Role of Shrimp Chitin in the Ecology of Toxigenic Vibrio cholerae and Cholera Transmission

Seasonal plankton blooms correlate with occurrence of cholera in Bangladesh, although the mechanism of how dormant Vibrio cholerae, enduring interepidemic period in biofilms and plankton, initiates seasonal cholera is not fully understood. In this study, laboratory microcosms prepared with estuarine Mathbaria water (MW) samples supported active growth of toxigenic V. cholerae O1 up to 7 weeks as opposed to 6 months when microcosms were supplemented with dehydrated shrimp chitin chips (CC) as the single source of nutrient. Bacterial counting and detection of wbe and ctxA genes were done employing culture, direct fluorescent antibody (DFA) assay, and multiplex-polymerase chain reaction methods. In MW microcosm, the aqueous phase became clear as the non-culturable cells settled, whereas the aqueous phase of the MW–CC microcosm became turbid from bacterial growth stimulated by chitin. Bacterial chitin degradation and biofilm formation proceeded from an initial steady state to a gradually declining bacterial culturable count. V. cholerae within the microenvironments of chitin and chitin-associated biofilms remained metabolically active even in a high acidic environment without losing either viability or virulence. It is concluded that the abundance of chitin that occurs during blooms plays an important role in the aquatic life cycle of V. cholerae and, ultimately, in the seasonal transmission of cholera

The Guillain-Barré Syndrome at Two Hospitals in Trinidad, West Indies: A Review of 26 Patients

Over a four-year period, 26 consecutive patients with Guillain-Barré syndrome (GBS) were seen. Their ages ranged from 18 months to 68 years. Fifteen were male and 11 female. The crude annual incidence was estimated to be 1.5 per 100 000 population. East Indians made up the majority of the patients. An antecedent infection was reported in 65% of patients. Significant pain was present in half of the cohort. F-wave abnormalities were the commonest electrophysiological disturbance. Twenty-nine per cent of patients required ventilation. Intravenous immunoglobulin (IVIG) treatment was beneficial in 88% of patients. Eighty-four per cent made a complete or near complete recovery. One patient died. Keywords: Guillain-Barré Syndrome, Trinidad "El Síndrome de Guillain-Barré en Trinidad, West Indies Una revisión de 26 pacientes" A Esack, S Teelucksingh RESUMEN Por un periodo de cuatro años, se atendieron 26 pacientes consecutivos con el síndrome de Guillain-Barré (GBS). Sus edades fluctuaban de 18 meses a 68 años. Quince eran varones y 11 hembras. Se calculó que la incidencia anual bruta era 1.5 por 100 000 población. La mayor parte de los pacientes eran indo-orientales. El 65% de pacientes reportó antecedentes de infección. La mitad de la cohorte presentaba dolor significativo. El trastorno electrofisiológico más común fue las anormalidades de la onda F. Veintinueve por ciento de los pacientes necesitaron ventilación. El tratamiento de inmunoglobulina intravenosa (IVIG) fue beneficioso en 88% de los pacientes. Ochenta y cuatro por ciento tuvo una recuperación completa o casi completa. Un paciente murió. Palabras claves: Síndrome de Guillain-Barré, Trinida

Membebaskan yang tertindas: Al-Qur'an, liberalisme, pluralisme

Buku ini mengklaim kebenaran eksekusi satu agama dan menawarkan kunci-kunci hermeneutika bagi islam yang inklusi. Buku ini juga memperlihatkan penafsiran tradisional Islam kadang digunakan untuk mendukung rezim yang tidak adil. Rintisan teologi pembebasan Islam yang lahir dari konteks yang dihadapi kaum Muslim Afrika Selatan.338 hlm.; 24 c

Guillain-Barré syndrome in the course of dengue: case report Síndrome de Guillain-Barré no curso de dengue: relato de caso

This case report describes the findings of a 45-year-old white woman from Brazil, who developed myalgia, fever and macular rash. She was diagnosed as having dengue, based on clinical manifestations and specific IgM titers. One week after the first symptoms of dengue, the patient developed muscle weakness, followed by tetraplegia with areflexia, and respiratory insufficiency. The electromyography had evidence of demyelinating neuropathy and the cerebrospinal fluid showed albuminocytologic dissociation. These neurologic findings were consistent with the diagnosis of Guillain-Barré syndrome. The patient was treated with immunoglobulin and metylprednisolone. Mechanical ventilation was started one week after hospital admission and maintained for four weeks. After six weeks of hospitalization the patient was discharged from the hospital on wheel chair, presenting mild muscle weakness and loss of patellar and ankle reflexes. When the patient was seen at the outpatient service three weeks after hospital discharge she was able to walk with help. This case report suggests a possible association between dengue and Guillain-Barré syndrome.<br>Este relato de caso descreve os achados de uma mulher de 45 anos, branca, que desenvolveu mialgia, febre e eritema macular. Ela recebeu o diagnóstico de dengue, tomando por base os achados clínicos e títulos específicos de IgM. Uma semana depois do início dos primeiros sintomas de dengue, a paciente desenvolveu fraqueza muscular, tetraplegia e insuficiência respiratória. A eletromiografia mostrou evidência de uma neuropatia desmielinizante e o liquor apresentou quadro de dissociação albuminocitológica. Os achados neurológicos foram consistentes com o diagnóstico de síndrome de Guillain-Barré. A paciente foi tratada com imunoglobulina e metilprednisolona. Ventilação mecânica foi iniciada uma semana após a admissão hospitalar, sendo mantida por quatro semanas. Após seis semanas de internamento a paciente teve alta em cadeira de rodas, apresentando fraqueza muscular e perda dos reflexos patelar e aquileu. Quando a paciente foi vista no ambulatório, três semanas após a alta hospitalar, ela já era capaz de andar com ajuda do acompanhante. Este relato de caso sugere uma possível associação entre dengue e síndrome de Guillain-Barré