Nocardiosis in Quebec,Canada, 1988–2008

Nocardia is an uncommon pathogen, but immunosuppression, its main risk factor, is becoming more frequent. We aimed to evaluate changes in the annual incidence of nocardiosis and in the susceptibility profile of its aetiological agents. Demographic data were analysed for all isolates of Nocardia forwarded to the provincial public health laboratory of Quebec, Canada during the last two decades. Population incidence could be measured from 1997 onwards. Resistance patterns were analysed for those isolates selected for in vitro susceptibility testing. Throughout Quebec, 575 incident cases were identified between 1997 and 2008. The annual incidence of Nocardia infection/colonization increased from 0.33 (1997–1998) to 0.87 (2007–2008) per 100 000 inhabitants (p 0.001). In a small subset of patients for whom detailed clinical information was available, 59% of isolates corresponded to genuine infections. Nocardia farcinica predominated in specimens representing invasive infections (blood, brain, lung or pleural aspirates). Isolates were often non‐susceptible to several antimicrobials, with the exception of amikacin and linezolid. Overall, 43% of 157 isolates were non‐susceptible to trimethoprim–sulphamethoxazole. In conclusion, Nocardia infection/colonization remains rare. However, from 1997–1998, a progressive increase in incidence was noted in the province of Quebec. In regions such as ours, where a substantial proportion of invasive isolates are non‐susceptible in vitro to trimethoprim–sulphamethoxazole, the latter may no longer be the empirical treatment of choice in immunosuppressed and severely ill patients with nocardiosis.     

PEGylation is effective in reducing immunogenicity,immunotoxicity, and hepatotoxicity of α-momorcharin in vivo

Background and aim: α-momorcharin (α-MMC), a type I ribosome-inactivating protein (RIP) from Momordica charantia, is well known for its antitumor and antivirus activities. However, the immunotoxicity and hepatotoxicity hampers its potential therapeutic usage. In order to reduce its toxicity, we had modified the α-MMC with polyethylene glycol (PEG), and detected the toxicity of the PEGylated α-MMC conjugates (α-MMC-PEG) in vivo.

Materials and methods: After α-MMC purified from bitter melon seeds, α-MMC-PEG was constructed with a branched 20 kDa (mPEG) 2-Lys-NHS, the tests of immunogenicity, immunotoxicity, and general toxicity of α-MMC-PEG were conducted in guinea pig and rat.

Results: The titer of specific IgG in rats, immunized by α-MMC-PEG, were approximately one-third of those that by α-MMC, all the guinea pigs treated with α-MMC died of anaphylaxis shock within 5 min, while no animals treated with α-MMC-PEG died in the active systemic anaphylaxis (ASA) test. The passive cutaneous anaphylaxis (PCA) reaction of α-MMC-PEG challenge in rats was significantly smaller than that of the α-MMC. The liver damage was greatly released, such as the change of globulin (GLB), aspartate aminotransferase (AST), total bilirubin (TBIL) cholesterol (CHOL), albumin (ALB), and the degree of hepatocyte necrosis in repeated toxicity study.

Conclusions: PEGylation is effective in reducing the immunogenicity, immunotoxicity, and hepatotoxicity of α-MMC in vivo.     

Can history, ultrasound, or ELISA chlamydial antibodies, alone or in combination, predict tubal factor infertility in subfertile women?

BACKGROUND: This study aimed to determine whether medical history, transvaginal ultrasound (TVU) or Chlamydia trachomatis antibody testing (CAT), alone or in combination, could provide a non-invasive, clinically useful screening test for predicting tubal factor infertility (TFI) in subfertile women. METHODS: Prior to tubal evaluation, relevant medical history, TVU findings, and enzyme-linked immunosorbent assay (ELISA) IgG CAT results were collected. Sensitivity, specificity, likelihood ratios (LR) and accuracy for predicting TFI, as determined by laparoscopy and dye hydrotubation, were calculated for each test alone, and in parallel and series combination. RESULTS: Thirty per cent (63/207) were diagnosed with TFI. The highest sensitivity (67%, 95% CI: 54-77) included any positive test, yet missed one in three women with TFI. The highest specificity (100%, 95% CI: 97-100) required all three tests positive, but identified only three women. Only the combination of CAT and TVU rated as a good clinical test, but confidence intervals were wide due to the small numbers affected. The combination of CAT or TVU and CAT alone reported the highest accuracy (73%, 95% CI: 66-78), misdiagnosing one in four women. CONCLUSION: Medical history, TVU appearances, and ELISA IgG CAT alone, or in combination, failed to predict accurately TFI in subfertile women.     

Über den Vitamin A-Nachweis im Blute,in Exsudaten,im Duodenalsaft und in Faeces

Ohne Zusammenfassung     

PEGylation is effective in reducing immunogenicity, immunotoxicity, and hepatotoxicity of α-momorcharin in vivo

Background and aim: α-momorcharin (α-MMC), a type I ribosome-inactivating protein (RIP) from Momordica charantia, is well known for its antitumor and antivirus activities. However, the immunotoxicity and hepatotoxicity hampers its potential therapeutic usage. In order to reduce its toxicity, we had modified the α-MMC with polyethylene glycol (PEG), and detected the toxicity of the PEGylated α-MMC conjugates (α-MMC-PEG) in vivo. Materials and methods: After α-MMC purified from bitter melon seeds, α-MMC-PEG was constructed with a branched 20 kDa (mPEG) 2-Lys-NHS, the tests of immunogenicity, immunotoxicity, and general toxicity of α-MMC-PEG were conducted in guinea pig and rat. Results: The titer of specific IgG in rats, immunized by α-MMC-PEG, were approximately one-third of those that by α-MMC, all the guinea pigs treated with α-MMC died of anaphylaxis shock within 5 min, while no animals treated with α-MMC-PEG died in the active systemic anaphylaxis (ASA) test. The passive cutaneous anaphylaxis (PCA) reaction of α-MMC-PEG challenge in rats was significantly smaller than that of the α-MMC. The liver damage was greatly released, such as the change of globulin (GLB), aspartate aminotransferase (AST), total bilirubin (TBIL) cholesterol (CHOL), albumin (ALB), and the degree of hepatocyte necrosis in repeated toxicity study. Conclusions: PEGylation is effective in reducing the immunogenicity, immunotoxicity, and hepatotoxicity of α-MMC in vivo.     

Defensins: key players or bystanders in infection, injury, and repair in the lung?

Antimicrobial peptides have been identified as key elements in the innate host defense against infection. Recent studies have indicated that the activity of antimicrobial peptides may be decreased in cystic fibrosis, suggesting a major role for these peptides in host defense against infection. One of the most intensively studied classes of antimicrobial peptides are defensins. Defensins comprise a family of cationic peptides that in human subjects can be divided into the alpha- and beta-defensin subfamilies. The alpha-defensins are produced by neutrophils and intestinal Paneth's cells, whereas beta-defensins are mainly produced by epithelial cells. Although studies on beta-defensins have so far focused on their antimicrobial activity, studies on alpha-defensins have suggested a role of these peptides in inflammation, wound repair, and specific immune responses. alpha-Defensins, which accumulate in airway secretions of patients with various chronic inflammatory lung disorders, were shown to be cytotoxic toward airway epithelial cells and to induce chemokine secretion in several cell types. Furthermore, the capacity of alpha-defensins to promote bacterial adherence to epithelial cells in vitro further supports a role for these peptides in the pathogenesis of chronic obstructive pulmonary disease and cystic fibrosis. Increased numbers of neutrophils are also present in the airways of patients with asthma, suggesting that neutrophils are involved in the pathogenesis of this disease. Because defensins are able to induce histamine release by mast cells and increase the airway hyperresponsiveness to histamine, it is tempting to speculate that defensins may also contribute to the inflammatory processes in asthma. Besides these proinflammatory effects, alpha-defensins may also display anti-inflammatory activities, including regulation of complement activation and proteinase inhibitor secretion. Finally, defensins may be involved in wound repair because defensins increase epithelial cell proliferation. Thus recent defensin research has revealed potential links between the innate and acquired immune system.     

Placentophagia in naïve adults, new fathers, and new mothers in the biparental dwarf hamster, Phodopus campbelli

Placentophagia in mammals typically occurs only in females during the birth. Male hamsters, Phodopus campbelli, with an extensive paternal behavior repertoire eat placenta during the birth and as alloparental juveniles. Two fresh placentae were presented to sexually naïve males and females covering the developmental range from puberty through reproductive maturity and into senescence. Expectant parents and new mothers were also tested. Placentophagia occurred in both sexes at all developmental stages and was higher in reproductive than in naïve hamsters. Placentophagia declined with increasing age in females, but not males. Liver was readily accepted, but acceptance did not decline with age in females, and was not low in juvenile males, confirming that animals distinguished between the two tissues. Senescent females consumed both tissues willingly. In these paternal males, which do not experience pregnancy or parturition, and in naïve females that selectively refuse placenta, the stimuli influencing placentophagia remain unknown. © 2005 Wiley Periodicals, Inc. Dev Psychobiol 47: 179–188, 2005.     

Hot flushes in a male population aged 55, 65, and 75 years,living in the community of Linköping,Sweden

OBJECTIVE: Hot flushes are as common in castrated men as in menopausal women. We investigated whether hot flushes exist in a normal aging male population and to what extent. DESIGN: A questionnaire was sent to all men living in Link?ping, Sweden, who were 55, 65, and 75 years old ( = 1,885). The questionnaire asked for demographic data, medical history, mood status, medication, castrational therapy, and smoking, exercise, and alcohol habits, among other items. We asked specifically for current hot flushes unrelated to exercise or a warm environment. RESULTS: Of the questionnaires received, 1,381 were eligible for evaluation; 33 were analyzed separately because these men had been castrated. Hot flushes of any frequency were reported by 33.1% of noncastrated men, 4.3% reported flushes at least a few times per week, and 1.3% reported daily flushes. Half of the men reporting flushes were also bothered by them, ie, almost every sixth man in total. We found a relation between occurrence of hot flushes and other symptoms thought to be related to low testosterone concentration, such as decreased muscle strength or endurance, decreased enjoyment of life, sadness or grumpiness, and lack of energy ( < 0.05). CONCLUSIONS: Hot flushes occur in one third of a population of noncastrated older men, approximately half of whom consider flushes as bothersome. Neither the mechanisms nor whether the symptoms would respond to testosterone supplementation is known. Androgen substitution to treat symptoms possibly related to a male climacteric is still controversial. Studies are needed to evaluate the needs for and the effects of androgen treatment on vasomotor symptoms.     

Accidents of circumcision in children in Abidjan, Côte d'Ivoire

Circumcision is the most common surgical procedure carried out in boys in our countries. It is performed by medical members but also by traditional practitioners. Circumcision is considered as a benign operation but its complications are common, sometimes severe and the treatment delicate. Authors reported 35 cases of circumcision's complications in boys, aged of 2 days to 14 years old who were circumcised by traditional practitioners and by medical members. The most frequent complications were urinary meatus stenosis (17 cases), haemorrhage (5), total glans section (3), urethral fistula (3), and incomplete circumcision (3). These complications were caused by traditional practitioners in 19 cases, paramedical members in 11 cases, and 5 cases by physicians. Among these complications, fistula and amputation had required delicate surgical procedure. All the stenosis were treated by meatal plasty and fistula were sutured with one recurrence. Partial glans section underwent Mathieu's procedure and the total sections were referred to the plastic surgeon. Authors recommend surgical procedure for circumcision which must be performed in medical center or by well trained practitioners.     

Immunology, Autoimmunity, and Autoantibodies in Parkinson’s Disease

Recent revelations of immune alterations in Parkinson??s disease have led to the convergence that an autoimmune mechanism may play a role in the etiopathogenesis of this neurodegenerative disease. In the current study, 77 Parkinson??s disease patients and 77 matched healthy controls were analyzed for the presence of seven autoantibodies previously found to be associated with central nervous system manifestations namely: antineuronal-cells, anti-brain lysate, anti-dsDNA, anti-phosphatidylserine, anti-cardiolipin, anti-serotonin, and anti-melanocytes antibodies. Patients underwent systematic assessments of demographics, clinical, and biochemical manifestations. Three autoantibodies were found to be more prevalent among Parkinson??s disease patients (antineuronal cells10.3% vs. 1.3%, p?=?0.017; anti-brain lysate 9.1% vs. 1.3%, p?=?0.032; anti-dsDNA 10.3% vs. 2.6%, p?=?0.049). Clinical manifestations of Parkinson??s disease, particularly dyskinesia and depression, were found to be associated with the presence of these autoantibodies.     

The epidemiology,clinical characteristics,and macrolide susceptibility of Mycoplasma pneumoniae pneumonia in children in Southern Taiwan, 2019–2020

BackgroundSince the global use of the pneumococcal conjugate vaccine, Mycoplasma pneumoniae (MP) has become the most common bacterial cause of lower respiratory tract infections among children. Monitoring the changing epidemiology and antimicrobial resistance rates of this organism is important for MP clinical management.MethodsThis study characterizes key features of MP during the 2019–2020 epidemic in children in Taiwan. The cohort included all hospitalized children under 18 years of age with polymerase chain reaction (PCR)-confirmed community-acquired mycoplasma pneumonia (CAMP) in southern Taiwan. Macrolide resistance was identified by mutations in domain V of MP 23S rRNA. Severe disease referred to symptoms warranting oxygen therapy, septic shock, or intensive care unit admission.ResultsAmong 495 LRTI patients, 195 (39.4%) had CAMP, of which 106 (54.4%) had concurrent serological evidence of MP infection. The diagnostic sensitivity of IgM in the acute phase was 65.6%. CAMP case numbers were highest from July 2019 to January 2020. The most common clinical presentations of CAMP were fever (99.0%), cough (99.0%), and coryza (31.8%). Despite a high rate of macrolide resistance (88.1%), macrolide-resistant MP (MRMP) did not differ from macrolide-sensitive MP (MSMP) in clinical course or severity. Delayed administration of effective antimicrobial treatment was also associated with severe disease (p < 0.05).ConclusionEarly diagnosis and determination of MRMP are needed for effective management of MP infection.     

BamH1 polymorphism in the Chinese,Malays, and Indians in Singapore and its application in the prenatal diagnosis of β-thalassemia

Summary The distribution of restriction fragment length polymorphism (RFLP) at theBamH1 site of the -globin gene was investigated in the Chinese, Indian, and Malay race in Singapore. The sample comprised of 183 normal individuals and 35 -thalassemia carriers in which 13 were couples with at least one -major child. The results from this study indicate thatBamH1 polymorphism will be informative in 22% of pregnancies at risk for -thalassemia major in Chinese, 19% in Malays and 7% in Indians. In prenatal diagnosis usingBamH1 polymorphism for one -major affected family, the fetus was diagnosed to be normal or -carrier. The validity ofBamH1 polymorphism in the exclusion of -thalassemia major was subsequently confirmed at birth by globin chain biosynthesis.     

Animal-based folk remedies sold in public markets in Crato and Juazeiro do Norte, Ceará, Brazil

Background  

Human communities consistently develop a detailed knowledge of the therapeutical and medicinal properties of the local flora and fauna, and these folk remedies often substitute medicines produced by the pharmaceutical industry. Animals (and their derived products) are essential ingredients in the preparation of many traditional remedies. The present work prepared an inventory of the animals sold in public markets in the cities of Crato and Juazeiro do Norte, Ceará State, Brazil.     

High in situ mRNA levels of IL-22, TFG-β, and ARG-1 in keloid scars

Keloid scars are currently considered a chronic inflammatory process and no longer a benign skin tumor. Keloids are defined as highly inflamed, hyperproliferative pathological scars. Growth factors and cytokines have important functions in the keloid inflammatory etiopathogenesis. The aim of this study was to analyze the in situ expression of cytokines and growth factors in keloid scars in comparison with that in normal scars. Among them, we specifically assessed TGF-β, FGF, IL-33, IL-22, ARG-1, ARG-2, iNOS, VIP, VIP-R1, TAC, and TAC-R1. A total of 98 biopsies were evaluated, including of 53 keloid and 45 normal scars. The age of patients with keloids ranged from 11 to 73 years, with a mean age of 28 years and predominance of the female gender (58.5% of the total patients). Around 64.15% of the patients belonged to the black ethnic group. Evaluated keloids were most commonly located in the earlobe because of ear piercing, representing 73.6% of the cases. We found significantly greater expression of TGF-β, IL-22, and ARG-1 in keloids when compared with that in normal scars. As for IL-33, ARG-2, and VIP-R1, despite the higher number of mRNA copies found in keloids, this difference was not significant. Furthermore, FGF, iNOS, VIP, TAC, and TAC-R1 mRNA levels were not detectable, and therefore these results were inconclusive in this study. Considering these results, understanding the cellular and molecular mechanisms that control the inflammatory response during cutaneous healing may promote the development of strategies to improve the treatment of patients with keloids.