Physiotherapists' experiences of respiratory compromise in patients with Parkinson's disease: A qualitative study

Background/Aims: To explore the experiences and perceptions of physiotherapists involved in the care of people with Parkinson's disease and respiratory compromise. Methods: This exploratory qualitative study recruited four physiotherapists who participated in a focus group and completed reflective diaries over a 3-month period. Experiences were explored using Interpretative Phenomenological Analysis. Findings: The study highlights three key themes: application of professional knowledge, application of clinical decision making and challenges to application of care. Conclusions: The results demonstrate sensitive awareness in caring for a dependent and vulnerable population whose key motor signs, compounded by ageing are perceived as influencing the presentation of respiratory compromise. There are descriptions of a reactive response to illness, alongside reflections on the challenges faced when asserting autonomy and recognising where the role of physiotherapy fits within the multidisciplinary team. Sputum clearance is perceived as being a key aspect of this role, although there is uncertainty with regard to the effectiveness and appropriateness of treatment options. Multiple perceived challenges to care provision are highlighted, with key concerns surrounding clinician and patient knowledge levels, maintenance of patient mobility, person-centred care and clarity in the direction of care

The incidence of pneumatised inferior turbinate and relation to close anatomic structures

Background: Pneumatisation of the inferior turbinate (PIT) is a rare abnormality of the paranasal sinus. It is very difficult to differentiate from the hypertrophia of the inferior turbinate clinically. Thus, it is important to be considered, especially in cases with no response to medical treatments. We aimed to investigate the presence and the frequency of PIT by computed tomography (CT). Materials and methods: A total of 2905 cases (1381 female, 1524 male) with an age range between 16 and 84 were included. Results: The pneumatisation of the inferior turbinate was observed in 1.72% of the cases with a percentage of 1.88% in women and 1.57% in men. In PIT (+) cases the bilaterality was found in 54% of them. According to the subtypes, 70% was lamellar, 28% was bullous and 2% was extensive. No statistically significant difference was found for age distribution. The most commonly associated variations were the pneumatisation of the middle and upper turbinate and the septal deviation. Conclusions: The pneumatisation of the inferior turbinate is a rare variation with a similar frequency among men and women. It is diagnosed by CT and when symptomatic, the optimal treatment is surgery

Translation Regulation and Proteasome Mediated Degradation Cooperate to Keep Stem-Loop Binding Protein Low in G1-Phase: REGULATION OF SLBP EXPRESSION IN G1-PHASE

Histone mRNA levels are cell cycle regulated, and the major regulatory steps are at the posttranscriptional level. A major regulatory mechanism is S- phase restriction of Stem-loop binding protein (SLBP) which binds to the 3′ end of histone mRNA and participates in multiple steps of histone mRNA metabolism, including 3′ end processing, translation and regulation of mRNA stability. SLBP expression is cell cycle regulated without significant change in its mRNA level. SLBP expression is low in G1 until just before S phase where it functions and at the end of S phase SLBP is degraded by proteasome complex depending on phosphorylations on Thr 60 and Thr61. Here using synchronized HeLa cells we showed that SLBP production rate is low in early G1 and recovers back to S phase level somewhere between early and mid-G1. Further, we showed that SLBP is unstable in G1 due to proteasome mediated degradation as a novel mechanism to keep SLBP low in G1. Finally, the S/G2 stable mutant form of SLBP is degraded by proteasome in G1, indicating that the SLBP degradation mechanism in G1 is independent of the previously identified S/G2 degradation mechanism. In conclusion, as a mechanism to limit histone production to S phase, SLBP is kept low in G1 phase due to cooperative action of translation regulation and proteasome mediated degradation which is independent of previously known S/G2 degradation

Elucidation of key odorants and sensory propertiesof five different extra virgin olive oils from Turkey by GC-MS-Olfactometry

The present study investigates the aroma, key odorants and sensory profile of extra virgin olive oils from five well-known Turkish cultivars. The aromatic extract obtained by the purge and trap extraction system, according to a sensory analysis, resembled the odor of olive oil. A total of 22, 21, 18, 22 and 21 aroma-active compounds were detected in the extracts of Ayvalık, Memecik, Gemlik, Sarı Ulak and Beylik olive oils, respectively. The results show that Ayvalık has the highest flavor dilution (FD) value of 1024 with hexanal, (E)-2-hexenal and α-farnesene. Memecik has the highest FD value at 2048 with (E)-2-hexenal. Gemlik has the highest FD value of 1024 with (Z)-3-hexenyl acetate, (E)-2-hexen-1-ol and α-farnesene. Sarı Ulak has the highest FD value at 2048 with (E)-2-hexenal. Beylik has the highest FD value of 2048 with (E)-2-hexenal and hexanal. All cultivars represent the characteristic green, cut-grass, fruity odor notes

Cyclic di-GMP-dependent Signaling Pathways in the Pathogenic Firmicute Listeria Monocytogenes

We characterized key components and major targets of the c-di-GMP signaling pathways in the foodborne pathogen Listeria monocytogenes, identified a new c-di-GMP-inducible exopolysaccharide responsible for motility inhibition, cell aggregation, and enhanced tolerance to disinfectants and desiccation, and provided first insights into the role of c-di-GMP signaling in listerial virulence. Genome-wide genetic and biochemical analyses of c-di-GMP signaling pathways revealed that L. monocytogenes has three GGDEF domain proteins, DgcA (Lmo1911), DgcB (Lmo1912) and DgcC (Lmo2174), that possess diguanylate cyclase activity, and three EAL domain proteins, PdeB (Lmo0131), PdeC (Lmo1914) and PdeD (Lmo0111), that possess c-di-GMP phosphodiesterase activity. Deletion of all phosphodiesterase genes (ΔpdeB/C/D) or expression of a heterologous diguanylate cyclase stimulated production of a previously unknown exopolysaccharide. The synthesis of this exopolysaccharide was attributed to the pssA-E (lmo0527-0531) gene cluster. The last gene of the cluster encodes the fourth listerial GGDEF domain protein, PssE, that functions as an I-site c-di-GMP receptor essential for exopolysaccharide synthesis. The c-di-GMP-inducible exopolysaccharide causes cell aggregation in minimal medium and impairs bacterial migration in semi-solid agar, however, it does not promote biofilm formation on abiotic surfaces. The exopolysaccharide also greatly enhances bacterial tolerance to commonly used disinfectants as well as desiccation, which may contribute to survival of L. monocytogenes on contaminated food products and in food-processing facilities. The exopolysaccharide and another, as yet unknown c-di-GMP-dependent target, drastically decrease listerial invasiveness in enterocytes in vitro, and lower pathogen load in the liver and gallbladder of mice infected via an oral route, which suggests that elevated c-di-GMP levels play an overall negative role in listerial virulence

Cyclic di-GMP-Dependent Signaling Pathways in the Pathogenic Firmicute \u3cem\u3eListeria monocytogenes\u3c/em\u3e

We characterized key components and major targets of the c-di-GMP signaling pathways in the foodborne pathogen Listeria monocytogenes, identified a new c-di-GMP-inducible exopolysaccharide responsible for motility inhibition, cell aggregation, and enhanced tolerance to disinfectants and desiccation, and provided first insights into the role of c-di-GMP signaling in listerial virulence. Genome-wide genetic and biochemical analyses of c-di-GMP signaling pathways revealed that L. monocytogenes has three GGDEF domain proteins, DgcA (Lmo1911), DgcB (Lmo1912) and DgcC (Lmo2174), that possess diguanylate cyclase activity, and three EAL domain proteins, PdeB (Lmo0131), PdeC (Lmo1914) and PdeD (Lmo0111), that possess c-di-GMP phosphodiesterase activity. Deletion of all phosphodiesterase genes (ΔpdeB/C/D) or expression of a heterologous diguanylate cyclase stimulated production of a previously unknown exopolysaccharide. The synthesis of this exopolysaccharide was attributed to the pssA-E (lmo0527-0531) gene cluster. The last gene of the cluster encodes the fourth listerial GGDEF domain protein, PssE, that functions as an I-site c-di-GMP receptor essential for exopolysaccharide synthesis. The c-di-GMP-inducible exopolysaccharide causes cell aggregation in minimal medium and impairs bacterial migration in semi-solid agar, however, it does not promote biofilm formation on abiotic surfaces. The exopolysaccharide also greatly enhances bacterial tolerance to commonly used disinfectants as well as desiccation, which may contribute to survival of L. monocytogenes on contaminated food products and in food-processing facilities. The exopolysaccharide and another, as yet unknown c-di-GMP-dependent target, drastically decrease listerial invasiveness in enterocytes in vitro, and lower pathogen load in the liver and gallbladder of mice infected via an oral route, which suggests that elevated c-di-GMP levels play an overall negative role in listerial virulence

Outcomes of standart heparin treatment in deep vein thrombosis

Amaç: Kliniğimizde derin venöz tromboz tanısıyla sürekli unfraksiyone (standart) heparin kullanılarak tedavi edilen olgulara ait sonuçların retrospektif olarak incelenmesi. Yöntem:KliniğimizdeOcak 2002-Nisan 2005 tarihleri arasında derin venöz tromboz tanısıyla tedavi ve takipleri yapılan 44 olgu çalışmaya dahil edildi. Tedavi protokolünde tüm hastalara en az 1 hafta süreyle olmak üzere mutlak yatak istirahati uygulandı. Sürekli intravenöz heparin infüzyonu başlanarak doz a PTT değerlerine göre titre edildi. Oral antikoagülan tedavi başlanarak INR değeri 2'nin üzerine çıkıncaya kadar intravenöz heparin tedavisine devam edildi. Olguların tümünde klinik bulguların yanı sıra tanısal olarak renkli doppler USGtetkiki kullanıldı. Bulgular: Yaş ortalamaları 43,2 olan olguların, 27'si erkek (% 61,3) ve 17'si kadın (%38,7) idi. Olguların % 4.5'inde pulmoner emboli saptandı. Pulmoner emboli gelişen olgularda mortalite gözlenmedi.Heparin tedavisine olguların%45'inde 5-6. gün,%36'sında 7-10. gün devamedildi. 24 hastada yatışının 0-3. gününde, 20 hastada da 4-7. gününde oral antikoagülan tedaviye başlandı. Tedavi süresince hiçbir olguda majör kanama komplikasyonu ya da mortalite gözlenmedi. 3 aylık takipte hiçbir olguda rekürren tromboembolizm ile karşılaşılmadı. Sonuç: Derin venöz trombozda devamlı unfraksiyone heparin tedavisinin güvenle uygulanabilecek bir yöntem olduğu görüşündeyiz.Aim: In this retrospective study we aimed to investigate the outcomes of continuous unfractioned ( standart ) heparin treatment for deep vein thrombosis. Methods: 44 patients who were hospitalized between January 2002 and April 2005 with the diagnosis of deep vein thrombosis are included in this study. Strict bed rest was applied in treatment protocol to all cases. Continious intravenous heparin infusion was started and the dosage was titrated regardinga PTT values. Patients were put on oral anticoagulant therapy and intravenous heparin was continued until the INR value is greater than 2. Besides clinical findings colour Doppler USG was used diagnostically. Results: The mean age of the patients was 43.2 and 27 were male ( % 61.3 ) and 17 were female ( %38.7 ). Pulmonary embolism was detected in 4.5 % of cases. There was no mortality in patients who had pulmonary embolism. Heparin treatment was continued for 5-6 days in 45 % of cases and for 7-10 days in 36 % of cases. In 24 of cases oral anticoagulant therapy was started on0 - 3 rd day of hospitalization while in 20 of them therapy was started on4 - 7 th day of hospitalization. No mortality or major bleeding complication ocuured during the course of therapy. Neither of the cases faced reccurent thromboembolism in 3 months follow up. Conclusion: Unfractioned heparin treatment can be suggested asa reliable method for the treatment of deep vein thrombosis

Global phylogenomic analysis of nonencapsulated Streptococcus pneumoniae reveals a deep-branching classic lineage that is distinct from multiple sporadic lineages.

The surrounding capsule of Streptococcus pneumoniae has been identified as a major virulence factor and is targeted by pneumococcal conjugate vaccines (PCV). However, nonencapsulated S. pneumoniae (non-Ec-Sp) have also been isolated globally, mainly in carriage studies. It is unknown if non-Ec-Sp evolve sporadically, if they have high antibiotic nonsusceptiblity rates and a unique, specific gene content. Here, whole-genome sequencing of 131 non-Ec-Sp isolates sourced from 17 different locations around the world was performed. Results revealed a deep-branching classic lineage that is distinct from multiple sporadic lineages. The sporadic lineages clustered with a previously sequenced, global collection of encapsulated S. pneumoniae (Ec-Sp) isolates while the classic lineage is comprised mainly of the frequently identified multilocus sequences types (STs) ST344 (n = 39) and ST448 (n = 40). All ST344 and nine ST448 isolates had high nonsusceptiblity rates to β-lactams and other antimicrobials. Analysis of the accessory genome reveals that the classic non-Ec-Sp contained an increased number of mobile elements, than Ec-Sp and sporadic non-Ec-Sp. Performing adherence assays to human epithelial cells for selected classic and sporadic non-Ec-Sp revealed that the presence of a integrative conjugative element (ICE) results in increased adherence to human epithelial cells (P = 0.005). In contrast, sporadic non-Ec-Sp lacking the ICE had greater growth in vitro possibly resulting in improved fitness. In conclusion, non-Ec-Sp isolates from the classic lineage have evolved separately. They have spread globally, are well adapted to nasopharyngeal carriage and are able to coexist with Ec-Sp. Due to continued use of PCV, non-Ec-Sp may become more prevalent

Structural and biochemical characterization of the exopolysaccharide deacetylase Agd3 required for Aspergillus fumigatus biofilm formation

The exopolysaccharide galactosaminogalactan (GAG) is an important virulence factor of the fungal pathogen Aspergillus fumigatus. Deletion of a gene encoding a putative deacetylase, Agd3, leads to defects in GAG deacetylation, biofilm formation, and virulence. Here, we show that Agd3 deacetylates GAG in a metal-dependent manner, and is the founding member of carbohydrate esterase family CE18. The active site is formed by four catalytic motifs that are essential for activity. The structure of Agd3 includes an elongated substrate-binding cleft formed by a carbohydrate binding module (CBM) that is the founding member of CBM family 87. Agd3 homologues are encoded in previously unidentified putative bacterial exopolysaccharide biosynthetic operons and in other fungal genomes. The exopolysaccharide galactosaminogalactan (GAG) is an important virulence factor of the fungal pathogen Aspergillus fumigatus. Here, the authors study an A. fumigatus enzyme that deacetylates GAG in a metal-dependent manner and constitutes a founding member of a new carbohydrate esterase family.Bio-organic Synthesi