Molecular analysis of a sunflower gene encoding an homologous of the B subunit of a CAAT binding factor

A genomic DNA fragment containing the complete LEAFY COTYLEDON1-LIKE (HaL1L) gene was retrieved by chromosome walking. Its sequence was confirmed and elongated by screening a sunflower genomic DNA BAC Library. HaL1L, whose cDNA had already been sequenced and characterized, encodes a NF-YB subunit of a CCAAT box-binding factor (NF-Y) involved in the early stages of zygotic and somatic embryogenesis in the Helianthus genus. In the HaL1L 50-flanking region, elements specific to a putative TATA-box promoter and two ‘‘CG isles’’ were identified. An investigation of the methylation status of these CG rich DNA regions showed that differentially methylated cytosines were recognizable in the DNA of embryos on the fifth day after pollination in comparison to leaf DNA suggesting that during plant development epigenetic regulation of HaL1L transcription was achieved by methylating cytosine residues. We also searched the HaL1L nucleotide sequence for cis-regulatory elements able to interact with other transcription factors (TFs) involved in the HaL1L regulation. Of the elements identified, one of the most intriguing is WUSATA, the target sequence for the WUSCHEL (WUS) TF, which may be part of a complex regulation network controlling embryo development. In this article, we show that the WUSATA target site, located in the intron of HaL1L, is able to bind the TF WUS. Interestingly, we found auxin and abscisic acid responsive motifs in the HaL1L promoter region suggesting that this gene may additionally by under hormonal control. Finally, the presence of a cytoplasmic polyadenylation signal downstream to the coding region indicates that this gene may also be controlled at the translation level by a temporarily making the pre-synthesized HaL1L mRNA unavailable for protein synthesis

Genotipizzazione delle accessioni della collezione ‘Vitiarium’

The 231 accessions of the most famous grapevine collection in Tuscany, the ‘Vitiarium’, have been genotyped analysing the polymorphism of 14 SSR loci. The analysis reveal 130 varieties belong to 28 international and 30 Italian varieties, 30 Tuscan local varieties and 42 unique genotypes, exclusive of the ‘Vitiarium’. Several synonyms, homonyms and misnomer have been identified. All data will be uploaded in the Italian Vitis Database

Supplemental red LED light promotes plant productivity, “photomodulate” fruit quality and increases Botrytis cinerea tolerance in strawberry

This work provides new evidences on the effect of pre-harvest red (R), green (G), blue (B), and white (W - R:G:B; 1:1:1) LED light supplementation on production, nutraceutical quality and Botrytis cinerea control of harvested strawberry fruit. Yield, fruit color, firmness, soluble solid content, titratable acidity, primary and specialized metabolites, expression of targeted genes and mold development were analyzed in fruit from light-supplemented plants, starting from the strawberry flowering, radiating 250 mu mol m-2 s-1 of light for five hours per day (from 11:00 to 16:00 h), until the fruit harvest. Briefly, R light induced the highest productivity and targeted antho-cyanin accumulation, whilst B and G lights increased the accumulation of primary and secondary metabolites especially belonging to ellagitannin and proanthocyanidin classes. R light also promoted pathogen tolerance in fruit by the upregulation of genes involved in cell wall development (F x aPE41), inhibition of fungus poly-galacturonases (F x aPGIP1) and the degradation of B. cinerea beta-glucans (F x aBG2-1). Our dataset highlights the possibility to use red LED light to increase fruit yield, "photomodulate" strawberry fruit quality and increase B. cinerea tolerance. These results can be useful in terms of future reduction of agrochemical inputs through the use of R light, enhancing, at the same time, fruit production and quality. Finally, further analyses might clarify the effect of pre-harvest supplemental G light on postharvest fruit quality

PENFIGÓIDE BOLHOSO, DESAFIO TERAPÊUTICO EM PACIENTE COM MÚLTIPLAS COMORBIDADES

Bullous pemphigoid (BP) is an autoimmune bulge, more common in the elderly, characterized by subepidermal, tense and large blisters. This study presents an elderly patient with diabetes mellitus and systemic arterial hypertension, with diffuse blisters on the body. Laboratory examination showed eosinophilia of 742/mm3 and an increase of IgE equivalent to 469 kU/L; anatomopathological with subepidermal bubble and inflammatory infiltrate rich in eosinophils; and immunofluorescence with immunodeposits at the dermo-epidermal junction consisting of IgG and C3. Based on these findings, the patient was diagnosed with BP. Due to the comorbidities of the patient, corticotherapy was not the first option, tetracycline presented therapeutic failure, and dapsone 100mg / day for 6 months was resolution. It is concluded that each patient should have their individualized management for best results.O Pênfigóide bolhoso (PB) é uma bulose autoimune, mais comum em idosos, caracterizada por bolhas subepidérmicas, tensas e grandes. Este trabalho apresenta uma paciente idosa, portadora de Diabetes melitus e Hipertensão arterial sistêmica, com queixa de bolhas difusas pelo corpo. Ao exame laboratorial demonstrou eosinofilia de 742/mm3 e aumento de IgE equivalente a 469 kU/L; anatomopatológico com bolha subepidérmica e infiltrado inflamatório rico em eosinófilos; e imunofluorescência com imunodepósitos na junção dermo-epidérmica constituídos por IgG e C3. Mediante esses achados, paciente recebeu diagnóstico de PB. Devido as comorbidades apresentadas, a corticoterapia não foi a primeira opção, a tetraciclina apresentou falha terapêutica e a dapsona 100mg/dia, por 6 meses, foi resolutiva. Conclui-se que cada paciente deve ter seu manejo individualizado para melhores resultados. Palavras-chave: penfigóide bolhoso; bulose; doença autoimune. ABSTRACT Bullous pemphigoid (BP) is an autoimmune bulge, more common in the elderly, characterized by subepidermal, tense and large blisters. This study presents an elderly patient with diabetes mellitus and systemic arterial hypertension, with diffuse blisters on the body. Laboratory examination showed eosinophilia of 742/mm3 and an increase of IgE equivalent to 469 kU/L; anatomopathological with subepidermal bubble and inflammatory infiltrate rich in eosinophils; and immunofluorescence with immunodeposits at the dermo-epidermal junction consisting of IgG and C3. Based on these findings, the patient was diagnosed with BP. Due to the comorbidities of the patient, corticotherapy was not the first option, tetracycline presented therapeutic failure, and dapsone 100mg / day for 6 months was resolution. It is concluded that each patient should have their individualized management for best results. Keywords: Ashy pemphigoid; bulge; autoimune disease

COINFECTION BETWEEN AMERICAN TEGUMENTARY LEISHMANIOSIS AND THE HUMAN IMMUNODEFICIENCY VIRUS

Introdução: A Leishmaniose Tegumentar Americana (LTA) é uma doença infecto parasitária de acometimento cutâneo mucoso causada por protozoários do gênero Leishmania. O quadro clínico depende da espécie da Leishmania envolvida e da resposta imune do hospedeiro. Indivíduos infectados com o vírus da imunodeficiência humana (HIV) podem apresentar quadros atípicos e exuberantes de LTA. Desenvolvimento: Este trabalho relata um caso de LTA mucocutânea em um paciente HIV positivo com acometimento extenso de hemiface esquerda. Esse paciente esteve aos cuidados de uma equipe interdisciplinar e as lesões cutâneas melhoraram após uso de Anfotericina B lipossomal. Considerações Finais: O diagnóstico e tratamento precoce de casos atípico de LTA é fundamental. Mais estudos deveriam ser propostos para elucidar a imunologia da coinfecção entre HIV e LTA.Introduction: American Cutaneous Leishmaniasis (ACL) is a parasitic infectious disease of mucocutaneous impairment caused by protozoa of the genus Leishmania. Clinical features depend on the species of Leishmania involved and the immune response of the host. Human immunodeficiency virus (HIV)-infected individuals may present atypical and exuberant clinical manifestations of ACL. Development: This study reports a case of mucocutaneous ACL in a HIV-positive patient with extensive involvement of left hemiface. This pacient was in the care of an interdisciplinary team and skin lesions improved after liposomal amphotericin B. Final considerations: Early diagnosis and adequate treatment of atypical ACL is crucial. More studies should be proposed to better understand the immunology of coinfection between HIV and ACL

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication