The role of virulence factors in the outcome of staphylococcal peritonitis in CAPD patients

<p>Abstract</p> <p>Background</p> <p>Peritonitis continues to be the most frequent cause of peritoneal dialysis (PD) failure, with an important impact on patient mortality. Gram-positive cocci such as <it>Staphylococcus epidermidis</it>, other coagulase-negative staphylococci (CoNS), and <it>Staphylococcus aureus </it>are the most frequent etiological agents of PD-associated peritonitis worldwide. The objective of the present study was to compare peritonitis caused by <it>S. aureus </it>and CoNS and to evaluate the factors influencing outcome.</p> <p>Methods</p> <p>Records of 86 new episodes of staphylococcal peritonitis that occurred between 1996 and 2000 in the Dialysis unit of a single university hospital were studied (35 due to <it>S. aureus</it>, 24 to <it>S. epidermidis </it>and 27 to other CoNS). The production of slime, lipase, lecithinase, nuclease (DNAse), thermonuclease (TNAse), α- and β-hemolysin, enterotoxins (SEA, SEB, SEC, SED) and toxic shock syndrome toxin-1 (TSST-1) was studied in <it>S. aureus </it>and CoNS. Antimicrobial susceptibility was evaluated based on the minimal inhibitory concentration determined by the E-test. Outcome predictors were evaluated by two logistic regression models.</p> <p>Results</p> <p>The oxacillin susceptibility rate was 85.7% for <it>S. aureus</it>, 41.6% for <it>S. epidermidis</it>, and 51.8% for other CoNS (p = 0.001). Production of toxins and enzymes, except for enterotoxin A and α-hemolysin, was associated with <it>S. aureus </it>episodes (p < 0.001), whereas slime production was positive in 23.5% of CoNS and 8.6% of <it>S. aureus </it>strains (p = 0.0047). The first model did not include enzymes and toxins due to their association with <it>S. aureus</it>. The odds of resolution were 9.5 times higher for <it>S. epidermidis </it>than for <it>S. aureus </it>(p = 0.02) episodes, and were similar for <it>S. epidermidis </it>and other CoNS (p = 0.8). The resolution odds were 68 times higher for non-slime producers (p = 0.001) and were not influenced by oxacillin resistance among vancomycin-treated cases (p = 0.89). In the second model, the resolution rate was similar for <it>S. aureus </it>and <it>S. epidermidis </it>(p = 0.70), and slime (p = 0.001) and α-hemolysin (p = 0.04) production were independent predictors of non-resolution.</p> <p>Conclusion</p> <p>Bacterial species and virulence factors rather than antibiotic resistance influence the outcome of staphylococcal peritonitis.</p

Aeromagnetic anomalies reveal the link between magmatism and tectonics during the early formation of the Canary Islands

The 3-D inverse modelling of a magnetic anomaly measured over the NW submarine edifice of the volcanic island of Gran Canaria revealed a large, reversely-magnetized, elongated structure following an ENE-WSW direction, which we interpreted as a sill-like magmatic intrusion emplaced during the submarine growth of this volcanic island, with a volume that could represent up to about 20% of the whole island. The elongated shape of this body suggests the existence of a major crustal fracture in the central part of the Canary Archipelago which would have favoured the rapid ascent and emplacement of magmas during a time span from 0.5 to 1.9 My during a reverse polarity chron of the Earth’s magnetic field prior to 16 Ma. The agreement of our results with those of previous gravimetric, seismological and geodynamical studies strongly supports the idea that the genesis of the Canary Islands was conditioned by a strike-slip tectonic framework probably related to Atlas tectonic features in Africa. These results do not contradict the hotspot theory for the origin of the Canary magmatism, but they do introduce the essential role of regional crustal tectonics to explain where and how those magmas both reached the surface and built the volcanic edifices.Project CGL2015-63799-P of the Spanish Ministry of Economy and Competitivenes

Rapid continental break-up and microcontinent formation in the western Indian Ocean

Two of the main factors that determine the nature of a rifted continental margin are rheology and magmatism during extension. Numerical models of lithospheric extension suggest that both factors vary with extension rate; yet until now extension rates of studied margins, as indicated by the rate of initial seafloor spreading, are mostly less than -30 mm/yr on each margin. This article presents the first geophysical results from the Seychelles-Laxmi Ridge conjugate pair of rifted margins which separated at -65 mm/yr. The Seychelles, with its spectacular exposures of Precambrian granite, was the earliest scientifically recognized microcontinent and arguably remains the classic example of one [Wegener, 1924; Matthews and Davies, 1966]. However, it is still unknown whether microcontinents result from plumes, changes in plate-boundary forces, lithospheric heterogeneity, or a combination of these factors

Evolução neurológica e eletrencefalográfica em crianças após meningencefalites purulentas

Twenty children with diagnosed meningitis were available for prospective study; each was submitted to neurological and electroencephalographic examination, Distractability Quotient (Gesell) and Intelligence Quotient (Raven) tests. Patients were followed from 6 months to 3 years after the acute phase of the disease. There is a statistically significant difference between the D.Q of post-meningitic children and the D.Q. of non meningitic controls of the same social class and ages, when the onset of illness was before 30 months of age. No statistically significant correlation was found between the D.Q. and the patient's length of hospitalization or the first cerebrospinal fluid protein level. There is a possibility that significant correlation between the D.Q. and age at onset of illness may be observed by studying a larger number of patients. No statistically significant difference was found between the I.Q. of post-meningitic children and controls when the onset of illness was after age 4

Immunological disturbance in West and Lennox-Gastaut syndromes

Cell-mediated and humoral immunity were investigated in 18 patients with West syndrome, 12 with Lennox-Gastaut syndrome and 19 healthy controls. The study included determination of Ô and  peripheral blood lymphocytes, serum levels of IgG, IgA and IgM, skin sensibilization with DNCB, intracutaneous PHA, leucocyte migration inhibition test and lymphocyte blastic transformation in the presence of PHA. Cell-mediated deficiency was detected in 28 children whereas low levels of immunoglobulins were observed only in 6 children. Immunological disturbances were more prominent in children with West syndrome

A rapid burst in hotspot motion through the interaction of tectonics and deep mantle flow

Volcanic hotspot tracks featuring linear progressions in the age of volcanism are typical surface expressions of plate tectonic movement on top of narrow plumes of hot material within Earth\u27s mantle1. Seismic imaging reveals that these plumes can be of deep origin2-probably rooted on thermochemical structures in the lower mantle3, 4, 5, 6. Although palaeomagnetic and radiometric age data suggest that mantle flow can advect plume conduits laterally7, 8, the flow dynamics underlying the formation of the sharp bend occurring only in the Hawaiian-Emperor hotspot track in the Pacific Ocean remains enigmatic. Here we present palaeogeographically constrained numerical models of thermochemical convection and demonstrate that flow in the deep lower mantle under the north Pacific was anomalously vigorous between 100 million years ago and 50 million years ago as a consequence of long-lasting subduction systems, unlike those in the south Pacific. These models show a sharp bend in the Hawaiian-Emperor hotspot track arising from the interplay of plume tilt and the lateral advection of plume sources. The different trajectories of the Hawaiian and Louisville hotspot tracks arise from asymmetric deformation of thermochemical structures under the Pacific between 100 million years ago and 50 million years ago. This asymmetric deformation waned just before the Hawaiian-Emperor bend developed, owing to flow in the deepest lower mantle associated with slab descent in the north and south Pacific