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Difficile
Kinds of Difficile Terms modified by Difficile Selected AbstractsStudy of faecal shedding of Clostridium difficile in horses treated with penicillinEQUINE VETERINARY JOURNAL, Issue 2 2004A. Gustafsson No abstract is available for this article. [source] Evaluation of in vitro properties of di-tri-octahedral smectite on clostridial toxins and growthEQUINE VETERINARY JOURNAL, Issue 7 2003J. S. Weese Summary Reasons for performing study: Clostridial colitis and endotoxaemia of intestinal origin are significant causes of morbidity and mortality in horses. Intestinal adsorbents are available for treatment of these conditions; however, little information exists supporting their use. Objectives: To evaluate the ability of di-tri-octahedral smectite to bind to Clostridium difficile toxins A and B, C. perfringens enterotoxin and endotoxin, inhibit clostridial growth and the actions of metronidazole in vitro. Methods: Clostridium difficile toxins, C. perfringens enterotoxin and endotoxin were mixed with serial dilutions of di-tri-octahedral smectite, then tested for the presence of clostridial toxins or endotoxin using commercial tests. Serial dilutions of smectite were tested for the ability to inhibit growth of C. perfringens in culture broth, and to interfere with the effect of metronidazole on growth of C. perfringens in culture broth. Results: Clostridium difficile toxins A and B, and C. perfringens enterotoxin were completely bound at dilutions of 1:2 to 1:16. Partial binding of C. difficile toxins occurred at dilutions up to 1:256 while partial binding of C. perfringens enterotoxin occurred up to a dilution of 1:128. Greater than 99% binding of endotoxin occurred with dilutions 1:2 to 1:32. No inhibition of growth of C. difficile or C. perfringens was present at any dilution, and there was no effect on the action of metronidazole. Conclusions: Di-tri-octahedral smectite possesses the ability to bind C. difficile toxins A and B, C. perfringens enterotoxin and endotoxin in vivo while having no effect on bacterial growth or the action of metronidazole. Potential relevance: In vivo studies are required to determine whether di-tri-octahedral smectite might be a useful adjunctive treatment of clostridial colifis and endotoxaemia in horses. [source] Role of the monomeric GTPase Rho in hematopoietic progenitor cell migration and transplantationEUROPEAN JOURNAL OF IMMUNOLOGY, Issue 1 2006Stephan Göttig Abstract To investigate the role of the monomeric guanosine triphosphatase (GTPase) Rho on migration of hematopoietic progenitor cells (HPC), we employed different clostridial toxins which inhibit the Rho family of GTPases. Pretreatment with C2I-C3, a cell-accessible C3 transferase fusion protein that targets Rho, increased chemokinetic migration of the factor-dependent multipotent cell line Factor Dependent Cell Paterson with mixed lineage differentiation potential (FDCP-mix) and of primary lineage marker-depleted HPC in vitro. In contrast, treatment with lethal toxin (LT) from Clostridium sordellii, which predominantly inactivates Rac, and with toxin,B from C.,difficile, which inactivates Rho, Rac and Cdc42, decreased in vitro migration. When HPC pretreated with LT or toxin,B were transplanted into mice, homing to the bone marrow was impaired, whereas C2I-C3 treatment did not alter HPC homing. However, in a competitive hematopoietic repopulation experiment in C57BL/6 mice, pretreatment of bone marrow cells with any of the inhibitors, including the Rho inhibitor C2I-C3, resulted in suppressed donor-type hematopoiesis. Our data indicate that whereas Rac supports HPC cell cycling, migration, short-term homing and hematopoietic regeneration, Rho coordinates down-regulation of HPC migration and is required for hematopoietic regeneration. [source] Antimicrobial Gallium-Doped Phosphate-Based Glasses,ADVANCED FUNCTIONAL MATERIALS, Issue 5 2008Sabeel P. Valappil Abstract Novel quaternary gallium-doped phosphate-based glasses (1, 3, and 5 mol % Ga2O3) were synthesized using a conventional melt quenching technique. The bactericidal activities of the glasses were tested against both Gram-negative (Escherichia coli and Pseudomonas aeruginosa) and Gram-positive (Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, and Clostridium difficile) bacteria. Results of the solubility and ion release studies showed that these glass systems are unique for controlled delivery of Ga3+. 71Ga NMR measurements showed that the gallium is mostly octahedrally coordinated by oxygen atoms, whilst FTIR spectroscopy provided evidence for the presence of a small proportion of tetrahedral gallium in the samples with the highest gallium content. FTIR and Raman spectra also afford an insight into the correlation between the structure and the observed dissolution behavior via an understanding of the atomic-scale network bonding characteristics. The results confirmed that the net bactericidal effect was due to Ga3+, and a concentration as low as 1 mol % Ga2O3 was sufficient to mount a potent antibacterial effect. The dearth of new antibiotics in development makes Ga3+ a potentially promising new therapeutic agent for pathogenic bacteria including MRSA and C. difficile. [source] Similar geographic variations of mortality and hospitalization associated with IBD and Clostridium difficile colitisINFLAMMATORY BOWEL DISEASES, Issue 3 2010Amnon Sonnenberg MD Abstract Background: Superinfection with Clostridium difficile can aggravate the symptoms of preexisting inflammatory bowel disease (IBD). The study served to assess whether the geographic variation of IBD within the United States might be influenced by C. difficile infection. Methods: Hospitalization data of the Healthcare Cost and Utilization Project (HCUP) from 2001,2006 and mortality data from 1979,2005 of the US were analyzed by individual states. Hospitalization and mortality associated with Crohn's disease (CD), ulcerative colitis (UC), and C. difficile colitis were correlated with each other, using weighted least square linear regression with the population size of individual states as weight. Results: Among the hospitalization rates, there were strong correlations between both types of IBD, as well as each type of IBD with C. difficile colitis. Similarly, among the mortality rates there were strong correlations between both types of IBD, as well as each type of IBD with C. difficile colitis. Lastly, each type of hospitalization rate was also strongly correlated with each type of mortality rate. In general, hospitalization and mortality associated with IBD tended to be frequent in many of the northern states and infrequent in the Southwest and several southern states. Conclusions: The similarity in the geographic distribution of the 3 diseases could indicate the influence of C. difficile colitis in shaping the geographic patterns of IBD. It could also indicate that shared environmental risk factors influence the occurrence of IBD, as well as C. difficile colitis. (Inflamm Bowel Dis 2010) [source] Fulminant small bowel enteritis: A rare complication of Clostridium difficile -associated diseaseINFLAMMATORY BOWEL DISEASES, Issue 6 2009Fergal Fleming MD No abstract is available for this article. [source] On the Way to a Better Future: Belgium as Transit Country for Trafficking and Smuggling of Unaccompanied Minors1INTERNATIONAL MIGRATION, Issue 4 2005Ilse Derluyn ABSTRACT During the last decade, irregular border crossings emerged as a new element in international migratory flows, with smuggling and trafficking networks being an essential part. Many people are compelled to use these networks to realize their dream of a better living, and for many this "promised land" is the United Kingdom (UK). Belgium has important sea connections with the UK, and is, therefore, an important migration transit zone, although many migrants are intercepted on Belgian territory during their tempt to reach the UK. Some are unaccompanied or separated children and adolescents, minors travelling without parent(s) or a legal caregiver. This study aims to gain insight about this population of unaccompanied minors travelling to the UK. We use the situation in Zeebrugge, one of Belgium's main ports, as a case study. We analysed 1,093 data files of unaccompanied minors intercepted in Zeebrugge, and carried out participatory observation at the shipping police station. The intercepted unaccompanied minors are mainly male, between 15 and 18 years of age, and from an Asian or Eastern European country. Of the 899 unique persons found in the data files, 113 were intercepted several times. After the interception, the Aliens Office gives the majority (82.9%) an identity document without a requirement to leave Belgium, while 15.3 per cent must leave Belgium immediately or within five days. In 82.9 per cent of the cases, a child protection officer is contacted to make a decision about the situation. In 67.2 per cent of these cases, no child protection measure is taken, and the minor may leave the police station; in 32 per cent of the cases, the minor is transferred to a centre, mostly crisis reception. Almost all unaccompanied minors are convinced they want to reach the UK to create a better livelihood, join a family member, or escape a difficult political situation. Nevertheless, most travel in difficult circumstances; are scared; and lack essential information about life in the UK, their possibilities in Belgium, what will happen if they are transferred to a centre, and so forth. Most minors also do not want to be transferred to a centre, and many , although not all , disappear again from the centres. This study has several implications concerning the kind of decisions taken by the legal authorities, the necessary physical and psycho-social care and the availability of an interpreter and social worker during the interception, the number of reception places and the care in these centres, and the tasks of the legal guardian. Finally, some limitations of the study are mentioned. VERS UN AVENIR MEILLEUR : LA BELGIQUE COMME PAYS DE TRANSIT POUR LA TRAITE ET L'INTRODUCTION CLANDESTINE DE MINEURS NON ACCOMPAGNÉS Au cours de la dernière décennie, le franchissement irrégulier des frontières est apparu comme un nouvel élément des flux migratoires internationaux, dont les réseaux de traite et d'introduction clandestine sont un aspect essentiel. Beaucoup de gens sont forcés d'utiliser ces réseaux pour réaliser leur rêve d'une vie meilleure et pour beaucoup, cette « terre promise », c'est le Royaume-Uni. La Belgique ayant d'importantes liaisons maritimes avec le Royaume-Uni con-stitue de ce fait une importante zone de transit pour les migrations, bien que de nombreux migrants soient interceptés sur le territoire belge alors qu'ils tentent d'atteindre le Royaume-Uni. Certains d'entre eux sont des enfants et des adoles-cents non accompagnés, séparés, des mineurs qui voyagent sans parent(s), sans personne qui en ait la garde juridique. Cette étude vise à mieux connaître cette population de mineurs non accompagnés voyageant en direction du Royaume-Uni. Nous prenons comme cas concret la situation à Zeebrugge, l'un des principaux ports belges. Nous avons analysé 1 093 fichiers de données concernant des mineurs non accompagnés interceptés à Zeebrugge, et nous sommes livrés à une observation participative au poste de police du port. Les mineurs non accompagnés inter-ceptés sont pour la plupart des garçons âgés de quinze à dix-huit ans originaires d'un pays d'Asie ou d'Europe orientale. Sur les 899 personnes trouvées dans les fichiers, 113 ont été interceptées plusieurs fois. Après l'interception, les Ser-vices de l'immigration donnent à la majorité de ces garçons un document d'identité sans obligation de quitter la Belgique, alors que 15,3 pour cent d'entre eux doivent quitter le pays, soit immédiatement soit dans les cinq jours. Dans 82,9 pour cent des cas, un agent de protection de l'enfance est contacté pour prendre une décision quant à la situation. Dans 67,2 pour cent de ces cas, aucune mesure de protection de l'enfant n'est prise et le mineur peut quitter le poste de police. Dans 32 pour cent des cas, le mineur est transféré dans un centre, un lieu d'accueil pour les situations de crise. Presque tous les mineurs non accompagnés sont convaincus de vouloir se rendre au Royaume-Uni pour y gagner leur vie, retrouver un membre de leur famille ou échapper à une situation politique difficile. Pourtant, la plupart de ces mineurs voyagent dans des circonstances difficiles. Ils ont peur. Ils n'ont pas les informations essentielles sur la vie au Royaume-Uni, sur les possibilités qui existent pour eux en Belgique, sur ce qui se passera s'ils sont transférés dans un centre. Beaucoup , mais pas tous , disparaissent de ces centres. Cette étude a diverses implications concernant le genre de décisions que pren-nent les autorités juridiques, les nécessaires soins physiques et psychosociaux pendant l'interception ainsi que la présence d'un interprète et d'un travailleur social, le nombre de places et les soins dans les centres d'accueil, les tâches de la personne qui a la responsabilité légale du mineur. Enfin, certaines limites de cette étude sont évoquées. CON MIRAS A UN MEJOR FUTURO: BÉLGICA COMO PAÍS DE TRÁNSITO DE LA TRATA Y EL TRÁFICO DE MENORES NO ACOMPAÑADOS Durante la última década, los cruces fronterizos irregulares se han convertido en un nuevo elemento de las corrientes migratorias internacionales, siendo un componente esencial de ellas las redes de tráfico y trata de personas. Son muchas las personas que se ven obligadas a recurrir a estas redes para hacer realidad su sueño de una vida mejor y para muchos "la tierra prometida" es el Reino Unido. Bélgica tiene importantes conexiones marítimas con el Reino Unido y, por consi-guiente, es una zona de tránsito de la migración sumamente importante, aunque muchos migrantes son interceptados en territorio belga en su intento por llegar al Reino Unido. Entre las personas interceptadas se encuentran niños y adoles-centes, menores de edad que viajan solos, sin sus padres o tutor legal. Este estudio tiene por objeto comprender cómo esta población de menores no acom-pañados viaja al Reino Unido. Con ese fin, se recurre a un estudio por casos examinando la situación en Zeebrugge, uno de los principales puertos de Bélgica. Se han analizado 1.093 expedientes de menores no acompañados, interceptados en Zeebrugge, y se ha realizado una observación participativa en la estación de policía naval. Los menores no acompañados interceptados eran principalmente varones, entre 15 y 18 años de edad, provenientes de Asia y Europa oriental. De las 899 personas no acompañadas encontradas en los expedientes, 113 habían sido interceptadas varias veces. Tras la intercepción, el Servicio de Inmigración otorga a la mayoría un documento de identidad (82,9 por ciento) sin obligarles a abandonar Bélgica, mientras que el 15,3 por ciento debe salir inmediatamente de Bélgica, o bien en un plazo máximo de cinco días. En el 82,9 por ciento de los casos, se establece contacto con un oficial de la protección de la infancia para que decida en cuanto a la situación del menor. En el 67,2 por ciento de estos casos, no se adopta ninguna medida de protección del menor y éste puede abandonar la estación de policía; y en el 32 por ciento de los casos, se transfiere al menor a un centro de recepción que se ocupa de casos críticos. Prácticamente todos los menores no acompañados tienen la certeza de que llegarán al Reino Unido para tener una mejor vida, reunirse con un familiar, o escapar de la difícil situación política. No obstante, la mayoría viaja en condiciones difí-ciles, tiene miedo y carece de información esencial sobre la vida en el Reino Unido, sobre sus posibilidades en Bélgica, y sobre lo que ocurrirá si son trans-feridos a un centro, etc. La mayoría de estos menores no quiere ser transferida a un centro y muchos, aunque no todos, se escapan de los mismos. Este estudio repercutirá, sin lugar a dudas, en las decisiones que adoptan las autoridades jurídicas, en la atención física y sicosocial necesarias, en la disponi-bilidad de un intérprete o trabajador social durante la intercepción, así como en el número de plazas de acogida y de atención en estos centros, y en las tareas que incumben a todo tutor legal. Finalmente, se enumeran algunas de las limitaciones de este estudio. [source] Simulating the East African wildebeest migration patterns using GIS and remote sensingAFRICAN JOURNAL OF ECOLOGY, Issue 4 2004Douglas E. Musiega Abstract The Serengeti,Mara ecosystem in East Africa is a spectacular natural heritage endowed with diverse fauna and flora. The presence of the seasonally migrating wildebeest (Connochaetes taurinus) is a major boost for tourism. This migration however has enormous impacts to the ecosystem. Consequently efforts at monitoring the herd's migration trends and patterns remain a challenge to wildlife managers and ecologists in the region. In this paper, the relative influence of vegetation (normalized difference vegetation index), landscape and relief on herds migration routes are investigated and the migration routes simulated using GIS and remote sensing techniques. The results are compared with the annual mean route taken by the herds, as determined by radio tracking over the 1995,1997 period. Green vegetation availability is shown to be the major criterion in route choice. It is also shown that during the dry season phases of the migration (western trek, western corridor), the herd endures complex relief (complexity quantified based on slope and inter-visibility) in the search for greener grass. During the season of abundance (southern trek), relief becomes critical in making route choices, with herds avoiding difficult terrain, notwithstanding their relatively more abundant vegetation. The method proposed in this paper is viable for rapid prediction of approximate routes for the migrating wildebeest in different climatic conditions. Résumé L'écosystème Serengeti,Mara en Afrique Occidental est un patrimoine naturel spectaculaire, doté des divers variétés de flore et de faune. La présence du gnou migrateur (Connochaetes taurinus) représente un atout majeur pour le tourisme. Néanmoins, cette migration a un impact énorme sur l'écosystème. Par conséquence, la surveillance des tendances migratoires du troupeau est un défi constant pour les gérants et les écologistes dans la région. Dans cette enquête, l'influence relative de la végétation (NDVI), le paysage et le relief, sur les routes du migration prises par le troupeau ont étéétudiés, et simulés utilisant le Système d'Information Géographique (SIG) et des techniques de perception à distance. Les résultats sont comparés à la moyenne annuelle des routes prises par les troupeaux, déterminée par le repérage radio pendant la période allant de 1995 a 1997. Le disponibilité de végétation verte s'avère le déterminant majeur dans le choix du chemin. Il est aussi démontré que pendant les phases du migration en saison sèche (périple vers l'ouest, couloir vers l'ouest) le troupeau subit des reliefs complexes (complexité calculée sur la pente et inter visibilité) à la recherche de l'herbe la plus verte. Pendant la saison d'abondance (périple vers le sud), l'impact du relief sur le choix des routes devient critique, les troupeaux évitant le terrain difficile, malgré sa végétation relativement abondante. La méthode présentée dans cette étude permet de prédire de façon rapide et valable la route approximative des gnous en cours de migration dans des conditions climatiques diverses. [source] Diagnostic and treatment delays in recurrent clostridium difficile,associated diseaseJOURNAL OF HOSPITAL MEDICINE, Issue 2 2008Danielle Scheurer MD Abstract BACKGROUND: Because Clostridium difficile,associated disease (CDAD) is primarily an inpatient issue, hospitalists are at the forefront of the timely diagnosis and treatment of patients with this disease. DESIGN: The study was a retrospective cohort of all inpatients with CDAD at Brigham and Women's Hospital from 1997 to 2004 in order to determine the time to diagnosis and treatment in initial and recurrent episodes of disease. RESULTS: The mean time to sampling, between 2.09 and 2.24 days, was not significantly different between initial and recurrent CDAD hospital episodes. The mean time to treatment (from symptoms and sampling) was shorter in recurrent episodes but was still 2.5 days. CONCLUSIONS: Patients with recurrent disease were more likely to be treated earlier but not diagnosed earlier than those with initial disease. Because both groups had significant diagnostic and treatment delays, this is an area in which hospitalists can have a major impact on patient care. Journal of Hospital Medicine 2008;3:156,159. © 2008 Society of Hospital Medicine. [source] Probiotics and gastrointestinal diseasesJOURNAL OF INTERNAL MEDICINE, Issue 1 2005Å. SULLIVAN Abstract. There is increasing evidence indicating health benefits by consumption of foods containing microorganisms, i.e. probiotics. A number of clinical trials have been performed to evaluate the effects in the prevention and treatment of gastrointestinal diseases caused by pathogenic microorganisms or by disturbances in the normal microflora. Gastrointestinal infections caused by Helicobacter pylori, traveller's diarrhoea, rotavirus diarrhoea, antibiotic-associated diarrhoea (AAD) and Clostridium difficile -induced diarrhoea are conditions that have been studied. There are also studies performed on the preventive effect of probiotics on radiation-induced diarrhoea and diarrhoea in tube-fed patients. Inflammatory bowel disease and irritable bowel syndrome, two idiopathic conditions where alterations in the normal microflora have been implicated as responsible for initiation, are two further areas where the use of probiotics has been regarded as promising. The results from clinical studies have not been conclusive in that the effects of probiotics have been strain-dependent and different study designs have been used. Treatment of acute diarrhoea in children and prevention of AAD are the two most justified areas for the application of probiotics. [source] Lactobacillus plantarum 299v reduces colonisation of Clostridium difficile in critically ill patients treated with antibioticsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 8 2008B. KLARIN Background: The incidence of Clostridium difficile -associated disease (CDAD) in hospitalised patients is increasing. Critically ill patients are often treated with antibiotics and are at a high risk of developing CDAD. Lactobacillus plantarum 299v (Lp299v) has been found to reduce recurrence of CDAD. We investigated intensive care unit (ICU) patients with respect to the impact of Lp299v on C. difficile colonisation and on gut permeability and parameters of inflammation and infection in that context. Methods: Twenty-two ICU patients were given a fermented oatmeal gruel containing Lp299v, and 22 received an equivalent product without the bacteria. Faecal samples for analyses of C. difficile and Lp299v were taken at inclusion and then twice a week during the ICU stay. Other cultures were performed on clinical indication. Infection and inflammation parameters were analysed daily. Gut permeability was assessed using a sugar probe technique. Results: Colonisation with C. difficile was detected in 19% (4/21) of controls but in none of the Lp299v-treated patients (P<0.05). Conclusions: Enteral administration of the probiotic bacterium Lp299v to critically ill patients treated with antibiotics reduced colonisation with C. difficile. [source] Extended spectrum beta-lactamase-producing bacteria and Clostridium difficile in patients with pouchitisALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2010S. D. McLaughlin Aliment Pharmacol Ther 2010; 32: 664,669 Summary Background, Treatment with fluoroquinolones is associated with the development of Clostridium difficile and extended spectrum beta-lactamase-producing bacteria (ESBL). Clostridium difficile and ESBL are resistant to many antibiotics and each may cause pouchitis after restorative proctocolectomy (RPC) refractory to empirical antibiotic therapy. Aim, To assess the prevalence and establish risk factors for the development of ESBL and Clostridium difficile toxins (CDT) in RPC patients with recurrent or refractory pouchitis under follow-up at our institution over a 1-year period. Method, An enzyme-linked immunosorbent assay was used to detect CDT and a culture technique was used to identity ESBL in faecal samples. All patients had previously received fluoroquinolone treatment. Results, Forty-eight patients (35 (74%) men; median age 42 years) underwent testing at a median interval from RPC of 8 (range 1,25) years. No patient had a positive CDT result, but ESBL bacteria were identified in 16 (33%) samples. ESBL positivity was significantly related to prepouch ileitis (P = 0.035) and maintenance antibiotic therapy (P = 0.039). Conclusions, Extended spectrum beta-lactamase, but not CDT, is a common finding in faecal samples from patients with recurrent or refractory pouchitis. Treatment with maintenance antibiotics and prepouch ileitis are risk factors for developing ESBL-producing bacteria. [source] Proton pump inhibitors as a risk factor for paediatric Clostridium difficile infectionALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2010R. TURCO Aliment Pharmacol Ther,31, 754,759 Summary Background, Proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RAs) may play an important role on the onset of Clostridium difficile -associated disease (CDAD) in adults. The impact of Clostridium difficile on children treated with gastric acid-suppressing agents remains unknown. Aim, To investigate the relationship between CDAD and exposure to acid suppressive therapy in hospitalized paediatric patients. Methods, We reviewed the medical records of children, with a diagnosis of protracted diarrhoea and abdominal pain, whose stool was analysed for C. difficile toxins. We identified 68 patients with CDAD. For each patient, we randomly selected one control subjects with stool analysis negative for C. difficile. Comorbid illnesses, previous hospitalizations, antibiotics, corticosteroids, immunosuppressants and gastric acid suppressing exposures were recorded. Results, The use of PPI was significantly higher in C. difficile positive group compared with C. difficile negative group [odds ratio (OR): = 4.5; 95% confidence interval (CI) = 1.4,14.4]. We also found a trend for the use of H2RAs in patients infected by C. difficile compared with C. difficile negative comparison group (OR: = 3.8; 95% CI = 0.7,18.9). Conclusions, Children exposed to PPIs therapy seem to be at higher risk for the development of Clostridium difficile -associated disease. [source] In vitro fermentation of cereal dietary fibre carbohydrates by probiotic and intestinal bacteriaJOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 8 2002Ross Crittenden Abstract A range of probiotic and other intestinal bacteria were examined for their ability to ferment the dietary fibre carbohydrates ,-glucan, xylan, xylo-oligosaccharides (XOS) and arabinoxylan. ,-Glucan was fermented by Bacteroides spp and Clostridium beijerinckii but was not fermented by lactobacilli, bifidobacteria, enterococci or Escherichia coli. Unsubstituted xylan was not fermented by any of the probiotic bacteria examined. However, many Bifidobacterium species and Lactobacillus brevis were able to grow to high yields using XOS. XOS were also efficiently fermented by some Bacteroides isolates but not by E coli, enterococci, Clostridium difficile, Clostridium perfringens or by the majority of intestinal Lactobacillus species examined. Bifidobacterium longum strains were able to grow well using arabinoxylan as the sole carbon source. These organisms hydrolysed and fermented the arabinosyl residues from arabinoxylan but did not substantially utilise the xylan backbone of the polysaccharide. Arabinoxylan was not fermented by lactobacilli, enterococci, E coli, C perfringens or C difficile and has potential to be an applicable carbohydrate to complement probiotic Bif longum strains in synbiotic combinations. © 2002 Society of Chemical Industry [source] Infliximab and other immunomodulating drugs in patients with inflammatory bowel disease and the risk of serious bacterial infectionsALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2009S. SCHNEEWEISS Summary Background, There remain concerns about the safety of infliximab therapy in patients with inflammatory bowel disease (IBD). Aim, To assess the association between the initiation of infliximab and other immunomodulating drugs and the risk of serious bacterial infection in the treatment of IBD. Methods, We assembled a cohort study of patients with IBD, including Crohn's disease (CD) and ulcerative colitis (UC). All patients initiating an immunomodulating drug between January 2001 and April 2006 were identified in British Columbia from linked health care utilization databases. Exposure of interest was initiation of infliximab or corticosteroids compared with initiation of other immunosuppressive agents, including azathioprine, mercaptopurine (MP) and methotrexate (MTX). Outcome of interest was serious bacterial infections requiring hospitalization, including Clostridium difficile. Results, Among 10 662 IBD patients, the incidence rate of bacteriaemia ranged from 3.8 per 1000 person-years (95% confidence interval 2.1,6.2) for other immunosuppressive agents to 7.4 (3.3,19.3) for infliximab with slightly higher rate for serious bacterial infections resulting in an adjusted relative risk 1.4 (0.47,4.24). Clostridium difficile infections occurred in 0/1000 (0,5.4) among 521 infliximab initiations and 14/1000 (10.6,18.2) for corticosteroids. Corticosteroid initiation tripled the risk of C. difficile infections (RR = 3.4; 1.9,6.1) compared with other immunosuppressant agents. This corticosteroid effect was neither dose-dependent nor duration-dependent. Bacteriaemia and other serious bacterial infections were not increased by corticosteroids or infliximab (5 events). Conclusions, In a population-based cohort of patients with IBD, we found no meaningful association between infliximab and serious bacterial infections, although some subgroups had few events. Corticosteroid initiation increased the risk for C. difficile infections in these patients. [source] Prevalence of Diarrhea and Enteropathogens in Racing Sled DogsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 1 2010E. McKenzie Background: Diarrhea is highly prevalent in racing sled dogs, although the underlying causes are poorly understood. Hypothesis: Clostridium perfringens enterotoxin (CPE) and Clostridium difficile Toxin A and B are associated with diarrhea in racing sled dogs. Animals: One hundred and thirty-five sled dogs. Methods: Freshly voided feces were obtained from 55 dogs before racing and from 80 dogs after 400 miles of racing. Samples were visually scored for diarrhea, mucus, blood, and melena. CPE and C. difficile Toxin A and B were detected by ELISA. Samples were cultured for C. perfringens, C. difficile, Campylobacter, Salmonella, and Escherichia coli 0157; Giardia and Cryptosporidium spp. were detected via immunofluorescence. Results: Diarrhea occurred in 36% of dogs during racing, and hematochezia, fecal mucus or melena, or all 3 occurred in 57.5% of dogs. Salmonella was isolated from 78.2% of dogs before racing, and from 71.3% of dogs during racing. C. perfringens and C. difficile were isolated from 100 and 58.2% of dogs before racing, and from 95 and 36.3% of dogs during racing. Dogs were more likely to test positive for CPE during than before racing (18.8 versus 5.5%, P= .021); however, no enteropathogens or their respective toxins were significantly associated with hematochezia or diarrhea. Conclusions and Clinical Importance: Sled dogs participating in long distance racing have a high prevalence of diarrhea and hematochezia that is not associated with common enteropathogens. It is possible that diarrhea and hematochezia represent the effect of prolonged exercise on the gastrointestinal tract. [source] Clinical trial: effectiveness of Lactobacillus rhamnosus (strains E/N, Oxy and Pen) in the prevention of antibiotic-associated diarrhoea in childrenALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2008M. RUSZCZY Summary Background, Convincing evidence that probiotic administration can lower the risk of antibiotic-associated diarrhoea is limited to certain micro-organisms. Aim, To determine the efficacy of administration of Lactobacillus rhamnosus (strains E/N, Oxy and Pen) for the prevention of antibiotic-associated diarrhoea in children. Methods, Children (aged 3 months to 14 years) with common infections were enrolled in a double-blind, randomized, placebo-controlled trial in which they received standard antibiotic treatment plus 2 × 1010 colony forming units of a probiotic (n = 120) or a placebo (n = 120), administered orally twice daily throughout antibiotic treatment. Analyses were by intention to treat. Results, Any diarrhoea (,3 loose or watery stools/day for ,48 h occurring during or up to 2 weeks after the antibiotic therapy) occurred in nine (7.5%) patients in the probiotic group and in 20 (17%) patients in the placebo group (relative risk, RR 0.45, 95% confidence interval, CI 0.2,0.9). Three (2.5%) children in the probiotic group developed AAD (diarrhoea caused by Clostridium difficile or otherwise unexplained diarrhoea) compared to nine (7.5%) in the placebo group (RR 0.33, 95% CI 0.1,1.06). No adverse events were observed. Conclusion, Administration of L. rhamnosus (strains E/N, Oxy and Pen) to children receiving antibiotics reduced the risk of any diarrhoea, as defined in this study. [source] Failure of dietary oligofructose to prevent antibiotic-associated diarrhoeaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2005S. Lewis Summary Background :,Oligofructose is metabolized by bifidobacteria, increasing their numbers in the colon. High bifidobacteria concentrations are important in providing ,colonization resistance' against pathogenic bacteria. Aim :,To reduce the incidence of antibiotic-associated diarrhoea in elderly patients. Methods :,Patients over the age of 65 taking broad-spectrum antibiotics received either oligofructose or placebo. A baseline stool sample was cultured for Clostridium difficile and tested for C. difficile toxin. A further stool sample was analysed for C. difficile if diarrhoea developed. Results :,No difference was seen in the baseline characteristics, incidence of diarrhoea, C. difficile infection or hospital stay between the two groups (n = 435). Oligofructose increased bifidobacterial concentrations (P < 0.001, 95% CI: 0.69,1.72). A total of 116 (27%) patients developed diarrhoea of which 49 (11%) were C. difficile -positive and were more likely to be taking a cephalosporin (P = 0.006), be female (P < 0.001), to have lost more weight (P < 0.001, 95% CI: 0.99,2.00) and stayed longer in hospital (P < 0.001, 95% CI: 0.10,1.40). Amoxicillin (amoxycillin) and clavulanic acid increased diarrhoea not caused by C. difficile (P = 0.006). Conclusion :,Oligofructose does not protect elderly patients receiving broad-spectrum antibiotics from antibiotic-associated diarrhoea whether caused by C. difficile or not. Oligofructose was well-tolerated and increased faecal bifidobacterial concentrations. [source] NMR-based metabonomics analysis of mouse urine and fecal extracts following oral treatment with the broad-spectrum antibiotic enrofloxacin (Baytril)MAGNETIC RESONANCE IN CHEMISTRY, Issue S1 2009Lindsey E. Romick-Rosendale Abstract The human gastrointestinal tract is home to hundreds of species of bacteria and the balance between beneficial and pathogenic bacteria plays a critical role in human health and disease. The human infant, however, is born with a sterile gut and the complex gastrointestinal host/bacterial ecosystem is only established after birth by rapid bacterial colonization. Composition of newborn gut flora depends on several factors including type of birth (Ceasarian or natural), manner of early feeding (breast milk or formula), and exposure to local, physical environment. Imbalance in normal, healthy gut flora contributes to several adult human diseases including inflammatory bowel (ulcerative colitis and Crohn's disease) and Clostridium difficile associated disease, and early childhood diseases such as necrotizing enterocolitis. As a first step towards characterization of the role of gut bacteria in human health and disease, we conducted an 850 MHz 1H nuclear magnetic resonance spectroscopy study to monitor changes in metabolic profiles of urine and fecal extracts of 15 mice following gut sterilization by the broad-spectrum antibiotic enrofloxacin (also known as Baytril). Ten metabolites changed in urine following enrofloxacin treatment including decreased acetate due to loss of microbial catabolism of sugars and polysaccharides, decreased trimethylamine- N -oxide due to loss of microbial catabolism of choline, and increased creatine and creatinine due to loss of microbial enzyme degradation. Eight metabolites changed in fecal extracts of mice treated with enrofloxacin including depletion of amino acids produced by microbial proteases, reduction in metabolites generated by lactate-utilizing bacteria, and increased urea caused by loss of microbial ureases. Copyright © 2009 John Wiley & Sons, Ltd. [source] Structural insights into the molecular organization of the S-layer from Clostridium difficileMOLECULAR MICROBIOLOGY, Issue 5 2009Robert P. Fagan Summary Clostridium difficile expresses a surface layer (S-layer) which coats the surface of the bacterium and acts as an adhesin facilitating interaction of the bacterium with host enteric cells. The S-layer contains a high-molecular-weight S-layer protein (HMW SLP) and its low-molecular-weight partner protein (LMW SLP). We show that these proteins form a tightly associated non-covalent complex, the H/L complex, and we identify the regions of both proteins responsible for complex formation. The 2.4 Å X-ray crystal structure of a truncated derivative of the LMW SLP reveals two domains. Domain 1 has a two-layer sandwich architecture while domain 2, predicted to orientate towards the external environment, contains a novel fold. Small-angle X-ray scattering analysis of the H/L complex shows an elongated molecule, with the two SLPs arranged ,end-to-end' interacting with each other through a small contact area. Alignment of LMW SLPs, which exhibit high sequence diversity, reveals a core of conserved residues that could reflect functional conservation, while allowing for immune evasion through sequence variation. These structures are the first described for the S-layer of a bacterial pathogen, and provide insights into the assembly and biogenesis of the S-layer. [source] Probiotics and health: a review of the evidenceNUTRITION BULLETIN, Issue 4 2009E. Weichselbaum Summary Probiotics are live microorganisms , mainly bacteria , which when administered in adequate amounts confer a health benefit on the host. There is rising interest in this area, but reports in the media are often conflicting. The aim of this review is to consider the current evidence on the effects of probiotics on health, focusing on gut-related health issues and the immune system, with the objective to provide a clearer picture of whether and how probiotics can be beneficial for health. The outcomes of this review are based on more than 100 original studies, meta-analyses and systematic reviews. A variety of different strains have been used in studies on probiotics, and it is important to remember that the effectiveness of probiotics is strain-specific, which means that each single probiotic strain has to be tested to assess its potential health benefits. Overall, despite the diversity of strains used in the studies included in this review, there is evidence that probiotics have the potential to be beneficial for our health. Studies in patients with inflammatory bowel disease show probiotic strains to be able to decrease the recurrence of ulcerative colitis and occurrence and recurrence of pouchitis, however, current evidence suggests that probiotics are ineffective in treating patients with Crohn's disease. Patients with irritable bowel syndrome show a reduction in symptoms when treated with selected probiotic strains, but high placebo effects have been reported as well. The evidence of the efficacy of probiotics in patients suffering from constipation is limited, but the evidence seems promising for some strains to bring relief to patients suffering from constipation. There is good evidence that a number of probiotic strains are effective in preventing antibiotic-associated diarrhoea. The most commonly studied strains are Lactobacillus rhamnosus GG (LGG) and Saccharomyces boulardii, but other strains and mixtures of strains seem to be effective as well. There is also promising evidence of a preventive effect of probiotics in Clostridium difficile -associated diarrhoea, although some studies have been too small to obtain statistically significant findings. The effect of probiotics in acute diarrhoea, particularly in children, is well studied. Selected probiotic strains seem to be effective in reducing the duration of acute diarrhoea. LGG and S. boulardii are again the most commonly used strains and a number of studies have shown them to be effective, although one meta-analysis showed that the effect of LGG was only significant in children in Western countries, not in children in developing countries, which may be due to different causes of diarrhoea in these regions. Studies investigating the preventive effect of probiotics in the context of common cold and flu infections show that the studied strains failed to lower the incidence of episodes but that they have the potential to decrease the duration of episodes, which suggests that the immune system may be more efficient in fighting off common cold and flu infections after consuming these strains. The evidence so far does not suggest that probiotics are effective in preventing or treating allergies or in treating eczema. However, some probiotic strains seem to lower the risk of developing eczema if taken by pregnant women and their infants in early life. [source] Saccharomyces boulardii in a child with recurrent Clostridium difficilePEDIATRICS INTERNATIONAL, Issue 1 2009Chee Y. Ooi No abstract is available for this article. [source] Semi-automated risk estimation using large databases: quinolones and clostridium difficile associated diarrhea,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 6 2010Robertino M. Mera Abstract Purpose The availability of large databases with person time information and appropriate statistical methods allow for relatively rapid pharmacovigilance analyses. A semi-automated method was used to investigate the effect of fluoroquinolones on the incidence of C. difficile associated diarrhea (CDAD). Methods Two US databases, an electronic medical record (EMR) and a large medical claims database for the period 2006,2007 were evaluated using a semi-automated methodology. The raw EMR and claims datasets were subject to a normalization procedure that aligns the drug exposures and conditions using ontologies; Snowmed for medications and MedDRA for conditions. A retrospective cohort design was used together with matching by means of the propensity score. The association between exposure and outcome was evaluated using a Poisson regression model after taking into account potential confounders. Results A comparison between quinolones as the target cohort and macrolides as the comparison cohort produced a total of 564,797 subjects exposed to a quinolone in the claims data and 233,090 subjects in the EMR. They were matched with replacement within six strata of the propensity score. Among the matched cohorts there were a total of 488 and 158 outcomes in the claims and the EMR respectively. Quinolones were found to be twice more likely to be significantly associated with CDAD than macrolides adjusting for risk factors (IRR 2.75, 95%CI 2.18,3.48). Conclusions Use of a semi-automated method was successfully applied to two observational databases and was able to rapidly identify a potential for increased risk of developing CDAD with quinolones. Copyright © 2010 John Wiley & Sons, Ltd. [source] Latest news and product developmentsPRESCRIBER, Issue 17 2008Article first published online: 15 SEP 200 Small AED suicide risk Antiepileptic drugs (AEDs) are associated with a small increase in the risk of suicidal thoughts, the MHRA has warned. In the latest Drug Safety Update (2008;2:Issue 1) the MHRA says that, compared with placebo, AEDs are associated with an additional two cases of suicidal thoughts and behaviour per 1000 patients (0.43 vs 0.22 per cent). This may occur as early as one week after starting treatment. It is unclear whether the risk varies among AEDs. Also in this issue, the MHRA warns of an increased risk of tumour progression and reduced survival in patients with cancer treated with recombinant erythropoietin. Other topics include the use of lenalidomide (Revlimid) and thalidomide for multiple myeloma; new restrictions on the use of moxifloxacin (Avelox) due to adverse effects; and a reminder that metronidazole should be administered orally, not by intravenous injection, for the treatment of C. difficile -associated diarrhoea. Low-fat diet least effective option? A low-fat diet is associated with less weight loss and less favourable metabolic changes over two years than a low-carbohydrate (Watkins) diet or a Mediterranean diet in 322 moderately obese patients (mean BMI 30kg per m2; N Eng J Med 2008;359:229,41). Estimated energy intake was similar for all diets. Mean weight loss in all randomised patients was 2.9kg for the low fat diet, 4.4kg for the Mediterranean diet and 4.7kg for the low-carbohydrate diet. The low-carbohydrate diet was associated with greater increases in HDL-cholesterol and greater reductions in triglycerides and total cholesterol/HDL-C ratio compared with the low-fat diet. Among people with diabetes, fasting plasma glucose and insulin resistance were decreased only in those assigned to the Mediterranean diet, and only the low carbohydrate diet significantly decreased HbA1c. Stopping post-MI statins Patients who stop taking a statin first prescribed after an acute MI almost double their risk of death compared with nonusers, a new study shows (Eur Heart J; published online 29 July 2008; doi: 10.1093/eurheartj/ehn346). The analysis of 9939 MI survivors in the General Practice Research Database showed that, compared with patients who had never used a statin, the risk of death was unchanged for those previously taking a statin who continued treatment after MI. The risk was reduced by 28 per cent for those who started a statin post-MI and continued it but, in those who started a statin but then stopped it, the hazard ratio for death was 1.88 (CI 95% 1.13-3.07). Stopping control medication (aspirin, beta-blockers or proton pump inhibitors) did not alter the risk of death. Smoking quit rates with NRT and varenicline Differences in quit rates between nicotine replacement therapy (NRT) and varenicline (Champix) are small, according to a multinational study (Thorax 2008;63:717,24). The trial compared transdermal NRT (21mg to 7mg per day over 10 weeks) with varenicline (1mg twice daily for 12 weeks). Over the final four weeks of treatment, the abstinence rate was significantly higher with varenicline (56 vs 43 per cent). After one year, the four-week abstinence rates were 26 and 20 per cent respectively (p = 0.056) and seven-day point prevalence abstinence rates at 6 or 12 months were not significantly different. Varenicline reduced craving, withdrawal symptoms and smoking satisfaction compared with NRT but at the cost of a higher incidence of nausea (37 vs 10 per cent). Azithromycin goes OTC The MHRA has announced that azithromycin will be available without prescription for the treatment of Chlamydia infection. Under the brand Clamelle, azithromycin will be supplied from pharmacies to over-16s who have tested positive for infection but have no symptoms; their partners may also be treated. A urine testing kit will be marketed to pharmacists. Product news Sodium valproate (Epilim Chronosphere) is now available as modified-release granules to be taken with food or a drink; 30 sachets, in five strengths from 50750mg, cost £30. Boehringer Ingelheim has introduced a higher strength of its telmisartan/hydrochlorothiazide combination (Micardis Plus) for hypertension; 80mg/25mg costs £14.18 for a month's supply. Copyright © 2008 Wiley Interface Ltd [source] Modified volume expansion method for measuring gas holdupTHE CANADIAN JOURNAL OF CHEMICAL ENGINEERING, Issue 2 2002Annie X. Meng Abstract A simple, modified volume expansion method, or inclined tube method, is compared to the pressure difference method for determining gas holdup in an airlift bioreactor. The modified volume expansion method could be used for all pneumatic bioreactors where fluid fluctuation is vigorous and visual observation of the continuous phase rise is difficult. The overall gas holdup data measured using the inclined tube method are shown to be very close to overall gas holdup determined using a gamma ray density monitor system. However, the overall gas holdup measured by the pressure difference method is found to be significantly different. This difference is due to energy dissipation in the External Loop Airlift Bioreactor (ELAB) used in this study, which causes the pressure difference method to be incorrect. On compare une méthode d'expansion de volume modifiée simple, ou méthode à tubes inclinés, à une méthode de différence de pression pour déterminer la rétention des gaz dans un bioréacteur à air ascendant. La méthode d'expansion de volume modifiée pourrait être utilisée pour tous les bioréacteurs pneumatiques oú la fluctuation du fluide est vigoureuse et l'observation visuelle de l'ascension de la phase continue difficile. Les données globales de rétention de gaz mesurées à l'aide de la méthode à tubes inclinés s'avèrent très proches de la rétention de gaz globale déterminéd à l'aide d'un moniteur de densité à rayons gamma. Toutefois, on a trouvé que la rétention de gaz globale mesurée par la méthode de différence de pression était significativement différente. Cette différence est due à la dissipation d'énergie dans le bioréacteur à air ascendant à boucle externe (ELAB) utilisé dans I'étude, qui rend la méthode de différence de pression incorrecte. [source] Clostridium difficile in Solid Organ Transplant RecipientsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 2009E. R. Dubberke First page of article [source] Detection of virulence genes of Clostridium difficile by multiplex PCRAPMIS, Issue 8 2009JENNI ANTIKAINEN Antikainen J, Pasanen T, Mero S, Tarkka E, Kirveskari J, Kotila S, Mentula S, Könönen E, Virolainen-Julkunen A-R, Vaara M, Tissari P. Detection of virulence genes of Clostridium difficile by multiplex PCR. APMIS 2009; 117: 607,13. Clostridium difficile strains belonging to the PCR ribotype 027, pulse-field gel electrophoresis (PFGE) type NAP1, toxinotype III and restriction endonuclease analysis group BI harbouring mutations in the tcdC gene and possessing binary toxin components A and B have been described to cause epidemics with increased morbidity and mortality. In the present study we developed a conventional multiplex PCR designed to detect selected virulence associated markers of the hypervirulent C. difficile PCR ribotype 027. The multiplex PCR assay detected the major toxins A and B, binary toxin components A and B as well as a possible deletion in the tcdC gene: a characteristic pattern of amplification products for the PCR ribotype 027 strains was detected. This rather simple method was specific for the screening of this hypervirulent C. difficile strain. The correlation between the multiplex PCR and PCR ribotyping methods was excellent. The sensitivity and specificity were 100% in our epidemiological situation. In conclusion, this multiplex PCR was found useful in the preliminary screening for the hypervirulent C. difficile PCR ribotype 027. [source] Potentiel de Productivité et Efficacité Technique du Secteur Agricole en AfriqueCANADIAN JOURNAL OF AGRICULTURAL ECONOMICS, Issue 3 2006Joachim Binam Nyemeck This study utilizes frontier metaproduction functions to analyze inter-region agricultural productivity differences. Technical efficiency scores are examined through estimation of stochastic frontiers for 16 African countries divided into three different regions (West Africa, East and Southern Africa, and North Africa) from 1970 to 2001. The idea is to explore the differences in efficiency and technological gaps of agricultural sector. Apart of common traits that characterize African agricultural sector, countries exhibit national and regional specificities. These diversities are such that it is difficult to make valuable generalizations. It appears from the results that: in West Africa, the level of technology is relatively good, meaning that there is no problem of input constraints. By contrast, the efficiency with which inputs are used is very low. The situation is very different in the East and Southern Africa, with the level of technology relatively low and appreciable technical level. At least, the North Africa countries make a performing mixture between technology and efficiency. Cette étude utilise les Meta frontières de production pour analyser les différences inter-régionales de la productivité agricole. Les niveaux d'efficacité technique sont examinées par l'estimation des frontières stochastiques de 16 pays africains regroupés en trois régions (l'Afrique de l'Ouest, l'Afrique de l'Est et Australe, et l'Afrique du Nord), sur une période allant de 1970 à 2001. L'idée étant d'explorer les différences d'efficacité et les écarts technologiques du secteur agricole. Au-delà des simples traits communs qui caractérisent le secteur agricole africain, on trouve des expériences nationales et régionales dont il est difficile, du fait de leur grande diversité, de tirer des généralisations valables. Des résultats de l'étude, il ressort que: en Afrique de l'Ouest, le niveau technologique est relativement satisfaisant, traduisant le fait que la présence des inputs ne représente pas une contrainte. Par contre le niveau d'efficacité avec lequel ces intrants sont utilisés est assez faible. La situation est tout autre en Afrique de l'Est et Australe avec un niveau technologique relativement faible et un niveau d'efficacité appréciable. L'Afrique du nord enfin fait un savant dosage entre efficacité et technologie. [source] Governing the multicultural city-regionCANADIAN PUBLIC ADMINISTRATION/ADMINISTRATION PUBLIQUE DU CANADA, Issue 2 2003Frances Frisken Many of the agencies were trying to accommodate their multicultural clienteles in a variety of ways. There were large differences in agency responses, however, not only among municipalities but also among agencies providing different services within the same municipality, and even among district offices of the same municipal agencies. Moreover, municipal agencies often found it difficult or impossible to adapt to new clienteles, even when they were seriously committed to doing so, in the face of provincial government indifference, cuts in provincial and local funding, and community ambivalence or antagonism. The study concluded that municipal agencies are unlikely to devote many resources to helping the immigrant settlement process without financial and legislative support from central governments. Sommaire: Le présent article porte sur une étude qui a cerné les défis que posent d'importantes populations d'immigrants aux gouvemements de ome municipalités de la Région du Grand Toronto, et sur la manière dont ces défis ont été relevés par des organismes municipaux assurant neuf services locaux: logement subventionné par le gouvernement, aménagement du territoire, services de police, enseignement public, santé publique, bibliothèques publiques, loisirs publics, transport en com-mun et services sociaux. Un grand nombre de ces organismes ont essayé de répondre aux besoins de leurs clientèles multiculturelles par différents moyens. Cependant, les écarts étaient grands dans la manière d'y parvenir, non seulement parmi les municipalités mais également parmi les organismes foumissant différents services au sein de la même municipalité, et même parmi les bureaux de districts des mêmes organimes municipaux. En outre, les organismes municipaux trouvent souvent qu'il est difficile, voire même impossible, de s'adapter à de nouvelles clientèles, même lorsqu'ils se sont sérieusement engagés à le faire, face à l'indifférence du gouvemement provincial, aux compressions budgétaires à I'échelle provinciale et locale, et face à I'ambivalence ou à I'antagonisme de la colledivité. L'étude a conclu qu'il y avait de fortes chances que les organismes municipaux ne consacrent pas d'énormes ressources à I'aide au processus d'établissement des immigrants s'ils ne reçoivent pas un appui financier et législatif des gouvernements centraux. [source] Serine-71 phosphorylation of Rac1/Cdc42 diminishes the pathogenic effect of Clostridium difficile toxin ACELLULAR MICROBIOLOGY, Issue 12 2009Janett Schoentaube Summary Clostridium difficile toxin A and B (TcdA/TcdB) are glucosyltransferases that glucosylate GTPases of the Rho family. The epidermal growth factor (EGF) positively modulates C. difficile toxin-induced disturbance of the intestinal barrier function by an unknown mechanism. We found that EGF-treated CaCo-2 monolayers were less susceptible to TcdA-catalysed glucosylation of Rac1 but not of RhoA, which correlated with phosphorylation of Rac1 at Ser-71. Phospho-Rac1/phospho-Cdc42 (Ser-71) still bound to the PAK-CRIB domain indicating an active state. A more detailed characterization of phospho-Rac1 was performed using the phosphomimetic mutant Rac1 S71E. Ectopic expression of Rac1 S71E induced a specific phenotype of cells showing an increase in filopodial structures that were also induced by EGF. Rac1 S71E (and Cdc42 S71E) but not Rac1 S71A was at least fivefold weaker substrate for TcdA-catalysed glucosylation compared with wild type Rac1. The protective effect was checked in transfection experiments where Rac1 S71E and, to a lesser extent, Cdc42 S71E reduced the TcdA-induced cytopathic effect. Thus, Ser-71 phosphorylation of Rac1 might be interesting for modulation of microbial pathogenesis where Rho GTPases, especially Rac1 and Cdc42, are involved. In addition, this is the first description of a specific functional outcome of Rac1 phosphorylation at Ser-71. [source] | ||||||||||||||||||||||