RESUMEN
The aim of this study was to investigate whether Burkholderia cepacia is capable of survival and growth within the free-living amoeba Acanthamoeba polyphaga using a differential immunofluorescence assay of bacterial-amoebal cocultures and viable counts of bacteria determined after amoebal lysis. The numbers of intra-amoebal bacteria and the numbers of infected amoebae increased over time; although, when heat-killed bacteria were used, no intracellular bacteria were observed. These findings should be taken into account in future studies of environmental reservoirs of Burkholderia cepacia.
Asunto(s)
Acanthamoeba/microbiología , Burkholderia cepacia/crecimiento & desarrollo , Acanthamoeba/crecimiento & desarrollo , Animales , Recuento de Colonia Microbiana , Medios de Cultivo , Técnica del Anticuerpo Fluorescente , HumanosRESUMEN
We used the fully automated medical record system at Kaiser Permanente of Ohio to direct appropriate interventions to diabetic patients at risk for amputation. The computer identified all patients with a diagnosis of diabetes, reminded physicians, at the moment of care, of the need to enter the patient's risk status for amputation, and kept track of patients at medium or high risk for amputation who were due for an evaluation with education in the podiatry department. Two years and four months after activation of this reminder system, the risk level had been determined for 76% of the diabetic population (n = 10,000), and two thirds of those at medium or high risk had received the appropriate intervention. In patients in the medium and high risk groups, the risk ratio for amputation was 17.5.
Asunto(s)
Amputación Quirúrgica , Angiopatías Diabéticas/diagnóstico , Pie Diabético/diagnóstico , Diagnóstico por Computador , Sistemas de Registros Médicos Computarizados , Sistemas Recordatorios , Programas Informáticos , Angiopatías Diabéticas/prevención & control , Pie Diabético/prevención & control , Humanos , Ohio , Medición de RiesgoRESUMEN
In Staphylococcus epidermidis and Staphylococcus aureus, a number of cell wall- and cytoplasmic membrane-associated lipoproteins are induced in response to iron starvation. To gain insights into the molecular basis of iron-dependent gene regulation in the staphylococci, we sequenced the DNA upstream of the 3-kb S. epidermidis sitABC operon, which Northern blot analysis indicates is transcriptionally regulated by the growth medium iron content. We identified two DNA sequences which are homologous to elements of the Corynebacterium diphtheriae DtxR regulon, which controls, in response to iron stress, for example, production of diphtheria toxin, siderophore, and a heme oxygenase. Upstream of the sitABC operon and divergently transcribed lies a 645-bp open reading frame (ORF), which codes for a polypeptide of approximately 25 kDa with homology to the DtxR family of metal-dependent repressor proteins. This ORF has been designated SirR (staphylococcal iron regulator repressor). Within the sitABC promoter/operator region, we also located a region of dyad symmetry overlapping the transcriptional start of sitABC which shows high homology to the DtxR operator consensus sequence, suggesting that this region, termed the Sir box, is the SirR-binding site. The SirR protein was overexpressed, purified, and used in DNA mobility shift assays; SirR retarded the migration of a synthetic oligonucleotide based on the Sir box in a metal (Fe2+ or Mn2+)-dependent manner, providing confirmatory evidence that this motif is the SirR-binding site. Furthermore, Southern blot analysis of staphylococcal chromosomal DNA with the synthetic Sir box as a probe confirmed that there are at least five Sir boxes in the S. epidermidis genome and at least three in the genome of S. aureus, suggesting that SirR controls the expression of multiple target genes. Using a monospecific polyclonal antibody raised against SirR to probe Western blots of whole-cell lysates of S. aureus, S. carnosus, S. epidermidis, S. hominis, S. cohnii, S. lugdunensis, and S. haemolyticus, we identified an approximately 25-kDa cross-reactive protein in each of the staphylococcal species examined. Taken together, these data suggest that SirR functions as a divalent metal cation-dependent transcriptional repressor which is widespread among the staphylococci.
Asunto(s)
Proteínas Bacterianas/genética , Hierro/metabolismo , Proteínas Represoras/genética , Staphylococcus epidermidis/genética , Secuencia de Aminoácidos , Proteínas Bacterianas/metabolismo , Secuencia de Bases , Cationes Bivalentes , Cobalto , ADN Bacteriano , Electroforesis en Gel de Poliacrilamida , Manganeso , Datos de Secuencia Molecular , Níquel , Regiones Operadoras Genéticas , Proteínas Represoras/metabolismo , Homología de Secuencia de Aminoácido , Staphylococcus epidermidis/metabolismoRESUMEN
Plantar fibromas are a disease entity that are encountered by all foot surgeons. When a tentative diagnosis is made, aggressive surgical resection of the mass and the plantar fascia is necessary to prevent recurrence. Presented in this paper is a review of the literature and clinical illustrations of recurrent plantar fibromatosis with long-term follow-up.