Analysis of antimicrobial susceptibility and virulence factors in Helicobacter pylori clinical isolates

BACKGROUND: In this study, we evaluated the prevalence of primary resistance of Brazilian H. pylori isolates to metronidazole, clarithromycin, amoxicillin, tetracycline, and furazolidone. In addition, the vacA, iceA, cagA and cagE genotypes of strains isolated from Brazilian patients were determined and associated with clinical data in an effort to correlate these four virulence markers and antibiotic resistance. METHODS: H. pylori was cultured in 155 H. pylori-positive patients and MICs for metronidazole, clarithromycin, amoxicillin, tetracycline, and furazolidone were determined by the agar dilution method. Genomic DNA was extracted, and allelic variants of vacA, iceA, cagA and cagE were identified by the polymerase chain reaction. RESULTS: There was a strong association between the vacA s1/cagA -positive genotype and peptic ulcer disease (OR = 5.42, 95% CI 2.6–11.3, p = 0.0006). Additionally, infection by more virulent strains may protect against GERD, since logistic regression showed a negative association between the more virulent strain, vacA s1/cagA-positive genotype and GERD (OR = 0.26, 95% CI 0.08–0.8, p = 0.03). Resistance to metronidazole was detected in 75 patients (55%), to amoxicillin in 54 individuals (38%), to clarithromycin in 23 patients (16%), to tetracycline in 13 patients (9%), and to furazolidone in 19 individuals (13%). No significant correlation between pathogenicity and resistance or susceptibility was detected when MIC values for each antibiotic were compared with different vacA, iceA, cagA and cagE genotypes. CONCLUSION: The analysis of virulence genes revealed a specific association between H. pylori strains and clinical outcome, furthermore, no significant association was detected among pathogenicity and resistance or susceptibility

Between privilege and poverty: the affordances of mobility among aid worker children

Contemporary research on children affected by migration in Southeast Asia has examined the impact of mobility on their life chances, choices and overall welfare. Extending this concern, this article seeks to address these questions in the context of privileged migration. Specifically, it asks how the mobility of children whose parents work for aid agencies in low-income countries shapes the way they understand and negotiate experiences of privilege, as well as their everyday encounters with poverty. Based on ethnographic research with young people and their families in Cambodia, the findings suggest that parents and children may envisage their international mobility as a chance for personal growth, specifically as manifest in the form of ‘open-mindedness.’ Such positive discourses are complicated, however, by a simultaneously engendered sense of superiority toward those who are less mobile. They are also intertwined with practices of ‘bracketing’ possible frictions arising from their interactions with children of local elite members. While the young people’s proximity to poverty provides opportunities for locally-based service-learning activities, connections with their parents’ work can remain abstract. The article therefore suggests that this form of international mobility may not, in itself, enable a critical engagement with poverty or with their own and others’ privilege

The Medicalization of Popular Culture: Epistemical, Ethical and Aesthetical Structures of Biomedical Knowledge as Cultural Artefact.

This handbook explores the ways biomedicine and pop culture interact while simultaneously introducing the reader with the tools and ideas behind this new field of enquiry. From comic books to health professionals, from the arts to genetics, from sci-fi to medical education, from TV series to ethics, it offers different entry points to an exciting and central aspect of contemporary culture: how and what we learn about (and from) scientific knowledge and its representation in pop culture. Divided into three sections the handbook surveys the basics, the micro-, and the macroaspects of this interaction between specialized knowledge and cultural production: After the introduction of basic concepts of and approaches to the topic from a variety of disciplines, the respective theories and methods are applied in specific case studies. The final section is concerned with larger social and historical trends of the use of biomedical knowledge in popular culture. Presenting over twenty-five original articles from international scholars with different disciplinary backgrounds, this handbook introduces the topic of pop culture and biomedicine to both new and mature researchers alike. The articles, all complete with a rich source of further references, are aimed at being a sincere entry point to researchers and academic educators interested in this somewhat unexplored field of culture and biomedicine

Inter-rater reliability of the evaluation of muscular chains associated with posture alterations in scoliosis

<p>Abstract</p> <p>Background</p> <p>In the Global postural re-education (GPR) evaluation, posture alterations are associated with anterior or posterior muscular chain impairments. Our goal was to assess the reliability of the GPR muscular chain evaluation.</p> <p>Methods</p> <p>Design: Inter-rater reliability study. Fifty physical therapists (PTs) and two experts trained in GPR assessed the standing posture from photographs of five youths with idiopathic scoliosis using a posture analysis grid with 23 posture indices (PI). The PTs and experts indicated the muscular chain associated with posture alterations. The PTs were also divided into three groups according to their experience in GPR. Experts’ results (after consensus) were used to verify agreement between PTs and experts for muscular chain and posture assessments. We used Kappa coefficients (K) and the percentage of agreement (%A) to assess inter-rater reliability and intra-class coefficients (ICC) for determining agreement between PTs and experts.</p> <p>Results</p> <p>For the muscular chain evaluation, reliability was moderate to substantial for 12 PI for the PTs (%A: 56 to 82; K: 0.42 to 0.76) and perfect for 19 PI for the experts. For posture assessment, reliability was moderate to substantial for 12 PI for the PTs (%A > 60%; K: 0.42 to 0.75) and moderate to perfect for 18 PI for the experts (%A: 80 to 100; K: 0.55 to 1.00). The agreement between PTs and experts was good for most muscular chain evaluations (18 PI; ICC: 0.82 to 0.99) and PI (19 PI; ICC: 0.78 to 1.00).</p> <p>Conclusions</p> <p>The GPR muscular chain evaluation has good reliability for most posture indices. GPR evaluation should help guide physical therapists in targeting affected muscles for treatment of abnormal posture patterns.</p