SdrF, a surface protein, appears to play a critical role in the i

SdrF, a surface protein, appears to play a critical role in the initial colonization step by adhering to type I collagen and Dacron™. The role of ionic interactions in S. epidermidis adherence to prosthetic material was examined. SdrF was cloned and expressed in Lactococcus lactis. The effect of pH, cation concentration, and detergents on adherence to different types BIBW2992 of plastic surfaces was assessed by crystal

violet staining and bacterial cell counting. SdrF, in contrast with controls and other S. epidermidis surface proteins, bound to hydrophobic materials such as polystyrene. Binding was an ionic interaction and was affected by surface charge of the plastic, pH, and cation concentration. Adherence of the SdrF construct was increased to positively charged plastics and

was reduced by increasing concentrations of Ca2+ and Na+. Binding was optimal at pH 7.4. Kinetic studies demonstrated that the SdrF B domain as well as one of the B subdomains was sufficient to mediate binding. The SdrF construct also bound more avidly to Goretex™ than the lacotococcal control. SdrF is a multifunctional protein that contributes to prosthetic devices infections by ionic, as well as specific receptor–ligand interactions. Infections are among the most common complications of prosthetic device implantation (Baddour et al., 2003; Gandelman et al., 2007; Wang et al., 2007). The capacity of bacteria to adhere to these devices through both specific and nonspecific interactions is a critical first step in the initiation of these infections (Broekhuizen Tanespimycin et al., 2006; Tsapikouni et al., 2008; Otto, 2009). This problem is enhanced when the infection involves devices such as ventricular assist devices that are critical to patient survival (Rose et al., 2001). Infections MG-132 in vitro involving these devices occur in 15–30% of patients and generally

require either device removal or transplantation to affect a cure (Herrmann et al., 1997; Holman et al., 1997; Gordon et al., 2006) [INTERMACS (http://www.intermacs.org)]. Staphylococcus epidermidis remains the most common cause of prosthetic device-related infections (Simon et al., 2005; Gordon et al., 2006). As part of the commensal skin flora, staphylococci are uniquely situated to contaminate wounds when cutaneous barriers are breached. Surface proteins known as microbial surface components recognizing adhesive matrix molecules facilitate the initial colonization step (Patti et al., 1994; MacKintosh et al., 2006; Otto, 2009). SdrF, a S. epidermidis surface protein, appears to contribute to the initiation of prosthetic device infections. Previous studies showed that SdrF, a member of the serine–aspartate (SD) family of surface proteins, binds type I collagen and mediates adhesion of S. epidermidis to the ventricular assisted device (VAD) driveline (Bowden et al., 2005; Arrecubieta et al., 2007, 2009).

25 m KH2PO4 and 075 mm NaN3 (flow rate of 06 mL/min) They were

25 m KH2PO4 and 0.75 mm NaN3 (flow rate of 0.6 mL/min). They were then automatically derivatized by online mixing with 0.1% o-phthalaldehyde, 2 m NaOH and 0.2 m H3BO3 in a reaction coil incubated at 45 °C, and finally stabilized this website with 3 m H3PO4. Fluorescence was measured at λEm 450 nm (λEx 360 nm). The method was based on post-column o-phthalaldehyde/β-mercaptoethanol derivatization as described in detail in Miyamoto et al. (2004). The supernatants of precipitated samples collected as described

above were neutralized with 10 volumes of 0.4 m borate buffer. They were then subjected to solid-phase extraction with BondElut CBA 100-mg SPE cartridges (Varian, Palo Alto, CA, USA) that were equilibrated selleck chemicals with 1 mL of CH3OH, 1 mL of 0.01 m HCl, and 3 mL of H2O. The cartridges were washed with 1 mL of water, and histamine, 1-methylhistamine

and 3-methylhistamine were then eluted with 500 μL of 0.1 m HCl containing 1 mm EDTA. Then, 50 μL of the elution fraction was injected into the HPLC system for further analysis. Histamine and 1-methylhistamine were separated on a 4.6 × 150-mm, 5-μm C18 Phenomenex Gemini column equipped with a SecurityGuard C18 4 × 3-mm pre-column cartridge (Phenomenex) with the HPLC system described above. The mobile phase consisted of methanol/0.15 m KH2PO4 (4 : 96, v/v) containing 200 mg/L sodium salt of octanesulphonic acid (flow rate of 0.6 mL/min). The eluent line was connected by a T-piece to a reagent line that mixed a 0.05% o-phthalaldehyde/0.2% β-mercaptoethanol solution and 0.5 m NaOH in a short reaction coil. The analytical column and the reaction coil were kept at 42 °C with a HIS25 heating oven (Grant Institute, Olopatadine Edinburgh, UK). Fluorescence was measured at λEm 450 nm (λEx 360 nm). Male 10-week-old C57BL/6J mice were kept individually for 2 weeks before surgery. Mice were operated on under general anaesthesia

induced by intraperitoneal ketamine (75 mg/kg) in combination with intraperitoneal medetomidine (1 mg/kg). The guide cannula (CMA 7 Guide; CMA/Microdialysis, Solna, Sweden) was implanted into the posterior part of the hypothalamus 1 mm above the target site, the TMN. Stereotaxic coordinates (relative to bregma) were: anterior, −2.5; lateral, +0.5; and vertical, −4.4 (Paxinos & Franklin, 2004). Electrodes for electromyography were placed in the neck musculature. Two gold-coated screws were installed into the skull for frontoparietal epidural EEG recording. The electrodes, guide cannula and supporting screws were secured to the skull with dental cement. To enable mice to recover from anaesthesia, they were injected with subcutaneous Antisedane (0.5 mg/kg) and given the analgesic buprenorphine (0.1 mg/kg, subcutaneous). Five mice were used for microdialysis sampling and EEG/electromyographic (EMG) recording. EEG/EMG recording was started 5–6 days after surgery.

These features were apparent for up to 28 days post-operatively

These features were apparent for up to 28 days post-operatively. During this post-operative period, the nocifensive behaviour and enhanced reflex activity were significantly attenuated by intrathecal application of MSO (5 μL, 10 mM) but not by vehicle application. In electrophysiological recordings of nociceptive neuronal activity in the MDH, central sensitization was also evident in pulp-exposed rats but not in intact rats and could be significantly attenuated by MSO application but not by vehicle

application. These behavioural and neuronal findings suggest that the astroglial glutamate–glutamine shuttle is responsible for the maintenance of inflammation-induced nocifensive behavioural changes and the accompanying central sensitization in MDH nociceptive neurons in this chronic

pulpitis pain model. “
“The correlation Osimertinib order of discharges between single neurons can provide information about the computations and network properties of neuronal populations during http://www.selleckchem.com/products/BKM-120.html the performance of cognitive tasks. In recent years, dynamic modulation of neuronal correlations by attention has been revealed during the execution of behavioral tasks. Much less is known about the influence of learning and performing a task itself. We therefore sought to quantify the correlated

firing of simultaneously recorded pairs of neurons in the prefrontal cortex of naïve monkeys that were only required to fixate, and to examine how this correlation was altered after they had learned to perform a working memory task. We found that the trial-to-trial correlation of discharge rates between pairs of neurons (noise correlation) differed across neurons depending on their responsiveness and selectivity for stimuli, even before training in a working memory task. After monkeys had learned to perform the task, correlated firing decreased overall, although the effects varied according to the functional properties of the neurons. The greatest decreases were observed on comparison of populations Bumetanide of neurons that exhibited elevated firing rates during the trial events and those that had more similar spatial and temporal tuning. Greater decreases in noise correlation were also observed for pairs comprising one fast spiking neuron (putative interneuron) and one regular spiking neuron (putative pyramidal neuron) than pairs comprising regular spiking neurons only. Our results demonstrate that learning and performance of a cognitive task alters the correlation structure of neuronal firing in the prefrontal cortex.

These features were apparent for up to 28 days post-operatively

These features were apparent for up to 28 days post-operatively. During this post-operative period, the nocifensive behaviour and enhanced reflex activity were significantly attenuated by intrathecal application of MSO (5 μL, 10 mM) but not by vehicle application. In electrophysiological recordings of nociceptive neuronal activity in the MDH, central sensitization was also evident in pulp-exposed rats but not in intact rats and could be significantly attenuated by MSO application but not by vehicle

application. These behavioural and neuronal findings suggest that the astroglial glutamate–glutamine shuttle is responsible for the maintenance of inflammation-induced nocifensive behavioural changes and the accompanying central sensitization in MDH nociceptive neurons in this chronic

pulpitis pain model. “
“The correlation GW-572016 concentration of discharges between single neurons can provide information about the computations and network properties of neuronal populations during Palbociclib order the performance of cognitive tasks. In recent years, dynamic modulation of neuronal correlations by attention has been revealed during the execution of behavioral tasks. Much less is known about the influence of learning and performing a task itself. We therefore sought to quantify the correlated

firing of simultaneously recorded pairs of neurons in the prefrontal cortex of naïve monkeys that were only required to fixate, and to examine how this correlation was altered after they had learned to perform a working memory task. We found that the trial-to-trial correlation of discharge rates between pairs of neurons (noise correlation) differed across neurons depending on their responsiveness and selectivity for stimuli, even before training in a working memory task. After monkeys had learned to perform the task, correlated firing decreased overall, although the effects varied according to the functional properties of the neurons. The greatest decreases were observed on comparison of populations Montelukast Sodium of neurons that exhibited elevated firing rates during the trial events and those that had more similar spatial and temporal tuning. Greater decreases in noise correlation were also observed for pairs comprising one fast spiking neuron (putative interneuron) and one regular spiking neuron (putative pyramidal neuron) than pairs comprising regular spiking neurons only. Our results demonstrate that learning and performance of a cognitive task alters the correlation structure of neuronal firing in the prefrontal cortex.

These findings, which show an increase over time in the use of tr

These findings, which show an increase over time in the use of triple drug PEP for infants www.selleckchem.com/products/ch5424802.html born to HIV-infected women, highlight the impact that changes in national guidelines have had on clinical practice. Combined with effective antiretroviral therapy in pregnancy and careful management of delivery, neonatal prophylaxis contributes to the success

of MTCT prevention programmes across the UK and Ireland. National surveillance of obstetric and paediatric HIV infection is undertaken through the National Study of HIV in Pregnancy and Childhood (NSHPC) in collaboration with the Health Protection Agency Centre for Infections, and Health Protection Scotland. We gratefully acknowledge the contribution of the midwives, obstetricians, genito-urinary physicians, paediatricians, clinical nurse specialists and all other colleagues who report to the NSHPC through the British Paediatric Surveillance Veliparib in vitro Unit of the Royal College of Paediatrics and Child Health, and the obstetric reporting scheme run under the auspices of the Royal College of Obstetricians and Gynaecologists. We thank Janet Masters who co-ordinates the study and manages the data, and provided comments on drafts

of this paper, and Icina Shakes for administrative support. We also thank Mario Cortina-Borja, Catherine Peckham and Hermione Lyall for their helpful comments on this manuscript. Author contributions: HH-S and CLT carried out the statistical analyses and jointly drafted the paper. All authors contributed to the interpretation of the results, commented on all drafts of the paper, and approved the final version.

PAT is the guarantor. Sources of financial support: The National Study of HIV in Pregnancy and Childhood receives core funding from the Health Protection Agency (grant number GHP/003/013/003). CLT was funded by the UK Medical Research Etofibrate Council (MRC) between 2006 and 2009 (grant number G0501895). This work was undertaken at the Centre for Paediatric Epidemiology and Biostatistics which benefits from funding support from the MRC in its capacity as the MRC Centre of Epidemiology for Child Health. The University College London (UCL) Institute of Child Health receives a proportion of funding from the Department of Health’s National Institute for Health Research Biomedical Research Centres funding scheme. Any views expressed in this paper are those of the authors, and not necessarily those of the funders. Ethics approval: Ethics approval for the NSHPC was renewed following review by the London Multi-Centre Research Ethics Committee in 2004 (ref. MREC/04/2/009). Disclosure of interests: We declare that we have no conflicts of interest. “
“Treated HIV-1-infected patients with lipodystrophy often develop insulin resistance and proatherogenic dyslipidaemia.

73; 95% confidence interval (CI) 107–283], compared with no dru

73; 95% confidence interval (CI) 1.07–2.83], compared with no drug use. Also, mortality was increased among former injecting drug users (IDUs) who reported noninjecting drug use (SHR 2.34; 95% CI 1.49–3.69). Noninjecting drug use was see more associated with higher dropout rates. The mean proportion of time with suppressed viral replication was 82.2% in

all participants, irrespective of ART status, and 91.2% in those on ART. Drug use lowered adherence, and increased rates of ART change and ART interruptions. Virological failure on ART was more frequent in participants who reported concomitant drug injections while on opiate substitution, and in current IDUs, but not among noninjecting drug users. Noninjecting drug use and injecting drug use are modifiable

risks for death, GSI-IX purchase and they lower retention in a cohort and complicate ART. “
“The objective of the study was to analyse key HIV-related outcomes in migrants originating from Latin America and the Spanish-speaking Caribbean (LAC) or sub-Saharan Africa (SSA) living in Spain compared with native Spaniards (NSP). The Cohort of the Spanish AIDS Research Network (CoRIS) is an open, prospective, multicentre cohort of antiretroviral-naïve patients representing 13 of the 17 Spanish regions. The study period was 2004–2010. Multivariate logistic or Fine and Gray regression models were fitted as appropriate to estimate the adjusted effect of region of origin on the different outcomes. Of the 6811 subjects in CoRIS, 6278 were NSP (74.2%), LAC (19.4%) or SSA (6.4%). For these patients, most the follow-up time was 15870 person-years. Compared with NSP, SSA and LAC under 35 years of age had a higher risk of delayed diagnosis [odds ratio (OR) 2.0 (95% confidence interval (CI) 1.5–2.8) and OR 1.7 (95% CI 1.4–2.1), respectively], as did LAC aged 35–50 years [OR 1.3 (95% CI 1.0–1.6)]. There were no major differences in time to antiretroviral therapy (ART) requirement or initiation. SSA exhibited a poorer immunological

and virological response [OR 0.8 (95% CI 0.7–1.0) and OR 0.7 (95% CI 0.6–0.9), respectively], while no difference was found for LAC. SSA and LAC showed an increased risk of AIDS for ages between 35 and 50 years [OR 2.0 (95% CI 1.1–3.7) and OR 1.6 (95% CI 1.1–2.4), respectively], which was attributable to a higher incidence of tuberculosis. However, no statistically significant differences were observed in mortality. Migrants experience a disproportionate diagnostic delay, but no meaningful inequalities were identified regarding initiation of treatment after diagnosis. A poorer virological and immunological response was observed in SSA. Migrants had an increased risk of AIDS, which was mainly attributable to tuberculosis.

73; 95% confidence interval (CI) 107–283], compared with no dru

73; 95% confidence interval (CI) 1.07–2.83], compared with no drug use. Also, mortality was increased among former injecting drug users (IDUs) who reported noninjecting drug use (SHR 2.34; 95% CI 1.49–3.69). Noninjecting drug use was Smad inhibition associated with higher dropout rates. The mean proportion of time with suppressed viral replication was 82.2% in

all participants, irrespective of ART status, and 91.2% in those on ART. Drug use lowered adherence, and increased rates of ART change and ART interruptions. Virological failure on ART was more frequent in participants who reported concomitant drug injections while on opiate substitution, and in current IDUs, but not among noninjecting drug users. Noninjecting drug use and injecting drug use are modifiable

risks for death, http://www.selleckchem.com/products/Oligomycin-A.html and they lower retention in a cohort and complicate ART. “
“The objective of the study was to analyse key HIV-related outcomes in migrants originating from Latin America and the Spanish-speaking Caribbean (LAC) or sub-Saharan Africa (SSA) living in Spain compared with native Spaniards (NSP). The Cohort of the Spanish AIDS Research Network (CoRIS) is an open, prospective, multicentre cohort of antiretroviral-naïve patients representing 13 of the 17 Spanish regions. The study period was 2004–2010. Multivariate logistic or Fine and Gray regression models were fitted as appropriate to estimate the adjusted effect of region of origin on the different outcomes. Of the 6811 subjects in CoRIS, 6278 were NSP (74.2%), LAC (19.4%) or SSA (6.4%). For these patients, this website the follow-up time was 15870 person-years. Compared with NSP, SSA and LAC under 35 years of age had a higher risk of delayed diagnosis [odds ratio (OR) 2.0 (95% confidence interval (CI) 1.5–2.8) and OR 1.7 (95% CI 1.4–2.1), respectively], as did LAC aged 35–50 years [OR 1.3 (95% CI 1.0–1.6)]. There were no major differences in time to antiretroviral therapy (ART) requirement or initiation. SSA exhibited a poorer immunological

and virological response [OR 0.8 (95% CI 0.7–1.0) and OR 0.7 (95% CI 0.6–0.9), respectively], while no difference was found for LAC. SSA and LAC showed an increased risk of AIDS for ages between 35 and 50 years [OR 2.0 (95% CI 1.1–3.7) and OR 1.6 (95% CI 1.1–2.4), respectively], which was attributable to a higher incidence of tuberculosis. However, no statistically significant differences were observed in mortality. Migrants experience a disproportionate diagnostic delay, but no meaningful inequalities were identified regarding initiation of treatment after diagnosis. A poorer virological and immunological response was observed in SSA. Migrants had an increased risk of AIDS, which was mainly attributable to tuberculosis.

6% occurred between 6 and 12 months and 29% after

6% occurred between 6 and 12 months and 2.9% after Z-VAD-FMK 12 months. Among seroconverting patients who initiated HAART after enrolling into care, the median

time to seroconversion of the seronegative partner was 73 days after initiating therapy. Patients in relationships that seroconverted within 6 months of enrolling into care had significantly higher PVLs than patients in discordant relationships (178 251 vs. 88 456 copies/mL) (P=0.001). Patients in relationships that seroconverted within 6 months of enrolment were less likely to use condoms with their primary partners than patients in discordant relationships (41.8%vs. 50.9%) (P=0.047). Similar to the patients in relationships that seroconverted within 6 months of enrolment, patients in relationships that seroconverted between 6 and 12 months after enrolment had significantly higher PVLs than patients in discordant relationships (125 865 vs. 115 858 copies/mL) (P=0.035). Patients in relationships that seroconverted between 6 and 12 months after enrolment were diagnosed more often with genital Herpes simplex than patients in discordant relationships

(46.2%vs. 3.6%) (P=0.001). Among patients in discordant relationships, one patient developed syphilis and another patient developed vaginal candidiasis between 6 and 12 months. Patients in relationships that seroconverted between 6 and 12 months after enrolment reported less condom Sucrase use with their primary partners than patients in discordant relationships (61.5%vs. 74.9%) (P=0.035). More patients in relationships AZD6244 that seroconverted between

6 and 12 months after enrolment reported alcohol consumption than patients in discordant relationships (30.8%vs. 7.2%) (P=0.044). Table 3 summarizes the baseline demographic, behavioural and clinical correlates associated with seroconversion. In the univariate logistic regression, HIV-infected patients with a PVL >100 000 were 1.82 times more likely to transmit (95% CI: 1.1–2.8), HIV-infected patients who did not disclose their HIV status were 5.5 times more likely to transmit (95% CI: 4.3–6.2) and HIV-infected patients who did not use condoms were 2.8 times more likely to transmit (95% CI: 2.4–3.6) infection. These factors remained significant in the multivariate logistic regression analyses. The current study documents a substantial risk for heterosexual HIV transmission within South Indian discordant couples, and identifies several preventable behavioural and biological factors associated with HIV transmission. Patients who had not initiated HAART were more likely to transmit the virus to their partners. Men were more likely to transmit HIV to their wives, which reflects the continued risk of HIV transmission to married women [2].

saccharolyticus (van de Werken et al, 2008), including two genes

saccharolyticus (van de Werken et al., 2008), including two genes that were annotated to code for a PFK (Csac_1830 and Csac_2366). A sequence alignment of these kinases against PFK-A family members (data not shown) and a more detailed analysis of their amino acid Cell Cycle inhibitor sequences (Fig. 1), revealed that Csac_1830 belongs to the B1 group and contains the typical ATP-dependent PFK amino acid combination G104 and G124 (Chi & Kemp, 2000; Bapteste et al., 2003). On the

other hand, Csac_2366 belongs to the B2 group and contains the typical PPi-dependent PFK amino acid residues D104 and K124 (Chi & Kemp, 2000; Moore et al., 2002). These results strongly suggest that Csac_1830 is an ATP-dependent PFK and that Csac_2366 is a PPi-dependent PFK. The genome also contains the genes encoding a PK (Csac_1831) and a PPDK (Csac_1955), which are both able to perform the catabolic conversion of PEP to pyruvate (van de Werken et al., 2008). PPDK catalyzes a PPi-dependent reaction, whereas PK requires ADP (Fig. 2a). The anticipated PPi dependence of the specified glycolytic steps prompted us to seek other PPi-dependent reactions. The C. saccharolyticus genome lacks any homolog to cytosolic pyrophosphatases (COG0221, COG1227) (Bacillus type; Shintani et al., 1998). Instead, ABT-199 research buy it was found to contain a gene coding

for a V-type proton-pumping membrane-bound pyrophosphatase (H+-PPase, COG3808, Csac_0905). The anticipated H+-PPase has 14 predicted membrane

helices and is expected to be an integral membrane protein. Sequence-based phylogenetic analysis of the H+-PPase revealed Silibinin it as a member of the K+-insensitive group of the H+-PPase protein family (data not shown; Serrano et al., 2004). To confirm the genome sequence-based predictions, we performed enzyme assays on crude CEs. The activities of PK, PPDK, PPi-PFK, ATP-PFK and membrane-bound PPase could all be detected in CEs of C. saccharolyticus (Table 1). Under the specified assay conditions, the average PPDK activity (0.4 U mg−1) was twice the PK activity. For the ATP- and PPi-dependent PFKs, no significant difference was observed in the activity levels (∼0.05 U mg−1). In line with the presence of a membrane-associated pyrophosphatase, high levels of PPase activity (∼0.15 U mg−1) could be demonstrated in the membrane fraction, while the membrane-free CE barely showed PPase activity. Whether the membrane-bound PPase in C. saccharolyticus couples pyrophosphatase activity to the translocation of protons across the membrane remains to be investigated. The presence of PPi-dependent enzymes in the central metabolic pathway suggested the involvement of PPi as an energy carrier in the metabolism of C. saccharolyticus. Therefore, the levels of both ATP and PPi were determined during growth (Fig. 3). The PPi levels were relatively high (approximately 4 ± 2 mM), while the ATP levels were remarkably low (0.43 ± 0.07 mM).

1, SAS Inc, Cary, NC, USA) except MCA which was conducted with X

1, SAS Inc., Cary, NC, USA) except MCA which was conducted with XLStat 2007.5 software (Addinsoft, Paris, France). Between June 2005 and May 2009, travel outside Canada was recorded in 493 cases reported in the study area. Six of these cases reported onset dates before their departure dates, three cases reported onset dates after departure and before the minimum incubation period, and 38 cases reported onset dates after their return

dates and find more beyond the maximum incubation period. Thus, these 47 cases were considered as DC, leaving 446 TRC for analysis. The three most frequent diseases among TRC were Campylobacter enteritis, non-typhoidal salmonellosis, and giardiasis, accounting for three quarters of the cases (Table 1). Thirty-four cases were hospitalized; the most with salmonellosis (12 cases) or paratyphoid or typhoid fever (9 cases) (Table 1). Overall, the Epacadostat most common symptoms were diarrhea (77%), abdominal pain (58%), malaise (52%), fever (51%), nausea (44%), and headache (36%) with some variations between illnesses (Table 1). The onset date was available for 379 cases (85%)

with the following yearly distribution (from June to May the following year): 82 cases in 2005 to 2006, 117 cases in 2006 to 2007, 97 cases in 2007 to 2008, and 83 cases in 2008 to 2009. The total monthly distribution combined over 4 years ranged from 23 cases in October to 51 cases in August. No significant differences were found between years and months. Both onset and return dates were recorded in 353 cases (79%). The onset date for 204 of these cases (58%) occurred after their return date; and within the first 4 days for 75% of them (Figure 1). The other cases (148/353 or 42%) became ill while abroad, within the last 7 days prior to return for 60% of them (Figure 1). Among the cases who became ill abroad with known departure date (n = 143), the delay between

departure and onset dates had the following quartiles: 5 (Q1), 7 (median), and 20 days (Q3). Overall, 50.4% TRC were Histidine ammonia-lyase male with some variations between diseases (Table 2). Age ranged from a few months to 80 years with a right skewed distribution, the quartiles being 12 (Q1), 26 (median), and 46 (Q3). The disease-specific age distribution showed potentially different patterns; cryptosporidiosis TRC were less than 40 years old, cyclosporiasis TRC over 25 years, and hepatitis A TRC under 25 years (Table 2). Among the 446 TRC, 42 (9.4%) were classified as new immigrants as a result of adoption (6 cases), refugee status (16 cases), or immigration (20 cases). Most of them were in the 5 to 14 years (23 cases) or <5-year-age groups (8 cases). Overall, the main destinations were to Latin America/Caribbean (160 cases) and Asia (134 cases), with some variations between the diseases (Table 3). Destination for cases identified as new immigrants were Asia (23 cases), Africa (12 cases), and Latin America/Caribbean (7 cases).