Role of a large plasmid of Salmonella typhi encoding multiple drug resistance

Twenty isolates of Salmonella typhi from cases of typhoid during the 1989-1990 epidemic in Calcutta were examined. Most isolates (84% of all isolates in the epidemic) were resistant to chloramphenicol, ampicillin, tetracycline and streptomycin but were sensitive to nalidixic acid and ciprofloxacin. Plasmids of 120 kb and 14 kb were identified amongst the multi-drug resistant isolates of S. typhi. However, there was no plasmid in the antibiotic-sensitive isolates. The 120-kb plasmid was transferable and transconjugants were resistant to chloramphenicol, ampicillin, tetracycline and streptomycin. Restriction endonuclease analysis patterns after EcoRI digestion of the 120-kb antibiotic-resistance plasmids from the S. typhi isolates and transconjugants were similar.     

Use of multiple antigenic peptides related to antigenic determinants of infectious bursal disease virus (IBDV) for detection of anti-IBDV-specific antibody in ELISA--quantitative comparison with native antigen for their use in serodiagnosis

Multiple antigenic peptides (MAPs) prepared for the predicted antigenic determinants on the VP2 protein of infectious bursal disease virus (IBDV) were used as antigens in enzyme-linked immunosorbent assay (ELISA)--an alternative to whole viral antigen to detect anti-IBDV antibodies in the chicken sera. Two MAPs were synthesized, which could specifically detect the anti-IBDV antibodies in serum samples by ELISA. The optimum quantity of MAP1 and MAP2 required to coat the wells of the ELISA plate was 5 ng/ml, whereas the amount of purified IBDV whole viral antigen was 500 ng/ml, indicating the high efficiency of MAPs. In this study, we mainly focused on the antigenicity of two eight-branched MAPs to detect anti-IBDV antibodies in ELISA, which would serve as safe, chemically defined, noninfectious alternative antigens to whole virus in serodiagnosis. The specificity and sensitivity of both MAP1 and MAP2 were found to be relatively better than the whole viral antigen.     

Sertoli-Leydig cell tumor of ovary with heterologous element: a case report

Sertoli-Leydig cell tumors are uncommon tumors of ovary accounting for about 1% of sex cord stromal tumors. They constitute between 0.1% to 0.5% of all the primary ovarian neoplasms. The majority of reported cases are moderately or poorly differentiated combined Sertoli-Leydig cell tumors. A rare case of Sertoli-Leydig cell tumor with heterologous element in a 14 year girl is described. The heterologous component comprised smooth muscle, an uncommon element, that was seen in 60 to 70% of the tumor area. The epithelial element of the tumor consisted of solid, tubular and foci of retiform pattern. Both these features imply a poor prognosis.     

A real-world study of user characteristics,safety and efficacy of open-source closed-loop systems and Medtronic 670G

We report a real-world evaluation of the first commercially approved automated insulin delivery (AID) system, MiniMed 670G (670G), and open source-automated insulin delivery (OS-AID) systems. This was undertaken as a retrospective observational study in adults with type 1 diabetes using AID systems for 6 months or longer in a publicly funded health service using clinically validated data. Sixty-eight adults (38 670G, 30 OS-AID systems) were included. OS-AID system users were younger, had a shorter diabetes duration and a higher education status. OS-AID systems displayed a significantly better change in HbA1c (median −0.9% [−0.4%, −1.1%] vs. −0.1% [IQR −0.7%, 0.2%], P = .004) and time in range 3.9-10 mmol/L (mean 78.5%, SD ± 12.0% vs. 68.2% ± 14.7%, P = .024) compared with 670G. Both systems showed minimal hypoglycaemia, with OS-AID systems revealing significantly improved secondary outcomes of mean glucose and percentage of time more than 10 mmol/L, with a higher percentage of time of less than 3 mmol/L. OS-AID system users displayed improved glycaemic outcomes with no clinical safety concerns compared with 670G, although higher weight-adjusted insulin dose and weight gain were noted. The study highlights key differences in OS-AID system user characteristics that are important for interpreting real-world findings from recent OS-AID system studies.     

Hypoglycaemia in type 1 diabetes: technological treatments,their limitations and the place of psychology

Advances in technology allowing improved insulin delivery and glucose monitoring can significantly reduce the burden of hypoglycaemia when used appropriately. However, limitations of the current technology, and the skills, commitment and motivation required to use them, mean that it does not work for all people. Education and informed professional support are key to success. In the context of problematic hypoglycaemia, data suggest that newer technology has lower efficacy and uptake in those with most need. Identifying the causes of hypoglycaemia and understanding some of the underlying behavioural drivers may prove useful and psycho-educational strategies may be effective in selected individuals. Ultimately, as in many spheres of medicine, successful management of problematic hypoglycaemia depends upon matching the right treatment to the right individual.