No abstract

This clinical study included 219 (Child A/B) consecutive variceal bleeders. Electively 123 had distal splenorenal shunt (DSRS) and 96 had splenectomy with gastroesophageal devascularization (S&GD). Liver pathology was documented in 73% of patients, with schistosomal fibrosis in 41% and nonalcoholic cirrhosis or mixed pattern (fibrosis and cirrhosis) in 59%. The surgical groups were similar before operation, with a mean follow-up of 82 +/- 13 and 78 +/- 18 months, respectively (range, 60 to 120 months). The two pathologic populations were also similar before each and both procedures. The operative mortality rates were low, with incidences of 3.3% (DSRS) and 3.1% (S&GD). Rebleeding occurred significantly (p less than 0.05) more frequently after S&GD (27%) compared to DSRS (5.7%). Sclerotherapy salvaged 65% of S&GD rebleeders. Encephalopathy developed significantly (p less than 0.05) more after DSRS (18.7%) compared to S&GD (7.3%), with no significant difference among the current survivors. The difference in overall rebleeding and encephalopathy rates between both procedures was statistically related to patients with cirrhosis and mixed lesions (p less than 0.05). Distal splenorenal shunt significantly reduced the endoscopic variceal size more than S&GD (p less than 0.05). Prograde portal perfusion was documented in 94% of patients in each group, with a variable distinct pattern of portaprival collaterals in 91% (DSRS) and 65% (S&GD). The total population cumulative survival was similar with 80% for DSRS and 79% for S&GD (plus sclerosis in 23%), with hepatic cell failure the cause of death in 46% and 50%, respectively. However, in the schistosomal patients, survival was better improved after DSRS (90%) compared to S&GD (75%), with no difference among the cirrhotic and mixed group (DSRS 73%, S&GD 72%). In conclusion (1) both DSRS and S&GD have low operative mortality rates, (2) DSRS is superior to S&GD in the schistosomal patients, and (3) S&GD backed by endosclerosis for rebleeding is a good surgical alternative to selective shunt in the nonalcoholic cirrhotic and mixed population.

Cronobacter sakazakii is an emerging foodborne pathogen, which is linked to life-threatening infections causing septicemia, meningitis, and necrotizing enterocolitis. These infections have been epidemiologically connected to ingestion of contaminated reconstituted powder infant formula. Even at low water activity C. sakazakii can survive for a long time; it is capable of protective biofilm formation and occasionally shows high virulence and pathogenicity even following stressful environmental conditions. Hence it is a challenging task for the food industry to control contamination of food ingredients and products through the entire production chain, since an increasing number of severe food-related outbreaks of C. sakazakii infections has been observed. The seemingly great capability of C. sakazakii to survive even strict countermeasures combined with its prevalence in many food ingredients requires a greater in depth understanding of its virulence factors to master the food safety issues related to this organism. In this context, we present the whole genome sequence (WGS) of two different C. sakazakii isolated from skimmed milk powder (C7) and ready-to-eat salad mix (C8), respectively. These are compared to other, already sequenced, C. sakazakii genomes. Sequencing of the fusA allele revealed that both isolates were C. sakazakii . We investigated the molecular characteristics of both isolates relevant for genes associated with pathogenesis and virulence factors, resistance to stressful environmental conditions (e.g., osmotic and heat), survival in desiccation as well as conducted a comparative genomic analysis. By using multi-locus sequence typing (MLST), the genetic type of both isolates is assessed and the number of unique genes is determined. DNA of C. sakazakii C8 is shown to hold a novel and unique sequence type; the number of unique genes identified in the genomic sequence of C. sakazakii C7 and C8 were 109 and 188, respectively. Some of the determined unique genes such as the rhs and VgrG genes are linked to the Type VI Secretion System cluster, which is associated with pathogenicity and virulence factors. Moreover, seven genes encoding for multi-drug resistance were found in both isolates. The finding of a number of genes linked to producing capsules and biofilm are likely related to the observed resistance to desiccation.

The distal splenorenal shunt was performed in 60 patients with schistosomal hepatic fibrosis in whom no evidence of cirrhosis was documented by preoperative needle and operative wedge biopsy. No patients have been lost to follow-up with a median of 37 months (range: 17-86). The results showed low operative mortality (1.7%), high patency rate (92.5%), and low recurrent variceal hemorrhage (6.7%). Thrombosed shunts were treated either by refashioning the shunt (1 patient) or splenectomy and gastric devascularization (2 patients). Initial hyperbilirubinemia and reduction in serum albumin were found in the early postoperative period, with persistent hyperbilirubinemia in 32% of the patients. The 5-year survival was 88%, with liver disease related mortality in only three patients. Clinical encephalopathy was detected in three patients (5.1%); only one of them was incapacitated. These data showed that: selective shunt (distal splenorenal shunt, DSRS) is an effective surgical procedure in the treatment of schistosomal variceal bleeding, shunt thrombosis is rare and can possible be corrected if detected early, schistosomal patients have a better survival and a lower incidence of encephalopathy after DSRS than that reported in cirrhotics, and liver biopsy should be performed for proper assessment of the schistosomal population especially in the geographic areas where the schistosoma parasite and viral hepatitis are endemic.

Novel 4(3H)-quinazolinone derivatives with biologically active moieties were synthesized. Reactions of 2-cyano-N-(6-iodo-2-methyl-4-oxoquinazolin-3(4H)-yl) acetamide with carbon disulfide, isothiocyanates followed by cycloalkylation afforded acrylamide, 1,3-dithiazole, 1,3dithiane, thiazole and pyrazole derivatives. The 2-pyridone derivatives were obtained via reaction of cyanoacetamide with some acetylacetone or arylidenes. Cyclocondensation reaction of cyanoacetamide with o-hydroxy aldehydes furnished chromene derivatives. Screening for some selected compounds was carried for their potential antitumor and antifungal activities. 2-Cyano-N-(6-iodo-2-methyl-4-oxoquinazolin-3(4H)-yl)-2-(4-methyl-3phenyl-thiazol-2(3H)ylidene)-acetamide with 3-side chain incorporated with substituted thiazole moiety was found to be of high to moderate activity towards cells. Also, the latter product showed high activity against Aspergillus ochraceus Wilhelm with inhibition zone (18 mm) compared with (20 mm) Nystatin inhibition zone.

Some foodborne pathogens can cause mastitis, in which the organism is directly excreted into milk. Therefore, we undertook the steps to determine the prevalence and molecular characteristics of Shiga toxin-producing Escherichia coli (STEC) isolates from bovine mastitic milk in Egypt. Forty milk samples from dairy cattle showing mastitis were collected and examined for the presence of E. coli. Following enrichment and plating on selective agar, confirmation of the isolates was based on biochemical tests and the isolates were determined at the species level using cytochrome oxidase, triple sugar iron agar, urea, and indole tests as putatively E. coli. About 77.4% of the isolates belonged to four different O serogroups (O26, O86, O111, and O127). The multiplex polymerase chain reaction (PCR) found that the seven isolates revealed positive amplification of the Eagg gene from the extracted DNA of the E. coli isolates in an incidence of 100%. Also, the selected isolates were subjected to a simple PCR for the detection of 12 of the most important E. coli genes associated with virulence. Those genes detected were stx1, stx2, hylA, Flic(h7), stb, F41, K99, sta, F17, LT-I, LT-II, and eaeA. A total of seven E. coli isolates that were non-O157 isolates were investigated. Among the seven isolates, none was stx positive, and all seven lacked F41, K99, LT-I, LT-II, and Flic(h7). Of these seven isolates, three (42.85%) were enterohemorrhagic E. coli hlyA positive and two (28.57%) were eaeA positive. STEC isolates were not found in bovine mastitic milk in Egypt. Isolates from mastitic milk were potentially pathogenic for human in that they belonged to serogroups associated with diarrhea and hemolytic-uremic syndrome, and some of them were hylA, stb, sta, F17, and eaeA positive.

Novel 5-aminopyrazole and pyrazolo[1,5-a]pyrimidine derivatives have been synthesized from the readily accessible cyanoacetanilide derivative (2).

Meat commonly contain the same Aeromonas spp. which occur in human diarrhoeal and non-diarrhoeal faecal samples. Motile Aeromonas were isolated from 5.6% of total 302 samples. The distribution of the isolates were 5.9 and 5.2% in fresh and frozen samples, respectively. Of the 302 samples taken of the four animal meat species investigated, the genus Aeromonas were isolated in 12.3% of the fresh samples collected from buffalo meat, in 6.5% of the samples collected from sheep meat and 14.0% from the samples collected from the cattle frozen meat samples. The camel meat did not reveal any Aeromonas isolates. Aeromonas hydrophila was isolated as the most prevalent species with 6.8%, followed by Aeromonas caviae with 2.7% and Aeromonas sobria with 2.1% from the total meat samples. Aerolysin toxin gene (aerA) was detected in 3/17 isolates of A. hydrophila isolated from contaminated meat. Infection due to bacterial pathogen with such virulent factor through contact with contaminated meat while handling them, poses health hazards to humans.