3, 76.9% undetectable HIV-VL). 116 patients satisfied criteria for serological response analysis (89 early, 24 late/indeterminate). At 12 months of early syphilis treatment (89.2% penicillin) there were 16 (18%) failures, and at 24 months of late/indeterminate syphilis (91.7% penicillin) there were 5 (18.5%) failures. Overall, 36 (31.0%) patients presented serofast state. Treatment failure was related with lower CD4 count (295 vs 510/μL; p=0.045) only in patients with coincident diagnosis. Serofast state was related with older age (41 vs 36 years; p=0.024), and lower CD4 count (391 vs 513/mm3; p=0.026). Conclusions: In this series of HIV-infected patients, with many patients on ART and with good immunological and virological parameters, serological failure and serofast state were frequent. Immunological status, and age could influence on serological response to syphilis treatment in HIV-infected patients.

A genome-wide association search for type 2 diabetes genes in African Americans.

African Americans are disproportionately affected by type 2 diabetes (T2DM) yet few studies have examined T2DM using genome-wide association approaches in this ethnicity. The aim of this study was to identify genes associated with T2DM in the African American population. We performed a Genome Wide Association Study (GWAS) using the Affymetrix 6.0 array in 965 African-American cases with T2DM and end-stage renal disease (T2DM-ESRD) and 1029 population-based controls. The most significant SNPs (n = 550 independent loci) were genotyped in a replication cohort and 122 SNPs (n = 98 independent loci) were further tested through genotyping three additional validation cohorts followed by meta-analysis in all five cohorts totaling 3,132 cases and 3,317 controls. Twelve SNPs had evidence of association in the GWAS (P<0.0071), were directionally consistent in the Replication cohort and were associated with T2DM in subjects without nephropathy (P<0.05). Meta-analysis in all cases and controls revealed a single SNP reaching genome-wide significance (P<2.5×10(-8)). SNP rs7560163 (P = 7.0×10(-9), OR (95% CI) = 0.75 (0.67-0.84)) is located intergenically between RND3 and RBM43. Four additional loci (rs7542900, rs4659485, rs2722769 and rs7107217) were associated with T2DM (P<0.05) and reached more nominal levels of significance (P<2.5×10(-5)) in the overall analysis and may represent novel loci that contribute to T2DM. We have identified novel T2DM-susceptibility variants in the African-American population. Notably, T2DM risk was associated with the major allele and implies an interesting genetic architecture in this population. These results suggest that multiple loci underlie T2DM susceptibility in the African-American population and that these loci are distinct from those identified in other ethnic populations.

Application of colon capsule endoscopy (CCE) to evaluate the whole gastrointestinal tract: a comparative study of single-camera and dual-camera analysis.

BACKGROUND AND STUDY AIMS Colon capsule endoscopy (CCE) was developed for the evaluation of colorectal pathology. In this study, our aim was to assess if a dual-camera analysis using CCE allows better evaluation of the whole gastrointestinal (GI) tract compared to a single-camera analysis. PATIENTS AND METHODS We included 21 patients (12 males, mean age 56.20 years) submitted for a CCE examination. After standard colon preparation, the colon capsule endoscope (PillCam Colon™) was swallowed after reinitiation from its "sleep" mode. Four physicians performed the analysis: two reviewed both video streams at the same time (dual-camera analysis); one analyzed images from one side of the device ("camera 1"); and the other reviewed the opposite side ("camera 2"). We compared numbers of findings from different parts of the entire GI tract and level of agreement among reviewers. RESULTS A complete evaluation of the GI tract was possible in all patients. Dual-camera analysis provided 16% and 5% more findings compared to camera 1 and camera 2 analysis, respectively. Overall agreement was 62.7% (kappa = 0.44, 95% CI: 0.373-0.510). Esophageal (kappa = 0.611) and colorectal (kappa = 0.595) findings had a good level of agreement, while small bowel (kappa = 0.405) showed moderate agreement. CONCLUSION The use of dual-camera analysis with CCE for the evaluation of the GI tract is feasible and detects more abnormalities when compared with single-camera analysis.

Gregorius IX, papa, Decretales, libri I-II.

Cet exemplaire de la Lectura d’Henri de Suso sur les Décrétales, dont il ne reste que le premier volume, présente la particularité de contenir aussi le texte des Décrétales, chacune d’elles étant suivie par le commentaire correspondant. Certaines anomalies de la copie permettent de préciser que les copistes avaient comme modèle deux manuscrits différents, un pour la Lectura et l’autre pour les Décrétales dans une édition augmentée des Novelles d'Innocent IV, qui devaient être insérées à la suite des titres correspondants, selon la prescription pontificale de 1245. Le texte même des Novelles qui n’était pas commenté dans la Lectura n’a pas été repris dans la copie, sauf l’Extravagante Quia frequenter, au f. 37v, et Sext. I, 13, 1, au f. 133. F. 1-360v. F. 1-177v. "Apparatus [HENRICI de SEGUSIO cardinalis] Ostiensis super textum Decretalium". [Prooemium:] "[A]d Dei omnipotentis gloriam et universalis ecclesie decus et decorem necnon rei publice et maxime scolasticorum utilitatem... - ...emendate"; — [In epistola dedicatoria Gregorii IX:] "Vicarius regis pacifici ad communem utilitatem et maxime studencium quinque compilationes... - ...et punit" (éd.Venise, I, 3-3v). — "Incipit liber primus Decretalium". [GREGORIUS IX papa, Epistola dedicatoria, salutatio] ; suivi de [HENRICUS DE SEGUSIO, Lectura :] "Gregorius episcopus. Omnes sunt episcopi licet vocentur archiepiscopi, primates vel patriarche... de manu apud eum"; — [GREGORIUS IX papa, Epistola dedicatoria] terminée par l'inscription rubriquée de la première Décrétale; suivi de: [HENRICUS DE SEGUSIO, Lectura in epistola dedicatoria :] "Rex. Regum et omnium potestatum. VIII di. que contra mores... - ...super verbo hac tantum"; et de [ID., Lectura in prima rubrica : ]"Quoniam omne quod non est in fine... - ...de fide catholica" (éd.Venise, I, 3v-5) (1-2v). — Extra 1, 1, 1 ; suivi de [ID., Lectura : ] "Firmiter credimus. Bene dicit nam dubius in fine... - ...Extra 1, 37, 1 ; suivi de [ID., Lectura : ] "Clerici... Et si beneficio etc. careant... de foro compe.", incomplet de la fin par lacune matérielle (éd.Venise, I, 5-182, § 10) (2v-177v). A noter: var. de plusieurs lignes à l'explicit des commentaires sur Extra 1, 1, 2 et 1, 3, 11. A noter les anomalies suivantes :L’inscription de chaque Décrétale, à quelques exceptions près, a été inscrite à la fin du texte de la Décrétale précédente. Le libellé: "Innocentius IIIIus" ou bien "Innocentius IIIIus in concil. Lugdun", qui a été inscrit à la fin des titres I, 3 (25v), 6, (85), 10 (103), 28 (132v), 29 (153), 30 (155v), 31 (164) correspond, en fait, à l'inscription des Novelles d'Innocent IV éditées dans le Sexte, livre I, en tête des titres 3, 6, 8, 13, 14, 15, 16.Au f. 37v, à la suite d'Extra 1, 6, 6, le texte de la constitution d'Innocent IV Quia frequenter a été copié, puis exponctué en marge par un correcteur avec la mention "vacat": "Quia frequenter in electione summorum pontificum colupna Dei... - ...minime computato" avec l'inscription: "Idem" écrite à la fin de la Décrétale précédente qui renvoie à Alexandre III. Sur ce texte qui n’a pas été repris dans le Sexte ; cf. H. Singer, Zeitschrift der Savigny-Stiftung für Rechtesgeschichte, Kan. Abt., VI (1916), 1-140 (éd. Friedberg, 946, Sext. 1, 6, 3, note c). Autres manuscrits recensés : Londres, B.L. ms. Add. 18368, f. 8v ; Paris, BNF ms. latin 14324, f. 234 ; Paris, Bibl. Sainte-Geneviève ms. 339, f. 90 ; Prague, I-B4, f. ? (renseignement aimablement communiqué par Michèle Bégou-Davia).Au f. 133, le titre I, 28 est suivi du texte de Sext. I, 13, 1.Au f.114v, le texte d’Extra 1, 15, 1 §1-6 a été copié une première fois dans le module de la glose à la fin d'un cahier, puis exponctué en marge avec la mention "vacat" et recopié dans le gros module habituel sur un feuillet additionnel (115).Aux ff. 133v-134, les Décrétales 1, 29, 3 et 4, suivies de leurs commentaires, ont été interverties ; de même que les Décrétales 1, 29, 42 et 43, aux ff. 152v-153v. F. 178-360v. "Incipit liber secundus". Extra 2, 1, 1 ; suivi de [HENRICUS DE SEGUSIO, Lectura:] "[D]e Quovultdeo etc. Supple ita statutum est d. n. sed propter hoc plene non subvenitur constronccioni [sic].." - ... Extra 2, 30, 6 "... archid. c. fi. § fi". "Explicit liber secundus. Benedictus sit Deus." (éd.Venise, II, 2-209v). Comme dans le livre I, le libellé inscrit à la fin des titres II, 1 (187), 2 (196v), 5 (202), 13 (240), 14 (247), 15 (249), 18 (252v), 25 (312v), 27 (329v), 28 (357v) correspond à l'inscription des Novelles d'Innocent IV éditées dans le Sexte, livre II, en tête des titres 1-3, 5-7, 9, 12, 14, 15.Au f. 196v, le copiste a copié à la suite les commentaire sur Extra 2, 2, 19 et 20, omettant le texte de Extra 2, 20 qu'il a dû ajouter ensuite dans la marge. Au f. 205, le copiste a mal apprécié l’espace réservé pour Extra 6, 2, le texte commencé normalement en gros module d'écriture, se poursuit en petit module et se termine dans la marge inférieure. De même, au f. 227, les dernières lignes d’ Extra 12, 7 ont dû être écrites dans la marge, avec un signe de renvoi. F. 360v-362. Commentaire anonyme sur Extra 2, 28, 59 De appellationibus: "Ut debitus honor etc. More solito dominus Innocencius premittit causam constitutionis exprimens duas causas motivas: qualiter hec constitutio promulgatur antipophornando... - ... se scit et c. arguta". A noter, f. 1-72v, en marge. PETRUS DE SAMPSONA, Distinctiones super Decretalibus 1, 1, 1-1, 6, 44, excerpta; cf. M. Bertram, "Pierre de Sampson et Bernard de Montmirat...", dans L'Eglise et le droit dans le Midi (XIIIe-XIVe s.) (Cahiers de Fanjeaux, 29), Toulouse, 1994, 37-74 et part. 66, parmi les mss recensés. En marge de l'inscription de l'épitre de Grégoire IX: "Greg. ep. etc. Dominus papa Christi universitatis vicarius set episcopus dicitur singularis quare dominus papa dicatur servus... - ...a papa"; en marge de l'épitre dédicatoire: "Rex pacificus quarum alique propter nimiam similitudinem quedam propter contrarietatem sed numquid in hac compilacione... - ...per totum", incipit A de M. Bertram, art. cit., 64 (1) ; — en marge de la Lectura sur l'épitre dédicatoire: Rex pacificus dicitur esse pacificus et Christus pacem diligit temporalem... - ...approbatur" (1v). — Dernière glose en marge d'Extra 1, 6, 44: "Itaque interim etc. Hii etiam qui pape... - ... et similibus" (72v). A noter, au f. 55v, à la fin de la glose, la signature "P. Sampsone" et au f. 67, "P. Samp.". F. 1-69v, passim et 124v-125. Gloses marginales ajoutées par une main cursive anglaise, contemporaine de la copie. « Doctoribus. Qui faciunt universitatem... - ...dilectus. [signé] Abb(at)is" (Bernardus de Montmirat, Lectura in Decretales, ed. Venise, 1588, I, 2) (1). —En marge de la Lecture sur Extra 1, 6, 42: "B. in apostillis suis dicit quod si aliquis potestatem... - ...commento Hostiensis" (69v).

Estimating national-level syringe availability to injecting drug users and injection coverage: Switzerland, 1996-2006.

BACKGROUND: Measuring syringe availability and coverage is essential in the assessment of HIV/AIDS risk reduction policies. Estimates of syringe availability and coverage were produced for the years 1996 and 2006, based on all relevant available national-level aggregated data from published sources. METHODS: We defined availability as the total monthly number of syringes provided by harm reduction system divided by the estimated number of injecting drug users (IDU), and defined coverage as the proportion of injections performed with a new syringe, at national level (total supply over total demand). Estimates of supply of syringes were derived from the national monitoring system, including needle and syringe programmes (NSP), pharmacies, and medically prescribed heroin programmes. Estimates of syringe demand were based on the number of injections performed by IDU derived from surveys of low threshold facilities for drug users (LTF) with NSP combined with the number of IDU. This number was estimated by two methods combining estimates of heroin users (multiple estimation method) and (a) the number of IDU in methadone treatment (MT) (non-injectors) or (b) the proportion of injectors amongst LTF attendees. Central estimates and ranges were obtained for availability and coverage. RESULTS: The estimated number of IDU decreased markedly according to both methods. The MT-based method (from 14,818 to 4809) showed a much greater decrease and smaller size of the IDU population compared to the LTF-based method (from 24,510 to 12,320). Availability and coverage estimates are higher with the MT-based method. For 1996, central estimates of syringe availability were 30.5 and 18.4 per IDU per month; for 2006, they were 76.5 and 29.9. There were 4 central estimates of coverage. For 1996 they ranged from 24.3% to 43.3%, and for 2006, from 50.5% to 134.3%. CONCLUSION: Although 2006 estimates overlap 1996 estimates, the results suggest a shift to improved syringe availability and coverage over time.

The SYNTAX score predicts early mortality risk in the elderly with acute coronary syndrome having primary PCI.

BACKGROUND: The SYNTAX score (SXscore), an angiographic score reflecting coronary lesion complexity, predicts clinical outcomes in patients with left main or multivessel disease, and in patients with ST-segment elevation myocardial infarction undergoing primary PCI. The clinical SXscore (CSS) integrates the SXscore and clinical variables (age, ejection fraction, serum creatinine) into a single score. We analyzed these scores in elderly patients with acute coronary syndrome (ACS) undergoing primary PCI. The purpose of this analysis was not to decide which patients should undergo PCI, but to predict clinical outcomes in this population. METHODS: The SXscore was determined in a consecutive series of 114 elderly patients (mean age, 79.6 ± 4.1 years) undergoing primary PCI for ACS. Outcomes were stratified according to SXscore tertiles: SXLOW ≤15 (n = 39), 15< SXMID <23 (n = 40), and SXHIGH ≥23 (n = 35). The primary endpoint was all-cause mortality at 30 days. Secondary endpoints were nonfatal major adverse cardiac and cerebrovascular events (MACCE) at 30 days, and 1-year outcomes in patients discharged alive. RESULTS: Mortality at 30 days was higher in the SXHIGH group compared with the aggregate SXLOW+MID group (37.1% vs 5.1%; P<.0001), and in the CSSHIGH group compared with the aggregate CSSLOW+MID group (25.5% vs 1.4%; P=.0001). MACCE rates at 30 days were similar among SXscore tertiles. The CSS predicted 1-year MACCE rates (12.1% for CSSHIGH vs 3.1% for CSSLOW+MID; P=.03). CONCLUSIONS: The SXscore predicts 30-day mortality in elderly patients with ACS undergoing primary PCI. In patients discharged alive, the CSS predicts risk of MACCE at 1 year.

Missing Persons Bulletin, Iowa Department of Public Safety, October 2001

Monthly newsletter for public safety

Protein kinase A-dependent phosphorylation of GLUT2 in pancreatic beta cells.

In pancreatic beta cells, cyclic AMP-dependent protein kinase regulates many cellular processes including the potentiation of insulin secretion. The substrates for this kinase, however, have not been biochemically characterized. Here we demonstrate that the glucose transporter GLUT2 is rapidly phosphorylated by protein kinase A following activation of adenylyl cyclase by forskolin or the incretin hormone glucagon-like peptide-1. We show that serines 489 and 501/503 and threonine 510 in the carboxyl-terminal tail of the transporter are the in vitro and in vivo sites of phosphorylation. Stimulation of GLUT2 phosphorylation in beta cells reduces the initial rate of 3-O-methyl glucose uptake by approximately 48% but does not change the Michaelis constant. Similar differences in transport kinetics are observed when comparing the transport activity of GLUT2 mutants stably expressed in insulinoma cell lines and containing glutamates or alanines at the phosphorylation sites. These data indicate that phosphorylation of GLUT2 carboxyl-terminal tail modifies the rate of transport. This lends further support for an important role of the transporter cytoplasmic tail in the modulation of catalytic activity. Finally, because activation of protein kinase A stimulates glucose-induced insulin secretion, we discuss the possible involvement of GLUT2 phosphorylation in the amplification of the glucose signaling process.

Kalemia during combined therapy with an angiotensin converting enzyme inhibitor and a potassium-sparing diuretic.

Both angiotensin converting enzyme (ACE) inhibitors and potassium-sparing diuretics tend to increase serum potassium levels. This retrospective study was undertaken to assess whether these two types of agents can nevertheless be combined safely. Twelve hypertensive patients were treated for 1-70 months (mean = 17) with an ACE inhibitor together with a potassium-sparing diuretic (spironolactone, n = 10; amiloride, n = 2). In addition, eight patients also took a thiazide or a loop diuretic. Nine patients had a normal and three a slightly impaired renal function. No clinically relevant hyperkalemia was observed during the course of the study. These data suggest that it is not impossible to combine an ACE inhibitor with a potassium-sparing diuretic, as long as renal function is normal and serum potassium concentration is monitored closely.

Functional analysis: evaluation of response intensities--tailoring ANOVA for lists of expression subsets.

Background: Microarray data is frequently used to characterize the expression profile of a whole genome and to compare the characteristics of that genome under several conditions. Geneset analysis methods have been described previously to analyze the expression values of several genes related by known biological criteria (metabolic pathway, pathology signature, co-regulation by a common factor, etc.) at the same time and the cost of these methods allows for the use of more values to help discover the underlying biological mechanisms. Results: As several methods assume different null hypotheses, we propose to reformulate the main question that biologists seek to answer. To determine which genesets are associated with expression values that differ between two experiments, we focused on three ad hoc criteria: expression levels, the direction of individual gene expression changes (up or down regulation), and correlations between genes. We introduce the FAERI methodology, tailored from a two-way ANOVA to examine these criteria. The significance of the results was evaluated according to the self-contained null hypothesis, using label sampling or by inferring the null distribution from normally distributed random data. Evaluations performed on simulated data revealed that FAERI outperforms currently available methods for each type of set tested. We then applied the FAERI method to analyze three real-world datasets on hypoxia response. FAERI was able to detect more genesets than other methodologies, and the genesets selected were coherent with current knowledge of cellular response to hypoxia. Moreover, the genesets selected by FAERI were confirmed when the analysis was repeated on two additional related datasets. Conclusions: The expression values of genesets are associated with several biological effects. The underlying mathematical structure of the genesets allows for analysis of data from several genes at the same time. Focusing on expression levels, the direction of the expression changes, and correlations, we showed that two-step data reduction allowed us to significantly improve the performance of geneset analysis using a modified two-way ANOVA procedure, and to detect genesets that current methods fail to detect.