Prevalence of Gardnerella vaginalis: an estimate

To assess the prevalence of Gardnerella vaginalis in the community 300 women aged 16-59 were randomly selected from a general practice's age-sex register and invited to attend for a health check. Out of 282 women who were eligible to attend, 192 did so. They were asked whether they had any vaginal symptoms, and swabs were taken from 182 women for culture for G vaginalis. Sixty women were positive for G vaginalis, of whom 26 had symptoms. Infections with G vaginalis may be present in women who have no symptoms. By careful questioning, examination, and side room testing general practitioners may be able to diagnose these infections in such women consulting them for other reasons.     

Seasonality of type 1 diabetes mellitus in children and its modification by weekends and holidays: retrospective observational study.

BACKGROUND: Diagnoses of type 1 insulin dependent diabetes mellitus are generally more common in winter, although this seasonal pattern has not been observed in children of preschool age (0-4 years) or in all countries. AIMS: To confirm the persistence of seasonality and the influence of age, holidays, and weekends. METHODS: We extracted data on date of birth, date of presentation, age, and sex of children diagnosed with diabetes and registered with the Scottish Study Group for the Care of Diabetes in the Young. Cosinor analysis was applied to monthly and mid-monthly data. Two sample Z tests were used to compare the epochs 1984-1992 and 1993-2001. RESULTS: Some 4517 children between 0 and 14 years of age (2407 male and 2110 female) presented with IDDM between 1 January 1984 and 31 December 2001. Seasonality was evident in children above 4 years of age with amplitudes of 19.5-25.7% and peaks between mid December and mid January. Presentation was strongly influenced by weekends and holiday periods, with reduced presentations in December compared with November and January, and with the lowest presentations in July (the main Scottish holiday month). Using mid-month to mid-month data did not change the overall seasonality but did improve the fits for cosinor analysis. Mondays and Fridays were the most common days for presentation. CONCLUSION: Initial presentation of IDDM in Scotland follows a stable seasonal pattern in all but the youngest children with lower rates of presentation in holiday periods and at weekends for all age groups.     

Cultivation practices and manufacturing processes to produce Hoodia gordonii extract for weight management products

Hoodia gordonii (Masson) Sweet ex Decne., is a succulent shrub, indigenous to the arid regions of southern Africa. Indigenous people have historically utilised certain species of Hoodia, including H. gordonii, as a source of food and water. Studies by the Council for Scientific and Industrial Research (CSIR, South Africa) identified that extracts of H. gordonii had appetite suppressant activity associated with specific steroid glycosides. A programme to develop weight management products based around this discovery was implemented in 1998. An agronomy programme was established which demonstrated that it was possible to cultivate this novel crop on a commercial scale (in excess of 70 ha). In parallel, a food grade manufacturing process was developed consisting of four main steps: harvesting of H. gordonii plant stems, comminution, drying under controlled conditions and extraction using food grade solvents. Appropriate Quality Control (QC) procedures were developed. The extraction process is capable of delivering a consistent composition despite natural variations in the composition of the dried H. gordonii. Specifications were developed for the resulting extract. The intended use of the standardised H. gordonii extract was as a functional food ingredient for weight management products. Other development studies on characterisation, toxicology and pharmacology are reported separately.     

Validation of the neutrophil-to-lymphocyte ratio as a new simple biomarker of adult onset Still’s disease: A STROBE-Compliant prospective observational study

This study was performed to investigate the role of neutrophil-to-lymphocyte ratio (NLR) in the diagnosis of adult onset Still disease (AOSD) and its performance to improve the sensitivity of the classifications criteria (Yamaguchi and Fautrel Classifications).We conducted a multicenter prospective nationwide case-control study in Internal medicine, Rheumatology and Infectious disease departments, to include successively patients with suspected AOSD (2 or more major criteria of Yamaguchi or Fautrel classifications). All clinical and biological features were collected in a consensual and standardized clinical assessment at baseline and during follow-up. A receiving operating characteristic (ROC) curve was used to reassess the cutoff value of NLR. After determination of the cutoff value for NLR by ROC curve, 2 composite sets (Yamaguchi classification + NLR as a major criterion and Fautrel classification + NLR as a major criterion) were performed and evaluated.One hundred sixty patients were included, 80 patients with AOSD and 60 controls with different diagnoses. Twenty patients with incomplete data were excluded. The cutoff value for NLR equals 4 (area under the curve, AUC: 0.82). The NLR was ≥ 4 in 93.7% (75/80) of AOSD patients with a sensitivity of 93.8% and specificity of 61.7%. The association of NLR as a major criterion with the classification of Yamaguchi or Fautrel improved their sensitivity, respectively for Fautrel (76.3% to 92.5%, P = .004) and Yamaguchi (78.8% to 90%, P = .05).This study validates the NLR as a good simple biomarker of AOSD with a cutoff value of 4 and high sensitivity (93.8%). The addition of NLR (NLR ≥ 4) as a major criterion to the classifications (Yamaguchi and Fautrel) improved significantly their sensitivity and accuracy.     

Antibodies against the N-terminal domain of annexin A2 in antiphospholipid syndrome

Annexin A2 (ANXA2, an endothelial cell receptor for plasminogen and tissue plasminogen activator) has been identified as a new autoantigen in antiphospholipid syndrome (APS). The aim of the present study was to evaluate the presence of antibodies against the N-terminal domain of annexin A2 (ANXA2) in primary APS (PAPS). By using a synthetic peptide corresponding to the 31N-terminal amino acids of ANXA2 (ANXA2(N31)) as an antigen, we performed an enzyme-linked immunosorbent assay (ELISA) to measure anti-ANXA2(N31) IgG and IgM antibodies in the serum of PAPS patients (n=19), systemic lupus erythematosus (SLE) patients (n=50) and healthy blood donors (n=106). We did not find any statistically differences between the three groups in terms of IgG and IgM anti-ANXA2(N31) titres. Elevated IgG anti-ANXA2(N31) titres were not observed in the serum of PAPS or SLE patients who had previously tested positive for anti-ANXA2 antibodies. Thus, the ANXA2 N-terminal domain does not appear to be the target antigen for anti-ANXA2 antibodies in APS.     

Further studies on adrenarche in nonhuman primates

Serum concentrations of dehydroepiandrosterone (DHA), DHA sulfate, and cortisol were measured in 52 chimpanzees (aged 0.5--10 yr), 76 Macaca mulatta (aged 0.25--5 yr), and 80 Macaca nemestrina (aged 0.5--9 yr). Sexual maturation was assessed by age and by the presence of menarche or the appearance of perineal turgescence in the females and by measurement of serum testosterone in the males. In an additional group of 10 young adult female M. mulatta, four repeated determinations of these same steroids at 30-min intervals demonstrated that the stress of capture and venipuncture caused a significant rise in serum levels of not only cortisol but also of DHA and DHA sulfate. The chimpanzees demonstrated an age-related rise in serum concentrations of DHA and DHA sulfate relative to cortisol which began before the onset of puberty and thus closely resembled human adrenarche. In M. mulatta, serum DHA levels showed no change with age, while DHA sulfate values decreased progressively both before and during puberty. The pattern in M. nemestrina was similar, with stable DHA and declining DHA sulfate levels before and during puberty. However, in the oldest group (aged 6--9 yr) of mature M. nemestrina, there was a significant postpubertal rise of both DHA and DHA sulfate with no change in serum cortisol. These data suggest that monkeys, just as higher primates, may show increasing adrenal secretion of C19 steroids at around 6--9 yr. This adrenarchal process appears to be completely independent of sexual maturation and probably merely reflects the influence of progressive adrenal growth and the resulting impact of changing intraadrenal steroid concentrations upon steroidogenesis in the zona reticularis.