Disease surveillance in recombining pathogens: multilocus genotypes identify sources of human Coccidioides infections

Molecular surveillance of pathogenic microbes works by genotyping isolates with DNA fingerprinting techniques and then using these genotypes to assign individuals to populations. Clonality is assumed in many fingerprinting studies, although this assumption has been shown to be false for many organisms. To accommodate recombining organisms into surveillance programs, methods using population allele frequencies in combination with individual multilocus genotypes are necessary. Here, we develop a statistical method appropriate for haploid recombining microbes that allows individuals to be assigned to populations. We illustrate the usefulness of this technique by inferring the source populations for Coccidioides isolates recovered from patients treated outside the endemic area of Coccidioides sp., the etiological agents of human coccidioidomycosis, but with a travel history including visits to one or more endemic areas.     

Flow cytometry antifungal susceptibility testing of Aspergillus fumigatus and comparison of mode of action of voriconazole vis-à-vis amphotericin B and itraconazole

Aspergillus fumigatus isolates were tested with three antifungals by flow cytometry (FC) and fluorescence-activated cell sorting. FC results after 4 h correlated well with MICs obtained by the NCCLS M38-A method; voriconazole exhibited fungicidal activity, albeit to a lesser extent than amphotericin B, but to a greater extent than itraconazole.     

Copper nanoparticles synthesized by polyol process used to control hematophagous parasites

The present study was based on assessments of the anti-parasitic activities of the hematophagous (blood feeding) larvae of malaria vector, Anopheles subpictus Grassi, filariasis vector, Culex quinquefasciatus, Say (Diptera: Culicidae), and the larvae of cattle tick Rhipicephalus (Boophilus) microplus, Canestrini (Acari: Ixodidae). The metallic copper nanoparticles (Cu NPs) synthesized by polyol process from copper acetate as precursor and Tween 80 were used as both the medium and the stabilizing reagent. The efficacy of synthesized Cu NPs was tested against the larvae of blood-sucking parasites. UV-vis spectra characterization was performed, and peak was observed at 575 nm, which is the characteristic to the surface plasmon bond of Cu NPs. The strong surface plasmon absorption band observed at 575 nm may be due to the formation of non-oxidized Cu NPs. X-ray diffraction (XRD) spectral data showed concentric rings corresponding to the 26.79 (111), 34.52 (200), and 70.40 (220) reflections. XRD spectrum of the copper nanoparticles exhibited 2θ values corresponding to the copper nanocrystal. No peaks of impurities are observed in XRD data. The scanning electron micrograph (SEM) showed structures of irregular polygonal, cylindrical shape, and the size range was found to be 35–80 nm. The size of the Cu NPs was measured by atomic force microscope (AFM) in non-contact mode. For imaging by AFM, the sample was suspended in acetone and spins coated on a silicon wafer. The line profile image was drawn by the XEI software and the horizontal line at 6 μm on a 2D AFM image. Research has demonstrated that metallic nanoparticles produce toxicity in aquatic organisms that is due largely to effects of particulates as opposed to release of dissolved ions. Copper acetate solution tested against the parasite larvae exposed to varying concentrations and the larval mortality was observed for 24 h. The larval percent mortality observed in synthesized Cu NPs were 36, 49, 75, 93,100; 32, 53, 63, 73, and 100 and 36, 47, 69, 88, 100 at 0.5, 1.0, 2.0, 4.0, and 8.0 mg/L against A. subpictus, C. quinquefasciatus and R. microplus, respectively. The larval percent mortality shown in copper acetate solution were 16, 45, 57, 66 and 100, 37, 58, 83, 87, and 100 and 41, 59, 79, 100, and 100 at 10, 20, 30, 40, and 50 mg/L against A. subpictus, C. quinquefasciatus, and R. microplus, respectively. The maximum efficacy was observed in Cu NPs and copper acetate solution against the larvae of A. subpictus, C. quinquefasciatus, and R. microplus with LC₅₀ and r ² values of 0.95 and 23.47, 1.01 and 15.24, and 1.06 and 14.14 mg/L with r ² = 0.766; 0.957 and 0.908; 0.946; and 0.816 and 0.945, respectively. The control (distilled water) showed nil mortality in the concurrent assay. The chi-square value was significant at p ≤ 0.05 level. This is the first report on anti-parasitic activity of the synthesized Cu NPs and copper acetate solution.     

Mind-body therapies for menopausal symptoms: A systematic review

Objective

To systematically review the peer-reviewed literature regarding the effects of self-administered mind-body therapies on menopausal symptoms.

Methods

To identify qualifying studies, we searched 10 scientific databases and scanned bibliographies of relevant review papers and all identified articles. The methodological quality of all studies was assessed systematically using predefined criteria.

Results

Twenty-one papers representing 18 clinical trials from 6 countries met our inclusion criteria, including 12 randomized controlled trials (N = 719), 1 non-randomized controlled trial (N = 58), and 5 uncontrolled trials (N = 105). Interventions included yoga and/or meditation-based programs, tai chi, and other relaxation practices, including muscle relaxation and breath-based techniques, relaxation response training, and low-frequency sound-wave therapy. Eight of the nine studies of yoga, tai chi, and meditation-based programs reported improvement in overall menopausal and vasomotor symptoms; six of seven trials indicated improvement in mood and sleep with yoga-based programs, and four studies reported reduced musculoskeletal pain. Results from the remaining nine trials suggest that breath-based and other relaxation therapies also show promise for alleviating vasomotor and other menopausal symptoms, although intergroup findings were mixed. Most studies reviewed suffered methodological or other limitations, complicating interpretation of findings.

Conclusions

Collectively, findings of these studies suggest that yoga-based and certain other mind-body therapies may be beneficial for alleviating specific menopausal symptoms. However, the limitations characterizing most studies hinder interpretation of findings and preclude firm conclusions regarding efficacy. Additional large, methodologically sound trials are needed to determine the effects of specific mind-body therapies on menopausal symptoms, examine long-term outcomes, and investigate underlying mechanisms.     

Congenital Aneurysm of Left Atrial Appendage: A Case Report

Abstract   Aneurysm of the left atrial appendage (LAA) is a very infrequent condition. We report a case of a two-year-old child with congenital aneurysm of the LAA with a large thrombus in it. He presented with an episode of seizures with left-sided hemiparesis. Diagnosis was based on transthoracic echocardiography and magnetic resonance imaging. The patient was successfully treated by surgical resection of the aneurysm and removal of the thrombus. (J Card Surg 2010;25:37-40)     

Outcome of neonates requiring assisted ventilation

Over a two-year period, we studied a total of 100 newborns delivered in our hospital, needing ventilation. The indications for ventilation, complications, outcome, and factors influencing outcome were analyzed. Of the 100 babies, 54 were preterm, 44 term and 2 post-term. Overall survival was 58%. The commonest indication for ventilation was meconium aspiration syndrome in term babies and hyaline membrane disease in preterms. Babies ventilated for pneumonia had the best outcome, while the poorest outcome was in sepsis. Survival increased significantly with increasing birth weight and gestational age. Downes score, Apgar score and pH at birth did not correlate significantly with outcome. The maximum peak inspiratory pressure requirement was significantly higher in the non-survivors. In pneumonia and sepsis, increased FiO2 requirement significantly impaired survival. The commonest complication was shock. Incidence of disseminated intravascular coagulation, pulmonary hemorrhage and pneumothorax was significantly higher in non-survivors; however, none of these factors was independently predictive of mortality.     

Collaborative study of antibiotic medium 3 and flow cytometry for identification of amphotericin B-resistant Candida isolates

Center 1 used the National Committee for Clinical Laboratory Standards M27-A2 method and antibiotic medium 3 (AM3) test to determine amphotericin B resistance in 5 of 30 Candida isolates. These isolates were tested at center 2 by AM3 test and flow cytometry (FC). The agreements (C1-C2) were 90% for AM3 test and FC and 73% for the AM3 tests.     

Obstetric complications and cesarean delivery in Nepal

Objective

To determine the incidence of obstetric complications, the stillbirth rate, and the factors associated with cesarean delivery in central Nepal.

Methods

A community-based prospective cohort study was undertaken in the Kaski district during 2011–2012. In total, 701 women who were at least 5 months pregnant were recruited and interviewed. Participants were followed-up and interviewed again within 45 days after delivery.

Results

Of the 658 women who remained in the cohort after 43 were lost to follow-up, 12 (1.8%) had stillbirths. Cesareans accounted for 13.3% of the total deliveries. Age, urban residency, college-level education, and particularly presence of intrapartum symptoms significantly increased the likelihood of cesarean delivery. Prepartum, intrapartum, and postpartum symptoms were reported by 21.1%, 24.4%, and 10.2% of women, respectively. Common danger signs included prolonged labor, severe abdominal pain, swollen hand and body, and heavy bleeding.

Conclusion

Obstetric complications and stillbirth rates were relatively high in central Nepal. Cesarean delivery appeared to meet obstetric need and was performed with medical indication, particularly after the onset of labor.