Ligase chain reaction in detection of Chlamydia DNA in synovial fluid cells

Synovial fluid cells from 12 patients with reactive arthritis (ReA) triggered by Chlamydia trachomatis were studied for the presence of Chlamydia DNA using the ligase chain reaction (LCR) LCx (Abbott) and the polymerase chain reaction (PCR) Amplicor (Roche). In addition, peripheral blood leucocytes from 11 of these patients were analysed by LCR. As controls, seven patients with newly diagnosed rheumatoid arthritis (RA) were included. Chlamydia trachomatis DNA was detectable by LCR in samples of synovial fluid cells from 4/12 patients with C. trachomatis-triggered ReA, and in none by PCR. Chlamydia trachomatis DNA was not detectable in the synovial fluid cells of the seven RA patients by either method, neither was C. trachomatis DNA detectable in the peripheral blood leucocytes of the ReA patients (0/11) or controls (0/6) by LCR. The LCR technique may be useful in the demonstration of Chlamydia DNA in synovial fluid cells.      

Association of biomarkers of inflammation and oxidative stress with the risk of chronic kidney disease in Type 2 diabetes mellitus in North Indian population

Chronic kidney disease (CKD) is a major cause of morbidity and mortality worldwide. It results from diverse etiologies, diabetes being a frontrunner amongst them. Type 2 diabetes mellitus (DM) is being increasingly recognized as a proinflammatory state with increased oxidative stress which enormously increases the risk of micro and macro vascular diseases. This study was planned to explore the possible association between tumor necrosis factor-alpha (TNF-α), urinary monocyte chemoattractant protein-1 (uMCP-1), high-sensitivity C-reactive protein (hsCRP) and parameters of oxidative stress in patients with Type 2 diabetes mellitus (DM) and diabetic chronic kidney disease (DM–CKD). Fifty patients each were recruited in DM, DM–CKD and healthy control groups. Plasma TNF-α, hsCRP and uMCP-1 levels as inflammatory mediators were measured by ELISA, reduced glutathione (GSH), ferric reducing ability of plasma (FRAP) as parameters of antioxidant activity and malondialdehyde (MDA) as marker of oxidative stress, were measured spectrophotometrically. Plasma TNF-α, hsCRP and uMCP-1 were significantly higher in DM–CKD compared to DM and healthy controls. Lipid peroxidation, measured as MDA was significantly higher in patients with DM–CKD as compared to patients with DM and healthy controls. Further, antioxidant capacity of blood measured as FRAP and GSH was found to be significantly lower in patients with DM and DM–CKD as compared to healthy controls (p < 0.001). Plasma TNF-α and uMCP-1 showed a significant positive correlation with HbA_1c (r = 0.441, 0.643), hsCRP (r = 0.400, 0.584) and MDA (r = 0.423, 0.759) and significant negative correlation with GSH (R = ? 0.370, ? 0.800) and FRAP (r = ? 0.344, ? 0.684) Increased inflammatory markers viz. TNF-α, hsCRP and uMCP-1 and markers of oxidative stress i.e. increased MDA and decreased GSH and FRAP in DM–CKD suggest an important role of inflammation and oxidative stress in the pathogenesis of renal damage in diabetic patients.     

Relapse of Wegener's granulomatosis in the first trimester of pregnancy: a case report

The association of Wegener's granulomatosis and pregnancy is rare and poses unique therapeutic challenges, particularly when active disease presents in early pregnancy. We describe a 22-yr-old woman who recovered successfully from her initial episode of Wegener's granulomatosis with a standard course of treatment with prednisolone and cyclophosphamide. Two and a half years later, she presented with relapse during the first trimester of pregnancy (primigravida). Since the clinical features suggested mild disease, she was started on prednisolone at a dose of 1 mg/kg/day, to which she seemed to respond very well for 3 months. Unfortunately, she had a spontaneous abortion at 5 months of gestation while on 25 mg/day of prednisolone. At this time, her disease flared further, with clinically manifest lung disease which was not part of her initial presentation. She was treated with another course of oral cyclophosphamide and prednisolone, and a remission was achieved in 4 months. There are no agreed guidelines on the treatment of Wegener's granulomatosis during pregnancy. In this report, the therapeutic issues are discussed against the background of the available literature.      

Productivity of Aedes albopictus' breeding containers in Paraíba Valley, Brazil

OBJECTIVE: To estimate the potential productivity of artificial, permanent, and natural breeding containers of Aedes albopictus, potential vector species of dengue. METHODS: Three locations were selected for this study: a) warehouse of disposable material goods in the urban area of Pindamonhangaba, state of S?o Paulo, Brazil; b) a small leisure farmland in Tremembé, state of S?o Paulo; and c) residual forest in the periurban area of Pindamonhangaba. All breeding containers were assessed and classified according to their water volume ( small (up to 1 liter), medium (over 1 but up to 10 liters), and large (over 10 liters), and type (artificial, natural, and permanent). Collections were carried out fortnightly for a period of 12 months, and a sample of fourth-instar larvae and pupae were collected from each container. Statistical analysis was performed using the Kriskal-Wallis test, t-Student test, and emergence estimate. RESULTS: The statistical analyses and emergence estimate (E) showed that artificial large-size containers and permanent medium container were on average the most productive, resulting 2.8 females a day, each. Natural small and medium containers produced on average 0.5 and 0.6 females respectively. CONCLUSIONS: There is a need for further studies on the potential productivity of containers not only of Ae. albopictus but also of Aedes aegypti, the main vector of dengue, which could contribute to better assessments of population densities in surveillance and control programs.