A new photoreduction on quinoline alkaloids.
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Alkaloids↗
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Occurrence of pathogens on vegetables harvested from soils irrigated with contaminated streams.
The study assesses the contamination level, the seasonal distribution and the toxigenicity of pathogens isolated from irrigated vegetables and the water used for irrigation. A total of 196 samples of water used for irrigation and 326 irrigated vegetables were obtained from Kawo drain, Sabon Gari drain and River Galma and examined using standard procedures for coliform and viable counts and the presence of E. coli, Salmonella and Vibrio during the dry and wet seasons. Irrigation water from Kawo drain had significantly higher coliform counts by location and season than water from the other two locations. Although all the vegetables had coliform counts higher than the recommended standard (range 3.40-6.38 log(10) cfuml(-1)), amaranthus had significantly higher (P<0.05) counts than other vegetables during the dry season. Salmonella was significantly more likely to be detected during the dry season than during the wet (OR 4.91, 1.07<OR<31.16). Of the 39 enteropathogenic E. coli isolated, 15 (38.5%) were toxigenic by ileal loop test. There is need to educate farmers on the risk involved in the use of waste contaminated water for irrigation. The need to wash and disinfect raw vegetables before consumption is stressed.
Escherichia coli↗
Endodermal cyst of septum pellucidum and pregnancy: a case report.
BACKGROUND: Endodermal or Neurenteric cysts are commonly found in spine. Their intracranial occurrence is rare and such a cyst in the septum pellucidum is exceptional. METHOD: We report a woman, with 33 week pregnancy, presenting in a semiconscious state due to raised intracranial pressure (ICP) due to hydrocephalus caused by a large lesion in the septum pellucidum. Computed tomography (CT) revealed the lesion which was better characterised by the Magnetic Resonance Imaging (MRI). First baby was delivered by LSCS and bilateral ventriculo-peritoneal shunts were inserted; and later on the cyst was excised. RESULT: There was full neurological recovery following the insertion of VP shunt. After excision of cyst cerebrospinal fluid (CSF) pathway was established and shunts could be removed. Post-operative period was complicated by septic ventriculitis. Eventually patient was discharged home in excellent condition. CONCLUSION: Endodermal cyst of septum pellucidum is an uncommon condition. Such lesions may be large when revealed, good outcome is expected after surgical excision.
Adult↗
Autoclaved Leishmania major vaccine for prevention of visceral leishmaniasis: a randomised, double-blind, BCG-controlled trial in Sudan.
BACKGROUND: Visceral leishmaniasis is a major cause of morbidity and mortality in the Sudan. Drug treatment is expensive, and drug resistance is becoming increasingly common. Safe, effective, and cheap vaccines are needed. We report the results of a vaccine trial against human visceral leishmaniasis. METHODS: We undertook a double-blind randomised trial to test the safety and efficacy of an autoclaved Leishmania major (ALM) promastigote vaccine (1 mg per dose). Of 5093 volunteers screened, 2306 had negative leishmanin skin tests and reciprocal titres of less than 6400 in the direct agglutination test. They were randomly assigned two doses of ALM mixed with BCG or BCG alone. Volunteers were followed up for 2 years. The primary endpoint was clinical visceral leishmaniasis or post-kala-azar dermal leishmaniasis. Analyses were by intention to treat. FINDINGS: Side-effects were confined to the injection site. The cumulative frequency of visceral leishmaniasis at 2 years did not differ significantly between the group assigned ALM plus BCG and that assigned BCG alone (133/1155 [11.5%] vs 141/1151 [12.3%], p=0.6). The vaccine efficacy was 6% (95% CI -18 to 25). The proportion of individuals showing leishmanin skin conversion was significantly higher in the ALM plus BCG group than in the BCG alone group throughout follow-up (303 [30%] vs 72 [7%] at 42 days). Individuals whose leishmanin test converted after vaccination (induration > or =5 mm) had a significantly lower frequency of visceral leishmaniasis than non-responders (27/375 [7.2%] vs 210/1660 [12.7%], p=0.003). INTERPRETATION: We found no evidence that two doses of ALM plus BCG offered significant protective immunity against visceral leishmaniasis compared with BCG alone. Leishmanin skin conversion with an induration of 5 mm or more in either group was associated with protection from the disease.
Adolescent↗
Unwelcome exposure.
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Agricultural Workers' Diseases↗
Induction of mid-trimester therapeutic abortion by intra-amniotic urea and intravenous oxytocin.
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Abortion, Induced↗
Prenatal diagnosis and management of neonatal alloimmune thrombocytopenia.
Neonatal alloimmune thrombocytopenia (NAIT) is an uncommon (1 in 2,000 livebirths) but serious disorder characterized by marked thrombocytopenia in the fetus and neonate. Platelet destruction is caused by a maternal antibody directed against a fetal platelet antigen inherited from the father and lacking in the mother's platelets. Intracranial hemorrhage (ICH) is the most devastating complication of NAIT, affecting approximately 20% of all proven cases, up to 50% of which occur antenatally. Because close to 100% of subsequent pregnancies will be equally or more severely affected, antenatal management directed at preventing ICH in utero has assumed great clinical importance. In recent years, considerable progress has been made in this regard, and although clinical uncertainties still exist, the natural history of this disease and its response to various antenatal interventions have become reasonably well understood. This review will focus on the diagnosis and current management of NAIT, including controversies surrounding current treatment modalities and future prospects for treatment and prevention.
Blood Platelets↗
Fulminant septicaemic syndrome of Bacillus cereus: three case reports.
Three patients with acute leukaemia, who were severely neutropenic and iatrogenically immunosuppressed post-chemotherapy, developed rapidly fatal septicaemic shock and coma caused by Bacillus cereus (B. cereus). The illness was marked by two phases: a mild febrile illness lasting 6-14 h and accompanied by subtle symptoms of autonomic sympathetic nervous system overactivity, and a second short fulminant one, marked by high fever of 40-41 degrees C accompanied by major central nervous system disturbances, and ending with deep coma and brain stem dysfunction. One patient developed the sepsis in spite of 4 days of coverage with amikacin. In the other two patients, amikacin was commenced at the earliest phase of the infection, but failed to influence the outcome. This form of B. cereus sepsis in neutropenic patients seems to be caused by strains capable of causing bacteraemia and meningitis and has the ability to produce a substance that causes leptomeningeal and neuronal necrosis. Lack of early clinical and laboratory markers inevitably leads to death. Use of antibiotics effective against B. cereus and capable of achieving high concentrations in the cerebrospinal fluid. and identification and neutralization of the necrotizing substance may hopefully help to reverse this fatal illness.
Acute Disease↗
Fermentation of banana media by using kappa-carrageenan immobilized Lactobacillus acidophilus.
Fermentation media were prepared by using banana as the raw material, and cell immobilization of Lactobacillus acidophilus by kappa-carrageenan entrapment was applied to enhance the fermentation efficiency. Gel beads of diameters around 3.0 mm were prepared for the immobilized cells, ripe bananas were used for preparation of media, and both free and immobilized cells were employed to carry out the fermentation for 80 h. Cells leaked out from the gel beads and proliferated in the medium solution during the fermentation of immobilized cells. The final viable cell number reached 10(5) CFU/ml in the medium suspension, over 10(8) CFU/(ml gel) in gel beads for the immobilized cell fermentation and around 10(6) CFU/ml for the free cell fermentation. Immobilized cells withstand the adverse conditions in banana media resulting in better fermentation efficiency compared to free cells. Variation of fructooligosaccharides (FOS) in banana media was not significant in immobilized cell fermentation compared to free cell. Immobilized L. acidophilus fermented banana medium was found to possess synbiotic properties.
Carrageenan↗
Evaluation of parameters involved in preparation and release of drug loaded in crosslinked matrices of alginate.
Parameters affecting the characteristics of the drug loaded crosslinked sodium alginate matrix films and the release of metoclopramide hydrochloride and cisapride from these matrices were studied. It was shown that the release rate is influenced by the crosslinking technique of the matrix film, crosslinker type and concentration, drug physico-chemical properties especially solubility and the molecular weight, acidity of the release medium, concentration and the loaded quantity of the drug in the matrix. The crosslinking process of the matrix film was shown to be an interfacial phenomenon and the nature of crosslinking depends on the crosslinker type and concentration. This work also showed that crosslinked alginate in a matrix form has limitation in practical use due to the effect of acidic medium on the crosslinking of the matrix film and hence, the rate of drug release.
Alginates↗
Subungual metastatic choriocarcinoma.
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Adult↗
Antibiotic resistant Escherichia coli in a Sudanese hospital.
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Adult↗
Recruiting older adults for clinical trials.
More than 400 community-dwelling older adults were recruited into a clinical trial which compared the effectiveness of diagnosis and treatment through geriatric assessment with that provided through usual community physician care. Six recruitment methods were utilized: referrals, solicitations, presentations, media, mailings, and fliers. Each method is described and its results reported in terms of numbers recruited, yield, and cost per participant. The most efficient method was referrals; the method producing the largest number was presentations; the least effective method was fliers. Problems and solutions are discussed, and guidelines for recruiting older adults are suggested. These guidelines include: monitoring with accompanying adaptation, targeting the groups most likely to benefit, providing incentives, and reducing uncertainty among potential participants.
Advertising↗
Emerging role of gammadelta T-cells in health and disease.
The majority of T lymphocytes in the peripheral blood bear the alphabeta type of T-cell receptor (TCR) and less than 5% of circulating T lymphocytes bear the gammadelta type of TCR. The alphabeta and gammadelta T-cells contribute differently to the host immune defense. The immunologic function of gammadelta T-cell in humans is gradually unraveling. Pathologic studies have shown a relatively high proportion of gammadelta T-cells in the gastrointestinal mucosa, skin, and splenic red pulp where they appear to have an important immunologic function against pathogens attempting to enter body through the mucosal surfaces and possibly the skin. More data are emerging about the role of gammadelta T-cells in the course of infectious diseases and in the pathogenesis of autoimmunity. The possible role of these cells in immunologic surveillance against cancer has been inferred from their preferential expansion in certain malignancies. In parallel to the low frequency of these cells in normal lymphocytes, lymphomas bearing gammadelta type of T-cell receptors on cell surface are rare. These include hepatosplenic and non-hepatosplenic (including those involving the skin and those involving nasal cavity and upper aero digestive tract) and the rare non-B-cell cases of lymphomas seen in the immunosuppressed organ transplant patients. The limited available clinical data about gammadelta T-cell lymphomas suggest that these lymphomas tend to have an aggressive course particularly the hepatosplenic form with poor response to multi-agent chemotherapy and short median survival.
Autoimmunity↗
Family structure and patient survival in an African-American end-stage renal disease population: a preliminary investigation.
Few studies have examined the influence of the family on the course of chronic illness in African-Americans. We explore the relationship between family structure, defined as marital status and household composition, and patient survival. Patient gender was examined as a possible moderator in this relationship. Using data from a survey of 476 African-American end-stage renal disease (ESRD) patients, a significant association between household composition and patient survival was found. Results from Cox proportional hazards model, controlling for patient age, indicated that patients who live in 'complex' households (i.e. those with a partner and/or others) are at greater risk for shortened survival as compared to those who live alone or with a spouse/partner (p < 0.05). When we examined whether patient gender moderates this relationship, female patients who live in these households were found to be at 2 times greater risk for shortened survival (p < 0.01) than female patients who live alone or with their spouse/ partner only. Family structure was not significantly associated with survival in male patients. Discussion and implications of findings are addressed.
Adolescent↗
A molecular basis for the endo-beta 1,3-glucanase activity of the thaumatin-like proteins from edible fruits.
Fruit-specific thaumatin-like proteins were isolated from cherry, apple and banana, and their enzymatic and antifungal activities compared. Both the apple and cherry possess a moderate endo-beta 1,3-glucanase activity but are devoid of antifugal activity. In contrast, the banana thaumatin-like protein inhibits the in vitro hyphal growth of Verticillium albo-atrum but is virtually devoid of endo-beta 1,3-glucanase activity. Both structural and molecular modeling studies showed that all three thaumatin-like proteins possess an extended electronegatively charged cleft at their surface, which is believed to be a prerequisite for endo-beta 1,3-glucanase activity. Docking experiments showed that the positioning of linear (1,3)-beta-D-glucans in the cleft of the apple and cherry proteins allows an interaction with the glutamic acid residues that are responsible for the hydrolytic cleavage of the glucan. Due to a different positioning in the cleft of the banana thaumatin-like protein, the linear beta-glucans cannot properly interact with the catalytic glutamic acid residues and as a result the protein possesses no enzymatic activity. The possible function of the fruit-specific thaumatin-like proteins is discussed in view of the observed biological activities and structural features.
Antifungal Agents↗
Synchronous vulvar and breast cancer.
Synchronous vulvar and breast cancer is rare. A 44-year-old women presented with a lesion in the right labia majora and right upper quadrant breast lump. After work-up, she underwent radical wide local vulvar excision and modified radical mastectomy with axillary lymph node dissection. The pathology of the vulva revealed moderately-differentiated squamous cell carcinoma and that of the breast infiltrating ductal carcinoma. Only two such cases have been previously reported: one was an elderly patient and the second a young patient with HIV infection. Our patient is a young and healthy woman making her presentation a unique and rare case.
Adult↗