Identification and antifungal susceptibility of a large collection of yeast strains isolated in Tunisian hospitals.

Abstract In this study, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was used as a rapid method to identify yeasts isolated from patients in Tunisian hospitals. When identification could not be exstablished with this procedure, sequencing of the internal transcribed spacer with 5.8S ribosomal DNA (rDNA) (ITS1-5.8S-ITS2) and D1/D2 domain of large-subunit (LSU rDNA) were employed as a molecular approach for species differentiation. Candida albicans was the dominant species (43.37% of all cases), followed by C. glabrata (16.55%), C. parapsilosis (13.23%), C. tropicalis (11.34%), C. dubliniensis (4.96%), and other species more rarely encountered in human diseases such as C. krusei, C. metapsilosis, C. lusitaniae, C. kefyr, C. palmioleophila, C. guilliermondii, C. intermedia, C. orthopsilosis, and C. utilis. In addition, other yeast species were obtained including Saccharomyces cerevisiae, Debaryomyces hansenii (anamorph known as C. famata), Hanseniaspora opuntiae, Kodamaea ohmeri, Pichia caribbica (anamorph known as C. fermentati), Trichosporon spp. and finally a novel yeast species, C. tunisiensis. The in vitro antifungal activities of fluconazole and voriconazole were determined by the agar disk diffusion test and Etest, while the susceptibility to additional antifungal agents was determined with the Sensititre YeastOne system. Our results showed low incidence of azole resistance in C. albicans (0.54%), C. tropicalis (2.08%) and C. glabrata (4.28%). In addition, caspofungin was active against most isolates of the collection with the exception of two K. ohmeri isolates. This is the first report to describe caspofungin resistant isolates of this yeast.

Use of new biochemical plasmatic markers, plasma free and total metanephrines, for the diagnosis and follow-up of neuroblastoma in children with clinical correlation

Background: Neuroblastoma is a paediatrictumour derived from the neural crest. Biochemical diagnosis and follow up rely on quantitation of urinary catecholamines (dopamine and noradrenaline) and their metabolites vanillylmandelic acid (VMA) and homovanillic acid (HVA) (gold-standard). When combined, these analyses have a sensitivity of 95%. However, they are clearly limited by inaccuracy of urine collection in young children and normalisation of catecholamine concentrations by creatininuria. Recent development in biochemical diagnosis of pheochromocytoma, another neural crest tumour found in adults, shows that plasmatic measurement of methoxylated catecholamines called metanephrines are more sensitive and specific than other biomarkers. Moreover, a study to determine the reference intervals for metanephrines in a pediatric population has recently been completed. The aim of this work is to describe the role of metanephrines monitoring in the follow up of neuroblastoma. Method: This retrospective study included patients with neuroblastoma in whom the following parameters were determined: plasma free and total metanephrines, plasma catecholamines, 24h urinary catecholamines and metanephrines in absolute value and corrected by creatinine, VMA and HVA at the diagnosis and during treatment at the University Hospital of Lausanne (Switzerland). Eleven patients aged between the first day of life and 7 years old were followed between 2005 and 2012. Clinical outcome and biochemical concentrations of the analytes were correlated. Results: At diagnosis, plasma free and total normetanephrines and methoxytyramine have a sensitivity of 100% compared to 85% for the actual gold standard. Metanephrine remain below the upper reference limit as expected since these tumours do not produce adrenaline. The relationship between biochemical markers and clinical outcome is illustrated graphically. Plasma or urinary normetanephrine and methoxytyramine correlate better with the history of the patient than VMA and HVA, as evaluated by ordinal logistic regression. Concentrations of analytes in urine show a better correlation with clinical events when the results are corrected by creatininuria. Conclusion: Normetanephrine and methoxytyramine reflect disease history in neuroblastoma patients and could play a significant role in the follow up of this type of tumour. Formal studies in a sufficient number of patients are needed to confirm this preliminary observation.

Redox dysregulation in the pathophysiology of schizophrenia and bipolar disorder: insights from animal models.

Abstract Significance: Schizophrenia (SZ) and bipolar disorder (BD) are classified as two distinct diseases. However, accumulating evidence shows that both disorders share genetic, pathological, and epidemiological characteristics. Based on genetic and functional findings, redox dysregulation due to an imbalance between pro-oxidants and antioxidant defense mechanisms has been proposed as a risk factor contributing to their pathophysiology. Recent Advances: Altered antioxidant systems and signs of increased oxidative stress are observed in peripheral tissues and brains of SZ and BD patients, including abnormal prefrontal levels of glutathione (GSH), the major cellular redox regulator and antioxidant. Here we review experimental data from rodent models demonstrating that permanent as well as transient GSH deficit results in behavioral, morphological, electrophysiological, and neurochemical alterations analogous to pathologies observed in patients. Mice with GSH deficit display increased stress reactivity, altered social behavior, impaired prepulse inhibition, and exaggerated locomotor responses to psychostimulant injection. These behavioral changes are accompanied by N-methyl-D-aspartate receptor hypofunction, elevated glutamate levels, impairment of parvalbumin GABA interneurons, abnormal neuronal synchronization, altered dopamine neurotransmission, and deficient myelination. Critical Issues: Treatment with the GSH precursor and antioxidant N-acetylcysteine normalizes some of those deficits in mice, but also improves SZ and BD symptoms when given as adjunct to antipsychotic medication. Future Directions: These data demonstrate the usefulness of GSH-deficient rodent models to identify the mechanisms by which a redox imbalance could contribute to the development of SZ and BD pathophysiologies, and to develop novel therapeutic approaches based on antioxidant and redox regulator compounds. Antioxid. Redox Signal. 18, 1428-1443.

Cannabinoid addiction: behavioral models and neural correlates

The use of cannabis sativa preparations as recreational drugs can be traced back to the earliest civilizations. However, animal models of cannabinoid addiction allowing the exploration of neural correlates of cannabinoid abuse have been developed only recently. We review these models and the role of the CB1 cannabinoid receptor, the main target of natural cannabinoids, and its interaction with opioid and dopamine transmission in reward circuits. Extensive reviews on the molecular basis of cannabinoid action are available elsewhere (Piomelli et al., 2000;Schlicker and Kathmann, 2001).

Multi-receptor binding profile of clozapine and olanzapine: a structural study based on the new beta (2) adrenergic receptor template

Schizophrenia is a devastating mental disorder that has a largeimpact on the quality of life for those who are afflicted and isvery costly for families and society.[1] Although the etiology ofschizophrenia is still unknown and no cure has yet beenfound, it is treatable, and pharmacological therapy often producessatisfactory results. Among the various antipsychoticdrugs in use, clozapine is widely recognized as one ofthemost clinically effective agents, even if it elicits significant sideeffects such as metabolic disorders and agranulocytosis. Clozapineand the closely related compound olanzapine are goodexamples ofdrug s with a complex multi-receptor profile ;[2]they have affinities toward serotonin, dopamine, a adrenergic,muscarinic, and histamine receptors, among others.

FANCM regulates DNA chain elongation and is stabilized by S-phase checkpoint signalling.

FANCM binds and remodels replication fork structures in vitro. We report that in vivo, FANCM controls DNA chain elongation in an ATPase-dependent manner. In the presence of replication inhibitors that do not damage DNA, FANCM counteracts fork movement, possibly by remodelling fork structures. Conversely, through damaged DNA, FANCM promotes replication and recovers stalled forks. Hence, the impact of FANCM on fork progression depends on the underlying hindrance. We further report that signalling through the checkpoint effector kinase Chk1 prevents FANCM from degradation by the proteasome after exposure to DNA damage. FANCM also acts in a feedback loop to stabilize Chk1. We propose that FANCM is a ringmaster in the response to replication stress by physically altering replication fork structures and by providing a tight link to S-phase checkpoint signalling.

CB1 cannabinoid receptor modulates MDMA acute responses and reinforcement

Background: 3, 4-methylenedioxymethamphetamine (MDMA) is a popular recreational drug widely abused by young people. The endocannabinoid system is involved in the addictive processes induced by different drugs of abuse. However, the role of this system in the pharmacological effects of MDMA has not been yet clarified.Methods: Locomotion, body temperature and anxiogenic-like responses were evaluated after acute MDMA administration in CB1 knockout mice. Additionally, MDMA rewarding properties were investigated in the place conditioning and the intravenous self-administration paradigms. Extracellular levels of DA in the nucleus accumbens were also analyzed after a single administration of MDMA by in vivo microdialysis. Results: Acute MDMA administration increased locomotor activity, body temperature and anxiogenic-like responses in wild type mice, but these responses were lower or abolished in knockout animals. MDMA produced similar conditioned place preference and increased dopamine extracellular levels in the nucleus accumbens in both genotypes. Nevertheless, CB1 knockout mice failed to self-administer MDMA at any of the doses used. Conclusions: These results indicate that CB1 cannabinoid receptors play an important role in the acute prototypical effects of MDMA, and are essential in the acquisition of an operant behavior to self-administer this drug.

MDMA attenuates THC withdrawal syndrome in mice

3, 4-Methylenedioxymethamphetamine (MDMA) and cannabis are widely abused illicit drugs that are frequently consumed in combination. Interactions between these two drugs have been reported in several pharmacological responses observed in animals, such as body temperature, anxiety, cognition and reward. However, the interaction between MDMA and cannabis in addictive processes such as physical dependence has not been elucidated yet. In this study, the effects of acute and chronic MDMA were evaluated on the behavioral manifestations of Δ9-tetrahydrocannabinol (THC) abstinence in mice. THC withdrawal syndrome was precipitated by injecting the cannabinoid antagonist rimonabant (10 mg/kg, i.p.) in mice chronically treated with THC, and receiving MDMA (2.5, 5 and 10 mg/kg i.p.) or saline just before the withdrawal induction or chronically after the THC administration. Both, chronic and acute MDMA decreased in a dose-dependent manner the severity of THC withdrawal. In vivo microdialysis experiments showed that acute MDMA (5 mg/kg, i.p.) administration increased extracellular serotonin levels in the prefrontal cortex, but not dopamine levels in the nucleus accumbens. Our results also indicate that the attenuation of THC abstinence symptoms was not due to a direct interaction between rimonabant and MDMA nor to the result of the locomotor stimulating effects of MDMA. The modulation of the cannabinoid withdrawal syndrome by acute or chronic MDMA suggests a possible mechanism to explain the associated consumption of these two drugs in humans.

Diagnostic performance of urinary metanephrines for the postmortem diagnosis of hypothermia.

The purpose of this study was to assess the diagnostic potential of urinary metanephrines and 3-methoxytyramine compared to urinary catecholamine determination in diagnosing antemortem cold exposure and fatal hypothermia. 83 cases of fatal hypothermia and 144 control cases were included in this study. Catecholamines (adrenaline, noradrenaline and dopamine), metanephrines (metanephrine, normetanephrine) and 3-methoxytyramine were measured in urine collected during autopsy. All tested analytes were significantly higher in hypothermia cases compared to control subjects and displayed a generally satisfying discriminative value, thus indicating urinary catecholamines and their metabolites as reliable markers of cold-related stress and hypothermia related-deaths. Metanephrine and adrenaline had the best discriminative value between hypothermia and control cases compared to other tested analytes, though with different sensitivity and specificity. These can therefore be considered the most suitable markers of cold-related stress.

Development of neuronal markers in aggregating fetal rat telencephalon cells cultured in the presence of triiodothyronine.

The concentrations of the general neuronal markers D2-protein (N-CAM), D3-protein and neuron specific enolase (NSE) in reaggregating cultures of fetal rat telencephalon cells were affected by the presence of 30 nM triiodothyronine in the defined culture medium. The extent of normal developmental changes were enhanced by triiodothyronine, as demonstrated by crossed immunoelectrophoresis. From 13 to 19 days in culture, the concentration of D2-protein decreased, and the concentrations of both D3-protein and NSE increased. Nerve growth factor (NGF) was without effect on the development of these general neuronal markers. However, as shown previously both triiodothyronine and NGF increased the activity of choline acetyltransferase, a marker for cholinergic neurons. The results suggest an enhanced overall differentiation of several types of telencephalon neurons in the presence of triiodothyronine, and a specific stimulation of cholinergic telencephalon neurons by NGF.

Genetics of essential tremor.

Essential tremor (ET) is a prevalent condition manifesting with progressive action tremor. Although ET was traditionally viewed as a sporadic disease, a significant proportion of cases report a positive family history of tremor. Autosomal dominant inheritance can be demonstrated in many families. Previously, genome-wide linkage studies in families mapped three loci for ET, hereditary essential tremor-1 (ETM1), ETM2 and ETM3. However, no causal mutation has been replicated in candidate genes within these loci, including dopamine D3 receptor (DRD3) and HS1-binding protein 3 (HS1BP3). Recently, the first genome-wide association study in ET followed by replication studies conducted in diverse populations identified a significant association between the leucine-rich repeat and Ig domain containing 1 gene (LINGO1) SNP rs9652490 and risk for ET Although further novel variants were indentified in LINGO1 and its paralog LINGO2 that may be associated with risk for ET, the pathogenic mechanisms involved remain elusive. Given the possibility that ET as a complex trait may be influenced by the combined effects of rare variants, novel high-throughput technologies sequencing all exons across the genome (exome sequencing) or the whole genome (genome sequencing) may become crucial in understanding/deciphering the genetic background of ET.

Die Töpferin und der Schmied : Basel-Gasfabrik, Grabung 1989/5

RésuméDie Grabung 1989/5 der Archäologischen Bodenforschung Basel-Stadt im Zentrum der Siedlung Basel-Gasfabrik umfasste eine Fläche von etwa 900 m2. Auf etwa 370 m2 konnten intakte latènezeitliche Strukturen festgestellt werden. Der ehemalige Gehhorizont und die darunter liegende Siedlungsschicht waren jedoch nirgends erhalten geblieben.Die in den gewachsenen Boden eingetieften Pfostengrub en erlaubten die Rekonstrulction von zwei rechteckigen Häusern mit je vier Eckpfosten, die als Wohngebäude gedeutet werden.Über das ganze Areal verteilt wurden 14 Gruben unterschiedlicher Form und Grösse ganz oder teilweise ausgegraben. Bei der flachen Grube 261 handelt es sich wohl um den eingetieften Bereich eines kleinen Grubenhauses, das für nicht näher bestimmbare handwerkliche Aktivitäten genutzt wurde. Die beiden mit einem Pfostenbau überdeckten Gruben 258 und 259 können hingegen mit grosser Wahrscheinlichkeit als Schmiedegruben gedeutet werden. In Grube 258 waren gar die Reste von zwei Feuerstellen und der Unterbau eines kaminartigen Abzugs in situ erhalten. Die Gruben 253, 254A, 254B, 255,256 und 257 mit Resten von Lehmausideidungen dienten vermutlich als Getreidesilos. Sie liegen alle im Zentrum des Grabungsareals im Bereich einer anstehenden Lehmschicht. Bei einigen weiteren Gruben könnte es sich um Keller handeln.Im Westen der Grabungsfläche kamen die Heizkanäle von zwei Töpferöfen zum Vorschein. Es handelt sich um einfache Kuppelöfen mit gegenständiger Feuerung. In geringer Entfernung lagen drei kleine Gruben, die vielleicht zur Aufbereitung des Töpferlehms dienten. Aufgrund der klimatischen Verhältnisse ist mit einem saisonalen Betrieb der Töpferöfen während der Sommermonate zu rechnen. Die notwendigen Arbeiten wurden mit grosser Wahrscheinlichkeit von Frauen ausgeführt, da die Männer während dieser Jahreszeit in der Landwirtschaft beschäftigt waren. Der Töpfereibetrieb produzierte grössere Serien scheibengedrehter, reduzierend gebrannter Feinkeramik, von der im Bereich der Öfen zahlreiche Scherben gefunden wurden.Die räumliche Organisation der Bebauung zeugt von einer einheitlichen und wohl kontinuierlichen Nutzung der Grabungsfläche. ImWesten gruppieren sich Haus 1 und die Einrichtungen des Töpfereibetriebs um eine unbebaute Hofzone. Nach Osten zu folgt dann die Zone mit den Getreidesilos. Das östliche Bauensemble besteht aus Haus 2, den Schmiedegruben, dem Grubenhaus sowie einer mutmasslichen Kellergrube. Stratigra-phische Überschneidungen von Befunden sind nur im Bereich der Töpferöfen vorhanden.Die Grubenfüllungen erwiesen sich als sehr fundreich. Die gegen 20000 Keramikscherben repräsentieren das gesamte Spektrum der aus Basel-Gasfabrik bekannten einheimischen Grobund Feinkeramik. Bei den seltenen Scherben von Graphittonkeramik handelt es sich um Importe aus dem ostkeltischen Bereich.Die zahlreichen Amphorenscherben stammen von mindestens 35 verschiedenen Gefässindividuen des Typs Dressel 1A, von denen aber immer nur ein kleiner Prozentsatz vorhanden war. Die Typologie und die Datierung der Befunde zeigen, dass der Amphorenimport erst im Laufe von LT D1 einsetzte.Unter den Kleinfunden verdienen die zahlreichen Silber- und Potinmünzen sowie die Glasfunde besondere Erwähnung. Das Fragment eines möglicherweise latènezeitlichen Glasgefässes stammt leider aus einem unsicheren Fundzusammenhang.Die über 70 Fibeln und Fibelteile sind zu 70% aus Bronze gefertigt. Das Fibelspektrum wird von den Nauheimer Fibeln dominiert. Besonders bei den Eisenfibeln konnten aber auch typologisch ältere Typen identifiziert werden, welche in die Stufen LT C2 und LT D1a gehören. Bei den Glasarmringen machen mittellatènezeitliche Typen gegen 20 % der Fundmenge aus.Von besonderer Bedeutung sind die 23 Menschenknochen von 19 verschiedenen Individuen. Es handelt sich dabei um einen fast vollständigen Schädel, Schädelteile und Fragmente von Langknochen sowie wenige weitere Skelettteile. Die Zusammensetzung des Ensembles und der Zustand der Einzelknochen lässt sich sehr gut mit den Menschenknochen aus den Altgrabungen von Basel-Gasfabrik und aus Manching vergleichen. Eine detaillierte Untersuchung zeigt, dass die Knochen am Ende eines langwierigen Totenrituals, das aufgrund ethno - logischer Vergleiche als mehrstufige Bestattung bezeichnet werden kann, in der Siedlung vergraben wurden. In der Umgebung der Menschenknochen wurden in einigen Fällen auffallend viele Amphorenscherben gefunden, die bezeugen, dass der importierte Wein bei diesen Riten eine bedeutende Rolle spielte. Wahrscheinlich wurden diese Knochen auch als Ahnenrelikte verehrt.Neben den mehrstufigen Bestattungen konnten auch zwei Säuglingsbestattungen identifiziert werden.Die Analyse von Fundmenge und Fundverteilung in den Gruben zeigt, dass die Funde nicht direkt, sondern auf dem Umweg über primäre Deponien in die Gruben gelangten. In den pri-mären Deponien wurden Funde über längere Zeit akkumuliert und mit verschiedenen Erdmaterialien intensiv vermischt.Für den Grossteil der Funde wird eine profane Deutung als Abfälle vorgeschlagen. Daneben können aber auch einige Funde als gezielte Deponierungen angesprochen werden. Ver-schiedene Fibelpaare und wahrscheinlich auch Münzen wurden wohl als Opfergaben in die Gruben gegeben. Ein Zusammenhang dieser Opfergaben mit den Bestattungen von Men-schenknochen ist nicht erkennbar.Die Datierung der Funde zeigt einen Siedlungsbeginn in LT C2 und ein Ende noch vor dem Beginn der Stufe LT D2. Die Kombination dieser Datierungen mit den stratigraphischen Überschneidungen einiger Befunde erlaubt eine Rekonstruktion der Besiedlungsentwicklung auf dem Grabungsareal. Die Gruben 259 und 260 wurden bereits in LT C2 verfüllt, die Schmiedegrube 259 anschliessend durch Grube 258 ersetzt. Die beiden Töpferöfen waren nacheinander in LT D1 in Betrieb. Die beiden Häuser können leider nicht genauer datiert werden.Die Besiedlung des Area's setzte noch vor 150 V. Chr. ein und dauerte maximal 80 Jahre.Die Synthese aller Untersuchungen zeigt, dass auf dem Grabungsareal eine Gruppe von etwa 15 Personen ansässig war, die sich v. a. der Landwirtschaft widmete. Die handwerkliche Tätigkeit (Töpferei, Metallverarbeitung) erreichte keinen vollberuflichen Standard.Die dörfliche Siedlungsgemeinschaft bestand aus bäuerlichen Selbstversorgern, mit anderen Gemeinschaften wurden jedoch Keramik, Handwerksprodukte und Schlachtvieh ausge-tauscht. Von besonderer Bedeutung war offenbar das Getreide, das in grossen Mengen in der Siedlung gelagert wurde und mit grosser Wahrscheinlichkeit für den Export bestimmt war. Die Herkunft dieses Getreides und die sozialen Strukturen hinter diesem Austausch sind nicht ldar, aber mit hoher Wahrscheinlichkeit wurden durch den Getreideexport die Importe wie Salz, Rohstoffe (Metall) und Wein ermöglicht.

PPARgamma but not PPARalpha ligands are potent repressors of major histocompatibility complex class II induction in atheroma-associated cells.

Peroxisome proliferator-activated receptors (PPARs) are essential in glucose and lipid metabolism and are implicated in metabolic disorders predisposing to atherosclerosis, such as diabetes and dyslipidemia. Conversely, antidiabetic glitazones and hypolipidemic fibrate drugs, known as PPARgamma and PPARalpha ligands, respectively, reduce the process of atherosclerotic lesion formation, which involves chronic immunoinflammatory processes. Major histocompatibility complex class II (MHC-II) molecules, expressed on the surface of specialized cells, are directly involved in the activation of T lymphocytes and in the control of the immune response. Interestingly, expression of MHC-II has recently been observed in atherosclerotic plaques, and it can be induced by the proinflammatory cytokine interferon-gamma (IFN-gamma) in vascular cells. To explore a possible role for PPAR ligands in the regulation of the immune response, we investigated whether PPAR activation affects MHC-II expression in atheroma-associated cells. In the present study, we demonstrate that PPARgamma but not PPARalpha ligands act as inhibitors of IFN-gamma-induced MHC-II expression and thus as repressors of MHC-II-mediated T-cell activation. All different types of PPARgamma ligands tested inhibit MHC-II. This effect of PPARgamma ligands is due to a specific inhibition of promoter IV of CIITA and does not concern constitutive expression of MHC-II. Thus, the beneficial effects of antidiabetic PPARgamma activators on atherosclerotic plaque development may be partly explained by their repression of MHC-II expression and subsequent inhibition of T-lymphocyte activation.

Postoperative delirium. Part 1: pathophysiology and risk factors.

Delirium presents clinically with differing subtypes ranging from hyperactive to hypoactive. The clinical presentation is not clearly linked to specific pathophysiological mechanisms. Nevertheless, there seem to be different mechanisms that lead to delirium; for example the mechanisms leading to alcohol-withdrawal delirium are different from those responsible for postoperative delirium. In many forms of delirium, the brain's reaction to a peripheral inflammatory process is considered to be a pathophysiological key element and the aged brain seems to react more markedly to a peripheral inflammatory stimulus than a younger brain. The effects of inflammatory mediators on the brain include changes in neurotransmission and apoptosis. On a neurotransmitter level, impaired cholinergic transmission and disturbances of the intricate interactions between dopamine, serotonin and acetylcholine seem to play an important role in the development of delirium. The risk factors for delirium are categorised as predisposing or precipitating factors. In the presence of many predisposing factors, even trivial precipitating factors may trigger delirium, whereas in patients without or with only a few predisposing factors, a major precipitating insult is necessary to trigger delirium. Well documented predisposing factors are age, medical comorbidities, cognitive, functional, visual and hearing impairment and institutional residence. Important precipitating factors apart from surgery are admission to an ICU, anticholinergic drugs, alcohol or drug withdrawal, infections, iatrogenic complications, metabolic derangements and pain. Scores to predict the risk of delirium based on four or five risk factors have been validated in surgical patients.