2,144 research outputs found

    Helicobacter pylori infection and gastric dysbiosis: Can probiotics administration be useful to treat this condition?

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    Helicobacter pylori (Hp) is responsible for one of the most common infections in the world. 'e prevalence exceeds 50% of the population in developing countries, and approximately one-third of the adults are colonized in North Europe and North America. It is considered a major pathogenic agent of chronic gastritis, peptic ulcer, atrophic gastritis, gastric cancer, and mucosa-associated lymphoid tissue lymphoma (MALT). Hp colonization modifies the composition of gastric microbiota that could drive the development of gastric disorders. Currently, an emerging problem in Hp treatment is represented by the increasing rate of antimicrobial therapy resistance. In this context, the search for adjuvant agents can be very useful to overcome this issue and probiotics administration can represent a valid option. The aim of this review is to describe the gastric microbiota changes during Hp colonization, the mechanisms of action, and a possible role of probiotics in the treatment of this infection

    Conservation of structure and mechanism in primary and secondary transporters exemplified by SiaP, a sialic acid binding virulence factor from Haemophilus influenzae

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    Extracytoplasmic solute receptors (ESRs) are important components of solute uptake systems in bacteria, having been studied extensively as parts of ATP binding cassette transporters. Herein we report the first crystal structure of an ESR protein from a functionally characterized electrochemical ion gradient-dependent secondary transporter. This protein, SiaP, forms part of a tripartite ATP-independent periplasmic transporter specific for sialic acid in Haemophilus influenzae. Surprisingly, the structure reveals an overall topology similar to ATP binding cassette ESR proteins, which is not apparent from the sequence, demonstrating that primary and secondary transporters can share a common structural component. The structure of SiaP in the presence of the sialic acid analogue 2,3-didehydro-2-deoxyN-acetylneuraminic acid reveals the ligand bound in a deep cavity with its carboxylate group forming a salt bridge with a highly conserved Arg residue. Sialic acid binding, which obeys simple bimolecular association kinetics as determined by stopped-flow fluorescence spectroscopy, is accompanied by domain closure about a hinge region and the kinking of an alpha-helix hinge component. The structure provides insight into the evolution, mechanism, and substrate specificity of ESR-dependent secondary transporters that are widespread in prokaryotes

    Common features between neoplastic and preneoplastic lesions of the biliary tract and the pancreas

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    The bile duct system and pancreas show many similarities due to their anatomical proximity and common embryological origin. Consequently, preneoplastic and neoplastic lesions of the bile duct and pancreas share analogies in terms of molecular, histological and pathophysiological features. Intraepithelial neoplasms are reported in biliary tract, as biliary intraepithelial neoplasm (BilIN), and in pancreas, as pancreatic intraepithelial neoplasm (PanIN). Both can evolve to invasive carcinomas, respectively cholangiocarcinoma (CCA) and pancreatic ductal adenocarcinoma (PDAC). Intraductal papillary neoplasms arise in biliary tract and pancreas. Intraductal papillary neoplasm of the biliary tract (IPNB) share common histologic and phenotypic features such as pancreatobiliary, gastric, intestinal and oncocytic types, and biological behavior with the pancreatic counterpart, the intraductal papillary mucinous neoplasm of the pancreas (IPMN). All these neoplastic lesions exhibit similar immunohistochemical phenotypes, suggesting a common carcinogenic process. Indeed, CCA and PDAC display similar clinic-pathological features as growth pattern, poor response to conventional chemotherapy and radiotherapy and, as a consequence, an unfavorable prognosis. The objective of this review is to discuss similarities and differences between the neoplastic lesions of the pancreas and biliary tract with potential implications on a common origin from similar stem/progenitor cells

    Preliminary Computational Framework to Map MRI-Derived Markers to predict Response to Cardiac Resynchronization Therapy

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    Prediction of the response to cardiac resynchronization therapy (CRT) is still uncertain. On our previous CRT clinical research, we have found that a decrease in the ratio between the two principal axes of the 3D trajectory of the electrode at the pacing site (S1/S2) recorded before and after pacing could define a marker between responders and non-responders to CRT. The aim of this work is to design a framework to map the S1/S2 marker on the 3D ventricular anatomy as a preliminary test to verify if the concept of the S1/S2 may predict the response to CRT in a pre-implant scenario. Based on MR images of a CRT candidate, the 3D mesh of the left ventricle geometry is constructed. Using image registration we are able to track the deformation of the mesh throughout the cardiac cycle and to compute the trajectory of each point of the mesh. Then the S1/S2 is calculated for every trajectory and mapped on a 3D geometry representation. We have applied this framework to one CRT patient, highlighting that in the area in which the electrode was placed the S1/S2 was low. This value suggests a poor possibility of a pacing-induced decrease for the S1/S2 ratio after implant. Consistently the patient was classified as non-responder at the clinical follow-up. Ongoing work focuses on the clinical validation of S1/S2 as a tool for the prediction of CRT response and the acquisition of MR data of potential candidates to CRT for the assessment of the presented framework

    Outcomes analysis of new entrant screening for active tuberculosis in Heathrow and Gatwick airports, United Kingdom 2009/2010

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    BACKGROUND: In 2012, the United Kingdom (UK) Government announced that the new entrant screening for active tuberculosis (TB) in Heathrow and Gatwick airports would end. Our study objective was to estimate screening yield and diagnostic accuracy, and identify those at risk of active TB after entry. METHODS: We designed a retrospective cohort study and linked new entrants screened from June 2009 to September 2010 through probabilistic matching with UK Enhanced TB Surveillance (ETS) data (June 2009 to December 2010). Yield was the proportion of cases reported to ETS within three months of airport screening in the screened population. To estimate screening diagnostic accuracy we assessed sensitivity, specificity, positive and negative predictive values. Through Poisson regression we identified groups at increased risk of TB diagnosis after entry. RESULTS: We identified 200,199 screened entrants, of these 59 had suspected TB at screening and were reported within 3¬†months to ETS (yield‚ÄČ=‚ÄČ0.03¬†%). Sensitivity was 26¬†%; specificity was 99.7¬†%; positive predictive value was 13.2¬†%; negative predictive value was 99.9¬†%. Overall, 350 entrants were reported in ETS. Persons from countries with annual TB incidence higher than 150 cases per 100,000 population and refugees and asylum seekers were at increased risk of TB diagnosis after entry (population attributable risk 77 and 3¬†% respectively). CONCLUSION: Airport screening has very low screening yields, sensitivity and positive predictive value. New entrants coming from countries with annual TB incidence higher than 150 per 100,000 population, refugees and asylum seekers should be prioritised at pre- or post-entry screening

    Cambios en los hábitos alimentarios y actividad física durante el aislamiento físico durante el COVID -19: estudio descriptivo sobre una muestra de trabajadores (Uruguay, abril 2020)

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    C. Severi: Departamento de Medicina Preventiva y Social, Facultad de Medicina, Universidad de la Rep√ļblica.-- M. Medina, Facultad de Medicina, Universidad de la Rep√ļblica. Doctoranda de la Universidad de Granada.--Antecedentes: La aparici√≥n en Uruguay del coronavirus, hizo que el gobierno declarara emergencia sanitaria Entre otras medidas sugiri√≥ a la poblaci√≥n evitar en forma voluntaria, la circulaci√≥n fuera de su casa. Esto trajo algunas consecuencias en el cambio de h√°bitos alimentarios y la actividad f√≠sica.Objetivo: Identificar los cambios en el comportamiento respecto a la alimentaci√≥n y la actividad f√≠sica en la emergencia sanitaria, en los trabajadores donde se implement√≥ trabajo a distancia.Metodolog√≠a: Se aplic√≥ una encuesta telef√≥nica sobre una muestra por conveniencia de 170 trabajadores de una empresa sobre sus h√°bitos alimentarios y actividad f√≠sica. Resultados: La tercera parte de los trabajadores (30,6 %) perciben incremento de peso, y cambiaron su comportamiento, casi el 47 % manifiesta que come m√°s o con mayor frecuencia. Respecto al tipo de alimentos la mayor parte refiere que incrementaron alimentos ricos en carbohidratos y ultra procesados. En un porcentaje alto la poblaci√≥n redujo su actividad f√≠sica. En gran parte de los hogares conviven ni√Īos, lo que genera un ambiente obesog√©nico, que incrementa el riego de exceso de peso a corto y mediano plazo. Conclusi√≥n: Existen cambios de comportamiento alimentario y de actividad f√≠sica no saludables y que promueven el riego de enfermedades cr√≥nicas no transmisibles. Se sugiere tomar medidas que acompa√Īen las ya realizadas para contener la transmisi√≥n del coronavirus en la comunidad

    Lactobacillus rhamnosus GG supplementation on eradication rate and dyspepsia in Helicobacter pylori infection treated with three-in-one bismuth quadruple therapy

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    IntroductionHelicobacter pylori (Hp)-related dyspepsia has been related to gastroduodenal dysbiosis. The role of probiotic supplementation in the clinical management of Hp infection has been the object of several studies in terms of improvement of efficacy and tolerability of eradication treatments but data on their effects on the outcomes of post-eradication dyspepsia are lacking. The aim of the present study was to evaluate the influence of Lactobacillus rhamnosus GG (LGG) supplementation on bismuth quadruple therapy (BQT) in the clinical management of Hp-related infection both in terms of efficacy and tolerability and persistence of post-treatment dyspepsia. MethodsA total of 164 (121 women) Hp-positive adult patients were enrolled in this pilot study and assigned to two different treatment regimens: group A received BQT for 10 days (three capsules qid, IPP bid) and group B received BQT for 10 days in combination with 6 x 10(9)CFU LGG (ATCC53103) taken for 24 days (7 days before, 10 days during, and 7 days after therapy). Eradication was assessed after 45 days using the C-13-urea breath test (C-13-UBT). Dyspepsia, distinguished into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS), was assessed at the time of enrollment and 6 months after eradication. ResultsApproximately 98 patients were enrolled in group A and 66 patients in group B. At the enrollment, dyspepsia was present in 76.5% of group A and 86.5% of group B. No significant differences were observed in eradication rate between the 2 groups, both in intention-to-treat (ITT) analysis (82.3 vs. 75.0%) and per-protocol (PP) analysis (95 vs. 96%), and in the presence of side effects during the treatment (70.6 vs. 65.4%). At 6 months after eradication of Hp infection, the persistence of dyspepsia was statistically higher in patients of group A than in group B (38.8 vs. 16.1%; p = 0.032). The positive influence of LGG supplementation in improving post-eradication dyspepsia resulted in statistically more effectiveness in PDS dyspepsia, whose remission was 41.7% in group A and 84% in group B patients (p = 0.011). ConclusionIn conclusion, LGG supplementation during Hp eradication therapy, even if not affecting eradication rates and therapy-related side effects, significantly impacts the remission of dyspepsia

    The obstetric syndromes: Clinical relevance of placental hormones

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    Preterm delivery, preeclampsia and intrauterine growth restriction are the major diseases of pregnancy. A key role in their pathogenesis is played by the placenta, which is the source of hormones and other important regulatory molecules providing the metabolic and endocrine homeostasis of the fetal-placental unit. Since obstetric syndromes are characterized by important maternal and neonatal morbidity and mortality worldwide, numerous efforts have been made over the years to prevent and treat them. Due to their complex pathogenesis, however, the therapy is poor and not very effective. Therefore, great emphasis is currently given to the prevention of these diseases through the identification of biochemical and biophysical markers, among which placental factors play a crucial role. The increasing knowledge of the role of placental molecules can indeed lead to the development of new therapeutic and diagnostic tools. © 2013 Expert Reviews Ltd

    A Computational Framework to Benchmark Basket Catheter Guided Ablation

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    Rotor ablation guided by basket catheter mapping has shown to be beneficial for AF ablation. Yet, the initial excitement was mitigated by a growing skepticism due to the difficulty in verifying the protocol in multicenter studies. Overall, the underlying assumptions of rotor ablation require further verification. The aim of this study was therefore to test such hypotheses by using computational modeling. A detailed 3D left atrial geometry of an AF patient was segmented from a pre-operative MR scan. Atrial activation was simulated on the 3D anatomy using the monodomain approach and a variant of the Courtemanche action potential model. Ablated tissue was assigned zero conductivity. Reentry was successfully initialized by applying a single suitably delayed extra stimulus. Unipolar electrograms were computed at the simulated electrode positions. The final dataset was generated by varying location of reentry and catheter position within the LA. The effect of inter-electrode distance and distance to the atrial wall was studied in relation to the ability to recover rotor trajectory, as computed by a novel algorithm described here. The effect of rotor ablation was also assessed
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