Real-Time PCR in the early detection of invasive fungal infection in immunodeficient infants and children

Background: Crucial to the diagnosis and effective therapy of invasive fungal infection (IFI) in the immunodeficient is the early identification of the causative agent especially in patients who lack clinical evidence of the disease. The standard methods for the detection of fungi in clinical specimens are direct microscopy and mycological culture. Microscopy often lacks a satisfactory sensitivity, whereas diagnosis by mycological culture often requires a long growth period. Studies have demonstrated the feasibility of detecting molds and yeast in a single reaction using the universal fungal primer. Objective: Evaluation of the role of real-time PCR in the early detection of fungal infection in immunodeficient patients with suspected IFI, who lack clinical evidence of the disease. Methods: This study included 30 immunodeficiency patients suspected of having IFI; 9 with primary and 21 with secondary immunodeficiency. All patients had at least one host factor, but no clinical criteria according to the EORTC-MSG definition of IFI. Twenty seven had fever and 3 had bronchopneumonia, both not responding to broad spectrum antibiotics for 96 hrs. or more. Blood samples were cultured for fungi and were analyzed with real-time PCR using universal fungal primers. For positive samples of fungal infection, aspergillus-specific primers were used for detection of aspergillus. Results: Seventeen patients (56.7%) proved to have IFI. Blood culture detected Candida in 2 patients only, while PCR detected Candida in another 9 and Aspergillus in 6, thus 15/17 patients with IFI (88%) were missed by blood culture. Blood culture for IFI diagnosis had a very low sensitivity (12%) but had a 100% specificity and positive predictive value. The results PCR did not vary with gender, degree of fever, immunodeficiency type, clinical presentation or current intake of antifungal treatment. Patients with proven IFI showed significantly increased CRP levels as compared to those without infection. Conclusion: Real-time PCR proved superior to culture in early diagnosis of IFI in patients with immunodeficiency before the appearance of the characteristic clinical and imaging signs. Reliance on blood culture alone at that stage would result in missing most of the positive cases with consequent delay in the initiation of specific treatment. Keywords: Invasive fungal infection, immunodeficiency, blood culture, real-time PCR, candida, aspergillusEgypt J Pediatr Allergy Immunol 2012;10(2):67-7

Birth defects surveillance· A pilot system in the Cape Peninsula

A pilot birth defects surveillance system was established in 1982 as part of an epidemiological baseline study pertaining to potential changes in water quality in the Cape Peninsula. The methodology used for reporting birth defects for two information systems, one hospital-based and the other population- based, utilising statutory notifications of births, is described. Preliminary birth defect rates by cause are presented for a hospital-based system and are consistent with rates reported internationally. The system based on statutory notifications showed gross under-reporting

The epidemiology of hypertension family practice in Cape Town

A prevalence study of hypertension in 8 family practices in low socio-economic areas of Cape Town examined 1046 patients over the age of 15 years. The crude prevalence rate of hypertension was 20,26%. There was no significant sex difference. Systolic pressure, diastolic pressure and hypertensive status increased with age and body mass index (BMI). There were complex relationships with regard to sex in that the female sex was predictive of hypertensive status after the age of 45 years unexplained by differences in BM!. After adjusting for age, BMI and sex differences, widowhood, poor education, obesity, a family history of hypertension or stroke and a past history of hypertension were significant predictors of hypertensive status. Smoking status, occupational social class or property ownership were not predictive. Fifty-one per cent of hypertensive subjects were treated. Of those receiving treatment, 30% were controlled resulting in a control prevalence of only 18%. Younger male subjects were better controlled by treatment. A strong need for improved diagnosis and treatment of hypertension in family practice exists in this region.S Afr Med J 1990; 78: 7-1

Urbanisation and women's health in Khayelitsha Part 11. Health status and use of health services

A study was conducted among women in Khayelitsha to determine the relationship between urbanisation, health status and use of health services; 722 households were visited, and 659 female respondents provided information on acute and chronic illness for the 3229 individuals who were members of their households. In addition, they provided information concerning their reproductive health, AIDS awareness, knowledge of cervical smears and use and knowledge of health services. Acute illness was reported for .4,3% of the study population, the commonest complaints being diarrhoea, abdominal pain and upper respiratory infections; 4,4% reported chronic illness, the commonest complaints being hypertension and tuberculosis; 16,2% of women reported gynaecological illness; 86% had of heard of AIDS (although their knowledge of transmission and prevention was poor); and 45% had heard of cervical smears. Patterns of illness and knowledge and use of health services vary in the different areas of residence of Khayelitsha. This appears to be related to urbanisation, age, and environmental and socio-economic factors

Urbanisation and women's health in Khayelitsha Part I. Demographic and socio-economic profile

Demographic and socio-economic data and information on migration patterns and urban/rural links was collected from 722 households in the formal housing area and the serviced and the unserviced site areas of Khayelitsha; 659 women and 61 men were interviewed. Thirty-eight per cent of the population were aged under 15 years and 77% under 35 years. There was a predominance of females in the 5 - 35-year age group. There was a mean of 4,9 persons per household, and 93,5% of sites contained 1 dwelling. Of the 659 female respondents, 7% had received no formal education, 39% had primary school education, and 54% had secondary school education. unemployment among women was 45%. Domestic service accounted for 66,2% of formal employment. Of all women 86% were unskilled, 71,9% had been born in a 'homeland', and 69,7% had migrated to an urban area before 1985. Ties to the rural areas were strong, particularly in the 'shack' areas. 'New arrivals' to an urban area were young, mostly unemployed, and lived in the worst environmental conditions. In the unserviced 'shack' areas, 47,5% of women had migrated to an urban area in the last 5 years. These are important target areas for a study of the health effects of urbanisation and for possible interventions. This study tends to confirm the 'quadruple' oppression of women in Khayelitsha, on the basis of race, social class and gender and as new arrivals in an urban environment

Patterns of hepatocellular carcinoma incidence in Egypt from a population-based cancer registry

Hepatocellular carcinoma (HCC) is increasing worldwide, and is frequently attributed to rising rates of hepatitis C virus infection and interactions between viral and environmental risk factors. Because of Egypt's unique risk factor profile, we analyzed data from the Gharbiah Population-Based Cancer Registry for the period 1999–2003 to characterize demographic and geographic patterns of cases in this province. Methods:  We calculated age- and sex-specific and age- and sex-standardized HCC incidence rates for the eight districts in Gharbiah. We also compared rates from Gharbiah with the USA (US Surveillance Epidemiology and End Results [SEER] database). Results:  The analysis revealed a higher incidence in males than in females, significant geographic variations among districts, and a higher incidence in Gharbiah than that reported by SEER. Conclusion:  The findings of this study document the heterogeneous distribution of HCC at regional and international levels. This population-based registry offers the opportunity for careful representative studies of various etiologies, particularly infectious and/or environmental factors that may contribute to risk.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75374/1/j.1872-034X.2007.00299.x.pd

Isolation and characterisation of human gingival margin-derived STRO-1/MACS+ and MACS− cell populations

Recently, gingival margin-derived stem/progenitor cells isolated via STRO-1/magnetic activated cell sorting (MACS) showed remarkable periodontal regenerative potential in vivo. As a second-stage investigation, the present study's aim was to perform in vitro characterisation and comparison of the stem/progenitor cell characteristics of sorted STRO-1-positive (MACS+) and STRO-1-negative (MACS−) cell populations from the human free gingival margin. Cells were isolated from the free gingiva using a minimally invasive technique and were magnetically sorted using anti-STRO-1 antibodies. Subsequently, the MACS+ and MACS− cell fractions were characterized by flow cytometry for expression of CD14, CD34, CD45, CD73, CD90, CD105, CD146/MUC18 and STRO-1. Colony-forming unit (CFU) and multilineage differentiation potential were assayed for both cell fractions. Mineralisation marker expression was examined using real-time polymerase chain reaction (PCR). MACS+ and MACS− cell fractions showed plastic adherence. MACS+ cells, in contrast to MACS− cells, showed all of the predefined mesenchymal stem/progenitor cell characteristics and a significantly higher number of CFUs (P<0.01). More than 95% of MACS+ cells expressed CD105, CD90 and CD73; lacked the haematopoietic markers CD45, CD34 and CD14, and expressed STRO-1 and CD146/MUC18. MACS− cells showed a different surface marker expression profile, with almost no expression of CD14 or STRO-1, and more than 95% of these cells expressed CD73, CD90 and CD146/MUC18, as well as the haematopoietic markers CD34 and CD45 and CD105. MACS+ cells could be differentiated along osteoblastic, adipocytic and chondroblastic lineages. In contrast, MACS− cells demonstrated slight osteogenic potential. Unstimulated MACS+ cells showed significantly higher expression of collagen I (P<0.05) and collagen III (P<0.01), whereas MACS− cells demonstrated higher expression of osteonectin (P<0.05; Mann–Whitney). The present study is the first to compare gingival MACS+ and MACS− cell populations demonstrating that MACS+ cells, in contrast to MACS− cells, harbour stem/progenitor cell characteristics. This study also validates the effectiveness of the STRO-1/MACS+ technique for the isolation of gingival stem/progenitor cells. Human free gingival margin-derived STRO-1/MACS+ cells are a unique renewable source of multipotent stem/progenitor cells

A Brain-Computer Interface Based Attention Training Program for Treating Attention Deficit Hyperactivity Disorder

10.1371/journal.pone.0046692PLoS ONE710

Female sex pheromone of the cone moth, dioryctria mendacella: Investigation of synergism between Type I and Type II pheromone components

Polyunsaturated hydrocarbons (Type II pheromone components) have been reported to be synergists for unsaturated acetates, alcohols or aldehydes (Type I components) in the sex pheromones of several species of Lepidoptera. However, there is some debate over whether the active components are the hydrocarbons themselves or more volatile degradation products. Extracts of pheromone glands of adult females of the cone moth, Dioryctria mendacella (Lepidoptera: Pyralidae), contain (Z,E)-9,11-tetradecadienyl acetate (ZE9,11-14:Ac) and at least ten times as much (Z,Z,Z,Z,Z)-3,6,9,12,15-pentacosapentaene (ZZZZZ3,6,9,12,15-25:H). The former elicits a strong electroantennogram response from males while no response could be recorded to the latter. In field trapping tests, both compounds were individually unattractive to male D. mendacella moths, but blends of the two compounds containing at least a 10:1 ratio of ZZZZZ3,6,9,12,15-25:H : ZE9,11-14:Ac were highly attractive. The relatively involatile hydrocarbon was shown to be released from the dispensers used and no significant degradation could be detected. Furthermore, blends of ZE9,11-14:Ac and analogs of ZZZZZ3,6,9,12,15-25:H with fewer carbons and/or double bonds that might be expected to produce similar degradation products to ZZZZZ3,6,9,12,15-25:H were unattractive. This indicated a specific response to the hydrocarbon itself, further substantiated by the observation that related hydrocarbons did not interfere with the activity of ZZZZZ3,6,9,12,15-25:H. Thus a three-step conversion of fish oil was used to produce a blend of unsaturated hydrocarbons containing ZZZZZ3,6,9,12,15-25:H as the major component, albeit only 30% of the total, and a blend of this material with ZE9,11-14:Ac was as attractive to male D. mendacella moths as blends with an equivalent amount of the purified material. This mixture of unsaturated hydrocarbons is much cheaper to produce than the pure pentaene, and may be useful in lures for other species using these compounds. Dioryctria mendacella is a major constraint to production of edible pine kernels throughout the Mediterranean region. Pheromone traps will provide a means to improve monitoring of seasonal flight patterns and changes in population abundance of this pest

The use of medicinal plants in health care practices by Rohingya refugees in a degraded forest and conservation area of Bangladesh

People in developing countries traditionally rely on plants for their primary healthcare. This dependence is relatively higher in forests in remote areas due to the lack of access to modern health facilities and easy availability of the plant products.We carried out an ethno-medicinal survey in Teknaf Game Reserve (TGR), a heavily degraded forest and conservation area in southern Bangladesh, to explore the diversity of plants used by Rohingya refugees for treating various ailments. The study also documented the traditional utilization, collection and perceptions of medicinal plants by the Rohingyas residing on the edges of this conservation area. We collected primary information through direct observation and by interviewing older respondents using a semi-structured questionnaire. A total of 34 plant species in 28 families were frequently used by the Rohingyas to treat 45 ailments, ranging from simple headaches to highly complex eye and heart diseases. For medicinal preparations and treating various ailments, aboveground plant parts were used more than belowground parts. The collection of medicinal plants was mostly from the TGR. © 2009 Taylor & Francis