Seroprevalence of rubella antibodies among antenatal patients in the Western Cape

Objectives. To determine the seroprevalence of rubella virus infection among antenatal patients aged  between 15 and 45 years in the Western Cape province of South Africa, in order to provide data to  determine the need for vaccination to protect women of childbearing age.Design. A cross-sectional study.Setting. Virology laboratory, Groote Schuur Hospital, National Health Laboratory Service (NHLS), South Africa.Subjects and methods. One thousand two hundred provincial serum specimens from participants in  the 2003 Department of Health antenatal HIV /syphilis serosurvey were selected from the 4 districts of the Western Cape. The specimens were agestratified and screened qualitatively for  rubellaimmunoglobulin G (IgG) antibodies by means of a commercial immunoassay during October 2004.Results. Within the Western Cape a total o£95.3% of women in the 15- 24-year age group, 97.5% in the 25 - 34-year group and 98% in the 35 - 45-year age group were immune to rubella. There was no statistically significant difference in the rate of rubella susceptibility between the 4 districts tested.Conclusions. The study is an important step in addressing the seroprevalence of rubella infection in  women of childbearing age in South Africa. Further information is needed on rubella seroprevalence from the other provinces in South Africa as well as formal implementation of rubella and congenital rubella syndrome surveillance to determine the feasibility of routine rubella immunisation

Malnutrition in the elderly

Changes that occur naturally throughout the ageing process place the elderly population at greater risk of malnourishment. This review discusses the significance, causes, consequences and assessment of malnutrition in the elderly

Interest in Otolaryngology-Head and Neck Surgery residency: Can Google Trends be a predictive tool?

Google Trends, an online internet search tool, was used to evaluate the association between the U.S. senior applicant pool for Otolaryngology-Head and Neck Surgery (Oto-HNS) residency programs and internet search queries for Oto-HNS residency. Retrospective analysis was performed on the relative search interest for Oto-HNS residencies using Google Trends. Google Trends data was compiled and compared to the National Residency Match Program (NRMP) data. Analysis demonstrated a recent decrease in relative search volume interest in Oto-HNS residencies. The Google Trends analysis mirrored the data from the NRMP which reported a relative decrease in the number of medical school graduate applicants in the field of Oto-HNS. These results suggest that online search tools such as Google Trends may be a useful tool providing insight into the interests of medical school graduates in Oto-HNS residency

Emergence of plasmid-mediated colistin resistance (MCR-1) among Escherichia coli isolated from South African patients

The polymyxin antibiotic colistin is an antibiotic of last resort for the treatment of extensively drug-resistant Gram-negative bacteria, including carbapenemase- producing Enterobacteriaceae. The State of the World’s Antibiotics report in 2015 highlighted South Africa (SA)’s increasing incidence of these ‘superbugs’ (3.2% of Klebsiella pneumoniae reported from SA were carbapenemase producers), and in doing so, underscored SA’s increasing reliance on colistin as a last line of defence. Colistin resistance effectively renders such increasingly common infections untreatable

Association of Rare Coding Mutations With Alzheimer Disease and Other Dementias Among Adults of European Ancestry

IMPORTANCE Some of the unexplained heritability of Alzheimer disease (AD) may be due to rare variants whose effects are not captured in genome-wide association studies because very large samples are needed to observe statistically significant associations. OBJECTIVE To identify genetic variants associated with AD risk using a nonstatistical approach. DESIGN, SETTING, AND PARTICIPANTS Genetic association study in which rare variants were identified by whole-exome sequencing in unrelated individuals of European ancestry from the Alzheimer’s Disease Sequencing Project (ADSP). Data were analyzed between March 2017 and September 2018. MAIN OUTCOMES AND MEASURES Minor alleles genome-wide and in 95 genes previously associated with AD, AD-related traits, or other dementias were tabulated and filtered for predicted functional impact and occurrence in participants with AD but not controls. Support for several findings was sought in a whole-exome sequencing data set comprising 19 affected relative pairs from Utah high-risk pedigrees and whole-genome sequencing data sets from the ADSP and Alzheimer’s Disease Neuroimaging Initiative. RESULTS Among 5617 participants with AD (3202 [57.0%] women; mean [SD] age, 76.4 [9.3] years) and 4594 controls (2719 [59.0%] women; mean [SD] age, 86.5 [4.5] years), a total of 24 variants with moderate or high functional impact from 19 genes were observed in 10 or more participants with AD but not in controls. These variants included a missense mutation (rs149307620 [p.A284T], n = 10) in NOTCH3, a gene in which coding mutations are associated with cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), that was also identified in 1 participant with AD and 1 participant with mild cognitive impairment in the whole genome sequencing data sets. Four participants with AD carried the TREM2 rs104894002 (p.Q33X) high-impact mutation that, in homozygous form, causes Nasu-Hakola disease, a rare disorder characterized by early-onset dementia and multifocal bone cysts, suggesting an intermediate inheritance model for the mutation. Compared with controls, participants with AD had a significantly higher burden of deleterious rare coding variants in dementia-associated genes (2314 vs 3354 cumulative variants, respectively; P = .006). CONCLUSIONS AND RELEVANCE Different mutations in the same gene or variable dose of a mutation may be associated with result in distinct dementias. These findings suggest that minor differences in the structure or amount of protein may be associated with in different clinical outcomes. Understanding these genotype-phenotype associations may provide further insight into the pathogenic nature of the mutations, as well as offer clues for developing new therapeutic targets