Prevalence of hypertension in a hemodialysis population

INTRODUCTION　　 Cardiovascular and cerebrovascular diseases remain the lead cause of death indialysis patients.Most studies have shown that hypertension has a close relationwith morbidity and mortality in hemodialysis population.There are a few papers de…     

Diversity of carbapenemases in clinical isolates of Enterobacteriaceae in Croatia—the results of a multicentre study

Since the first carbapenem-resistant Klebsiella pneumoniae strain was isolated in 2008, Enterobacteriaceae with reduced susceptibility to one or more carbapenems have emerged sporadically in different geographical regions in Croatia. These observations gave rise to a multicenter study on carbapenem resistance in Enterobacteriaceae from Croatia. Fifty-seven carbapenem-non-susceptible strains of Enterobacteriaceae were collected during 2011–2012 from four large hospital centres in Croatia. Overall, 36 strains produced VIM-1 β-lactamase, three produced NDM-1, and one produced KPC-2. A high degree of clonal relatedness was observed in Enterobacter cloacae and Citrobacter freundii strains, in contrast to K. pneumoniae strains. Bla_VIM genes were located within class1 integron which contained genes encoding resistance to aminoglycosides (aac_A4). The study found strong association between bla_VIM and qnr_B6 and between bla_NDM and qnr_A6 genes.     

Contribution of the FilmArray® Gastrointestinal Panel in the laboratory diagnosis of gastroenteritis in a cohort of children: a two-year prospective study

This study represents a 2-year picture of the epidemiology of enteric pathogens in children suffering from gastroenteritis using the FilmArray® Gastrointestinal Panel (FA-GP), a multiplex molecular assay that allows to simultaneously detect a large panel of pathogens independently of the etiological suspicion and to evaluate its potential contribution to the diagnosis compared to the conventional methods.A total of 1716 stool samples, collected from children with clinical suspicion of bacterial and/or viral gastroenteritis attending the University Hospital of Parma, was submitted to the FA-GP and, when an adequate aliquot was available, to electron microscopy (n = 1163) for virus detection and to an enterovirus-targeting real-time PCR (n = 1703). Specimens with positive results for Salmonella, Yersinia enterocolitica, Vibrio, diarrheagenic Escherichia coli/Shigella, Campylobacter, Plesiomonas shigelloides and/or parasites by the FA-GP were also submitted to conventional diagnostic methods.The FA-GP gave positive results in 958 (55.8%) cases, 64.8% from inpatients: 647 (67.5%) contained a single agent and 311 (32.5%) multiple agents, for a total of 1374 pathogens. Enteropathogenic E. coli, rotavirus, norovirus, toxigenic Clostridioides difficile, and sapovirus were the most commonly detected pathogens. A total of 812 additional agents (344 of which as single pathogen) was detected by the FA-GP and not included in the clinical suspicion. The overall recovery rate of the conventional methods from stools that resulted positive by the FA-GP was 38.6% for bacteria, 50% and 84.2% for Giardia intestinalis and Cryptosporidium, respectively, and ranged from 3.7% to 64.6% for viruses, if excluding all electron microscopy-negative astroviruses. Enterovirus, an agent not targeted by the FA-GP, was revealed in 9.6% (164/1703) of the examined samples, and in 52 cases it was the only agent detected.The results of this study allowed to extend the range of detectable pathogens independently of the clinical suspicion, to detect co-infections in almost one third of children positive for at least one agent and to show that conventional methods would have missed more than half of the enteric agents detected by the FA-GP.     

Entomological characteristics of malaria transmission in Manhiça, a rural area in southern Mozambique

From October 1997 to September 1998, an entomological survey was carried out in Manhi?a, Mozambique, to describe the anopheline population and intensity of malaria transmission. Ten different huts were randomly selected for entomological surveillance throughout the year. CDC light trap collections were conducted during three nights each month. Additional knockdown spraying catches were carried out in the morning, after the last catch. A total of 17,245 Culicinae and 1,251 Anophelinae were collected during the study. There was substantial house to house variation and seasonality in the distribution of Anophelinae population, with a peak in April towards the end of the warm and rainy season. Four species of genus Anopheles (Diptera: Culicidae) were described: Anopheles funestus Giles, Anopheles tenebrosus D?nitz, Anopheles arabiensis Patton, and Anopheles merus D?nitz. An. funestus constitutes 72.3% of the anopheline population. The estimated sporozoite rate was 1.2% and the average entomological inoculation rate for the area was 15 infective bites per person per year.     

Age-related differences in a delayed pointing of a Müller-Lyer illusion

It has been suggested that movements to visible or remembered targets are differently sensitive to the Müller-Lyer (ML) illusion. Indeed, when the target is continuously visible, movements rely on the veridical object characteristics, whereas remembered movements are thought to reflect the perceived characteristics of the object. The aim of the present study was to determine how movements to visible or remembered targets are influenced by the ML illusion in children aged 7 to 11 years old. Participants were asked to make a perceptual judgment or to point a shaft extremity of the ML configurations (Closed, Control, and Open) in three visual conditions (Closed Loop, Open Loop-0-s delay, and 5-s delay). Perceptual (Perceived Length, PL) and motor (Movement Magnitude, MM, and Peak velocity, PV) variables were measured. Results showed that PL was influenced to the same extent by the ML illusion in the three visual conditions. Moreover, it appears that in subjects as young as 7 years old, the activation of the ventral system features may give rise to the perceptual illusion effect observed in all three experimental conditions. However, regardless of the subject's age, MM and PV were only sensitive in the delay condition, suggesting that delayed movements are also mediated by the ventral stream. These data suggested that the distinction between perception and motor visual pathways appears quite early during childhood (before 7 years). Our data also demonstrated that children were relying on both visual processing streams during perceptual as well as visuomotor tasks during remembered movements.     

Is living in a border region a risk for a high prevalence of resistance?

This study assessed the antimicrobial resistance and population structure of Staphylococcus aureus isolated from general practice (GP) patients and nursing home (NH) residents in the province of Limburg (near the border with Germany and Belgium) in comparison with those obtained in the remaining provinces of the Netherlands. A total of 617 and 418 S. aureus isolates were isolated from 2,691 to 1,351 nasal swabs from GP patients and NH residents, respectively. Quantitative antibiotic susceptibility testing was performed using a microbroth dilution method. Putative methicillin-resistant S. aureus (MRSA) isolates were tested for the presence of the mecA gene and spa typing was performed on all S. aureus isolates. No significant differences in the prevalence of resistance were found between the two groups of GP isolates, but the isolates from the NH residents showed a lower resistance for trimethoprim–sulfamethoxazole (p = 0.003) in Limburg province compared with the remaining provinces in the Netherlands. Among the isolates from NH residents in Limburg province, the prevalence of spa-CC 084 was higher (p = 0.003) and that of spa-CC 002 was lower (p = 0.01) compared with isolates from NHs in the remaining provinces of the Netherlands. We observed no differences in resistance and population structure between S. aureus isolates from GP patients in Limburg and the remaining provinces of the Netherlands, and only a few differences were observed between the NH populations. There was no higher prevalence of resistance among the GP and NH isolates from Limburg compared with the remaining provinces.     

Immunoregulatory effects of α-GalCer in a murine model of autoimmune myocarditis

This study was designed to investigate the role of α-galactosylceramide (α-GalCer) on experimental autoimmune myocarditis (EAM), and to explore the underlying mechanisms. Balb/c mice were immunized with porcine cardiac myosin to establish the EAM model. All the immunized mice were divided into two groups, the α-GalCer group and the EAM group. α-GalCer or vehicle was given intraperitoneally at the time of immunization. Then α-GalCer or PBS was injected on alternate days for 6 weeks. Myocardial inflammation was evaluated by H & E staining and the expression levels of C/EBPβ and α-SMA were determined by immunohistochemistry. CD4⁺CD25⁺Foxp3⁺ Tregs and iNKT cells were analyzed and sorted by flow cytometry. Western blot analysis was performed to detect MMP-2 and MMP-9 protein expression. Following α-GalCer treatment for 6 weeks, myocardial inflammation improved significantly in the α-GalCer treated group compared to the EAM group. The proportions of CD4⁺CD25⁺Foxp3⁺ regulatory T cells and NK1.1⁺ iNKT cells were statistically increased in the α-GalCer treated group compared to the EAM and normal control groups. In contrast to the EAM group, α-GalCer treatment significantly increased myocardial MMP-2 and MMP-9 expression. Expression of C/EBPβ increased significantly in the EAM group compared to the other two groups. In contrast, the expression of α-SMA did not differ significantly among the three groups. This study demonstrated that α-GalCer alleviates EAM. Thus, α-GalCer represents a potential therapeutic target for autoimmune-inflammation mediated cardiac damage. α-GalCer protects EAM through upregulation of the proportion of iNKT and Tregs and increased expression of myocardial MMP-2 and MMP-9.     

Concordance of auriculo-cardiovascular-skeletal malformations: a new malformation complex in an infant of a diabetic mother?

The incidence of malformations among infants of diabetic mothers (IDM) is known to be higher than in the general population. These malformations usually involve several organ systems and in the past few years there has been an attempt to group them into distinct "syndromes." The present report concerns a child with a specific constellation of findings not yet reported in the infant of a diabetic mother, and we urge our colleagues to look for other associations existing in these infants, rather than just listing series of individual malformations.     

Interferon-γ release assays in the diagnosis of active tuberculosis disease in a low-incident setting: a 5-year review of data

The role of interferon-γ release assays in the diagnosis of active tuberculosis disease is uncertain, and recent guidelines do not support their routine use. We reviewed the clinical records of 415 patients who had a QuantiFERON-TB Gold In-Tube assay between 29 June 2005 and 28 October 2010 to determine its performance in the diagnosis of active tuberculosis disease in a low prevalence setting, specifically in human immunodeficiency virus (HIV) -positive and HIV-negative patients, those of UK and non-UK origin, and those with pulmonary and extrapulmonary disease. For the diagnosis of active tuberculosis disease the overall sensitivity of QuantiFERON-TB Gold In-Tube assay was 71.4% (95% CI 59.3–81.1), specificity was 81.0% (95% CI 75.5–85.6) and negative predictive value was 92.6% (95% CI 88.2–95.5). No significant difference in sensitivity was seen in culture-positive and culture-negative tuberculosis, in pulmonary and extrapulmonary disease, or with HIV infection. Specificity and negative predictive value were significantly higher in patients of UK origin compared with those of non-UK origin (89.3% (95% CI 83.3–93.3) and 97.1% (95% CI 92.7–98.9) versus 66.3% (95% CI 55.6–75.5) and 83.3% (95% CI 72.6–90.4)). Our study suggests that there may be a role for interferon-γ release assays in excluding active tuberculosis disease, particularly extrapulmonary disease, in patients originating from areas of low tuberculosis incidence, with a negative test highly predictive of a lack of active tuberculosis disease in this group. We cannot support the use of these assays in the diagnosis of active tuberculosis infection in patients from areas of higher incidence.     

Age-Related Characteristics of Sleep Impairments in a Model of the Preclinical Stage of Parkinson’s Disease in Rats

Neuroscience and Behavioral Physiology - Objective. To assess changes in the time characteristics of the states of sleep and waking which may serve as nonmotor signs of the initial stage of PD...     

Dynamics of malaria transmission in Kafiné, a rice growing village in a humid savannah area of Côte d'Ivoire

A study on malaria transmission based on samples of mosquitoes caught on human subjects was conducted from February to August 1995 in the rice growing area of Kafine, a village located in the Niakaramandougou district of northern C?te d'Ivoire. The village is surrounded by 117,500 acres of rice fields. Irrigation is sub-permanent in the rice field and harvests number two a year. During the 6 months of the study, 12.353 mosquitoes were caught. The average biting rate was 118.8 bites per man per night (b/m/n). Mansonia, Culex and Aedes represented only 17.5% of the total number of mosquitoes caught. Anopheles accounted for 82.5% of the number of anthropophilic mosquitoes. Anopheles gambiae s.s. represented 83.7% of the total Anopheles species. As a whole, the average biting rate recorded for the Anopheles was 98 b/m/n. The average biting rate of An. gambiae was 90.4 b/m/n. The highest rate (121.5 b/m/n) was recorded in April. During the dry and rainy season, the indoor biting cycle per hour of An. gambiae s.s. was studied from 6 p.m. to 6 a.m. In both seasons, a marked biting activity was noticed between 10 p.m. and 5 a.m. The average annual parity rate reached 40.2% but it ranged from 59.8% (n = 82) in February to 19% (n = 63) in May. The mean sporozoitic index of An. gambiae throughout the study period was 1.1% (14 positive salivary glands/1.251 dissected). The index ranged from 0 in April, May and June to 6.2 (n = 192) in July. The rate did not vary with rainfall but with the different stages of rice growing. The non-synchronisation of agricultural practises for each growing cycle seemed to be a conclusive factor in the transmission of malaria in this locality. Malaria transmission at Kafine can be characterised by 3 main elements: transmission is intensive with an estimated inoculation rate of 1 ib/m/n; transmission is more related to double phase rice cultivation (regardless of synchronisation on plots) than to rainfall; transmission shows particular variations linked to rice cultivation cycles with an increase during periods of ripeness and harvest. The nuisance caused by higher mosquito density has brought people to comply with use of pyrethroid impregnated bed nets advocated for wide use by the National Malaria Control Program.     

What plays a role in the severity of atopic dermatitis in children?

Background/aim Determining the characteristics and risk factors of severe disease is extremely important to combat atopic dermatitis (AD), which has recently shown increasing prevalence. In this study, we aimed to investigate the clinical characteristics of pediatric patients with AD and identifying the factors associated with the severity of the disease.Materials and methods A total of 304 pediatric patients diagnosed with atopic dermatitis were included in the study. The patients’ age at admission, age at onset of symptoms, the presence of atopy history in their family, eosinophil levels obtained from blood counts were recorded, together with the data of cigarette exposure, and area of residence. Disease severity was determined according to the SCORAD index. Epidermal prick tests (EPT) were applied to all patients.Results There was a negative correlation between the SCORAD score and both age at admission (r = 0.277, p < 0.001) and age at onset of the symptoms (r = –0.474, p < 0.001). Food sensitization rates were higher in individuals with moderate-severe disease (90.7% vs. 23.1%; p < 0.001) and patients with food allergy (FA) had significantly higher SCORAD scores [33 (IQR: 22–44) vs. 14 (IQR: 12–16); p < 0.001]. SCORAD scores of the individuals living in rural areas were higher than the ones living in urban [22 (IQR: 15–39.5) vs. 15 (IQR: 12–22); p < 0.001]. Familial atopy history was more common in patients with moderate-severe disease (66.5% vs. 17.5%; p < 0.001). The SCORAD scores were higher in patients exposed to passive smoking [21 (IQR:14.75–38) vs. 13 (IQR: 12–16); p < 0.001]. The eosinophil count found to be positively correlated with SCORAD scores (r = 0.531, p < 0.001).Conclusion Our findings show that early-onset, food sensitivity, living in rural areas, having familial atopy history and passive cigarette smoke exposure play a role in severe AD. Since it is remarkably correlated with SCORAD scores, eosinophil count can be used as a marker to assess the severity of AD in children.     

Urban schistosomiasis in Cameroon: a longitudinal study of its transmission in a new site of an extension of the intestinal schistosomiasis focus in Mélen, Yaoundé

In order to to set up the present situation on schistosomiasis in the neighbourhoods around the University of Yaounde I campus, a malacological survey (collection of freshwater snails, their identification and tests on cercarial emergence) was carried out monthly over 12 months in 2 water sources, followed by a parasitological diagnosis of intestinal schistosomiasis in subjects who acknowledge having come into contact with the infested water course. The malacological survey revealed 4 freshwater gastropod species, two (Bulinus globosus and Biomphalaria pfeifferi) of which are intermediate hosts of schistosomes. Biomphalaria pfeifferi specimens from the former quarry pond of Ngoa-Ekellé neighbourhood showed an average infestation rate of 9.7%, and emitted schistosome cercariae throughout the whole period of study The parasitological diagnosis included 112 (81.2%) out of the 138 individuals identified, including 55 males and 57 females; 27 out of the 112 subjects had S. mansoni eggs in stools, making a prevalence rate of 24.1%. These patients were composed of 21 males and 6 females. The prevalence of S. mansoni is therefore significantly higher in males. The average parasitic load for our sample was 248 eggs/g of stools. It was much higher (384 eggs/g stools) for males (280 eggs/g stools) than for females (136 eggs/g stools). The differences of prevalences and parasitic loads between sex can be explained in part by the varying activities of interest according to the different groups in the infested watering places.     

The risk of false inclusion of a relative in parentage testing – an in silico population study

Aim

To investigate the potential of false inclusion of a close genetic relative in paternity testing by using computer generated families.

Methods

10 000 computer-simulated families over three generations were generated based on genotypes using 15 short tandem repeat loci. These data were used in assessing the probability of inclusion or exclusion of paternity when the father is actually a sibling, grandparent, uncle, half sibling, cousin, or a random male. Further, we considered a duo case where the mother’s DNA type was not available and a trio case including the mother’s profile.

Results

The data showed that the duo scenario had the highest and lowest false inclusion rates when considering a sibling (19.03 ± 0.77%) and a cousin (0.51 ± 0.14%) as the father, respectively; and the rate when considering a random male was much lower (0.04 ± 0.04%). The situation altered slightly with a trio case where the highest rate (0.56 ± 0.15%) occurred when a paternal uncle was considered as the father, and the lowest rate (0.03 ± 0.03%) occurred when a cousin was considered as the father. We also report on the distribution of the numbers for non-conformity (non-matching loci) where the father is a close genetic relative.

Conclusions

The results highlight the risk of false inclusion in parentage testing. These data provide a valuable reference when incorporating either a mutation in the father’s DNA type or if a close relative is included as being the father; particularly when there are varying numbers of non-matching loci.The use of an increasing number of loci in a multiplex amplification leads inevitably to higher confidence in assignment of an individual as being a defined genetic relative of a known person. With an increase in the loci used in a paternity test comes also the increase in the chance of observing a mutational event; leading to the possibility of a false exclusion. However, there also comes the benefit of a potential higher power of discrimination. When testing close genetic relatives as part of a paternity assignment, it is expected that more alleles will be shared, such as in full siblings (1), when compared to a random member of the population. In support of this assumption, a previous study indicated that there was at least a 50% chance of two random men sharing at least one allele at 10 of the 14 loci tested (2). The chance of a false inclusion and exclusion is greater when testing one putative parent and an offspring (a duo scenario) than when there is an additional confirmed parent (a trio scenario). In instances of immigration cases, it may be that one relative poses as a parent of a child; such an incident was reported when a sibling claimed to be the father of a boy (3). The instance when a close genetic relative posed as a parent of an offspring where 9 or 10 loci were used in a paternity test led to unsatisfactory results (4). A similar study highlighted an instance when using 11 polymorphic short tandem repeat (STR) loci there was a matching allele at each locus between a child, the assumed mother, and skeletal remains that were not from the father of that child (5); this same study found 3 further instances of exactly the same scenario when using 10 STR loci. Recently, there has been a report of two tested men presenting matching alleles with a potential offspring at 19 STR loci in a duo case (6).The probability of excluding a relative from being a true father of an offspring was examined using data for 12 STR loci from a known population (7). An extension of this study, using 12 STR loci, derived the probability of excluding a relative for close genetic relatives (8). A conclusion was that full siblings impersonating parent/child proved the most difficult scenario to discredit with DNA profiling alone. Similarly, it was reported that there was a probability of 12% that there would be no inconsistencies (a shared allele at all loci tested) when comparing data using 18 STR loci when a sibling of a true parent posed as the parent of the tested child (9). In motherless paternity analysis using 15 STR loci, the differences between probabilities for father and uncle were observed to be small (10).The use of computer-simulated populations has the great benefit of an increase in the size of the available data. Evaluation of the efficacy of trio sibship testing and sibling assignment for forensic purposes by using such model populations was performed in our laboratory (11). In this study, we report on the false paternity probabilities with 15 STR loci when comparing two close genetic relatives (two siblings, paternal grandparent/grandchild, paternal uncle/nephew or niece, two half siblings, and two cousins) and two random persons. These different combinations were generated using 10 000 simulated 3-generation families based on data from the Taiwan population (12). The risks of false inclusion for duos and trios in parentage testing were evaluated respectively.     

Anti-astrocyte autoantibodies in Guillain-Barre Syndrome--possible involvement in the pathophysiology of a psychosyndrome?

Guillain-Barre syndrome (GBS) is an autoimmune disorder of the peripheral nervous system. However, GBS patients frequently display a psychosyndrome, indicating an accompanying involvement of the central nervous system (CNS), although the cause is not understood. Hepatic encephalopathy is possibly the best characterized example of a psychosyndrome, and astrocyte dysfunction appears to play a major role. We hypothesized that if compromised astrocyte function is of general importance in the pathomechanism of a psychosyndrome, then astrocytes should be involved in the CNS dysfunctions of GBS patients as well. Using immunocytochemistry, we found anti-astrocyte autoantibodies in about 60% of GBS patients and few or none in control groups. This finding was confirmed by Western blots. Our data are consistent with the suspected importance of an impaired astrocyte function in the pathomechanism of a psychosyndrome.     

Does a period of detraining cause a decrease in serum brain-derived neurotrophic factor?

Brain-derived neurotrophic factor (BDNF) is one of the neurotrophins promoting cognitive function and contributing to neurogenesis and neuroprotection. Available evidence suggests that exercise influences serum BDNF concentrations, but that the effect is transient. The purpose of this study is to determine whether a period of aerobic training, followed by a period of detraining, can influence basal serum BDNF levels in humans. Sixteen young, sedentary subjects were assigned to an experimental group (n = 9) and a control group (n = 7). The experimental group performed an aerobic training program during 8 weeks, followed by 8 weeks of detraining, during which subjects returned to their previous, sedentary activity level. The control group remained physically inactive during 16 weeks. In both groups, performance on short-term (Digit Span test) and mid-term memory (Recall of Images) was assessed. Aerobic training significantly increased the VO₂ peak in the experimental group, and these values returned to baseline after 8 weeks of detraining. Basal serum BDNF was not influenced by 8 weeks of aerobic training and detraining did not seem to have an effect on basal peripheral BDNF concentrations. Both training and detraining did not clearly influence short-term memory performance on the Digit Span test and no differences were present between the experimental and control group on the mid-term memory test. Future studies should focus on patient groups and elderly to further investigate the effect of training and detraining on neurotrophic factors and cognitive function, and on the effects of training and detraining on the BDNF response to acute exercise.     

Diuretics in Meniere disease: a therapy or a potential cause of harm?

Despite the lack of clear evidence for their effectiveness in treating vertigo, tinnitus, hearing loss and aural fullness, diuretics, represent a common treatment for Meniere disease (MD), as they are supposed to decrease volume and pressure in the endolymphatic partition of the labyrinth. Our group have outlined the possibility of an adverse effect on inner ear function derived from an abrupt lowering of blood pressure: a subsequent exaggerated vasomotor response inducing local ischemia could be responsible for more or less permanent damage. The inner ear, owing both to its terminal vascular supply and to the necessity of a steady metabolism, seems a reliable target for any hemodynamic imbalance that acutely affect its perfusion. In our opinion, the complexity of the inner ear anatomy and function argues against the usefulness of diuretics to reduce endolymphatic volume, in analogy to their effect on the volemia: too many active mechanisms and “buffer” systems are involved in the labyrinth. Even considering that the finding of mean low pressure values is relatively common in subjects with MD, an attempt should be to maintain a stable blood perfusion to the labyrinth; in fact, an abrupt decrease in systemic blood pressure can trigger an adverse sympathetic reaction and transmit misleading information to the cochlear vasopressin receptors.