Prevalence and Role of Candida in Acute Gastroenteritis (Choleraic and non-choleraic)

Candida species were isolated and identified from the stool samples of cholera and non-dioleraic acute gastroenteritis (GE) cases. From 500 samples (398 from GE and 102 from cholera cases) 129 strains of Candida were isolated. The total rate percentage of Candida in both the groups varied from 25–26 %.
The incidence of Candida in GE was higher in children from 1–4 years whereas in cholera cases the incidence was higher in the group from 5–9 years.
On statistical analysis it was found that the association of C. albicans and C. tropicalis with gastroenteritis, either choleraic or non-choleraic, bears no significance to the disorder. Complete dissociation of the species of C. albicans and C. tropicalis was found in the stool samples of the two groups of gastroenteritis cases.

Zusammenfassung

Candida -Arten — 129 Stämme — wurden aus Stuhlproben von Patienten, die an Cholera (102 Fälle) oder an einer akuten Gastroenteritis (398 Fälle) erkrankt waren, isoliert und identifiziert. Bei beiden Patientengruppen lag der Prozentsatz des Candida -Nachweises zwischen 25 bis 26 %. Das Sproßpilzvorkommen lag bei 1–4 Jahre alten Kindern nit einer Gastroenteritis höher. Bei der Vergleichsgruppe der Cholera-Kranken waren vermehrt Sproßpilze bei 5–9 Jahre alten Kindern nachzuweisen.
Statistische Berechnungen zeigten keine Verbindung zwischen Candida albicans - und Candida tropicalis -Nachweis zu den Cholera- oder nicht Cholera-bedingten Gastro-enteritiden. Die beiden Candida -Arten wurden in keinem Fall gemeinsam aus einer der Stuhlproben gezüchtet.     

Quantile regression for the statistical analysis of immunological data with many non-detects

Background

Hemolytic uremic syndrome (HUS) leading to acute kidney failure, is a condition linked to the production of primarily Shiga toxin 2 (Stx2) by some E. coli serotypes. We have previously shown that Stx2 A subunit-specific human monoclonal antibody (HuMAb) 5C12, and B subunit-specific HuMAb 5H8 inhibit cultured cell death, and protect mice and piglets from fatal Stx2-intoxication. We have also shown that 5H8 blocks binding of Stx2 to its cell-surface receptor globotriaosyl ceramide (Gb₃), whereas Stx2 when complexed with 5C12 binds Gb₃ with higher affinity than Stx2. The mechanism by which 5C12 neutralizes Stx2 in vitro involves trapping of Stx2 in the recycling endosomes and releasing it into the extracellular environment. Because of the clinical implications associated with the formation of Stx2/antibody complexes and the potential for trapping and clearance through a severely damaged kidney associated with HUS, we investigated the likely site(s) of Stx2/antibody localization and clearance in intoxicated mice treated with antibody or placebo.

Results

Mice were injected with radiolabeled Stx2 (¹²⁵I-Stx2) 4 hours after administration of 5C12, 5H8, or phosphate buffered saline (PBS) and the sites of localization of labeled Stx2, were investigated 3, 24 and 48 hours later. The liver recorded statistically much higher concentrations of labeled Stx2 for groups receiving 5C12 and 5H8 antibodies after 3, 24 and 48?hours, as compared with the PBS group. In contrast, highest levels of labeled Stx2 were detected in the kidneys of the PBS group at all 3 sampling times. Mice receiving either of the two HuMAbs were fully protected against the lethal effect of Stx2, as compared with the fatal outcome of the control group.

Conclusions

The results suggest that HuMAbs 5C12 and 5H8 promoted hepatic accumulation and presumably clearance of toxin/antibody complexes, significantly diverting Stx2 localization in the kidneys, the target of Stx2 and the cause of HUS. This is in contrast to the fatal outcome of the control group receiving PBS. The results also confirm earlier observations that both HuMAbs are highly and equally protective against Stx2 intoxication in mice.     

Neutralizing antibodies to interferon-α and circulating interferon in patients with chronic hepatitis C non-responding to pegylated interferon plus ribavirin re-treated by pegylated interferon-α-2a and ribavirin (ANRS HC16 GAMMATRI substudy)

A lack of antiviral response in patients with chronic hepatitis C treated with pegylated (PEG)‐interferon (IFN)‐α‐2a + ribavirin (RIBA) may be explained by neutralizing antibodies to IFN‐α‐2a. The aim of this study was to assess neutralizing antibodies to IFN‐α‐2a and IFN levels in non‐responder patients who were re‐treated by PEG IFN‐α‐2a and RIBA for 12 weeks. Non‐responders to a first‐line treatment of PEG IFN‐α‐2a + RIBA were included for treatment with PEG IFN‐α‐2a (180 µg/week) + RIBA (1,000 mg/day if <75 kg, 1,200 mg otherwise) for 48 weeks. HCV RNA was measured at week 12. IFN levels and neutralizing antibodies to IFN‐α‐2a were measured retrospectively on stored sera at baseline and weeks 4 and 12, using a quantitative sandwich ELISA for neutralizing antibodies to IFN‐α‐2a. Twenty‐three patients were non‐responders and 19 patients were responders at week 12 of the initial phase of the second‐line treatment. Non‐responders and responders did not differ statistically: baseline age (median age 47 vs. 50 years), HCV RNA (median 6.8 vs. 6.4 log₁₀ copies/ml), gender (70% vs. 73% males), genotype (genotype 1: 91% vs. 80%). The median IFN‐α‐2a levels (pg/ml) at weeks 0, 4, and 12 (interquartile range) did not differ between the 19 responders to initial phase of second‐line treatment and the 23 non‐responders: <3.3 (<3.3–371.4), 1457.3 (106.8–3284.8), and 1,652 (90.8–5,000); 84.5 (3.3–277.4), 1407.4 (120.2–2443.4), and 1620.1 (120.2–2287.1), respectively. Among non‐selected consecutive non‐responder patients, re‐treatment with PEG IFN‐α‐2a + RIBA is associated with virological response regardless of the presence of antibody‐mediated resistance to conventional IFN treatment. J. Med. Virol. 82:2027–2031, 2010. © 2010 Wiley‐Liss, Inc.     

Malabsorption and nutritional balance in the ICU: fecal weight as a biomarker: a prospective observational pilot study

Introduction  

Malabsorption, which is frequently underdiagnosed in critically ill patients, is clinically relevant with regard to nutritional balance and nutritional management. We aimed to validate the diagnostic accuracy of fecal weight as a biomarker for fecal loss and additionally to assess fecal macronutrient contents and intestinal absorption capacity in ICU patients.     

Morphine: double-faced roles in the regulation of tumor development

Morphine, a highly potent analgesic, is one of the most effective drugs for the treatment of severe pain associated with cancer. It directly acts on the central nervous system to relieve pain, but also cause secondary complications, such as addiction, respiratory depression and constipation due to its activities on peripheral tissues. Besides pain relief, morphine is of great importance on cancer management with its effect on tumor development being the subject of debate for many years with some contradictory findings. Morphine has shown both tumor growth-promoting and growth-inhibiting effects in many published research studies. And various signaling pathways have been suggested to be involved in these effects of morphine. Based on a thorough literature review, we summarized the double-faced effects of morphine in tumor development, including tumor cell growth and apoptosis, metastasis, angiogenesis, immunomodulation and inflammation. And we attempted to optimize morphine administration in cancer patients to attenuate its tumor growth-promoting effects.     

How pediatricians can respond to the psychosocial implications of disasters. American Academy of Pediatrics. Committee on Psychosocial Aspects of Child and Family Health, 1998-1999

Natural and human-caused disasters, violence with weapons, and terrorist acts have touched directly the lives of thousands of families with children in the United States.1 Media coverage of disasters has brought images of floods, hurricanes, and airplane crashes into the living rooms of most American families, with limited censorship for vulnerable young children. Therefore, children may be exposed to disastrous events in ways that previous generations never or rarely experienced. Pediatricians should serve as important resources to the community in preparing for disasters, as well as acting in its behalf during and after such events.     

A prospective cohort study to investigate cost-minimisation,of Traditional open,open fAst track recovery and laParoscopic fASt track multimodal management,for surgical patients with colon carcinomas (TAPAS study)

Background

The present developments in colon surgery are characterized by two innovations: the introduction of the laparoscopic operation technique and fast recovery programs such as the Enhanced Recovery After Surgery (ERAS) recovery program. The Tapas-study was conceived to determine which of the three treatment programs: open conventional surgery, open 'ERAS' surgery or laparoscopic 'ERAS' surgery for patients with colon carcinomas is most cost minimizing?

Method/design

The Tapas-study is a three-arm multicenter prospective cohort study.All patients with colon carcinoma, eligible for surgical treatment within the study period in four general teaching hospitals and one university hospital will be included. This design produces three cohorts: Conventional open surgery is the control exposure (cohort 1). Open surgery with ERAS recovery (cohort 2) and laparoscopic surgery with ERAS recovery (cohort 3) are the alternative exposures. Three separate time periods are used in order to prevent attrition bias.Primary outcome parameters are the two main cost factors: direct medical costs (real cost price calculation) and the indirect non medical costs (friction method). Secondary outcome parameters are mortality, complications, surgical-oncological resection margins, hospital stay, readmission rates, time back to work/recovery, health status and quality of life.Based on an estimated difference in direct medical costs (highest cost factor) of 38% between open and laparoscopic surgery (alfa = 0.01, beta = 0.05), a group size of 3×40 = 120 patients is calculated.

Discussion

The Tapas-study is three-arm multicenter cohort study that will provide a cost evaluation of three treatment programs for patients with colon carcinoma, which may serve as a guideline for choice of treatment and investment strategies in hospitals.

Trial registration

ISRCTN44649165.

     

麝香保心丸对内皮素-1诱导原代培养的人脐动脉血管平滑肌细胞增殖的影响

目的:观察麝香保心丸(SXBXW)对内皮素-1(ET-1)诱导原代培养的人脐动脉血管平滑肌细胞(VSMCs)增殖作用的影响。方法:建立ET-1刺激原代培养人脐动脉VSMCs增殖的细胞模型,设对照组、ET-1组、ET-1+SXBXW0.25g/L组、ET-1+SXBXW0.5g/L组、ET-1+SXBXW1.0g/L组和ET-1+SXBXW2.0g/L组,采用MTT法测定ET-1和SXBXW对细胞增殖的影响;用台盼蓝拒染和乳酸脱氢酶检测方法观察不同浓度的SXBXW对VSMCs的毒性作用;用流式细胞术观察ET-1和SXBXW对VSMCs增殖周期的影响。结果:与对照组相比,ET-1可显著促进VSMCs的增殖,一定剂量的SXBXW能够有效地抑制ET-1诱导的VSMCs细胞增殖,呈剂量依赖性;SXBXW抑制细胞增殖,但对活细胞数目和乳酸脱氢酶释放量均没有影响,提示对VSMCs无毒性作用。ET-1能够刺激VSMCs从G1期进入S期,从而促进细胞增殖,而SXBXW能抑制这一作用。结论:SXBXW能够有效抑制ET-1诱导的VSMCs增殖作用,其作用机制可能与其抑制细胞周期从G1期进入S期有关。