9 research outputs found
Low prevalence of detectable serum cardiac troponin I among healthy Tanzanian adults: observational study
Background: Cardiac troponin test is used in detecting various heart disorders. The objective of this study was to establish normal reference levels for serum cardiac Troponin I which could be utilized for selection of vaccines and determine any electrocardiogram (EKG) changes among healthy volunteers.Methods: A total of 263 healthy blood donors from Dar es Salaam, Tanzania were included in this sub-study. A thorough medical history and physical examination to rule out any major chronic disease like heart failure, chronic kidney diseases, diabetes mellitus and HIV was undertaken. Ten mL of blood sample for the purpose of establishing normal reference values for Troponin I assessment and parallel EKG was performed to all participants. Results: Of the 263 subjects, males were156 (59.3%) and females were 107 (40.7%). Median (range) age was 34 years old. The manufacture’s reference level for serum Cardiac Troponin I was 0.00-0.39 µg/L. Serum Cardiac Troponin I was detected in two blood donors (0.76%). However, their Troponin I levels were within the manufacturer’s normal range (0.01-0.36 µg/L). Clinically both subjects were healthy and their EKG tracing were unremarkable.Conclusions: Our study has shown that among healthy subjects, detectable serum cardiac Troponin I is a rare finding. The manufacturer’s range is applicable in our setting and can be used in the ongoing vaccine trial. The significance of minimally elevated serum cardiac Troponin I may represent a subclinical cardiac injury and have important clinical implications, a hypothesis that should be tested in future longitudinal outcome studies
Risk Factors for Mortality among HIV-Positive Patients with and Without Active Tuberculosis in Dar es Salaam, Tanzania.
The aim of this study was to describe risk factors for mortality and clinical characteristics of HIV-infected patients with and without tuberculosis (TB) coinfection. A cohort of HIV-infected patients with CD4(+) T-cell counts of ≤200 cells/μl was recruited, consisting of 255 HIV-infected patients without active TB and 231 patients with active TB. All received a well-supervised treatment with an efavirenz-based HAART, and those coinfected with TB received appropriate anti-TB treatment. They were followed up for 48 weeks after HAART initiation. Common presenting symptoms in HIV-only patients were fever (36.5%), headache (34.5%), skin rash (34.5%) and weight loss (32%), while in HIV-TB patients the symptoms were weight loss (58%), cough (57.6%), night sweats (44.6%) and fever (34.2%). HIV-TB patients had significantly lower body mass index, Karnofsky scores and haemoglobin levels compared to those infected with HIV only, despite similar baseline CD4(+) T-cell counts. Overall, 12 (4.7%) HIV patients developed TB and 7 (3%) HIV-TB patients had worsening of their TB symptoms during the study period. Mortality was similar in the two groups, being 10.9% (16 deaths per 100 person years) and 11.3% (17 deaths per 100 person years) in HIV-only and HIV-TB patients, respectively. Overall, more males (13.1%) died compared to females (9.6%). Predictors of mortality were presence of oral candidiasis, Kaposi's sarcoma, low Karnofsky score, and low baseline white blood cell and CD4(+) T-cell counts. The outcomes following well-supervised treatment of HIV-TB patients are similar to those in patients with HIV alone. Predictors of mortality were those of advanced disease
In vitro infection of human nervous cells by two strains of Toxoplasma gondii: a kinetic analysis of immune mediators and parasite multiplication.
International audienceThe severity of toxoplasmic infection depends mainly on the immune status of the host, but also on the Toxoplasma gondii strains, which differ by their virulence profile. The relationship between the human host and T. gondii has not yet been elucidated because few studies have been conducted on human models. The immune mechanisms involved in the persistence of T. gondii in the brains of immunocompetent subjects and during the reactivation of latent infections are still unclear. In this study, we analyzed the kinetics of immune mediators in human nervous cells in vitro, infected with two strains of T. gondii. Human neuroblast cell line (SH SY5Y), microglial (CMH5) and endothelial cells (Hbmec) were infected separately by RH (type I) or PRU (type II) strains for 8 h, 14 h, 24 h and 48 h (ratio 1 cell: 2 tachyzoites). Pro-inflammatory protein expression was different between the two strains and among different human nervous cells. The cytokines IL-6, IL-8 and the chemokines MCP-1 and GROα, and SERPIN E1 were significantly increased in CMH5 and SH SY5Y at 24 h pi. At this point of infection, the parasite burden declined in microglial cells and neurons, but remained high in endothelial cells. This differential effect on the early parasite multiplication may be correlated with a higher production of immune mediators by neurons and microglial cells compared to endothelial cells. Regarding strain differences, PRU strain, but not RH strain, stimulates all cells to produce pro-inflammatory growth factors, G-CSF and GM-CSF. These proteins could increase the inflammatory effect of this type II strain. These results suggest that the different protein expression profiles depend on the parasitic strain and on the human nervous cell type, and that this could be at the origin of diverse brain lesions caused by T. gondii
BÂŻokin-bÂŻobai
Bone scintigraphy has a long and useful track record in the early detection of trauma, both acute and chronic, since its introduction in the 1970s as a new imaging modality. It has been widely used in the early detection of occult bone injury that is not evident on plain x-ray, with a significant increase in sensitivity with the adoption of SPECT. Adoption of scintigraphy into the investigation of sporting injuries was a more successful enterprise in the last 1970s and 1980s and, in many instances of stress fracture and the medial tibial stress syndrome, became the reference standard. MRI has diminished the role of scintigraphy with its exquisite contrast resolution and excellent spatial resolution, especially for soft-tissue injury. It reflects the cyclical nature of technological advances in imaging. We are now at another exciting crossroad, where SPECT has been combined with CT, allowing the marriage of the superb contrast resolution of SPECT with the high spatial resolution of CT. Early experience suggests that there is an incremental value of 25-30 % over SPECT or CT alone, opening up exciting possibilities for imaging trauma. Evidence for its utility in sporting and non-sporting trauma will be evaluated