Serum levels of matrix metalloproteinases-2 and-9 and their tissue inhibitors in inflammatory neuromuscular disorders

We monitored serum levels of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) before and during intravenously applied immunoglobulin (IVIG) therapy in 33 patients with chronic immune-mediated neuropathies and myopathies and 15 controls. Baseline MMP-2 and TIMP-2 serum levels were lower and MMP-9 and TIMP-1 serum levels higher in all patients compared to age-matched controls. Eight days after IVIG treatment, MMP-2, TIMP-2, and TIMP-1 serum levels increased, while MMP-9 serum levels decreased, indicating tissue repair. After 60 days, MMP-9 levels increased, MMP-2 approached normal levels, while TIMP-1 and TIMP-2 serum levels were below day 8 levels, indicating relapsing tissue damage. Comparing the MMP/TIMP results with the clinical courses, IVIG treatment tended to change MMP/TIMP levels in a way that paralleled clinical improvement and relapse. In sum, during a distinct time period, IVIG therapy seems to be able to modulate VIMP-mediated tissue repair. Copyright (c) 2006 S. Karger AG, Basel

Antibiotic resistant shiga toxin producing Escherichia coli isolates from milk and milk products

Totally  450 milk and milk products (50 each of raw buffalo & cow milk; Kareish, Tallaga and Roquefort cheeses; yoghurt; rayeb; condensed milk and sour cream) samples were randomly purchased from various markets in Kafr El-Sheikh for isolation and identification of STEC. Results showed that 60%, 80%, 30%, 10%, 12%, 20%, 6% and 22% of buffalo & cow milk, Kareish, Roquefort, Tallaga, yoghurt, rayeb and sour cream respectively, contained E.coli, but negative in condensed milk. Fifty suspected isolates were serologically identified using E.coli O157:H7 kits, and confirmed in 69.2%, 53.8%, 60%, 16.7% and 20% isolates of buffalo & cow milk, Kareish, Tallaga and yoghurt, while was negative in Roqufort, rayeb, and sour cream. Using PCR assay, 21 confirmed isolates were examined, 44.4, 71.4, 66.7, 100 and 100% isolates of buffalo & cow milk, Kareish, Tallaga and yoghurt were positive for rfbE gene; while 55.6, 42.8, 66.7, 100 and 100 % isolates of buffalo & cow milk, Kareish, Tallaga and yoghurt were positive for blaTEM, but all isolates were negative for blaCMY2. Consequently, raw milk and most dairy products including fermented products were possible source of E.coli O157:H7food poisoning, so usage of accurate hygienic measures through manufacture and retail of milk products be essential

Translational evidence for two distinct patterns of neuroaxonal injury in sepsis: a longitudinal, prospective translational study

Background Brain homeostasis deteriorates in sepsis, giving rise to a mostly reversible sepsis-associated encephalopathy (SAE). Some survivors experience chronic cognitive dysfunction thought to be caused by permanent brain injury. In this study, we investigated neuroaxonal pathology in sepsis. Methods We conducted a longitudinal, prospective translational study involving (1) experimental sepsis in an animal model; (2) postmortem studies of brain from patients with sepsis; and (3) a prospective, longitudinal human sepsis cohort study at university laboratory and intensive care units (ICUs). Thirteen ICU patients with septic shock, five ICU patients who died as a result of sepsis, fourteen fluid-resuscitated Wistar rats with fecal peritonitis, eleven sham-operated rats, and three human and four rat control subjects were included. Immunohistologic and protein biomarker analysis were performed on rat brain tissue at baseline and 24, 48, and 72 h after sepsis induction and in sham-treated rats. Immunohistochemistry was performed on human brain tissue from sepsis nonsurvivors and in control patients without sepsis. The clinical diagnostics of SAE comprised longitudinal clinical data collection and magnetic resonance imaging (MRI) and electroencephalographic assessments. Statistical analyses were performed using SAS software (version 9.4; SAS Institute, Inc., Cary, NC, USA). Because of non-Gaussian distribution, the nonparametric Wilcoxon test general linear models and the Spearman correlation coefficient were used. Results In postmortem rat and human brain samples, neurofilament phosphoform, β-amyloid precursor protein, β-tubulin, and H&E stains distinguished scattered ischemic lesions from diffuse neuroaxonal injury in septic animals, which were absent in controls. These two patterns of neuroaxonal damage were consistently found in septic but not control human postmortem brains. In experimental sepsis, the time from sepsis onset correlated with tissue neurofilament levels (R = 0.53, p = 0.045) but not glial fibrillary acidic protein. Of 13 patients with sepsis who had clinical features of SAE, MRI detected diffuse axonal injury in 9 and ischemia in 3 patients. Conclusions Ischemic and diffuse neuroaxonal injury to the brain in experimental sepsis, human postmortem brains, and in vivo MRI suggest these two distinct lesion types to be relevant. Future studies should be focused on body fluid biomarkers to detect and monitor brain injury in sepsis. The relationship of neurofilament levels with time from sepsis onset may be of prognostic value

Cerebral perfusion in sepsis

This article is one of ten reviews selected from the Yearbook of Intensive Care and Emergency Medicine 2010 (Springer Verlag) and co-published as a series in Critical Care. Other articles in the series can be found online at http://ccforum.com/series/yearbook. Further information about the Yearbook of Intensive Care and Emergency Medicine is available from http://www.springer.com/series/2855

Study of Spectrally Resolved Thermoluminescence in Tsarev and Chelyabinsk Chondrites with a Versatile High-sensitive Setup

Thermoluminescence (TL) research provides a powerful tool for characterizing radiationinduced processes in extraterrestrial matter. One of the challenges in studying the spectral features of the natural TL of stony meteorites is its weak intensity. The present work showcases the capabilities of a high-sensitive original module for measuring the spectrally resolved TL characteristics of the Chelyabinsk and Tsarev chondrites. We have analyzed the emission spectra and glow curves of natural and induced TL over the 300–650 nm and RT–873 K ranges. A quasi-continuous distribution of traps active within the 350–650 K range was found in the silicate substructure of both meteorites under study. Based on the general order kinetic formalism and using the natural TL data, we also estimated the activation energies of EA = 0.86 and 1.08 eV for the Chelyabinsk and Tsarev chondrites, respectively. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.This work was supported by the Minobrnauki research project, number FEUZ-2020-0059

Focus on clinical neuroscience

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Research considerations for prospective studies of patients with coma and disorders of consciousness

Disorders of consciousness are neurological conditions characterized by impaired arousal and awareness of self and environment. Behavioural responses are absent or are present but fluctuate. Disorders of consciousness are commonly encountered as a consequence of both acute and chronic brain injuries, yet reliable epidemiological estimates would require inclusive, operational definitions of the concept, as well as wider knowledge dissemination among involved professionals. Whereas several manifestations have been described, including coma, vegetative state/unresponsive wakefulness syndrome and minimally conscious state, a comprehensive neurobiological definition for disorders of consciousness is still lacking. The scientific literature is primarily observational, and studies-specific aetiologies lead to disorders of consciousness. Despite advances in these disease-related forms, there remains uncertainty about whether disorders of consciousness are a disease-agnostic unitary entity with a common mechanism, prognosis or treatment response paradigm. Our knowledge of disorders of consciousness has also been hampered by heterogeneity of study designs, variables, and outcomes, leading to results that are not comparable for evidence synthesis. The different backgrounds of professionals caring for patients with disorders of consciousness and the different goals at different stages of care could partly explain this variability. The Prospective Studies working group of the Neurocritical Care Society Curing Coma Campaign was established to create a platform for observational studies and future clinical trials on disorders of consciousness and coma across the continuum of care. In this narrative review, the author panel presents limitations of prior observational clinical research and outlines practical considerations for future investigations. A narrative review format was selected to ensure that the full breadth of study design considerations could be addressed and to facilitate a future consensus-based statement (e.g. via a modified Delphi) and series of recommendations. The panel convened weekly online meetings from October 2021 to December 2022. Research considerations addressed the nosographic status of disorders of consciousness, case ascertainment and verification, selection of dependent variables, choice of covariates and measurement and analysis of outcomes and covariates, aiming to promote more homogeneous designs and practices in future observational studies. The goal of this review is to inform a broad community of professionals with different backgrounds and clinical interests to address the methodological challenges imposed by the transition of care from acute to chronic stages and to streamline data gathering for patients with disorders of consciousness. A coordinated effort will be a key to allow reliable observational data synthesis and epidemiological estimates and ultimately inform condition-modifying clinical trials.Tinti et al. outline critical considerations for prospective studies of disorders of consciousness. They emphasize the importance of selecting diverse source populations, using standardized assessment scales, and addressing challenges in case verification. The authors recommend ordinal analysis methods and comprehensive covariate measurements and provide action points to enhance research accuracy