Cross-effects of nickel contamination and parasitism on zebra mussel physiology

Aquatic organisms are exposed to pollution which may make them more susceptible to infections and diseases. The present investigation evaluated effects of nickel contamination and parasitism (ciliates Ophryoglena spp. and intracellular bacteria Rickettsiales-like organisms), alone and in combination, on biological responses of the zebra mussel Dreissena polymorpha, and also the infestation abilities of parasites, under laboratory controlled conditions. Results showed that after 48 h, more organisms were infected in nickel-exposed groups, which could be related to weakening of their immune system. Acting separately, nickel contamination and infections were already stressful conditions; however, their combined action caused stronger biological responses in zebra mussels. Our data, therefore, confirm that the parasitism in D. polymorpha represents a potential confounding factor in ecotoxicological studies that involve this bivalve.     

Identification of mycobacteria and other acid fast organisms associated with pulmonary disease

ObjectiveTo identify Mycobacterium tuberculosis (M. tuberculosis) and other acid fast organisms isolated from sputum of HIV positive adult patients with pulmonary disease in Jos, Nigeria.MethodsAcid fast organisms isolated from 80 acid fast bacilli (AFB) positive sputa of HIV positive adult patients suspected for tuberculosis in Jos, Nigeria were identified for members of M. tuberculosis complex (M. tuberculosis, Mycobacterium bovis, Mycobacterium africanum, Mycobacterium canetti, Mycobacterium microti and Mycobacterium caprae) by use of spoligootyping, Multiplex Gen Probe, Hain genotype assay and gene sequencing for spoligotype negative isolates.ResultsSeven different spoligotypes of M. tuberculosis complex were identified from 70/80 (87.5%) total number of isolates. Mycobacterium kansasii (1), Mycobacterium dulvalii (1) Nocardia species (1) and Tsukamurella species (2) were detected from 5/10 spoligotype negative isolates.ConclusionsAlthough M. tuberculosis is the dominant AFB associated with chronic pulmonary disease in Jos, Nigeria, other clinically relevant mycobacteria were also observed in the study. This suggests that other AFB positive microorganisms associated with tuberculosis-like symptoms might be misdiagnosed and incorrectly treated as M. tuberculosis. It is therefore necessary for laboratories in tuberculosis high burden countries to step up diagnostic procedures beyond routine smear microscopy.     

The continuous erythropoietin receptor activator (C.E.R.A.) corrects anemia at extended administration intervals in patients with chronic kidney disease not on dialysis: results of a phase II study

AIM: This study was designed to assess the potential of the continuous erythropoietin receptor activator (C.E.R.A.) to correct anemia at extended administration intervals in erythropoiesis-stimulating agent-naīve patients with chronic kidney disease (CKD) not on dialysis and to determine its optimal starting dose. METHODS: Patients were assigned to subcutaneous C.E.R.A. at 3 doses: 0.15, 0.30 and 0.60 microg/kg/wk. During the first 6 weeks, dose adjustments for efficacy were not permitted in order to assess dose response. Within each of the 3 dose groups, patients were randomized to receive C.E.R.A. QW, Q2W or Q3W; the total dose during the first 6 weeks was the same for a particular dose group across the frequency subgroups. During the next 12 weeks, dose was adjusted according to predefined hemoglobin (Hb) criteria. The primary efficacy parameter was change in Hb over 6 weeks, estimated from regression analysis between baseline and the point at which the patient received a dose change or blood transfusion. It therefore provided an estimate of Hb increase based on starting dose. Other endpoints included Hb response rate (proportion of patients with a Hb increase > 1.0 g/dl on 2 consecutive occasions). A 1-year extension period investigated long term tolerability and efficacy. RESULTS: A dose-dependent relationship was noted in the mean change in Hb from baseline over 6 weeks (p < 0.0001), independent of administration schedule (p = 0.9201). There was also a significant relationship between Hb change and median serum C.E.R.A. concentration (p < 0.0001). Erythropoietic responses were sustained in all groups with mean changes from baseline in Hb > 1.2 g/dl observed at doses > or = 0.30 microg/kg/wk. Hb response rate increased with increasing dose: 67, 72 and 90% with C.E.R.A. 0.15, 0.30 and 0.60 microg/kg/wk, respectively. Generally, the median Hb response time was faster with increasing dose (89, 43 and 31 days, respectively). Response was unrelated to administration frequency. Stable Hb concentrations were maintained throughout the 1-year extension period. C.E.R.A. was generally well tolerated, and the most common adverse events were hypertension, urinary tract infection and renal failure. CONCLUSIONS: C.E.R.A. corrected anemia and maintained sustained and stable control of Hb over 1 year. These results suggest that 0.60 microg/kg subcutaneous C.E.R.A. given twice monthly is a suitable starting dose for further investigation in Phase III studies in patients with CKD not on dialysis.     

Antimicrobial activity of the methanolic extracts and compounds from Vismia laurentii De Wild (Guttiferae)

Methanolic extracts prepared from the leaves, twigs and the roots of Vismia laurentii De Wild as well as nine compounds isolated from these crude extracts, were tested for their antimicrobial activity against Gram-positive bacteria (six species), Gram-negative bacteria (12 species) and two Candida species using disc diffusion and well micro-dilution methods. The disc diffusion assay indicated that the crude extract was active against all the pathogens tested, whereas isolated compounds showed selective activities. The degree of sensitivity of the test organisms to purified compounds varied from 25 to 90%. Fridelin (8) was found to be the most active compound, while Bivismiaquinone (3) was the least active. The lowest minimum inhibition concentration (MIC) values as obtained by the micro-dilution assays were 19.53 and 1.22 microg/ml for the crude extracts and purified compounds, respectively. The lowest value for the purified compounds (1.22 microg/ml) was obtained with O(1)-demethyl-3',4'-deoxypsorospermin-3',4'-diol (6) on Candida gabrata and Bacillus subtilis; 1,8-dihydroxy-6-methoxy-3-methylanthraquinone (5) on Bacillus subtilis and 6-deoxyisojacareubin (7) on Bacillus stearothermophilus. These results provide promising baseline information for the potential use of these crude extracts as well as some of the isolated compounds in the treatment of bacterial and fungal infections.     

The native arteriovenous fistula in 2007. Surveillance and monitoring

In the past 5 years, some clinical trials have questioned the value of surveillance in managing vascular accesses. Although prolongation of access life span is an important end point, reduction of thrombotic events reduces patient risks resulting from loss of access patency. Most of the available evidence suggests that detection of stenosis and prevention of thrombosis is valuable. When a test indicates the likely presence of a stenosis, then venography or fistulography should be used to definitively establish the presence and degree of the stenosis. In most but not all cases, angioplasty should be performed if the stenosis is greater than 50% by diameter. The value of routine use of any surveillance technique for detecting anatomic stenosis alone, without concomitant functional assessment by measurement of access flow, venous pressure, recirculation or other physiologic parameters, has not been established. Stenotic lesions should not be repaired merely because they are present. If such correction is performed, then intraprocedural or periprocedural measurement of access flow (QA) or intra-access pressure should be conducted to demonstrate a functional improvement with a successful percutaneous transluminal angioplasty.     

Surgical salvage of the autogenous arteriovenous fistula (AVF)

Numerous studies have shown that the native arteriovenous fistula (AVF) has better long-term outcomes than other forms of access for hemodialysis. However, complications may require challenging salvage procedures. The present review summarizes and discusses surgical solutions for AVF salvage recently proposed within the Fistula First Breakthrough Initiative. These include strategies to salvage primary failed fistulae due to early thrombotic events or lack of maturation, ischemia, venous hypertensive problems, aneurysms and infections.     

Screening of some medicinal plants from cameroon for beta-lactamase inhibitory activity

In efforts to find new bioactive beta-lactamase inhibitors, this study investigated 16 Cameroonian plants belonging to 10 families which were evaluated for anti-beta-lactamase activity. The investigation showed that extracts 2, 6, 3 and 5 of the 16 plants investigated presented interesting in vitro beta-lactamase inhibition (over 90%), respectively, of the beta-lactamases TEM-1, OXA-10, IMP-1 and P99. These extracts were from Mammea africana (all beta-lactamases), Garcinia lucida, G. kola (OXA-10, IMP-1 and P99), Bridelia micrantha (OXA-10, P99), Ochna afzelii (OXA-10, P99), Prunus africana (IMP-1) and Adenia lobata (TEM-1). After elimination of tannins (according to the European Pharmacopoeia) the extracts from B. micrantha, G. lucida and M. africana were tested further for their anti-beta-lactamase activity. The extracts from B. micrantha and G. lucida exhibited potent inhibitory activity, respectively, of beta-lactamase OXA-10 (IC(50) = 0.02 mg/mL) and P99 (IC(50) = 0.01 mg/mL). The anti-beta-lactamase activity of M. africana extract was weak. The isolation and the structural elucidation of the active constituents of G. lucida and B. micrantha will provide useful leads in the development of beta-lactamase inhibitors.