Current Issue : October - December Volume : 2013 Issue Number : 4 Articles : 7 Articles
Parkeratosis is a disease of zinc (Zn) deficiency, most commonly encountered in endemic areas where soils are deficient in Zn. The present communication puts on record the clinical signs, severity and therapeutic management of the disease. The clinical examination of present study revealed alopecia throughout the body with cracks in the skin of coronary bands around the hooves and teats of the udder with deep fissures, dry scaly skin around the nostrils and red, scabby and wrinkled skin on udder. The serum biochemical examination revealed lowered concentration of Zn and alkaline phosphatase activity (ALP). In view of above findings it was diagnosed as parakeratosis and treated by supplementing with Zn carbonate for period of 15 days....
Background: To investigate perceptions and attitude to prescribe Pre-Exposure Prophylaxis (PrEP) among HIV specialists.\r\nMethods: A questionnaire developed through a Focus Group and literature review was administered to a convenience\r\nsample of HIV specialists during educational courses in two Regions and an online survey in February-May 2012.\r\nParticipants were classified as having a positive or negative attitude according to their willingness to prescribe PrEP.\r\nDemographic and working information, experience with HIV-infected patients, information and provision of antiretrovirals\r\nto uninfected persons, self-reported knowledge, perceptions and concerns regarding PrEP were assessed. The association\r\nbetween a different attitude towards PrEP prescription and selected characteristics was assessed through univariate and\r\nmultivariate regression analysis.\r\nResults: Of 311 specialists, 70% would prescribe PrEP, mainly to serodiscordant partners (64%) but also to people at\r\nongoing, high risk of HIV infection (56%); 66% advocated public support of costs. A negative attitude towards PrEP was\r\nsignificantly associated with lack of provision of information on, and prescription of, antiretroviral post-exposure\r\nprophylaxis; specialists with a negative attitude believed behavioural interventions to be more effective than PrEP and\r\nwere more concerned about toxicity. Overall, 90% of specialists disagreed regarding a lack of time for engaging in\r\nprevention counselling and PrEP monitoring; 79% would welcome formal guidelines, while those with a negative attitude\r\ndid not consider this advisable.\r\nConclusions: Although conflicting attitudes appear evident, most specialists seem to be willing, with guidance from\r\nnormative bodies, to promote PrEP within multiple prevention strategies among vulnerable populations. More scientific\r\nevidence regarding effectiveness could overcome resistance....
Background: In Canada, surveillance systems have highlighted the increasing trend of Salmonella enterica serovar\r\nEnteritidis (S. Enteritidis) human infections. Our study objectives were to evaluate the epidemiology of S. Enteritidis\r\ninfections in Ontario using surveillance data from January 1, 2007 through December 31, 2009.\r\nMethods: Annual age-and-sex-adjusted incidence rates (IRs), annual and mean age-adjusted sex-specific IRs, and\r\nmean age-and-sex-adjusted IRs by public health unit (PHU), were calculated for laboratory-confirmed S. Enteritidis\r\ncases across Ontario using direct standardization. Multivariable Poisson regression with PHU as a random effect was\r\nused to estimate incidence rate ratios (IRRs) of S. Enteritidis infections among years, seasons, age groups, and sexes.\r\nResults: The annual age-and-sex-adjusted IR per 100,000 person-years was 4.4 [95% CI 4.0-4.7] in 2007, and 5.2 [95%\r\nCI 4.8-5.6] in both 2008 and 2009. The annual age-adjusted sex-specific IRs per 100,000 person-years ranged from\r\n4.5 to 5.5 for females and 4.2 to 5.2 for males. The mean age-adjusted sex-specific IR was 5.1 [95% CI 4.8-5.4] for\r\nfemales and 4.8 [95% CI 4.5-5.1] for males. High mean age-and-sex-adjusted IRs (6.001-8.10) were identified in three\r\nwestern PHUs, one northern PHU, and in the City of Toronto. Regression results showed a higher IRR of S. Enteritidis\r\ninfections in 2009 [IRR = 1.18, 95% CI 1.06-1.32; P = 0.003] and 2008 [IRR = 1.17, 95% CI 1.05-1.31; P = 0.005]\r\ncompared to 2007. Compared to the fall season, a higher IRR of S. Enteritidis infections was observed in the spring\r\n[IRR = 1.14, 95% CI 1.01-1.29; P = 0.040]. Children 0ââ?¬â??4 years of age (reference category), followed by children 5ââ?¬â??9\r\nyears of age [IRR = 0.64, 95% CI 0.52-0.78; P < 0.001] had the highest IRRs. Adults = 60 years of age and 40ââ?¬â??49 years\r\nof age [IRR = 0.31, 95% CI 0.26-0.37; P < 0.001] had the lowest IRRs.\r\nConclusions: The study findings suggest that there was an increase in the incidence of S. Enteritidis infections in\r\nOntario from 2007 to 2008ââ?¬â??2009, and indicate seasonal, demographic, and regional differences, which warrant\r\nfurther public health attention....
Background: Escherichia coli is a common cause of asymptomatic and symptomatic bacteriuria in hospitalized\r\npatients. Asymptomatic bacteriuria (ASB) is frequently treated with antibiotics without a clear indication. Our goal\r\nwas to determine patient and pathogen factors suggestive of ASB.\r\nMethods: We conducted a 12-month prospective cohort study of adult inpatients with E. coli bacteriuria seen at a\r\ntertiary care hospital in St. Louis, Missouri, USA. Urine cultures were taken at the discretion of treating physicians.\r\nBacterial isolates were tested for 14 putative virulence genes using high-throughput dot-blot hybridization.\r\nResults: The median age of the 287 study patients was 65 (19ââ?¬â??101) years; 78% were female. Seventy percent had\r\ncommunity-acquired bacteriuria. One-hundred ten (38.3%) patients had ASB and 177 (61.7%) had symptomatic\r\nurinary tract infection (sUTI). Asymptomatic patients were more likely than symptomatic patients to have congestive\r\nheart failure (p = 0.03), a history of myocardial infarction (p = 0.01), chronic pulmonary disease (p = 0.045), peripheral\r\nvascular disease (p = 0.04), and dementia (p = 0.03). Patients with sUTI were more likely to be neutropenic at the\r\ntime of bacteriuria (p = 0.046). Chronic pulmonary disease [OR 2.1 (95% CI 1.04, 4.1)] and dementia [OR 2.4\r\n(95% CI 1.02, 5.8)] were independent predictors for asymptomatic bacteriuria. Absence of pyuria was not predictive\r\nof ASB. None of the individual virulence genes tested were associated with ASB nor was the total number of genes.\r\nConclusions: Asymptomatic E. coli bacteriuria in hospitalized patients was frequent and more common in patients\r\nwith dementia and chronic pulmonary disease. Bacterial virulence factors could not discriminate symptomatic from\r\nasymptomatic bacteriurias. Asymptomatic E. coli bacteriuria cannot be predicted by virulence screening....
Background: Metabolic abnormalities are common in HIV-infected individuals on antiretroviral therapy (ART), but\r\nthe biochemical details and underlying mechanisms of these disorders have not been defined.\r\nMethods: Untargeted metabolomic profiling of plasma was performed for 32 HIV patients with low nadir CD4\r\ncounts (<300 cells/ul) on protease inhibitor (PI)-based ART and 20 healthy controls using liquid or gas\r\nchromatography and mass spectrometry. Effects of Hepatitis C (HCV) co-infection and relationships between altered\r\nlipid metabolites and markers of inflammation, microbial translocation, and hepatic function were examined.\r\nUnsupervised hierarchical clustering, principal component analysis (PCA), partial least squares discriminant analysis\r\n(PLS-DA), Random forest, pathway mapping, and metabolite set enrichment analysis (MSEA) were performed using\r\ndChip, Metaboanalyst, and MSEA software.\r\nResults: A 35-metabolite signature mapping to lipid, amino acid, and nucleotide metabolism distinguished HIV\r\npatients with advanced disease on PI-based ART from controls regardless of HCV serostatus (p<0.05, false discovery\r\nrate (FDR)<0.1). Many altered lipids, including bile acids, sulfated steroids, polyunsaturated fatty acids, and\r\neicosanoids, were ligands of nuclear receptors that regulate metabolism and inflammation. Distinct clusters of\r\naltered lipids correlated with markers of inflammation (interferon-a and interleukin-6), microbial translocation\r\n(lipopolysaccharide (LPS) and LPS-binding protein), and hepatic function (bilirubin) (p<0.05). Lipid alterations\r\nshowed substantial overlap with those reported in non-alcoholic fatty liver disease (NALFD). Increased bile acids\r\nwere associated with noninvasive markers of hepatic fibrosis (FIB-4, APRI, and YKL-40) and correlated with\r\nacylcarnitines, a marker of mitochondrial dysfunction.\r\nConclusions: Lipid alterations in HIV patients receiving PI-based ART are linked to markers of inflammation,\r\nmicrobial translocation, and hepatic function, suggesting that therapeutic strategies attenuating dysregulated innate\r\nimmune activation and hepatic dysfunction may be beneficial for prevention and treatment of metabolic disorders\r\nin HIV patients....
Background: Bacteria and fungi are believed to influence mucosal inflammation in chronic rhinosinusitis (CRS).\r\nHowever their presence and relationship to disease is debated. This study used multiple detection methods to\r\ncompare microbial diversity and microbial abundance in healthy and diseased sinonasal mucosa. The utility of\r\ncontemporary detection methods is also examined.\r\nMethods: Sinonasal mucosa was analyzed from 38 CRS and 6 controls. Bacterial and fungal analysis was performed\r\nusing conventional culture, molecular diagnostics (polymerase chain reaction coupled with electrospray ionization\r\ntime-of-flight mass spectrometry) and fluorescence in situ hybridization.\r\nResults: Microbes were detected in all samples, including controls, and were often polymicrobial. 33 different\r\nbacterial species were detected in CRS, 5 in control patients, with frequent recovery of anaerobes. Staphylococcus\r\naureus and Propionibacterium acnes were the most common organisms in CRS and controls, respectively. Using a\r\nmodel organism, FISH had a sensitivity of 78%, and a specificity of 93%. Many species were detected in both CRS\r\nand controls however, microbial abundance was associated with disease manifestation.\r\nConclusions: This study highlights some cornerstones of microbial variations in healthy and diseased paranasal\r\nsinuses. Whilst the healthy sinus is clearly not sterile, it appears prevalence and abundance of organisms is critical in\r\ndetermining disease. Evidence from high-sensitivity techniques, limits the role of fungi in CRS to a small group of\r\npatients. Comparison with molecular analysis suggests that the detection threshold of FISH and culture is related to\r\norganism abundance and, furthermore, culture tends to select for rapidly growing organisms....
Background: Toxoplasma gondii, an obligate intracellular apicomplexan parasite, infects a wide range of warmblooded\r\nanimals including humans. T. gondii expresses five members of the C1 family of cysteine proteases,\r\nincluding cathepsin B-like (TgCPB) and cathepsin L-like (TgCPL) proteins. TgCPB is involved in ROP protein\r\nmaturation and parasite invasion, whereas TgCPL contributes to proteolytic maturation of proTgM2AP and\r\nproTgMIC3. TgCPL is also associated with the residual body in the parasitophorous vacuole after cell division has\r\noccurred. Both of these proteases are potential therapeutic targets in T. gondii. The aim of this study was to\r\ninvestigate TgCPB and TgCPL for their potential as DNA vaccines against T. gondii.\r\nMethods: Using bioinformatics approaches, we analyzed TgCPB and TgCPL proteins and identified several linear-B\r\ncell epitopes and potential Th-cell epitopes in them. Based on these results, we assembled two single-gene\r\nconstructs (TgCPB and TgCPL) and a multi-gene construct (pTgCPB/TgCPL) with which to immunize BALB/c mice\r\nand test their effectiveness as DNA vaccines.\r\nResults: TgCPB and TgCPL vaccines elicited strong humoral and cellular immune responses in mice, both of which\r\nwere Th-1 cell mediated. In addition, all of the vaccines protected the mice against infection with virulent T. gondii\r\nRH tachyzoites, with the multi-gene vaccine (pTgCPB/TgCPL) providing the highest level of protection.\r\nConclusions: T. gondii CPB and CPL proteases are strong candidates for development as novel DNA vaccines....
Loading....