Echinococcus multilocularis in Denmark 2012–2015: high local prevalence in red foxes

Parasitology Research - In Western Europe, the Echinococcus multilocularis lifecycle is predominantly sylvatic, typically involving red foxes (Vulpes vulpes) as the main definitive hosts with...     

Infection of red foxes (Vulpes vulpes) with Echinococcus multilocularis during the years 2001–2004 in Poland

During the period of 2001-2004, 1,514 red foxes from the north and the southeast of Poland were sampled and examined parasitologically for infections with Echinococcus multilocularis. A mean 23.8% were found infected in the whole study area. The highest prevalence (50.0-62.9%) was found in some counties in the northeastern (Warmia-Mazuria) and the southeastern (Carpathian Foothill) part of the country. During the study period, significant differences in the prevalence were found on a regional level. Based on the results obtained to date, the paper presents an overview of the current epidemiological situation of E. multilocularis in the fox population in Poland.     

The role of evolutionarily conserved signalling systems in Echinococcus multilocularis development and host–parasite interaction

Alveolar echinococcosis, one of the most serious and life-threatening zoonoses in the world, is caused by the metacestode larval stage of the fox-tapeworm Echinococcus multilocularis. Mostly due to its accessibility to in vitro cultivation, this parasite has recently evolved into an experimental model system to study larval cestode development and associated host–parasite interaction mechanisms. Respective advances include the establishment of axenic in vitro cultivation systems for parasite larvae as well as culture systems by which the early development of metacestode vesicles from totipotent parasite stem cells can be reconstituted under controlled laboratory conditions. A series of evolutionarily conserved signalling molecules of the insulin, epidermal growth factor and transforming growth factor-β pathways that are able to functionally interact with corresponding host cytokines have been described in E. multilocularis and most likely play a crucial role in parasite development within the liver of the intermediate host. Furthermore, a whole genome sequencing project has been initiated by which a comprehensive picture on E. multilocularis cell–cell communication systems will be available in due time, including information on parasite cytokines that are secreted towards host tissue and thus might affect the immune response. In this article, an overview of our current picture on Echinococcus signalling systems will be given, and the potential to exploit these pathways as targets for anti-parasitic chemotherapy will be discussed.     

The prevalence of HPV infection in rectal cancer – Report from South – Central Poland (Cracow region)

Some studies suggest that HPV infection may be important carcinogenic factor in development of some part of colorectal cancers. However, in the worldwide literature concerning this type of tumours, the great variability in HPV frequency is noticed. In Poland, the incidence of HPV infection in colorectal cancers was examined in five studies so far and their results are also conflicting. Therefore, the aim of the present study was to assess the HPV presence in the group of 120 patients with adenocarcinomas of rectum. HPV infection was assessed on the basis of DNA extracted from collected formalin fixed paraffin embedded tumour specimens. Viral presence was evaluated using two PCR based methods: nested PCR and quantitative PCR (qPCR) with primers specific for HPV16. All HPV positive samples were subjected to virus genotyping using AmoyDx^® Human papillomavirus (HPV) Genotyping Detection Kit and P16 immunostaining. Among 120 evaluated colorectal tumours, HPV DNA was detected in 2 cancers (1.67%) by nested PCR and in 2 (1.67%) tumours by qPCR, including 1 sample diagnosed as HPV positive on the basis of both PCR variants. Two HPV positive cancers had HPV16 infection and other one HPV18. All three tumours with positivity of HPV DNA were P16 negative. In south – central Poland, HPV infection in rectal cancers probably has not influence on rectal carcinogenesis.     

Scraping or shaking—a comparison of methods for the quantitative determination of Echinococcus multilocularis in fox intestines

A modified sedimentation technique (the shaking in a vessel technique; SVT) to examine intestines for smaller helminths such as Echinococcus multilocularis is described and compared with the intestinal scraping technique (IST). Out of 356 foxes, 26 were E. multilocularis positive, 19 using IST (sensitivity 73.1%) and 25 with SVT (sensitivity 96.2%) after IST. Especially low infection intensities went undetected with IST. The result is comparable to the established sedimentation and counting technique (SCT). SVT is recommended for the routine examination of fox intestines as an alternative to SCT.     

The prevalence of X-linked hypohidrotic ectodermal dysplasia (XLHED) in Denmark, 1995–2010

X-linked hypohidrotic ectodermal dysplasia (XLHED) is characterised by hypohidrosis, sparse hair, and teeth abnormalities. Infants with XLHED have an increased risk of death by hyperpyrexia. XLHED is the most common form of hypohidrotic ectodermal dysplasia (HED); however, no population-based prevalence estimates are available. We aimed to: 1) estimate the prevalence of XLHED in the Danish population per January 1, 2011; 2) identify the most frequent age at time of diagnosis; and 3) quantify the most frequent clinical feature associated with XLHED.Materials and methodsWe conducted a nationwide cross-sectional study (1995–2010). We leveraged national medical registries and data from clinical departments to categorise XLHED cases into three groups: 1) Molecularly-confirmed XLHED; 2) Clinically-diagnosed HED (registered with ICD-10 Q 82.4); and 3) Possible HED (registered with sufficient clinical features based on a clinical algorithm that we designed).ResultsWe identified 90 molecularly-confirmed XLHED, 146 clinically-diagnosed HED, and 988 possible HED cases between 1995 and 2010 (total n = 1224). The prevalence was 21.9 per 100,000 overall and 1.6 per 100,000 when restricting to molecularly-confirmed XLHED cases. The most frequent age at time of XLHED diagnosis occurred between the ages of 11 and 18 years. Teeth abnormalities occurred in 79% of all cases and 52% of molecularly-confirmed cases as a primary clinical marker.ConclusionWe present the first ever population-based prevalence estimates of XLHED and suggest that the prevalence of XLHED may be higher than previously estimated. Diagnosis occurs most frequently during adolescence and teeth abnormalities were the most frequent clinical marker of XLHED.     

Assessment and prevalence of depression in women 45–55 years of age visiting gynecological clinics in Poland

Summary ¶The aims of the Polish survey were to assess efficacy of screening for depression in gynecological practice and to estimate prevalence of depressive disorders in midlife women visiting gynecologists. The study included 2262 female outpatients aged 45–55, who were screened by 120 gynecologists throughout Poland. Patients completed the Becks Depression Inventory (BDI) and were assessed by gynecologists to verify the presence of symptoms of a current Depressive Episode according to ICD-10 diagnostic criteria. Patients who obtained a score of 12 points or more on the BDI were referred for psychiatric evaluation, including the modified version of Mini International Neuropsychiatric Interview (MINI). The study showed that gynecologists in Poland are able to perform screenings for depression effectively in outpatient settings. Results also suggested that about 19% of women aged 45 to 55 years visiting gynecologists may suffer from depressive disorders.Received December 4, 2003; accepted May 9, 2003 Published online July 3, 2003     

Liver fluke (Opisthorchiidae) findings in red foxes (Vulpes vulpes) in the eastern part of the Federal State Brandenburg, Germany – a contribution to the epidemiology of opisthorchiidosis

Parasitological examination of 677 livers from red foxes shot in connection with a rabies control programme were carried out in the eastern districts of the Federal State Brandenburg/Germany in 1996. Of the foxes, 32.5% were positive for opisthorchiid flukes. Metorchis bilis, the most frequently occurring fluke was found in 28.1% of foxes with numbers between 1 and 185. Opisthorchis felineus was found in 6.7% of fox livers. A maximum of 169 specimens was removed from one animal. Pseudamphistomum truncatum was present in only 2 foxes. The percentage of positive foxes in different districts varied between 15.8 and 43.3%. Significant differences in fluke prevalence were found between districts with a high share of surface water compared with a district with a low percentage of surface water. No sex-dependent differences in opisthorchiid prevalence were established. Received: 20 May 1998 / Accepted: 18 June 1998     

Long-term changes in body composition and prevalence of overweight and obesity in girls (aged 3–18 years) from Kraków (Poland) from 1983, 2000 and 2010

Background: Body mass disorders are an increasing problem, especially in industrialized countries.

Aim: Determination of time- and age-related differences in the prevalence of overweight, obesity and in body composition in girls from 1983, 2000 and 2010.

Subject and methods: In 2010 an anthropological study was conducted on 1970 girls aged 3–18 years living in Kraków (Poland). Data on selected skin-folds, BMI, muscle mass and bone mass were compared to two studies on analogous populations carried out in 1983 and 2000.

Results: Compared to 1983, the share of overweight girls in 2010 had decreased (from 12.4% to 11.2%), while the obesity rate had increased slightly from 2.3% to 3.2%. Girls from 2010 had lower overall body fat content than their peers studied in 1983. However, in 2010 suprailiac adiposity prevalence was higher, while triceps, subscapular and abdominal adiposity rates were lower. They also had higher muscle mass and lower bone mass.

Conclusion: The prevalence of overweight and obesity has not changed significantly over the last 30 years. However, significant changes have occurred in body composition. Girls measured in 2010 had lower total adipose tissue, although they also showed a tendency towards increased central adiposity.     

Physical growth curves of indigenous Xavante children in Central Brazil: results from a longitudinal study (2009–2012)

Abstract

Background: The nutritional profile of Indigenous children in Brazil is comparable to those observed in some of the least developed regions of the world.

Aim: Weight and height growth curves were characterised based on longitudinal data from a local Indigenous population experiencing the double burden of child under-nutrition and adult obesity.

Subjects and methods: Anthropometric data were collected in six waves from 2009–2011 for children <10 in two proximate Xavante villages in Central Brazil. Prevalence rates for stunting, wasting and thinness were calculated using WHO references. Weight and height data were adjusted for generalised additive mixed models to generate growth curves.

Results: Prevalence rates of stunting and wasting were high, but cases of thinness and excess weight were negligible. Weight and height began close to WHO medians, but fell substantially before 12 months. Boys but not girls were able to catch-up in weight before age 10. From 3–10 years, height for both sexes remained between ?2 and 0 z-scores.

Conclusion: Impaired Xavante growth before 1 year followed by inconsistent recovery before 10 years reflects health and wellbeing disparities with regard to the Brazilian national population and a complex epidemiology of growth involving rapid nutritional change.     

Intergenerational changes in birth parameters in Kraków (Poland) in the context of socio-economic transformation from 1985–2010

Background: Analyses of birth parameters worldwide reveal relatively high variability over time, often related to socioeconomic factors.

Aim: The aim was to determine the existence of inter-generational changes in birth parameters in Kraków (Poland) in recent years and factors responsible.

Subjects and methods: This research analysed data on 7800 newborns (e.g. body length and weight) and their parents in the years 1985–2010. The significance of differences was calculated using ANOVA. To examine the potential effect of environmental factors, MANOVA were used.

Results: In the case of birth weight no significant changes were observed. A significant decreasing tendency in birth length from the beginning of the 21st century was shown – this observation is quite rare. Accordingly, BMI increased significantly in the 2000s. A decreasing tendency was observed for head circumference.

Conclusion: In the analysed period Poland experienced significant socio-economic changes, which could have partly contributed to the observed changes. Some of the observed trends in birth parameters are recent phenomena and it seems necessary to continue the research to confirm if these changes form a steady trend or are only temporary. Tracking any phenomena related to the development is important for the determination of disruptive factors and the reduction of their adverse effects.     

The prevalence of human endogenous retroviruses in cerebrospinal fluids from patients with sporadic Creutzfeldt–Jakob disease

BackgroundAbout 8% of human genome is constituted by retroviral sequences. Some of these have been classified as human endogenous retroviruses (HERVs), which have been implicated in both health and disease. Recently, indirect evidence for a possible role of retroviral elements in neurological diseases has been provided by several studies.ObjectivesIn the present study, we aimed to evaluate the relationship between HERVs and sporadic Creutzfeldt–Jakob disease (CJD), one of the human forms of prion diseases.Study designWe investigated the prevalence of HERV families by RT-PCR in cell-free cerebrospinal fluids (CSFs) samples from normal controls, patients with sporadic CJD and other neurological diseases (OND).ResultsThe incidence rate of some HERV families were significantly different in CSF samples from the group of sporadic CJD compared to samples from normal individuals; HERV-W (P = 0.001), T (P = 0.039), FRD (P < 0.001), L (P = 0.003) and ERV-9 (P < 0.001) and the incidence rate of HERV-W (P = 0.021) and HERV-L (P = 0.049) were significantly increased in CSF samples from the group of sporadic CJD compared to samples from OND group. Moreover, our results from combining frequencies of two HERV families indicated that the prevalence of many combination groups was significantly different between sporadic CJD and normal CSF samples and between two patients’ CSF samples. In addition, a large number of HERV sequences were newly identified in CSFs from normal and diseased individuals.ConclusionsOur study about distinct prevalence patterns of HERVs reflects that some HERVs families may be associated with the development of prion diseases, and considered as a candidate marker for the diagnosis of sporadic CJD.     

The use of medical care and the prevalence of serious illness in an adult Prader–Willi syndrome cohort

IntroductionAdults with Prader–Willi syndrome (PWS) have an increased occurrence of several medical conditions. We report on the consequences of high morbidity rates such as prevalence rate of hospital admissions, medication use and surgery in a Dutch cohort of adults with PWS. Special attention is paid to causes and symptoms of serious illness.MethodParticipants were contacted via the Dutch Prader–Willi Parent Association and through physicians specializing in persons with ID. The persons with PWS and their main caregivers were visited at home. Information was collected through semi-structured interviews on 102 adults with PWS.ResultsThe need for medical care in the neonatal period is associated with hypotonia and feeding problems. Hospital admissions for respiratory tract infections are frequent. During childhood most hospital admissions were due to PWS syndrome specific surgery. During adolescence hospital admissions occurred for scoliosis surgery and endocrine evaluations. At adult age, hospitalization was associated with inguinal hernia surgery, diabetes mellitus, psychosis, erysipelas, water and drug intoxications. In the older group, respiratory infections were again the main reason for hospital admissions. Frequently used medications at adult age included psychotropics, laxatives, anti-diabetics and dermatologic preparations. Abnormal drinking patterns, problems with anesthesia, decreased ability to vomit, abnormal pain awareness and unpredictable fever responses were frequent and often lead to delayed diagnoses of serious conditions.DiscussionPeople with PWS are frequent users of medical-care. Reasons for hospitalization and medication use are age specific. Knowledge on the different presentation of symptoms in people with PWS is needed. In case of unexplained illness, disturbances of consciousness and behavioral changes in people with PWS, an infection should be ruled out in the first place. Information from this study may help in preventing conditions and recognizing conditions in an early stage. Adequate preventive management and treatment of PWS related morbidity, could reduce medical care use in the long term and could improve quality adjusted life years.     

Treatment outcomes of multidrug-resistant tuberculosis patients in Zhejiang,China, 2009–2013

ObjectivesTo examine treatment outcomes and factors associated with poor outcome of multidrug-resistant (MDR) tuberculosis (TB) in China.MethodsWe conducted a prospective observational cohort study including consecutive patients with MDR-TB between 2009 and 2013 in six regions of Zhejiang province. Patients were prescribed treatments by infectious disease specialists, and treatment outcomes were recorded. Sociodemographic characteristics were obtained through a structured questionnaire. The primary endpoint was poor treatment outcomes, defined as treatment failure based on microbiologic persistence, default (lost to follow-up) or death at 24 months. We assessed risk factors for poor treatment outcomes using a Cox proportional hazards model.ResultsA total of 820 MDR-TB patients were observed, and 537 with known treatment outcomes were included in our study. Overall, the treatment success rate was 40.2 per 100 years (374/537 participants, 69.6%), while treatment failure, death and default rates were 10.0 per 100 years (101 participants, 18.8%), 3.4 per 100 years (36 participants, 6.7%) and 2.7 per 100 years (26 participants, 4.8%) respectively. Independent predictors of poor treatment outcomes included age >60 years (hazard ratio (HR) 2.3, 95% confidence interval (CI) 1.2–4.2), patients registered as experiencing relapse (HR 2.2, 95% CI 1.1–4.4), patients registered as receiving treatment after failure (HR 2.4, 95% CI 1.2–4.9), use of standardized MDR-TB regimens (HR 0.6, 95% CI 0.4–1.0), cavitary disease (HR 4.9, 95% CI 2.8–8.6) and adverse events (HR 2.5, 95% CI 1.2–5.5).ConclusionsUnder well-designed treatment and management scheme, high treatment success rates were achieved in a high-MDR-TB-burden country. Antimicrobial susceptibility testing for all second-line drugs should be conducted to further assist in the treatment of MDR-TB.     

The pathogenic role of Epstein–Barr virus (EBV) in sclerosing polycystic adenosis

Sclerosing polycystic adenosis (SPA) is a pathology of the salivary gland which occurs infrequently and has a controversial etiology. In this study, we investigated the possible roles of HPV and EBV in the pathogenesis of SPA.