Current diagnosis and treatment algorithms for anal incontinence

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75666/1/j.1464-410X.2006.06307.x.pd

Evaluation of the Widal tube agglutination test for the diagnosis of typhoid fever among children admitted to a rural hdospital in Tanzania and a comparison with previous studies

BACKGROUND: The diagnosis of typhoid fever is confirmed by culture of Salmonella enterica serotype Typhi (S. typhi). However, a more rapid, simpler, and cheaper diagnostic method would be very useful especially in developing countries. The Widal test is widely used in Africa but little information exists about its reliability. METHODS: We assessed the performance of the Widal tube agglutination test among febrile hospitalized Tanzanian children. We calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of various anti-TH and -TO titers using culture-confirmed typhoid fever cases as the "true positives" and all other febrile children with blood culture negative for S. typhi as the "true negatives." RESULTS: We found that 16 (1%) of 1,680 children had culture-proven typhoid fever. A single anti-TH titer of 1:80 and higher was the optimal indicator of typhoid fever. This had a sensitivity of 75%, specificity of 98%, NPV of 100%, but PPV was only 26%. We compared our main findings with those from previous studies. CONCLUSION: Among febrile hospitalized Tanzanian children with a low prevalence of typhoid fever, a Widal titer of > or = 1:80 performed well in terms of sensitivity, specificity, and NPV. However a test with improved PPV that is similarly easy to apply and cost-efficient is desirable

Malaria and obesity: obese mice are resistant to cerebral malaria

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Malaria and Under-Nutrition: A Community Based Study Among Under-Five Children at Risk of Malaria, South-West Ethiopia

BACKGROUND: The interaction between malaria and under-nutrition is not well elucidated in Ethiopia. The objective of this study was to assess the magnitude of under-nutrition and its correlation with malaria among under-five children in south-west Ethiopia. METHODS: This cross-sectional study was undertaken during March-February, 2009 as part of the baseline assessment of a cluster randomized trial around Gilgel Gibe Hydroelectric dam, south-west Ethiopia. A total of 2410 under-five children were included for anthropometric measurement and blood investigation for the diagnosis of malaria and anemia. The nutritional status of children was determined using the International Reference Population defined by the U.S National Center for Health Statistics (NCHS). Blood film was used to identify malaria parasite and haemoglobin concentration was determined by Hemo Cue analyzer (HemoCue Hb 301, Sweden). RESULTS: Significant proportion (40.4%) of under-five children were stunted (height-for-age<-2SD). The prevalence of under-weight was 34.2%. One third and one tenth of the children had anemia and malaria parasite respectively. Older children were more likely to have under-nutrition. There was no association between malaria and under-nutrition. Children who had malaria parasite were 1.5 times more likely to become anaemic compare to children who had no malaria parasite, [OR = 1.5, (95% CI: 1.1-2.0)]. CONCLUSION: In this study, there is no association between malaria and under-nutrition. Children who have malaria are more likely to be anaemic. Malaria prevention and control program should consider nutrition interventions particularly anemia

The association between malnutrition and the incidence of malaria among young HIV-infected and -uninfected Ugandan children: a prospective study

BACKGROUND: In sub-Saharan Africa, malnutrition and malaria remain major causes of morbidity and mortality in young children. There are conflicting data as to whether malnutrition is associated with an increased or decreased risk of malaria. In addition, data are limited on the potential interaction between HIV infection and the association between malnutrition and the risk of malaria. METHODS: A cohort of 100 HIV-unexposed, 203 HIV-exposed (HIV negative children born to HIV-infected mothers) and 48 HIV-infected children aged 6 weeks to 1 year were recruited from an area of high malaria transmission intensity in rural Uganda and followed until the age of 2.5 years. All children were provided with insecticide-treated bed nets at enrolment and daily trimethoprim-sulphamethoxazole prophylaxis (TS) was prescribed for HIV-exposed breastfeeding and HIV-infected children. Monthly routine assessments, including measurement of height and weight, were conducted at the study clinic. Nutritional outcomes including stunting (low height-for-age) and underweight (low weight-for-age), classified as mild (mean z-scores between -1 and -2 during follow-up) and moderate-severe (mean z-scores < -2 during follow-up) were considered. Malaria was diagnosed when a child presented with fever and a positive blood smear. The incidence of malaria was compared using negative binomial regression controlling for potential confounders with measures of association expressed as an incidence rate ratio (IRR). RESULTS: The overall incidence of malaria was 3.64 cases per person year. Mild stunting (IRR = 1.24, 95% CI 1.06-1.46, p = 0.008) and moderate-severe stunting (IRR = 1.24, 95% CI 1.03-1.48, p = 0.02) were associated with a similarly increased incidence of malaria compared to non-stunted children. Being mildly underweight (IRR = 1.09, 95% CI 0.95-1.25, p = 0.24) and moderate-severe underweight (IRR = 1.12, 95% CI 0.86-1.46, p = 0.39) were not associated with a significant difference in the incidence of malaria compared to children who were not underweight. There were no significant interactions between HIV-infected, HIV-exposed children taking TS and the associations between malnutrition and the incidence of malaria. CONCLUSIONS: Stunting, indicative of chronic malnutrition, was associated with an increased incidence of malaria among a cohort of HIV-infected and -uninfected young children living in an area of high malaria transmission intensity. However, caution should be made when making causal inferences given the observational study design and inability to disentangle the temporal relationship between malnutrition and the incidence of malaria. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00527800

Submilliarcsecond Optical Interferometry of the High-mass X-Ray Binary BP Cru with VLTI/GRAVITY

This is the final version. Available from American Astronomical Society via the DOI in this recordWe observe the high-mass X-ray binary (HMXB) BP Cru using interferometry in the near-infrared K band with VLTI/GRAVITY. Continuum visibilities are at most partially resolved, consistent with the predicted size of the hypergiant. Differential visibility amplitude () and phase () signatures are observed across the He i and Brγ lines, the latter seen strongly in emission, unusual for the donor star's spectral type. For a baseline m, the differential phase rms corresponds to an astrometric precision of . We generalize expressions for image centroid displacements and variances in the marginally resolved limit of interferometry to spectrally resolved data, and use them to derive model-independent properties of the emission such as its asymmetry, extension, and strong wavelength dependence. We propose geometric models based on an extended and distorted wind and/or a high-density gas stream, which has long been predicted to be present in this system. The observations show that optical interferometry is now able to resolve HMXBs at the spatial scale where accretion takes place, and therefore to probe the effects of the gravitational and radiation fields of the compact object on its environment

Gene Expression Profiling during Early Acute Febrile Stage of Dengue Infection Can Predict the Disease Outcome

Background: We report the detailed development of biomarkers to predict the clinical outcome under dengue infection. Transcriptional signatures from purified peripheral blood mononuclear cells were derived from whole-genome gene-expression microarray data, validated by quantitative PCR and tested in independent samples. Methodology/Principal Findings: The study was performed on patients of a well-characterized dengue cohort from Recife, Brazil. The samples analyzed were collected prospectively from acute febrile dengue patients who evolved with different degrees of disease severity: classic dengue fever or dengue hemorrhagic fever (DHF) samples were compared with similar samples from other non-dengue febrile illnesses. The DHF samples were collected 2-3 days before the presentation of the plasma leakage symptoms. Differentially-expressed genes were selected by univariate statistical tests as well as multivariate classification techniques. The results showed that at early stages of dengue infection, the genes involved in effector mechanisms of innate immune response presented a weaker activation on patients who later developed hemorrhagic fever, whereas the genes involved in apoptosis were expressed in higher levels. Conclusions/Significance: Some of the gene expression signatures displayed estimated accuracy rates of more than 95%, indicating that expression profiling with these signatures may provide a useful means of DHF prognosis at early stages of infection. © 2009 Nascimento et al

Detection of the gravitational redshift in the orbit of the star S2 near the Galactic centre massive black hole

This is the author accepted manuscript. the final version is available from EDP Sciences via the DOI in this recordThe highly elliptical, 16-year-period orbit of the star S2 around the massive black hole candidate Sgr A∗ is a sensitive probe of the gravitational field in the Galactic centre. Near pericentre at 120 AU ≈ 1400 Schwarzschild radii, the star has an orbital speed of ≈ 7650 km s-1, such that the first-order effects of Special and General Relativity have now become detectable with current capabilities. Over the past 26 years, we have monitored the radial velocity and motion on the sky of S2, mainly with the SINFONI and NACO adaptive optics instruments on the ESO Very Large Telescope, and since 2016 and leading up to the pericentre approach in May 2018, with the four-telescope interferometric beam-combiner instrument GRAVITY. From data up to and including pericentre, we robustly detect the combined gravitational redshift and relativistic transverse Doppler effect for S2 of z = Δλ / λ ≈ 200 km s-1/c with different statistical analysis methods. When parameterising the post-Newtonian contribution from these effects by a factor f, with f = 0 and f = 1 corresponding to the Newtonian and general relativistic limits, respectively, we find from posterior fitting with different weighting schemes f = 0.90 ± 0.09|stat ± 0.15|sys. The S2 data are inconsistent with pure Newtonian dynamics