ADAMTS13 phenotype in plasma from normal individuals and patients with thrombotic thrombocytopenic purpura

The activity of ADAMTS13, the von Willebrand factor cleaving protease, is deficient in patients with thrombotic thrombocytopenic purpura (TTP). In the present study, the phenotype of ADAMTS13 in TTP and in normal plasma was demonstrated by immunoblotting. Normal plasma (n = 20) revealed a single band at 190 kD under reducing conditions using a polyclonal antibody, and a single band at 150 kD under non-reducing conditions using a monoclonal antibody. ADAMTS13 was not detected in the plasma from patients with congenital TTP (n = 5) by either antibody, whereas patients with acquired TTP (n = 2) presented the normal phenotype. Following immunoadsorption of immunoglobulins, the ADAMTS13 band was removed from the plasma of the patients with acquired TTP, but not from that of normal individuals. This indicates that ADAMTS13 is complexed with immunoglobulin in these patients. The lack of ADAMTS13 expression in the plasma from patients with hereditary TTP may indicate defective synthesis, impaired cellular secretion, or enhanced degradation in the circulation. This study differentiated between normal and TTP plasma, as well as between congenital and acquired TTP. This method may, therefore, be used as a complement in the diagnosis of TTP

Staphylococcus aureus bloodstream infections: Diverging trends of meticillin-resistant and meticillin-susceptible isolates, EU/EEA, 2005 to 2018

Background: Invasive infections caused by Staphylococcus aureus have high clinical and epidemiological relevance. It is therefore important to monitor the S. aureus trends using suitable methods. Aim: The study aimed to describe the trends of bloodstream infections (BSI) caused by meticillin-resistant S. aureus (MRSA) and meticillin-susceptible S. aureus (MSSA) in the European Union (EU) and the European Economic Area (EEA). Methods: Annual data on S. aureus BSI from 2005 to 2018 were obtained from the European Antimicrobial Resistance Surveillance Network (EARS-Net). Trends of BSI were assessed at the EU/EEA level by adjusting for blood culture set rate (number of blood culture sets per 1,000 days of hospitalisation) and stratification by patient characteristics.Results: Considering a fixed cohort of laboratories consistently reporting data over the entire study period, MRSA percentages among S. aureus BSI decreased from 30.2% in 2005 to 16.3% in 2018. Concurrently, the total number of BSI caused by S. aureus increased by 57%, MSSA BSI increased by 84% and MRSA BSI decreased by 31%. All these trends were statistically significant (p Conclusions: The results indicate an increasing health burden of MSSA BSI in the EU/EEA despite a significant decrease in the MRSA percentage. These findings highlight the importance of monitoring antimicrobial resistance trends by assessing not only resistance percentages but also the incidence of infections. Further research is needed on the factors associated with the observed trends and on their attributable risk

Multiple crustal sources for post-tectonic I-type granites in the Hercynian Iberian Belt

A post-tectonic plutonic array of felsic I-type granites crops out in the western Hercynian Iberian Belt. Isotope (Sr, N d, Pb) data favour the absence of an important input of juvenile magmas in late- to post- tectonic Hercynian felsic magmatism in western Iberia, but suggest a reworking of different crustal protoliths, including oceanic metabasic rocks accreted to mid-to-Iower crustal levels during the early stages of the collision. I-type granites were derived from different meta-igneous protoliths ranging from metabasic to felsic compositions depending on their geographical position from the external (e.g. Galicia-N Portugal, GNP) to the innermost continental areas (Spanish Central System and Los Pedroches Batholiths). The GNP 1- type pIu tons related to eo-Hercynian accretional terranes have lower initial 87Sr/86Sr ratios, lower negative εNd values, and higher 206PbP04Pb ratios than other I-type granites of the Central Iberian zone. These more isotopically primitive Hercynian I-type granites are important in tracking pre-Hercynian accreted oceanic lithosphere terranes