Poster Session : PS 0605 ; Pulmonology ; How Far Can We Go without Empiric Treatment?

( Lise Brosseron ),( Sara Almeida Pinto ),( Jose Ribeiro Almeida ),( Tiago Pereira ),( Judite Quintas ),( Vitor Paixao Dias ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Tuberculosis is a known cause of fever of unknown origin. Nowadays most authors consider mycobacterium tuberculosis isolation essential prior to treatment. Case Report: A 63 year-old women was admitted to our department with vespertine fever, night sweats, anorexia and weight loss in the past 4 months. She had a history of childhood pulmonary tuberculosis, with sequelar bronchiectasis. Besides paleness and low BMI no other relevant physical fi ndings were observed. Laboratory evaluation revealed anemia and elevation of CRP and ESR. Thorax-CT showed bronchiectasis on the upper and inferior right lobe. Bronchoalveolar lavage cultures were negative to bacteria, mycobacteria and fungus as well as M.tuberculosis complex DNA. Despite multiple antibiotic courses she maintained intermittent pyrexia. After excluding most relevant causes of fever of unknown origin, a PET scan confi rmed exclusive involvement of the right superior pulmonary lobe. In the second bronchofi broscopy signifi cant bronchial hemorrhage was visible, so catheter embolization of the right bronchial artery was performed. An arterio-arterial subclavian-pulmonary fi stula was detected. Two days later multiple infra and supratentorial intracerebral hemorrhages were diagnosed. In the following week she had two ischemic strokes affecting the right and left middle cerebral artery territory. Transcranial Doppler showed moderate right-to-left shunt. All those events were suggestive of embolic etiology. Despite all negative cultural and DNA results, attending to typical manifestations, exclusion of other foci and to this rapid deterioration, empiric treatment was started with isoniazid, rifampin, ethambutol and pyrazinamide. One month after treatment initiation, persistent apyrexia was obtained with normalization of all infi ammatory parameters. In the last 3 months good evolution of pulmonary lesions and signifi cant improvement of her neurologic state were observed. Conclusions: We present a bizarre case of tuberculosis with catastrophic consequences, which demonstrates that empiric treatment still has its place in modern medicine.

Kinetic and Energetic Parameters of Carob Wastes Fermentation by Saccharomyces cerevisiae: Crabtree Effect, Ethanol Toxicity, and Invertase Repression

Rodrigues, B.,Peinado, J.M.,Raposo, S.,Constantino, A.,Quintas, C.,Lima-Costa, M.E. The Korean Society for Microbiology and Biotechnol 2015 Journal of microbiology and biotechnology Vol.25 No.6

Carob waste is a useful raw material for the second-generation ethanol because 50% of its dry weight is sucrose, glucose, and fructose. To optimize the process, we have studied the influence of the initial concentration of sugars on the fermentation performance of Saccharomyces cerevisiae. With initial sugar concentrations (S₀ ) of 20 g/l, the yeasts were derepressed and the ethanol produced during the exponential phase was consumed in a diauxic phase. The rate of ethanol consumption decreased with increasing S₀ and disappeared at 250 g/l when the Crabtree effect was complete and almost all the sugar consumed was transformed into ethanol with a yield factor of 0.42 g/g. Sucrose hydrolysis was delayed at high S₀ because of glucose repression of invertase synthesis, which was triggered at concentrations above 40 g/l. At S₀ higher than 250 g/l, even when glucose had been exhausted, sucrose was hydrolyzed very slowly, probably due to an inhibition at this low water activity. Although with lower metabolic rates and longer times of fermentation, 250 g/l is considered the optimal initial concentration because it avoids the diauxic consumption of ethanol and maintains enough invertase activity to consume all the sucrose, and also avoids the inhibitions due to lower water activities at higher S₀ .

Transcriptional profile of processing machinery of 30 end of mRNA in Trichomonas vaginalis

Miguel A ´ ngel Del-Moral-Stevenel,Alma Villalobos-Osnaya,Mavil Lo´pez-Casamichana,Laura Itzel Quintas-Granados,Ce´sar Lo´pez-Camarillo,Jose´ Manuel Ferna´ndez Sa´nchez,Selene Zarate-Guerra,Marı´a Eli 한국유전학회 2015 Genes & Genomics Vol.37 No.4

Trichomonas vaginalis is the causative agent of trichomonosis, a sexually transmitted disease (STD) that affects over 180 million people worldwide. This parasite is capable to infect the urogenital tract of women and men, both microenvironments might affect the expression of key genes that may be involved in the parasite pathogenesis. The processing of 30 end of mRNA promotes mRNA stability in many eukaryotes, however in T. vaginalis this molecular machinery is under research. By means of an in silico analysis we identified putative proteins of the 30 end mRNA processing machinery of T. vaginalis, and by RTPCR assays we evaluated the expression of eight of these genes in a female and male T. vaginalis isolates. According to the in silico analysis, the T. vaginalis 30 end mRNA processing machinery, comprises a similar complex and protein factors that those described in Homo sapiens, Arabidopsis thaliana, Saccharomyces cerevisiae and Entamoeba histolytica. The complex contains several subcomplexes, including cleavage and polyadenylation specificity factor (CPSF), cleavage stimulation factor (CstF), cleavage factor I (CFIm) and cleavage factor II (CFIIm). We demonstrated that genes tvpsf2p, tvcfi25, tvcpsf160, tvcpsf73, tvfip1, tvpap1, tvpc4 and tvpabp are expressed in male or female T. vaginalis isolates. Besides we identify two different isoforms of TvPC4. T. vaginalis genome contains most of genes encoding for 30 end mRNA processing, which may be transcriptionally active and could be involved in the capping, splicing, cleavage and polyadenylation of mRNAs in this parasite. Further studies are necessary to elucidate the biological meaning of our findings.

Prospective study analyzing risk factors and characteristics of healthcare-associated infections in a Urology ward

José Medina-Polo,Raquel Sopeña-Sutil,Raúl Benítez-Sala,Alba Lara-Isla,Manuel Alonso-Isa,Javier Gil-Moradillo,Juan Justo-Quintas,Esther García-Rojo,Daniel Antonio González-Padilla,Juan Bautista Passas- 대한비뇨의학회 2017 Investigative and Clinical Urology Vol.58 No.1

Purpose: Healthcare-associated infections (HAIs) in urological patients have special features due to specific risk factors. Our objective was to evaluate the characteristics and risk factors for HAIs in patients hospitalized in a Urology ward. Materials and Methods: We evaluated prospectively, from 2012 to 2015, the incidence, types and risk factor for HAIs, microbiological and resistance patterns. Results: The incidence of HAIs was 6.3%. The most common types were urinary infections (70.5%) and surgical site infections (22.1%). Univariate analysis showed an increased risk of HAIs among patients with American Society of Anesthesiologists physical status classification system III–IV (odds ratio [OR], 1.39; p<0.001), immunosuppression (OR, 1.80; p=0.013), previous urinary infection (OR, 4.46; p<0,001), and urinary catheter before admission (OR, 1.74; p<0.001). The surgical procedures with the highest incidence of HAIs were radical cystectomy (54.2%) and renal surgery (8.7%). The most frequently isolated microorganisms were Escherichia coli (25.1%), Enterococcus spp. (17.5%), Klebsiella spp. (13.5%) and Pseudomonas aeruginosa (12.3%). Enterococcus sp was the most common microorganism after radical cystectomy and in surgical site infections, E. coli showed resistance rates of 53.5% for fluoroquinolones, 9.3% for amikacin. The percentage of extended-spectrum betalactamase producing E. coli was 24.7%. Klebsiella spp. showed resistance rates of 47.8% for fluoroquinolones, 7.1% for amikacin and 4.3% for carbapenems. Enterococcus spp showed resistance rates of 1.7% for vancomycin and; P. aeruginosa of 33.3% for carbapenems and 26.2% for amikacin. Conclusions: Comorbidities, previous urinary infections, and urinary catheter are risk factors for HAIs. The microorganisms most commonly isolated were E. coli, Enterococcus and P. aeruginosa. Prospective monitoring may decrease the incidence of infections.

A Food Supplement of Hydrolyzed Collagen Improves Compositional and Biodynamic Characteristics of Vertebrae in Ovariectomized Rats

Elisa de Almeida Jackix,Floreˆncia Cu´neo,Jaime Amaya-Farfan,Juvenal Vieira de Assunc¸ao,Kesia Diego Quintaes 한국식품영양과학회 2010 Journal of medicinal food Vol.13 No.6

Collagen hydrolysates (CHs) are mixtures of peptides obtained by partial hydrolysis of gelatins that are receiving scientific attention as potential oral supplements for the recovery of osteoarticular tissues. The effect of supplementing the diets with a CH was assessed in 48 ovariectomized rats by analyzing the compositional and biomechanical characteristics of the bone. Six groups of rats (three ovariectomized, one sham-operated, and two intact) were fed a standard diet, supplemented with either CH or gelatin (Control), at two levels: a dose equivalent to five times the amount suggested for humans (10g/day) or another 10 times greater. After 8 weeks, the femora and vertebrae were excised, the blood was collected, and serum alkaline phosphatase and osteocalcin were determined. Bone weight, total protein, and biomechanical strength were also determined. The vertebrae of the ovariectomized group that received the higher dosage of CH withstood a load four times greater and exhibited higher levels of protein and osteocalcin content than those receiving either gelatin or no supplement. CH supplementation at the higher level in the ovariectomized rat had an unequivocal contribution in the conservation or preservation of vertebral mass, protein content, and mechanical strength not seen when gelatin was used as a supplement. Similar treatment of the intact rat with the CH, however, appeared to have the opposite effect.