Myalgic Encephalomyelitis/Chronic Fatigue Syndrome – evidence for an autoimmune disease

Abstract Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a frequent and severe chronic disease drastically impairing life quality. The underlying pathomechanism is incompletely understood yet but there is convincing evidence that in at least a subset of patients ME/CFS has an autoimmune etiology. In this review, we will discuss current autoimmune aspects for ME/CFS. Immune dysregulation in ME/CFS has been frequently described including changes in cytokine profiles and immunoglobulin levels, T- and B-cell phenotype and a decrease of natural killer cell cytotoxicity. Moreover, autoantibodies against various antigens including neurotransmitter receptors have been recently identified in ME/CFS individuals by several groups. Consistently, clinical trials from Norway have shown that B-cell depletion with rituximab results in clinical benefits in about half of ME/CFS patients. Furthermore, recent studies have provided evidence for severe metabolic disturbances presumably mediated by serum autoantibodies in ME/CFS. Therefore, further efforts are required to delineate the role of autoantibodies in the onset and pathomechanisms of ME/CFS in order to better understand and properly treat this disease

Neither MRI, CT nor US is superior to diagnose tumors in the salivary glands – an extended case study

OBJECTIVES: Ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) are the most common radiological procedures for the diagnosis of tumor-like lesions of the salivary glands. The aim of the present study was to determine whether MRI or CT provide additional information besides that delivered by US. STUDY DESIGN/METHODS: 109 patients with a tumor-like lesion of the salivary glands underwent surgery. MRI and CT were arranged in 73 and in 40 patients respectively, whereas all 109 patients were prospectively diagnosed by US. The results of CT, MRI and US were compared with the histological outcome. Furthermore, the recent rise in the number of CT and MRI studies was investigated. RESULTS: On CT and MRI, there was no rise in the percentage of malignant tumors or advanced surgical procedures. In respect of the radiological assessment of the lesion (benign/malignant) and the correct diagnosis, CT, MRI and US were comparable in terms of sensitivity, specificity and accuracy. No significant difference was found in the Chi-square test (p > 0.05). CONCLUSION: The evaluation of the preoperative results of CT, MRI and US revealed no advantage for CT or MRI; these procedures are only required in specific cases. An update or revision of the current preoperative diagnostic management is deemed necessary

Verified and potential pathogens of predatory mites (Acari: Phytoseiidae)

Several species of phytoseiid mites (Acari: Phytoseiidae), including species of the genera Amblyseius, Galendromus, Metaseiulus, Neoseiulus, Phytoseiulus and Typhlodromus, are currently reared for biological control of various crop pests and/or as model organisms for the study of predator¿prey interactions. Pathogen-free phytoseiid mites are important to obtain high efficacy in biological pest control and to get reliable data in mite research, as pathogens may affect the performance of their host or alter their reproduction and behaviour. Potential and verified pathogens have been reported for phytoseiid mites during the past 25 years. The present review provides an overview, including potential pathogens with unknown host effects (17 reports), endosymbiotic Wolbachia (seven reports), other bacteria (including Cardinium and Spiroplasma) (four reports), cases of unidentified diseases (three reports) and cases of verified pathogens (six reports). From the latter group four reports refer to Microsporidia, one to a fungus and one to a bacterium. Only five entities have been studied in detail, including Wolbachia infecting seven predatory mite species, other endosymbiotic bacteria infecting Metaseiulus (Galendromus, Typhlodromus) occidentalis (Nesbitt), the bacterium Acaricomes phytoseiuli infecting Phytoseiulus persimilis Athias-Henriot, the microsporidium Microsporidium phytoseiuli infecting P. persimilis and the microsporidium Oligosproridium occidentalis infecting M. occidentalis. In four cases (Wolbachia, A. phytoseiuli, M. phytoseiuli and O. occidentalis) an infection may be connected with fitness costs of the host. Moreover, infection is not always readily visible as no obvious gross symptoms are present. Monitoring of these entities on a routine and continuous basis should therefore get more attention, especially in commercial mass-production. Special attention should be paid to field-collected mites before introduction into the laboratory or mass rearing, and to mites that are exchanged among rearing facilities. However, at present general pathogen monitoring is not yet practical as effects of many entities are unknown. More research effort is needed concerning verified and potential pathogens of commercially reared arthropods and those used as model organisms in research

The effect of age on the response to the pneumococcal polysaccharide vaccine

<p>Abstract</p> <p>Background</p> <p><it>Streptococcus pneumoniae </it>is a leading cause of morbidity and mortality in the elderly. To prevent invasive pneumococcal diseases, the 23-valent pneumococcal polysaccharide vaccine (PPV) is recommended in subjects over 65 years of age. Although it has been reported to provide approximately 50-80% protection against invasive disease in the general elderly population, there is still controversy as to the effectiveness of the PPV in the elderly.</p> <p>Methods</p> <p>To evaluate the immune response to the pneumococcal polysaccharide vaccine in the elderly, samples from young adults and elderly were obtained before and one month after vaccination. The quantitative and qualitative response to the vaccine were measured by the ELISA and opsonophagocytic killing assay for eight vaccine type serotypes (4, 6B, 9V, 14, 18C, 19A, 19F, 23F) and one vaccine-related serotype (6A).</p> <p>Results</p> <p>The response to the pneumococcal polysaccharide vaccine showed a similar response between adults and elderly when evaluated by the ELISA, however the functional activity of the antibodies elicited after vaccination were lower in the elderly group for more than half of the serotypes evaluated. In comparison of the antibody needed for 1:8 opsonic titer, more antibodies were needed in the elderly for serotypes Pn 4, 19F, 23F and 6A, suggesting the functional activity of antibody detected by the ELISA was lower in the elderly compared with the adult group for these serotypes. As for subjects with an opsonic titer <8 after vaccination, only one subject each for serotypes Pn 4, 9V and 6A were found in the adult group. However, up to 10 (30.3%) of the subjects did not show opsonic activity after vaccination in the elderly group for serotypes Pn 4, 9V, 14, 19A and 6A.</p> <p>Conclusions</p> <p>Although the amount of antibodies elicited were similar between the two age groups, distinct differences in function were noted. This report highlights the importance of a quantitative and qualitative evaluation of the immunogenic response to the PPV in the elderly age group.</p> <p>Trial registration</p> <p>This trial is registered with Clinical trials.gov. Registration number NCT00964769</p

Analysis of density based and fuzzy c-means clustering methods on lesion border extraction in dermoscopy images

<p>Abstract</p> <p>Background</p> <p>Computer-aided segmentation and border detection in dermoscopic images is one of the core components of diagnostic procedures and therapeutic interventions for skin cancer. Automated assessment tools for dermoscopy images have become an important research field mainly because of inter- and intra-observer variations in human interpretation. In this study, we compare two approaches for automatic border detection in dermoscopy images: density based clustering (DBSCAN) and Fuzzy C-Means (FCM) clustering algorithms. In the first approach, if there exists enough density –greater than certain number of points- around a point, then either a new cluster is formed around the point or an existing cluster grows by including the point and its neighbors. In the second approach FCM clustering is used. This approach has the ability to assign one data point into more than one cluster.</p> <p>Results</p> <p>Each approach is examined on a set of 100 dermoscopy images whose manually drawn borders by a dermatologist are used as the ground truth. Error rates; false positives and false negatives along with true positives and true negatives are quantified by comparing results with manually determined borders from a dermatologist. The assessments obtained from both methods are quantitatively analyzed over three accuracy measures: border error, precision, and recall. </p> <p>Conclusion</p> <p>As well as low border error, high precision and recall, visual outcome showed that the DBSCAN effectively delineated targeted lesion, and has bright future; however, the FCM had poor performance especially in border error metric.</p

Dye-Sensitized Solar Cell Based on a Three-Dimensional Photonic Crystal

We present a material assembly route for the manufacture of dye-sensitized solar cells, coupling a high-surface mesoporous layer to a three-dimensional photonic crystal (PC) Material synthesis aided by self-assembly on two length scales provided electrical and pore connectivity at the mesoporous and the microporous level This construct allows effective dye sensitization. electrolyte infiltration, and charge collection from both the mesoporous and the PC layers, opening up additional parameter space for effective light management by harvesting PC-induced resonance

Platelet Transfusion Practices in Critically Ill Children

Rationale: The epidemiology, indications, and outcomes for critically ill children transfused red blood cells or plasma have been described recently in large multicenter studies. This information is not known regarding platelet transfusions in this population. Objectives: To describe the epidemiology, indications, and outcomes of platelet transfusions among critically ill children. Methods: This point-prevalence study was conducted in 82 pediatric intensive care units in 16 countries during six assigned weeks. All children included received a platelet transfusion prescribed during one of the screening days. Measurements and Main Results: During six weeks of screening, 16,934 patients were eligible, of whom 559 received at least one platelet transfusion (prevalence 3.3%). The indications for transfusion included prophylaxis in 67%, minor bleeding in 21% and major bleeding in 12%. Thirty-four percent of prophylactic platelet transfusions were prescribed when the platelet count was ≥ 50 x 109 cells/L. The median (IQR) change in platelet count was 48 x 109 cells/L (17-82) for major bleeding, 42 x 109 cells/L (16-80) for prophylactic transfusions, 38 x 109 cells/L (17-72) for minor bleeding, and 25 x 109 cells/L (10-47) for prophylaxis in patients at risk of bleeding from a device. Overall mortality for all patients was 25%. Conclusions: The majority of platelet transfusions prescribed are given as prophylaxis to non-bleeding children and significant variation in platelet thresholds exists. Studies are needed to clarify appropriate indications, with a particular focus on prophylactic transfusions