Serodiagnosis of neurocysticercosis in patients with epileptic seizure using ELISA and immunoblot assay

Sera from 88 patients from Santa Catarina and S?o Paulo states of Brazil, with epileptic seizures who underwent cerebral computed tomography (CT) were analyzed for the detection of antibodies to T. solium cysticercus by ELISA and Immunoblot (IB) with the following antigens: Taenia solium cysticercus total saline (Tso), Taenia crassiceps cysticercus vesicular fluid (Tcra-vf) and T. crassiceps cysticercus glycoproteins (Tcra-gp). ELISA carried out with Tso, Tcra-vf and Tcra-gp antigens showed 95%, 90% and 80% sensitivities, respectively, and 68%, 85% and 93% specificities, respectively. In the epileptic patients group, ELISA positivity was 30%, 51% and 35% with Tso, Tcra-vf and Tcra-gp antigens respectively. Considering the IB as the confirmatory test, the positivity was 16% (14/88) in the epileptic patients total group and 22% (12/54) in the epileptic patients with positive CT and signals of cysticercosis. We found a significant statistical correlation among ELISA or IB results and the phase of the disease when any antigens were used (p < 0.05). We emphasize the need to introduce in the laboratory routine the search for neurocysticercosis (NC) in patients presenting with epileptic seizures because of the high risk of acquiring NC in our region and its potential cause of epilepsy.     

Immunodiagnosis of human cysticercosis (Taenia solium): a field comparison of an antibody-enzyme-linked immunosorbent assay (ELISA), an antigen-ELISA, and an enzyme-linked immunoelectrotransfer blot (EITB) assay in Peru. The Cysticercosis Working Group in Peru (CWG).

We compared results of an enzyme-linked immunosorbent assay (ELISA) and an enzyme-linked immunoelectrotransfer blot (EITB) assay for the diagnosis of cysticercosis in sera and cerebrospinal fluid (CSF). Sera from 34 patients with confirmed cysticercosis were tested by both ELISA and EITB assays. Cerebrospinal fluid from some of these patients was also tested by ELISA for the presence of antibody (AB-ELISA) (n = 21) and antigen (AG-ELISA) (n = 15). Specificity in sera was examined by testing 51 serum samples from Bangladesh, where cysticercosis is not endemic. Cross-reactivity was evaluated in sera from patients with Echinococcus granulosus (hydatid) and Hymenolepis nana infections. Sensitivity in detecting cysticercosis in sera was 94% by EITB and 65% by AB-ELISA (P less than 0.01). Sensitivities in the CSF tested by EITB, AB-ELISA, and AG-ELISA were 86%, 62%, and 67%, respectively. The specificity of the EITB was 100%, while that of AB-ELISA was 63% (P less than 0.01). Cross-reactions occurred in the AB-ELISA with 11% and 20% of sera from hydatid and H. nana patients, respectively. Our results demonstrate that the EITB is the best assay available for the diagnosis of cysticercosis in both sera and CSF.     

老年人癫痫发作的临床特征分析

目的探讨老年人癫痫发作的临床表现、病因及其诊断与鉴别诊断。方法回顾性分析139例患者的临床资料,其中癫痫发作125例,非癫痫发作误诊为癫痫发作14例。结果主要病因为脑血管病(46.4%),其次为病因不详(29.6%)。125例癫痫发作患者中,部分性发作86例(68.8%),全面性发作39例(31.2%);53例行常规脑电图检查,12例(22.6%)出现非特异性异常,1例(1.9%)出现癫痫样电发放;43例行长程视频脑电图检查,38例(88.4%)出现癫痫样电发放。14例非癫痫发作均误诊为癫痫发作。结论脑血管病是老年患者癫痫发作最常见的病因,部分性发作为老年患者癫痫发作最常见的发作形式。Todd麻痹和非抽搐性癫痫持续状态为癫痫发作的特殊形式,极易误诊。代谢障碍性疾病、晕厥、短暂性全面性遗忘、短暂性脑缺血发作所致的非癫痫发作与癫痫发作的鉴别诊断较为困难。     

Cardiac troponin I (CTnI) level among children with epileptic seizures

Epilepsy is a common chronic neurological disorder in pediatric age characterized by recurrent, unprovoked seizures; these seizures are transient signs of abnormal excessive or hyper synchronous neuronal activity in the brain. Complicated epilepsy is associated with high seizure frequency, prolonged seizures and may lead to some sort of cardiac ischemia, myocardial injury and elevated serum CTnI.AimA possible importance of Cardiac troponin I (CTnI) level in epileptic children.Patients and methodsThe study was carried out upon 90 children, classified into three groups: Group I: 30 with uncomplicated epilepsy. Group II: 30 with complicated epilepsy. Group III (control): 30 apparently clinically healthy children with similar age and sex. All groups were subjected to the following: full history taking – thorough clinical examination – EEG – assessment of serum cardiac troponin I- and CT only for groups I and II.ResultsOur research revealed a significant statistical increase in the cardiac troponin level (CTnI) maximum in group II followed by group I then lastly group III and revealed a direct correlation between cardiac troponin I and presence of prenatal problem, mental retardation, EEG abnormality and abnormal C T or MRI. There was an indirect correlation between cardiac troponin I and age of seizure onset. Also there was one between cardiac troponin I and etiology of epilepsy.ConclusionCardiac troponin I is a perfect tool for early detection of cases with myocardial dysfunction in epileptic patients – cardiac troponin I is significantly increased in children with epilepsy especially the complicated epilepsy. Cardiac injury in epileptic children is more common in patients with early onset epilepsy, positive prenatal problem, idiopathic epilepsy, abnormal imaging and EEG – elevated TnI levels may be of value in assessing the severity and eventual outcome and mortality risk of the disease in children with epilepsy.     

An enzyme-linked immunoelectrotransfer blot assay and glycoprotein antigens for diagnosing human cysticercosis (Taenia solium)

An enzyme-linked immunoelectrotransfer blot (EITB) assay was developed for immunodiagnosing human cysticercosis. The assay uses lentil-lectin, affinity-purified glycoprotein antigens. A battery of 532 serum and 46 cerebrospinal fluid (CSF) samples (148 cases of parasitologically confirmed cysticercosis, 54 healthy controls, and 18 types of heterologous infections [376 cases]) were used to ascertain the assay's efficacy. All but three of the samples from cases of confirmed cysticercosis were positive; none of the samples from healthy controls or heterologous infections reacted to any of the diagnostic bands. Thus, the assay is 98% sensitive and 100% specific. We identified seven major glycoprotein bands that are commonly recognized by virtually all serum and/or CSF samples from patients with confirmed cysticercosis. There was no significant difference in test performance when CSF was compared with serum. The EITB assay is highly reproducible and simple to perform, and the reagents (including the antigens blotted onto strips) are very stable.     

Antiphospholipid and antinuclear antibodies in patients with epilepsy or new-onset seizure disorders

PURPOSE: The increased prevalence of autoantibodies in patients with epilepsy has been traditionally regarded to be a consequence of antiepileptic drugs. The purpose of this study was to measure autoantibodies in well-defined groups of patients with seizures to determine the effects of epilepsy and antiepileptic medications on the presence of autoantibodies. PATIENTS AND METHODS: We studied the frequency of antinuclear antibodies, anti-beta2-glycoprotein I antibodies, and anticardiolipin antibodies in 50 patients with therapy-resistant localization-related epilepsy, 50 patients with generalized epilepsy syndromes, 52 patients with a newly diagnosed seizure disorder but no antiepileptic medication, and 83 healthy controls. RESULTS: Compared with controls, newly diagnosed patients had a significantly greater prevalence of immunoglobulin (Ig) G class anticardiolipin antibodies (21% versus 7%); the prevalence was 14% in patients with localization-related epilepsy and 8% in patients with generalized epilepsy. The prevalence of IgM class anticardiolipin antibodies was significantly greater in all seizure groups (60% in localization-related epilepsy, 42% in generalized epilepsies, and 33% in newly diagnosed patients) compared with controls (7%). Antinuclear antibodies were significantly more common in newly diagnosed patients (21%) and localization-related epilepsy (24%) compared with controls (12%). When patients with generalized epilepsy (8%) were used as the reference group, antinuclear antibodies were also significantly more frequent in localization-related epilepsy (relative risk [RR] = 2.9, 95% confidence interval [CI]: 1.1 to 8.2) and newly diagnosed seizures (RR = 3.4, 95% CI: 1.2 to 9.3). There were no consistent associations between autoantibodies and specific antiepileptic medications. CONCLUSIONS: The prevalence of autoantibodies is greater in patients with epilepsy, including newly diagnosed seizure disorder. The increased prevalence of autoantibodies is more strongly associated with epilepsy than with antiepileptic drugs, perhaps indicating that immune dysregulation may be commonly associated with epilepsy.     

NEUROCYSTICERCOSIS IN CHILDREN PRESENTING WITH AFEBRILE SEIZURE: CLINICAL PROFILE,IMAGING AND SERODIAGNOSIS

Neurocysticercosis (NCC) is one of the major causes of childhood seizures in developing countries including India and Latin America. In this study neurological pediatric cases presenting with afebrile seizures were screened for anti-Cysticercus antibodies (IgG) in their sera in order to estimate the possible burden of cysticercal etiology. The study included a total of 61 pediatric afebrile seizure subjects (aged one to 15 years old); there was a male predominance. All the sera were tested using a pre-evaluated commercially procured IgG-ELISA kit (UB-Magiwell Cysticercosis Kit ^™). Anti-Cysticercus antibody in serum was positive in 23 of 61 (37.7%) cases. The majority of cases with a positive ELISA test presented with generalized seizure (52.17%), followed by complex partial seizure (26.08%), and simple partial seizure (21.73%). Headaches were the major complaint (73.91%). Other presentations were vomiting (47.82%), pallor (34.78%), altered sensorium (26.08%), and muscle weakness (13.04%). There was one hemiparesis case diagnosed to be NCC. In this study one child without any significant findings on imaging was also found to be positive by serology. There was a statistically significant association found between the cases with multiple lesions on the brain and the ELISA-positivity (p = 0.017). Overall positivity of the ELISA showed a potential cysticercal etiology. Hence, neurocysticercosis should be suspected in every child presenting with afebrile seizure especially with a radio-imaging supportive diagnosis in tropical developing countries or areas endemic for taeniasis/cysticercosis.     

Frequency of serum anti-cysticercus antibodies in the population of a rural Brazilian community (Cássia dos coqueiros, SP) determined by Elisa and immunoblotting using Taenia crassiceps antigens

Considering the impact of cysticercosis on public health, especially the neurologic form of the disease, neurocysticercosis (NC), we studied the frequency of positivity of anti-Taenia solium cysticercus antibodies in serum samples from 1,863 inhabitants of Cássia dos Coqueiros, SP, a municipal district located 80 km from Ribeir?o Preto, an area considered endemic for cysticercosis. The 1,863 samples were tested by enzyme linked immunosorbent assay (ELISA) using an antigenic extract from Taenia crassiceps vesicular fluid (Tcra). The reactive and inconclusive ELISA samples were tested by immunoblotting. Of the 459 samples submitted to immunoblotting, 40 were strongly immunoreactive to the immunodominant 18 and 14 kD peptides. Considering the use of immunoblotting as confirmatory due to its high specificity, the anti-cysticercus serum prevalence in this population was 2.1%.     

Cysticercosis in an urban black South African community: prevalence and risk factors

Cysticercosis still represents a significant health problem in developing communities, despite supposed improvements in sanitation and personal hygiene. An ELISA for Cysticercosis antibodies was performed on serum from 230 random adult admissions to Baragwanath Hospital. Seventeen patients were seropositive giving a prevalence of 7.39% for this group of urban black South Africans. Twenty-one patients with documented cerebral cysticercosis were selected in order to evaluate risk factors for cysticercosis. Of the risk factors considered only a history of tapeworm infestation appeared to be significant. Even urbanisation has not resulted in n reduction in the prevalence of Cysticercosis and it appears that the disease continues to be endemic in this developing community.     

Referral of epileptic patients in North East Coast of West Malaysia an area with poor MRI coverage: an analysis

Advances in neuroimaging techniques, particularly Magnetic Resonance Imaging (MRI), have proved invaluable in detecting structural brain lesions in patients with epilepsy in developed countries. In Malaysia, a few electroencephalography facilities available in rural district hospitals run by trained physician assistants have Internet connections to a government neurological center in Kuala Lumpur. These facilities are more commonly available than MRI machines, which require radiological expertise and helium replacement, which may problematic in Southeast Asian countries where radiologists are found in mainly big cities or towns. We conducted a cross-sectional study over a two year period begining January 2001 on rural patients, correlating EEG reports and MRI images with a clinical diagnosis of epilepsy to set guidelines for which rural patients need to be referred to a hospital with MRI facilities. The patients referred by different hospitals without neurological services were classified as having generalized, partial or unclassified seizures based on the International Classification of Epileptic Seizures proposed by the International League Against Epilepsy (ILAE). The clinical parameters studied were seizure type, seizure frequency, status epilepticus and duration of seizure. EEG reports were reviewed for localized and generalized abnormalities and epileptiform changes. Statistical analysis was performed using logistic regression and area under the curve. The association between clinical and radiological abnormalities was evaluated for sensitivity and specificity. Twenty-six males and 18 females were evaluated. The mean age was 20.7 +/- 13.3 years. Nineteen (43.2%) had generalized seizures, 22 (50.0%) had partial seizures and 3 (6.8%) presented with unclassified seizures. The EEG was abnormal in 30 patients (20 with generalized abnormalities and 10 localized abnormalities). The MRI was abnormal in 17 patients (38.6%); the abnormalities observed were cerebral atrophy (5), hippocampal sclerosis (4), infarct/gliosis (3), cortical dysgenesis (2) and tumors (2). One patient had an arachnoid cyst in the right occipital region. Of the 17 patients with an abnormal MRI, 14 had an abnormal EEG, this difference was not statistically significant. There was no significant associaton between epileptographic changes and MRI findings (p = 0.078). EEG findings were associated with MRI findings (p = 0.004). The association between an abnormal EEG and an abnormal MRI had a specificity of 82.4%, while epileptogenic changes had a specificity of 64.7% in relation to abnormal MRI findings. This meants that those patients in rural hospitals with abnormal EEGs should be referred to a neurology center for further workup and an MRI to detect causes with an epileptic focus.     

检测血清和脑脊液中囊尾蚴循环抗原诊断脑囊虫病的研究

目的：用抗血清检测脑囊虫病患者血清和脑脊液（ Ｃ Ｓ Ｆ）中囊尾蚴循环抗原（ Ｃ Ａｇ）诊断脑囊虫病。方法：用 Ｓ Ｄ Ｓ Ｐ Ａ Ｇ Ｅ提纯的蛋白质分子量为 ６４ ｋ Ｄａ、５３ ｋ Ｄａ、３２ ｋ Ｄａ～３０ ｋ Ｄａ 的囊尾蚴抗原分别免疫家兔,制备相应的抗血清,以双夹心 Ｅ Ｌ Ｉ Ｓ Ａ 检测患者血清和 Ｃ Ｓ Ｆ中 Ｃ Ａｇ。结果：抗５３ ｋ Ｄａ 抗原抗血清对 ３２ 例脑囊虫病活动型患者血清和 Ｃ Ｓ Ｆ中 Ｃ Ａｇ 的检出率分别为９３．８％ 和９１．７％ ,１６ 例脑囊虫病非活动型患者仅１ 例 Ｃ Ｓ Ｆ Ｃ Ａｇ 阳性。 Ｃ Ａｇ 检出率明显高于用抗６４ ｋ Ｄａ、３２ ｋ Ｄａ～３０ ｋ Ｄａ 囊尾蚴抗原抗血清检测的结果（ Ｐ＜ ０．０５）。结论：抗５３ ｋ Ｄａ 囊尾蚴抗原抗血清检测活动型脑囊虫病患者血清和 Ｃ Ｓ Ｆ中的 Ｃ Ａｇ 敏感性较高,特异性较强,可用于活动型脑囊虫病的诊断和疗效考核。     

Neurocysticercosis: a major aetiological factor of late-onset epilepsy in Madagascar

To assess the impact of cysticercosis on public health in Madagascar, we compared patients < 15 years with late-onset epilepsy to non-epileptic controls in a matched case-control study. The association between epilepsy and cysticercosis was studied by enzyme-linked immunoelectrotransfer blot (EITB) assay for antibodies specific to Taenia solium. The EITB assay was performed on 104 pairs of sera specimens and on 95 pairs of cerebrospinal fluid (CSF) specimens. Depending on whether we consider the results obtained from sera or from CSF, we obtain for the population attributable risk percent of cysticercosis in late-onset epilepsy two slightly different estimates: 22.3% and 17.6%. Therefore cysticercosis is a major aetiological factor of late-onset epilepsy in Madagascar. In the control group, the frequency of positive results, especially in CSF specimens (7.4%), confirms the existence of asymptomatic cases of neurocysticercosis.     

Effect of internal migration on diabetes and metabolic abnormalities in India - The ICMR-INDIAB study

AimsTo assess the effect of migration (rural-to-urban and vice versa) on prevalence of diabetes and metabolic disorders in Asian Indians participating in the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study.Materials and methodsThe ICMR–INDIAB study is a national study on diabetes and associated cardiometabolic disorders in individuals aged ≥20 years from 28 states and 2 union territories of India. Individuals who moved to a different place from their place of birth and had resided in the new location for at least one year were considered as migrants. Anthropometric measurements, blood pressure estimation and a capillary oral glucose tolerance test were performed.ResultsOf the 113,043 participants, 66.4% were non-migrant rural dwellers, 19.4% non-migrant urban dwellers, 8.4% rural-urban migrants, 3.8% multiple migrants and 2.0% urban-rural migrants. Weighted prevalence of diabetes was highest in rural-urban migrants followed by urban dwellers, urban-rural migrants and rural dwellers [14.7%, 13.2%, 12.7% and 7.7% respectively (p < 0.001)]. Rural-urban migrants had highest prevalence of abdominal obesity (50.5%) compared to the other three groups. The risk for diabetes was 1.9 times higher in rural-urban migrants than among rural dwellers. Five risk factors [hypertension, abdominal and generalized obesity, physical inactivity and low fruit and vegetable intake] together explained 69.8% (partial population attributable risk) of diabetes among rural-urban migrants and 66.4% among non-migrant urban dwellers.ConclusionsRural-to-urban migration is associated with increased risk of developing diabetes and other cardiometabolic abnormalities. Adoption of healthier lifestyle patterns among migrants could help prevent/delay onset of these abnormalities in this population.     

颅骨成形术后癫痫发作的临床研究

目的分析颅骨成形术后癫痫发作的发生率、相关因素和预防性应用抗癫痫药物(AED)的临床效果。方法选择行颅骨成形术患者107例,分析术后癫痫发作、AED预防性使用及术后早期癫痫发作者术后住院日及晚期癫痫发作情况。结果术后早期癫痫发作17例(15.9%),晚期癫痫发作19例(17.8%)。自体颅骨成形术后早期癫痫发作发生率低于钛网成形术(P<0.05)。术后未使用AED患者早期癫痫发作发生率为23.5%,术后使用AED发生率为2.6%(P<0.01)。术后出现早期癫痫发作患者术后平均住院日和晚期癫痫发作发生率明显高于术后未出现早期癫痫发作患者(P<0.01)。结论颅骨修补术后早期和晚期癫痫发作发生率高,早期癫痫发作可导致平均住院日延长,并增加晚期癫痫发作的风险。预防使用AED可以显著减少术后早期癫痫发作的发生。     

Seroepidemiological study of toxoplasmosis in different sections of population of Union Territory of Chandigarh

Infections with Toxoplasma gondii in humans are usually asymptomatic or in the form of mild febrile illness. Primary infection in pregnant women may result in congenital toxoplasmosis while infection in immunocompromised subjects like AIDS patients may cause potentially fatal toxoplasma encephalitis. In India, only a few studies in hospital based patients have shown prevalence of toxoplasmosis to be between 1.5 and 21%. No field study involving general population is available. The present study investigates the prevalence of toxoplasmosis in subjects from rural, urban and urban slum populations of Union Territory, Chandigarh. Serum samples from 500 subjects from each group were collected and antitoxoplasma IgM and IgG was detected by conventional micro ELISA technique using soluble Toxoplasma gondii tachyzoite antigen. Overall 5.4% subjects were positive for IgM while 4.66% showed IgG antitoxoplasma antibodies. Amongst the three groups, significantly higher number of subjects in slum area (7.8%) showed IgM antibodies as compared to urban and rural areas (4.2% each). There was no significant difference in IgG positivity between three study areas. Prevalence of T. gondii specific IgG antibodies was significantly higher amongst females of both slum (7.31%) and rural area (8.44%) as compared to the males (2.85% and 3.27% respectively) in the same areas (p<0.05) and also to females of the urban area (2.98%, p<0.05). Prevalence of IgM antibodies was significantly higher (p<0.05) in females in the slum area (10.5%) as compared to females in the urban area (2.55%). In both urban and slum areas, highest IgM seropositivity was observed in age group 6-12 years (10% and 13.3% respectively), while in the rural area the highest IgM seropositivity was seen in the age group > or = 5 years (17.7%). These data indicate that majority of children are exposed to toxoplasma before 12 years of age and particularly in rural areas higher number of subjects acquire Toxoplasma gondii infection early in childhood probably as a result of higher exposure due to farming, poor hygiene and handling of animals.     

Combined use of an antigen and antibody detection enzyme-linked immunosorbent assay for cysticercosis as tools in an epidemiological study of epilepsy in Burundi

OBJECTIVE: To evaluate the benefits of the detection of both circulating antibodies (Ab) and antigens (Ag) for the diagnosis of cysticercosis in people with epilepsy. Neurocysticercosis is a cause of neurological diseases world-wide, especially epilepsy. The clinical symptoms of neurocysticercosis are non-specific and diagnosis is often difficult. METHODS: Serum samples were collected from subjects in a matched case-control study for epilepsy in the Kiremba area, Burundi, between March and April 2001 (epileptic cases=303; controls without epilepsy=606). The enzyme-linked immunosorbent assay (ELISA) was used for the detection of antibodies (Ab-ELISA) and circulating Ag (Ag-ELISA). RESULTS: The Ab-ELISA revealed 58.7% positivity in epilepsy cases and 31.4% in healthy controls; and Ag-ELISA revealed 38.3% positivity in epilepsy cases and 20.0% in controls. The matched odds ratios were 3.6 (95% CI: 2.5-4.9) for Ab-ELISA, and 2.9 (95% CI: 2.1-4.3) for Ag-ELISA. CONCLUSION: Both Ag- and Ab-ELISA detected a significantly higher number of seropositives among people with epilepsy than among controls. The risk of epilepsy was high in cases with a positive Ag-ELISA, although less important than in cases with positivity for Ab-ELISA. Dead or degenerating cysticerci appear to be more frequently associated with epilepsy than living cysts. The high number of people with circulating Ag of Taenia solium suggests that the study area is a focus of active transmission of the parasite.     

癫痫型脑囊虫病患者血桨和脑脊液环核苷酸变化及意义

本文对16例癫痫型脑囊虫病患者和34例原发性癫痫患者血浆和脑脊液环核苷酸进行了测定,并与19名正常人作了比较,发现癫痫型脑囊虫病患者血桨和脑脊液CAMP、CGMP明显增高,原发性癫痫患者血桨和脑脊液CAMP明显增高,CGMP未见改变,初步证明了癫痫型脑囊虫病,癫痫的发病机理可能与环核苷酸有关。     

The seroprevalence of Taenia solium cysticercosis among epileptic patients in León, Nicaragua, as evaluated by ELISA and western blotting

The Taenia solium taeniasis/cysticercosis complex is an important public-health problem in several countries, where many epileptic seizures appear to be associated with neurocysticercosis. As few data on this problem in Nicaragua exist, the seroprevalence of antibodies reacting with antigens from T. solium cysticerci was investigated among 88 Nicaraguan epileptics (45 males and 43 females, aged 6-53 years). In questionnaire-based interviews, each adult subject and a caregiver of each child investigated were asked about potential risk factors for taeniasis/cysticercosis. When a serum sample from each subject was then checked for anti-cysticercus antibodies, 8.0% of the subjects were found seropositive by ELISA and 14.8% by western blotting. Five samples (all from individuals who had been epileptic for > 5 years) were positive in both tests. When the level of association between each potential risk factor and seropositivity (in ELISA or by blotting) was evaluated, the only statistically significant association detected was that between a positive ELISA and the subject living in a household where pigs were raised (odds ratio = 5.18; 95% confidence interval = 0.8-41.6; P = 0.05). The bands most frequently recognized in the western blots (of 50, 42-39, 24 and 14 kDa) were those previously reported. The results indicate that, in the city of Léon, cysticercosis may be endemic and the cause of a significant proportion of the epilepsy recorded.     

507例绦、囊虫病人循环抗体与循环抗原测定结果与脑CT分型对照分析

本文总结５０７例临床确诊的绦、囊虫病人血清和脑脊液免疫学测定结果,分别以ＩＨＡ、ＥＬＩＳＡ测定循环抗体,以夹心ＥＬＩＳＡ测定循环抗原,其阳性检出率依次为血清６７．５％、６３．８％、６０．６％;脑脊液为５９．４％、４６．１％、６７．５％。其中循环抗体的阳性检出率以血清为高,循环抗原以脑脊液为高。脑ＣＴ呈小囊型、炎症型及混合型表现的脑囊虫病患者抗体与抗原的阳性检出率均高于钙化型脑囊虫病组及单纯绦虫感染和单纯皮肌型囊虫病组;三种方法六项试验配合应用可以显著降低绦、囊虫病患者的漏诊率。     

Physical activity and its relationship with obesity, hypertension and diabetes in urban and rural Cameroon

OBJECTIVES: To evaluate and compare physical activity patterns of urban and rural dwellers in Cameroon, and study their relationship with obesity, diabetes and hypertension. METHODS: We studied 2465 subjects aged >or=15 y, recruited on the basis of a random sampling of households, of whom 1183 were urban dwellers from Yaoundé, the capital city of Cameroon and 1282 rural subjects from Bafut, a village of western Cameroon. They all had an interviewer-administered questionnaire for the assessment of their physical activity and anthropometric measurements, blood pressure and fasting blood glucose determination. The procedure was satisfactorily completed in 2325 (94.3%) subjects. Prevalences were age-adjusted and subjects compared according to their region, sex and age group. RESULTS: Obesity was diagnosed in 17.1 and 3.0% urban and rural women, respectively (P<0.001), and in 5.4 vs 1.2% urban and rural men, respectively (P<0.001). The prevalence of hypertension was significantly higher in urban vs rural dwellers (11.4 vs 6.6% and 17.6 vs 9.1% in women and men, respectively; P<0.001). Diabetes was more prevalent in urban compared to rural women (P<0.05), but not men. Urban subjects were characterized by lower physical activity (P<0.001), light occupation, high prevalence of multiple occupations, and reduced walking and cycling time compared to rural subjects. Univariate analysis showed significant associations between both physical inactivity and obesity and high blood pressure. The relationship of physical inactivity with hypertension and obesity were independent in both urban and rural men, but not in women. Body mass index, blood pressure and glycaemia were higher in the first compared with the fourth quartiles of energy expenditure. CONCLUSION: Obesity, diabetes and hypertension prevalence is higher in urban compared to rural dwellers in the populations studied. Physical activity is significantly lower and differs in pattern in urban subjects compared to rural. Physical inactivity is associated with these diseases, although not always significant in women.