High burden of invasive Streptococcus agalactiae disease in South African infants

The epidemiology of invasive Streptococcus agalactiae (GBS) disease was evaluated in South African children. Records of 208/220 children in whom GBS was isolated between January 1997 and December 1999 were reviewed. These included 63%, 31.7% and 5.3% children with early- (EOD, <7 days of age), late- (LOD, age 7-90 days) and childhood-onset disease (COD, age >90 days), respectively. The overall burden of EOD and LOD were 2.06 and 1/1000 live births, respectively. The overall mortality was 19.8% and 13.6% for infants with EOD and LOD, respectively. Risk factors for mortality in infants with EOD and LOD included septic shock (82.1% vs 1.9%), prematurity (35.2% vs 9.6%), low birthweight (29.2% vs 11.0%) and a leucocyte count <5000/mm(3) (43.5% vs 18.6%). Eight (72.7%) of 11 children with COD had an immunosuppressive, predisposing cause for invasive bacterial disease. In infants with EOD and LOD, serotype III isolates caused 49.2% and 75.7% of disease, respectively, and, together with serotype Ia isolates, caused 78.9% and 100% of invasive disease, respectively. Invasive GBS disease is common in South African infants and current strategies aimed at reducing the burden of the disease should be reconsidered.     

Successful treatment of refractory low grade duodenal lymphoma with rituximab,an anti-CD20 monoclonal antibody

Duodenal lymphoma accounts for a small percentage of gastrointestinal tumors and has a very poor prognosis. The majority of patients have little or no cure with limited time of remission. Median survival is 5 to 10 years, and most patients die of lymphoma, its complications, or complications of therapy. We report a patient with lymphoma refractory to treatment with cyclophosphamide, vincristine, and prednisone, who was successfully treated with rituximab, a CD-20 monoclonal antibody.     

Non PC liposome entrapped promastigote antigens elicit parasite specific CD8+ and CD4+ T-cell immune response and protect hamsters against visceral leishmaniasis

Leishmania donovani promastigote soluble antigens (sLAg) were encapsulated in non-phosphatidylcholine (non-PC) liposomes (escheriosomes) prepared from E. coli lipids. The escheriosome-based vaccine was investigated for its potential to elicit a protective immune response against experimental visceral leishmaniasis. The vaccine administration induced strong humoral as well as cell mediated immune responses both in hamsters and BALB/c mice. Immunization of BALB/c mice with escheriosome entrapped sLAg (EL-sLAg) elicited stronger CD8+ cytotoxic T lymphocyte (CTL) response as compared to sLAg entrapped in egg PC/chol liposome (EPC-sLAg) or sLAg administered with incomplete Freund's adjuvant (IFA-sLAg). EL-sLAg also induced the release of mixed (Th1 and Th2) types of cytokines in the immunized BALB/c mice. In addition, the delivery of sLAg via escheriosomes enhanced the expression of costimulatory signals (CD80 and CD86) as determined in peritoneal macrophages obtained from BALB/c mice. In another set of experiments, the EL-sLAg immunized hamsters were found to be better protected than those immunized with EPC-sLAg. The prophylaxis coincided with increased lymphocyte proliferation as well as high nitric oxide (NO) production by peritoneal macrophages among EL-sLAg immunized hamsters. Escheriosomes thus seem to have potential in delivering the antigen to cytosol of the antigen presenting cells (APCs) and in the development of liposome-based vaccine against leishmaniasis as well as other intracellular infections.     

Transmissibility, infectivity and immunogenicity of a live human parainfluenza type 3 virus vaccine (HPIV3cp45) among susceptible infants and toddlers

BACKGROUND: This study examined the transmissibility between young children of an intranasally administered live attenuated human parainfluenza virus type 3 (HPIV3)-cp45 vaccine candidate. METHODS: Eighty subjects were enrolled in playgroups among whom there was at least one infected vaccinee in close contact with a seronegative placebo recipient over 21 days without a confounding infection with wtHPIV3. Following vaccination viral cultures were obtained on nine occasions to detect shedding and transmission of HPIV3cp45. Serum antibody titers were measured before and 7 weeks after vaccination. RESULTS: No child fulfilled the criteria for transmission of HPIV3cp45 giving a risk of transmission of 0.04 (95% CI 0.01-0.19), hence establishing that HPIV3cp45 is less infectious than wtHPIV3 and risk of transmission is not a limitation to further clinical development of this vaccine candidate.     

The macular xanthophylls

The macular pigments are predominantly composed of three carotenoids: lutein, zeaxanthin, and meso-zeaxanthin. These carotenoids are concentrated and distributed in a selective manner. The properties of these pigments are further explored along with their methods of uptake, stabilization, and storage. The dual nature of these pigments as filters and antioxidants are elaborated upon in relation to their protective effects upon the macula, specifically in age-related macular degeneration. Evidence suggests that increased levels of macular pigment are correlated with a decreased risk of age-related macular degeneration. Many have sought to exploit this therapeutic relation. Studies reveal that oral supplementation with lutein and zeaxanthin can increase the levels of macular pigments in the retina and plasma. The effects of such supplementation on actual ocular function have yet to be fully addressed. New and standardized methods of assessing macular pigment density are discussed and future areas of research to further our understanding of macular xanthophylls as they pertain to age-related macular degeneration are highlighted.     

Chemical constituents of Citrus sinensis var. Shukri from Pakistan

The variety ‘Shukri’ is a new hybrid of Citrus sinensis and is frequently grown for its sweet edible fruits in the southern part of Pakistan. The leaves of this hybrid variety have been investigated in search of secondary metabolites for the first time. As a result of chromatographic analysis of the methanolic extract, a new ceramide along with a flavonone glycoside and two steroids has been isolated, which were spectroscopically characterized as (E)-N-(1,3,4,5-tetrahydroxyhexadecan-2-yl)dec-4-enamide (1), atripliside B (2), β-sitosterol (3), and β-sitosterol-3-O-β-D-glucopyranoside (4), respectively. Compound 1 was found to be a new addition in the list of natural products, whereas, to the best of our knowledge, compounds 2–4 have been isolated for the first time from this source.     

New phenethyl alcohol glycosides from Stachys parviflora

Phytochemical investigations of the whole plant of Stachys parviflora (Lamiaceae) resulted in the isolation of two new phenethyl alcohol glycosides. The structures of the new compounds named parviflorosides A and B were established as 2-(3,4-dihydroxyphenyl)-ethyl-O-α-l-rhamnopyranosyl-(1 → 2)-4-O-E-caffeoyl-β-d-glucopyranoside (1) and 2-(3,4-dihydroxyphenyl)-ethyl-O-α-l-rhamnopyranosyl-(1 → 2)-6-O-E-caffeoyl-β-d-glucopyranoside (2), respectively. The structure elucidation of the new compounds was based primarily on 1D and 2D NMR analysis, including COSY, HMBC and HMQC correlations.     

Characteristics of Veterans in Community-Based Treatment Programs for Substance use Disorders: An Analysis of Data from a State-Wide System

This study examined records of patients in New York State treatment programs for substance use disorders from 1995 to 2012, which consisted of 81,471 patients with a self-reported veteran status and 1,260,618 without. Results indicated that, compared to other patients in community-based treatment, veterans have distinctive demographic characteristics, primary substance use, and treatment participation. Implications of the findings were discussed. The authors call for more in-depth research to examine veterans' pathways into community-based treatment, their perception of and experience with treatment services, and the likely influence of cultural background and the role of specific military experiences on their treatment outcomes.     

Human milk banking; current evidence and future challenges

Human milk banks systematically collect, pasteurize, store, and distribute donated breast milk. In situations when a mother's own milk is insufficient or unavailable donor milk may be used as an alternative. There are a number of clinical groups who may benefit from donor milk; due to limitations in supply and evidence of benefit in term infants, most commonly donor milk is administered to preterm infants. Guidelines regarding the management of milk banks recommend potential donors are screened and tested and that milk is heat treated to minimize risk of transmission of infectious agents. Although essential to safety, pasteurization alters bioactive and nutritional properties of human milk. Pasteurized donor milk is lower in protein, calories and bioactive molecules compared with mother's own preterm milk produced in the first few weeks after delivery.Current evidence suggests that there are some health advantages for preterm infants to being fed pasteurized donor milk over preterm formula. There are challenges with regard to providing adequate nutrition with donor milk as well as logistical and ethical concerns. Formation of a national milk-bank network within the UK combined with standardized data collection would assist in the distribution and further evaluation of the potential benefits of this precious resource.     

The intra-observer reproducibility of cardiovascular magnetic resonance myocardial feature tracking strain assessment is independent of field strength

Background

Cardiovascular magnetic resonance myocardial feature tracking (CMR-FT) is a promising novel method for quantification of myocardial wall mechanics from standard steady-state free precession (SSFP) images. We sought to determine whether magnetic field strength affects the intra-observer reproducibility of CMR-FT strain analysis.

Methods

We studied 2 groups, each consisting of 10 healthy subjects, at 1.5 T or 3 T Analysis was performed at baseline and after 4 weeks using dedicated CMR-FT prototype software (Tomtec, Germany) to analyze standard SSFP cine images. Right ventricular (RV) and left ventricular (LV) longitudinal strain (Ell_RV and Ell_LV) and LV long-axis radial strain (Err_LAX) were derived from the 4-chamber cine, and LV short-axis circumferential and radial strains (Ecc_SAX, Err_SAX) from the short-axis orientation. Strain parameters were assessed together with LV ejection fraction (EF) and volumes. Intra-observer reproducibility was determined by comparing the first and the second analysis in both groups.

Results

In all volunteers resting strain parameters were successfully derived from the SSFP images. There was no difference in strain parameters, volumes and EF between field strengths (p > 0.05). In general Ecc_SAX was the most reproducible strain parameter as determined by the coefficient of variation (CV) at 1.5 T (CV 13.3% and 46% global and segmental respectively) and 3 T (CV 17.2% and 31.1% global and segmental respectively). The least reproducible parameter was Ell_RV (CV 1.5 T 28.7% and 53.2%; 3 T 43.5% and 63.3% global and segmental respectively).

Conclusions

CMR-FT results are similar with reasonable intra-observer reproducibility in different groups of volunteers at 1.5 T and 3 T. CMR-FT is a promising novel technique and our data indicate that results might be transferable between field strengths. However there is a considerable amount of segmental variability indicating that further refinements are needed before CMR-FT can be fully established in clinical routine for quantitative assessment of wall mechanics and strain.