Development of a loop-mediated isothermal amplification method for detection of Theileria lestoquardi

A loop-mediated isothermal amplification (LAMP) assay was developed for the diagnosis of Theileria lestoquardi infection. The primers were designed based on the clone-5 sequence of T. lestoquardi. The specificity and sensitivity of the assay were established. Analysis of the specificity showed that the selected LAMP primers amplified the target sequence from T. lestoquardi DNA successfully, while no amplification was seen with DNA from Theileria annulata, Theileria ovis, Babesia ovis, Anaplasma ovis, or ovine genomic DNA. The specificity of the LAMP product was further confirmed by restriction digestion and sequencing. The sensitivity of the LAMP assay was analyzed in comparison to PCR resulting in a detection limit of 10 fg/μl of plasmid DNA containing the clone-5 sequence. The suitability for utilizing the LAMP assay in the field for the diagnosis of T. lestoquardi infection was tested on 100 field samples collected in Sudan and compared with results obtained by PCR. The relative specificity and sensitivity of the established LAMP assay was determined to be 92.1% and 87.5%, respectively, indicating that it may be regarded as an alternative molecular diagnostic tool to PCR which could be used for epidemiological surveys on T. lestoquardi infection.     

Dosimetric study of field junction in adjacent beams using asymmetric collimators and MLC

Adjacent treatment fields are commonly employed in external beam radiation therapy, such as the mantle and inverted-Y fields for the treatment of Hodgkin＇s disease. In some cases, the adjacent fields are orthogonal, such as the cra- niospinal fields used in the treatment of medulloblastoma. Another example is the irradiation of head and neck tumors when the lateral neck fields are placed adjacent to the anterior supraclavicular field. In each of these situations, there is a possibility of introducing very large dosage errors across the junction. Consequently, this region is at risk for tumor recurrence if it is underdosed or severe complications if it is overdosed. Four millimeter overlap and gap resulted in an unacceptable dose in homogeneity in the junction. As a result of this study, the magnitudes of hot and cold spots might be clinically acceptable for 3 mm gap between photon fields.     

Medicaid integrity program: what you need to know

Over the last few years, Congress has established more programs for increased Medicaid enforcement activities. One of the earliest of these is the Medicaid Integrity Program, a federal program that was established in 2005 to cause uniform and consistent Medicaid enforcement activities across all states. Since that time, the Centers for Medicare & Medicaid Services (CMS) has been slowly implementing this program. Although it is based within CMS's framework, the vast majority of the work will be done by subcontractors, similar to the Medicare Recovery Audit Contractor program. The actual roll out of this program has been slow, but it is expected that enforcement activities will increase over the next 6 to 12 months.     

Lidocaine vs. magnesium: effect on analgesia after a laparoscopic cholecystectomy

Background: This double‐blinded study aimed at evaluating and comparing the effects of magnesium and lidocaine on pain, analgesic requirements, bowel function, and quality of sleep in patients undergoing a laparoscopic cholecystectomy (LC). Methods: Patients were randomized into three groups (n=40 each). Group M received magnesium sulfate 50 mg/kg intravenously (i.v.), followed by 25 mg/kg/h i.v., group L received lidocaine 2 mg/kg i.v., followed by 2 mg/kg/h i.v., and group P received saline i.v. Bolus doses were given over 15 min before induction of anesthesia, followed by an i.v. infusion through the end of surgery. Intraoperative fentanyl consumption and averaged end‐tidal sevoflurane concentration were recorded. Abdominal and shoulder pain were evaluated up to 24 h using a visual analog scale (VAS). Morphine consumption was recorded at 2 and 24 h, together with quality of sleep and time of first flatus. Results: Lidocaine or magnesium reduced anesthetic requirements (P<0.01), pain scores (P<0.05), and morphine consumption (P<0.001) relative to the control group. Lidocaine resulted in lower morphine consumption at 2 h [4.9 ± 2.3 vs. 6.8 ± 2.8 (P<0.05)] and lower abdominal VAS scores compared with magnesium (1.8 ± 0.8 vs. 3.2 ± 0.9, 2.2 ± 1 vs. 3.6 ± 1.6, and 2.1 ± 1.4 vs. 3.3 ± 1.9) at 2, 6, and 12 h, respectively (P<0.05). Lidocaine was associated with earlier return of bowel function and magnesium was associated with better sleep quality (P<0.05). Conclusion: I.v. lidocaine and magnesium improved post‐operative analgesia and reduced intraoperative and post‐operative opioid requirements in patients undergoing LC. The improvement of quality of recovery might facilitate rapid hospital discharge.     

Relative importance of abnormalities of CCK and 5‐HT (serotonin) in Giardia‐induced post‐infectious irritable bowel syndrome and functional dyspepsia

Aliment Pharmacol Ther 31 , 883–891

Summary

Background Post‐infectious irritable bowel syndrome (PI‐IBS) and functional dyspepsia (FD) have been described after both Campylobacter jejuni gastroenteritis and Giardia infection. After C. jejuni, there is increased rectal serotonin (5‐HT)‐containing EC cells and postprandial plasma 5‐HT, while a pilot study suggested increased plasma cholecystokinin (CCK) after Giardia infection. Aim To determine changes in plasma and duodenal mucosal 5‐HT and CCK in Giardia‐induced PI‐IBS. Methods A total of 32 patients previously infected with Giardia and 19 who had recovered fully (controls) completed symptom questionnaires. Endoscopic duodenal biopsies were obtained from all subjects and immunohistochemically stained for CCK, 5‐HT and CgA containing entero‐endocrine cells and mast cells. 5‐HT content was also assessed. Twenty‐one of 32 patients and 19 controls consumed a high‐carbohydrate meal, while fasting and postprandial plasma CCK and 5‐HIAA were measured. Results Post‐infectious irritable bowel syndrome patients had increased numbers of CCK cells (P = 0.02), but lower numbers of EC cells (P = 0.009). Plasma CCK did not differ significantly between the groups, but correlated significantly with postprandial dyspepsia scores (r = 0.5, P = 0.05). PI‐IBS patients had significantly lower plasma 5‐HIAA, before and after meal (P = 0.05) as well as more dyspepsia (P < 0.0001) compared with recovered subjects. Conclusions Post‐infectious bowel dysfunction following Giardia infection is associated with increased duodenal mucosal CCK. Postprandial dyspeptic symptoms correlate better with CCK than measures of 5‐HT metabolism.     

Preimplantation genetic diagnosis as a source of human embryonic stem cells for disease research and drug discovery

Embryos surplus to therapeutic requirements following preimplantation genetic diagnosis can be used to derive human embryonic stem cell (hESC) lines carrying mutations significant to human disease. These cells provide a powerful in vitro tool for modelling disease progression in a number of cell types as well as having the potential to revolutionise drug discovery. Robust and reproducible directed differentiation protocols are needed to maximise the potential of these cells. In this review, we explore the current use of hESC and induced pluripotent stem cells in disease-specific research and discuss the use of stem cell technology in drug discovery and toxicity testing.     

A comparative study of palatal height in a Saudi and Egyptian population

SUMMARY The present study constitutes an attempt to compare normal traits for palatal height and width at different stages of dentition development of two ethnic groups of the Middle East. The observations were obtained from 346 randomly selected normal subjects, 188 Saudis and 158 Egyptians. The stone models were divided into three categories in both groups — primary, mixed and permanent dentitions. Palatal index values were calculated at two levels. Vernier calipers were used to measure the palatal width. Palatal depth was measured by profile Gauge by Vitrex. The results of this study demonstrate no significant difference between ethnic groups at levels 1 and 2 in relation to the palatal height, width and index. For both groups, palatal index increased significantly from the primary to mixed and permanent dentition at level 1.
At level 2, palatal index and height showed decreases in measurement in the mixed dentition compared with the primary and the permanent dentitions.
Subjective assessment of the palatal height correlated with palatal index. The casts were then labelled so that the shallow group had the smallest palatal index followed by the normal and the deep group had the largest palatal index. The results contribute to the information available on the development of palatal shape within two Middle Eastern populations. Knowledge of the normal range in shape can act as a baseline for studies of certain oral developmental abnormalities.