Relationships of varicella zoster virus (VZV)-specific cell-mediated immunity and persistence of VZV DNA in saliva and the development of postherpetic neuralgia in patients with herpes zoster

There are no surrogate markers for the development of postherpetic neuralgia (PHN) in patients with herpes zoster (HZ). All patients with HZ were prospectively enrolled to evaluate the associations of saliva varicella zoster virus (VZV) DNA persistence and VZV-specific cell-mediated immunity (CMI) with the development of PHN. Slow clearers were defined if salivary VZV DNA persisted after day 15. Salivary VZV was detected in 60 (85.7%) of a total of 70 patients with HZ on initial presentation. Of 38 patients for whom follow-up saliva samples were available, 26 (68.4%) were classified as rapid clearers and 12 (31.6%) as slow cleares. Initial VZV-specific CMI was lower in slow clearers than rapid clearers (median 45 vs 158 spot forming cells/10 ⁶ cells, P = .02). Of the 70 patients with HZ, 22 (31.4%) eventually developed PHN. Multivariate analysis showed that slow clearers (OR, 15.7, P = .01) and lower initial VZV-specific CMI (OR, 13.8, P = .04) were independent predictors of the development of PHN, after adjustment for age and immunocompromised status. Initial low VZV CMI response and persistence of VZV DNA in saliva may be associated with the development of PHN.     

Legionella feeleii: pneumonia or Pontiac fever? Bacterial virulence traits and host immune response

Medical Microbiology and Immunology - Gram-negative bacterium Legionella is able to proliferate intracellularly in mammalian host cells and amoeba, which became known in 1976 since they caused a...     

Infection patterns,clinical significance,and genetic characteristics of Enterocytozoon bieneusi and Giardia duodenalis in dairy cattle in Jiangsu,China

The infection patterns and clinical significance of Enterocytozoon bieneusi and Giardia duodenalis in dairy cattle remain poorly investigated despite their common occurrence. Data on the genetic diversity are also needed to understand the transmission and human-infective potential of the two pathogens. In this study, fecal specimens from 1366 dairy cattle on a large farm were examined for the presence and genotype distribution of E. bieneusi and G. duodenalis by PCR and DNA sequencing. The overall infection rates of E. bieneusi and G. duodenalis were 13.0% and 20.6%, respectively. Pre-weaned calves had significantly higher infection rates of both pathogens than post-weaned and adult cattle (P < 0.001), with peak occurrence of the pathogens in animals of 7–12 weeks. In both pre- and post-weaned calves, animals with diarrhea were 2.1–3.0 times more likely to be infected with either pathogen than those without diarrhea (P < 0.01). The E. bieneusi identified belonged to five genotypes, including J (n = 138), I (n = 21), BEB4 (n = 10), Type IV (n = 1), and a novel genotype CHC17 (n = 1). Genotype J was the dominant one in all age groups, whereas genotype I was only identified in calves of 6–11 weeks. Genotyping of G. duodenalis at three genetic loci identified assemblage E (n = 278), assemblage A (n = 2), and concurrence of the two (n = 1). Altogether, 13, 7 and 10 subtypes of assemblage E were detected at the bg, gdh, and tpi loci, respectively, forming 65 multilocus genotypes. The formation of two major clusters of MLGs in eBURST analysis indicated that intra-assemblage genetic recombination of two dominant MLGs could have led to the high genetic heterogeneity within assemblage E on a single farm. Results of this study provide much needed data on the pathogenicity of E. bieneusi and G. duodenalis in pre- and post-weaned calves. The clinical significance of the two pathogens in dairy cattle warrants further investigations.

     

Novel missense mutation in VPS33B is associated with isolated low gamma‐glutamyltransferase cholestasis: Attenuated,incomplete phenotype of arthrogryposis,renal dysfunction,and cholestasis syndrome

The typical phenotype of arthrogryposis, renal dysfunction, and cholestasis (ARC) syndrome involves three cardinal symptoms as the name describes, harboring biallelic mutations on VPS33B or VIPAS39. Except for ARC syndrome, low gamma‐glutamyltransferase (GGT) cholestasis often implies hereditary hepatopathy of different severity; however, some remain undiagnosed. Several monogenic defects typically with multiorgan manifestations may only present liver dysfunction at times, such as DGUOK defect and AGL defect. Previously, four VPS33B mutated cases were reported without arthrogryposis, or with less severe symptoms and longer lifespan, indicating the possibility of incomplete ARC phenotype of isolated hepatopathy. So we retrospectively reviewed all patients with confirmed VPS33B/VIPARS39 defect in our center and identified three presenting isolated low‐GGT cholestasis with intractable pruritus. Distinguished from others with typical ARC phenotype, these patients did not suffer the other two typical characteristics, survived much longer, and shared a novel missense VPS33B variation c.1726T>C, p.Cys576Arg, causing declined protein expression and abolished interaction with VIPAS39 in‐vitro. Serum bile acid profiles of our VPS33B/VIPAS39 mutated patients revealed similar changes to primary defect of bile salt export pump, among which those with isolated cholestasis phenotype had a higher level of total secondary bile acids than that with typical ARC phenotype, indicating the partial residual function of VPS33B.     

The Closing Digital Divide: Delivery Modality and Family Attendance in the Pathways for African American Success (PAAS) Program

Although family-focused, evidence-based programs (EBPs) have the potential to reduce disparities in health and behavioral outcomes for youth, access to such programs is severely limited in the most affected areas, including African American communities in the rural South. As expanding the reach of EBPs is the primary goal of translational research, interest is growing in the potential of technology as a viable platform to disseminate services to areas with limited resources. To test whether African American families in the rural South would be willing to engage in a technology-based family-focused EBP to prevent adolescent risk behavior, we examined attendance using data from two arms of a three-arm community-based trial of the Pathways for African American Success (PAAS) program. In the overall study, sixth graders (N?=?412) and their primary caregivers were randomly assigned to the following conditions: (a) in-person, small group sessions led by facilitators; (b) self-directed, technology-based sessions; or (c) a literature control with home-mailed educational materials. Results indicated that attendance was higher in the technology condition than in the small group condition. Parental age, education, and socioeconomic status did not limit attendance in the technology condition. We conclude from these results that the use of technology can be an acceptable strategy for disseminating parenting EBPs to African American families in the rural South.     

韩延华诊治外阴白斑经验

韩延华教授认为外阴白斑病机:一为肝肾不足,或年老体衰,精血亏损;或久病不愈,阴血不足而致肝肾阴虚,肝脉过阴器,肾司二阴,肝肾阴虚,精血亏少,冲任血虚阴部肌肤失养,阴虚生风化燥,风动则痒。二为肝经湿热,郁怒伤肝,肝郁化热,肝气犯脾,脾虚湿盛以致湿热互结,而发痒痛。韩延华教授以补益肝肾,清热祛湿止痒为治疗原则,自拟方药"外阴白斑洗方"中药熏洗坐浴,配合局部外抹重组人干扰素α-2b凝胶与口服育阴丸或妇科养荣胶囊,临床效果满意。     

Age,period, and cohort analysis of regular dental care behavior and edentulism: A marginal approach

Background

Microbial communities inhabiting human mouth are associated with oral health and disease. Previous studies have indicated the general prevalence of adult gingivitis in China to be high. The aim of this study was to characterize in depth the oral microbiota of Chinese adults with or without gingivitis, by defining the microbial phylogenetic diversity and community-structure using highly paralleled pyrosequencing.

Methods

Six non-smoking Chinese, three with and three without gingivitis (age range 21-39 years, 4 females and 2 males) were enrolled in the present cross-sectional study. Gingival parameters of inflammation and bleeding on probing were characterized by a clinician using the Mazza Gingival Index (MGI). Plaque (sampled separately from four different oral sites) and salivary samples were obtained from each subject. Sequences and relative abundance of the bacterial 16 S rDNA PCR-amplicons were determined via pyrosequencing that produced 400 bp-long reads. The sequence data were analyzed via a computational pipeline customized for human oral microbiome analyses. Furthermore, the relative abundances of selected microbial groups were validated using quantitative PCR.

Results

The oral microbiomes from gingivitis and healthy subjects could be distinguished based on the distinct community structures of plaque microbiomes, but not the salivary microbiomes. Contributions of community members to community structure divergence were statistically accessed at the phylum, genus and species-like levels. Eight predominant taxa were found associated with gingivitis: TM7, Leptotrichia, Selenomonas, Streptococcus, Veillonella, Prevotella, Lautropia, and Haemophilus. Furthermore, 98 species-level OTUs were identified to be gingivitis-associated, which provided microbial features of gingivitis at a species resolution. Finally, for the two selected genera Streptococcus and Fusobacterium, Real-Time PCR based quantification of relative bacterial abundance validated the pyrosequencing-based results.

Conclusions

This methods study suggests that oral samples from this patient population of gingivitis can be characterized via plaque microbiome by pyrosequencing the 16 S rDNA genes. Further studies that characterize serial samples from subjects (longitudinal study design) with a larger population size may provide insight into the temporal and ecological features of oral microbial communities in clinically-defined states of gingivitis.