Direct amplification and differentiation of pathogenic and nonpathogenic Entamoeba histolytica DNA from stool specimens

Discrimination of pathogenic and nonpathogenic Entamoeba histolytica is of great clinical importance. A simple and rapid DNA extraction method that can be used directly with stool specimens was developed without the need for prior cultivation of the parasites. The entire protocol can be performed at room temperature in a 1.5-ml microcentrifuge tube format. There is no DNA precipitation step. The subsequent nested polymerase chain reaction consists of an initial E. histolytica-specific amplification, followed by two separate amplifications using two primer pairs specific for pathogenic and nonpathogenic E. histolytica, respectively. Amplification products can be verified by restriction endonuclease digests. There is no need for hybridizations or the use of radionucleotides. One trophozoite per milligram of stool sample could be detected and differentiated in a 0.1-g specimen

Modèles d'apprentissage automatique de la persistance aux médicaments : application au cancer du sein

International audienceL'adhésion aux traitements médicamenteux, c'est-a-dire le fait de prendre ses médicaments conformémentà la posologie, aété au centre des attentions ces dernières années. L'Organisation Mondiale de la Santé souligne dans ses rapports 1 que le fait de ne pas respecter le plan de traitement est en réalité un problème majeur, car cela compromet gravement l'efficacité de thérapieà long terme et augmente le coût des services de santé. En effet, dans les pays développés, environ 50% seulement des patients atteints de maladies chroniques suivent correctement leurs traitements. Dans cet article, nous présentons nos travaux sur la modélisation de la consommation de médicaments par les patientes dans les traitements du cancer du sein. Nous nous concentrons sur la persistance au traitement qui indique si le patient a arrêté son parcours de soins avant la fin prévue. Nous détaillons les différentesétapes de notre approche. A partir des données de remboursement du système de santé français, nous reconstruisons les parcours de soins des patients. Ensuite, des méthodes statistiques sont utilisées pour prédire la non-persistance des hormonothérapies et es-timer les variables explicatives des décisions de nos modèles. Nous montrons ainsi que les variables explicatives de notré etude sont conforme auxétudes médicales antérieures sur les facteurs de non persistance. Nous détaillons ensuite la com-paraison de plusieurs méthodes d'apprentissage automatique pour prédire un arrêt de traitement illégitime et discutons leurs limites, en particulier sur l'interprétabilité de leurs résultats.

New experimental setup for the measurement of cleaning efficacy and force of interdental aids in 3D-reproduced interdental areas

BACKGROUND:Interdental rubber picks (IRP) have become a frequent and convenient alternative for interdental cleaning. However, only little evidence exists supporting the effectiveness of newer designs available on the market. Therefore, a new in vitro model was evaluated to measure the experimental cleaning efficacy (ECE), as well as the force needed for insertion and during the use of IRP, with high reproducibility. Interdental tooth surfaces were reproduced by a 3D-printer (Form 2, Formlabs Sommerville, MA, USA) according to human teeth and matched to morphologically equivalent pairs (isosceles triangle, concave, convex) fitting to different gap sizes (1.0 mm, 1.1 mm, 1.3 mm). The pre-/post brushing situations at interdental areas (standardized cleaning, computer aided ten cycles) were photographically recorded and quantified by digital image subtraction to calculate ECE [%]. Forces were registered with a load cell [N]. RESULTS:IRP-F have to be inserted with significant higher forces of 3.2 ± 1.8 N compared to IRP-S (2.0 ± 1.6 N; p < 0.001) independent of the size and type of artificial interdental area. During cleaning process IRP-S showed significantly lower values for pushing/pulling (1.0 ± 0.8 N/0.5 ± 0.4 N) compared to IRP-F (1.6 ± 0.8 N/0.7 ± 0.3 N; p < 0.001) concomitant to significantly lower ECE (19.1 ± 9.8 vs. 21.7 ± 10.0%, p = 0.002). Highest ECE was measured with largest size of IRP-F/IRP-S independent the morphology of interdental area. CONCLUSIONS:New interdental cleaning aids can be tested by the new experimental setup supported by 3D printing technology. Within the limitations of an in vitro study, IRP-F cleaned more effectively at higher forces compared to IRP-S

In vitro comparison of cleaning efficacy and force of cylindric interdental brush versus an interdental rubber pick

Background Interdental brushes (IDB) are according to the actual evidence the first choice for cleaning interdental areas (IDR). Their size should be chosen individually according to the IDR morphology. However, interdental rubber picks (IRP) are appreciated better by the patients and are hence becoming more and more popular but the evidence regarding their efficacy is still limited. The aim of this in vitro study was to measure the experimental cleaning efficacy (ECE) and force (ECF) during the use of interdental brushes versus newer wireless types with rubber filaments (IRP), both fitted and non-fitted for different IDR. Results Overall, a higher ECE was recorded for IDB compared to IRP (58.3 ± 14.9% versus 18.4 ± 10.1%; p < 0.001). ECE significantly depended on the fitting of the IDB. ECE was significant higher in isosceles triangle compared to concave and convex IDR for both IDB and IRP (p ≤ 0.001). ECF was lower for IDB (0.6 ± 0.4N) compared to IRP (0.8 ± 0.5N; p ≤ 0.001). ECE in relation to ECF increases with smaller IDB. For IRP highest values of ECF were found in the smallest IDR. Conclusions Within the limitations of an in vitro study, size fitted IDB cleaned more effectively at lower forces compared to conical IRP

Evidence for West Nile Virus and Usutu Virus Infections in Wild and Resident Birds in Germany, 2017 and 2018

Wild birds play an important role as reservoir hosts and vectors for zoonotic arboviruses and foster their spread. Usutu virus (USUV) has been circulating endemically in Germany since 2011, while West Nile virus (WNV) was first diagnosed in several bird species and horses in 2018. In 2017 and 2018, we screened 1709 live wild and zoo birds with real-time polymerase chain reaction and serological assays. Moreover, organ samples from bird carcasses submitted in 2017 were investigated. Overall, 57 blood samples of the live birds (2017 and 2018), and 100 organ samples of dead birds (2017) were positive for USUV-RNA, while no WNV-RNA-positive sample was found. Phylogenetic analysis revealed the first detection of USUV lineage Europe 2 in Germany and the spread of USUV lineages Europe 3 and Africa 3 towards Northern Germany. USUV antibody prevalence rates were high in Eastern Germany in both years. On the contrary, in Northern Germany, high seroprevalence rates were first detected in 2018, with the first emergence of USUV in this region. Interestingly, high WNV-specific neutralizing antibody titers were observed in resident and short-distance migratory birds in Eastern Germany in 2018, indicating the first signs of a local WNV circulation

Genetic Diversity of the Cestode Echinococcus multilocularis in Red Foxes at a Continental Scale in Europe

Echinococcus multilocularis is a tapeworm of the red fox, which represents a considerable health threat to respectively infected humans. Main endemic areas are located in China, Siberia, and central Europe. Alarmed by an emerging or reemerging situation in Europe, the question of how the parasite gets spatially and temporally spread and transmitted becomes essential to prepare appropriate control programs. The question was tackled by using genetic data on a large sample size of E. multilocularis adult stage tapeworms, combined with geographical site location data input. The historically documented endemic area, represented by the northern Alpine arch, was shown to harbour the highest genetic richness and diversity, as compared to surrounding areas in northern and eastern Europe. The spatial and temporal spread of different E. multilocularis genotypes in Europe seems to be ruled by a founder event, linked to exportation of parasites from the central core to newly identified (western and eastern) areas or subregions, where these parasites could subsequently disseminate under geographical separation from the original foci

HUS and atypical HUS

Hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy characterized by intravascular hemolysis, thrombocytopenia, and acute kidney failure. HUS is usually categorized as typical, caused by Shiga toxin-producing Escherichia coli (STEC) infection, as atypical HUS (aHUS), usually caused by uncontrolled complement activation, or as secondary HUS with a coexisting disease. In recent years, a general understanding of the pathogenetic mechanisms driving HUS has increased. Typical HUS (ie, STEC-HUS) follows a gastrointestinal infection with STEC, whereas aHUS is associated primarily with mutations or autoantibodies leading to dysregulated complement activation. Among the 30% to 50% of patients with HUS who have no detectable complement defect, some have either impaired diacylglycerol kinase epsilon (DGK epsilon) activity, cobalamin C deficiency, or plasminogen deficiency. Some have secondary HUS with a coexisting disease or trigger such as autoimmunity, transplantation, cancer, infection, certain cytotoxic drugs, or pregnancy. The common pathogenetic features in STEC-HUS, aHUS, and secondary HUS are simultaneous damage to endothelial cells, intravascular hemolysis, and activation of platelets leading to a procoagulative state, formation of microthrombi, and tissue damage. In this review, the differences and similarities in the pathogenesis of STEC-HUS, aHUS, and secondaryHUSare discussed. Commonfor the pathogenesis seems to be the vicious cycle of complement activation, endothelial cell damage, platelet activation, and thrombosis. This process can be stopped by therapeutic complement inhibition in most patients with aHUS, but usually not those with a DGK epsilon mutation, and some patients with STEC-HUS or secondary HUS. Therefore, understanding the pathogenesis of the different forms of HUS may prove helpful in clinical practice.Peer reviewe

Limited Range of Genetic Variation in \u3ci\u3eEchinococcus multilocularis\u3c/i\u3e

DNA sequencing of 1.3 kb of rDNA containing both internal transcribed spacers (ITS1, ITS2) and adjoining rRNA coding regions in each of 11 Echinococcus multilocularis isolates from Germany, Japan, and Alaska resulted in identical nucleotide sequences except for a single polymorphic locus 54 bp upstream of the 3\u27 end of the 18S coding region, separating Eurasian isolates from an Alaskan isolate. The same base substitution was found in each of two additional isolates from Alaska. The distribution of the resulting genotypes with regard to their origin is highly significant (\u3e99.9%) and corresponds to the traditional subspecies Echinococcus multilocularis multilocularis and Echinococcus multilocularis sibiricensis