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We report a case of human Dirofilaria repens infection in a woman in Slovenia who had concomitant pleural and subcutaneous manifestations of the infection. This case report illustrates the clinical course of a severe symptomatic parasitic infection that had multisystemic manifestations.

The NLRP3 inflammasome is cytosolic multi-protein complex that induces inflammation and pyroptotic cell death in response to both pathogen (PAMPs) and endogenous activators (DAMPs). Recognition of PAMPs or DAMPs leads to formation of the inflammasome complex, which results in activation of caspase-1, followed by cleavage and release of pro-inflammatory cytokines. Excessive activation of NLRP3 inflammasome can contribute to development of inflammatory diseases and cancer. Autophagy is vital intracellular process for recycling and removal of damaged proteins and organelles, as well as destruction of intracellular pathogens. Cytosolic components are sequestered in a double-membrane vesicle-autophagosome, which then fuses with lysosome resulting in degradation of the cargo. The autophagy dysfunction can lead to diseases with hyperinflammation and excessive activation of NLRP3 inflammasome and thus acts as a major regulator of inflammasomes. Autophagic removal of NLRP3 inflammasome activators, such as intracellular DAMPs, NLRP3 inflammasome components, and cytokines can reduce inflammasome activation and inflammatory response. Likewise, inflammasome signaling pathways can regulate autophagic process necessary for balance between required host defense inflammatory response and prevention of excessive and detrimental inflammation. Autophagy has a protective role in some inflammatory diseases associated with NLRP3 inflammasome, including gouty arthritis, familial Mediterranean fever (FMF), and sepsis. Understanding the interregulation between these two essential biological processes is necessary to comprehend the biological mechanisms and designing possible treatments for multiple inflammatory diseases.

Clathrin-mediated endocytosis (CME) engages over 30 proteins to secure efficient cargo and membrane uptake. While the function of most core CME components is well established, auxiliary mechanisms crucial for fine-tuning and adaptation remain largely elusive. In this study, we identify ArhGEF37, a currently uncharacterized protein, as a constituent of CME. Structure prediction together with quantitative cellular and biochemical studies present a unique BAR domain and PI(4,5)P2-dependent protein–membrane interactions. Functional characterization yields accumulation of ArhGEF37 at dynamin 2-rich late endocytic sites and increased endocytosis rates in the presence of ArhGEF37. Together, these results introduce ArhGEF37 as a regulatory protein involved in endocytosis., Summary: Accumulation of ArhGEF37 at dynamin 2-rich late endocytic sites yields increased rates of endocytosis.

Antibiotics have always appeared miraculous, saving innumerable lives. However, the unwise use of antimicrobial drugs has led to the appearance of resistant bacteria. The purpose of this study was to evaluate antimicrobial resistance in Escherichia coli (n =160) isolated from food of animal origin. The focus was on E. coli -producing extended-spectrum β-lactamases. E. coli was chosen because it is a part of the normal microbiota in mammals and can enter the food chain during slaughtering and food manipulation. Subsequently, its resistance genes can be transferred to pathogenic bacteria and human microbiota. Phenotypic and genotypic analyses of selected antimicrobial resistances were carried out together with a molecular analysis of virulence genes. E. coli isolates from food of animal origin were compared with clinical E. coli strains isolated from the human intestinal tract. Extended-spectrum β-lactamase-producing E. coli isolates were found in 9.4% of food isolates and in 1.8% of intestinal isolates. Phylogenetically, the majority of food (86.3%) and intestinal E. coli (58.1%) isolates were found to belong to the commensal phylogenetic groups A and B1. The distribution of 4 of 14 analyzed virulence factors was similar in the food and intestinal isolates. Strains isolated from food in Slovenia harbored resistance genes and virulence factors, which can constitute a problem for food safety if not handled properly.

In antibiotic residue analyses the first step of screening is just as important as the following steps. Screening methods need to be quick and inexpensive, but above all sensitive enough to detect the antibiotic residue at or below the maximum residue limit (MRL). In the case of a positive result, the next step is conducted and further methods are used for confirmation. MRLs stated in European Union Regulation 37/2010 for tetracyclines in raw milk are: 100 µg kg(-1) for tetracycline, 100 µg kg(-1) for oxytetracycline, 100 µg kg(-1) for chlortetracycline and no limit for doxycycline because it is prohibited for use in animals from which milk is produced for human consumption. The current five-plate microbiological screening method for the detection of antibiotic residues in raw milk was found to be simple and inexpensive, but not specific, sensitive and reliable enough to detect tetracycline at MRL in routine raw milk screening procedures. Spiking samples with tetracycline at the MRL level and applying them on Bacillus cereus ATCC 11778 microbiological plates often gave false-negative results, indicating that tetracyclines may have to be inactivated or masked. Tetracyclines seem to bind to a certain component in milk. Consequently, when applying samples to the B. cereus microbiological plate the antibiotic cannot inhibit the growth of B. cereus which disables the formation of inhibition zones on the test plate. After adding the appropriate amount of citric acid into the milk samples, we solved the problem of false-negative results. During the validation 79 samples of milk were spiked with tetracyclines at different concentrations: 100 µg kg(-1) for tetracycline, 100 µg kg(-1) for oxytetracycline, 80 µg kg(-1) for chlortetracycline and 30 µg kg(-1) for doxycycline. Concentrations used in the validation matched the requirements for MRLs (they were either at or below the MRLs) stated in European Union Regulation 37/2010. The sensitivity of the validation was 100%.

To study the adipokines concentration and glucose homoeostasis in the early-second trimester of women who will develop gestational diabetes mellitus (GDM).Maternal plasma and fetal amniotic fluid samples were prospectively collected between 2006 and 2007 at the time of mid-trimester amniocentesis. Eight patients found to be affected by GDM were compared with 10 control patients with a normal pregnancy course. Adipokines leptin and adiponectin, as well as insulin and glucose concentration both in amniotic fluid and maternal plasma were compared between cases and controls. HOMA-IR (homeostatic model assessment for insulin resistance) was also calculated both for amniotic fluid and maternal serum.The amniotic fluid adiponectin concentration was higher in women who would develop GDM than in controls (29.9 ng/ml, 95% CI 26.7-49.8 ng/ml, versus 14.9 ng/ml, 95% CI 13.5-18.8 ng/ml), p 0.05). No difference was shown for leptin both in amniotic fluid and maternal serum. Insulin concentrations in the amniotic fluid were found to be lower in GDM than in controls, while HOMA-IR-index resulted lower in amniotic fluid and higher maternal serum (p 0.05).Our data suggests that an earlier alteration in the fetal glucose metabolism will precede the glucose dysmetabolism in pregnancies later complicated by GDM.

Due to the environmental influences on health, the goal of this study was to describe and compare the built environment in 3 socially contrasting neighbourhoods of Buenos Aires city.In 2011 a cross-sectional study was conducted in 3 socially contrasting neighbourhoods of Buenos Aires city: Recoleta (upper class), Almagro (middle class) and Constitución (lower class). Grocery stores and food stands were surveyed as well as all suitable spaces to perform physical activity. An analysis was conducted to assess the density of every food outlet per Km2 of each neighbourhood's area and per 10000 inhabitants. 2778 food stores and 149 outdoor physical activity facilities were surveyed. A higher density was observed in Constitución for fast food restaurants (Recoleta 3.6; Almagro 2.4; Constitución 6.7) and food stands (Recoleta 4.2; Almagro 1.2; Constitución 25.7) and a lower density for outdoor physical activity facilities. Population density and area density proved to be analogous. Statistically relevant differences were observed regarding the dimension of each food outlet: grocery stores, fruit stands, pubs, restaurants and food stands, as well as in the number of food stores and outdoor physical activity facilities. The information gathered in this study could be highly useful for public health policies on healthy lifestyles, and could eventually redefine the built environment in order to improve the city's equality regarding outdoor physical activity facilities and food stores.Debido a que el ambiente influye sobre la salud de la población, nuestro objetivo fue describir y comparar el ambiente construido (alimentario y de actividad física) en tres barrios representativos de diferente nivel socioeconómico (NSE) de la Ciudad Autónoma de Buenos Aires (CABA). Se realizó un estudio de corte transversal durante 2011 en tres barrios de la CABA representantes de diferente NSE: Recoleta (alto), Almagro (medio) y Constitución (bajo). Se relevaron todos los locales estables y puestos ambulantes de venta de alimentos (LA) y los espacios destinados a la realización de actividad física (AF). Se estimaron las densidades de cada tipo de local por Km2 de superficie del barrio y por cada 10.000 habitantes.Se relevaron 2778 LA y 149 AF. Se observó una mayor densidad en el barrio de Constitución para locales de comidas rápidas (Recoleta 3.6; Almagro 2.4; Constitución 6.7) y Puestos ambulantes (Recoleta 4.2; Almagro 1.2; Constitución 25.7) y menor en AF. Las densidades por habitantes fueron concordantes con las densidades por superficie. Se observaron diferencias estadísticamente significativas en las proporciones de despensas, kioscos, verdulerías, bares, restaurantes, puestos ambulantes y en las cantidades totales de LA y AF.La información generada en este estudio podría ser muy útil en la gestión de salud pública para promoción de estilo de vida saludable modificando el ambiente construido para mejorar la equidad en la CABA.

Retinol (ROH) is an essential micronutrient required for normal fetal development and an essential molecule for antioxidant processes. To investigate the putative role of ROH as a marker of preeclampsia in early second trimester amniotic fluid (AF). Case–control study comparing the concentration of ROH and other antioxidants such as uric acid, vitamin E and malondialdehyde (MDA) in second trimester AF in patients that later developed preeclampsia with normal pregnancies. The concentration of ROH in amniotic fluids of women that later developed preeclampsia was significantly higher than those of uncomplicated pregnancies (66.72 µg/l (49.00–70.56) vs. 44.4 µg/l (31.9–51.17), p

The purpose of this study was to investigate radiation doses in cerebral perfusion computed tomography (CT) examination. As a part of routine patient monitoring, data were collected on patients in terms of the skin dose and CT dose index (CTDIvol) and dose-length product (DLP) values. For the estimation of the dose to the lens a phantom study was performed. Dose values for skin and lens were below the threshold for deterministic effects. The results were also compared with already published data. For better comparison, the effective dose was also estimated. The values collected on patients were in the ranges 230-680 mGy for CTDI and 2120-2740 mGy cm for DLP, while the skin dose and estimated effective dose were 340-800 mGy and 4.9-6.3 mSv, respectively. These values measured in the phantom study were similar, while the doses estimated to the lens were 53 and 51 mGy for the right and left lens, respectively.

Background A combined protocol of voxel-based morphometry (VBM) and diffusion-weighted imaging (DWI) was applied to investigate the neurodevelopment of gray and white matter in autism. Methods Twenty children with autism (mean age = 7 ± 2.75 years old; age range: 4–14; 2 girls) and 22 matched normally developing children (mean age = 7.68 ± 2.03 years old; age range: 4–11; 2 girls) underwent magnetic resonance imaging (MRI). VBM was employed by applying the Template-o-Matic toolbox (TOM), a new approach which constructs the age-matched customized template for tissue segmentation. Also, the apparent diffusion coefficients (ADC) of water molecules were obtained from the analysis of DWI. Regions of interests (ROIs), standardized at 5 pixels, were placed in cortical lobes and corpus callosum on the non-diffusion weighted echo-planar images ( b = 0) and were then automatically transferred to the corresponding maps to obtain the ADC values. Results Compared to normal children, individuals with autism had significantly: (1) increased white matter volumes in the right inferior frontal gyrus, the right fusiform gyrus, the left precentral and supplementary motor area and the left hippocampus, (2) increased gray matter volumes in the inferior temporal gyri bilaterally, the right inferior parietal cortex, the right superior occipital lobe and the left superior parietal lobule, and (3) decreased gray matter volumes in the right inferior frontal gyrus and the left supplementary motor area. Abnormally increased ADC values in the bilateral frontal cortex and in the left side of the genu of the corpus callosum were also reported in autism. Finally, age correlated negatively with lobar and callosal ADC measurements in individuals with autism, but not in children with normal development. Conclusions These findings suggest cerebral dysconnectivity in the early phases of autism coupled with an altered white matter maturation trajectory during childhood potentially taking place in the frontal and parietal lobes, which may represent a neurodevelopmental marker of the disorder, possibly accounting for the cognitive and social deficits.

The acronym FLAIR refers to fluid attenuation inversion recovery sequences, which are T2-weighted MR pulse sequences with liquor signal saturation by a long TI. They are characterized by long TR and TE and therefore the acquisition time is very long in the conventional mode, while fast imaging (the Turbo mode) reduces acquisition time to less than 2 minutes. Our study was aimed at codifying the use of this type of sequence in neuroradiologic studies. All the exams were performed with an MR unit with a 1-Tesla magnetic field. We carried out 150 neuroradiologic exams with this pulse sequence on patients with cerebral, medullary or orbital conditions. This technique is very useful to study periventricular or cortical lesions in multiple sclerosis and in other multifocal cerebral conditions (e.g., multiple metastases or lacunar infarcts), but we pointed out the following other advantages: better definition of the extent of infiltrative white matter lesions (i.e., gliomatosis cerebri and lymphomas), better differentiation of cystic from necrotic cavities and exact characterization of cortical damage in cerebral ischemic lesions (useful also for the differential diagnosis). Moreover, FLAIR pulse sequences could diagnose some globe conditions, such as amelanotic uveal melanomas and malformations with no need of contrast agent administration. In contrast, they were useless to study deep ischemic areas, solid neoplasms, hemorrhagic lesions, poroencephalic areas, intrinsic medullary lesions and intra-orbital and extra-ocular conditions. In conclusion, the FLAIR technique is a major diagnostic tool in neuroradiologic MR studies because they overcome such limitations of Turbo SE PD sequences as blurring artifacts; moreover, their acquisition time is always very short. In some cases, FLAIR images are decisive for the diagnosis.

In the last few years, new magnetic resonance (MR) pulse sequences called Fast or Turbo Spin Echo (TSE) sequences have become available. This kind of T2-weighted images is particularly useful for the study of spondylosis and degenerative spinal conditions, because it both reduces involuntary motion artifacts and its acquisition time is shorter than that of conventional SE T2-weighted images. Our study was aimed at assessing the diagnostic gain of this new type of pulse sequences in intrinsic spinal cord conditions. Therefore, we acquired TSE and conventional SE sequences, consequently, in 36 patients with intrinsic spinal cord conditions, which were apparent on T2-weighted images, and then compared the sensitivity, contrast resolution, and depiction of lesion margins and extent in both acquisition techniques. The results of our study follow: even though all lesions were identified with both techniques, contrast resolution was higher with TSE than with conventional SE images. Lesion margins and extent were substantially equally depicted with both techniques. Finally, TSE sequences had the same, and sometimes even higher, diagnostic yield than conventional SE sequences: therefore, TSE can be considered the sequence of choice in the study of intrinsic spinal cord conditions.

The authors report the cases of two patients with CT-documented paramedian mesencephalo-thalamic infarcts, showing language disturbances. The first patient showed a non fluent, transcortical motor-like aphasia, the other had a fluent but severely paraphasic language disorder. The CT study disclosed that it was the dorso-median thalamic nucleus that was mostly involved in both cases. These findings agree with a few previous pathological studies suggesting that the paramedian thalamic nuclei, particularly the dorso-median nucleus may play some role in language disturbances. However the anatomical basis for thalamic aphasia remains speculative, taking into account the importance of cortical connections in the origin of subcortical neuropsychological disturbances.

Parkinson’s disease (PD) is treated by medication, less with deep brain stimulation and physiotherapy. Different opinions on the clinical meaningfulness of the physiotherapy or recommended intensive physiotherapy were found. Our objectives were to design intensive target-based physiotherapy for upper extremities suitable for telerehabilitation services and examine the clinical meaningfulness of the exergaming at an unchanged medication plan. A telerehabilitation exergaming system using the Kinect sensor was developed; 28 patients with PD participated in the study. The system followed the participants’ movements and adapted the difficulty level of the game in real time. The outcomes of the study showed that seven out of 26 participants could set up the equipment at home alone. Clinical outcomes of Box and Blocks Test (mean: 47 vs. 52, P=0.002, Cohen’s d=0.40), UPDRS III (mean: 27 vs. 29, P=0.001, d=0.22), and daily activity Jebsen’s test; writing a letter (mean: 24.0 vs. 20.6, P=0.003, d=0.23); and moving light objects (mean: 4.4 vs. 3.9, P=0.006, d=0.46) were statistically significant (P

Intravenously administered iodinated contrast media have been demonstrated, since early experience with computed tomography of the brain, to improve clinical value of the procedure for detecting intracranial lesions. There is no universal agreement about the amount and the method of administration of the contrast medium. Many authors maintain that the use of large doses gives better results for the diagnosis of tumors and metastases. The purpose of this paper is to evaluate the tolerance of iopamidol administered by rapid intravenous infusion in a large number of patients undergoing contrast enhanced computed tomography to detect brain metastases. The authors examined 969 consecutive adult patients suffering from lung cancer, brain metastases have been detected in 17% of cases. Adverse reactions to contrast media occurred in 3 patients. Non ionic contrast media are recommended in this diagnostic procedure.

The authors expose their experience in neuroradiological applications of dynamic-CT (D-CT) or angio-CT. The examinations are performed by means of a G.E. 8.800 CT/T. A special software offers automatic analysis of the region of interest. Vascular and tumoral patients are examined trying to evaluate: (a) the blood flow in patients suffering from transient ischaemic attacks and (b) to estimate the possibilities of D-CT in the evaluation of tumoral vascularity and in the identification of characteristic curves for different kinds of tumors.

Results of a clinical trial in CT myelocisternography performed with a new reduced concentration of iopamidol (150 mg I/ml) are reported. This compound is characterized by very low osmolality and osmotic pressure close to those of blood and CSF. Thirty patients were examined. Before, during and after the procedure pulse rate and blood pressure were recorded, EEG was taken and neurologic examination performed. After the examination no alteration in these parameters was recorded. The demonstration of the subarachnoid space and related structures was invariably adequate for diagnosis. In no case was a repeat study using a higher concentration of contrast medium needed. Mild reactions occurred only in three patients (10%). The authors conclude that iopamidol 150, owing to its safety and good imaging capacity, is useful in CT imaging of the subarachnoid space.

The non-ionic water-soluble contrast medium Iopamidol was used for urography in 10 patients and for angiography in 20 patients. In every investigation excellent visualization was obtained and non adverse reaction occurred. Good tolerability to Iopamidol permitted to carry out painless peripheral angiography and translumbar angiography without general anaesthesia.

The biologic cost-effectiveness of computed tomography (CT) versus myelography is so favorable to CT that it is now the method of choice for evaluating patients with less clear-cut clinical findings. CT is now used to detect lesions formerly difficult to diagnose, such as subluxation, arthrosis, facet osteophytes, and stenosis of the vertebral canal, as well as herniated disks and lateral disks. The findings in over 1,000 patients examined by CT for lumbosacral spinal pathology are documented. Associated or multiple abnormalities were present in about 60% of cases, with bulging or herniated disks occurring in 45% and 44%, respectively. Postsurgical arachnoiditis was seen in 43% of 64 patients studied for recurrence of symptoms after surgery.

The authors report their experience in the formulation of an Expert System for computer aided diagnosis in the examination of the lumbar spine with computed tomography. A large number of steps are identified in the process of diagnostic evaluation of CT examinations; about 80 decisional rules are considered and arranged in five 'areas'. The Expert System under study is a first proposal, intended for use by radiologists with some basic training.