Intestinal tuberculosis

Purpose of reviewIntestinal tuberculosis (TB) is increasing due partly to the HIV pandemic. Its clinical presentation mimics inflammatory conditions such as Crohn's disease and malignancies, which are becoming more prevalent, so the diagnosis is problematic.Recent findingsGreater awareness of intestinal TB is needed, both in countries where TB is endemic and developed countries with immigrant populations. Some strains of Mycobacterium tuberculosis are associated with more extrapulmonary disease and greater dissemination, thereby exacerbating the rise in HIV-associated extrathoracic TB. Recent retrospective and prospective studies are leading to the development of diagnostic algorithms. A wide range of imaging techniques is available for sampling and diagnosis. New biochemical, immunological and molecular diagnostic methods are being developed but must be standardized and validated. Developments in drug delivery will facilitate oral therapy even in patients suffering from malabsorption.SummaryThere is an increasing consensus on the risk factors and clinical presentations of intestinal TB. Imaging techniques, coupled with fine needle biopsies, are useful aids to diagnosis, but most important is a greater awareness of the condition by clinicians

Helicobacter pylori virulence factors in duodenal ulceration: A primary cause or a secondary infection causing chronicity

Reports from countries with a high prevalence of Helicobacter pylori. (H pylori) infection do not show a proportionately high prevalence of duodenal ulceration, suggesting the possibility that H pylori cannot be a primary cause of duodenal ulceration. It has been mooted that this discrepancy might be explained by variations in the prevalence of virulence factors in different populations. The aim of this paper is to determine whether the published literature gives support to this possibility. The relevant literature was reviewed and analyzed separately for countries with a high and low prevalence of H pylori infection and virulence factors. Although virulent strains of H pylori were significantly more often present in patients with duodenal ulcer than without the disease in countries with a low prevalence of H pylori infection in the population, there was no difference in the prevalence of virulence factors between duodenal ulcer, non - ulcer dyspepsia or normal subjects in many countries, where the prevalence of both H pylori infection and of virulence factors was high. In these countries, the presence of virulence factors was not predictive the clinical outcome. To explain the association between virulence factors and duodenal ulcer in countries where H pylori prevalence is low, only two papers were found that give little support to the usual model proposed, namely that organisms with the virulence factors are more likely than those without them to initiate a duodenal ulcer. We offer an alternative hypothesis that suggests virulence factors are more likely to interfere with the healing of a previously produced ulcer. The presence of virulence factors only correlates with the prevalence of duodenal ulcer in countries where the prevalence of H pylori is low. There is very little evidence that virulence factors initiate duodenal ulceration, but they may be related to failure of the ulcer to heal

Precise role of H pylori in duodenal ulceration

The facts that H pylori infection is commoner in duodenal ulcer (DU) patients than in the normal population, and that eradication results in most cases being cured, have led to the belief that it causes DU. However, early cases of DU are less likely than established ones to be infected. H pylori-negative cases are usually ascribed to specific associated factors such as non-steroidal anti-inflammatory drugs (NSAIDs), Crohn’s disease, and hypergastrinaemia, but even after excluding these, several H pylori-negative cases remain and are particularly common in areas of low prevalence of H pylori infection. Moreover, this incidence of H pylori negative DU is not associated with a fall in overall DU prevalence when compared with countries with a higher H pylori prevalence. In countries with a high H pylori prevalence there are regional differences in DU prevalence, but no evidence of an overall higher prevalence of DU than in countries with a low H pylori prevalence. There is no evidence that virulence factors are predictive of clinical outcome. After healing following eradication of H pylori infection DU can still recur. Medical or surgical measures to reduce acid output can lead to long-term healing despite persistence of H pylori infection. Up to half of cases of acute DU perforation are H pylori negative. These findings lead to the conclusion that H pylori infection does not itself cause DU, but leads to resistance to healing, i.e., chronicity. This conclusion is shown not to be incompatible with the universally high prevalence of DU compared with controls

Middle atmosphere project. A semi-spectral numerical model for the large-scale stratospheric circulation

The complete model is a semispectral model in which the longitudinal dependence is represented by expansion in zonal harmonics while the latitude and height dependencies are represented by a finite difference grid. The model is based on the primitive equations in the log pressure coordinate system. The lower boundary of the model domain is set at the 100 mb level (i.e., near the tropopause) and the effects of tropospheric forcing are included in the lower boundary condition. The upper boundary is at approximately 96 km, and the latitudinal extent is either global or hemispheric. The basic differential equations and boundary conditions are outlined. The finite difference equations are described. The initial conditions are discussed and a sample calculation is presented. The FORTRAN code is given in the appendix

Viscosity Information from Relativistic Nuclear Collisions: How Perfect is the Fluid Observed at RHIC?

Relativistic viscous hydrodynamic fits to RHIC data on the centrality dependence of multiplicity, transverse and elliptic flow for sqrt{s}=200 GeV Au+Au collisions are presented. For Glauber-type initial conditions, while data on integrated v_2 is consistent with a ratio of viscosity over entropy density up to eta/s=0.16, data on minimum bias v_2 seems to favor a much smaller viscosity over entropy ratio, below the bound from the AdS/CFT conjecture. Some caveats on this result are discussed.Comment: 4 pages, 5 figures; v2: matches published version, title changed by journa

Suffix conjugates for a class of morphic subshifts

Let A be a finite alphabet and f: A^* --> A^* be a morphism with an iterative fixed point f^\omega(\alpha), where \alpha{} is in A. Consider the subshift (X, T), where X is the shift orbit closure of f^\omega(\alpha) and T: X --> X is the shift map. Let S be a finite alphabet that is in bijective correspondence via a mapping c with the set of nonempty suffixes of the images f(a) for a in A. Let calS be a subset S^N be the set of infinite words s = (s_n)_{n\geq 0} such that \pi(s):= c(s_0)f(c(s_1)) f^2(c(s_2))... is in X. We show that if f is primitive and f(A) is a suffix code, then there exists a mapping H: calS --> calS such that (calS, H) is a topological dynamical system and \pi: (calS, H) --> (X, T) is a conjugacy; we call (calS, H) the suffix conjugate of (X, T). In the special case when f is the Fibonacci or the Thue-Morse morphism, we show that the subshift (calS, T) is sofic, that is, the language of calS is regular

A comparative analysis of decision trees vis-a-vis other computational data mining techniques in automotive insurance fraud detection

The development and application of computational data mining techniques in financial fraud detection and business failure prediction has become a popular cross-disciplinary research area in recent times involving financial economists, forensic accountants and computational modellers. Some of the computational techniques popularly used in the context of - financial fraud detection and business failure prediction can also be effectively applied in the detection of fraudulent insurance claims and therefore, can be of immense practical value to the insurance industry. We provide a comparative analysis of prediction performance of a battery of data mining techniques using real-life automotive insurance fraud data. While the data we have used in our paper is US-based, the computational techniques we have tested can be adapted and generally applied to detect similar insurance frauds in other countries as well where an organized automotive insurance industry exists

Mathematical characterization of a microfluidic ultrasound driven transfection device.

The objective of this thesis is to develop a mathematical model characterizing the behavior of a microfluidic sonoporation device in order to understand how standing wave conditions influence molecular delivery to cells and determine whether the model predicts device performance. A prior model based on an ultrasonic separation cell that uses standing waves to separate particles is adapted for translation to the microfluidic device. This study generates data on acoustic pressure profiles across the cell as well as identifying optimal driving frequencies. This model is validated and the equations and methods for developing this model are translated to the microfluidic device. An investigation into the variation of cell layer parameters and driving frequencies is conducted to understand their influence on acoustic pressure profiles and resonant frequencies across the cell. These data are compared to experimental trials which measure cellular uptake of fluorescence when driven through the microfluidic device exposed to different ultrasound frequencies. Results suggest that the 6 MHz driving frequency generates the largest pressure profile across the cell but does not correlate with high molecular delivery efficiency during experimental trials. Additional conclusions regarding the acoustic pressure profile dependency on density, thickness, and speed of sound within the layers show a significant effect for specific frequencies. The large variation in results for differing material and geometric parameters shows the need for further refinement of these parameters for the laboratory device. Once additional experimental trials are conducted, more iterations of the model are tested, and cell parameters are more precisely determined, the translated model can be used for extensive characterization of acoustic pressure profiles across the cell for future design iterations of the device

Widespread occurrence of Mycobacterium tuberculosis DNA from 18th-19th century Hungarians

A large number (265) of burials from 1731-1838 were discovered in sealed crypts of the Dominican Church, Vac, Hungary in 1994. Many bodies were naturally mummified, so that both soft tissues and bones were available. Contemporary archives enabled the determination of age at death, and the identification of family groups. In some cases, symptoms before death were described and, occasionally, occupation. Initial radiological examination of a small number of individuals had indicated calcified lung lesions and demonstrable acid-fast bacteria suggestive of tuberculosis infection. Tuberculosis was endemic in 18th-19th century Europe, so human remains should contain detectable Mycobacterium tuberculosis complex (MTB) DNA, enabling comparisons with modern isolates. Therefore, a comprehensive examination of 168 individuals for the presence of MTB DNA was undertaken. Specific DNA amplification methods for MTB showed that 55% of individuals were positive and that the incidence varied according to age at death and sampling site in the body. Radiographs were obtained from 27 individuals and revealed an association between gross pathology and the presence of MTB DNA. There was an inverse relationship between PCR positivity and MTB target sequence size. In some cases, the preservation of MTB DNA was excellent, and several target gene sequences could be detected from the same sample. This information, combined with MTB DNA sequencing data and molecular typing techniques, will enable us to study the past epidemiology of TB infection, and extends the timeframe for studying changes in molecular fingerprints. Am J Phys Anthropol 120:144-152, 2003. (C) 2003 Wiley-Liss, Inc