In silico analysis of sequenced strains of Clostridium difficile reveals a related set of conjugative transposons carrying a variety of accessory genes

The human gut pathogen Clostridium difficile contains many conjugative transposons that have an array of accessory genes. In the current study, recently sequenced genomes were analyzed to identify new putative conjugative transposons. Eleven new elements in 5 C. difficile strains were identified and all had a similar structure to the previously described elements CTn1, CTn5 and CTn7 in C. difficile strain 630. Each element identified did however contain a new set of accessory genes compared with those previously reported; including those predicted to encode ABC transporters, a toxin/antitoxin system and multiple antibiotic resistance genes

De Baten van Wonen aan Water: Een internet keuze experiment

Het doel van de hier gepresenteerde studie is om nader onderzoek te doen naar de waarde van wonen aan water en specifiek te kijken naar de toegevoegde waarde van ecologische waterkwaliteit en natuurvriendelijke oevers in huizenprijzen. Hiertoe is een internetenquête ontwikkeld waarin woningzoekenden een aantal keren worden gevraagd te kiezen tussen een tweetal identieke huizen, die alleen van elkaar verschillen wat betreft de aanwezigheid en kwaliteit van water in de buurt. Achtergrondrapport voor de ex ante evaluatie kaderrichtlijn water (KRW

IMMUNOSENESCENCE AND ITS IMPACT ON MEDICAL PRACTICE. A NEW LOOK AT AN OLD PROBLEM.

Introdução:O envelhecimento é um processo complexo que influencia todos os sistemas do corpo humano e seu impacto no sistema imune é chamado Imunosenescência. Essa condição é resultado de várias modulações imunológicas causadas por interações entre fatores genéticos e ambientais e é responsável por importantes condições clínicas em indivíduos idosos como alta prevalência de doenças infecciosas e autoimunes, neoplasias e menor eficácia de vacinas. Objetivo: Nesta revisão serão discutidos os problemas clínicos mais comuns na população idosa relacionados a Imunosenescência, e os novos achados da ciência básica relevantes a este tópico. Conclusão: A melhor compreensão da Imunosenescência é importante para prevenção de doenças comuns relacionadas à idade e para a promoção de um envelhecimento saudável.Background: Ageing is a very complex process that modulates all the organ systems of the human body, and its impact on the immune system is called Immunosenescence. This condition is the result of several immune modulations due to genetic and environmental interactions and is responsible for important clinical conditions in elderly subjects, such as a higher incidence of infectious and autoimmune diseases, neoplasias and decreased vaccine efficacy. Objective: In this current review we will discuss the most common clinical problems in the elderly population related to Immunosenescence and new findings in basic science relevant to this topic. Conclusion: A better understanding of Imunosenescence is important to prevention of common age related diseases and for the promotion of healthy ageing

Is a high tibial osteotomy (HTO) superior to non-surgical treatment in patients with varus malaligned medial knee osteoarthritis (OA)?

Objective: No randomized controlled trial (RCT) has compared the high tibial osteotomy (HTO) with non-surgical treatment in patients with medial knee osteoarthritis (OA) and varus malalignment. The aim was to compare the effectiveness of an unloader brace treatment or a usual care program to the HTO regarding pain severity and knee function. Design: Surgical treatment (HTO) to two non-surgical options was compared by combining the data of two RCTs. One RCT (n = 117) compared an unloader brace to usual care treatment; the other RCT (n = 92) compared closing to opening wedge HTO. One-to-many propensity score matching was used to equalize patient characteristics. We compared clinical outcome at 1 year follow-up (VAS pain (0-10) and knee function (HSS, 0-100)) with mixed model analysis. Results: Propensity score matching resulted in a comparison of 30 brace patient with 83 HTO patients, and of 28 usual care patients with 71 HTO patients. Pain at 1 year after HTO (VAS 3.8) was lower than after valgus bracing (VAS 5.0) with a mean difference of -1.1 (95% CI -2.2; -0.1). Function showed a nonsignificant mean difference of 2.1 [95% CI -3.1; 7.3]. Comparing HTO to usual care a difference was seen in pain (-1.7 [95% CI -2.8; -0.6]) and function (6.6 [95% CI 0.2; 13.1])